Spondylolisthesis Treatment

It’s been a while since my last post about what’s going on, so I thought I’d share about my spondylolisthesis, treatment, and repeatedly frustrating medical experiences over the last several months.

First, spondylolisthesis (which took me a few years to be able actually pronounce… Spawn-DEE-lawl-liss-thesis) is a condition in the back. For a super information overload, head over to Wikipedia. For the cliff’s notes, read on.

Essentially, I have a vertebrae that goes all out of alignment, and hurts like a son of a bitch. See here:

From what I understand, my particular instance of this is due to a genetic pre-disposition… I remember the first of my back problems starting when I was in high school, wrestling with a friend in 1995. He’d was on my back pinning me down, and I tried to sit up. I spent the next several hours wishing I was dead. The worst pain in the history of (my) pain.

Ancient History

I went to my Dr. at the time, and was told (and I quote) “You have the two most common chronic health problems: Back problems, and migraine headaches. Not a lot we can do about it, try to take it easy. If it hurts, don’t do it.” There may have been a couple of other stupid recommendations, but that was the conversation. “Thanks, here’s your co-pay. I’ll go crawl home now.”

Believing that the doctors (you know, the conventionally recognized experts?) weren’t able to help, I made meals out of ibuprofen and laying on my back for a few years. The pain came and went with different degrees of intensity, but I got by. Just figured “Eh, living with pain is normal.”

Years later (perhaps 2007?) my brother recommended that I go to his chiropractor, who had treated several defects in my brother’s spine, a couple of which were birth-related. I went in, described my problems. He poked an prodded a little and then did X-rays. Sure enough, he diagnosed the condition. I climbed onto the table, and in 5 minutes my pain was gone.

I returned a couple of times a week for a little while, as when things are out of whack that long, the muscles get used to it, and tend to pull things back out-of-place until they are conditioned to do what they’re supposed to. I had zero pain for YEARS following my chiropractic treatment.

I’d relayed this information to people over the years, and was met with a variety of responses, which both confused, and frustrated me. Why someone would choose to believe that I was lying, or simply mistaken is beyond me – but they do. Western doctors approach chiropractic medicine with skepticism and sometimes contempt. Otherwise perfectly reasonable people have actually said “I realize you drank the chiropractic Kool-aide, but I just don’t buy it.”

To me, it makes perfect sense… Something is where it shouldn’t be, put it back where it belongs.

Recent history

March of this year, I was gathering the trash to take out to the curb. I was leaning over partially, sorting the recycling into its different bins, and suddenly there was a sharp stabbing pain, like a kick in the spine. I dropped to my back, writhing in pain for a few minutes. I knew exactly what it was.

Knowing that my primary care physician wouldn’t know what to do, I hobbled to the car, sat very awkwardly in the seat, and drove to the chiropractor. He was able to get me partially treated, but my muscles were all in spasm, and the full treatment would have been too painful. He told me to come back in a couple of days, but in the meantime, call my primary care, and get a muscle relaxer.

As you may be imagining, the fact that I had never (since ’95) included them in any of the discussion about this condition was a problem. I went to my doctor, almost in tears. Met with nurse practitioner, who prescribed me percoset, flexural and naproxen, but was skeptical that it was Spondylolisthesis.

I called them the next day in unimaginable pain despite the drugs. They told me to take an additional percoset at each dosage. (making 2 in the am, 2 at lunch, and 2 at bed). A couple of days later, I called again with the same complaints, hoping they’d speed things up, or something… They told me to take a 3rd pill at each dosage. They’d had to call in several additional prescriptions over the next couple weeks, as I kept running out.

I got the x-rays, and they reviewed them. “there’s definitely something going on in there!” I was told. They also saw a couple of degenerated disks. “We’re going to send you for an MRI to be sure, and then have it reviewed by a Neurosurgeon. I’d say we should send you to physical therapy, but I want them to give an okay first.”

I asked if they’d like to see the X-rays my Chiropractor had done, as they clearly showed the Spondylolisthesis. “No,” I was told. I was not given a reason. The problem with the X-rays I got most recently, I was laying on my back… The vertebrae is hyper-mobile, so on my back, it slips back (maybe not completely) into place.

I went and got my Chiropractor’s x-rays anyway. While there, he asked me if he could give me another treatment. I hesitated, as I sort of wanted to be in the worst shape possible when I went for the MRI, but by then I was having to walk with a cane, and still the massive doses of opiates I was taking weren’t touching the pain. He said they’d still see all the tissue damage evidence anyway. I agreed. Five minutes later, I was walking out of there upright with moderate discomfort (still on Percosets). No cane necessary.

I arrived for my MRI, greeted with a $270 co-pay. Had the MRI (again, laying on my back) and went about my business. I was still having a fair amount, although not as much as before. I contacted my doctor to see about a new prescription. I was told “the insurance company will not agree, so we’re going to give you vicodin.” I said it was fine, and asked if it mattered who picked up my prescription. They said no… I said I would send my wife in a couple of hours, and again asked if that was okay. I was told “Yes, that’s no problem.”

I got tired of sitting around at home, and felt My wife and I went out to lunch that day, and stopped at the medical center. She went in, and came out 20 minutes later, frustrated. They told her it had to be me who picked up the prescription.

