Need Help

[Guest guest]

Hi Guys,

Thank you all for your advice and support. I do have a call in to my

pcp for another referral and if he doesn't have anyone he really

likes, I'm going to contact Dr. Don in Statesville. I got some really

practical ideas from your responses and I appreciate those and your

suport. I never did the insurance fight with the MGB because it was

an exclusion and it was one strike and I was out so I was private pay.

I'm ready to take them on now. I may be calling on you all again

since I am new to the insurance fight. Well, not really but that's OT

so I won't go in to it. And of course I have Cigna, the world's most

difficult insurance company. I campaigned in every way I knew how to

get my employer to change companies when the contract was renewed in

the spring but the almighty dolloar won. It was really out of all our

hands. Sorry, I'm going on and on but thanks again. Hugs, Beverly in

NC

P.S. , No, I would never ask the ps to falsify his record. I

just wanted to talk to him about changing the estimate and writing

another letter for me for the appeal. By changing the number, I mean

actually take more tissue. I don't care if I end up an A. I was a C

in the eighth grade. I've had this problem long enough. Thanks for

your help.

[Guest guest]

Hi,

The correct answer would be:

weight (in lb) x adult dose / 150 (avg wt of adult) = child's dose

In all honesty, this rule as well as Young's rule is not really that

effective when dosing for children. Today in the real world of

medicine, we use more specific pertinent information, such as

children's dose per body weight (kg). If we were wanting to get even

more specific, we would use body surface area (BSA) in dosing as well

as pharmacokinetic parameters such as lab values and organ function.

But, for some reason, everyone is interested in both 's and

Young's Rule. Does anyone know about Cowling's Rule or Fried's Rule?

Yes these both exist and yes they do deal with dosing.

Respectfully,

Joe Medina, CPhT

------------

I've seen in the file section clark's rule as weight x adultdose

divided by 150 and in another litrature as weight x adultdose divide

by weight plus 150,which one is right?

when I got a problem which ask about whether the dose is safe,which

is having both age and weight of the child I can use both young as

well as clark's rule.But let's say the result on both cases is

different.one lessthan the given dose and the other greater than

that which eventually lead to the dose is safe in one case and is

not safe in another .So how could I solve this kind of proble

[Guest guest]

Hi Joe-

Here's what I've found:

Frieds Rule:(used for children < 1 year old)

Adult dose X childs age in months/150

Cowlings Rule: age of child at next birthday/24 X adult dose

Will you please confirm, Joe?

Thanks,

Dora

[Guest guest]

Hi Dora,

Well done. Now what about Joe's Rule?

Respectfully,

Joe Medina, CPhT

--------------

Hi Joe-

Here's what I've found:

Frieds Rule:(used for children < 1 year old)

Adult dose X childs age in months/150

Cowlings Rule: age of child at next birthday/24 X adult dose

Will you please confirm, Joe?

Thanks,

Dora

[Guest guest]

Dear Students,

I have had a Tutorial on Pediatric Math on this site since 10-27-02.

In there I also entertain the question of which is safe and which is

not to use. The following is an excerpt of what I have included or

written in this Tutorial.

" " -Because all of the information is given in this problem we MUST

try each of the three methods/formulas. If two out of the three say

NO it is UNSAFE then we must not dispense this amount. However in the

case where one of the formula or method shows that the amount is too

high, yet the two remaining show it is okay, it would be acceptable

to give the ordered dose if and only if the child was being

constantly monitored professionally. If however the child could be

started on the lower dose this would be the safest method of

administration. " "

While I agree with Joe that there are BETTER ways of Pediatric

Dosing (BSA formula etc.,) the questions remains WHY is this being

studied. For some reason many of the study guides for pharmacy tech

and pharmacy tech math manuals will discuss this math. Perhaps the

questions are asked on the PTCB exam. Since I have not taken the exam

since l996 and because I am not, nor is anyone else, allowed to

discuss it specifically, I can only assume that it is still on the

exam.

If that is the case then one must study the rules and be prepared for

such a math problem.

And for the record I do have Fried's Rule on my site in the Tutorial.

However I do not know of Cowling's Rule, but then again I am not a

pharmacist. I will also say that given the scenario of not knowing

which answer to use, other than a math problem where I had to choose,

the correct answer would be: " As a pharmacy technician I will discuss

and seek the advice and directive of the pharmacist " . Since in a math

problem this would not be an option I added the above information in

my Tutorial on Pediatric Math.

Respectfully,

Educator

Jeanetta Mastron CPhT BS Chemistry

Founder/Owner

-- In , " Joe Medina "

<techlectures@e...> wrote:

> Hi,

>

> The correct answer would be:

>

> weight (in lb) x adult dose / 150 (avg wt of adult) = child's dose

>

> In all honesty, this rule as well as Young's rule is not really

that

> effective when dosing for children. Today in the real world of

> medicine, we use more specific pertinent information, such as

> children's dose per body weight (kg). If we were wanting to get

even

> more specific, we would use body surface area (BSA) in dosing as

well

> as pharmacokinetic parameters such as lab values and organ

function.

>

> But, for some reason, everyone is interested in both 's and

> Young's Rule. Does anyone know about Cowling's Rule or Fried's

Rule?

>

> Yes these both exist and yes they do deal with dosing.

>

> Respectfully,

>

> Joe Medina, CPhT

>

>

> ------------

> I've seen in the file section clark's rule as weight x adultdose

> divided by 150 and in another litrature as weight x adultdose

divide

> by weight plus 150,which one is right?

