UPDATE: TODAY'S ER VISIT

[Missus835]

The mystery of back pain has been solved. Two fragility compression fractures at L1, L2. Which were found in the ct scan of July 7th. My rheumy never read the report. Fortunately the ER doc had the smarts to go over my history. Dr. Das. I will ever remember him. Just waiting for a Rheumatologist to call him back. Will keep you posted. I'm blazing mad that had I not come in today, I woild never have known. I could actually punch my rheumy right now....if I could.

[SnazzyD]

That’s appalling. So sorry you’ve had this needless mountain to climb. Well done, for keeping at it.

[HeronNS]

So you've had an extra month of debilitating pain because the person responsible for your care didn't bother to keep up with checking reports? That's horrible. I'm so sorry. Fingers crossed now there's a diagnosis you'll get some effective care asap. 🌼

[Missus835 in reply to HeronNS]

Exactly. Now have dilaudid for awhile and then they have gotten me into some radiology thing where they insert a needle and essentially plaster up the fractured parts of the spine. How long that will take? Chief Rheumatologist at the Infirmary said he would not hazard a guess. Thank goodness. Not the best news but at least I'm not nuts nor will the ER look at me like I am. Thanks Heron

[PMRpro Ambassador in reply to Missus835]

Kyphoplasty? Vertebroplasty?

steelcityspine.com/blog/wha...

[Missus835 in reply to PMRpro]

I don't know Pro, sorry Just hoping it doesn't take eons

[Missus835 in reply to PMRpro]

Wow what an informative link. He did not mention restoration of height, but I haven't shortened much. One is mild and the other more involved. I will have more info when they contact me. At least they don't have to cut, which they may not anyway.Do you know, given PMR and all, if these fractures could heal on their own...eventually.

[PMRpro Ambassador in reply to Missus835]

Another link from a reliable source

my.clevelandclinic.org/heal....

If they don't need surgery they will heal but it takes about 3 months - though if they are saying kypoplasty it sounds as if they think it is beyond self-healing. Which is quite likely as they have been ignored for so long and could be unstable now. When my husband had a spinal fracture they wouldn't let him home until he was fitted with a corset to help stabilise it and that did help the pain som.

By the way - with the dilaudid do watch out for constipation developing. They should have warned you and provided suitable stuff to take from the start but they often forget. DON'T let it develop, prevention is far preferable to cure.

[Missus835 in reply to PMRpro]

They did warn me about constipation, but provided nothing. I'll get some dried prunes today. I do have collace suppositories and another laxative here. Plus I do eat a lot of oatmeal. Not porridge though. Lol. Hopefully the natural way will work. Bonus is at least I can get up to the loo and have done for a couple of weeks or three. I don't think my g-daughter cared much for the commode I rigged up. Thanks a million Pro for all your help.🌹

[Missus835 in reply to PMRpro]

According to the report, these fractures are fairly recent i.e. between May 3 and July 7. These are the two scans compared by the ortho surgeon. I firmly believe the day I was just standing in the living room and my back kind of "popped" and my spine "torqued" and down I went onto the couch is the day at least one of them fractured. It was on that afternoon about 6 weeks ago, I ended up in bed. A broken back never occurred to me. Just the muscle spasms I've been going on about. I wonder if those huge spasms were pulling enough on my already compromised spine to actually break the vertebrae??

[PMRpro Ambassador in reply to Missus835]

I believe they can but collapsing vertebrae can go with nothing.

[Missus835 in reply to PMRpro]

Wow. Thank you Pro. Enjoy your day.

[HeronNS in reply to Missus835]

When I started physiotherapy to help with PMR my physiotherapist said my back muscles were "like bricks" and that muscle spasms like that can cause fractures. She did "dry needling" which reset the electrical signals in the back and it seems they've behaved ever since - at least in my back, not quite sure about neck! She seems to have very limited appointments this summer, think she had difficulty getting childcare, but if you can I bet she can give you some useful advice virtually. She does offer virtual appointments which of course have their limitations, like you can't get hands-on care virtually, but she might be able to offer some help. I had a couple of virtual appointments during that now long ago covid lockdown and found them useful for a new problem (knees). bluenosephysio.ca/

[Missus835 in reply to HeronNS]

I thought it could possibly cause fractures and also dry needling. Something has to work for goodness sake. That's where all the pain is coming from pretty much. I can pinpoint when they happened as well. I definitely felt my spine pop and let go. Didn't consider fractures though. Ugh!

[Missus835 in reply to HeronNS]

Sorry I wasn't very clear. I meant to say had thought about dry needling. The dilaudid certainly is doing nothing.