I went in, and was read a riot act… If I need someone else to pick up my prescriptions, I need to provide permission in writing. And if I was going to take more than the prescribe amount, I needed to notify them first. Oh, and this prescription wasn’t even on my med list. I decided to let all that go, but I was pretty pissed off. Not only had I notified them, but I was TOLD BY them to take more, and the fact that the news stuff wasn’t on my med list, was not my fault.

I eventually got my appointment with the neurosurgeon. He said that he was unable to see Spondylolisthesis, but certainly Spondylolysis. He said that treatment is a surgery, but only recommended if I experienced a similar “episode” like I had in March, more often than 3 or 4 times a year. He then said “but we’ll have a CT scan done for you, that’ll show us for sure.”

By now, I was getting pretty low on patience with this whole thing. If the CT scan would tell us for sure, why didn’t we do that first? …or second?

He said that he’d send me to physical therapy in the meantime, and if he sees anything surprising in the CT scan results, he’d contact me. Otherwise, have a nice life.

I went to 11 sessions of physical therapy, and I asked several times about a co-pay. Was kinda just shrugged at. Upon my 12th, I was told “Do you know you have a $50 co-pay??” That was the end of my physical therapy.

I went back to my primary care recently as just a follow-up. I gave them this whole story about my frustrations with the mis-communication and dysfunction. I was kind of shrugged at. I was told I should call the neurosurgeon to follow-up even though he said he’d call me if there was a reason, AND that they’d set me up with another guy. “We work with a new guy now, he’s pretty good”.

I asked about the occasional pain flare up, was told “We do all that different now, if you can tolerate it, that’s probably best.” I wasn’t interested enough to find out what they meant by “do it differently now”, but I have to imagine it’s an improvement.

I discussed this all with my chiropractor, and he explained that Spondylolisthesis is a condition where the vertebrae is out of alignment, like in that picture above. Spondylolysis is a condition where there are fractures in the vertebrae which can LEAD to Spondylolisthesis. So essentially, when I go TO the chiropractor, I have thesis… when I leave, I have lysis. Apparently neurosurgery also includes splitting hairs.

SO. As you can see, I have had a personally frustrating last few months with regard to health, and I refrained from posting about it until now, because at this point I’m sort of fine, and just looking back…

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8 thoughts on “Spondylolisthesis Treatment

  1. I can relate. I herniated a disk back in ’98 and the next YEAR was a total mess o’ pain, drugs, surgery, and rehab. Back problems are the worst. My condolences, Matt.

  2. Did anyone do plain xrays standing and bending to measure slipage in the affected vertebrae? A differential dx in spondylolithesis… If your chiropractic therapy is working then by all means continue but if you have radiating pain or pain not managed by meds greater than 3-4 weeks consult a neurosurgeon you TRUST!

    • The Chiropractor is the only one who ever did standing Xrays at all. No one did bending to measure slippage. I haven’t been on pain meds now for a few months, I believe and seem fine for the most part. Occassional twinges, sometimes an ache, but nothing I can’t live with.

      … Though this whole thing illustrated pretty clearly – it’s only a matter of time.

  3. Man, I’m pissed off – on behalf of you, and because I didn’t get my ass over here to see this until now.

    OK, of what help I can be… Percocet (or percodan, or oxycodone, which is what it is without other things mixed in, and more on that right now) is a fine drug for relieving pain, but the thing almost nobody tells you is that Percocet (specifically) is Ox mixed with acetaminophen (Tylenol) and taking too much of that in any one 24-hour period can fuck up your liver permanently. If at all possible, get your physicians to prescribe the pure item, not the one mixed with Tylenol. At the least, see if they’ll make it PercoDAN, which is mixed with aspirin as opposed to Tylenol. Stomach bleeding sucks, but it’s better than a liver transplant. The Tylenol does DICK in comparison to the Ox, anyway, so why take a chance at liver damage? AND, if you have the pure stuff, you can go over the recommended dosage in the rare instance when it’s needed (always being extremely careful to monitor yourself on that, of course, because too much can lead to respiratory failure, but that means quite a bit more than the usual, usually. AND don’t drink or take other depressants.)

    You want to avoid more than 8 doses of Tylenol-containing drugs in a 24-hour time period.

    Vicodin is less effective as a pain reliever, but has the same exact chance to fuck up your liver. It is also a compound with Acetaminophen, this time with Hydrocodone rather than Oxycodone. Actually, since you need to pop more Vicodin to get the same pain relief as Percocet, you have a GREATER chance for liver damage.

    The government, in it’s infinite D’Oh, makes it easier for folks to get the less-effective drugs, thus increasing the chances for liver damage because folks take more of the lesser drugs but the lesser drugs contain just as much Acetaminophen, dig? So, be careful. Always try to get pure drugs.

    I wish I knew more about treating the thing that’s causing the pain, but I don’t. I just know pain relief, having dabbled in it extensively šŸ™‚

    • Wow. that’s some great info there. And you’re right, I can’t remember EVER getting any relief from Tylenol. Frankly, my liver has it’s work cut out for it as it is…

      At this point, I really haven’t been in any “real” pain. I’ve had the usual aches and such, but nothing I can’t shrug off for the most part.

      Thanks for the info!

      • Actually the tylenol is an opiate potentiator… It enhances and prolongs the effects of the oxy or hydro codone. But I never noticed enough of a difference to make it worth it

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