Opinions

I guess I should start this entry with a touch of background. My back hurts. Not the soreness of mowing the lawn and playing golf in the same day, but rather more of a please remove the red hot poker from directly on my spine kind of hurt. This has been going on for a bit over two years now and an entire team of doctors and scientists have tried to put me back together again and so far have failed. There are other entries somewhere in this blog.

With that intro, yesterday was my appointment with my pain doctor. This is the person who has inserted around nine catheters into my back to inject lidocaine, phenol and ablate my nerve with radio waves...oh, and he also tries to give me some quality to my life by dispensing narcotic pain meds. I have a love-hate relationship with the pain meds. On one hand I love them because I can actually function in the world with their help. On the other hand, I live in a brain fog and try to function and do my job through it. Anyway, yesterday was my meeting and I had a bunch of things to discuss and get their opinions on prior to my meeting in about three weeks with my neurosurgeon.


So I was ushered into a room to meet with Beth, my nurse-helper-person. She has APRN after here name, but I really don't know what all that means...she's like a nurse-plus I think. Anyway, I ran my options by here as I see them. She then took my three options to doctors Chen and Oakey to get their takes on it and they all conferenced Doctor Rosenthal (the main dude) in to give his opinion on the various options.

Rhizotomy
This is a big word that mean cut the stinking nerve out! This option would be removal of the one nerve that is bothering me and not having it any longer. On the plus side, my pain is so specific that we could easily identify the bad nerve and yank the sucker out. On the down side I could feel phantom pain from the nerve being gone forever. The pain was described to me as horrific burning and electrical shocking sensation that is there always. I informed Beth that this is the pain I experience daily and there's no big difference there, but the team didn't care. To a doctor, they are horrified at the thought oft his option. My bringing it up seemed to be a very bad thing.

Spinal Cord Stimulator
This thing is so neat! You get a little paddle implanted in your back. They do have to remove a tiny slab of bone from a vertebrae, but after that you get this paddle that connects to a tiny computer that is implanted under your skin. This tiny computer then sends signals to the paddle that interrupt the pain signal traveling up your spine! Rather than pain, you get a tingle and that's it! It's really a neat technology. And, unfortunately, I am not a candidate for it. My pain is in my thorasic spine. Okay, quick lesson on anatomy, doctors have split your spine into four parts. The cervical spine is basically your neck. Your lumbar spine is your lower back which gets sore lifting things and all. Your sacrum is your tailbone. Your thorasic spine is between your cervical and lumbar. That's the part that connects the two others. Typically people have problems in their neck or lumbar regions but not me...I want to be different! I have problems in the middle of my back so the stimulator cannot interrupt the pain signals there very well and all the thorasic patients who have tried are still not happy with the results.

Intrathecal pump
This one was my least favorite option. I mean, I want to get off all the stinking meds I'm on not be on them permanently! But, of course, this is the one the three doctors at the pain clinic are really excited about. This one is where a catheter is permanently installed in the body with the end positioned right at the nerve that is sending pain signals. It then slowly and constantly drips morphine directly on the nerve causing all the problems. The bad news is of course I'm still on narcotics with the morphine drip going on and there is a computer and reservoir implanted in the body that needs to be refilled. The up side is rather than oral or transdermal delivery of the medicine, it is being placed right on the affected spot so the amount of medicine used would be very very small hopefully clearing my head. Now my insurance requires that I jam some other medicine into myself to see if it clears my head prior to being a candidate for this expensive goody, so we're trying that now.

The next step is to run all these various ideas past my neurosurgeon and get his take on it. The stimulator was looking like a real option when my wife spoke with the rep from the company. I guess he was just excited at the prospect of selling another system because after we started pursuing it further and asking more questions he's wasn't so adamant that it would solve all my problems. Three more weeks until I meet with doctor Gardner then some decisions will need to be made.