>

> when I got a problem which ask about whether the dose is safe,which

> is having both age and weight of the child I can use both young as

> well as clark's rule.But let's say the result on both cases is

> different.one lessthan the given dose and the other greater than

> that which eventually lead to the dose is safe in one case and is

> not safe in another .So how could I solve this kind of proble

[Guest guest]

Others will likely have some good advice, but what I would suggest is present your scoli doctor with a diary or list of regular normal activities and what you can and cannot do, how long it takes you to do these activities, if you need aids to do these activities. In other words, how this is affecting your life. Have others who really know you write a letter or go with you to explain how this affects your life and your relationships. Ask the doctor how many revision surgeries he has done. Also, mention the fact that you have been in touch with others in the same situation/condition. In other words, let him know that you are educated enough to know that it is not in your head and there are things that can be done. You have a right to good quality care and he has the responsibility to give you that care, if not legally, then definitely morally.

Since you mentioned that he mainly does original surgery and he is not willing to help, then ask who deals with adult scoliosis with expertise in revision surgery. He might feel more comfortable in referring you to someone that you need. That's my two cents worth.

Llweyn in BC

-----Original Message-----From: attlinda [mailto:attlinda@...]Sent: July 14, 2003 5:01 PM Subject: Need Help

Hi Everyone, I have a doctor's appointment next Monday with my scoliosis specialist. I will give a bit of background for new folks who may not have read all the posts. I had original surgery with harrington rod in 1975 fused from T-4 to L-5. Because of pain in upper back had 2nd surgery around 1987 (I think) to take out harrington rod. Bone had grown so around it that it could not be removed so they cut the tip off and took out the hook. Continued to have upper back pain some chest pain where the ribs and sternum connect. Learned to live with it. Diagnosed with fibromyalgia by family doctor shortly after. Lived pretty normal life after I learned to deal with it all. Past few years have had much lower back pain also. Finally went to the scoli doc again in May of 2002. He X-rayed me said the discs below the fusion are deteriorating. Spent about 15 minutes with me and told me to exercise and live with it. The past year I have been in pain a lot. When I can exercise it does make me feel much better, but so much of the time I can't exercise. Sometimes it is so bad I can't walk around the block. Did tonight, but with much pain. Missed about 4 days of work last month because of back pain. Finally couldn't take it anymore so went to the family doctor. He gave me muscle relaxers and anti- inflammatory pills. As long as I layed around a lot and took the pills I was getting better, but as soon as I went back to work I started much pain all over again. I am basically getting through the day and coming home and laying down for the evening. My family doctor thought I should go back to the scoli specialist again so now I have an appointment Monday. When I stand up it takes about 10 minutes for me to be able to stand up straight and then I am not really straight, but straight enough to look pretty normal. Here's where I need your help. I am so afraid this visit will just be wasted again. What do I need to ask or do to let him know exactly how I feel? What should I expect out of this visit? I really feel like I need some help. I live in a small town in South Carolina. I travel about 1 hour into Charlotte, NC for this visit. The doctor I am seeing is Dr. Craig Brigham at the Clinic. He did my 2nd surgery. He is listed on the Scoliosis Research Society. He does original scoliosis surgerys and his nurse said he had done some revisions, but she didn't know how many. If you have deteriorating disc's and the trouble standing up does this necessarily mean you have flat back? I really do not know what to do. Please, if you have any advice for me, I would welcome it. Thank you all in advance for your help. EagleSupport for scoliosis-surgery veterans with Harrington Rod Malalignment Syndrome. Not medical advice. Group does not control ads or endorse any advertised products.

[Guest guest]

Hello ,

Welcome to the group and I'm so glad you found us! There is nothing

worse than a doctor telling you to live with the pain! Life with

harrington rods is no party and I'm continually shocked to hear of

spine doctors who take the " live with it " approach! I went to my

original surgeon and 2 others that told me the same thing and I

limped along for several years until I found this group!

I had my 2 harrington rods out April 16, 2003 in Plano, Texas and

almost all my paralyzing pain between my shoulder blades is gone! I

have neck issues I am still dealing with, but I am doing so much

better! My rods were both encased in bone and my surgeon basically

chiseled them out along with nerve filled bursitis that had wrapped

around all my hardware. I'm confused by those who have said they

were unable to get them out because my revision surgeon said he has

never been " unable " to get harrington rods out. Certainly, there

could be individual situations that could complicate removal, but

generally it is my understanding that they can come out. Mind you,

many folks that have HARMS have no need to get their harrington rods

out because they are not bothering them (they are having posture

issues, not bursitis), but I had bursitis and crippling pain coming

directly from the rods. I think others can comment more

specifically, but I think most harrington rods come out during

revision surgery. Our moderator, , still has hers after

revision though. There was no guarantee going into surgery that

this would take care of my pain, but my surgeon (and three others I

saw) felt this was my best shot at pain relief. I'm thrilled at 3

months out!

I am only fused to L2, so I do not have the lower back issues (yet!)

and flatback or HARMS so please just take my story as that. I am

out of balance in my upper back (harrington rods over flatened my

upper thorasic region throwing my neck out of balance). I only

had rod removal, not revision surgery. I could never suggest that

having your rods removed would be the answer for you, I just don't

understand why they could not remove them just because they were

encased in bone. Could there have been other issues that led your

doctor to not remove them once he was inside? You might want to

request your doctor's notes from both surgeries. I found a wealth

of information in mine that my doc never told me!

