Spinal Stenosis-What has Worked or not Worked for our Viewers- Part III of a III Part
Article on Stenosis
(6/28/17)- As noted in our item dated 3/24/17, Barry J. Condon, who headed the New England Compounding Center, was sentenced to 9 years in prison because of mail fraud and racketeering. His compounding company was responsible for 753 cases and 64 deaths of individuals injected with serums that contained molds that in turn lead to spinal meningitis.
Prosecutors had requested a sentence of 35 years, while Mr. Cadden’s defense had requested a 3 year sentence.
(3/24/17)- As a follow-up to our item dated 1/5/17 below, the trial in the federal court in Boston of Barry J. Condon who headed the, ended in a split verdict on Wednesday. Mr. Cadden, 50, the head pharmacist at the company was convicted of more than 50 counts of mail fraud and racketeering, but was acquitted on the 25 counts of second-degree murder counts.
The Centers for Medicare and Medicaid Services (CMS) said that 62 people had perished from meningitis after receiving tainted serum in their spinal cortisone steroidal shots.
(1/5/17)- In our item dated 10/13/12 below, we wrote about the outbreak of
meningitis from contaminated medication given to patients who were injected
with cortisone into their spinal column area to hopefully alleviate the pain
that they were undergoing.
The contaminated medication was produced by a compounding pharmacy, the New England Compounding Center, in Framingham, Mass. The U.S. Centers for Disease Control and Prevention concluded that three contaminated lots from the New England company resulted in 750 cases of fungal meningitis in 20 states, including 64 deaths. Food and Drug inspectors found unsanitary conditions and some unshipped batches of the medication at the center.
Two of the pharmacists at the now defunct New England Compounding Center are being tried in federal court in Boston charged with 2nd degree murder. The owner of the compounding pharmacy Barry J. Cadden is being tried first, with the trial of one of the pharmacists who worked there, Glenn Chin, will go to trial immediately after the conclusion of Mr. Cadden’s trial.
Both pharmacists have pleaded not-guilty to all charges.
(6/19/16)- David Wright, the 33 year old N.Y. Met 3rd baseman who we wrote about in our item dated 6/2/15 below, underwent surgery for a herniated disc in his neck in California. The All-Star Met player in all probability will not return to the ball field this season.
He was not able to play at the end of last season because of his spinal stenosis issue, but he did manage to get into over 30 gamed this season, before this most recent ailment sidelined him.
(6/2/15)- The media has carried the news recently that David Wright, the 3rd baseman for the NY Mets, who was placed on the disabled list on April 15, was diagnosed with spinal stenosis. Spinal stenosis is a degenerative illness, with the spinal canal narrowing either because of injury, generational factors or the aging process.
Mr. Wright will be 33 years-old in December, and it is a rarity for it to be occurring at such a young age. In our item dated 10/23/06 below, a viewer of this site wrote about being diagnosed with spinal stenosis at the age of 41.
The media reported that he went to California last week to get a spinal epidural shot.
We at therubins would like to point out that the shot, if it does work, doesn’t happen immediately. The decrease in pain level takes place at a very gradual level, and should not be rushed. We would like to take this opportunity to wish him well.
(1/20/15)- When you are having pain as a result of spinal stenosis, the level of pain is off the charts. There is little, to no quality of life while going through one of these pain episodes. It is only natural to think about taking pain-killers to help restore some degree of functionality to your life.
As a result of the abuse of painkillers for various and sundry reasons, lawmakers have made it difficult to obtain opioid drugs, as they try to deal with this problem. The number of deaths from drug overdose rose by 6% in 2013 from 2012. Deaths from opioid pain relievers were up 1%, according to government figures in 2013 from 2012. In 2012, such deaths declined by 5%, the first drop since thee late 1990s.
The Food and Drug Administration has approved the first wearable motorized device that helps people with spinal cord injuries to walk. The device is called ReWalk, and it consists of a fitted metal brace that supports the legs and parts of the upper body, and a motor that moves the hips, knees and ankles.
The user of the device can operate it to move the hips, knees and ankles. The user can stand up, sit or walk using a wireless remote control worn on the wrist, but the individual must be assisted by another individual.
(2/25/13)- The following e-mail from Janice J discusses the procedure that she undertook in connection with her treatment for spinal stenosis.
Please keep in mind that we at therubins are not recommending any particular treatment for spinal stenosis. We are just trying to keep our viewers informed as to what has worked, or failed to work in their own case.
"Follow-up letter.
