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L5S1 Radiculopathy in left foot
I’ve recently been accepted for a medical exam and surgical consult at Mayo on Nov 8 after sending my mri and emg results for review. I’ve been dealing with severe nerve pain in my left foot for 7 weeks now. It had started to get better after second week but emg test made it really fire up. I had a bilateral transforminal steroid injection as week ago now with only minor relief.
Is anyone else dealing with this and how do you cope with waiting weeks to be seen? I haven’t been able to work since it began. I am doing PT and very light chiro with cold laser treatments.
Does this pain ever go away on its own or is surgery the only option? My mri shows my age (45) deterioration but no spinal column compression, minor bulges on l3 and l2 with some l5 forminal narrowing on my right side with no obvious signs of compression. My pain is in my left foot and some minor muscle spasm above the outside of left ankle. What could be causing this and if Mayo is scheduling a surgical consult does that mean they saw something my docs in Des Moines didn’t see and I likely need surgery? If so, how do I keep going like this for another 3 weeks prior to seen? Thank you all!
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@jorgy20 Welcome to Connect, and congratulations on becoming a Mayo patient. What this means is that when the doctors at Mayo reviewed you imaging and records, they saw something that they can help with. Don't worry about that right now because you don't know what type of help they will offer. If it is surgery, know that you will be in very good hands. I came to Mayo as a spine surgical patient and had a cervical fusion there. The level of care and compassion exceeded my expectations and I had great results. Do the best you can on focusing on getting ready for your trip. You may want to rethink seeing a Chiropractor because sometimes that can cause damage to an already compromised spine and perhaps rupture a weakened disc. I wasn't seeing a chiropractor, but all I had to do to rupture my bulging disc was turn my head while I was stretching and it popped.
You're not alone. There are lots of spine patients with similar issues. You need information before your questions can be answered. I know 3 weeks seems like a long time to wait, but that is a short wait time, sometimes patients wait 3 months or more, and in other countries a year or more. It will be here before you know it. What surgeon will be doing your consult? Do you need travel information? Mayo has a free Concierge service that can give you information on accommodations.
You might like this discussion.
Visiting Mayo Clinic-
""What are your accommodation recommendations when coming to Mayo?"
https://connect.mayoclinic.org/discussion/what-are-your-accommodation-recommendations-when-coming-to-mayo/
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3 Reactions@jenniferhunter thank you very much for your response. I can’t express how much it means to me and my family and how fortunate we feel to have been accepted into Mayo. I’ve been assigned to Dr. Mikula for the surgery consult and PA Kadlec as the medical evaluation physician. Medical evaluation in the morning and surgical around noon. If it is surgery, do they do it that day or do we come back? Thank you so very much for your help!
Dain
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1 ReactionJorgy,
I would get a copy of your MRI and go see Dr. Chad Carlson
at Stadia Sports Medicine in Des Moines for a consult.
I think Mayo is good, BUT lumbar surgeries are often
failures, regardless of who does them.
Best,
Doug
Doug, @soby
What is your experience with the people in Des Moines? Thank you,
Dain
I live in Des Moines part-time and I see Carlson for Lumbar problems,
@jorgy20 Dain, I'm sorry I missed your post here, but I was traveling that day. Mayo would likely not be scheduling surgery the same day as your consult. If you were in an emergency situation and transported to the hospital with a substantial spine injury, you could have surgery the same day with a surgeon who is on emergency call that day. You will have your consult, and if they think your best option is surgery, they will schedule it according to the surgeons schedule. It may be in a couple weeks, but that depends on when the doctor is available for planned surgeries and not attending medical conferences, etc. I was looking for the doctor you mentioned, but can't find them. Is that spelling correct for Dr. Mikula?
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2 Reactions@jorgy20 Dain, I did find Dr. Anthony Mikula. He is a 6th year neurosurgery resident at Mayo according to the website.
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1 ReactionThank you @jenniferhunter !!! No worries at all and really appreciate the insight!!
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1 Reaction@jorgy20 Since you are waiting for a diagnosis, and understandably worried about what it might mean, this information may help ease your mind a bit if you can understand what kinds of problems exist and possible solutions. Here are a couple of technical articles about diagnosis lumbar spine problems and other problems that mimic spine problems. Sometimes surgery is needed, and sometimes physical therapy can help without surgery. It just depends on what is wrong.
-"Chronic spinal pain and radiculopathy: Diagnostic approach and common imaging pitfalls"
In this articles he stated "The spinal cord is much more sensitive to compression than the roots."
Posted on May 23, 2021 by Kjetil Larsen
https://mskneurology.com/chronic-spinal-pain-and-radiculopathy-diagnostic-approach-and-common-imaging-pitfalls/
In this section, he describes diagnostic examination for pain similar to what you described, and what it may indicate:
"Approach for spinogenic low back and lower limb pain "
This other article describes symptoms that are not related to spine problems, but that have symptoms that mimic spine problems.
- "How to identify and treat lumbar plexus compression syndrome (LPCS)"
Posted on March 30, 2017 by Kjetil Larsen
https://mskneurology.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/
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2 Reactions@jenniferhunter following up on your comment here. We went up to Mayo and neither person I met with saw anything in my mri where they would offer surgery. So they referred me to neurology. So waited a week and came back up to get the suggestion it might be plantar fasciitis…. I saw my podiatrist the next day and she could not believe that was even suggested…. It’s not. It’s nerve pain and follows the L5S1 nerve root. I let the Nero know and they referred me back to surgery. Surgery in our meeting said no need to try injections again as they didn’t believe it was back related pain. Now they say to shoot the nerves again apparently. Met the injection doc today and he can’t believe this was mayo’s response either.
While I’m glad it’s not something like a neurological disorder, I know what I’m feeling and I know the answer is not to pump me full of gabapentin and hope it goes away (as the Mayo surgeon suggested sometimes these just go away) but no idea if in a year or two or tomorrow….
I went to NE Spine as it is the group my alma mater uses and they really couldn’t believe the Mayo response either. Yes my mri isn’t horrible, but it’s not great either. There’s also more to looking at a picture. My symptoms largely go away when I lay down on my back. Mri was taken from on my back. It fires up when I stand and when I sit (when my foramen are under pressure) and I have significant weakness in my leg with a lot of muscle mass lost and stretching my legs can cause serious shooting pain. They suggested it’s foramen narrowing. Suggested an ALIF L5S1. A doc in iowa and in Nebraska suggested Mayo won’t operate if they don’t see it as textbook in the imaging. So now, based on my experience, why they even accepted me up there in the first place?
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