Rustable

So to clarify, did you mean that the scar will reach 30% as strong as the original fibers and that is as strong as it will ever be or did you mean that it will reach 30% at 3 months? Thanks again!

To update, I met with my NS this past week to discuss recent MRI which as previously mentioned showed significant edema and inflammation as well as fluid in the affected disk area and a patch of fluid away from it as. NS said that the fluid was to be expected and that he did not feel that it was compressing on any nerves. He stated that the surgery area is futile ground for infection so he did not recommend aspirating it but rather giving it more time. I told him that the 2 tabs or Alleve both am and pm were not working and that I had concerns about it’s effect on my kidneys. He started me on a three week course of Decadron. I have been on the top dose to start with for 4 days and will be on this dose for 2 full weeks before titrating down on the third week. Don’t feel any progress thus far on the Decadron. I asked him if a ESI might speed up my progress and again, he stated that there is always a risk of introducing infection in this currently fragile area with a needle so he does not recommend it.

Again, the sciatica is gone in both my buttock and leg. No sharp pains in my lower back. I am just crazy stiff in spite of doing hamstring, piriformis, and lower back stretches. I can bend quite well but get back up just as stiff. I am an avid cyclist but I couldn’t run 3 steps to get out of a burning house the way my back feels (like there is a 50 lb. weight in my lower back).

I would think that the Decadron would be having some effect at this point after 4 days if it was going to. Again, I was doing absolutely great up to 6 weeks post op and so it’s hard for me to understand how all this swelling and inflammation developed so insidiously. Do you have any thoughts on this…should I just give this some more time? Thanks again!

I am just now able to write you again as I have just now had another MRI with and without contrast. I was turned down by insurance for the MRI but was finally approved. I saw the MRI DVD and it appeared to me that the L4/L5 disk was yet again out of the vertebrae. The cross sectional view did not to my untrained eye show herniation so I was somewhat optimistic that I hadn’t. I did see a white mass a bit aways from the disk area and was thinking it was perhaps either a seroma as you referenced or a disk fragment.

I called the NS office to see if they had gotten the radiology report. The NS through his secretary told me that I had not re-herniated. Said the white mass area I mentioned was fluid (he had referred to it as “juice”) which was typical after having a surgery. The sciatica is much less starting only yesterday but it feels as if I have a 50 lb. weight in my lower back on my right side (the surgical side). I’m very stiff and have to walk pretty slowly. I am hoping this is just muscular in nature and that I am finally on the mend.

Couple of things mentioned in the radiology report.

“There is prominent edema and a fluid collection in the laminectomy bed at L4/L5 with enhancement. There is disc desiccation at other lumbar levels. Some minimal enhancement of the endplates at L4/L5 is present which is nonspecific but the T1 weighted images show mild fluid and irregularity as well as fluid in the disk space”. Findings: Postoperative change with laminectomy on the right at L4/L5 with ring enhancing fluid collection in the laminectomy bed as well as some inflammation around the forming right nerve root.

We ruled out infection last week with blood work. I won’t be able to see the NS until 11/23. I’m wondering what is causing the problem now given I was completely pain free for the better part of 6 weeks post op (I am now at 12th week). Is it possible this fluid as referenced above is causing my symptoms? I am thinking that when I see him, he will say this is normal and to give my body time (how much?) to reabsorb it. If it can be aspirated as you mentioned, well I’d sure like to have that done to speed up the time to being pain free and back to work as I sure can’t get to work the way I am now. If so, who can that be done by, the NS or perhaps my neurologist that has provided me the epidural shots pre surgery? Again, my sciatic pain pre op was not terrible and I only had the surgery because of calf atrophy and the pain I had would not allow me to sleep at all at night. Accordingly, I’m not thinking that this is a case of the nerve having to heal itself especially since I was pain free after the surgery.

Thanks again for your thoughts. All the best –Tim