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Piriformis release surgery, anyone???


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Radam
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PostPosted: 02/13/10 - 13:45    Post subject:
Dr. Filler performed surgery on my piriformis in Dec. 2008, as well as Pudendal and Superior Gluteal nerves. My sciatic nerve was trapped in several places on both sides and I had a lot of scar tissue. I did get some relief from the surgery but like Shirley, I'm still in pain. I have an appointment March 8 to have another MRN as well as meeting with Dr. Filler. Like many others, I don't look forward to the additional expense but I don't have another alternative. Filler's nurse says that it's possible an injection will dissolve scar tissue if that's the cause of pain. If there are collagen or fibrovascular bands around the nerves, it will require more surgery. Shirley, please post your results as soon as possible as it looks like I'm facing some of the same issues as you. Hope everything goes well for you.

For those of you considering the surgery, please don't let Shirleys and my lack of immediate results discourage you. I have two friends who had the surgery and are pain free today. So hang in there!
scamp
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PostPosted: 02/13/10 - 17:04    Post subject:
RAdam, Our surgeries are almost exactly alike. All the same nerves involved and he traced my sciatic nerve down to the ischial tunnel. I too had fibrovascular bands one of which deformed the sciatic nerve and pressed it into the sciatic notch against bone. He refers to my dsurgery as atypical so glad to hear some one else is similar but not glad we are both still in pain.

Did you ever have a hard fall on the side where you had surgery?
Gotta go now. Am expecting family for dinner.

I will definitely let you know what my outcome is. Don't know if I can afford a 2nd surgery as I am from Canada and paid for the whole thing and the recession hit me hard because of large holdings in US banks.

Tou hang in too.

Shirley
scamp
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PostPosted: 02/13/10 - 17:10    Post subject:
RAdam, Just reread your post --not exactly the same nerves. I had the obturator internus nerve done and not the pudental but the sciatic and the superior gluteal nerves. Did you mean that you had bilateral surgery? Lynne or Hawaii girl had bilateral and there was pudental nerve involvement. She had a postsurgery injection and is doing very well--just occasional flareups.

Bye for now.

Bye for now.

Shirley
Radam
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PostPosted: 02/13/10 - 17:41    Post subject:
Shirley, thanks for the prompt reply. Yes, I had bilateral surgery. I also had a membrane that covered the sciatica nerve as well as the sciatic notch. Dr. Filler had to remove it and said it was genetic. I sure hope an injection will help. I've been on 2 rounds of Medrol, the first one helped but the second did nothing for the pain. I am now back on pain medication and have the burning awful pain in the butt and upper legs again. I spoke with Jodean in Dr. Filler's office and she explained the injection for scar tissue. I have to say I'm not terribly enthused about it because she referred to it as "subtle" release of the adhesions/scar tissue. I understood her to say it removes slight cases but not a lot.

I look forward to hearing what Filler tells you. Hopefully, yours will be simple enough to fix at his facility.
Radam
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PostPosted: 02/13/10 - 17:45    Post subject:
Shirley, I forgot to answer the part about the fall. I fell down some steps on my butt about two years prior to surgery. I was having pain at the time but nothing like what I had before surgery. He also said I had a lot of scar tissue on the piriformis muscle which had caused a "whole suite" of minor nerves, as well as the major ones to attach themselves to the piriformis.

Please stay in touch.
menzie
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PostPosted: 02/14/10 - 00:57    Post subject:
Jen and Shirley, thanks for your kind words and positive thoughts.
Jen, I do sometimes think God hates us, but I do still pray everyday, Smile but nothing from the big guy yet. I am so so so so glad that your procedures have worked out so well. Very Happy You are a lucky young lady.

Shirley, I sent you and email. I am done with my pity party for the moment. Thanks for caring Very Happy Thank goodness I can talk my feelings out on this site! Especially my icky ones. I really appreciate yours and everyones support. I always feel better when someone knows how I really feel. Truly this site is a blessing.

