Severed nerve between L4/L5...long-term affects can occur?

I was shot in the back 14 years ago and the bullet landed between my L4/L5 vertebrae (Doctor left it due to its location) after severing a nerve (I do not know which). After months of PT and pushing myself, I was able to care for myself and now no one would know what happened unless you saw my scars or I told them. I have diagnoses of ADD, Neurogenic bladder, ED and neuropathy pain in my right foot, which causes spasms in my foot (heel and outside of the foot mostly), in addition to 80% loss of feeling in my foot (gets worse from big toe to pinky).

I just turned 40, and I realize my body is changing/aging, however I have noticed a few differences, most notably with my mental capacities. Since my injury, I have lifelong neuropathy in my right foot
am having trouble with my memory in general, specifically short-term, and abilities. I am curious if nerve damage (such as mine) can lead to more physical issues, especially with the brain. I have found some medical journal articles connecting a GSW w/ nerve damage to brain degeneration. Not looking for any specific diagnoses, but more so to better understand, prepare and trying to limit long-term issues.

ALL input is important and useful, so I appreciate ANY input or feedback, whether personal experience or knowledge.

Hi @basenjidad, welcome. I merged your 2 discussions into one that appears in multiple relevant support groups (Brain & Nervous System, Neuropathy, and Spine Health).

GSW = gun shot wound
I had to look up the acronym, so I thought I would spell it out for others reading your post.

What a remarkable recovery you've made. However, I can understand that you are concerned about late-term side effects as you age. What feedback have you gotten from your neurologist about memory or other possible brain effects?

I don't qualify with personal experience or knowledge, but I'm wondering if you've had imaging in the last few years. There may be a minimally invasive procedure that wouldn't have been available 14 yers ago. You could get a lumbar MRN which images the nerves. Then you'd now how much damage and which nerve. I'm curious because the bullet must be in the vertebral disc. Now they are having great success with artificial discs. Would it have destroyed the disc. And has the bullet moved as even intentional hardware does.
I'm not someone who runs around hugging everyone on the internet but I should have just tapped hug and kept my lack of knowledge to myself. And would have if you were getting more responses. Your situation is quite unusual. If you do get at least the MRI, post again.
Wishing you the best.

@basenjidad
I have spine issues and just had surgery on L3-L5 to decompress my spinal cord/nerve roots and remove damaged discs/fuse. I am 55. I never had a GSW but can relate with how injured/damaged nerves and spinal cord feels. I also had spinal cord compression injury at cervical spine in neck at C5-C6 which affected my head/neck on down to my legs/feet (had daily headaches, dropped things, couldn’t control my bladder and had heaviness in my legs).

My symptoms were pain/numbness/weakness in lower back, hips, buttocks, legs and feet. My bladder was also affected. I was diagnosed with stenosis, degenerative disc disease and neurogenic clarification plus small fiber neuropathy.

It would be good to get an updated MRI and to see a neurologist for EMG/nerve conduction studies plus skin punch biopsy to test for small fiber neuropathy. Have you ever had a MRI of your head and cervical spine (did you fall after being shot in the back where you may have hit your head or hurt your neck?

Do you know exactly where the bullet is lodged and what it is pressing against? Is it in your vertebrae and near spinal cord/nerve roots/nerves which is causing your symptoms? A good neurosurgeon or orthopedic spine specialist/surgeon should be able to tell you today if removing the bullet is an option to relieve some of your symptoms. You may want a couple different opinions and look up reviews of the surgeons and only pick the best with a lot of good reviews. Nerves and spinal cord can’t fully heal if constantly irritated by the bullet or scar tissue that formed around it. You will want to read your medical records and MRI reports in detail.

Do you drink or smoke? If so, that could add to your nerve pain. Have you been tested for vitamin deficiencies or toxicities which add to nerve pain?

As for your ADD, my teenage son and his father have ADHD so I am quite familiar with it. Your memory issues seem tied to ADD more than your lumbar spine. Both my son and his dad struggle with short term memory which is classic ADHD. They struggle with managing time, procrastination, strong emotions, impulsivity, focus/attention, etc. They both constantly say, “I forgot,” when asked if they did something they said they would do. Have you had a recent psychological evaluation/testing to check how ADD is affecting your functioning and accommodations needed? Are you being medicated for ADD? My son takes methylphenidate (Ritalin) and guanfacine to help with focus/attention and regulate mood. Are you struggling with depression and would you benefit from counseling and/or medication? Do you have family/friends who help and support you?

I

@basenjidad
Continued from previous:

I hope you can get answers and options to help you improve your quality of life. You are too young to not get more options. You should get options for pain management (if spine injections, medications like gabapentin/Cymbalta for nerve pain, physical therapy, pain patches or creams would help with your nerve pain, etc.). Removing the bullet to allow nerves/spinal cord to heal may be the only option to improve your weakness/numbness.

Btw…My autocorrect changed neurogenic claudication to clarification. It sounds like you may have similar symptoms that I had before my surgery.

Just a thought, but have you been checked for lead poisoning? Leaving bullets in the body do have some long term impacts…see a CDC article.
https://www.cdc.gov/mmwr/volumes/66/wr/mm6605a2.htm
Take good care of yourself…you are priceless.

Kindest regards.

Dear @basenjidad
I’m glad with all of YOU! 14 years ago, you had a “bullet lunged”… wow, oh, wow…n for me I had surgury (sp?) a few mths ago. 20 years ago another doctor fixed with the first surgery at the end on my back. Back-then that was great, but sure no more running outside, but started running my bicycle.

Anyway, the recent back, fixed the, same-what, places on my bottom back. Well, losing my pain on my legs and rear-ends go rid of pain. But still my falling or doesn’t the balance is not “normal” of this. I work on my lower body when stretching, rasing (sp?) as much I Ann. It works a little better every 4 mths.

Thx,
Greg D. @greg1956

Thank you for merging and keeping in one location.

My neurologist stated that he was happy with my progression, even reducing my Gabapentin consumption (went from prescribed 4800mg/day down to 300mg/day), however he stated due to the severity. Basically, it could be difficult to specify potential issues, but did allude to the fact there WILL be long-term issues present; onset will depend on my overall health.

Overall, if no further guidance or advice is derived from these discussion boards, I am appreciative for each person, because I have found some uplifting and kind words throughout...its nice to know you are not alone and we are all struggling to do what we can!

@gently Thank you for the suggestion and advice. I have not thought about that in quite a while, I had hoped the future would yield new medical innovation but have not looked into in about 10 years.

I am not sure about the disc or its exact proximity, but I will definitely be mentioning this at the next neurology appointment.

If my doctor proceeds with the MRI, I will most definitely post about it, even if just to help someone else looking for answers.

We never know when what we say will help someone or not, but I can say you've been an encouragement and uplifting to me. I appreciate your kind words!

@vaniag Thank you for your time and the very insightful advice. I don't think I ever considered this, so I will be looking into this too.

Much thanks and appreciation!