Piriformis release surgery, discussion and information

I am now over 9 weeks post-op Dr. Filler. I have absolutely no change in my symptoms at all. It is as if nothing was done. I have not spoken to Filler since the operation. The 4 week post-op call was cancelled because they said I didn't schedule it correctly. Had another date set this week for Filler to call but the office called the day before and said it would have to be rescheduled and would not be until March 10th. I am not impressed. Good news is at least I am no worse.

Lhuggable

Just wanted you all to know that the nerve pain I felt was very short lived and after those few days of probably too many hills and too much activity, the nerve pain has not returned. Since then I've been consistent, but slower about increasing activity. My muscles have had opportunity to wake up and each walk I take feels better than the one before.

I've been exercising (stretches and strengthening) somewhat consistently for the past few weeks and am really feeling better than I have in a long long time. I've eased into it and have not had anything other than a bit of normal muscle fatigue. Increasing my activity has really felt good and I enjoy being able to exercise again.

Last week my husband and I went to a water fall that we've been to several times. For the first time in 2 years, I was able to walk the 100 steps to the bottom with out pain....and no pain whatsoever afterward!!!!

Hope this encourages all of you to hang in there. For those recovering from surgery, keep remembering "slow and steady wins the race".

Donna

Lhuggable,

So sorry to hear you're not any better. You must be so frustrated. I'm just curious.......after the surgery, did Dr. Filler indicate that he felt (based on what he saw when he was in there) that he'd corrected the problem for you? Or have you even been able to talk to him about it? I'm a couple of weeks away from my surgery and that's my biggest fear is that Dr. Barbaro will get in there and say, "Hmmm. Guess I was wrong! She doesn't have PS after all!"

Margie

Good to hear from Dr. Huggablde again but really sorry your news isn't better. This must be very frustrating. Seems like h'girl said you had had hip surgery as well as piriformis andthen this obdurator internus surgery with Filler. Must be very, very frustrating.

So glad for Leesa that things are better. Donna and David continue to be what gives hope to those of us who still may have surgery.

H'girl, how are you doing. Hope that nerve pain has eased. Seems like all of us have stories about the physical activiy we have had to give up. And then of course the sitting. If you can't sit and you can't walk then what is left??

I am in the middle of preparations for seeing Dr. Filler next Wednesday. I get worried each time I hear a story about misunderstandings about telephone appointments as that is how most of us will have to depend on him. You are lucky, Leesa to be so close that you can just go in and wait until he sees you. He is oviously very overworked.

Margie, will be very interested to hear how things go wiht Dr. Barbaro and good luck to you. I too have had this for 10 years so that is why I will be particularly interested to hear you story.

Bye and will check in when I am in L.A. on my laptop. Am a bit wired about leaving Monday.

Shirley

Dr. Huggable, I too am sorry to hear things aren't better and hope you get to talk to Dr. Filler ASAP.

Margie, that is the scary part of all of this. Finally finding someone who we think may have the answer but not knowing for sure if it s going to work. All you can do is continue forward because like most of us, what other options do you have?

Donna, great news about your waterfall hike! Can t wait to get back to exercising myself.

Shirley, I AM very grateful to be so close to Dr. Filler. It would be hard to muster up the courage to fly to another place for answers. I m sure you are nervous about your trip but it will all be ok. Including the weather!!!

Another decent day under my belt, I woke up in minimal pain again. I took it very easy today and am going out for a few hours tonight. I ll check back in over the weekend sometime.

Leesa

Hi everyone,

Dafid, I e-mailed the pt, the only elaboration I received is that if someone gets muscle spasms after exercise they are not stretching enough or properly prior to the workout......does that help?

I have not talked with my neurosurgeon again, but did ask the therapist who is doing trigger point therapy on my oh soooo sore behind....he had read a paper written by an orthopedic doc who believed there was a correlation between bone brittleness and narcotic pain relievers....that doesn't help much I know, but will double check when I go back to my doc.

Margie, I truly believe Dr. Barbaro would not do the surgery if he did not feel confident he could help you, rest your mind and wishing you an easy recovery!

Oh, sure wish we could all just feel good again....what we wouldn't give for just a normal day....

take care, patty

Margie,

Yes Filler did find alot of fibrous scar tissue at the ischial tuberosity where he thought it was(and where I thought the problem is). At least that is what he told my wife long distance just after the operation. He talked to me post-op but I don't remember any of it. He felt like he got to the problem. However, when I had a piriformis release done 3 years ago by another MD he found that muscle greatly impinging on the sciatic nerve and he really thought he had corrected the problem-but it didn't change my symptoms at all.

I am still hopeful the operation will help. I do have good days(but had those before the operation).

lhuggable

Dr. Huggable, do you know what the cause of that scar tissue was? Didn't he also find something at the obdurator internus? Do you have any low back pain as well as pain in the butt? Do you have much stenosis with the L4-5 spondylolisthesis? Am asking all this because as you may remember I also have spondylolisthesis at L4-5. Still my main pain and the one that is more constant is in the central butt and at the attachments of the piriformis along the sacrum and the greater trochanter. Then intermitenly I have burning in the shin and foot and less severe in the lateral thigh. I think that the pain is caused by both but my fear is that it is more a result of the spondylolisthesis and that I would be like you and not see much change with piriformis release.

