Julie and others,
I'll quote from my surgical report exactly what Dr. Filler did to my piriformis muscle " the piriformis muscle was sectioned proximally and distally to remove a segment approximately 2.5 cm in length to fully disconnect it"
I think that translates to say the muscle was cut in half, but I'm not exactly sure. Any expert medical translations? I also had "neuroplasty of sciatic and posterior femoral cutaneous nevrves and the nerve to the obturator internus" A band of restricting tissue was on the sciatic nerve and that was removed.
In my case, these steps worked and as you know, I've been almost completely free of nerve pain since the surgery. So, I don't think its necessarily the procedure itself that does or doesn't help.
I agree with Shirley in that I don't think Dr. Filler is a quack. Knowing what I know now, I probably would look into Dr Barbaro before making a decision, but I wouldn't rule out having Dr. Filler do my surgery. I have been very happy with the results and have been pain free for 5 months!
I certainly am in agreement that his follow up care is lacking and he is over busy. I can't really comment on follow up in my case, since I have never had reason to contact him since surgery. I do wish he would've spent time with me following surgery (the 2minutes just after waking up after surgery doesn't really count) to explain what he did. He did talk to my husband, but Tim says that was only about a 5 minute chat. I would also have liked to see more instruction in the rehabilitation area.
I'm glad that we are hearing more about Dr. Barbaro so that others can have options and even the possibility of an informed second option. Especially as Dr. Filler seems to becoming busier and less organized, another surgeon can be a really good thing.
Glad to hear you are doing well, Margie. Take it slowly on the road to recovery and just take one day at a time.
Hope every one is having a relatively low pain day.
Donna
Hi folks,
I read in the yahoo group that a lady that had gotten a botox injection into one of her piriformis muscles and that it made her SI pain worse. The moderator wondered if maybe paralyzing the piriformis had caused an imbalance in the SI joint since the piriformis is attached to it.
Anybody here have any comments about that or has that happened or not happened to you when you got a botox injection?
Just curious as I'm supposed to have an injection soon.
Thanks,
Aztec
I read in the yahoo group that a lady that had gotten a botox injection into one of her piriformis muscles and that it made her SI pain worse. The moderator wondered if maybe paralyzing the piriformis had caused an imbalance in the SI joint since the piriformis is attached to it.
Anybody here have any comments about that or has that happened or not happened to you when you got a botox injection?
Just curious as I'm supposed to have an injection soon.
Thanks,
Aztec
Hi Aztec,
I had 3 botox injections into the piriformis muscle. Since I was already suffering with SI pain, I also received SI pain blocks at the same time. These injections provided the same short term relief as they had at times when I didn't receive botox. So Idon't feel that my SI was negatively effected by the botox.
Of course, testing of the muscle after the injections showed that even at best only 70% of my piriformis muscle was paralyzed. The first botox injection only did about 30%
Hope this helps
Donna
I had 3 botox injections into the piriformis muscle. Since I was already suffering with SI pain, I also received SI pain blocks at the same time. These injections provided the same short term relief as they had at times when I didn't receive botox. So Idon't feel that my SI was negatively effected by the botox.
Of course, testing of the muscle after the injections showed that even at best only 70% of my piriformis muscle was paralyzed. The first botox injection only did about 30%
Hope this helps
Donna
Donna,
Yup, sounds like he cut it in half. THANK YOU so much for the surgical report details. I'm starting to really understand the surgery now and reading the surgical notes makes it make much more sense. I am so happy you are doing so well.
Take care,
Julie
Yup, sounds like he cut it in half. THANK YOU so much for the surgical report details. I'm starting to really understand the surgery now and reading the surgical notes makes it make much more sense. I am so happy you are doing so well.