I hope that you can see at least two " revision surgeons " to review

your case. Dr. LaGrone in Amarillo (one of four I saw) will allow

you to mail your x-rays for review. He will send you a letter and

let you know if he thinks he can help you.

Also, please search our archives. They are available from the main

page. There is so much information archived on this site and it is

hard for many of us to repeat our stories over and over. Good

search words could be " revision surgery " " harrington rod removal "

and " revision surgeons " . You can even reply to an archived letter

to ask someone about their specific message.

I wish you the best and you are not along and certainly do not have

to just " live with the pain " !

M. in Waco

wrote:

> surgery around 1987 (I think) to take out harrington rod. Bone had

> grown so around it that it could not be removed so they cut the

tip

> off and took out the hook. Continued to have upper back pain some

> chest pain where the ribs and sternum connect. Learned to live

with

> it. Diagnosed with fibromyalgia by family doctor shortly after.

[Guest guest]

> If you have deteriorating

> disc's and the trouble standing up does this necessarily mean you

> have flat back?

Hi ,

As always, this is not medical advice but suggestions based on my

(and mine alone) experience with disc degeneration. Your milage may

vary...

I understand your issues. Disc degeneration is very painful.

Flatback and disc deterioration are two separate things. You can

have one without the other, but, of course, it is possible to have

them together. (My first scoli surgeon told me that the discs above

and below my fusion would deteriorate because they are taking the

daily pounding that the fused area would be taking.)

I was originally fused from T4-L4. The discs between L4 and S1

deteriorated resulting in problems much like yours. I addressed the

issue by fusing from L3-S1 (L3-L4 done again because of some non-

fusion).

My situation is different from yours. My family doc admits that

my back (after even the first fusion, much less two) is more than he

is qualified to handle. He has no problem giving referals to scoli

specialists. He does, on the other hand, help with basic pain

management. (I found that I do better now with daily Vioxx and

occasional Vicodin which he is willing to prescribe.)

As for how to approach the doctors, hmmmm. (I've never had one

tell me to learn to live with my pain with the exception of possible

arthritis in the spine.) This will take more than one paragraph :-)

I didn't do this deliberatly, but it turned out that when I

talked to my ortho, it was about " quality of life " issues. For

example, I wanted to be able to work, I didn't want to live my life

on pills, I wanted to be able to be somewhat active, I wanted to be

able to do things with my family, I wanted to be able to walk more

than 100 feet, ... You get the idea. Also, if the meds you're

taking aren't working, add that to your list of things to mention to

your doc. (Pain meds, or lack of them, affect your quality of life.)

My ortho also sent me to a pain management doctor before he fused

me. (This might be a possibility for you.) The meds the pain doc

gave me worked to some extent, but didn't allow me to perform my job

as a programmer. They left me without much concentration and short-

term memory. --> But the main thing that the pain management doc

did was diagnose the cause of my back pain. <-- He used several

diagnostics (cortisone, discogram, etc.).

There are also personal considerations. If you have to work,

being unable to stand affects your abiltiy to provide. It also

affects your ability to care for your family. This is true even if

you don't have a spouse or kids. You have to have the ability to

take care of yourself!

Mention what you've tried, what works, and what doesn't. If

you've tried all the non-invasive stuff (PT, anti-inflamitories,

muscle relaxers, etc.), tell him/her that. Then ask " what's the

next step? " If there isn't a next step, you either have to live

with it (not too pleasant) or get another doc who's willing to treat

you more aggressively. (I don't know what your insurance situation

is, or even if its possible for you to see another family doc or

specialist.)

[Guest guest]

- after having additional fusion to S1, did you feel more limited in

movement than before? I also am fused T4 to L4 and have disc degeneration

and possible flatback (am investigating). My feeling has been that if I

were to fuse even more, all that would bend is my elbows and my knees!! I

am very active and am 36 with 3 young boys, so daily pain is interfering

with my ability to do all I want to do, and I don't have much luck with painkillers

during the day.

I know every case is different. but in your case, are you happy with your

decision to fuse to S1, and did you consider or try other options?? I have

tried the injections, pain meds. anti inflammatories and muscle relaxers,

also pt and chiro. Do NOT want to make myself sorse, but would like to

take action, if necessary, while I am younger and in better shape. Thanks

-

scott_blackledge wrote:

> If you have deteriorating

> disc's and the trouble standing up does this necessarily mean you

> have flat back?

Hi ,

As always, this is not medical advice but suggestions based on my

(and mine alone) experience with disc degeneration. Your milage may

vary...

I understand your issues. Disc degeneration is very painful.

Flatback and disc deterioration are two separate things. You can

have one without the other, but, of course, it is possible to have

them together. (My first scoli surgeon told me that the discs above

and below my fusion would deteriorate because they are taking the

daily pounding that the fused area would be taking.)

I was originally fused from T4-L4. The discs between L4 and S1

deteriorated resulting in problems much like yours. I addressed the

issue by fusing from L3-S1 (L3-L4 done again because of some non-

fusion).

My situation is different from yours. My family doc admits that

my back (after even the first fusion, much less two) is more than he

is qualified to handle. He has no problem giving referals to scoli

specialists. He does, on the other hand, help with basic pain

management. (I found that I do better now with daily Vioxx and

occasional Vicodin which he is willing to prescribe.)