Shirley

Hi Dr. Huggable,

My symptoms were similar to yours for almost 15 years. Tried and tried, could not find the problem. I simply stopped sitting and walking up hill, which wasn't great for quality of life. Finally a series of accidents inflamed that area till I had the screaming nerve pain, etc.

Then finally I had a doc say "Oh, if it's that low down it's proximal hamstring tendinopathy...and the pain and swelling from that is impinging on your sciatic nerve and causing the local muscles to spasm which impinge on the nerve even more."

Treatment was: 1) get it all to calm down via steroid shots and no exercise for a year 2) slow reconditioning of the hamstring tendon (very very challenging to fix) via isometric exercise etc.

Still not sure if it will work. Hamstring tendons are almost impossible to fix once they start to fray. My active life is almost totally ruined, can barely walk at all. But at least I found something that explained the symptoms.

Not sure if this applies to you but it's yet another possibility. Look up high hamstring tendinopathy Dr. Fredicson Stanford University for classic paper on it.

Ok, so we have a big choice to make. My d appt is on the 25th. We would be leaving when spring break is starting and coming back when it is ending. Not sure if we will be lucky in getting her two seats so she can lay down on the plane. Not sure if she will be able to lay down on the way back either, so my question is for those of you who had surgery, would you go the plane route, airport, waiting, laying/sitting after surgery and you only having to be on the plane for 3 hours, or if you had a van, drive the 14 hours or so, of course I will be driving, she could lay on her side. She also has a very plush foam mattress topper from costco that she has on her bed. We could take one of the van seats out and she could also lay down. She is not good with pain. Also new med Sobutex, think she is allergic, 3 1/2 days on it her lips swelled and she has blisters on her lip and on the back of her throat. Urgent care said what I already knew, guess you should stop the med, because maybe she is having a reaction. DUH. Right now she is in withdrawl, sleeping. If she is building strength and character from all of this, she is going to be one powerful, beautiful, smart young woman. I don't mind what ever way we get to LA, just trying to see what will be most comfy for a slightly agitated, young lady. Thanks guys, hope it is sunny where you all are. 3:23 pm here and I have to go do some yardwork, my neighbor is sweeping my side walk, I got the message.

Hi Menzi,

I don't fly at all, except on a private medvac. I travel on foam pad in back of car with seatbelt like attachments (like they do in an ambulance). It's mandatory to avoid aggravating the area. Every time you sit and cause pain, you are just adding another month on recovery time (that's my motto). I was on restricted sitting (only in emergencies) for 10 years and that worked well until my accident. Now I have not sat...at all, ever, not even once...for the past 18 months. To get on and off the bed I use a thick piece of foam on the non-affected buttock as a landing pad to prevent any contact on affected side. No doctor, physical therapist, massage therapist, or anybody, has touched my pelvic area in 2 years Every one of them will want to "prod" and I will lose 3 months trying to recover from that. Physical therapists and Chiropractors are utterly damaging, all of them. Avoid like the plague.

By following these rules I have slowly, ever so slowly, reduced the pain and slowly began to reduce the inflammation of my sciatic nerve. I hope to walk again like a normal person in another 6 months. Maybe drive my car, if I put the setback waayyyyy back and sit on a pad on the non affected side. I know however that I will never again sit in an airplane, never sit in a restaurant, never sit at an office desk. Cannot use a wheelchair. I am permanently handicapped and have accepted that. The alternative is unbearable pain and loss of all use of my left leg.

I cannot take pain pills or anti-inflammatories like Mottrin, because all the steroids I took in the past damaged my kidneys, which means I have had to let the inflammation reduce by time and relaxation alone. Remember that painkiller dull the pain but do zero to reduce the inflammation so ultimately they are not helping except to help one endure the torture.

Ultimately the only cure is to quiet the inflammation of the nerve, and to quiet the spasming of the various pelvic muscles which are currently crushing the inflamed nerve. The muscles spasm because of the inflammation, which causes more inflammation, which causes more spasm, it's a downward spiral which can only be stopped by rest or anti inflammatories. Or surgery if one can identify the specify muscles causing the inflammation.

That is all I know. Good luck

B.

PS. I have children. The thought of this being inflicted on them would drive me insane with fear. I don't know how you endure it. God Bless You and keep you and your daughter.

B.

PPS. When I said "back of car" I meant I travel in the back of a van, lying on a piece of foam, with seatbelt straps so I don't break my legs in a fender bender. We raised the bed of the van with plywood so I could get in without bending at the hip too much. Sorry to go on so long, I'm not a great internet commenter.

Hi Elliot,
Your post is was from a year ago, but I am wondering how you are doing after your piriformis surgery with Dr Filler? I have been diagnosed by Dr Filler with the same result, but also in the Obturator muscle.

Surgery is very expensive, but might have to go that route.

Thanks,
Craig

Menzie:

First, unbelievable about the medication and your daughter's reaction. Can it get any worse? I hope not.

I'll let those who flew respond with their thoughts on that route because I live in the area and didn't have to make that decision. I would say lying down as much as possible after surgery is her best bet. As far as driving, since your D will have to change positions every 20 minutes that may not be such a good idea or it will take you forever to get home if you need to stop every 20 minutes to let her stand up or whatever she needs to do. That's the only thing I can think of that would make driving harder. Like I said, maybe those who flew can give you a better idea on your options by their experience.

Again, so sorry to hear about the medication reaction. I will continue to keep you and your D in my thoughts and prayers.

Hope your neighbor didn't give you any grief!!

Leesa