answers about Cauda Equina Syndrome

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The information in midnightdemon is not intended to substitute for medical professional advice but is to be used only as an aid in understanding this condition. This site is not maintained by physicians. No medical decision should be made based on information in this site. A physician should always be consulted for any health problem or medical condition. This site is a compilation of CES patients’ thoughts, ideas and discussions, which we hope you will find useful, but it is not medical advice.

My doctor is an idiot at times, especially when it comes to treating CES. He thinks that because I have no back pain, I should be ok. What he doesn’t realize is the damage is in my foot/ankle and that is what is causing me the most pain.

WHAT IS CES?

The syndrome arises through nerve damage to the cauda equina, the horse’s tail of nerves that come after the spinal cord.

There is a specific pattern:

Severe pain in radicular (nerve root) pattern: back, buttocks, perineum(saddle area), genitalia, thighs, legs.


Loss of sensation: often tingling or numbness in the saddle area.


Weakness: in legs, often asymmetric (one side)


Bladder/bowel/sexual dysfunction: incontinence / retention of urine; incontinence of feces; impotence/loss of ejaculation or orgasm


Loss of reflexes: knee/ankle reflexes may be diminished, as may anal and bulbocavernosus. (a muscle of the perineum, the area between the anus and the genitals)

Any of these symptoms arising suddenly is a medical emergency and should be treated as such. These are the red flags of CES. You do not need ALL of these symptoms to have a case of CES. Any compression of the Cauda Equina nerves (shown through an MRI) IS CES!

I have had CES, Cauda Equina Syndrome, for the past 12.5 years. In the first few months it was difficult. I didn’t have supportive people in my life I could go to because there was no one I could find that knew what CES was. Recovery was slow. Painfully slow. It took almost a week till I was able to move the toes on my foot after surgery. It took almost three months to learn to walk with just a cane. Luckily the first go round did not affect my bowels or bladder. I had some retention of the bladder but this was thought to stem from my use of opioid medication. My surgery was at the L4/L5 level on the left side.

My second surgery (yes you can get CES twice) was at the L2/L3 level and it really caused me to become disabled five years later. At first my left leg was affected and still is. I still get nerve pain in my thigh at times, especially if I sit too long. My ankle/foot is another matter.

When I first got CES, I fell and sprained my left ankle while it was numb. Because I had no sensation in my foot/ankle I didn’t realize the extent of the damage until feeling came back, weeks later. Then I resprained my ankle in 2010 and again in 2011. This invariably lead to a condition known as CRPS (complex regional pain syndrome).

I have what I term CES-Lite. I didn’t have the textbook case of CES, where you lose function of your bowels and bladder, sexual function, weakness in one leg or both, loss of sensation in the saddle area, etc. I just had leg and back pain. My CES was caught within the 24-48 hour window. Anything greater than that risks permanent nerve damage.

It is possible to recover from CES. You just have to give yourself a LOT of time and perseverance. What one goes through is not going to be the same for another, even if they have had the same surgery at the same level. It is possible to walk again but you need to work hard at it. Going to a physical therapist that has had nerve damage experience is very helpful. Typical recovery time is anywhere from 9 months to two years or longer. It all depends on the circumstances the individual has faced and if the surgery itself didn’t cause more damage. This is all my opinion and I am not a medical professional. I am just writing this to inform those that come to my site looking for answers to these questions.

See my page about CES 101 to help with nerve pain and other complications from CES.

just the back

I had another easy day today. I didn’t go out despite the temperature being higher than it has the past few days. I did get some work done with my book. But now I feel downhearted. I remember what it was like getting diagnosed with my condition and not knowing if I was going to walk again. I took therapy into my own hands and relearned to walk again on my own with a little bit of help from this therapist and that. It wasn’t until my second diagnosis that I really decided I was going to be the ones making the call to walk again. I have learned to walk three time in my life and hopefully the third time was the last time.

I’m also downhearted because I keep thinking of my ex and what she is up to. But I know it would be too painful for both of us to open a line of communication again. I also been thinking of my other ex as I just wrote about her in my book. I’m not sure if that part is going to stay in it or not but for now it’s there.

I know I should not be so hard on myself for things that happened that weren’t my fault but I do still blame myself for things. I should have stopped seeing the chiropractor when I started to feel better. I should have stopped seeing my ex the minute she didn’t want to be around me because I was loud (second ex). And I should have killed myself in 2005 so I wouldn’t have had to face the last few years of being in horrific pain. Nobody understands what it is like to be in chronic physical pain unless they have gone through it themselves. And no one can tell me that the pain can’t be that bad to want to kill myself because I don’t have cancer. I wish it was cancer because then I know it would be terminal and there would be an end to the pain.