Radam and Meg, my d also had some stuff done on her pudendal nerve by Dr. Filler and I do feel that it did help some of her bladder issues. She does not retain as much #residuals if that makes any sense??? I really don't know what to do, so I go on, and try to not take myself out of any moments that seem to be going ok. But boy do I want my D to start having some radical improvement, and I wish that for you all.

I hope everyone truly has a wonderful Valentines day. My it be filled with sweets and laughter for you all. Your friend, Menzie Very Happy Smile Sad Smile Very Happy Sad Confused Mad : Smile That's me all
Meg
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PostPosted: 02/18/10 - 22:26    Post subject: Thanks for the welcome.
javascript:emoticon('Very Happy')Shirley and Mary, thanks for the reply. Here's what has been explained to me by a variety of very specialized physical therapists: the piriformis muscle is one of only 3 muscles that stabilize the hip, pelvis and sacrum. By removing that muscles ability to stabilize the entire pelvis, hip and lower back will rotate to the weak destabilized side, or maybe it's the opposite ( I just got out of the pool therapy and hit the morphine).

What I am hearing is the number of patients they are treating after surgery that are worse off. I have studied the bone, muscle and nerve anatomy at nausea-um. I already have a severe destabilized pelvis rotating right and arched forward (twisted) which can corkscrew the lower spine. At 60 years old I don't want to choose the wrong treatment. Therapists say the key is to develop the gluts to overpower and turn off the piriformis. this makes some sense if you don't have a giant spasm they can get to relax or quote let go.

The botox intrigues me as if it would put the muscle to sleep, allowing to build up my gluts. MRI or any such scan i.e. Dr. Filler are out for me as I have on large battery in my butt. My pain Dr. uses some type of image guided equipment for steriod shots, of which I just had my 12th and last!

There are so many of you that have had the surgery, do you experience any of the items I mentioned and how many of you honestly feel it was worth it after a year or two. Have you gotten more relief and mobility than a dose of morphine would bring. Not that I'm promoting morphine, but hell at my age I may be better off.

Look forward to all feedback I can get. I am facing a difficult decision and I know people may be cured and don't need support on a forum so how can you get the otherside of the story. Thanks

Meg Very Happy
menzie
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PostPosted: 02/21/10 - 23:14    Post subject:
Meg, my daughter had the surgery on March 25, 2008. She is not better in the idea that she still can not really sit or stand. But, her back of the thigh pain, calf pain, and ankle pain are all gone. Thanks for being a part of this site.

Shirley, thought of you all day on Tuesday, sending you good thoughts at your appt. I hope you had a positive visit.

Everyone else, hello, and I hope you have a good week. Menzie
scamp
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PostPosted: 02/21/10 - 23:30    Post subject:
Hi everyone. I got back home at 12:30 AM on Friday or Saturday. I was exhausted and did so much sitting that it has been hard to post. I will try to let everyone know how it went tomorow. Dr. Filler was great. He was in quite a good mood in spite of still being at work at 8:30 PM.

I will report tomorrow how it all went.

Bye for now. Am ff to bed.

Shirley
kartracer
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PostPosted: 02/22/10 - 14:23    Post subject:
I guess that I am late to the party. I am one of the gang and didn't even know there was a gang. I thought it was just me.

I am 5 years into piriformis pain. I fell on my butt on the garage floor from a 4 foot ladder at about 30 years old. It hurt like you would expect, but nothing permanent and I forgot about it. 6 months to a year later, I get the burning pain in my left buttock. First, only when I sit (while driving), and then also when I am sitting at my desk, and then gradually the pain is always with me. Just much worse when I sit.

I saw all of the doctors, therapists, MRI's, injections. As my life deteriorated, I felt forced to take a risk. All of the doctors that I trusted said it was discogenic pain, my L5-S1 has a central herniation and wouldn't hold fluid pressure during a discogram. I spent hours on the spine pain forums. Never really found anyone with quite my situation.

