Jim 9-16-07 March 2008 - new update on me & my preparing for an RFA Almost 8 months have passed since I updated this page and a lot has happened. First off my pain management doctor has raised my pain meds to the next level and it certainly has helped a great deal. While I still don't have the benefit of brak thru pain meds my base pain is much more under control. Most days , when I am relatively in active , my pain levels are such that I am now actually able to sit and read again. Reading was hard as the pain often kept me from remembering what I had read just moments before, now that isn't the case . While I am still in pain , it now on most days is at a point I can live with. So Thanks to Dr Battastia for finally getting my meds to this point. Life is going decently for me right now. With my pain under control better , my home life looking somewhat better , my spirit has improved quite a bit. I am not longer depressed ( most days ) I think my envolvement with both my online pain group and my Buffalo pain group has helped a lot as far as that goes too In Decemeber , Sheri land ( one AWESOME FEMALE ) and I decided to start our own pain group online It was because the one we called home had been revamped by the owners , who had decided that their pride was more important than the group itself. After they flexed their owner muscles and dropped the moderators that made the group great the group quickly fell apart. It has now been disbanded due to the owners no longer having members that cared enough to post They unfortunately learned too late that the people in a group are the important thing and because they themselves seldom even read the group , they had lost touch with the membership A group that was once a premier chronic pain group was down to 2 posts a day and I feel it was truely as shame the owners egos got the best of the group Myself, Sheri and others left in support of the booted moderators and luckily kept in touch with most of the former group members So by the end of December we organized Chronic Pain Lifestyles We asked Annie G. ( Another AWESOME FEmale) to join us as co-owner of the group and brought it online January 8th Since then the group has grwon to surpass the old group in number of daily posts ( most days) and while we aren't into the stat end of things , we are happy to see this happen We don't have a huge base of members but the ones we have are ALL GREAT CARING PEOPLE And thats what it takes to make a good support group Egos will never be an issue here at Chronic Pain Lifestyles our only issue is PAIN and helping our members live thru it BTW - another great person has joined our "group staff" - Beth , she too is a caring , compassionate person Beth long with Sheri and Annie , make up one of the webs best pain topic research teams . Our groups file section on pain , causes and treatments has to be one of the best found online When ever a person asks for some help , they comb the web for all the info they can find My other endevore was starting the Buffalo,NY chronic pain support group. Since 2005 when I started my life of chronic pain , I quickly found there WAS no support group anywhere near here that dealt with chronic pain alone. There were many that dealt with Arthritus , RSD , Fibro and many other pain full diseases / illnesses but none that dealt with back pain or pain in general. So in the summer of 2007 , I started looking into what it would take to start one. After a while I can across the county funded group Action for Mental Health Along with them , We brought about the Buffalo Chronic Pain support group It's first meeting was February 6th 2008 For more on it look at the webpage here on the GargoylesDomain site Now for the other big news pain wise for me Come April 25th , I am undergoing what is called an RFA. Officially it's called a RFA is Radio Frequency Ablation An RFA uses radio frequency energy to disrupt the nerve function or basically "burn" the nerve off. The doc told me its almost like a micro wave built into the end of a needle , when he switches it on the radio /micro waves are very controllable and will only burn what they are aimed at.. When this is done to a medial branch nerve, the nerve can no longer transmit pain signalsfrom the spine and hopefully all the other nerves that control different stuff won't be damaged. I sure would hate to have him fry the wrong one The RFA procedure will start with fentanyl sucker to mellow me out and drop my pain levels and a local anesthetic will be used to numb my skin. The doctor will then insert a thin needle near the facet joint. Fluoroscopy, a type of x-ray, will be used to position the needle. If you go below here you'll see the pics from when he did the testing shots and this procedure will be about the same except he won't be doing by the screws because they are too close he said to the nerves and the metal will disrupt the radio waves and could screw up other nerves that he doesn't want to damage. The doctor will then check to make sure it is at the correct nerve by zapping it some. This may cause muscle twitching and provoke some of my pain. Once the needle is properly placed, the area will be numbed. Radio frequency energy will then be used to disrupt the medial branch nerve on both side of one level and on one side of two more vertebras. I will be monitored after the RFA. When I am ready to leave, the clinic will give me discharge instructions and a pain diary. It is important to fill this out because it helps