ER Doc further messed up my back?

[Missus835]

On Tuesday gone by I went the ER here in Nova Scotia. During his exam, the doctor manipulated my legs up and down and had me press feet, etc. to test strength, which he said was good. My lower back has been an issue since January 2023 and a long time prior to that. Because I had lost some continence and no feeling on needing to urinate, possible cauda equina. This and pain in left side was why I went in. No longer peeing myself as though my water had broken during childbirth. CE was ruled out. Doc looked at scan results and said "your back is your back". How helpful. After urine, blood and CT-scan of abdomen and back, it turns out it's diverticulosis which second doc on Friday says "doesn't usually cause pain".

Since that day (and I returned to ER on Friday as they said if pain got worse to do so), my back is excrutiatingly bad. Yesterday, top of left thigh down to mid thigh, started with pins and needles (almost numb) and then turned hot/cold. Through the night, an extremely sharp pain has started from front near groin straight through to back. A pain which makes one cry. This was Wednesday morning I think and I was going to call an ambulance as I knew I would not be able to get down the one flight of stairs, I have had none of these symptoms prior to Tuesday. I couldn't sleep in my bed (and of course by then the Pred had kicked in because I take it at bedtime). Moved to couch.

Early this morning my wonderful daughter brought me her heating pad. It helps as long as I'm on it. So now, I'm using a kitchen chair as a walker, to help me get to washroom and such, so I don't fall. I also have a prescription for Baclofen 10 mg. which is a muscle relaxer. I reached out to pharmacy to ensure this is okay, but had to leave a voicemail. I took 1/2 a pill (so 5 mg.) Trying to ascertain if this is muscular or a disc or whatever. Hoping it's bursitis not sciatica. Eye roll! Ibuprofen/tylenol is barely touching this, where it completely helped before, but this cocktail I will only take in the morning for obvious reasons. Reports were sent of to my rheumy and also back surgeon to whom I was referred last January and just spoke with him last week. He wasn't that helpful because it wasn't "knife worthy". On second trip in (Friday), they sent me home with an antibiotic prescription? After waiting 8 hours.

At times, I feel like I cannot take anymore pain. It's not PMR pain. It's one type of pain on top of another...and then there's the new Crestor pill for high cholesterol, which I will start just as soon as the back pain knocks of a bit. I also have extreme abdominal pain starting around 3AM which could be a result of taking the Pred at night and I'm considering splitting my dose or going back to mornings???

Hoping much rest will help the back pain, as it has in the past. Apologies for long post. So much going on here in Darmouth, NS.😣😒

[Chris_1236]

Cauda equina is very knife worthy; it is considered a medical emergency in fact.

No MRI of L4-S1? Impingements should be quite visible.

I have had constant pain similar to that you describe for the past three months without the bladder/colon issues. 30mg of Pred just does mask the worst of it. An MRI last Friday clearly shows a L5-S1 herniation center left protrusion pressing on the left S1 nerve root.

I'm going to try traction using an inversion table later this week to hopefully avoid the knife.

L5-S1 Protrusion

[Missus835 in reply to Chris_1236]

Wow. Saw this same back surgeon in Jan 2019. L5-S1 issues back then which were not knife worthy. MRI done back then showed a cyst in that area which "we were going to keep an eye on". Never ever heard from him until recent convo resulting fr a GP referral. Yes! Cauda Equina very serious but ER doc determined from CT that it was not that. However, back was almost tolerable prior to this Tuesday. Now not at all and I'm having dejavue moments. Good luck with the decompression. I've had two prior back surgeries which went well. Positive vibes!

[HeronNS in reply to Missus835]

Any medical coverage? I have a miracle of a physiotherapist and will private message you.

[Missus835 in reply to HeronNS]

Sadly no. It's cut off when I stop working. Blue Cross. BUT rheumy is referring me to physio at the hospital. Spent yesterday at the ER in dire pain. If it is diverticulitis, what do they do - antibiotics. Going to post a second post about yesterday's ER visit.

[HeronNS in reply to Missus835]

Just read that other post. Thanks for keeping us updated. I am wishing very hard for you to get some useful answers and treatment soon!