Take care,
Julie
I just had a piriformis release Surgery four days ago after seven years of constant pain and hip restriction. I had tried every modality that could possibly help. Prolotherapy, PRP, BMA, laser therapy, ASTYM, Actupuncture, cupping, and all types of massage… These helped to a certain degree but could not release the restriction. It took me 22 doctors to go through before I found the surgeon that knew exactly what the problem was. The piriformis tendon at the posterior insertion was restricted causing a tension in the tendon and piriformis muscle which caused pain at the anterior of the sacrum. This pain at the sacrum can be misunderstood As back pain and of course it really is not because it is actually coming from the puriformis. My procedure involved first, removing the trochanteric bursa, releasing the tethered sciatic nerve and scar tissue and And then the surgeon released the tendon of the piriformis. I had immediate relief from all pulling in the hip and at the sacrum and also the sciatic pain. Surgical intervention is the only way to resolve these type of issues.
As stated below I also had puriformis Muscle tendon release which involved the sciatic nerve and one other muscle also. The surgery went well and the surgeon was outstanding. When I initially went to see him he examined me and in 10 minutes tell me what the problem was but did not really explain any procedures nor did his positions assistant… Just before surgery the surgeon came to see me said a few words verified the surgery area and that was it. I was an out patient and not given any post surgery instructions. I do know that after surgery there will be scar tissue which can be a problem and this problem is not for consideration by a surgeon so it is the responsibility of the patient to do so. I have had seven years of dealing with pain and the best way to illuminate scar tissue is by class 4 Lightforce laser or ASTYM... for me the ASTYM work the best because it actually helps to heal injured tendons, Ligaments, muscles, and facia. Hope this helps.
Question for those of you with problems in the superior (or inferior) gluteal nerve. Do you have pain extending down into the hamstring especially when sitting, or does it stay in the buttock?
Thanks
Mark
Thanks
Mark
Marie: Sounds like you are doing great considering how recent your surgery was. Thanks for keeping us updated .we really care.
Julie: I haven t gotten my surgery report yet (I need to request a copy) but Dr. Filler said he cut the muscle which I assume is the same as a release but I ll report back once I get the report.
Donna: Pain free .music to my ears. So happy for you.
Shirley: Easy does it! Sounds like you are feeling better enough to push it but please take care and don t do too much.
I m still doing pretty well. Working a bit more each week. Not pain free yet but feel like I m on my way. I also don t think Filler is a quack, but agree with all about his after care. It breaks my heart to read about H Girl, DrHuggable, and others who haven t had results. But, if PS surgery or any other surgery (back, knee, etc) were evaluated by the numbers, you d most likely find some with good results and some with little or no results. I also think results depend on how extensive the damage is. I hope that doesn t sound uncaring, just makes sense to me.
Julie: I haven t gotten my surgery report yet (I need to request a copy) but Dr. Filler said he cut the muscle which I assume is the same as a release but I ll report back once I get the report.
Donna: Pain free .music to my ears. So happy for you.
Shirley: Easy does it! Sounds like you are feeling better enough to push it but please take care and don t do too much.
I m still doing pretty well. Working a bit more each week. Not pain free yet but feel like I m on my way. I also don t think Filler is a quack, but agree with all about his after care. It breaks my heart to read about H Girl, DrHuggable, and others who haven t had results. But, if PS surgery or any other surgery (back, knee, etc) were evaluated by the numbers, you d most likely find some with good results and some with little or no results. I also think results depend on how extensive the damage is. I hope that doesn t sound uncaring, just makes sense to me.
Margie - Were you taking your pain meds with solid food? They are hard on an empty tummy. I found peanut butter on bread or a big chunk of cheese just before taking the drug, eliminated the stomach problems. I don't see how you will be able to manage without narcotics so soon after surgery. Good luck. Mary
I want to thank NervePain for piping up with her opinion on Dr. Filler. I could not have been easy taking the risk to post a negative opinion on this site, that until recently, was so overwhelming positive about him. Her first hand experience is valuable and a warning of possible problems. Her post was the first time I have read that a few LA doctors thought he was a quack. That scares me.
Her experience shows there are no guarantees with surgery and that is just an inherent risk of surgery.
NervePain - would you please explain what you meant when you wrote "he crossed the lines of ethical behavior of a surgeon". What did he do or didn't do that was unethical? Thanks.
Mary,
Yes, I was taking the Tylenol with codeine along with solid food. Didn't help though. I've just got a really sensitive stomach. I'm doing fine without them though. I'm just using regular Tylenol and since it seems to be doing the trick, I'll just stick with it. They offered me Norco but if regular Tylenol works I'd rather just use that.