my doctor know how the RFA is working. I may be hurting for one to four days. This is normal and may be due to muscle and nerve irritation. My back may feel numb, weak, or itchy for a couple weeks. Full extent of the pain relief normally comes in two to three weeks. Nerves regenerate after an RFA, but how long this takes varies. Your pain may or may not return when the nerves regenerate. For the majority of people it does, but another RFA can be done . I don't know anyone who has had more than two of them I'll have to ask the doc about this I know I'll still have some pain from the two areas that he won't touch but I am hoping the drop in pain I get will be worth it. I feel just about any drop in pain will make it worth trying it. So for the rest of the story and how I got to this point read below I hope if your reading this - that your finding your live to be in a good way and hopefully low pain. Basically this page has 3 sections : 1 ) My Injury 2 ) Treatments I've had and currently that I am undergoing 3 ) How I see my future evolving with these condition The Injury A better medical description will be coming someday . Some X-rays , MRI images and full size post op incision picture at bottom of this page My original back injury happened back in the 1993 In 1994 I underwent a laminectomy at L4-L5 level and also had bone spurs removed I returned to work with limitations but was told basically I could do 95% of what I did before Basically , the only limitations were to watch the heaviest weights and quit Tae Kwon Do I still could lift 100 or more pounds with no problems , IF I lifted correctly Bending or twisting at work would bring on "minor" pain but ibuprofen was all I needed most times In september of 2003 things changed again. I was sore one day and when I was awakened at 3 AM by back pain ( nothing new there ), I got out of bed and was planning on icing down ,same as lots of mornings but when I put weight on my right leg ,I crumpled. I had no feeling in my right foot and the pain in my back was off the scales - 10++ levels I was pulled out of work that day by my chiro and told to see a neuro-surgeon. I saw Doctor Doug Moreland in Amherst ,NY ( an excellent surgeon - and I recommend him to all ). He basically said the original problems had re-occurred and we tried various options. Minor narcotics ( darvocet and progressed up wards) and Physical Therapy. I was out of work for 2 weeks and returned at my own insistence. The doctors actually would have preferred me staying out longer but at work there was an internal shift and I felt it was best for me to return and deal with my department. I kept working thru much pain full time for the next few months. By February the doctors wanted surgery and me of work but being the "company man" I was, I kept working thru pain levels of 9s and 10s but reduced my time at work to 4 hours a day. The company after 2 months insisted that wasn't working for them and about the same time surgery was OKd by workers compensation. So I had surgery in May of 2004 by the beginning of August I was ready to go back to work. When I returned to work ( due to the underhanded "production manager" - later FIRED for incompetence after 2 years LOL) I was forced out of my department head job ( of 15 years ) and into a project managers job. Originally this was "TEMPORARY just to get me used to working again and help out the company because they were seriously short on project managers". In december of 2004 , I was told by the company , I "wasn't in the production managers comfort zone" as a department head and was told my only option was either return as a mill-worker or stay on as a Project Manager. due to the weight lifting and movement limitations everyone knew I wouldn't last as a "mill-worker". So I took the Project Managers job permanently. 2 months later while walking from my van into our shipping office , I slipped and fell on the companies ice covered parking lot ( 1-28-05 ). The company had been warned repeatedly on salting and plowing better by workers AND the union, and already had one comp case going because they had refused to deal with the ice removal properly I landed basically sitting upright and instantly felt a shot of 10 level pain , with one of our delivery trucks driving straight at me. I worked another couple hours that day but was told to go home by my boss , who saw the pain I was in. I saw the chiropractor the next morning figuring it was just serious muscle pain and a good jarring of my spine and the new fusion. He wanted me to stay off work and see the neuro immediately. Like a fool ( or the company man is was -even tho actually unappreciated LOL ) I kept dragging myself into work for the next 2 weeks ,eating Lora-tabs like TicTacs until the 2nd neuro surgeons visit to review the MRIs taken. He said my fusion was still stable but I had herniated the discs above and below the fusion area. He said at that time the pain may get better with PT and time resting but He had doubts as far as a "full recovery" and he told me that the new herniations & scaring around the surgical areas was probably causing the pain. Since I had so much scar tissue around the nerves already , he told me that I was no longer a good surgical risk for lessening the pain thru surgery. He applied for and received permission for surgery and said while he could stabilize my spine, gave me odds of less than 10% chance of being in less pain and said that 30 % chance of the same pain and probably 