Hello all,
I may have mentioned this is the past in reference to Dr. Huggable, but everyone who has pain centered "low" in their hip, consider the possibility of High Hamstring Tendinopathy. This is the chronic damage to the hamstring tendon where it connects to the Ischium (bony knob at bottom of hip). This frequently has same symptoms as PIriformis Syndrome because the sciatic nerve runs next to the tendon and it can get co-inflamed and also build up scar tissue. It's just a bit lower down.
So any time you use your hamstring (for going up a hill or stairs) the tendon gets inflamed and this always affects the sciatic nerve. Very, very difficult to treat. Common with runners and athletes. I myself ended up almost totally paralyzed in left leg for 6 months because of this. the usual horrifying pain. Sitting is a huge nono.
I have lost 3 years of my life and most of my health because of this stupid problem. Still can't work. Who would have thought that a hamstring tendon would have crippled me.
Dr. Lasse Lempainen in Finland is world expert and does surgery to clear out the area, although it also has it's risks. There is a website that has good info, google "Hamstring Syndrome Amanda Rego" to find it.
Good luck all.
Bill T.
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I'll probably have to have RF ablation one of these days.
Can you tell me about your experience with the procedure? I understand the mechanics and what they do, I'm more curious about your personal experience, ie worsening pain after the procedure? how long did it last? how long until you felt relief? Did you have sciatic like symptoms typical of piriformis syndrome and or SI joint dysfunction? Were these relieved by they RF treatment? Did you have L5 through S3 nerves ablated? Was it pulsed RF or heat RF? Anything you can think of would be helpful.
I know sometimes both SI and piriformis show up together and just curious as to what was relieved, what wasnt and your personal experience.
Thanks,
Aztec
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I had my first RF ablation last September at the same time I had a piriformis block. I don't really remember what type of block it was. As I recall, after that treatment I felt pretty badly the next day, not only in the pain area, but sick to my stomach and headache etc. I don't really remember how long it took to feel the full effect of the treatment, but I do know the SI pain was relieved fairly soon after while the piriformis didn't feel much relief.
My surgery was about a month after the RF, and I had almost immediate complete relief from the piriformis pain. That along with the fact that the RF was still in effect provided a full 5 months of relief.
When the pain started again this time, it was clearly only the SI joint with no sciatic nerve/piriformis involvement.
This time the treatment seemed a lot easier. Maybe because I had just the RF. I was in the treatment room for about an hour and a half and had both sides done. during the procedure, she discovered that some of the nerves were still dead, while others had returned to full strengthTo be honest I don't know which nerves she did or which type of RF was used.
After the treatment, I spent 15 minutes in the recovery room, just to make sure there was no abnormal reaction.
I did not feel the nausea that I had after the last treatment and ate a full meal afterward. The treatment caused a bit more pain, but not much. By the next day I was back to a normal schedule and by 3 days later I was feeling the full effect of the treatment and am pain free again.
I was originally told that I might experience up to 7 months of relief, and it was almost exactly that. This time, the doctor said she doubled the treatment, so that I should have relief for twice as long. I'm not exactly sure what she doubled.
I'm really glad that I had the treatment. For the SI joint, its the only thing that has provided more than about a week of relief. 7 months at a time is great!
Hope this helps you.
Donna
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Made it to Filler's office on Monday for her pre-op visit. We saw Filler and verified that we would get to see him after her surgery, he said yes, he went over D's paper work pre-op stuff and then proceded to expain what he anticipated for the next days surgery. We found a better motel, Days INN that was reasonable money wise, and they gave a hospital discount, with coffee and cont-breakfast. It was a quick drive from the hospital. We originally tried to stay on Beverly BlVD, but could only find some very old and dated motels. So we stay on Sunset BLVD. Very entertaining with a lot of food and pharmacy options.
We arrived at the hospital at 5:30. At about 6:30 they called her back, but had not wanted to allow me to go back with her. NOT!!! By the time my D got about 20 yards down the hall, the intake person, told me to come. She was crying and a bit hysterical. So yeah, I got to go to the prep section. The anesthsia man poked her 7 times, as my d was very upset, I asked him to maybe get some help, he did and the doctor got it. Ashley was rolled out to the OR at 7:40. They closed about 12:30 and she was in recovery at 12:50. She made it through, but it did really seem like a long time, but slow and steady can be good, and we are hoping for a good outcome.