I reported earlier that I thought my incision was about eight inches long but I took the bandages off today and found out it's 13 inches long!! There are 40 staples there!! Gnarly! Those of you who've used Dr. Filler, was yours that big? Just curious.
Margie
Yes, I was taking the Tylenol with codeine along with solid food. Didn't help though. I've just got a really sensitive stomach. I'm doing fine without them though. I'm just using regular Tylenol and since it seems to be doing the trick, I'll just stick with it. They offered me Norco but if regular Tylenol works I'd rather just use that.
I reported earlier that I thought my incision was about eight inches long but I took the bandages off today and found out it's 13 inches long!! There are 40 staples there!! Gnarly! Those of you who've used Dr. Filler, was yours that big? Just curious.
Margie
I'm just a wreck after reading the nerve pain post. I'm so scared and sad. I don't know what to do.
HawaiiGirl - You have ever right to feel scared & sad, especially since you don't have a chance to talk to Filler. ARGH!
I happen to know that Dr. Filler ultimately sent NervePain to a Pain Clinic, where, among other things, she got radio frequency ablations of the nerve done, and that at least gave temporary relief. So maybe that will be an option.
In her post here, she said the Fentanyl patch prescribed by her family doctor helped. Have you considered trying it? Have you tried any other drug?
What is supposed to happen next - is Ever going to call again or are you stuck waiting 2 more weeks for the phone consult?
I wish I can make the pain go away. I know you are going through hell, both physically & emotionally now. And it just is not fair. I hope someone or something can help you get through this. Best wishes, Mary
I happen to know that Dr. Filler ultimately sent NervePain to a Pain Clinic, where, among other things, she got radio frequency ablations of the nerve done, and that at least gave temporary relief. So maybe that will be an option.
In her post here, she said the Fentanyl patch prescribed by her family doctor helped. Have you considered trying it? Have you tried any other drug?
What is supposed to happen next - is Ever going to call again or are you stuck waiting 2 more weeks for the phone consult?
I wish I can make the pain go away. I know you are going through hell, both physically & emotionally now. And it just is not fair. I hope someone or something can help you get through this. Best wishes, Mary
Donna, how did they knowwhat percentage of your piriformis was paralyzed? Sounds like you had a more knowledgeabe pain doctor than I have. Your botox injections were before you saw Dr filler, right? I don't know of anyone else that Dr. Filler did botox injections on. He did it on me bedause I had kgotten some, but certainly not total relief before wiht botox. Still I am surprised he hasn't used it on anyone elso on the forum or maybe he has and I just don't know.
The nature of my pain has changed since he injected me and I have had minimal leg pain which I guess is a good sign. I am very sore today but yesterday I carried my year old granddaughter up and down the steps a number of times as well as squatted to pick her up and you are really using the piriformiswhen you squat and come up. Dr. filler told me that the botox would take at least 4 weeks to reach its maximum strength. So, we will see. Iam supposed to talk to Cece for a 2 week followup on Thursday and let's hope that I actually get the call this time.
Julie, thanks for looking up neuroplasty of the nerve. I will see if my brother-in-law can explain it to me. He is a neurologist.
Hope you are reciovering well, Margie. Keep us posted. HG I am thinking of you and hoping that your pain lets up soon. Aztec are you going ahead wiht the botox? Leesa how is your recovery going?
Gotta go.
Shirley
The nature of my pain has changed since he injected me and I have had minimal leg pain which I guess is a good sign. I am very sore today but yesterday I carried my year old granddaughter up and down the steps a number of times as well as squatted to pick her up and you are really using the piriformiswhen you squat and come up. Dr. filler told me that the botox would take at least 4 weeks to reach its maximum strength. So, we will see. Iam supposed to talk to Cece for a 2 week followup on Thursday and let's hope that I actually get the call this time.
Julie, thanks for looking up neuroplasty of the nerve. I will see if my brother-in-law can explain it to me. He is a neurologist.
Hope you are reciovering well, Margie. Keep us posted. HG I am thinking of you and hoping that your pain lets up soon. Aztec are you going ahead wiht the botox? Leesa how is your recovery going?