60% chance of being in more pain. In his opinion , I shouldn't have the surgery and should start seeing a pain management doctor. He recommended my retirement and then listed me as permanently and totally disabled. My chiropractor also backed the surgeons decision with the same permanently and totally disabled SO that basically bring me up to the present The past 24 months I have been learning to live with chronic pain and its many different problems. After 2 operations and another spinal injury 10 months following the 2nd operation , I am now considered "not a good surgical risk for lessening pain" So now basically it's "better living thru chemistry" and We are trying what ever various medicine the doctors feel like trying and so far , not much has worked. The best results in lessening my pain , other than the serious pain killers , has been from getting chiropractic and acupuncture treatments. At home use of multiple ice packs and a TENS Unit , helps as far as short term reduction of pain. I have achieved a base pain level I can live with , thanks to serious pain meds. I'm still in a great bit of pain but the levels are such that I can endure them. Break-thru pain still prevents me from having a more "normal" life My pain doctor doesn't believe in break thru pain meds so I have to live with the increases and the potential increases in pain definitely influences what I attempt to do each day Now, I am dealing with both workers compensation and social security. Since my UNION carpenter's pension went bankrupt , I get NOTHING for the thousands I invested. I am at the mercy of the government and the insurance company for my monthly means of living They do NOT let you forget it ! ! ! Case reviews and treatment denials are common place even with FOUR doctors stating I am permanently , totally disabled. Nothing like adding financial stress to an already complicated painful life See the treatment area for a current update Unfortunately , the pain alone is bad enough but then there are multiple other side effects. a few of the major ones are : Depression due to the non stop pain AND the loss of the ability to physically function as the person I once was. Family stress Not only has our income been greatly reduced by my loss of the ability to work , but my family has to deal with a person who emotionally feels at times he has lost his manhood , Everything I once was able to do physically both at professionally and with my family. Lack of sleep - I'm lucky to sleep a couple hours at a time before I am awakened by the pain. Altho , now with getting acupuncture treatments that has increased for at least 3 or 4 days a week and get up to 6 hours a night The rest of the nights , it's usually back to 2 hours but the extra sleep has made a HUGE difference in my outlook on things. The story will continue to evolve as I feel up to sitting here. I hope , if your experiencing the same type of injury or if your dealing with chronic pain that this site will give you some insight on the way I've dealt with my injury and the resulting life with chronic pain. The Treatments I've tried and am currently using This too will evolve as I am able to add to it but for now - it is what it is June 2007 lumbar medial branch block shots Starting June 7th I underwent a series of Lumbar medial branch block shots. Basically , this is sticking needles into each side of each vertebrae where the nerves exit the spine and run out to the rest of the body. One injection needle in each group of nerves exiting my spine covering 3 vertebrae So basically 2 in each level of my spine in the levels L4-L5-S1 First needle was inserted at 8:41 (running early scheduled for 9AM ) He was basically going to insert 12+ needles. Most of them being used as markers for him to guide the 6 for the injections. When he stuck me the first time we watched the needle bend and he said "shit" lol. I asked what was wrong and he said "you've got some hard scar tissue in there. It took ten minutes to set all the needles and adjust the visual aid for each side of the spine he worked on. We watched as multiple needles bent from scar tissue and had to be replaced , all together he stuck me about 20 or more times. Now I won't say the needles didn't hurt because most of them caused me more pain than my acupuncture needles do. When he started injecting Novocain , I definitely felt the pain level jump up another level but with the help of the fentanyl sucker I was around my usual pain level of 3 no Kadian taken so far at this point today or anti-inflamitories for last 5 days. He wasn't able to inject 2 of the 6 sites he wanted to because of screw placement from my fusion. So my right side only got 1 shot and left side got 3 total. By 8:59 I was off the table and being wheeled out into the recovery area. I was slightly dizzy when I first got up off the table but pain had already dropped down to a level 2 for me so I was already happy from the shots. It took me less than 15 minutes in recovery , mainly waiting to get BP done (130/78). As soon as vitals were taken and I was given my "pain level journal" , I was let go and walked out to meet the wife (my designated driver) . I was told not to drive for 4-6 hours due to the Fentanyl but as far as chemically impaired I have to admit I was a little buzzed , not to the point where I couldn't drive but glad I didn't have to and I could see why they insist on it. Now I don't know if the buzz was from the Fentanyl( never had before) or from the