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    Okay Still waiting but not as impatient
    MagPrincess posted:
    So I got a call from the new pain management doctor.

    The lower back pain he feels is actually from a herniated disc and wants to do epidural shots there. Okay didn't know it was herniated thought it was just bulging.

    But the pain I described in my neck they are unsure what it is really caused from but wants to do a new MRI at a different place paying special attention to C-8. Which the first MRI said was fine.

    So I have the MRI scheduled for Friday Eight am and then once they get the report they will call and schedule the appt to see the doctor so we can address everything at the same time and he can explain it all to me.

    Sounds good to me. This may just be the ticket to the right doctor for me.

    So that is my update.
    Socialwrkr responded:
    It's so much easier to wait when something is actually being done to help! So glad you seem to be on the right track!

    Take care
    Be Gentle on Yourself!!! ~~Aimee
    Anjl26 responded:
    Keeping my fingers crossed that this doc can help. :)
    Being happy doesn't mean everything's perfect. It means you decide to see beyond the imperfections. hugs Sharon
    annette030 responded:
    How long ago was the first MRI? If it was recently, I would ask him about the need for a second one. MRIs are very expensive, and uncomfortable for me anyway.

    My decision about having tests of any kind, is "How will the results of the test change my treatment plan?" If the results of the test will not change the treatment plan at all, I see no reason to do the test. At this point in my life, I am not really interested in just collecting test results. Whether the disc is bulging or herniated, if epidural injections would still be considered as the treatment, why get another MRI? Does he have other reasons for another MRI?

    Would it change the plan? For instance, if the disc is still bulging, but not herniated, would he cancel the epidural injection plan?

    If I were you, I would research the epidural shots as used for herniated disc related pain prior to actually having them. There are risks involved with any injection into the spine.

    My last comment is to ask if this doctor is an "interventionalist" PM doctor. Are injections and procedures the only kind of treatment he uses for pain?

    Some pain management doctors only do this kind of treatment, and do not do non-interventional treatments like oral meds, cognitive therapy, OT, PT, massage, biofeedback, etc. that just require repeated office visits. The cynical side of me wonders if it is because insurance companies reimburse much better for injections and procedures than they do for office visits.

    Just things to think about.

    I hope it all works out well for you.

    Take care, Annette
    MagPrincess replied to annette030's response:

    Yes he does do other methods of treatment but they have not been effective i am currently doing CBT and have just completed a round of PT. I can't afford all the massage. I currently take lortab up to four times a day and sometimes it does help but when i had the Facet joint injections i had no pain and was not taking any pain meds. I want to get back to that!.

    The MRI was in January and they said then that there was severe muscle spams blocking a clear view of the discs. This one is a called a Hi-scan and should be able to see past the muscle spams. I am only getting the neck done as the rest was clear and he has accurate reports for that area.

    He does the injections as part of the office visit so I am not sure insurance wise what the difference is but they want the MRI done first so that i don't have to have two visits plus the MRI.

    Thanks for the food for thought though much appreciated.
    forgetful88 replied to MagPrincess's response:
    Make sure you check with your insurance. Some insurances will not pay for another test if one has already been done for the same problem.
    hisfaithful1 replied to forgetful88's response:
    Is there a difference between a bulged and a herniated disk? I thought they were the same thing, does anyone know? If so please share.

    krb005 responded:
    Hi Erin!! So glad things are looking up for you !!
    Being one step closer to answers are a good thing!!

    Warm thoughts & soft hugs
    forgetful88 replied to hisfaithful1's response:
    I don't know the answer to that, but wanted to make her aware of some insurance companies stipulations when it comes to medical testing.
    annette030 replied to MagPrincess's response:
    It sounds like you got the good kind of PM doc. I adore CBT, I learned that years ago and it has saved my life on more than one occasion.

    I have not had the epidurals or facet joint injections, but if the facet joint ones worked for you before, is there any reason not to do them again? Is it too soon? How often can you get them?

    I had a trigger point injection once that worked really well during an office visit. My insurance company was charged $200 just for the trigger point part of the visit, plus the regular $100 charge for the rest of the visit. I only had to pay a $20 copay and 20% of the $200 so it was still well worth it for me. The doctors do make a lot of money for injections that they do not get for office visits to talk about meds, etc.

    Best of luck to you.

    Take care, Annette
    annette030 replied to hisfaithful1's response:
    The disk is a leathery pad between the vertebrae of the spine, it contains a jelly like substance, like a pillow, and provides a cushion between the bones.

    A bulge is when the pad is bulging or protruding out of place, a herniated disc is when the leathery pad has actually broken open and the jelly like interior may leaking out. Generally, first a disc bulges, and later it might herniate. Herniated discs may heal over time, surgery is not always necessary to repair them.

    Take care, Annette
    annette030 replied to forgetful88's response:
    Good point.

    Take care, Annette
    MagPrincess replied to annette030's response:

    THe Facet injections can only be done twice a year. My insurance company required I pay a 1500 dollar deductable for them. Couldn't afford it so the epidurals are covered and are similar so hoping they work just as well. Not sure how much they cost i wanna say my coworker who also gets them pays 60 bucks for them. Fairly reasonable.

    I have been seeing my therapist for almost three years and we have balanced between talk therapy and CBT. I think it has made a huge difference as well. Not only that it has shown my doctors just how serious I am about my treatment options.

    The MRI today was great. Its a highscan MRI and the radiologist was struggling to get a clear scan on one area. He came in and asked me what medications i have taken and then asked if i meditate. Yes I do why? I need you to get that still and that calm. Your muscles are spasming so badly i can't get a clear image. I had already taken a muscle relaxer and a xanax. Nothing else he could do medication wise. took four tries but he finally got a good view. It did cost more than the last one but now i have met my deductible so whatever they want now is great
    hisfaithful1 replied to annette030's response:
    Hey Annette, Thanks so much for answering my question.

    I was thinking I had read they were actually the same thing is why I asked.

    Also, I found out not to long ago that my L-3 & L-4 are bulged. Sometimes my lower and middle back really hurt something terrible.

    Thanks again,

    annette030 replied to hisfaithful1's response:
    Unfortunately, the latest medical research shows that back pain and MRI images of bad discs do not always go hand in hand.

    They did a very large study and found that people could have terrible disc disease and no pain at all, or terrible pain and normal discs, there just seems to be no correlation at all.

    I think it is a nice thing to know about your discs, but not as necessary as some people think. I will only have another MRI if the results will affect my treatment plan.

    I have terrible disc disease in my cervical spine according to my MRIs. I had one disc removed many years ago for functional deficits in my hands, but I have never had pain in my neck.

    Those of us with FMS have an even more complicated pain problem as far as making a diagnosis goes.

    Take care, Annette

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