As for how to approach the doctors, hmmmm. (I've never had one

tell me to learn to live with my pain with the exception of possible

arthritis in the spine.) This will take more than one paragraph :-)

I didn't do this deliberatly, but it turned out that when I

talked to my ortho, it was about "quality of life" issues. For

example, I wanted to be able to work, I didn't want to live my life

on pills, I wanted to be able to be somewhat active, I wanted to be

able to do things with my family, I wanted to be able to walk more

than 100 feet, ... You get the idea. Also, if the meds you're

taking aren't working, add that to your list of things to mention to

your doc. (Pain meds, or lack of them, affect your quality of life.)

My ortho also sent me to a pain management doctor before he fused

me. (This might be a possibility for you.) The meds the pain doc

gave me worked to some extent, but didn't allow me to perform my job

as a programmer. They left me without much concentration and short-

term memory. --> But the main thing that the pain management doc

did was diagnose the cause of my back pain. <-- He used several

diagnostics (cortisone, discogram, etc.).

There are also personal considerations. If you have to work,

being unable to stand affects your abiltiy to provide. It also

affects your ability to care for your family. This is true even if

you don't have a spouse or kids. You have to have the ability to

take care of yourself!

Mention what you've tried, what works, and what doesn't. If

you've tried all the non-invasive stuff (PT, anti-inflamitories,

muscle relaxers, etc.), tell him/her that. Then ask "what's the

next step?" If there isn't a next step, you either have to live

with it (not too pleasant) or get another doc who's willing to treat

you more aggressively. (I don't know what your insurance situation

is, or even if its possible for you to see another family doc or

specialist.)

Support for scoliosis-surgery veterans with Harrington Rod Malalignment

Syndrome. Not medical advice. Group does not control ads or endorse any advertised

products.

[Guest guest]

> One thing that struck me was he felt that people who have fusion

to the sacrum really don't have a great deal less mobility than

those who are fused to L4, like I am - can you guys who are fused

please let me know the real life version of that? I know Elaina was

talking about not being able to reach her toenails anymore - now

that's the kind of down and dirty I'm talking about!

Dannelle, is the following what you want? I'm not really organized

for the following couple of paragraphs, but...

Depends on what the doc is imagining you doing when he uses the

word " mobility " and what he means by " great deal of. " I've been

fused to S1 like many on this list. My particulars are probably

different from others. I think that you'll be surprised in the

everyday stuff you do that requires L4-S1 bending.

I've found that I have problems reaching my rear from the back in

the shower and, ahem, other places. This is solved by going through

the front side (hope this isn't " too much information " ). I've found

that my walking gait is different, more awkward. I feel more strain

in the hips when walking. Anything requiring bending backward

(something as simple as looking up) or side-to-side is somewhere

between difficult and impossible. Making a simple basketball layup

is very difficult. Taking walks over a couple of miles is tiring,

as is being upright for a long time.

I'm not exactly sure where I'm going on this paragraph, but on the

plus side, I can reach anywhere on my legs, toes included. I don't

play sports anymore but most of what's remaining in my life is

possible. I've been told not to lift more than 40 lbs. As a

practical matter, I max out at less than that. But I don't need to

do more than that to live a reasonable life. I can bump a

volleyball back and forth with the kids if their passing is somewhat

accurate. I was able to get on a ladder the other day to install a

section of rain gutter. In spite of what I wrote earlier, walking

is both possible and enjoyable.

I'm sure that others will give more examples of what you can and

can't do.

------------

[Guest guest]

> > With the deterioration,

> > did you have trouble standing up straight? I don't

> > have the pain down my leg like most have with this, at

> > least not yet, but I do have quite a bit of numbness

> > in my legs and feet, and my legs feel sore a lot. Most

> > of the pain is in my back and hips.

>

> I don't remember standing being an issue. Sitting was much more a

> problem. Going from sitting to standing was also difficult. I

> didn't have numbness or pain down the leg. I did feel a strong

ache

> in the right side of the groin, kind of like the after effects of

> being kicked there. These went away after awhile. The symptoms

> that lasted all the way to surgery were very strong " aches " in the

> front and back.

I forgot all about lying on my back. This was the *worst*. If I

was ever on my back, I had to keep my knees bent. I slept with a

rolled up quilt under my knees.

[Guest guest]

Hi ,

Sorry for taking so long to reply.

> - after having additional fusion to S1, did you feel more

limited

> in movement than before? I also am fused T4 to L4 and have disc

> degeneration and possible flatback (am investigating). My feeling

has

> been that if I were to fuse even more, all that would bend is my

elbows

> and my knees!!

I'm guessing that you notice some difference between the " unfused

you " and the " fused you " but not *that* much. When fused to S1,

you'll notice a much bigger difference. You will be surprised how

much you use those last two joints. But you will be functional.

I'm finding that as long as stuff is more or less in front of me, I

can do what I need to do.

See msg 1208 in this list's archive.

> I am very active and am 36 with 3 young boys, so daily

> pain is interfering with my ability to do all I want to do, and I

don't

> have much luck with painkillers during the day.

>

> I know every case is different. but in your case, are you happy

with

> your decision to fuse to S1, and did you consider or try other

options??

I have two kids myself. They were 8 and 6 when I had my first

fusion.

I tried PT, pain meds, cortisone, and anti-inflamatories, but they

didn't work at all. (I did not try facet blocks.) I'm an engineer

and have that " fix the durn problem " attitude. Probably because of

that, I can't see getting temporary solutions. This may be what

makes me more comfortable with surgery than alternative treatments.

