lumbar spinal stenosis

[hmr1978]

One year ago my grandmother had surgery for lumbar spinal stenosis.  She had titanium rods put in her back.  6 months before that surgery she had the same surgery done but it didn't help, which is why she had the 2nd surgery.  Her scans are showing that everything looks good and there is increased blood flow to the area.  She is always complaining of being in constant pain.  I can't say that she's not because I'm not her.  My first concern is that she is trying to make a case for the painkillers she "likes" but becomes instantly addicted to.  She never did any of the walking or exercises her doctor asked her to do and she literally sits all day.  She is 69 years old, 5'2, and about 270 lbs.  Could her weight and inactivity be causing problems or could a real medical issue be the cause?

[namnam46]

Hi hmr,

Believe me, no one thought that you were "suggesting" that your Grandmother "likes pills" and "is faking her pain". We understood what you were saying.  :)

I'm so very glad that you added that about the TKR (Total Knee Replacement). That is one of the most painful of all surgeries to come back from.  Most of the people that I know that have had it will still have pain after the TKR.  There's so much pressure that goes on your knee with every step that you take.  For example your knees absorb 5 times your weight with every step you take.  Not only that but couple it with the fact that for every 5 lbs you are overweight your knees absorb an additional 25 lbs.  So you can see how much extra weight your Sweet Grandmother is having to absorb on her artificial knee.  It's probably very painful for her to be up and around much because of this additional pressure to her joints.  I learned all of this when I was just in my 20's because of my Hip problems.  I'm going to be facing the prospect of having my knees replaced down the road and I don't look forward to that surgery at all.  I've seen how hard it is for some of my Friends that have gone through it in the past. :(

I hope that all of this additional information that Atonicat and Tuckand I have provided has been helpful to you.  Believe me, we only want to help you and your Sweet Grandmother. I'm very close to your Grandmother's age (I'm 65 in 2 weeks) and I know what age can do to your pain also.  It's just not that easy to get your body to move around like it used to. It's sad, but true!!  :(

As I said before, I know how much you Love your Sweet Grandmother as you have taken your time to try to find answers to better understand what she is having to endure daily and that says a lot about the Sweet and Loving Granddaughter that you are!!  :)

Please know I'm keeping you both in my Thoughts and hope you will keep us updated on how your Grandmother is doing...............Sherry :)

[Tuckamore]

Good point Atonicat. I have to change positions frequently also. Just sitting or even laying increases my pain. I can't exercise as most ppl do or can... but I do "move."

Hmr, your grandmother probably doesn't truly understand the difference between dependency and addiction, many ppl don't.There is a huge difference. Early on in opiate therapy some ppl get a bit of euphoria from the prescribed opiate/narcotic and some ppl don't. Either way this "feeling" doesn't last more then a few days as your system adjusts and the narcotic does what it's suppose to do, relieve your pain. When your grandmother expressed her "addiction" concern to the physician I am guessing that he understood her comment and knew she was not truly addicted.  However I cannot guess what your grandmother's status may be. My opinions are just that, my opinion.

If you would like more information on that difference between addiction and dependency I can provide a link to a good informational article.

And sweetie I certainly didn't think you were/would, "stoop so low as to suggest she likes pills and is faking her pain."  You have legitimate questions and concerns. I am happy that you are trying to understand where your grandmother is right now. She is fortunate to have your love and concern.  

I wish you both the best.
~Tuck

[atonicat]

I to want to say that I'm not your grandmother so I don't know her pain. But for me personally, sitting makes my pain worse. But so does too much movement. I sit for 8 hours at a desk at work and it really takes it's toll on my back. But if I am walking around all day, that to takes it toll. It's a delicate balance between movement and rest that we have to find. The spine is really complicated, and it's really hard to say what's best for someone. Me for example, my posture is really horrible but it actually helps with my back pain. If I sit up straight it puts too much strain on my spin and I'm in horrible pain. It could be the complete opposite for someone else.

Surgery is also not a cure all. It can make things better or it can make things worse. It's really a gamble.

[hmr1978]

Thanks so much for your help.  I just wanted so state for the record that the only reason I said my grandmother likes pain killers is because she admitted it to me while I was taking care of her after both back surgeries & knee replacement.  She admitted to her various doctors she was addicted to her Dilaudid and they still kept giving it to her.  I would never stoop so low as to suggest she likes pills and is faking her pain.

