Hypokyphosis ???

[LindaRacine]

Rohrer....

Two observations:

1) I don't see a lot of rotation in your thoracic spine. However, it looks like the file was taken A/P instead of P/A, which makes it more difficult to see the pedicles. But, your ribs also look like they're not deformed.

2) Do you have any lower back pain, or is it all in your mid or upper back?

--Linda

[LindaRacine]

Looking at my profile x-rays up close, it almost looks like there might be a mild spondolisthesis at about T-10. Does anyone else see that? I have a LOT of pain in that area, as it feels unstable.

No, I definitely do not see a spondy.

[jrnyc]

hey rohr
i aint no doctor...or surgeon...not trying to be...i had enough with work in education and addiction!!

but if i were you...i say this only as a patient with a good pain guy...besides good surgeon...no...great surgeon...but my pain guy doesnt quit on me...now, to me, with no medical training, the curve doesnt look big to my eyes, and i'd guess your pain is higher up vs more low down...but...i have 42 and 61 curves with all kinds of disc prpblems, listhesis, stenosis...i wont delineate each and every problem..just to say that my pain guy has his hands full with my spine!!! never has he suggest implanting something in me to dispense medicine...nor would i trust such a device!!!

i am NOT trying to minimize your pain...many things hurt that may or may not show on an X ray...learned that with a hairline fracture in a tooth..didn't show til dentist opened the tooth up!!! What i am saying is i'd find myself a better pain guy...and not take any excuses from any of them...i didn't find a good one on the first try...believe me...took at least 4 tries!!

i still keep getting injections..even when they evaporate after a week or a month...i still dont give up on it...please remember, they could operate on you and leave you with as much of more pain as when you started!!!

hope you feel better and get out from under the pain for a while..

jess

[rohrer01]

Rohrer....

Two observations:

1) I don't see a lot of rotation in your thoracic spine. However, it looks like the file was taken A/P instead of P/A, which makes it more difficult to see the pedicles. But, your ribs also look like they're not deformed.

2) Do you have any lower back pain, or is it all in your mid or upper back?

--Linda

1) The radiograph was taken with me standing with the machine behind me. If you were to actually look at me from behind, the apex of the top curve bends toward the left and and apex of the bottom curve bends toward the right. So the X-rays would have penetrated the posterior side of my body and left my body on the anterior side (I'm assuming that this is in fact a P/A film). This is a very unusual curve, since most thoracic curves are the typical "right thoracic". Mine is a left thoracic curve. I have a rib hump under my left shoulder blade, which makes it stick out, and another rib hump below my right shoulder blade.

2) I have pain throughout the entire spine from C-1 to sacrum. The most constant intense pain is in my neck which causes some pretty intense headaches at times. I have a substantial amount of pain in my thoracic spine and in the ribs themselves. At times I find it very difficult to breathe due to the pain in the intercostal muscles. I get pain in the sternum as well but usually only during bad flare-ups. I also get a LOT of muscle spasms under the scapulae. The lower back hurts due to mild degenerative disc disease in the L5/S1 disc. I told my pain doctor if this is how badly "mild" DDD hurts, I can't even imagine severe DDD. I could barely walk. I could not dress myself, I could not even lift the lid to the toilet seat! I had an epidural steroid injection for that, and what a relief!! I have only mild aching in the L-spine now. The spine in general hurts enough that I have to log-roll to get out of bed most mornings.

Since I'm back on the fentanyl, percocet, klonopin, and now gabapentin (I feel like a complete failure after how hard I worked to get "clean"), about the only thing I can do is keep doing my PT exercises. I am very religious about them and have chosen ones from all of my past PT experiences that cover every section of the spine and the core muscles. I am not able to do many of the exercises that I used to be able to do, due to nerve pain caused by them. I have also developed a sympathetic nerve response to the sever pain that I am in, in which I get swelling above many of the spinous processes. I started another thread for this topic. I guess my point is, is that I am doing all that I can possibly do non-surgically and it is not working. I'm finding it quite frustrating that others with similar degrees of pathology seem to be able to get help and no one in a position to help me seems to believe that I am at the level of pain that I am. Of course, with being doped up all the time, I can do things that most people can do. However, I do not like having to take medication if I don't need it. It would be one thing if I had a failed surgery and I needed the meds, but there are so many success stories where people say they are living pain free after their surgeries. I don't expect to be pain free, as there may be other things going on as well (I'm no spring chicken!), but I certainly would expect to cut down on the amount pain that I have and on the amount of drugs I require to function in day to day life.

[rohrer01]

You can see the heart and stomach in the x-ray. That should orient you to the way in which I am standing. It is as if you are looking at me directly from behind.