In the end, I had a fusion on L5-S1 in July 2008, but it didnt heal. Went back in to fix it in December 2008. It did heal. Some of my pain definitely went away. Low back pain went away. Some of the buttock pain seemed to go away. But the most intense area of piriformis pain stayed. Maybe overall, my pain level was reduced by 30-40%. It is hard to explain to friends and family that I thank God for even that improvement as I was near my limit of coping ability. Really gave me perspective when I know how bad it was, and how bad it could be again since I am not really sure what is going on.

5 years of narcotics. I have come to grips long ago that I will never be "normal". I don't even think about that anymore and it is counterproductive for me. I am just trying to carve out a "sustainable" life in which I can provide for my family and not suffer "too much."

I would love to have a piriformis operation if I thought I had a real chance of getting better. I have read the thread forwards and backwards and I am not sure what to think. I really want to believe, but I don't want to get any more messed up than I already am.

I am going to evaluate a spinal cord stimulator, just to see if I get any tangible benefit.

Sorry for rambling. I feel like I kind of know you all. I have spent 5 years trying to pretend that it isn't that bad, and only you guys really know what it is like. I hope you all find some peace.
scamp
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PostPosted: 02/22/10 - 22:05    Post subject:
First, Radam, as promised I will tell you about my trip to see Dr. Filler. The trip was exhausting. We arrived in on Tuesday. Then Wed. I had an appointment with Dr. Filler at 9 AM but didn't actually see him until about 11 AM. Got out of that appointment and went straight to Pasadena for the MRN by cab---very expensive but we didn't have a car and I would not drive on the LA freeway anyway. Then back to his office and got there about 5:30 PM--waited again for about an hour and a half. He then took me into his room with the open MRI and gave me an injection which seem to take forever. This time it hurt. I didn't get done until 8:30 PM and he still had more people to inject. He was in a great mood and joking around with me. I couldn't believe he was still working after I left.

He told me that I had one spot where the sciatic nerve was flattened by scar tissue and another place where the superior gluteal nerve was surrounded by scar tissue. He said the adhesions/scar tissue were so hard that he had trouble getting the needle in and kept having to change the direction of the needle--not fun. Also the piriformis ligament at the sacrum edge was like grissle or calcified and that may be why I was getting pain there even though the piriformis was gone.

I think he would have preferred to do another surgery. He continues to let me know that I am atypical in that I have so many areas that haave scar tissue or adhesions. He injected me with marcaine, cortosone and wydase. Jodean told me that he used a lot of wydase as well as marcaine. I couldn't stand on my right foot at all after the injection so had to use a walker to go back to the hotel. The sciatic nerve was temporarily numb. I was so glad to have my friend with me. It had settled down by morning. I think that the marcaine helped me to be rid of all the burning. I was extremely sore going home on Friday. I was better on Sat. and Sunday, again maybe the cortisone and marcaine. Today I am not doing as well. Dr. Filler said it would be 2-3 weeks before I would get any benefit from the wydase or is it wybase? So I will just wait and see.

Sorry to be so long winded.

Meg, like you, my glute max. as well as the medius and minimus which are hip abductors are totally weak and atrophied. I had botox for about 2 years every 4 months in order to be able to stretch the piriformis but never could do the strengthening of the glutes without getting lots of pain. After surgey I started out with the clam strengthen exercise and I can do that now. I will gradually build upto harder exercises. What do you mean that you have a large battery in your butt? I recommend that you consider the botox and it may help you work the other muscles.

Welcome kartracer. Sorry you have had to join us but this is a good forum to be on to have people understand how painful this condition can be. You are right. It is hard to explain to others. I too had a very hard fall and it was months later when the pain started and I didn't initially connect it with the fall but now am sure that is what started the whole thing. Some Doctors think it is my facet problem at L4-5 with stenosis which is probably part of the pain but not all of it. Most of my pain is in the middle of the butt, a stabbing pain and then burning all through the butt and down into the lower right leg to the foot, sometimes on the bottom and sometimes on the top. I also get pain in the IT band area and Dr. Filler said that is related to lthe superior gluteal nerve. I don't regret having surgery with Dr. Filler even if I am not fixed. Like you I am not sure I will ever be "normal" again. It has all become very complicated. If I can just get some relief from the surgery and be able to walk a good distance without lots of pain, I would be happy.