[HeronNS in reply to Missus835]

I understood what you meant.

[LindaB-66 in reply to Missus835]

Hi there - I fractured the T7 on my spine when I fell downstairs about 4 years ago. Kept me in two nights - sent home with instructions to take Codeine and stay in bed for a couple of weeks - getting up now and then for a little walk round. Back seemed to heal on its own. Hope you get better attention. Take care.

[Missus835 in reply to LindaB-66]

Thanks Linda. Hopefully they will do something. ER doc was great. Rheumatology Nursing Line called me back this morning, which is the fastest they've ever. Rheumy is in clinic today. Nurse was going to drop in to see her. I told Nurse to make sure Rheumy reads the report from July 7. Glad to hear your back is good now.

[Rox2112 in reply to Missus835]

I had that done twice due to multiple fractures. I feel much better now! Blessings on your procedure!

[123-go]

Shocking! The very least you deserve is an apology and now the best care possible. 💐

[PMRpro Ambassador]

Someone needs some retraining. Is there a professional body to complain to?

[Missus835 in reply to PMRpro]

Yes. The NS College of Physicians and Surgeons and I fully intend to do so. I was so angry when the ER doc read the report, I cried an angry cry. He was appalled and very apologetic. I told him it's not your fault and I would hug you if I could..He was very handsome Pro. Lol

[SheffieldJane]

Your tenacity is awe inspiring. Keep it up. Wishing you the best! X

[Missus835 in reply to SheffieldJane]

Tenacious and resilient if nothing else. Thank you. X

[powerwalk]

Oh wow!!!! Thats mad. I hope you get the treatment you need without too long a wait. I feel you frustration, i definitely feel i would not have ended up in the severe mess i did with my back if the pain guy did the scan i asked for!!! So glad you finally have an answer!

[Bfp1]

Strangely enough it happened to me exactly the same way! I live with back pain as a consequence and then i broke my back in a fall. I have never been pain free since. I hope you fare better. L1 and 2 abd 3 were broken to a more or lesser degree. L1 is dreadful and i a m being re referred to a man called Jim Greenwood in UCH. I have the most amazing Rheumy who treats me as a whole person. Good luck x

[Missus835 in reply to Bfp1]

I'm so sorry for your pain. It's been 2.5 hrs since I took my new pain medication and nothing. I don't want to take anything with it until I see how it works by itself. I'm hoping to get some kind of "plasty" procedure done. My rheumy is almost non-existent. All the best to you my friend. Keep us posted.

[Blearyeyed]

I know it's awful but it is why I contact the GP or Consultant every time I have a test after the time they say they receive them to check what the results were. Unfortunately, it can happen with any doctor and any department, especially if they are dealing with a backlog or the doctor did the tests " just in case" and were not expecting an issue.I got into that habit years ago after an incident that happened to my cousin.

He had a crash during a Superbike race. When they took him to hospital and did his x-rays the doctor asked him exactly when he had fractured his neck and spine that year. He was also a Fireman. He had a minor fall off a ladder six months before the crash and had , had precautionary x-rays but the results had not been looked at by the right departments so he had no advice and had gone back to work and racing within the month!

He was just lucky that the injuries had healed well on their own but the ER doc told him he was also lucky with his jobs that he hadn't had another injury and been paralysed,

Totally different circumstances but the same can occur no matter whom it is.

I also walked about on a set of fractures for two weeks and caused a much worse Achilles tendon injury for similar mistakes over an x-ray.

That's why I always ring and check now.

Hope you get the right help now and feel better soon, take care , Bee

[Missus835 in reply to Blearyeyed]

I do not have a GP here in NS snd I have called every resource available. Unfortunately, in this case it is the Rheumatologist and luck I asked that a copy of the scan report be sent to the orthopedic surgeon who was the one who did the comparison of scans.

[Ronnie101]

Are you osteoporotic and do you take bone drugs? I complained of back pain to my rheumy and he sent me for an xray which showed I had a compression fracture, but his response was basically "I told you so" as he'd been trying to get me on bone drugs for years - he still is, and I may give in, as I'm still suffering pain. I would have liked some discussion about what could have been done about the existing fracture, though.

[PMRpro Ambassador in reply to Ronnie101]

Mostly it is just allowing time for it to heal unless it is unstable and surgery is required. Here in Italy they supply a corset to stabilise things which does reduce the pain a bit and reduces the risk of it worsening.

