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  • jayd10033
    Participant
    Post count: 29

    Thanks, that’s what my spinal surgeon and ID both said as well today.

    One thing nobody can really tell me is when I can expect to feel SIGNIFICANTLY better, pain-wise. Everyone tells me I caught this early (at 1 month) – but after 2 weeks of IV antibiotics I was hoping to be able to be a lot less sidelined. I can’t tie my shoe, put on socks, get out of a chair or bed without a lot of pain.

    Is it possible that even after 6 weeks of antibiotics and lower ESR and CRP, I still have pain? I was assuming that because labs are lower, pain would be too.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8018

    Symptoms and imaging always recover much more slowly than labs. You might take as long as 3 months to improve.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    jayd10033
    Participant
    Post count: 29

    Thanks, so feeling substantial pain even as labs look better is NOT something I should be worried about? I worry that pain means the infection is still raging and that the infection will continue to destroy disc/bone.

    After I get my latest MRI results and labs, I was thinking of setting up a tele consult with you would be comfortable doing at this stage of my situation?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8018

    For this type of treatment, you need to be in person so I think you are better off staying where you are.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    jayd10033
    Participant
    Post count: 29

    Thank you, and understand re consult. Update is MRI shows progressing inflammation, basically, worse than previous images. Pain is also worse than it was a week ago. The confounding thing is that all labs are down. CRP is 5, WBC is 6.5, SED is 37 (down from 54).

    I have been put on a secondary/additional antibiotic orally that covers a few things the other does not (Zyvox)

    You may recall we that the IR said the abscesses were so tiny that getting a good yield was low, and given how bad I was feeling, we skipped right to broad spectrum, which labs seem to have responded to, but inflammation is getting worse (which doesn’t make 100% sense to me as a lay person). How can infection be responsive to the drugs, but inflammation not worsens?

    Options now facing me other than just waiting longer, which both doctors agree isn’t the right move:

    1. Needle biopsy (chances of good yield very low)
    2. Minimually invasive biopsy of the L3-4 disc area through same incision as original surgery to both visualize the area and get some tissue for culture and adjust antibiotics AND/OR
    3. Debridement and fusion.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8018

    The problem is the infecting organism and sensitivity to which specific antibiotic is unknown. That is why knowing the infecting organism prior to antibiotic treatment is so important. The chance of getting a positive surgical culture on antibiotics is now poorer.

    Remember that imaging improvement is much delayed over clinical improvement but you are not feeling better which is a big marker for treatment effectiveness. I don’t have the films to review so my suggestions are not going to be highly valid but if the infection is not advancing profoundly, I would vote for an open culture. If the infection is still advancing, a fusion might be something to consider.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
Viewing 6 posts - 7 through 12 (of 24 total)
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