injections( I doubt) , Over the next 6 days I definitely saw a reduction in pain Still when I'm active I see breakthru pain but even that for the most part is a lot less than before. My normal non active day my pain is around a 2 out of 10 Getting out will bring on higher levels ,depending on amount of activity My highest pain level in the last 6 days was about an 7 but usually I'll have days where 8s are the norm The 7/10 was on a day that I walked the farthest distance that I have walked in the last 2 years a whopping 3/4 of a mile each way with only one rest stop going and 3 returning. My pain is also noticeably less on the left side of my spine than on the right side I'm sure due to the fact I had 3 shots on the left and only 1 on the right June 14th I underwent another set of injections and they worked as well in keeping the pain levels reduced The doctor recommended he preform an RFA A medical procedure where they insert a needle into the same branch groups of nerves and basically microwave them into non-existence In reality they actually burn the nerves off. The procedure results should last 3 -12 months before the nerves either repair themselves or new ones grow Its not guaranteed to work and there are possible side effects but the chance at being in reduced pain makes it worthwhile for me to try SO far the insurance company is dragging their feet in giving me the OK for it. Social Security still hasn't told me what they have decided about my current " case review" Thanks guys , I needed more things to worry about One would think ALL of my four doctors wouldn't be wrong I'd even be happy to see one of their own if they have doubts Workers Comp thought the same way until .. all their IMEs kept coming back saying my pain is "causally related" to my last injury What they both don't understand is I'd rather be working and making more than I am on their monthly checks I know a lot of people look to milk the system but I would much rather be working AND LIVING MY LIFE Not trying to survive each days pain fix my pain and I'll be back working the NEXT DAY  Special thanks to Dr. Bagnall for supplying the pictures from branch blocks Pain Management Right now , I have been dealing with a pain management doctor. She is a very nice woman but is definitely running her practice deferring to the DEAs methods of pain relief. She is sometimes willing to let me try treatments I come up with but doesn't seem to offer much more than drugs as her options. The Doctor has recommended all of my "desired" therapy type treatments to my workers compensation insurance company. She and I have differing opinions on what we should be doing to treat my pain , drug wise. We both agree on my base pain medicine for the most part but we have widely different opinions on break thru pain meds. I believe I should be allowed to get a "real" pain killer. She and her "medical association" say that anti-inflammatories are what is the best way to treat it. Personally , I think if they had to live with boosted pain levels from doing the basic things in life such as sitting , walking and driving ,they probably would feel differently about medications. Especially , if the person has proven that they are not into abusing their pain prescriptions. Acupuncture this has probably been what I now consider , my life saver. During the treatments themselves , is the only time that I've found any "total relief" from pain. I have actually been "pain free" sometimes while the needles are in me and it is the only time I can feel something(not much tho) in my right foot. In New York State Workers Compensation Insurance is not required to pay for these treatments but my insurance company has been righteous enough to approve this form of treatment. Since I began acupuncture , my intake of base pain medicine has not increased I've always tried to get my "pain management" doctor to take a holistic approach and am glad she supported me in my requests for acupuncture The insurance companies SHOULD try to steer patients , like me , to these type of treatments , as the cost of the acupuncturist could be recouped by their savings in pain meds BUT this is only MY opinion. I , personally feel , that if I had tried a better thought out Physical Therapy approach and acupuncture sooner I may not have had or needed the second surgery. I can't say this for sure but it is my gut feeling Both the acupuncturists ,who have treated me for this injury , have told me that only a small percentage of people ( appox 20% ) with my type of injury and pain will see promising results from this treatment but I encourage any person with a seriously painful back to try this type of treatment. I have found a wonderful doctor who really cares about her patients and their quality of life. Since I started treatment with Dr.Greene , my use of pain meds and my pain levels have not increased. Activity tho , still brings on "break-thru pain" but the cycle of being in extreme pain 24/7 has been lessened greatly and my "dark" thoughts such as suicide have almost entirely stopped My biggest benefit is the fact that I can sleep longer again. For the first three or four days after a treatment , I can usually sleep up to six hours before being awakened by pain. This effect seems to wear off as the week progresses or if I attempt a more physical day. By the night before my next treatment I am usually back to sleeping about two hours a night. I am not sure what would happen if I went twice a week , as I never