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What is the treatment for back pain when suffering from worn away cartilage in L1?

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Spine Surgeon
Practicing since : 2002
Answered : 102 Questions
Dear Doctor. I implore you to keep a very open mind in my case. I ask that you suspend any beliefs that may influence a judgmental answer to each point I have touched on. I have osteoarthritis which as we know, can be progressive. My MRI looks gorgeous compared to other examples. My point is despite their appearance on the surface, I suffer chronic pain. I am on 8 peroccets a day which is Canada's legal limit. I have also been sneaking other pain meds and cannot say it on here but I will let you draw your own conclusion. I understand the ramifications concerning liver damage. I know that the barometric pressure is also a barometer of how much pain I am in. At times I have more meds left over and other times I double it up and it's gone a week early. While I speak candidly of narcotic drugs I am and am not a junkie. But I am treated like one by most doctors. I understand I have the same physical withdrawl symptoms junkies do, it's the nature of any human biochemistry combined with pain stuff after prolonged use. In my case is close to a decade. I am interested in spine surgery to help the DDD and perhaps get down to a normal dosage of pain meds which will be at first narcotic as I| believe in incremental withdrawl until I am comfortable with an nsaid. I am an INVOLUNTARY junkie and am well read within reason. I clicked on you because there wasn't a pathologist to select. My MRI shows worn away cartilage in L1 mainly which was my only concern the day I couldn't get out of bed to walk downstairs. \my doc had asked if the pain was bad enough to warrant opioids stronger than Tylenol 3. I kept saying I would take a stronger pill if the mri showed further deterioration. ( years of horseback riding and show jumping. Since I am relatively insolvent enough to afford massages etc I had to choose drugs to maintain a quality of life. What I mean by that is to be able to pursue my career path as a comedian. To be able to think and get even normal housework done without the sensation of someone lighting a match to my lower butt. I have been afraid of spine surgery because I hear stories of unreported cases of people unable to walk afterwards. If you are in the states and can help me I will tell my family who will be more than thrilled to help me regain control over my life without drugs or at least no many of them. PRNs are acceptable. I used to think everyone had pain when I used to get by on nsaids mainly for mentral cramps which have now disappeared for a year. Happy menopause to me! And anyone who gets in my way...(joke) In the meantime Im stuck in Canada where I am slowly dying of depression due to cold and lack of daylight. Had I been slvent at the outset of this I would have done all those physio things before thinking of drugs. In fact I'm a 25 yr man (so to speak) I do not like political correctness. So, I think I"ve said it all but which will happen first....a higher dosage of God forbid methadone! Or back surgery. Over here docs love to say they've never heard of methadone pills and are too quick to dispatch one to a clinic full of junkies. Yes, I am a privileged snob and so what? I was brought up that way. I don't mind them as long as nobody treats me as one, or makes a descision I should walk amongst them. This offends my sensibilities right to the core. I am too chicken to withdraw as I went into a full blown withdrawl on a plane on the way back from Barbados where the humidity was enough to deplete 2 weeks of 8 x a day in one week at 16! I was unable to fill out landing forms and or read. I had to remain still and not scream or punch the window out of fear the air marshal would get me. One kind lady told other passengers I didn't have that mosquito bite when they recoiled from me thinking it was cooties. I could speak but slowly. My brain was all there lucid but I stammered with panic at how I'd be perceived. I need surgery because travel is going to be a big part of my life. I've been flying since I was 10 but I can't afford another withdrawl on a plane!! Okay, now I am begging you to hook me up directly with a surgeon who can fix my Goddamned back once and for all! AND if not, at 50 this coming August, please help me find an action plan that will allow me a quality of life of sorts with the help of narcotic pain meds. 20 more yrs I will be 70. All I want to do is make people laugh. People think comedians are funny ALL the time and are shocked when they are desperate like I am now. I stand to get reasonably famous and or well paid. I'm in a correspondence course with a well known guy in San Francisco who has stars come in a teach the odd class. It's a job, and we all have a dark serious side from rotten childhoods even if they were privileged so to speak. Docs are often funny for reasons such as MASH related exprs. HELP ME be able to walk without my back brace! It gives me acid indigestion and one more dam pill to take. Drug list, Prozac, Wellbutrin, lorazopam x 3 mgs omniprozole one tablet daily, Percocet x 8 tabs, a hypnotic tranc which I can't pronounce, the two sedatives are given to try to offset the lack of legal access to stronger Percocet. Dexedrine 40 mgs daily. BTW, back whe I had those toe surgeries I either gave my tyleol 3s away or threw out the script. See, I'm not a thrill seeker in that way. It just kills the pain. Im not correcting typos because it's to much work at the moment. Thanks in advance. Kindest regards, XXXX
Posted Sat, 1 Feb 2014 in Back Pain
Answered by Dr. Krishna Kumar 1 hour later
Brief Answer: Dear XXXX Thank you for writing in great detail Detailed Answer: Dear XXXX Thank you for writing in great detail. As you suffer from significant back pain, you could be a candidate for spine surgery. It is a very safe surgery and in a trained spine surgeon's hands its as safe as any other surgery. So you need to find a spine surgeon who understands your problem and You, as it takes a lot of effort and belief between patient and surgeon before undergoing a surgery. Yes, surgery could bring down the dose of pain medicines. Let me know if you have any questions. Kind regards Dr XXXXXXX
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