Gotta go.
Shirley
Hawaii Girl,
I'm sorry that my post may have added to your hardship; I identified so much with your situation; the 4 months post-op prior to the Fentanyl patch were the worse 4 months of my life (even worse than chemotherapy) the patch helped to level out the pain; it stopped the roller coaster ride of pain/relief.
I don't agree and didn't mean that I feel that Dr. Filler is a quack; I believe that he is very intelligent and understands neuro-surgery very well; but he is not well-thought of by some of the doctors here in Los Angeles. I wanted him to be my hero; I know that piriformis syndrome is very real, and that the medical community needs to address it. I now believe that Dr. Filler puts fame and fortune before the true welfare of his patients; even more so after reading the posts (I was hoping that this perception was incorrect, and was still hoping that the other posts would prove me wrong). I know many other surgeons (I worked as an intensive care nurse prior to the injury). I have never before seen a patient so abandoned following a surgery, especially at the level of pain that I was in -- over a 4-month period. I saw him once about one month post-op; then was only able to see or talk to Sheila, until I agreed to -have another injection (4 months post-op). FOLLOWING the injection, he told me that I could have the same thing done at the pain clinic and have it covered by medical insurance. Sheila had in her report 3 months post-op that I was still unable to work and had no more money.
(My family doctor was the first to say that Dr. Filler's behavior was unethical; if a doctor performs a surgery, he is ethically bound to follow that patient post-op until the patient has adequately recovered.)
Also, if Dr. Barbaro is able to perform the surgery and have it covered by insurance, so is Dr. Filler, he just wouldn't receive as much money. That's why I believe he is putting himself before his patients. Dr. Barbaro sounds as though he is putting the patient's welfare first, and he is turning down patients if he doesn't believe his surgery will help.
(In Dr. Filler's defense, he didn't give any of us piriformis syndrome, and neurosurgery is always a risk. He is helping put piriformis syndrome on the medical map, but I wish that he was doing it in a way that GAINED respect from the medical community.)
Haiwaii Girl, please don't be so sad, think of it this way, it can only go uphill from here. Cold packs really helped me, and a TENS unit. The pain doctor that I go see has a huge heart, hopefully you will find a doctor that helps similarly. The radio frequency ablations helped a little with my lower back, but had nothing to do with the pain that I had (and believe you may be experiencing) as a result of the surgery.
This might sound silly, but simple breathing exercises also helped me tremendously to get the pain under control (a pain psychologist at the pain clinic worked with me). If I can pass any of that information on to you, I would be happy to.
The piriformis syndrome, per se, is resolved. (Replaced by the buttocks pain from the incision, numbness and pain down the lateral part of the leg;) the lower back pain is the same.
Someone asked some questions about the superior gluteal nerve. Prior to surgery, I experienced lower back pain, coupled with severe sciatic pain from the left trochanter area, through the left buttocks, straight down the back of the leg (including the hamstrings) sometimes to the foot. Hope that helps.
Dr. Filler had explained neuroplasty as dis-adhering any scar tissue from the nerve itself.
Hawaii Girl, take heart, and let's see what we can do to help you through this in spite of everything,
All the best,
Nerve Pain
I'm sorry that my post may have added to your hardship; I identified so much with your situation; the 4 months post-op prior to the Fentanyl patch were the worse 4 months of my life (even worse than chemotherapy) the patch helped to level out the pain; it stopped the roller coaster ride of pain/relief.
I don't agree and didn't mean that I feel that Dr. Filler is a quack; I believe that he is very intelligent and understands neuro-surgery very well; but he is not well-thought of by some of the doctors here in Los Angeles. I wanted him to be my hero; I know that piriformis syndrome is very real, and that the medical community needs to address it. I now believe that Dr. Filler puts fame and fortune before the true welfare of his patients; even more so after reading the posts (I was hoping that this perception was incorrect, and was still hoping that the other posts would prove me wrong). I know many other surgeons (I worked as an intensive care nurse prior to the injury). I have never before seen a patient so abandoned following a surgery, especially at the level of pain that I was in -- over a 4-month period. I saw him once about one month post-op; then was only able to see or talk to Sheila, until I agreed to -have another injection (4 months post-op). FOLLOWING the injection, he told me that I could have the same thing done at the pain clinic and have it covered by medical insurance. Sheila had in her report 3 months post-op that I was still unable to work and had no more money.