Dr. Filler came out and explained what he did, he said he did several things and felt that what he did should bring her relief. "Hopefully do the trick." She had a 3 cm incision of the greater trochanter, then a Bovie coagulator was then used to proceed through the underlying tissues to the level of the gluteal fascia. The gluteal fascia was coagulated with bipolar cautery and sut sharply with Metz scissors, then using blunt dissection technique progress was made through the leaves of the gluteal musculature, until the level of the pre-piriformis fascia was reached. Self retaining retractors were advanced and the prepirifomis was then explored to identify the superior gluteal nere, inferior gluteal nerve and the sciatic nerve. These were identified and carefully protected. Further dissection was carried out to further expose the sciatic nerve. The piriformis muscle was then exposed. It proved to be retained in a layer of dense fascia, pressing it on the sciatic nerve. In addition, the muscle was in two separated components. One component was the tendinous portion in contact with the nerve and a second more bulky portion proximally. Each of these was encircled with an 0 silk tie using bipolar cautery, the piriformis was fully sectioned proximally and distally so that they were completely diconnected, removing a segment of about 2.5cm in length. With this completed further dissection was carried out proximally through the sciatic notch to mobilize any remnants of the piriformis muscle and sciatic nerve. A proximal retrosciatic dissection was carried out within the sciatic notch which led to identification and mobilization of the pudendal nerve and the nerve to obturator internus within the sciatic notch. At this point a seprafilm was placed for the procimal exposure and attention was turned to the distal sciatic entrapment at the level of the ischial margin and then extending through the ischial tunnel which was also mobilized. Adhesions were cauterized and cut and seprafilm placed. Attention was then turned to the retrosciatic dissection involving identification of the nerve to the obturator internus and the pudendal nerve. A variety of adhesions were encountered which were gradually mobilized. A membrane sealing the lesser sciatic notch was opened to fully relax the entry of the nerve elements into the lesser sciatic notch. With good decompression along the course of the nerve to the obturator internus and pudendal nerrve from the greater sciatic notch across the ischial spine to the lesser sciatic notch. Attention was then turned to closure... Too much to list
We stayed at the hospital. I really liked the hospital staff. Although my d was slightly grouchy and in pain, but the pain drip machine worked well. We saw Filler the next morning, he said she would be released. She felt she wasn't ready to leave. Dr. Enyati (sp?)stopped by as well. She also had to cath so that positioning created some issues but we did finally leave the hospital and back to the Days INN. She was sore and and very fearful. She made it through and walked up and down the hall several times a day, it hurt but she wanted to keep going. Friday arrived and we showed up for our 10:00 appt at Filler's office. About 11:00 they put us in a room next to the normal office visit room. CiCi looked at her incision and then gave us some advice. I then said what about Dr. Filler seeing my D, she said it might not happen because things were very busy and an he needed to take care of a clotting issue in a patient, but Shirley came through and made sure we saw him quickly before he had to go off.
We left the office at 12:40 and began our journey home. I contacted Jodean on Monday to get help with prescription, she got right back and got it worked out with the pharmacy. She was very prompt. I also emailed her about some redness/bumps outside of the surgical strips today. Again, she was very prompt with suggestions.
D is doing ok, but she is hurting. She did walk around our neighborhood block yesterday(Wed) Monday was real bad. She still has the same pain, but time is what we have been told. Hopefully we will see some changes soon, something to grasp onto as hope. Dr. Filler treated us well, and we are looking forward to hopefully being one of his success stories. I want to thank all of you for all of your support. I am very tired as I get up a 5am and it is now 11:18pm. Good night for now, I will post more soon.
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Great to hear the details.
YES, it hurts. Perfectly, totally normal relative to my experience. It gets better in fits and starts. Tell your daughter that ATTITUDE is everything with this recovery and to keep her chin up. It was quite some time before I felt any real improvement but it came.
I never had any irritation with the surgical strips but many have commented that they did. Easy with the walking but I understand the desire to get moving and see if the surgery was postive.
Tell your daughter we are all pulling for her.
Menzie, when you look in the mirror, smile. You are one hell of a Mom.
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Everyone, THANK YOU so much for your support and encouragement. Yes, it is a HUGE relief to know that I'm not nuts, that there is a reason why my butt hurts to so much. And the support of this forum is wonderful. I was so happy to read all the messages yesterday!
Take care,
Julie
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Question: has anyone tried using an inversion table to see if this helps ?
Thanks
Mark
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Sorry to say that my inversion table actually made me worse. But EVERYONE IS DIFFERENT so I'd say it's worth a try. Maybe you know someplace where you can try one out on a regular basis before you invest in one. Good luck.
