Persistent Pain Post TFESI
Did bilateral L3/L4 tfesi on a lady above level of fusion. Has significant scoliosis to the right, along with massive facet and degenerative disc at L3L4 causing severe stenosis. She got 100% relief for day of and day after of her right sided symptoms but then pain worsened. Mostly muscles spasms and tightness in buttock and hip region. Also maybe some new occasional pain at very specific location of medial knee although states that pain has reduced. No pain in between hip and specific area...
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Source: Student Doctor Network - March 30, 2024 Category: Universities & Medical Training Authors: Dansk2011 Tags: Pain Medicine Source Type: forums
MBB/RFA approval after fusion?
I have a patient that is fused extensively from mid thoracic to pelvis due to severe scoliosis and DDD. Imaging does not show any significant disc herniation or stenosis, and doesn't have radicular symptoms. His pain is mostly mechanical & axial, and TPI helps for a short amount of time. I'm thinking back about my training days where some patients did get some relief with MBB/RFA despite having had lumbar fusion. However I've read that some insurances will not allow MBB post-fusion (patient...
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Source: Student Doctor Network - March 6, 2024 Category: Universities & Medical Training Authors: CarabinerSD Tags: Pain Medicine Source Type: forums
Redoing Occupational Health Check
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Redoing Occupational Health Check
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Source: The Student Room - July 31, 2021 Category: Universities & Medical Training Authors: turkeydinosaur16 Tags: Medicine Source Type: forums
My case today Cerebral palsy, impossible spinal, bad pulmonary function
22 year old 66 lbs 3’2 ft, with bad cerebral palsy, non verbal, badly contracted limbs, spine literally on the side with the worst kyphosis and scoliosis I have ever seen. Had a femur fracture a month ago, had a bout with multi resistant pneumonia which lef him with a bad Pulmonar function (which was bad to begin with due to his condition). Last week was scheduled for a femoral nail. I was not present but the attending then said meddling with the airway was out of the way, and just could...
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Source: Student Doctor Network - July 24, 2021 Category: Universities & Medical Training Authors: Sleeplessbordernights Tags: Anesthesiology Source Type: forums
Lumbar facet injection and Von Willebrand disease
18 yo female with a history of congenital scoliosis s/p surgical repair ~7 years ago. Apparently almost bled to death on the operating table. Later workup found that she has Von Willebrand's disease. Fast forward to now:
Came in for axial back pain. Imaging shows some adjacent level disease in the facets. Was thinking about injecting. I think most would get a heme consult prior to proceeding with something like an epidural. Would you guys do the same for IA facet injection as well?
thanks (Source: Student Doctor Network)
Source: Student Doctor Network - June 3, 2021 Category: Universities & Medical Training Authors: William Sparrow Tags: Pain Medicine Source Type: forums
Let ’s do another case
Add-on periectal abcess. Healthy Mildly obese 40yo female. She had this same procedure a year ago and ended up in the ICU for 4 days afterwards because of an MH event.
PMH: in significant other than MH. and some scoliosis.
PSH: above
Labs normal
PE: normal
she is extremely anxious since she “almost died” last time she was here.
Questions?
Plan? (Source: Student Doctor Network)
Source: Student Doctor Network - June 23, 2020 Category: Universities & Medical Training Authors: Noyac Tags: Anesthesiology Source Type: forums
OB intrathecal cath
Had a recent OB case:
Pt has scoliosis, semi difficult epidural placement but was able to get good LOR. No CSF coming out of tuohy, threaded the cath, little difficult but able to get it in, test dose with 3ml 1.5% lido w/ epi negative. Gave loading dose 8ml 0.2% ropi. Nurse called me 10 min later cause pt had hypotension. Pt is completely numb with motor block. I aspirated from the catheter and got CSF back so I suspected intrathecal cath. Stopped the infusion. Pt is comfortable and...
OB intrathecal cath (Source: Student Doctor Network)
Source: Student Doctor Network - March 1, 2020 Category: Universities & Medical Training Authors: XRanger Tags: Anesthesiology Source Type: forums
Blood Patch?
Alright, I had an OB pt yesterday that a colleague put an epidural in. She has a long history of spinal issues (repaired tethered cord, repaired scoliosis fused from T4-L4). First attempt his epidural did nothing. Second attempt he thought was successful, but produced profound analgesia and was obviously intrathecal. This is a sound and experienced individual placing the epidural. Now she's got a horrible spinal HA. She's also a chronic pain nightmare. I can't reasonably say that doing a...
Blood Patch? (Source: Student Doctor Network)
Source: Student Doctor Network - January 2, 2020 Category: Universities & Medical Training Authors: Pharmado Tags: Anesthesiology Source Type: forums
Strange flank pain case
69 y.o. female with severe kyphosis, scoliosis H/O recent compression Fx presents with right flank/abdominal pain. Big w/u by PCP and GI negative. On physical exam I note that PSIS is only a few finger breaths below her rib. Thinking that pain is mechanical in origin due to friction I bring her in and block two intercostal nerves with 100% pain relief for duration of bupivacaine.
What would you next move be? Repeat block with steroid, consider surgical resection of rib? She has been on COT...
Strange flank pain case (Source: Student Doctor Network)
Source: Student Doctor Network - April 21, 2018 Category: Universities & Medical Training Authors: pastafan Source Type: forums
short survey about SCOLIOSIS and SELF-ESTEEM
Forum: Student surveys and research
Posted By: by emma
Post Time: 21-03-2017 at 15:28 (Source: The Student Room)
Source: The Student Room - March 21, 2017 Category: Universities & Medical Training Source Type: forums
Random sharp, stabbing vaginal pains???
Discussion Boards)
Source: MD Health Forum - Medical Discussion Boards - March 30, 2013 Category: Consumer Health Advice Authors: roxjust Tags: Women's Health Source Type: forums
