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cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 9/28/2011 10:07 AM (GMT -6)   
I phoned the MD who gave me epidurals last year (which didn't help), inquiring about trigger point injections.

I just got a call from his nurse who said that the MD would rather do a discogram. I'm inclined to say no and would like some feedback.

My MRIs clearly show disk damage, neuroforamen narrowing, etc. from C4-T4. Most likely, a few levels are responsible for my pain and if I am absolutely against surgery, for what reason would a discogram be relevant? It might be able to identify some details at some levels that are missed by the MRI.

But if I'm not going to have surgery unless the pain gets far far worse, it seems to me that the further information, though I'm curious, is not risk the time, burden, pain, expense.

From what I've read, discograms can be very painful. I'm very busy and I just don't think I can at this time burden my wife. Also, though I have good insurance and can't be dropped (as I'm on a group plan through a large employer), I want to be fair to them. I've had an ER visit this year that cost $7000 -- about which I am terribly embarrassed (I just couldn't tolerate my vertigo one evening -- before it was diagnosed -- and was desperate for help and answers). I assume the discogram will cost $3000-$5000. If it isn't going to be used for a surgical decision, then it is not fair to the insurer.

I can't talk this over with my GP for he's the sort to tell me to just go with what the specialists suggests.


Am I missing something about the discogram? Am I right that it is very painful?

Thanks.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9664
   Posted 9/28/2011 10:34 AM (GMT -6)   
Call the nurse back and ask for an office appointment and then ask this doctor
why he feels the discogram is needed. Tell him your concerns and that you don't
have a lot of funds for such an expensive procedure.
The discogram for me revealed nothing but the contrast ct showed more as far
as damage to my spine. A discogram is a very controversal tests some doctors
says its useless, others argue it has so merit, my current pm doctor does not think anything of it.
and it can be expensive.
So make an office appointment with this doctor of yours and tell him your concerns
if he's a good doctor he'll listen to you.
Many well wishes to you and keep us posted on how things go.
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 9/28/2011 12:46 PM (GMT -6)   
Hi, Cogito,
I had a discogram prior to my L4-S1 fusion surgery (which failed, BTW, to help my pain). Chartreux makes a good point when she says it's a controversial test. I have never heard it suggested for anything but in advance of surgery. And it can be risky.

I'm not sure if they still do what was done to me, but they inject dye into the disk spaces that are problematic to get more information (and I'm not sure they really gained anything from mine as one disk space was already too narrow to get a needle into). But they also used (and maybe still do) to inject a "control" disk - one which was above or below the problematic disks, just to compare your response. You need to be conscious (although it's conscious sedation) to give feedback to the doctor while he/she is doing the test. It wasn't fun, but we're generally in so much pain I think we forget that we tolerate these procedures better than the average person!

I'd suggest doing some research and see if the procedure is even still recommended, but if you're not having surgery then I'd wonder why a doctor would want to do the test. There is some risk as the disk space gets punctured, and the research I read after my procedure indicated that they no longer recommended injecting a "control" disk because it might just damage a good disk.

I'd go with your thinking on this.

Good luck.

PaLady

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 9/28/2011 1:10 PM (GMT -6)   
Thanks for the responses. They reinforce my reservations about the test.

Now I have to decide whether to see if the same MD will do the trigger-point injections or find a different MD.

I also just made an appt. with a potential new GP. My current one just seems apathetic and I always feel rushed for he holds strictly to 15 min. per patient.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Screaming Eagle
Veteran Member


Date Joined Sep 2009
Total Posts : 5005
   Posted 9/28/2011 1:43 PM (GMT -6)   

 

          Good afternoon Cogito!

                I have had a discogram, and was done just prior to my double lumbar fusion surgery. Sedation was used, but I was kept awake, so that I could comfirm the pain in each disk that they tested. There was no or little pain as they started, but when they injected the disk, the pressure buildup caused me to moan a few times.

      I have to agree with the rest of the members here, and do not understand why they are doing this test, unless they are getting ready for surgery.

       Let us know, what comes out of the meeting with your Dr,

           Take care,

       SE wink


Moderator Chronic Pain Forum

Weekly Quote!

"Snowflakes are one of nature's most fragile things, but just look at what they can do when they stick together"

spinal soldier
Veteran Member


Date Joined Dec 2009
Total Posts : 687
   Posted 9/28/2011 8:08 PM (GMT -6)   
discogram was some of the worst pain i have ever had and it was done as a precursor to surgery.

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 9/30/2011 11:09 AM (GMT -6)   
Hi,

Brief update:

I went to see a new GP today, who was great. My previous one would rush through, and seemed just apathetic. This guy spent 45 minutes with me. He asked a lot of questions, was clearly happy with his career and committed.

Regarding the discogram, he said first that the MD should have had me come in, reviewed my MRIs, etc. discussed treatment options, etc. before jumping to a discogram -- ad the GP put it, it is like calling an auto mechanic because your car is making a noise and their recommending a new transmission. The GP added that there are only a few very specific pathologies for which a discogram is needed and as a final step before possible spinal surgery.


So, he's referred me to a different interventionist PM doc.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Screaming Eagle
Veteran Member


Date Joined Sep 2009
Total Posts : 5005
   Posted 9/30/2011 11:49 AM (GMT -6)   
 
       Well that comfirms what many of us were thinking. Glad you had a good visit, and hopefully you will have even better luck with a new PM.
 
      Good luck, and do keep us informed on how things turn out for you.
 
      Take care,
 
        SE wink
Moderator Chronic Pain Forum

Weekly Quote!

"Snowflakes are one of nature's most fragile things, but just look at what they can do when they stick together"

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9664
   Posted 9/30/2011 12:31 PM (GMT -6)   
So very glad you were able to talk with your gp first...
Many well wishes with your new PM doctor...Keep us posted on how that
goes...
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******
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