Margie
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Wanted to let you know that my surgery date is set for Friday, May 16th. I had to pick a side to do (he'll only do one at a time) so, after much thought, I chose my left. My leg pain is worst on the left, though my butt pain is worst on the right...so it was a hard choice. I figured I'd pick the side where the pain covered the most surface area. My left side is butt, back of thigh, behind knee, burning cramping freakin' calf, foot pain with a cherry on top. So, it's gonna be side #1.
Yes, I'm relieved, nervous, excited, a little pukey but READY. I'm still kinda in this "holy c**p I can't believe the MRN was positive" state...it's going to take a bit for it all to sink in. After a year of all tests coming back negative, I'm still in a state of shock that this one was glowing positive.
After speaking with Dr. Layzer today I got the impression that from the looks of my MRN, the state of my hiney is pretty bad. I had a piriformis injection 4 days before the MRN and they are concerned that some of the areas of high intensity in the soft tissue was a result of the injections, so I will repeat the MRN before surgery. If it wasn't the result of the injections, then it my indicate some damage in the soft tissue. I think they are all curious as to what lies inside my butt cheek. He was also surprised to see that the areas of high intensity signal when down to my ischial tuberosity on the left side. Me too!
Anwyay, the countdown begins...
Oh, I've hung upside down as well. Did nothing for me but give me a head rush. Aside from the inversion table (and boots hanging upside down from a pull-up bar, which i don't recommends) my fiance convinced me that standing on my HEAD a couple of times a day would help. Nope. Just made my head hurt.
HOWEVER, like Margie said, everyone is different. I have heard of a few people who it helped out immensely. Worth a try.
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A date set and everything! GOOD. I'm sure it was hard to choose a side, sounds like you chose the right one anyway.
Mark:
I have no experience with handing upside down. But hope you find something that works.
Menzie:
Thanks for the details and I will hold positive thoughts that your daughter gets through this as quickly as possible.
Update:
I'm around 9 1/2 weeks since surgery. I finished my second round of steriods a few days ago. I haven't felt much better since then but I have a call into Filler's office just to talk to them. It's been a bit of a struggle this last week or two. I've had quite a bit of returning pain in my leg and foot (mostly) and butt of course. Since I haven't reached that 3-4 month mark yet I'll just continue on and hope for the best. Not to put anything negative out there, just reporting the facts for me. Everyone is different so take it with a grain of salt as they say.
Leesa
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So happy to hear that you have a date; please continue to keep us updated on your progress, and Dr. Barbaro's care. I (along with everyone) wish you the very best. If I had to choose again, I would still elect to have surgery, even though the road has been rough. You seem to be prepared for that.
Aztec,
I also had the radio frequency ablations; they helped a little, but only for a few weeks.
Huggable,
Sounds like you also had a combination of back/buttocks/hip problems, have had some bad luck, and lots of medical bills. I know how you feel. Dr. Filler had recommended that I have the ischeal tuberosity surgery; (I'm still bummed about the $2400 bill for the injection) Needless to say, I declined to have the surgery. (I read one of the internet journals; they said there doesn't seem to be any statistics on the ischeal tunnel surgery, and they believe outcomes are poor.) Did Dr. Filler offer you any statistics?
Someone asked about the cost of the piriformis surgery. $10,050 for Dr. Filler. (My insurance paid about $1,500.) Blue Cross also paid the majority of the hospital bill (all except $500). I consider myself very lucky when I read about some of you that had to pay all the hospital costs. I believe this money was well spent, as I don't have that horrible gnawing buttock/psciatic pain which I remember so vividly when I read your posts. Granted, it was replaced with another kind of pain, the use of a cane, and the lower back pain is still severe. I can now sleep at night, rather than be curled up in the fetal position not knowing what to do.
My heart goes out to all of you that are still in the middle of this,
Ronesa
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We have had great communication with Jodean, and CiCi even called to check on my D's surgi-strip redness even though we did not call her. I am at this point feeling good about the follow up for my D. Her 2 week follow up call with Dr. Filler is on Tuesday. I hope you all are having a good weekend. Bye for now, Menzie :) :) :)
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So So SOOOOOOOO glad to hear that your daughter is getting some relief! Thank you for taking the time to share with us because we've all been thinking of her and sending thoughts and prayers her way as well as YOUR way. We know you take excellent care of her but don't forget to take excellent care of yourself as well!
And we're also thrilled to hear how well the communication with Filler's office has been. With all the stress you're already under, poor communication is NOT something you need to deal with. So that's a blessing!
Take care!
Margie
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