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[QUOTE=tetonteri66;4741720]I have some thoughts that are not a direct response to the questions you raised in your post. My comments are based on my experience with sciatic-type leg pain that I had for about six years...and it was finally resolved in June when I had a 3 level fusion. [/QUOTE]
I have never been told by any of the medical professionals I have seen since this all started that I have sciatica or that my pain in from the sciatic nerve. I have previously years ago suffered from sciatica but it always went away on its own and was NEVER this painful or even close.

[QUOTE=tetonteri66;4741720]The surgery went well, I recovered well, the surgery was a "success" except for the fact that it didn't resolve my leg pain. After about a year, I switched surgeons, and had a small procedure, a foraminotomy at L5, which the surgeon thought "might" help. It was more an experiment than anything else, because imaging did not reveal anything else that could possibly be causing the continued nerve compression. I was pain-free for the first time in years and it was such bliss...but, due to outside circumstances that I won't go into, it didn't last. [/QUOTE]
My NS did a foraminotomy already (during my 2nd surgery) or it might've been he did one during the first surgery and just tweaked it during the second surgery. I'd have to reread the surgical notes. I woke up from my first surgery pain free. I awoke from the second surgery with WAY more leg pain than I had prior to surgery that day.

[QUOTE=tetonteri66;4741720]At this point, no one could figure out why I continued to have leg pain. I was told it might be that the nerve was permanently damaged and this was as good as I was going to get. [/QUOTE]
That is one of the reasons he wants the EMG to look for damage....

[QUOTE=tetonteri66;4741720]I just couldn't accept that, so I kept at it. I just kept making appointments with this surgeon, kept going back every month or six weeks, asking him "what are we going to try now?" To shorten the story, eventually (because the surgeon and physiatrist were so tired of seeing me:eek:) my surgeon decided that something was going on that wasn't apparent on imaging. I had a series of nerve blocks and eventually it was decided that I needed more fusion. [/QUOTE]
I appreciate your persistence with office visits. However, I am not going to 'waste' his time or mine for that matter (since it is incredibly painful to sit there waiting to see him) for office visits when he has said the next step is this EMG. The physiatrist is performing the test so why would I continue to bother him with office visits when he has clearly stated when the test can be performed??

[QUOTE=tetonteri66;4741720]All along, I felt that my pain was coming from L5-S1, so he was going to fuse that level...but I had a positive reaction to a nerve block at L3-4, so it was decided to do an open fusion and check out that level...and see what was going on. So on June 1st I went into the operating room not really knowing what procedure I would be having.

When the surgeon got in there, he could not believe the damage at L3-4. He ended up having to do reconstructive surgery as well as the fusions. The facets had worn away to mere nubs and were allowing my spine to "move in ways the spine was not designed to move in" according to my doc. The nerves were getting trapped and then released depending on my position. It turned out L5-S1 wasn't nearly as bad as we had thought, but he decided to go ahead and fuse it anyway while he was in there, figuring it would eventually need it.

So I ended up with 3 levels fused....everything went well and by the 10th day post surgery, I was off all pain meds. By the 4th day, the leg pain vanished and I am doing very well today. [/QUOTE]
I am glad that you have such a wonderful success story.

[QUOTE=tetonteri66;4741720]Now -- what I learned from my experience that might apply to you: first, the problem with pain meds is that they really do nothing for sciatic-type pain. They take the edge off your whole sensory system, but they don't really help the nerve pain. I was able to take the "nerve pain" meds, but they didn't help. At various times I was on neurontin and Lyrica, but neither helped.[/QUOTE]
okay first let me say that NONE of the Drs have said that I suffer from Sciatica. I couldn't take the nerve pain meds. Well I did, but they had me quit taking them since they were making me so sick. And they weren't 'working' the way they wanted to help with the pain. I was getting much more relief from the actual narcotic type pain meds than I was from the lyrica, gabapentin, neurontin, cymbalta, etc....

