Spinal stenosis makes diabetic’s weight loss difficult

Q: I have been a long-time reader of your column and enjoy it very much.

I was just informed by my doctor that I have type II diabetes. Due to spinal stenosis, I have difficulty walking any distance and I need to lose weight. Can you get me on the right track to both control my diabetes and drop a few pounds?

A: Type II diabetes is a disease in which high levels of sugar known as glucose are in the blood. The disorder is the result of the way in which your body uses insulin. Liver, fat and muscle cells respond incorrectly and blood sugar cannot reach the cells where it would ordinarily be stored for energy. When this occurs, sugar builds up in the blood in a condition known as hyperglycemia. The condition occurs over an extended period of time and while it can occur in those individuals that are thin and elderly, most cases involve people who are overweight or obese, which makes it more difficult for the body to use insulin as it should.
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Pain dominates woman’s life

DEAR DR. GOTT: I have been diagnosed with several health issues, including neuropathy of my feet and hands. I have suffered from fibromyalgia for over 25 years, RA and OA. I am not diabetic, although I have two brothers that are. I am overweight and also have sleep apnea and use a CPAP.

My latest problem is spinal stenosis involving C5, C6 and C7. It has been suggested I have injections to block nerves to relieve the pain from the stenosis and I also saw a neurosurgeon whose first question was “how long do you expect to live”? If it’s 10 to 15 more years, I might consider to put plastic pads between my discs. I am almost 78. Friends tell me to see someone who uses Reiki treatments and all my ailments will go away.
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Young gal has bad disks

DEAR DR. GOTT: I’m a 23-year-old female and about one year ago I was diagnosed with moderate DDD in the cervical, thoracic and lumbar spine and spinal stenosis in the thoracic region. I have never sustained any kind of injury or had an accident of any kind. I was overweight throughout my teenage years but received bariatric surgery at 19 and all of my vitamin levels are within normal ranges. My rheumatoid levels are normal. I was diagnosed with PCOS at 17 but otherwise I am a healthy young woman. There doesn’t appear to be any reason why someone my age would have DDD. Are there any causes or additional factors that my current doctors may have overlooked? What could cause this at such a young age? I’m currently using a 50 mcg/hr Fentanyl patch and four mg of tizanidine two to three times daily for pain. I also take Lamictal and Wellbutrin for unrelated problems. Any insight would be appreciated.
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Talk about a pain in the neck

DEAR DR. GOTT: I am an 84-year-old female living in an assisted-living facility. I suffer from spinal stenosis, which has left me in a lot of pain since getting out of the hospital. The facility provides good care, but I remain in pain. Will it continue, or can I expect some relief?

DEAR READER: Spinal stenosis is a narrowing of a portion of the spine that causes pain, weakness and paresthesias, primarily of the neck, lower back, shoulders, arms or legs. Depending which nerves are affected, bladder and/or bowel difficulties might also occur and can lead to incontinence.
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Pain rules senior citizen’s life

DEAR DR. GOTT: My mom is 92 and has macular degeneration, so someone reads her your column every morning. It’s heartbreaking to see the horrendous pain that she is in. It’s extreme from her hip down to the foot on her right leg, and it travels, as well.

She has severe arthritis — bone rubbing on bone in her hip because the cartilage is gone, and her sciatic nerve is being pinched. She has spinal stenosis and fibromyalgia as well, as far as we can tell.

She’s tried things from your column from time to time. She’s been to pain doctors, had five shots, acupuncture, seen a chiropractor and has had physical therapy. [Read more...]

Octogenarian wants to dance again

DEAR DR. GOTT: I am an active 80-year-old female in good health. I’m writing about an injury to my left knee that occurred in December 2007 while dancing. In the same month, I fell down while bowling, injuring both my knee and back. The doctors diagnosed me with spinal stenosis and damaged cartilage of the knee.

I’ve since had chiropractic treatments and massage therapy but am unable to continue due to financial difficulties. I saw an orthopedic surgeon but to my dismay, he didn’t refer me for any treatment. Instead, he administered a cortisone shot and asked that I return for a follow-up visit in three months. Follow-up visits were disappointing as he did not even try to refer me for therapy or anything beneficial to my injury.
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Persistent Back Pain Need Specialist

DEAR DR. GOTT:
My son will be 35 soon. He has been suffering from low back pain for about four years. He has a small remodeling business, so does hard labor. He has had to make adjustments so as not to lift anything too heavy. He is very industrious and not working is not an option for him.

My son has incurred a large amount of debt from doctor visits, testing and treatment. He has seen neurologists, orthopedic specialists, pain specialists and chiropractors. He has tried acupuncture, exercise, prednisone, Oxycontin, Percocet, injections into his spine, and others. The narcotics helped the most but he does not want to be on them again because they caused severe withdrawal symptoms which he does not want to go through again.

None of his physicians have given him any hope. [Read more...]

Surgery last, best hope for pain relief

DEAR DR. GOTT: I am a 68 year-old female with back problems (spinal stenosis) for the past 10 years. Over this period, I have had eight cortisone shots and several physical therapy sessions — anything to avoid surgery.

Now I suffer muscular pain in one leg and even limp when I try to walk any distance. I also have difficulty in climbing stairs. I’m wondering if I can put off the surgery any longer and what the success rate is with the procedure.

DEAR READER: You appear to be the victim of a progressive neurological disorder: pressure on the nerves as they pass through or around the spinal discs, with resulting compression of the nerves leading to chronic pain.

I believe that you have put off repair as best you can but it is surgery alone that will “fix” your back and nerves. My conclusion is based on the limited information in your letter. Your best bet is to be examined and tested by an orthopedic surgeon specializing in discogenic disease. Speak with your primary care physician for his referral.

On the negative side, no surgery can be guaranteed free from side effects. Every person who undergoes surgery responds in a different manner. Some fare extremely well, while others having the identical procedure have a more difficult recuperation period. Age, physical condition, related or unrelated medical problems and a host of other issues all come into play. I cannot begin to guess which category you might fall into. Therefore, I’ll have to pass on projecting the success rate. Quality of life is an important issue and the risks of surgery must be weighed against the pain you are suffering. I recommend selecting a specialist you have confidence and who is highly recommended by your own doctor. This is often the foundation on which to build success.

While you are awaiting your appointment, you might try acupuncture, massage, physical therapy, chiropractic manipulation, and other modalities. Then, should you not be a candidate for a procedure, the specialist can advise which alternative therapy is appropriate.

To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed 4 ¼” X 9 ½” letter-sized stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.