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What does the following MRI report indicate?

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Posted on Wed, 17 May 2017
Question: i need the top dog neurologist, surgeon, pain management that believes in "if it works, don't try to fix it!" i am so complicated, I am a medic of 21 years and missed passing my RN program due to repeated issues of unable to sit or stand in one spot(spine compression) but, most of all I relocated from XXXXXXX area to the Cape and they took me off my meds that are considered those that are addictive. addictive? maybe for an addict but omg people are being punished for having chronic pain? How do I find a doc to just put me back on what I was on for the past year and several years before relocating here so I am not tortured? so embarrassing! MRI (upper and lower were done) L4,L5 ,S1 something down lower looks like tis "floating" according to whoever read it. , "riddled with arthritis , (my daughter is on permanent disability , both my brothers have been on disa for years, I am the only one who doesn't say one word just take my meds 6 hours apart same time work out until I relocated almost 5 years ago.was on pain mgmt. for one year and did great . now? XXXXXXX will be one year off that regime that worked and I am so desperate i am drinking alcohole and doubleing up on muscle relaxers anything to stop these powerful spasms and pain from bottom of my feet through out my back up to my head where i get migraines also. I was also taken off fiorocet which i only ised as a my own protocol (it works , i am no dummy I titrated and switched, changed things around until i got it right.

Hi Doc, I would upload but my reports are so many pages. It is more of a problem as I think docs are being brain washed that all certain types of meds are taboo and they aren't getting it--I am suffering for too long and I really thought this week I would stroke out even after being given beta blockers. My heart is not the primary problem. its the pain causing my body systems to go haywire and I have been holding this in for so long here I guess I feel myself who was so active less than a year ago on pain mgmt. (my pain doc wrote out 120 vikes on the first visit and he said to me after viewing my MRI and films, that he has NEVER done this before , first visit writing out pain meds. then he turns around and stops writing because I wanted to test clean for a job interview and despite our laws, and other, you will not be hired in my neck of the woods. I didn't take the 120 tabs because I titrated until i got things exactly where i wanted -to help my back and not touch my head as I need to stay alert during the day at all times. My PCP states she does not handle any pain mgmt. and only recommends I see pain mgmt. she doesn't manage this and that's ok but I am suffering right now i cant stand and type this the pain is excruciating so I apologize for my scattered info, ugh.


I am going to upload my MRI reports sometime before end of day today 4/13/2017
just an FYI: I was on pain mgmt. one year and worked hard doing/using a combination of several things including
1. stretching before getting out of bed
2. workout in my lower gym (abs, squats, etc) I have prof equip. due to my condition)
3. powerwalk daily (1.25 miles)
3. pain patches, and gel (x2 during day)
4. TENS
5. heating pad/recliner
6. inversion table (2 types)
7. MEDS: combo taken separate-ibuprofen, Vicodin, XXXXXXX
(Previously x15 yrs+ Ativan, Vicodin & ibuprofen. ) I had too much "bleeding episodes on 3200 mg of ibuprofen (cannot MOVE without ibu) so I suggested to my previous PCP to add 1tab Vicodin t.i.d. and cut ibuprofen in half (1600mg)and all bruising, strange bleed outs (GI, hemorrhagic bladder, etc, ) resolved.

after being on the above present for one year, I was so healthy but it took a lot of work. I missed a few days to have a clean pre-employment to get hired already discussed with my pain doc and he turned on me and said "that's it, if you missed any med doses that tells me you don't need me or these meds, not filling anymore. That was last XXXXXXX I have lost 2 GOOD paying jobs (because i didn't go back due to unable to stand or bend over without agony, out of shape) cant do housework and now I found a new pain mgmt. who wants to treat with injections only but my insurance denied it so he knows i just want to go back on medication combo that worked but in the meantime I am suffering . it wasn't one medication or one exercise it was the exact precise plan I did that worked and now i feel like at 60 I could go down fast and may never be able to recoup.
doctor
Answered by Dr. Erion Spaho (20 hours later)
Brief Answer:
Ideal to get the second opinion.

Detailed Answer:
Hello and thanks for writing to us.

I have read your question and understand your concerns.

Unfortunately, we can't prescribe any drugs through this online service.

However, if this helps in some way, if you are really in a lot of pain, you deserve to be treated.

I do agree with your initial statement that if a treatment plan works and offers relief to the patient it should not be changed, unless serious adverse effects are noted.

Spinal cord and column issues and conditions that cause a lot of pain and disability, are treated by epidural injections and by surgery, if conservative treatment ways such physical therapy and antineuralgic drugs failed to improve the condition.

The best way to get a correct treatment is to get a second or even a third opinion by different Doctors involved in spine disorders and pain management.

Yes, please upload MRI results so I can understand your condition better.

