Spinal stenosis pain troubles woman
Dear Dr. Roach: I am a 77-year-old female with spinal stenosis and have been treated by a pain management doctor over the course of several years. My pain is from my neck down to my lower back and radiates to my legs. The pain is constantly moving from one place to another and sometimes everywhere at the same time. I have received numerous injections in different areas, and at most, it has helped for about a month or two. I have read that a neurologist can be helpful, but I am not interested in surgery. Would seeing a neurologist be a waste of time?
V.D.
Answer: Local injections, medications, implantable devices and surgery all are potential treatments. Pain management doctors are very skilled in proper use of these treatments and can refer to a surgeon if necessary. I would consider a neurologist visit as a way to get a second opinion or another perspective.
Dear Dr. Roach: I am a 70-year-old woman. I started using a CPAP machine about 15 years ago. In the ensuing years I have lost 30 pounds. My CPAP machine recently started having problems, but due to insurance I won’t be able to replace it for a few weeks. So, I started sleeping without it. I use a Neti pot and a nasal strip before going to bed, and I take one Zyrtec every day. I have not experienced any daytime drowsiness that I had when I began using the machine. Is it possible I no longer need to use a CPAP machine?
N.O.
Answer: Obstructive sleep apnea is a condition where people periodically stop breathing at night. When a person is asleep, the muscles around the back of the throat relax, and this can be enough to close the airway. Oxygen levels drop until finally an internal alarm system wakes the person up.
It is possible that your weight loss has lessened the degree of obstruction. However, it’s also possible that you haven’t been off the CPAP machine long enough to develop the daytime sleepiness associated with poor sleep that is another hallmark of this syndrome. Another sleep study, where your oxygen levels are monitored overnight, would be necessary to tell for sure.