(Actually, cortisone worked extremely well with pain from a bulging

disc in the cervical area but that's a bit off-topic.) The ironic

thing is that, as we all know, surgery hasn't really " fixed "

anything.

(Everybody, all together now --> " Scoliosis Sucks! " )

I do believe I made the right decision. Are things great? No. But

they are much better than they were. I just can't do a lot of

activities that I would like. Fortunately, I have enough life

experience that I don't want/need to do many of those things that I

can't do anymore.

> I have tried the injections, pain meds. anti inflammatories and

muscle

> relaxers, also pt and chiro. Do NOT want to make myself worse,

but

> would like to take action, if necessary, while I am younger and in

> better shape.

If you have more questions that you think I can help with, ask away!

[Guest guest]

Many thanks, , for your help.

scott_blackledge wrote:

Hi ,

Sorry for taking so long to reply.

> - after having additional fusion to S1, did you feel more

limited

> in movement than before? I also am fused T4 to L4 and have disc

> degeneration and possible flatback (am investigating). My feeling

has

> been that if I were to fuse even more, all that would bend is my

elbows

> and my knees!!

I'm guessing that you notice some difference between the "unfused

you" and the "fused you" but not *that* much. When fused to S1,

you'll notice a much bigger difference. You will be surprised how

much you use those last two joints. But you will be functional.

I'm finding that as long as stuff is more or less in front of me, I

can do what I need to do.

See msg 1208 in this list's archive.

> I am very active and am 36 with 3 young boys, so daily

> pain is interfering with my ability to do all I want to do, and I

don't

> have much luck with painkillers during the day.

>

> I know every case is different. but in your case, are you happy

with

> your decision to fuse to S1, and did you consider or try other

options??

I have two kids myself. They were 8 and 6 when I had my first

fusion.

I tried PT, pain meds, cortisone, and anti-inflamatories, but they

didn't work at all. (I did not try facet blocks.) I'm an engineer

and have that "fix the durn problem" attitude. Probably because of

that, I can't see getting temporary solutions. This may be what

makes me more comfortable with surgery than alternative treatments.

(Actually, cortisone worked extremely well with pain from a bulging

disc in the cervical area but that's a bit off-topic.) The ironic

thing is that, as we all know, surgery hasn't really "fixed"

anything.

(Everybody, all together now --> "Scoliosis Sucks!")

I do believe I made the right decision. Are things great? No. But

they are much better than they were. I just can't do a lot of

activities that I would like. Fortunately, I have enough life

experience that I don't want/need to do many of those things that I

can't do anymore.

> I have tried the injections, pain meds. anti inflammatories and

muscle

> relaxers, also pt and chiro. Do NOT want to make myself worse,

but

> would like to take action, if necessary, while I am younger and in

> better shape.

If you have more questions that you think I can help with, ask away!

Support for scoliosis-surgery veterans with Harrington Rod Malalignment

Syndrome. Not medical advice. Group does not control ads or endorse any advertised

products.

[Guest guest]

,

Just read your posting to and if you don't mind my 2 cents...I just had anterior posterior fusion with the fusion extended from L4-5 to L5-S1. After the surgery, I thought it was really going to affect my mobility a lot but after a really good physical therapist and lots of hamstring stretches, I really don't notice much difference. I can still almost touch my toes but just bend at the hips like I used to anyway. The only problem I continue to have (AND MALES, EXCUSE THE GRAPHIC FEMALE STUFF. JUST DON'T READ THE REST OF THE POST IF YOU DON'T WANT TO KNOW! )

is reaching to use tampons! I am finally figuring out how to squirm around to work it all but that has been the most frustrating thing; and what doc is going to tell you that!

Please feel free to email me at dbanner@...

Banner-Lach, RN, CCM, RN-WCCMNurse Case ManagerFirst Rehabilitation Resources, Inc.

Re: Re: Need Help

- after having additional fusion to S1, did you feel more limited in movement than before? I also am fused T4 to L4 and have disc degeneration and possible flatback (am investigating). My feeling has been that if I were to fuse even more, all that would bend is my elbows and my knees!! I am very active and am 36 with 3 young boys, so daily pain is interfering with my ability to do all I want to do, and I don't have much luck with painkillers during the day.I know every case is different. but in your case, are you happy with your decision to fuse to S1, and did you consider or try other options?? I have tried the injections, pain meds. anti inflammatories and muscle relaxers, also pt and chiro. Do NOT want to make myself sorse, but would like to take action, if necessary, while I am younger and in better shape. Thanks - scott_blackledge wrote:

