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Good news. PICC line out today!

From my doc’s office:

The nerve root is adequately decompressed where we did the surgery to remove the disc herniation that was pinching the nerve. There is postoperative fibrosis and inflammatory tissue that is causing some stenosis, however that is a ‘normal’ and expected finding we see on early postop MRIs. This will subside as time goes on. There is no evidence of recurrent disc herniation where we operated. You do have significant disc degeneration at that level (hence the lower back discomfort/pain), as well as other degenerative disc changes at other levels in the lumbar spine.”

My hope is that as time goes on, I am in less discomfort, and that the significant disc degeneration at surgical site won’t cause chronic issues. I also saw on the before and after XRAY a loss of disc height.

Hi Doc – here is my latest MRI. It’s hard for me to make heads or tails of whether there is any improvement. I do see the word “decreasing” a lot :). What are your thoughts based on the below?

FINDINGS: Status post right extraforaminal L3-4 discectomy. Stable. There is moderate severe L3-4 disc space narrowing prominent, mildly enhancing, marrow edema within the L3 and 14 vertebra with L3-4 endplate Schmorl’s nodes. Stable.
There is prominent, enhancing soft tissue seen in the right lateral L3-4 paraspinal soft tissues, right L3-4 neural foramen surrounding and impinging upon the exiting right L3 nerve root sheath. Stable.
There is L3-4 disc bulging with enhancing central annulus fissure. There is decreased epidural enhancement seen in the anterior L3-4 epidural space with decreased left-sided thecal sac flattening There is decreased left greater than right-sided lateral recess spinal stenosis because of adjacent enhancing fibrosis decreased but continued impingement upon both the descending left greater than right L4 nerve root sheaths. There is mild thecal sac flattening. There is no central spinal stenosis
Mild L2-3 spondylosis, chronic endplate Schmorl’s nodes, degenerative grade 1 retrolisthesis L2-3 are redemonstrated. In addition at L2-3, there is uncovering of the disc by spondylolisthesis. There is mild central rightward intradiscal enhancement suggesting fibrosis. Degree of intradiscal enhancement is decreased from prior exam. There is no spinal stenosis or foraminal narrowing.
At L1-2, L4-5 and L5-S1, there are no disc herniations, significant disc bulges, spinal stenosis or foraminal narrowing. Stable findings
There are no compression fractures or other spondylolisthesis. Redemonstrated, small chronic endplate Schmorl’s nodes T11-12 through L2-3.
There are no destructive marrow processes.

Conus medullaris is at T12-L1. There are no enhancing mass lesions, abnormal signal or abnormal enhancement involving the distal thoracic spinal cord, conus medullaris or cauda equina nerve root sheaths.
There are no intraspinal or paraspinal masses.

IMPRESSION
1. Status post right extraforaminal L3-4 discectomy, prominent enhancing right lateral L3-4 paraspinal and foraminal soft tissue, surrounding and impinging upon the exiting right L3 nerve root sheath, mild L3-4 disc bulge with new enhancing annulus fissure, decreased anterior epidural enhancing soft tissue, decreased lateral recess spinal stenosis and decreased impingement of descending left greater than right L4 nerve root sheaths.

2. Prominent, mildly enhancing, L3 and 14 vertebral marrow edema without significant change. Findings may represent discitis/spondylitis. Correlation with laboratory values, C reactive protein or sedimentation rate is suggested for further evaluation, as warranted clinically.

3. Degenerative grade 1 retrolisthesis L2-3 without significant change. 4. Decreased, mild central rightward L2-3 intradiscal enhancing fibrosis. 5. Otherwise no significant interval change.

Update: On Monday I was given an additional oral antibiotic called Zyvox. I still have 3 weeks left on the IV Irtapenem (Invanz).

Today is the first day where I feel like there has been any improvement in the intensity of my pain and energy. Getting labs tomorrow which I hope will continue to show numbers going in the right direction.

Fingers crossed this day of (seeming) progress is a trend.