Severe spinal stenosis

Posted by gotoandrea @gotoandrea, Oct 5 1:48pm

Severe spinal stenosis in elderly. Tried hydrocodone, spinal injection and not interested in surgery. Currentky taking a blood thinner for atrial fibrillation. What gives you relief?

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@dstone501957

I had tried the Buprenorphine 10 MCG 7-day patch but ended up going back to Hydrocodone 7.5 - 325. I may need to change to Oxycodone 10 Mg soon though. I have what a Radiologist just reported on Cervical MRI on October 10, 2024, as "extremely severe foraminal narrowing (spinal stenosis) on right and left C5-6. I am currently waiting to hear from an Orthopedic Surgeon for a consultation after my Cervical MRI is reviewed. I had previously seen this Orthopedic Surgeon in August 2023, but he did not think surgery was required at that time. I am a 67-year-old male that has been dealing with symptoms that have increased in duration and intensity for the past 18 months

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I have had three neurosurgeons view my cervical mri. All three recommended surgery. My medicare plan disagreed with the three neurosurgeons. As a result , I am on pain management for my cervical. Currently, I take morphine 30mg er two times daily and hydrocodone 10/325 up to five times a day. The meds do not eliminate the pain, but make it tolerable. I just had a reverse total shoulder replacement and that took my mind off the back pain. I am 67 too. I'm just looking for some relief. I've tried injections nerve blocks and two different spine stimulator. Im at a loss on what to do next.

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@koneil

I have had three neurosurgeons view my cervical mri. All three recommended surgery. My medicare plan disagreed with the three neurosurgeons. As a result , I am on pain management for my cervical. Currently, I take morphine 30mg er two times daily and hydrocodone 10/325 up to five times a day. The meds do not eliminate the pain, but make it tolerable. I just had a reverse total shoulder replacement and that took my mind off the back pain. I am 67 too. I'm just looking for some relief. I've tried injections nerve blocks and two different spine stimulator. Im at a loss on what to do next.

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@koneil, you may have a very good medicare advantage plan. Then again, you might want to effect a change during the next three months. Original Medicare is so much better at paying for surgery . You probably could challenge your plan.
Opioids are sometimes necessary but they don't make a good long term plan and you are only 67.
If you do switch or challenge be sure and consider artificial disc replacement https://spinehealth.org/cervical-disc-replacement-procedure/?gad_source=1&gclid=CjwKCAjw1NK4BhAwEiwAVUHPUNpk8svWKsfnpntWRX1r5XfzRtUfqskTR_Mzlzg6cQ_QyZfRAKlk1BoCOTUQAvD_BwE

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@gently

gotoandrea,
no surgeries, would she consider injections. Radiofrequency ablation might help pain related to the spinal nerves. Some get great relief with epidural injections t L4-5, L2-3.
Steroid injections in the SI joints might help. They didn't help me at all.

Mom says that hydrocodone only makes you not care as much that you are in pain. She thinks percodan works better and fentanyl works best of all. Pain buster creme is her topical. It's just a distraction, though.

20 years is a lot of suffering.
Hoping she finds relief.

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I get about 6 weeks from my epidural injections. I am worried if that will make my Osteoporosis worse. I am currently going to PT and a chiropractor. I also get acupuncture in my SI area.

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@koneil

I have had three neurosurgeons view my cervical mri. All three recommended surgery. My medicare plan disagreed with the three neurosurgeons. As a result , I am on pain management for my cervical. Currently, I take morphine 30mg er two times daily and hydrocodone 10/325 up to five times a day. The meds do not eliminate the pain, but make it tolerable. I just had a reverse total shoulder replacement and that took my mind off the back pain. I am 67 too. I'm just looking for some relief. I've tried injections nerve blocks and two different spine stimulator. Im at a loss on what to do next.

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This is not uncommon unfortunately. I’m guessing you’re on an advantage plan or a PPO unfortunately. Contact the physicians and ask them to write a letter and you too need to write a letter to your insurance explaining how bad your situation is. Your insurance is weighing the cost of your medication monthly vs. the much higher cost of surgery and rehab. Don’t take it lying down. Your insurance may have an ombudsman you can speak with also to state your case. And also call your insurance company too and complain.

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@gotoandrea

Has anyone tried fentanyl patches for severe spinal stenosis?

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No but I did try and currently use buprenorphine 20mcg patch every 7 days.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675640/

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@jenatsky

This is not uncommon unfortunately. I’m guessing you’re on an advantage plan or a PPO unfortunately. Contact the physicians and ask them to write a letter and you too need to write a letter to your insurance explaining how bad your situation is. Your insurance is weighing the cost of your medication monthly vs. the much higher cost of surgery and rehab. Don’t take it lying down. Your insurance may have an ombudsman you can speak with also to state your case. And also call your insurance company too and complain.

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Thank you for the advice. I wrote the insurance company and requested the doctors to appeal the the denials . I'm still waiting for an answer. I'm wondering if I should change my medicare advantage plan to a medicare supplement. I have not researched the medicare supplements in my area. I'm wary of the cost and if dental and vision are included. If anyone has any advise on medicare supplement plans I would appreciate the information.
Thank you again for your advice.

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He uses a small instrument since I have Osteoporosis. I also get acupuncture, and go to PT. My main issue now is SI Joint pain.

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@koneil

Thank you for the advice. I wrote the insurance company and requested the doctors to appeal the the denials . I'm still waiting for an answer. I'm wondering if I should change my medicare advantage plan to a medicare supplement. I have not researched the medicare supplements in my area. I'm wary of the cost and if dental and vision are included. If anyone has any advise on medicare supplement plans I would appreciate the information.
Thank you again for your advice.

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If you were on traditional Medicare you wouldn’t have this issue.

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@koneil

Thank you for the advice. I wrote the insurance company and requested the doctors to appeal the the denials . I'm still waiting for an answer. I'm wondering if I should change my medicare advantage plan to a medicare supplement. I have not researched the medicare supplements in my area. I'm wary of the cost and if dental and vision are included. If anyone has any advise on medicare supplement plans I would appreciate the information.
Thank you again for your advice.

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I have original medicare with AARP as secondary. I talked to people in billing offices to canvas the best secondary. My plan name is F, without dental and vision. I pay $230 a month. Call the company and have a rep go over the coverage so you get a plan specific to your needs.

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