> If you have deteriorating > disc's and the trouble standing up does this necessarily mean you > have flat back?Hi , As always, this is not medical advice but suggestions based on my (and mine alone) experience with disc degeneration. Your milage may vary... I understand your issues. Disc degeneration is very painful. Flatback and disc deterioration are two separate things. You can have one without the other, but, of course, it is possible to have them together. (My first scoli surgeon told me that the discs above and below my fusion would deteriorate because they are taking the daily pounding that the fused area would be taking.) I was originally fused from T4-L4. The discs between L4 and S1 deteriorated resulting in problems much like yours. I addressed the issue by fusing from L3-S1 (L3-L4 done again because of some non-fusion). My situation is different from yours. My family doc admits that my back (after even the first fusion, much less two) is more than he is qualified to handle. He has no problem giving referals to scoli specialists. He does, on the other hand, help with basic pain management. (I found that I do better now with daily Vioxx and occasional Vicodin which he is willing to prescribe.) As for how to approach the doctors, hmmmm. (I've never had one tell me to learn to live with my pain with the exception of possible arthritis in the spine.) This will take more than one paragraph :-) I didn't do this deliberatly, but it turned out that when I talked to my ortho, it was about "quality of life" issues. For example, I wanted to be able to work, I didn't want to live my life on pills, I wanted to be able to be somewhat active, I wanted to be able to do things with my family, I wanted to be able to walk more than 100 feet, ... You get the idea. Also, if the meds you're taking aren't working, add that to your list of things to mention to your doc. (Pain meds, or lack of them, affect your quality of life.) My ortho also sent me to a pain management doctor before he fused me. (This might be a possibility for you.) The meds the pain doc gave me worked to some extent, but didn't allow me to perform my job as a programmer. They left me without much concentration and short-term memory. --> But the main thing that the pain management doc did was diagnose the cause of my back pain. <-- He used several diagnostics (cortisone, discogram, etc.). There are also personal considerations. If you have to work, being unable to stand affects your abiltiy to provide. It also affects your ability to care for your family. This is true even if you don't have a spouse or kids. You have to have the ability to take care of yourself! Mention what you've tried, what works, and what doesn't. If you've tried all the non-invasive stuff (PT, anti-inflamitories, muscle relaxers, etc.), tell him/her that. Then ask "what's the next step?" If there isn't a next step, you either have to live with it (not too pleasant) or get another doc who's willing to treat you more aggressively. (I don't know what your insurance situation is, or even if its possible for you to see another family doc or specialist.)Support for scoliosis-surgery veterans with Harrington Rod Malalignment Syndrome. Not medical advice. Group does not control ads or endorse any advertised products.

[Guest guest]

,

You need a new specialist who can diagnose your spinal problem or problems.

It sounds as if your family doctor means well but probably is not up to date on the long-term effects of the Harrington rod.

Your scoliosis specialist is apparently geared primarily toward first-time scoliosis corrections. If he made mistakes in his approach to your own Harrington rod (when initially intending to remove it), he does not seem interested in knowing about this or perhaps in acknowledging it to you if he does realize the shortcomings of his procedure at that time.

You are headed for more trouble with this scoliosis specialist, it seems to me, if you persist in trying to get him to respond.

Sadly, some surgeons simply can not or do not acknowlege problems with older surgeries and try to shift the blame somehow, often to the patient, either directly or subtlely.

Worse yet, this particular specialist might eventually volunteer to operate on you again. I think you need someone more experienced and specialized. Few of us ended up having revision surgery with the surgeons who operated on us previously. For the most part, these are two distinct groups within the scoliosis fraternity (or, in the case of revision surgery, sometimes a bit outside that fraternity, i.e., in an occasional academic neurosurgery practice).

In 1987, problems related to the Harrington rod had not been fully elucidated and revision surgeries were rare if they were done at all. It is clear that your own surgery was not definitive over the long term. It also sounds as if there was no attempt to redo part of the fusion. When you have HARMS (flatback) -- not that I am clear whether you have this, and you have not had a diagnosis as yet -- the key issue is not whether you remove the rod or leave it in place. There are successful revision procedures incorporating both approaches. My own spine has been radically restructured via massive anterior and posterior revision surgery, with new hardware attached to my old Harrington rod.

I don't know what your monetary or insurance constraints may be -- my own were formidable, and looking back, it is almost miraculous that I found the means to get myself to a revision surgeon 1,000 miles from home -- but if it is at all possible, I think you should try to get help from a new and experienced revision surgeon. I do not know offhand who might be the most geographically desirable revision specialist for you, but I expect that others at this list can help with suggestions.

You deserve and need to know the hard data as to how many revisions a given surgeon has done, how often he currently does revisions, etc. And please be sure that the nurse and you are defining "revision" the same way. Perhaps you should get a hard diagnosis first. Do you have fixed sagittal imbalance? Do you have some other long-term problem related to hardware? What is the nature and extent of disk damage, and which disks are involved? Once you know the problem for sure, you can start to inquire how much experience a surgeon may have in dealing with such problems. Make sure he is a seasoned revision specialist, not someone who intends to gain more initial revision surgery experience via your own back!

Especially if your problem is Harrington Rod Malalignment, commonly referred to as flatback syndrome or fixed sagittal imbalance, please, please try and get to someone who is prepared to take your situation seriously and discuss all available treatment options with you!

RE: Need Help

Others will likely have some good advice, but what I would suggest is present your scoli doctor with a diary or list of regular normal activities and what you can and cannot do, how long it takes you to do these activities, if you need aids to do these activities. In other words, how this is affecting your life. Have others who really know you write a letter or go with you to explain how this affects your life and your relationships. Ask the doctor how many revision surgeries he has done. Also, mention the fact that you have been in touch with others in the same situation/condition. In other words, let him know that you are educated enough to know that it is not in your head and there are things that can be done. You have a right to good quality care and he has the responsibility to give you that care, if not legally, then definitely morally.

Since you mentioned that he mainly does original surgery and he is not willing to help, then ask who deals with adult scoliosis with expertise in revision surgery. He might feel more comfortable in referring you to someone that you need. That's my two cents worth.