wanted to push the insurance company for extra visits but we found that if I stretch the visits out with longer periods between them ( 2 or 3 weeks between visits ) that my pain levels go right back up and the effectiveness of a single treatment lasts only about 2 days with a 3 week spacing of treatments. and I would recommend her as an acupuncturist to anyone in this area. Dr Constance Greene MD 6000 N Bailey Ave Amherst , NY (716) 834-5809 The needles in my head were a new treatment option 1st used 5/9/06 The needles in my back are shown with electrical stim unit wires attached Dr.Greene also uses needles in my right ankle and the back of my knee to treat the numbness in my right foot   Chiropractic this treatment kept me working for years after the original injury and 1st surgery. It offered me great reductions in pain and improved my ability to have a somewhat normal life until my back was too far gone to keep working. Now In New York State , Workers Compensation Insurance is required to pay for these treatments but I'm sure there is a big difference in the providers of this type of medical care. My Chiropractor , Dr. Ken Munroe , is a great guy and has given me excellent treatment and advice on dealing with this injury and resulting pain. He's suggested many exercises and types of stretching , that in my opinion helped me a great deal. He is also a very caring man who has great compassion for those , who are TRUELY in pain He has become a good friend over the years and has always been there for me in times of great pain / need. I would recommend him to anyone seeking chiropractic care in this area. Dr. Ken Munroe 6035 Main St. Williamsville , NY 14221 click here to go to Munroe Chiropractic's Web Site Meditation I've been trying meditation for 7 months now. Mainly due to the recommendation of my acupuncturist as being a different way to deal with pain. So far , I haven't been able to "block out my pain" or even get a short vacation from it . I've found it does help relax me and focus my thinking , I can generally block just about everything else out but the pain it self . I'm going to keep working on that. Even if I never totally succeed , I consider my attempts as something that has increased my quality of life , at least some what I was told by my acupuncturist to check out our library for this book but our system doesn't carry it . I did get a used copy cheap at amazon.com Maybe some peoples library system may carry it , so give a quick look for it.. Our public library is on the verge of closing due to financial reasons so they have cut back buying books and encourages the use of meditation as a way to deal with stress and help lessen chronic pain. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness by Jon Kabat-Zinn Ph.D. My TENS Unit This is my second unit in 12 years and I find that : It's great for temporarily negating pain. I some times use it as much as 10 hours in one day But relief disappears usually 10-20 minutes after use is discontinued It's not bad to use , especially if you don't mind small electrical shocks LOL The use of the TENS unit is about the only way I can be outside the house and moving around for more than 3 hours. I can still feel the back start hurting but the pain levels don't seriously increase until it is turned off. If I am out of the house and moving around for longer than a few hours , with the help of the unit , I usually find that my pain levels are much higher the next day, I'm sure due to the stress placed upon my back and the masking of the pain by the unit.  The Future This is evolving , I've lessened pain to a point where I no longer think of suicide but life still leaves a lot to be desired Family life still isn't great , as they still don't seem to understand what my life is like. Friends seem to be (for the most part) more worried about their lives than the changes in mine. Which is totally understandable , I mean who wants to keep hearing about some ones pain especially since now it is my whole life Which is one reason I try not to talk about it to them. The ones that know and care - do show it and the others care only for them selves anyways LOL Hopefully , as I try other things such as photography , this website and as many other things as I can think of I will come to grips with not being the physically active person I once was. That is the hardest part of the chronic pain thing , that almost any activity brings on "break-thru pain" Pain that keeps people from doing what "normals" do. Now the question is can whether or not I find something to occupy my time and mind. Something that can make me feel like a useful member of society again and not the the "pimple on societies ass" that I felt like when I first lost the ability to hold a job If this web site helps one person , then I feel that I may have once again become somewhat useful. The Pictures and Images Here are images of my spine and back Note Black circled area shows are of the "herniation" - as marked by spinal Doctor  ____
 Thanks for checking out the site any comments or ideas always welcomed Due to my back problems I CAN'T devote the time I once could to the internet but I'll try to return any communications as fast as possible If you wish to communicate feel free to , click the underlined link e-mail Broken_Gargoyle@GargoylesDomain.com website trial pages -UNDER CONSTRUCTION - not what it will be in final state Return to the Gargoyle's Domain Home Page Page updated September 16 , 2007 |