Harold
Hi - a few months ago I wrote you after reading your article about spinal stenosis and asked if you had heard about the x-stop spacer surgery. I was scheduled for the surgery and you asked me to let you know how I made out. Thought I would do that.
I had the surgery on Nov. 29th. Came home that day. I will say that my doctor's office did not feel me in a lot about what I would feel but maybe everyone is different so they can't. I didn't take the codeine, didn't need it. Couldn't take anti-inflammatories as my surgeon used synthetic bone to additionally seal the spacer in and that affects the healing.
I had my almost 3 month appt. with the surgeon last week and he told me I am doing better than he thought. Said my slippage (spondy) at the L4 was quite severe and he wasn't sure how much pain relief I would get. But other than when I roll over in bed and sometimes when I cough/sneeze when sitting I don't have any pain now. He said that over time the synthetic bone will harden more and the slippage will be even less and my pain will totally go away. If not I can get another epidural now that the space is there for the doctor to get the nerve where he couldn't before. Or I can try neurontin. Personally I think I am just going to wait and see.
I am very happy with the surgery. Surgeon said what I had was a 25 minute surgery vs. 4 hours for what I would have had to have before. It was definitely worth it to me.
Thought I would follow up with you. Maybe you could offer this as an option on your blog. I have stenosis and the spondy at the L4-L5.
Janice J.
Lancaster, NY"
(10/3/12)- An alarming news item came to our attention in that two people died and nine others are seriously ill with meningitis in Tennessee after receiving spinal steroidal cortisone shots at the Saint Thomas Outpatient Neurosurgery Center in Nashville. A patient who received the same shot in North Carolina has also been reported as ill by health officials in that state.
Meningitis is an infection involving the lining of the brain and central nervous systems. It is caused by a fungus and is not spread from person-to-person.
Medical officials think the infections were caused by contamination of the serum used for the procedure, by a fungus, known as aspergillus.
One lot of the serum has been recalled and more than 700 patients who received the shots at the Nashville clinic, which has been closed, have been notified.
(2/20/11)- Jilian Mincer, in her article "Rate of Spine Surgery Soars", that appeared in the February 15, 2011 edition of the Wall Street Journal further elucidates on both the greater number and soaring cost of spinal surgery procedures as we discussed in our item dated 4/20/10 below.
In our article "Spinal Stenosis- A Personal Chronicle" I wrote about my experience with spinal stenosis and I have kept you informed as to my progress with the disease since 2002. In my own particular case a spinal steroidal cortisone shot has worked over the years, so I have not had to undergo any spinal surgery at all.
If the steroidal shot had not worked in my own case, my pain management doctor would have tried a nerve blockage procedure before subjecting me to spinal surgery.
Ms. Mincer points out in her article the traditional simple spinal operation is called a "decompression, during which the bone, bone spurs and ligaments that are pushing on the nerves are removed." She is referring to the growth of these items in the spinal canal, which impinge on the nerves therein, causing the excruciating pain. After receiving my first shot in July 2002, I received my next shot in July 2004 and my last shot was given to me in July 2007.
Medical experts estimate that the shot is good for only about a year, but fortunately for me they have lasted longer. The shot was not painful since I was given a local anesthetic in the area where the shot was administered. It took a while for the shot to work, even though the improvement took place over a period of time.
A more complex surgical procedure is called spinal fusion, which involves fusing the vertebrae in the afflicted area. She points out that "rods and screws may be used to hold the bones together."
As we discussed in our item dated 4/20/10 below, Ms. Mincer points out in her article, "A recent study of Medicare patients found that the rate of traditional, decompression surgery for stenosis declined in the period from 2002 to 2007. But the rate of the complex surgery rose 15-fold in that period to 19.9 per 100,000 surgeries from 1.3 per 100,000."
"The report said the higher rate of complex procedures increased hospital costs for surgery by 40%. The complication rate of those cases also was higher at 5.6% compared to 2.3% for the simpler decompression surgery. Hospitals stays were on average two days longer for complex surgery, and average per-patient hospital charges were $80,888, compared with $23,724 for the simpler surgery."
(4/20/10)- The results of a study of Medicare records showed that the percentage of older adults undergoing a complicated fusion procedure for lower-back spinal stenosis has risen tenfold from 2002 to 2007, even though the cost of this procedure is much greater than some of the other operative procedures. On top of the greater cost is the fact that there is no definitive proof that this type of operation is more successful than the others.
The researchers also found that the overall rate of all types of surgery for spinal stenosis fell slightly during that five-year period of time. The proportion undergoing the complex fusion increased to 19.9 per 100,000 Medicare beneficiaries, up from 1.3.