Llweyn in BC

-----Original Message-----From: attlinda [mailto:attlinda@...]Sent: July 14, 2003 5:01 PM Subject: Need Help

Hi Everyone, I have a doctor's appointment next Monday with my scoliosis specialist. I will give a bit of background for new folks who may not have read all the posts. I had original surgery with harrington rod in 1975 fused from T-4 to L-5. Because of pain in upper back had 2nd surgery around 1987 (I think) to take out harrington rod. Bone had grown so around it that it could not be removed so they cut the tip off and took out the hook. Continued to have upper back pain some chest pain where the ribs and sternum connect. Learned to live with it. Diagnosed with fibromyalgia by family doctor shortly after. Lived pretty normal life after I learned to deal with it all. Past few years have had much lower back pain also. Finally went to the scoli doc again in May of 2002. He X-rayed me said the discs below the fusion are deteriorating. Spent about 15 minutes with me and told me to exercise and live with it. The past year I have been in pain a lot. When I can exercise it does make me feel much better, but so much of the time I can't exercise. Sometimes it is so bad I can't walk around the block. Did tonight, but with much pain. Missed about 4 days of work last month because of back pain. Finally couldn't take it anymore so went to the family doctor. He gave me muscle relaxers and anti- inflammatory pills. As long as I layed around a lot and took the pills I was getting better, but as soon as I went back to work I started much pain all over again. I am basically getting through the day and coming home and laying down for the evening. My family doctor thought I should go back to the scoli specialist again so now I have an appointment Monday. When I stand up it takes about 10 minutes for me to be able to stand up straight and then I am not really straight, but straight enough to look pretty normal. Here's where I need your help. I am so afraid this visit will just be wasted again. What do I need to ask or do to let him know exactly how I feel? What should I expect out of this visit? I really feel like I need some help. I live in a small town in South Carolina. I travel about 1 hour into Charlotte, NC for this visit. The doctor I am seeing is Dr. Craig Brigham at the Clinic. He did my 2nd surgery. He is listed on the Scoliosis Research Society. He does original scoliosis surgerys and his nurse said he had done some revisions, but she didn't know how many. If you have deteriorating disc's and the trouble standing up does this necessarily mean you have flat back? I really do not know what to do. Please, if you have any advice for me, I would welcome it. Thank you all in advance for your help. EagleSupport for scoliosis-surgery veterans with Harrington Rod Malalignment Syndrome. Not medical advice. Group does not control ads or endorse any advertised products.

[Guest guest]

Marilyn,

Have you gone to , then at the top, you can click on "My Groups" and then "Edit My Groups" where you can either leave the group or select No e-mails? If you forgot your password and/or ID, you click on "Sign-in problems page" where you provide basic information like your birthday and ZIP that you used when you first joined. If you are still having problems, then you might want to contact AOL for any differences, since I use Internet Explorer and cable-connection (LAN). I'm sorry to see you go but I understand with your upcoming surgery. I hope you will come back and give us an update when you are able. Good Luck and I wish you the best.

Llweyn in BC

-----Original Message-----From: mjkeit@... [mailto:mjkeit@...]Sent: July 21, 2003 8:07 PM Subject: Need helpI am very frustrated that my computer won't work like all of yours do.I don't have anything that says leave group. What is the e-mail address for the ? When I joined I don't even remember what password or name I used. Also when I put in your address there is only black letters on the left and right and I can't double click any of them. I can't get into links, chat, data base, photo, members or calendar. It does nothing when I double click. I have never found anything about when I go on vacation to even have a vacation stop. On the right side it says group info and then group settings. I can't double click. Once I think I quit so I would not receive so many e-mails so now I don't think I am a member but I still receive the e-mails. I may have to resort to changing my e-mail name. I love to read in the archives but not the daily. I think all of you are great but with my upcoming surgery I just have to have a vacation stop.Thanks,Marilyn Support for scoliosis-surgery veterans with Harrington Rod Malalignment Syndrome. Not medical advice. Group does not control ads or endorse any advertised products.

[Guest guest]

I'm so sorry you've been having all this trouble.

Elissa has helped me out with my own computer-Internet complexities. I am going to forward this to her (in case she has not gotten to the "feisty" posts yet), in hopes that she can come to your rescue!

I'm so glad you did not intend to leave the list.

Need help

I am very frustrated that my computer won't work like all of yours do.I don't have anything that says leave group. What is the e-mail address for the ? When I joined I don't even remember what password or name I used. Also when I put in your address there is only black letters on the left and right and I can't double click any of them. I can't get into links, chat, data base, photo, members or calendar. It does nothing when I double click. I have never found anything about when I go on vacation to even have a vacation stop. On the right side it says group info and then group settings. I can't double click. Once I think I quit so I would not receive so many e-mails so now I don't think I am a member but I still receive the e-mails. I may have to resort to changing my e-mail name. I love to read in the archives but not the daily. I think all of you are great but with my upcoming surgery I just have to have a vacation stop.Thanks,Marilyn Support for scoliosis-surgery veterans with Harrington Rod Malalignment Syndrome. Not medical advice. Group does not control ads or endorse any advertised products.

[Guest guest]

Dear Wafasn2,

Try my files section under Tutorials - 1 and then in the math

section.

Also try techlectures.com

While you may only get a few questions that are staright

trade/generic/classification , you will also get questions regarding

drug storage and handlng drug interactions. precaustions and such.

Tehrefore you must know many drugs. However which drugs to

learn 'just fore the test' no one can say.