Hope you found the answer helpful.

Looking forward to your follow-up queries.

Kind regards.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Erion Spaho (4 days later)
Thanks Doc, I will upload my MRI, I am delayed a bit as this is a genetic problem and I was occupied with my 27 year old daughter's condition. I just took her for her first epidural injection yesterday. She is this young and on a disability most likely for life. I do understand about medications and that you cannot prescribe them here ;) I am a 21 year paramedic in good standing with my state just not working. I think I am most angry about how those who have chronic pain suffer now because of others who abuse the system and medications for the wrong reasons. What makes me angry is the docs should know this and stand up for their patients as they rarely are the problem of addiction . In my opinion (although very sad) people who have such a problem are in pain elsewhere, I believe it's emotional pain and nothing to do with chronic pain but rather a lot of emotional pain that they want to numb. I have always said this. For the life of me I cannot understand how anyone can get addicted to anything other than maybe working out, spending time with their horse or dog maybe smoking... I was addicted to that but when i wanted to quit, I just did it, quit. It was hard for 3 days and then it's over. My only issue is this never ending pain and it runs daily 7/10 on that 0-10 pain scale. Occasionally it drops to 6/10 (having a baby without any anesthesia is my 10/10) sometimes when the back spasms kick in they are so powerful I swear they could snap a bone it's unbelievable. The pain is getting to me because I am normally active and not being able to walk and move or use my own muscle to my chores, work and clean my house is just killing me. . This atrophy will kill me, not the drugs that turn my life around, I have no emotional pain. I am too busy to take time out for that stuff...much too busy even in thought of what I have to do even if I can't do it this moment. I will be back later , I have a cd with my MRI butnow when I go to put them in the disc drive they say no palyer so I have no idea whats up. I'll try to find the print out. thanks! XXXX!
partial...looking for the other. (brief report)

MRI cocedure(s): Lumbar Spine

L4-5: There is a disc bulge. In addition, there is a right paracentral disc herniation. Disc material extends posteriorly 4 mm: narrowing the right lateral recess. There is also moderate bilateral neural foraminal stenosis.
L5-S1: As a result of the anterolisthesist there is severe bilateral neural foraminal stenosis. There is facet arthropathy. There is
A ilateral spondylolysis.
IMPRESSION*
1. Chronic grade 2 anterolisthesis 1.5-SI, associated with bilateral n evere neural foraminal stenosis.
2. Right paracentral disc herniation at L4-5 resulting in narrowing of the right lateral recess.
Signed By: xxxxxxxxxxxxxxx on 5/27/2015 10:00 AM

Technologist: xxxxxxxxx
Dictated By: xxxxxxxxxxxxxxxx Date/Time: 05/27/15 0955
Transcribed By: MDT Date/Time: 05/27/15 0955
Signed By: CC: MD copy To: MD
Signed
signed
Page 2 of 2
doctor
Answered by Dr. Erion Spaho (17 hours later)
Brief Answer:
Two issues to face.

Detailed Answer:
Welcome back and thanks for providing the MRI report.

It is clear now that there is significant compression of neurological structures due to herniated disc and spondylolisthesis, that, in, my opinion, cause the major part of the pain.

Emotional issues in the other hand increase this pain caused initially by degenerative changes.

So, in conclusion, there are two problems to face in your case, compression of neurological structures and emotional issues.

Treating the first one should improve the second one too.

Besides painkillers, in my opinion, decompressive and stabilization surgery is an option to consider.

Discuss with your Doctor about these issues.

Hope I helped you.

In good health.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Erion Spaho (5 hours later)
Yes, you are helpful. when i find the other one I will send to you( if you dont mind?)
thank you .
I have cervical MRI they did two upper and lower. will find
doctor
Answered by Dr. Erion Spaho (1 hour later)
Brief Answer:
Okay.

Detailed Answer:
Let me know when you will upload it.

Take care.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4225 Questions

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What does the following MRI report indicate?

Brief Answer: Ideal to get the second opinion. Detailed Answer: Hello and thanks for writing to us. I have read your question and understand your concerns. Unfortunately, we can't prescribe any drugs through this online service. However, if this helps in some way, if you are really in a lot of pain, you deserve to be treated. I do agree with your initial statement that if a treatment plan works and offers relief to the patient it should not be changed, unless serious adverse effects are noted. Spinal cord and column issues and conditions that cause a lot of pain and disability, are treated by epidural injections and by surgery, if conservative treatment ways such physical therapy and antineuralgic drugs failed to improve the condition. The best way to get a correct treatment is to get a second or even a third opinion by different Doctors involved in spine disorders and pain management. Yes, please upload MRI results so I can understand your condition better. Hope you found the answer helpful. Looking forward to your follow-up queries. Kind regards.