[jrnyc]

rohr
i am so sorry that you're in such pain...i know things can hurt whether they look like they "should" or not...i went through that with Lyme disease...a doctor at the great and wondrous Stonybrook Hosp told me i didnt need pain meds because "Lyme just doesn't hurt that much" so i know what it is to be in pain and have others doubt you...

again, i would go to a better pain doctor...and try injections rather than more oral meds...

also, do you have written documentation from a doctor that says what has been tried with you already...? maybe bringing such a written statement to a surgeon might make a difference...??? just a suggestion...

also..have you tried botox injections for rib humps..my left one is helped greatly by those injections every 3-4 months...if your guy doesnt do them, i'd find one that did...i know not all do...i saw a pain guy in CT who doesnt do them...i changed doctors!!

jess

[rohrer01]

rohr
i am so sorry that you're in such pain...i know things can hurt whether they look like they "should" or not...i went through that with Lyme disease...a doctor at the great and wondrous Stonybrook Hosp told me i didnt need pain meds because "Lyme just doesn't hurt that much" so i know what it is to be in pain and have others doubt you...

again, i would go to a better pain doctor...and try injections rather than more oral meds...

also, do you have written documentation from a doctor that says what has been tried with you already...? maybe bringing such a written statement to a surgeon might make a difference...??? just a suggestion...

also..have you tried botox injections for rib humps..my left one is helped greatly by those injections every 3-4 months...if your guy doesnt do them, i'd find one that did...i know not all do...i saw a pain guy in CT who doesnt do them...i changed doctors!!

jess

Well for one very big thing, I am limited by my HMO as to which doctors I can see. The doctor in Physical Medicine and Rehabilitation DOES do botox injections, just not on me. He's afraid that paralyzing the muscles around my spine will cause it to callapse, escpecially since just chiropractic adjustments did that much damage in just two years time. The thing with injections, is I don't know where to get them as the pain isn't always constant in one area as it was in the lower spine. I do get many muscle spasms under the scapulae and the left trapezius is pretty constant. But some of the other pain, such as the intercostal pain comes and goes. There is also the "bone" pain that I feel in my spine. I really don't know what they would do about that. I do worry about masking all of these symptoms up because, as you can clearly see from my x-ray, there isn't a whole lot of room in there for my heart and lungs. I have trouble taking deep breaths, especially when I'm flared up and I already have asthma and am prone to pneumonia. They symptoms of hypokyphosis also sound quite a bit like my "heart" problem. I'd really like to know and address the real issues at hand rather than masking them up. But, because of the insurance that I have, I may not have a choice unless I can find a way to come up with 1/2 a million dollars.

[jrnyc]

well, i dont know anyone with a half a million dollars for their medical treatment! we got paid fairly well (after 22 years and several graduate degrees ) at the DOE in NYC..but not that well! social workers don't make that kind of money..not even in private practice! if anyone on forum has that kind of $$ to spend on medicine, they dont talk like it!

the botox shots i get aren't on or near my spine..they are in the muscles in thoracic area...to stop them from spasming...the epidurals, facet blocks, nerve ablation, sacroiliac joint injections, etc, are all quite safe (all steroids have side effects, but where the injections are placed is safe)..and all they CAN do is treat the symptoms!! that is all pain medication is doing...treating the pain symptoms...so i dont know about "masking" things...

doctors who wont try something that might help...even temporarily...as long as a patient is not allergic to that treatment...??? doesnt make sense to me...

i dont know what else to suggest to you..
jess

[rohrer01]

well, i dont know anyone with a half a million dollars for their medicAL TREATMENT! we got paid fairly well (after 22 years and several graduate degrees ) at the DOE in NYC..but not that well! social workers don't make that kind of money..not even in private practice! if anyone on forum has that kind of $$ to spend on medicine, they dont talk like it!

the botox shots i get aren't on or near my spine..they are in the muscles in thoracic area...to stop them for spasming...the epidurals, facet blocks, nerve ablation, sacroiliac joint injections, etc, are all quite safe (all steroids have side effects, but where the injections are placed is safe)..and all they CAN do is treat the symptoms!! that is all pain medication is doing...treating the pain symptoms...so i dont know about "masking" things...

doctors who wont try something that might help...even temporarily...as long as a patient is not allergic to that treatment...??? doesnt make sense to me...

i dont know what else to suggest to you..
jess

I know. You are a great help. I don't know what else to suggest to me either. I am going to NC at the end of this month. I feel like this is my last chance. If I get the same opinion there, I will just have to resign to my fate of pain for the rest of my life. Believe me, I will do everything to fight it. It's just so hard that sometimes I just want to give up. I have too many people around me that love me for me to even be thinking like that. I just never saw myself as a 41 year old drug addict, and not by choice. I'm going broke on the meds and the co-pays. I'm starting to see the "senior" dilemma with either having money to pay for food or pay for drugs that they need. It's sad to see a system where people have to make that choice. I'm not there, yet. But if it keeps going this way it won't be long. My hubby doesn't want me to work because he's afraid of me having an episode. I've just found out that the school that is literally two blocks from my house is looking for substitute teachers. I've only subbed at the university level, so I don't know if I can handle the little monsters, I mean lovely little children, that are forced to be at school against their will. If I can't have my surgery, then I think I will give it a shot, not literally, but give it a go. LOL
Jess, you have given me a lot to ask the doctors about and for that I am truly thankful. You are a real blessing on this forum, as are many others. I'm still curious about the hypokyphosis and the IST. I really do wonder if they are related. hmmmm....

[jrnyc]

good luck in NC!

J.