[Missus835 in reply to PMRpro]

I'm going to get a corset or back brace Pro. Oh and unfortunately the dilaudid by itself relieves absolutely none of the pain. After 4 hours I was still waiting ; a little drowsy and thats it. Called the pharmacy. She said to take another...and nothing after 2 hours. So we're trying a combo of acetaminophen. Ibuprofen for the inflamed muscles and another dilaudid later. I reached out to the prescribing doctor and left a voicemail. Also going to try naproxen instead of Ibuprofen which may be easier on the gut. I do take NSAIDS with food and also 2 ppi"s so fingers crossed.

[PMRpro Ambassador in reply to Missus835]

They wouldn't let my husband out if hospital until he'd been fitted with the corset. It was the weekend - no-one to fit it.

[Missus835 in reply to PMRpro]

Well done them actually. It might have become worse had he left. Here they would have sent him home and said "come back in if you have any problems".

[HeronNS in reply to Missus835]

I did take naproxen for a time for migraine headaches. (Stopped after a while because it was hard on my stomach and when my doctor prescribed another drug to protect my stomach I thought it wasn't a great idea to start piling on the meds and stopped both, reverting to my erstwhile aspirin, although I kept a supply of codeine/acetaminaphen on hand to help with the worst ones.) This was years ago, long before PMR. But what I really wanted to say was, naproxen worked like a miracle, by far the fastest relief I'd ever had for vicious headaches. I didn't use it carefully enough. It's one of those things which must be taken with food.

[Missus835 in reply to HeronNS]

Yes ma'am. Next try is naproxen instead of ibuprofen. Hopefully, if I can get it, dry needling will relieve the muscle spasms.

[HeronNS in reply to Missus835]

It's definitely worth a discussion. I should tell you that I only had the dry needling done in a series, she worked her way up my back over several sessions. This would have been late 2015 or early 2016, and never again after that. For my neck she does some gentle manipulation and massage and low level light therapy. Whatever treatment you receive would, of course, be based on helping you and not causing any further damage to your spine.

[Missus835 in reply to HeronNS]

Thanks Heron. Tomorrow is Natal Day but will call regardless. I will leave a voicemail. Neck has started acting up so I'm presuming it is the muscles there also. Headaches on waking, which Tiger Balm does help. Have the best day ever...and as always, many thanks.

[HeronNS in reply to Missus835]

One feels so helpless here these days. If my doctor were taking new patients I'd certainly recommend him to you. Keep an eye on Richmond Family Practice in case they sign up more new doctors . They seem to be growing. There is one to avoid, however. I'll private message.

[Missus835 in reply to HeronNS]

I agree.

[Missus835 in reply to Ronnie101]

Wow. I am not taking my alendronate as it messes with my stomach and supposedly I am osteopoenic not porosis which will require another dexascan. If and when I get in touch with my rheumy. There are times when we don't even know we have them. In my case I have spasmed muscles which get really unflamed and extremely painful.

[PMRpro Ambassador in reply to Missus835]

Then you should be offered an alternative bisphosphonate - there are oral forms that do not affect the stomach so much as well as infusions once a year. Since you now have diagnosed compression fractures I imagine it is no longer in your rheumy's hands, it will be a spinal orthopaedic specialist.

[Missus835 in reply to PMRpro]

Well good. I was never in her hands anway apparently. I would love the once per year infusion Lol.

[PMRpro Ambassador in reply to Missus835]

Then enquire.

[Karenjaninaz]

Are you taking Vit D? Some have found it helps the pain of spinal fracture.

A nurse friend had fractures -spontaneous as a young lady- not on pred. Vit D helped her heal and reduce pain.

[Missus835 in reply to Karenjaninaz]

Thanks yes. D3 three to 4000 mg. Per day plus K2.

[priss58]

Blimey, that's shocking. I always follow up any tests etc with a call too, and ask for copies of the results. Of course it helps if a professional actually looks at them first!Ive had horrendous back pain for ever such a long time. Had some x rays last week whilst at the rheumy, and we looked at them right away. Turns out it's facet joints in the thoracic, as well as slight compression in the lumbar.

He's given me various physio exercises to do, and agreed that taking Vit K2 and Vit D good idea. But er, that's it..Still a worry though.

[Missus835 in reply to priss58]

Well follow-up with this rheumy is impossible. She is completely unavailable, hence going to ER 10 times since May and finally I got a doctor who actually did something. My back muscles are all spasmed and pulling on the spine and since these are fragility fractures we are of the opinion that the muscle pressure blew out the vertebrae. Next steps....hopefully some dry needling to relax the muscles and then some injections of cement-like substance to rebuild the vertebrae. Of course this rheumy will most likely not be responsible for that. Best of luck with yours. The pain is excrutiating.