[diana1998]

Instead of using a chair as a walker, research Tray Trolly in Google. My infirm friend with pmr and drop foot has one and she can now get round the house safely. You can put anything on it, food, drinks, newspapers, mob etc. My aunt in her nineties had one.

[powerwalk]

Just to say you're not alone. I feel like im going mad with the pain from my back which turns out is disc related. No painkillers are touching it and the sciatic pain is on fire. I cant stay standing more than 60 seconds or so. I did a post recently about my A and E experience! Waiting now for nerve block with ct scan as consultant wants to try avoid surgery. I really hope you get some relief very soon! Very best wishes.

[Missus835 in reply to powerwalk]

Aw...I feel you my friend.I'm going to ask about a nerve block today, but ER docs are really hesitant to prescribe much.

[PMRpro Ambassador in reply to Missus835]

Not that they are hesitant - it isn't their remit and at best they can refer you for a specialist clinic assessment. They are there to keep you alive until the experts can deal with you!

[powerwalk in reply to Missus835]

Oh I know. They send u off to someone else to do the follow up, Consultant or GP. Its inhuman really to have this kind of pain, hopefully we will be sorted asap. In the meantime im afraid im taking anything i can, im finding that a vallium and tramadol helps take the edge off having spent the night crying with the pain. Now to get GP to prescribe it for me til i get the job done. Do let us know how ur getting on. Xx

[PMRpro Ambassador in reply to powerwalk]

"They send u off to someone else to do the follow up"

But that is because their exertise is in pre-hospital medicine and it is a very different skill. On-the-road paramedics and emergency doctors even have different skills again. My daughter was an on-the-road paramedic and says it's scary in the ED - she used to keep people alive so they got to the ED for them to decide which experts to get in. Now she is making those decisions ...

[powerwalk in reply to PMRpro]

Yes i understand that alright, i was very glad to get some help with the pain, except obviously for the guy who dug his fist into my back! The other staff had been doing their best to help me and i was very grateful to them all.

[Missus835 in reply to PMRpro]

Smh.

[Missus835 in reply to PMRpro]

Hopefully won't be necessary Pro

[Missus835 in reply to powerwalk]

My GP would not prescribe my anxiety drug and refused yo be my GP because the rheumy prescribed it. So no GP.

[powerwalk in reply to Missus835]

Oh dear god, it helps relax the muscles. Thats awful. We really are at their mercy.

[PMRpro Ambassador in reply to Missus835]

Not much of a loss methinks ...

[HeronNS in reply to Missus835]

Whaaat!? There must be some way to make a complaint (when you feel up to it). I don't think a doctor should be allowed to dismiss a patient for that kind of reason.

[HeronNS in reply to HeronNS]

If you can find your doctor listed you can make an anonymous statement to warn other people. I had an absolutely shockingly bad GP between my old doctor retiring and new one leaving the practice for another location (thank goodness, although that left me GP-less for while when very ill with undiagnosed PMR). It's quite instructive to read the ratings this person has received over the years. There's also a strange sameness about the positive reviews which make me suspect at least some aren't authentic.

ratemds.com/ns/dartmouth/

I don't know if there is a formal/official complaint process, if you think it worth it. I suppose there must be.

[Missus835 in reply to HeronNS]

Yes comments on the clinic website and aldo NS College of Physicians and Surgeons. He wasca misogynistic quackadoo

[HeronNS in reply to Missus835]

My son was without a GP for a few years. Finally got one. Then the man moved to another community, there were complaints against him and now he's left the country. So son without GP again. Thankfully my doctor agreed to take him on as a patient (although the clinic is emphatic that they aren't accepting new patients). He did ask if it was just my son, I think picturing a family with a brood of little ones. I hastily said just my son. But I know his partner is wanting to get new doc as her's is really old and apparently not particularly competent. I told my son he'd have to ask about her, once he'd establlished a good relationshiop with his (my) new doctor. It's so foolish that we have to do stuff like this. I remember sort of "shopping around" for a new doctor back around 1980 when our first doctor "got an offer he couldn't refuse" and moved to Texas. No problems doing that. We ended up staying with the same practice and choosing new doc on basis of how great he was with our then very young child. No question of just taking whatever was available no matter whether you got on with them or they cared about you. This is the one who retired literally a week before I became an interesting patient in 2014!