(My family doctor was the first to say that Dr. Filler's behavior was unethical; if a doctor performs a surgery, he is ethically bound to follow that patient post-op until the patient has adequately recovered.)
Also, if Dr. Barbaro is able to perform the surgery and have it covered by insurance, so is Dr. Filler, he just wouldn't receive as much money. That's why I believe he is putting himself before his patients. Dr. Barbaro sounds as though he is putting the patient's welfare first, and he is turning down patients if he doesn't believe his surgery will help.
(In Dr. Filler's defense, he didn't give any of us piriformis syndrome, and neurosurgery is always a risk. He is helping put piriformis syndrome on the medical map, but I wish that he was doing it in a way that GAINED respect from the medical community.)
Haiwaii Girl, please don't be so sad, think of it this way, it can only go uphill from here. Cold packs really helped me, and a TENS unit. The pain doctor that I go see has a huge heart, hopefully you will find a doctor that helps similarly. The radio frequency ablations helped a little with my lower back, but had nothing to do with the pain that I had (and believe you may be experiencing) as a result of the surgery.
This might sound silly, but simple breathing exercises also helped me tremendously to get the pain under control (a pain psychologist at the pain clinic worked with me). If I can pass any of that information on to you, I would be happy to.
The piriformis syndrome, per se, is resolved. (Replaced by the buttocks pain from the incision, numbness and pain down the lateral part of the leg;) the lower back pain is the same.
Someone asked some questions about the superior gluteal nerve. Prior to surgery, I experienced lower back pain, coupled with severe sciatic pain from the left trochanter area, through the left buttocks, straight down the back of the leg (including the hamstrings) sometimes to the foot. Hope that helps.
Dr. Filler had explained neuroplasty as dis-adhering any scar tissue from the nerve itself.
Hawaii Girl, take heart, and let's see what we can do to help you through this in spite of everything,
All the best,
Nerve Pain
Margie, My scars are both about 2.5 inches long. The way they itched, that's quite long enough. I can't imagine putting up with 13 inches of itch! I'm glad you're feeling so well and taking so little medication.
Shirley, I feel very blessed to have such an excellent pain doctor. I was actually her first piriformis case and the first time she did a botox injection, but she was so determined to help me that she and my PT doctor spent hours researching for answers. Before and after the botox injection, they did an EMG (study of nerve funtion) and compared the two readings. That told them the % of paralysis. And yes, they were before I saw Dr. Filler.
All: for clarification, Dr. Filler does accept insurance and his office files insurance claims. He just isn't a part of any network or PPO, which means he doesn't negotiate better rates. I have wondered about that. However, my insurance agreed to pay him at in network rates. Also, his office "lost" the check from my insurance and was unable to find it until I sent them the check number and date they had been paid. They sent the bill with my balance on it to an incorrect address and I had to email and ask to be billed. They then sent a second bill to the same incorrect address, saying they couldn't email it to me. They finally decided they could send a statement via email when I convinced them that sending it a third time would still not reach me here in Honduras.
Donna
Shirley, I feel very blessed to have such an excellent pain doctor. I was actually her first piriformis case and the first time she did a botox injection, but she was so determined to help me that she and my PT doctor spent hours researching for answers. Before and after the botox injection, they did an EMG (study of nerve funtion) and compared the two readings. That told them the % of paralysis. And yes, they were before I saw Dr. Filler.
All: for clarification, Dr. Filler does accept insurance and his office files insurance claims. He just isn't a part of any network or PPO, which means he doesn't negotiate better rates. I have wondered about that. However, my insurance agreed to pay him at in network rates. Also, his office "lost" the check from my insurance and was unable to find it until I sent them the check number and date they had been paid. They sent the bill with my balance on it to an incorrect address and I had to email and ask to be billed. They then sent a second bill to the same incorrect address, saying they couldn't email it to me. They finally decided they could send a statement via email when I convinced them that sending it a third time would still not reach me here in Honduras.
Donna