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Readers comment on spinal stenosis




 

 

DEAR DR. DONOHUE: You have no idea how painful spinal stenosis is. Only oxycodone works. My doctor is afraid that I will become addicted. I am 75. I would rather die an addict than a person in constant pain. A surgeon told me it was too dangerous to operate unless I am in constant pain. Can you help? — B.A.

DEAR DR. DONOHUE: I read your article on spinal stenosis. I am 82, in good health, but plagued with back pain. My daughter had me see a neurosurgeon. He suggested a microsurgical procedure that took about three hours. I was discharged with a small bandage. I am now more than two months post-op, and my back feels better than it has in years. People with spinal stenosis should consider this operation. — M.R.

ANSWER: Spinal stenosis is one of the most frequent causes of back pain. The spinal cord is an extension of the brain. It runs from the neck to the lower back. It’s only as thick as your little finger. An eraser dropped from 12 inches onto it would smash it beyond repair. It, therefore, needs protection. Nature has encased it in the back bones (vertebrae) through a tunnel that runs the length of the spinal column. Narrowing of the tunnel is called spinal stenosis.

The narrowed part compresses the spinal cord and is quite painful. The narrowing comes from bone spurs, arthritis changes or thickening of back ligaments. Physical therapy, through strengthening back muscles and stretching thickened back ligaments, often lessens pain. Pain medicines can be used liberally. Injection of cortisone into the spinal canal (epidurals) is another way to ease pain and compression.

M.R.’s suggestion of surgery bears consideration, especially his comments on microsurgery, where a half-inch incision allows the surgeon to spread back muscles and other tissues so the surgeon can home in on the area of involved stenosis. A hollow cylinder is inserted through the spread back tissues, and special instruments allow visualization of the area with the ability to remove the compression. It’s something that B.A. ought to consider with the constant pain she endures.

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DEAR DR. DONOHUE: My wife has taken blood pressure medicine for many years. She’s now 66. Her doctor put her on a new medicine that has her pressure at 125/65. It’s never been that low before. Is that too low for someone her age? — L.W.

ANSWER: Does your wife complain of dizziness, especially upon standing up? If she doesn’t, then her pressure isn’t too low. Ideal blood pressure is lower than 120/80.

It’s true older people don’t always tolerate a sudden drop in their pressure, even though the pressure might be in the normal range. I don’t consider your wife to be “older.” You’d better not either.

Readers may write Dr. Donohue or request an order form of available health newsletters at P. O. Box 536475, Orlando, FL 32853- 6475.

©2013 North America Synd.


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