Thanks, Menaie for your well wishes. I really have to go. I am tired and my butt is still not happy sitting for long.

Bye for now.

Shirley

PS Radam is right. Remember that the people who are still posting on this forum are the ones who continue to have trouble. The successes don't post anymore bu there are a number of those earlier on the forum so don't let those of us who continue to have trouble scare you.[/b]
fitzroyj
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PostPosted: 02/22/10 - 23:33    Post subject:
Shirley, Sounds like such a long, exhausting day. Making that trip for the MRN is no fun; I really wish that facility were closer. I remember getting out late from my injections (it was around 7:30 or 8:00 pm) and there were still people after me - I couldn't believe it. I really hope this Wydase works for you and brings you some relief.

I have no doubt that there are many people who used to post here, and then got involved in life again once they began feeling better - the people still on this board are definitely not a representative sample. I was in that very lucky ten to twenty percent for whom injections alone brought long-lasting relief despite the severity of my piriformis and ischial tuberosity sciatic nerve impingement - so even though I never required surgery and I'm not one of Dr. Filler's typical patients (when he saw my MRN, he thought I'd need surgery), I did feel that it was important for me to stay here. I often feel very, very guilty posting on here because I'm one of the lucky ones who got her life back, but after the incredible support I was given prior to my visit with Dr. Filler, it's something I promised myself I'd do. I remember what it felt like to be be completely and totally hopeless and it's important for everyone to know that it actually is possible to experience normalcy, even after years of intractable pain.

~Jen
scamp
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PostPosted: 02/23/10 - 00:16    Post subject:
Thanks Jen. I am so glad that you stay on. It helps give a balance to the forum. Also you are always so supportive of others and that is greatly appreciated. I think it is wonderful that injections fixed you. Dr. Filler says in his study that there are some who are fixed by botox.

I am so tired that my head is dropping onto the keyboard so am off to bed.

Goodnight.

Shirley
Radam
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PostPosted: 02/23/10 - 15:15    Post subject:
Shirley, I'm glad your ordeal is over and hopefully you can get some rest. Did Dr. Filler tell you how long before you will know if the shots fixed your problem? I know you said 2-3 weeks to get relief but I had similar injections done prior to having surgery and got zero relief. It didn't even numb my legs or feet as it did to some other patients. I, too have to go to Pasadena for the MRN since it has been more than a year since I had surgery.

Sue, I tried massage therapy (trigger point release), physical therapy, chiropractors, stretching, epidurals, and just about every alternative you can think of before I had surgery. The stretching actually made me worse. Unfortunately, Dr. Filler is the only dr. who seems to have zeroed in on the area of pain. I went to neurosurgeons, orthopedic surgeons and you name it and was told that my back was in good shape. Nobody could tell me why I had the awful burning pain in my butt and legs. I also was very active, walked or biked every day and am in pretty good shape. Dr. Filler said that this condition can happen over a number of years and that a fall on the butt, which happened to me, can set off the pain. I had sciatic problems for most of my adult life but went to chiropractors who helped me over the pain. Although I believe Dr. Filler helped some of the pain, the intensity of the pain is back once again. So, I see him on 3/8 for my diagnosis. Hang in there, Sue. Thanks everyone for the posts. It helps to compare notes.

Rada
kartracer
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PostPosted: 02/23/10 - 16:02    Post subject:
Fitzroyj-

Please don't feel guilty. I, for one, get hope from your success. I am happy that someone in my situation actually made it to the other side.

There was a time after my fusion when I had convinced myself I was almost normal. It didn't last, but I also felt badly about posting on the spine forum where I had been a regular.

Now that I have been on both sides of the fence I can tell you that those of us who are trying to figure out what to do really appreciate you hanging around to tell us about your story, your success, and update us. That is very generous to do.

Bryan
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