In addition if one could tell you I would hope that they would not;

because you need t know them all as a pharmacy technician. So if you

pass a certification exam let us supppose you are certifable and know

this information.

Try my link section for the top 200 drugs, then go to my link section

for studystack.com to try to make electronic flash cards.

Respectfully,

Jeanetta Mastron CPhT BSChem

F/O

> Hello

>

> My name is Wafa,I am studying for the pharmacy technician test on

july but Iam having some trouble with math please would you guide me

somewhere that i can practice it,I do not really know what kind of

math to expect on the test,I am studying every thing but just need to

be oriented

> My second question is ;Do i need to learn by heart all the names of

medication or just few of them.

> I really want to be certified because I have a great passion for

medical field and every thing related to medications

> Thank you for any input.

>

>

> ---------------------------------

> : votre e-mail personnel et gratuit qui vous suit

partout !

> Créez votre

>

> Dialoguez en direct avec vos amis grâce à Messenger !

>

>

[Guest guest]

Hi Dawn, I'm not sure, but I think -- if you switch to another service or

even change your email with the same service, you will have to register to the

site again with your new email address. (But then again, I'm not sure).

If it were me and I were going to swtich emails and/or service, I'd make

sure I had the addresses to all the sites I participate in so that I could

re-register once I got the new email.

Once you get your new service and are up and running with a new email, you

can always contact someone via email, too, and maybe they could help you get

back on the sites you are registered to.

I'm not very " puter brilliant " and would be confused, too, if I had to figure

out how to function with new service and new email, but you'll do it! You'll

get it figured out . Good luck.

In a message dated 6/9/2004 4:31:58 AM Eastern Standard Time,

Dawnbeliever@... writes:

> Hey,

> I am dropping my current email address and changing to another service with

> a

> different email address very soon.. how do i go about getting these message

> boards sent to my new email address automatically? .. spose i could figure

> it

> out.. but running out of time and i have the memory problems.... i empathize

>

> with those with headaches on here.. cuz very rarely have any headache

> besides

> sinus headache problems in the past...

>

> confused,

> Dawn

>

[Guest guest]

Dawn...

Did anyone help you with this?

Tatezi

need help

Hey,

I am dropping my current email address and changing to another service with a

different email address very soon.. how do i go about getting these message

boards sent to my new email address automatically? ..

[Guest guest]

Dawn...

Did anyone help you with this?

Tatezi

need help

Hey,

I am dropping my current email address and changing to another service with a

different email address very soon.. how do i go about getting these message

boards sent to my new email address automatically? ..

[Guest guest]

>

> For the question of guilt, probably the biggest issue is of

being a wuss,

> feeling incapable and like a nuisance because of various special

needs (such

> as allergies, depression, and sensory integration problems), which

my family

> members don't grasp. I had made a lot of progress on these things,

but the

> current family crisis seems to have set me back considerably.

Marcia

Hello. Do you think that maybe the family issues are another aspect

of the problems of allergy, depression, etc. Family sometimes

doesn't grasp very much, but maybe it's our wanting them to grasp or

our need to have them understand us to " validate " us is really a

hindrance. If you don't care whether they understand you or not,

and care most of all that you understand you and honor you, family

be damned, pardon, then maybe the guilt gets better and the

allergies and depression do too? I'm no expert, LOL, as everyone

here knows. But I would tap on " Even though I have a need for my

family to ____, etc. " And what about profoundly accepting

yourself? Have you done much family/early childhood tapping? I did

alot, and came up with some really stupid stuff that I couldn't

believe actually meant something to my psyche in terms of how EFT

cleared away emotional garbage I would never have suspected to be

caused by these particular incidents. I had carried them around for

so long that the original meaning had been lost, but the emotions

were still there connected to the original event somehow. The one

thing I know is, " they " aren't going to give you what you need,

because they don't have it.

a

>

>

>

>

[Guest guest]

Seeing the movie 'What the Bleep *# & #* Do we Know' really explains all of this. Fabulous movie on quantum physics, body's, emotions, energy, intentions etc. MUST SEE MOVIE.

Need help

Are there anything wrong with the QXCI? doing research on it... couldnt find anything... all the websites write the same things.. also do what is the real definition of an emotion?............................................

[Guest guest]

Can you rent this movie?

Need help

Are there anything wrong with the QXCI? doing research on it... couldnt find anything... all the websites write the same things.. also do what is the real definition of an emotion?............................................

[Guest guest]

Derick,

Are you still drinking or stopped? I ask because alcoholics are prone to depression and HCV adds to it. Bottom line....drinking is not going to help, it's only going to make it worse.

Having said that, I see two options here: call your Doctor's office and tell them that what they gave you isn't working and/or call your local mental health department and tell them what you've told us here. They'll steer you in the right direction.

What are you? There are many people here from all over the country with a lot of good information and somebody can probably help if you let us know where you live.

Keep writing.

Best,

Kelli S.

Original Message-------

From: Hepatitis C

Date: 10/22/04 11:12:30

Hepatitis C

Subject: need help

hi my nameis derick i feel like i am the only person on earth. i have

hep c and i am an alcoholic. i am soooo depressed i dont know what to

do.i am hoping there is someone out there that can help steer me in

the right direction. i am on a waiting list for liver doctor (8

months) and psyciatrist (one year). my family doctor gave me two

weeks of diazapam which doeslittle good and i dont see him for five

weeks.

i need help derick