In the complex surgery, more than three vertebrae are fused and both the back and the front of the vertebrae are involved.
In simple fusion surgery, two or three vertabrae are fused and only the front or the back of the vertebrae are involved. In the other type of surgery, which is called decompression, part of the bone pressing on the nerve is removed.
The complex procedure costs almost four times as much as decompression and is associated with three times the rate of life-threatening complications, according to the study.
Earlier studies have not found that the complex surgery leads to better results or greater pain relief, according to Dr. Richar A. Deyo, a professor of family and internal medicine at Oregon Health and Science University in Portland, and the lead author of the study, published April 7 in The Journal of the American Medical Association.
(12/29/08)- We at therubins recently received the following e-mail from one of our viewers, Jack Rubens, who by the way is not related to any of us. If any of you have had a similar experience, we would appreciate either your e-mailing that experience on to us, and we will forward it on to Mr. Rubens, or to e-mail it directly to him.
Since I have suffered from this illness, there are many unanswered questions that some of you, our viewers may know the answers. Here are but a few of the questions that I have concerning this disease:
- The first spinal steroidal cortisone shot that I
received was in July 2 002, and it lasted til July 2004. I received the 2nd shot in
July 2004 and it stayed effective til July 2007.
It is now 1 1/2 years since my last shot. Why the difference in timing in
regards to how long the shot will stay effective? How come the shot is
effective only about 50% of the time, but once it has helped you, it means
that subsequent shots will also help you?
- It is said that you should only get 3 shots within a
6-month period of time. My pain management doctor said, that is because
Medicare or Medicaid will only pay for 3 shots within a 6-month timeframe,
and that your body will not be negatively effected by receiving more than 3 shots in the
6-month timeframe. Which answer is correct?
- How damaging to the body is the steroidal cortisone
shot?
- Is stenosis a genetically inherited dispostition?
Incidentally, my brother Harold has never suffered from this problem.
- Are men more predisposed to get the disease than are
women? Does race or religion enter into the equation?
- We at therubins
receive the most e-mail in regards to stenosis, and the e-mails are from
young as well as older individuals. Is age a factor in the disease?
- Are people who do more physical activity more
predisposed to getting the disease than are less active people? Does a
physical injury when a person is younger have a cause in the disease's
development?
- In Mr. Rubens case he states that the injection done
under the older method, meaning between the space,
rather than directly into the nerves works better. In my case, the
injection went between the spaces. Is that truly the better way for it to
be given?
- When I got the shot in 2004 another doctor was present
while my doctor administered the shot. He explained the steps to the other
doctor and I overheard all of what he was saying to him. One of the things
he said that has stayed with me to this day was that he "left the
needle in" for a few seconds longer than most other doctors leave it
in for. Is this significant? He also told the other doctor that the
mixture (he mentioned what was in the concoction, but I sure don't
remember what it was) varies with the particular patient. Does this truly
have a material effect on how and if the shot will work? Incidentally, the
shot does not hurt at all, and all I "felt" was the fluid from
the shot going into my body, since the shot takes a while to administer.
- Does diet have an effect in the whole process of the
development of the disease?
- How important is the pain-management doctor who
administers the shot? I will give my answer to this one- Yes he or she is
critically important as to how effective the shot will be. In my case,
even though all the doctors have x-rays and MRIs to work with, he probed
for quite a while before determining exactly where the needle to
administer the shot went.
- Does exercise and/or stretching help prevent or even
mitigate a stenosis attack?
These are the questions that I have and below is the e-mail that Mr. Rubens sent us. This article is strictly devoted to any answers, or even additional questions that you our viewers may have. We will gladly post these responses on this site, and if you don't want to have your name used, we will omit your name.
"Original Message -----
From: JackRub@aol.com
Sent: Wednesday, December 24, 2008 1:55 PM
Subject: Spinal stenosis
I was wondering if you could post this on your blog as I'm trying to find
out if anybody has had the experience I have had.
My spinal stenosis had been under excellent control through the use of
narcotics and an occasional epidural. Some epidurals helped and some didn't. In
my particular case, the newer technique of doing the injection directly into
the foramen (cluster of nerves), did not help and actually made things work.
The older style of injecting into the narrow space worked better for me.
I was doing quite well but in July, 2008 I took a bad fall. The injuries
cleared up within a month but the impact of the fall brought back my spinal
stenosis. I had an epidural and it helped. I had pretty much recovered from it.