[Missus835 in reply to HeronNS]

My former gp was so gor 29 years and then he retired during my pre PMR diagnosis. Just as well bec he was saying old age.

[HeronNS in reply to Missus835]

I guess this is one of the difficulties of becoming old ourselves - we outlast the working life of the people we've relied upon for years. I still miss my old hairdresser. Took me ages to find someone who understood my naturally curly (one stylist referred to it as "determined") hair, and he retired at the end of 2021, mostly ill health, he had cancer, and the covid situation was an added stress he couldn't handle. The second person I tried is reasonably good, but I never quite know what she'd going to do. Sometimes she leaves it too long, sometimes I feel like I've been scalped....

[Missus835 in reply to HeronNS]

🤣 thanks for your always great support Heron. My hair is silver or was but the Pred is making it salt n pepper again..Weird or what!

[musicality]

I also had severe pain in my groin which affected my leg and mobility on that side. Cut a long story short - was hospitalised - diagnosis - Diverticulitis. Antibiotics given. I do get flare-ups occasionally, and pain can be bad, but not as bad as when hospitalised. When flaring, eat low fibre food. i.e. good white bread instead of wholemeal - white cereals, low fibre veg, etc. I saw a dietician at hospital who gave that advice. Like lots of ills, stress and tiredness can be a strong factor in bringing it on.

[Missus835 in reply to musicality]

Definitely lots of stress right now. Lack of sleep due to pain. Probably start the antibiotics this aft after I get the prescription filled. They rarely hospitalize us herein NS due to lack of rooms and beds or so they say.

[musicality]

Hope the anti bees help the pain, etc., and restful sleep is yours. Keep us posted!

[micpenn222]

I've had diverticular disease and many bouts with diverticulosis, and I can assure you, and your rather less than stellar doctor, that diverticulosis does cause pain, and often rip roaring excruciating pain! It usually affects the lower abdomen, with the pain often radiating into the back. My flares were treated with anti biotics, which caused it to die down, that is until the next one. It got to the point where I had so many flare ups that the a part of the colon had so much scar tissue that it had narrowed and I needed that section of the colon removed. Just prior to the surgery the inflamed part of the colon was so bad it caused a fistula to be formed between the colon and bladder, whereby fecal matter spilled into my urine. Anyway, mine was a bad case and I let it go too long from being chicken of the surgery, and am not saying yours is the same. I am just saying that it often doesn't get the respect it deserves. An active cause of diverticulosis needs to be treated, and any doctor worth his, or her salt should know this...doesn't cause pain indeed!

[PMRpro Ambassador in reply to micpenn222]

I think it is important to distinguish between diverticulosis and diverticulitis - diverticulosis doesn't usually cause symptoms. However, when a diverticular pouch is inflamed, then you have diverticulitis and it most certainly does cause pain.

[Missus835 in reply to PMRpro]

Hi Pro. Yes, I believe the "osis" has now become "itis". Started some antibiotics yesterday afternoon and it's already improving. Also in a flare I believe which really helps issues - not. Upped my Pred to 40 mg. from 30 for a couple of days, also have a chest cold with productive cough. Hopefull AB's will wipe all this out. Productive cough started a few days ago and is now a lovely shade chartruese. I probably picked up this gem at the hospital last week.

Neck pain, head pain, (also jaw pain as a sidebar). ER doc suggested upping the Pred and I told him I already had. He looked surprised. I also advised the ER doc I saw yesterday that I had upped it and asked her to confirm this with rheumy. She is going to contact rheumy directly (as I cannot) and let her know what's going on. Rheumy has probably received last week's ER reports, an update is required for her.

[micpenn222 in reply to PMRpro]

Of course I didn't even realize I was writing " diverticulosis " when I should have been writing " diverticulitis " .... big difference!

[PMRpro Ambassador in reply to micpenn222]

Ah, right, Medical terms are like that!!!!

[Missus835]

No worries. I got your drift.