"The value of shared communication"

Back in June I experienced shooting pain down my left leg, most likely Sciatica, but in the next 3 days the pain in my lower body was excruciating. I commenced using a walk-in stick in order to move about but after 2 days it was time to head to St John of God Murdoch’s ED.

After examination by ED Doctor, an anti inflammatory injection, plus pain killers and referral for MRI. Fortunately we knew a radiologist who was able to get us an MRI in4 days. Medication was Lyzalon 75mg twice a day, Celaxib 100mg twice a day after meals, Palexia SR twice per day.

Mobility aids purchase the following day. Fortunately HBF covered 75% of the cost. 

MRI completed the following day with the report available the following morning.

Saw (Stand in GP) Doctor who provided referral for steroid injection under CT Scan. Added Panadol Optizorb

5 days time had the first injection into nerve sleeve, no noticeable change.

4 days time 2nd injection-L4/5 - again no noticeable change. Spoke to Remedial Masseur recommended by Parkinson’s Nurse - unfortunately out of action.

Saw another stand in GP for guidance and possible referral for pain relief.

Medication added Lyzalon 150mg before bed.

Following week recommenced Physio with a 30 minute session plus program provided to do daily.

Saw my regular doctor who organized an urgent referral to a Pain Specialist plus increased medication of Lyzalon to morning and night. Also Oxycodone Viatris 5mg with each meal or at least twice per day.

Asked my Neurologist if my condition (at this stage maybe Sciatica) could be linked to my Parkinson’s or if that might be causing increased pain.

Neurologist replied that it should not.

Saw Physio who worked on my legs with stretching exercises and provided two exercises to do at home, 4 times a day.

That then brings us to the appointment with the pain specialist, his opinion being that it was not sciatica as the MRI does not mention any nerves being pinched and he was of the opinion that it was a further stage of Parkinson’s. He also suggested that given the pain medication does not appear to be we should withdraw from the medication over a few weeks - starting with the Oxycodone 

Next appointment with GP and a schedule for pain medication implemented.

Following day remedial massage - undecided whether helpful or not.

A further visit to GP, as pain medication now significantly reduced it was agreed to start. With 1/2 5mg Diazepam at night to assist sleep

Tried another remedial massage - no pain relief.

A few days later a remedial massage with masseur who specializes with Parkinson’s patients -will decide if helpful.

Getting desperate with the pain - went to a chiropractor and had three sessions. He achieved removing the shooting pain.

The following day was my appointment with my neurologist who decided be would admit me to Hollywood Private Hospital to facilitate diagnosis and treatment.

Booked into Hollywood and for several days using his network of specialists sought to determine what is causing the ongoing pain in the lower body and hopefully a solution.

Sessions had with neurologist, Pain Specialist, Physiotherapist and neurosurgeon.

A Bone Scan was booked but then cancelled after the Neurosurgeon identified he could do the required decompression surgery on Monday afternoon at Mount Hospital that would result in total pain elimination.

It was agreed by the neurologist to write to the neurosurgeon to arrange the required surgery, which was duly done.’ 

Surgery took place as planned however no noticeable pain relief. Cramping of buttocks, thighs and/or calf muscles was excruciating.

Moved to Rehab Ward under a physician who favored a holistic and team orientated approach, and following several days with minimal improvement sourced another neurosurgeon who arranged admission back to HPH and Ketamine Infusion for 3 days, days 2 and 3 including oral steroid tablets, followed by cortisone injections into my lower spine. Some changes in medication were introduced.

A Geriatrician then took over the management of my treatment, who exemplified collaborative thinking and information sharing.

It was noted that the level of steroids in my body was causing high blood sugar readings, so one outcome was to register with NDSS.

The cramping pain had begun to lessen. Physio assessment was to commence walking with my “Ferrari GT-R” rollator - upto 4 times a day. Rehab continued and included a Bone Scan which revealed possible infection, and a further MRI was organized.

The main issue was spinal stenosis - a genetic narrowing of the spine around L4/L5.

The doctors, nurses, staff, including Pharmacists and Diabetes Educator, on John Carroll Ward ensured my hospital stay was to the highest standard of care, with staff handovers always being done with patients involved.

I’m now home still in recover but without pain.