[namnam46]

Hi hmr1978,

I want to join Tuck in welcoming you to the MH Forum.  :)

It's so very difficult when someone we love is in pain and we don't understand what is going on.  What Tuck said is exactly correct.  When you have any type of back surgery it almost always causes the person to have more pain or different pain than the person expeerienced before.  It will also cause extreme side-effects after the surgery.

When I was only 43 years old I had a ruptured disc in my back and had it removed.  I was told that one of the side-effects was Arthritis and sure enough within a year I was encountering the effect of Osteoarthritis.  Now I have Severe DDD (Degenerative Disc Disease) and was granted SSDI (Social Security Disability) by the time I was only 58 years old.  All because of the ruptured disc and the surgery that I had performed. Byt the way my Surgeon is one of the top Surgeons in the U.S.  It's unfortunately one of the horrible side-effects that can and does occur following any back surgery.  Now add your Grandmother's age to that and believe me your Sweet Grandmother is suffering a lot of real pain today.

I hope that you won't also wind up being a candidate for this surgery as you age, as it is very unpleasant to have to go through spinal surgery of any type.  

You need to be very cautious and have constant check-ups with your Doctor to be sure what shape your spine is in.  You need to be very careful as one of the main reasons for Spinal Stenosis is DDD, the condition that I suffer with.  This is genetic and there's a very good chance that you might wind up with it also.  I hope, as I'm sure your Grandmother does too, that you won't suffer from this condition as you age.  It's extremely painful and there is no relief and no cure for it.

Your Grandmother's weight will have some bearing on the pain that she is having, but believe me when I tell you that she would still be in a lot of pain even without the extra weight on her small frame.  I'm 5'1/2" and I weigh 125 lbs.   Even at that weight I still suffer from extreme pain from my back problems after several surgeries including THR (Total Hip Replacement). I'm on significant pain medication to enable me to be able to function at all. I hate having to take the medication as I'm sure your Grandmother does but there is no way for me to be able to move around and have any type of a life without my medication.

I hope that this will help you to understand a little more of what your Sweet Grandmother may be having to try to live with each and every day.

I'm not trying to frighten you but I hope that this gives you a better understanding of what it's like for your Grandmother each and every day. I'm glad that you love your Grandmother enough that you are concerned about her and have asked questions.  I know that she will appreciate your support and love for her and a better understanding of her pain.  :)

If you have anymore questions, please feel free to ask them and if your Grandmother is active on the computer, please suggest MH to her.  She might enjoy the opportunity of being able to talk with others that are experiencing the same medical problems that she is.

Best of luck to you...........Sherry  :)

[Tuckamore]

Hi Hmr,

Welcome to the Pain Management Forum. I am glad that you found us and took the time to ask a question.

Typically spinal surgery does not resolve 100% of a person's pain. Indeed ppl are often left with worse pain or different pain. However to the outsider it seems like if they had the problem "fixed" certainly there can be little or no pain. That simply is not the case.

Imagine the rearranging and trauma that your grandmother's spinal structure went through and then they placed a rod(s) in her spine. That has to be painful. I cannot say how much pain your grandmother is experiencing. I rather doubt she has become addicted and "likes" pain killers. I am more apt to believe that she truly has pain and the only "like" she gets from the opiates is that they control her pain and make her life better. Add her age and probable arthritic issues... as arthritis will more then likely begin if it wasn't there already and she has multiple reasons for chronic pain. Your attitude and doubt is fairly normal. Some ppl that have not been there have great difficultly understanding chronic pain, especially if they are younger.

A friend of mine (36) had titanium rods inserted a few years ago. He experiences significant pain everyday and requires opiates to help manage it. His nights are hellish and he has difficulty performing normal activities.

Your grandmother's weight may be compounding her pain issues but even at normal weight it is my guess she would still have pain. Her pain may keep her sitting much of the day. I can't judge as I haven't walked in her shoes. But I do know that ppl with chronic pain traditionally have a lot of difficultly obtaining family support and understanding. Family and friends often want them to "Buck Up" and get over it when it's simply not possible.

What your grandmother really needs is support and understanding. Chronic pain can be very lonely and isolating. My heart goes out to her. And to respond to your last line, I think this is a real medical issue.

The anonymous "Letter to People Without Chronic Pain" may help you understand a bit better from your grandmother's perspective. I hope you will take the time to read it. Here's the link:

http://www.medhelp.org/user_journals/show/155544/Letter-To-People-Without-Chronic-Pain?personal_page_id=14686

I hope I have not been harsh, it truly was not my intent. I am just concerned that your grandmother may not have the support she needs. It's a terrible and lonely place to be at any age but sometimes even more so at 69.

Peace,
~Tuck