[QUOTE=tetonteri66;4741720]If I were you, I would not be waiting around just to have a EMG. I don't really see what you gain from whatever information you would learn from it. Insurance companies won't even consider the results of EMG as proof that a patient has radiculopathy. They consider it a "subjective" test, with results open to interpretation. To me, it is just another has its purpose in diagnosis, but it isn't going to explain why you have pain.[/QUOTE]
Well with all due respect, you are not me. The physiatrist, the PM Dr, and the NS all concur that it is a worthwhile test to see if there is damage to the nerves or are they just healing and regenerating. The all have medical degrees. Not to be snarky, but do you have a medical degree? And I know another reason why my NS wants this test done and has picked a particular Dr to perform it. I am privy to this other concern, but I don't feel the need to air that info here. And regarding my insurance, what difference does that have to do with anything??? I don't understand your comments about insurance at all? But like you said yourself,the test has its purpose in diagnosis. The intention is that the Dr is eliminating causes of pain. And who does one know for sure and certain that it won't explain why I have pain? If the nerves are damaged that very well can explain why I am having pain, or if they find the other 'thing' they are looking for, that will explain alot too.

[QUOTE=tetonteri66;4741720]Have they tried nerve blocks to see if another level might be affecting your sciatic pain? I don't remember your history, but I think you've had a couple microdiscectomies of the same disc. Could you refresh my memory, please?

With a microdiscectomy, the surgeon is seeing a very small visual field. It may be that a small fragment of disc is pressing on a nerve, or perhaps that segment has become unstable from the two surgeries, and a nerve is getting trapped.

I don't know where you live, but I would encourage you to find the best orthopedic spine surgeon in your area and pay him/her a visit for a "second" opinion. It has been my experience that they are more willing to take the time to try to figure out what else "might" be causing the issue.[/QUOTE]
No I have not tried nerve blocks. Again no one has said it is sciatic pain. Where I live Ortho Spine surgeons are not common and the ones I have researched are not board certified and they don't have nearly the credentialing that my NS has. I think I will stick w/ him. thanks.... And my NS has been very willing to work w/ me and is trying to figure this out, but he can't make time move any faster. I guess my post was more of a vent except for the part asking whether or not I should discuss increasing my pain meds or try a different pain med.

[QUOTE=tetonteri66;4741720]You cannot depend on one particular doctor to find all the answers. If he can, great...but if not, do not give up and assume there are no answers to be found. [/QUOTE]
And that is why he is talking about sending me for a second and third opinion...
He has told me that he is doing everything he can think of and being as thorough as he has been trained. But if another Dr can find something he has missed or hasn't thought of "God Bless 'Em" because at least then we will have an answer. I don't think he could be any more honest with me than that.

[QUOTE=tetonteri66;4741720]I'm NOT suggesting that you are not getting proper advice and treatment from your doctors. I am suggesting that while you continue working with them, you might just want to have a consultation with an ortho spine surgeon to see if he/she might spot something that your neuro did not notice, or did not feel was important, etc. [/QUOTE]
Honestly, I do feel like you are suggesting that. I am happy that you have found a ortho spine specialist that has been successfully able to help you. But I feel very much like you have something against Neurosurgeons. And since you use a ortho spine specialist that that is the 'only' and 'correct' way to go. The ortho spine specialists I have researched here are not the least bit impressive to me with their training and such. I'm sorry if this seems snarky but EVERY post you can, you have to throw out there that ortho spine specialists are far superior than neurosurgeons. You have the right to feel that way. It is your opinion and you are entitled to it, but it doesn't mean it is completely correct. I am pleased with my neurosurgeon and his care. I haven't asked for anyone's approval regarding that.

[QUOTE=tetonteri66;4741720]You might want to read about "restless leg syndrome" and just see what ideas they recommend to soothe the legs so the person can get to sleep...
Sorry this is so long....I hope my story will provide a little ray of hope that you too will get better.

I have read a bit about restless leg syndrome but need to reread that. although, I only have problems with the one leg and I 'thought' in general RLS was in both legs, but I could very well be mistaken.
Thank you for you well wishes.

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