About 3 weeks later, I was lying on my back very still in bed. My right foot,
the foot that gets the pain from the stenosis, was gently lodged against the
left foot. Suddenly, I felt like what I thought was a cramp coming on. The pain
was excruciating. I had no choice but to scream loudly while at the same time
jumping up. In around 10 or 15 seconds it was over. After that, there was a
feeling of tightness in my ankle and moving up to around the calf. I was unable
to walk without the help of a cane. In around 48 hours, the pain went away. I
asked my doctor whether the epidural had anything to do with what happened and
he said that it might have because the nerve can do strange things.
5 months went by and last week I played a fairly strenuous game of
tennis. Upon leaving the court, I felt a slight pain in my ankle. I know from
experience that this is referred pain from the stenosis. That night, I went to
be and got another attack like the first one. Again, I was lying completely
still. Again, the pain caused me to scream involuntarily. Again, I had to use a
cane afterwards and then everything cleared up.
I would like to know whether anybody who reads your materials has ever
had this kind of experience from spinal stenosis. Because both times I was
lying completely still when the attack came, I do have a theory. After playing
tennis, there is an inflammation that takes place due to arthritis. When the
inflammation finally causes the nerve to touch something, the attack takes
place. This would explain the attack but wouldn't explain why the attack is
over in 10 seconds or so.
Any help would be appreciated.
Jack Rubens "
(10/20/06)- We at therubins received the following email from one of our viewers:
"how come on the articles with regard to spinal stenosis not a word mentioned about healthy eating, supplements, minerals etc. t.s."
Stenosis is a horrible disease that alters the afflicted individual's quality of life. You will try anything to alleviate the pain. As the article pointed out, I tried everything from acupuncture to painkillers, etc, In my case the spinal steroidal injection has alleviated the bulk of my pain. I do my stretching exercises, and so far it is under control.
In the email cited above, the viewer asks about eating right, dietary supplements, minerals, etc. We would appreciate anyone who has had experience with any of these items to email and tell us about your experience with it. We will withhold naming you, or even putting in your initials if so requested.
If you have any other possible suggestions as to a treatment that either helped or didn't help please let us know about it.
(10/23/06)- The following is an email we received from one of our viewers: "At the age of 41 I was diagnosed with spinal stenosis.I have the same diagnosis and have had very good results after going thru physical therapist after therapist. One I have been with for two years has me do 20 minutes of traction(works well for me takes the tingling feeling out of my right foot), stiff has hell for a a couple of minutes after getting off the table. Then we do I believe they are called the "thomas"stretches on a stiff padded bed type equipment. Then a cybex rotary torso machine 3 sets of 10 on setting plate #4(extremely light weight)(however the machine is not used as it is normally intended to. I stand instead of sitting, lock the two pads in all the way to the left side then grab both of them while I am standing up almost perfectly straight, push on the one closest to me with my left hand and pull the other pad with my right hand, again very low weight 3 sets of 10. Eventually do a roman chair at about 45 degrees, put my hands on my chest and remain in that position for 30 seconds, rest then do do again, eventually work up to 60 seconds etc. Then a cybex mutlipositional hip machine. Has a pad that goes right above the knee, lift up towards the chest say 10 if you can on very low weight, then the other, eventually more sets. Also they have me seated on a office stool with wheels facing some kind of cybex adjustable pulley machine, in this situation the pulley is positioned about paralell with the chest. All I do is pull the "t" bar handle back towards my chest with both hands while trying to keep th rest of my body quiet. The purpose of the wheels is that it forces you to use your stomach muscles. Then on the same machine they put me seated on a exercise ball sideways to the machine and have me use one arm at a time, pulling across my chest. then the other side. Ball forces you to keep balance and work the abs. I am looking to eliminate this tingling in my foot all together. I was thinking of trying Chinese herbs in combination with the exercise program. I have great confidence in the pt center I attend. Geez just the other day I threw out a question to my therapist about my pal having a sacroiliac strain and by God the info he gave me I called my bud in Utica NY and asked him what the treatment program was that helped him for the first time in 6 months and you would have thought my pt guy was treating him. " TS
Please also see: Tips on How to Keep Your Back
Healthy
Low Back Pain" Does Treatment Help
Spinal Stenosis- A Personal Chronicle - Part I
Spinal Stenosis-Clinical Trials- Part II
FOR AN INFORMATIVE AND PERSONAL ARTICLE ON PRACTICAL SUGGESTIONS WHEN SELECTING A NURSING HOME SEE OUR ARTICLE "Selecting a Nursing Home"
by Allan Rubin
updated June 28, 2017
e-mail: hrubin12@nyc.rr.com or allanrubin4@gmail.com