It’s like with the back pain. Everyone asks me how’s the back since I have had surgery. They don’t ask about my leg, foot, ankle, bowels, bladder. Just the back. As if that one thing determines everything else in your life. I know the reason for my foot, ankle, bowels, and bladder problems have to do with my back but the fact is that they don’t think the two are connected. And that hurts. It’s like my leg doesn’t matter only my back. I didn’t get operated on my leg. Just the back.

a Cold at Christmas time sucks!!

Today was another awful day. I forced myself out of the house to get my license renewed and nearly collapsed in exhaustion when I came home. I hardly ate anything today. I just ordered Chinese and didn’t even eat a small portion of it. I just have no appetite even though I have been thinking about food all day. I still am coughing and wheezing. I feel so drained. I am congested and I just feel awful.

Tomorrow is Christmas and I don’t think I will join in the festivities. I haven’t even wrapped my gifts or finished my shopping. I guess it will have to wait till I am feeling better. I don’t care. This cold has forced me to think about things. Yet not to think about them at all. Am I being selfish because I have not done anything? I don’t know. I just want to stay in bed where it is nice and warm and I don’t have to deal with anyone.

I am losing the sense of smell. My tastebuds have already flown the coop as my dinner didn’t taste as good as I thought it would.

I am pissed off at Walgreens for not filling my prescription because they need to have it clarified by my doctor. I don’t understand it. It says take as directed. How can that be misunderstood?? My doctor has told me how to take it so why is there a problem?? And it’s Christmas which means I most likely will run out of my script as the new one can’t be filled yet. I am so mad and when I went to voice my disgust with my mother I lost my voice because she couldn’t hear me because of my raspy voice. Nothing like trying to talk sense to a deaf person when you are ill. I hope they get this straightened out soon because I need my meds. I will fight with this stupid pharmacist if I have to.  She is a good person but I hate that she has to verify every prescription she gets!! That just takes too damn long in my book!!

I just realized I have not written anything in my journal in over a week now. And there are only six more days left in the year. I guess I will start a new journal sooner rather than later. I just haven’t had the energy of writing a blog and then writing a personal journal entry. It’s taken a lot of energy just for me to write this much.

I was supposed to go over my Aunt’s house but I never do on Christmas Eve. I have always done my own thing. Or I have worked. This is the first Christmas that I am not working. I got asked today what my job is and I told them I was disabled. How depressing.

Don’t know if I told you about my neuro opthalmalogist appt went. They still don’t know what is causing my eye changes. I still have to get new glasses as it was recommended that a new progressive lenses might help. I had to return my other ones as I could not see out of them at all, or I could for a little while and then all went blurry. I hated them. I have worn glasses since the first grade but these I absolutely could not stand. I liked the frame and all but there was just something wrong with the lenses. So my Christmas gift to me is to buy some new glasses. Course I will only go shopping if I am feeling better!!  This cold sucks!!

living with disability

Been thinking how this is the umpteenth Saturday that I have been out of work and I have to say not working on a Saturday night is weird. I had worked nearly every Saturday since 1996, with the exception of when I had to take the day off for family functions or vacations. It sucks to be disabled and I still cannot believe how fast things went from sucky to downright horrible in four months. In four months, I went from working two jobs, to working none. After fourteen years of working at a major medical center in the heart of academia, I was done, finished due to chronic pain cause by a disc fragment the size of an almond pressing on my nerve roots. This didn’t happen overnight. It took ten years to progress to a condition called Complex Regional Pain Syndrome (CRPS), all due to the fact that after my foot drop, I never regained strength in my foot/ankle enough to walk like a “normal” person or at least the way I walked before this fragment wrecked my life forever. I still remember going to a physiatrist that my psychiatrist highly recommended, only to be told that there was nothing to be done. That I was to live my life as is for the rest of my life. That my foot slapping and weakness was never going to get better. I just wish that he took the time to give me some alternatives other than this. If I perhaps was put into an AFO (Ankle/Foot Orthotic) sooner rather than later, maybe the outcome would have been different.
I have been trying to work on a comparison paper for the past few weeks and have hit a road block. I don’t know where I want this paper to go and am stumped as to who to ask for help with it. It was my idea but the depression of last month kind of through me for a loop and I am now trying to get back to my writing. The hard part is that I think this paper sucks, or rather that my writing sucks, and I just can’t move forward on it. I lost whatever it is that I was thinking when I first wrote the paper and I just can’t get back into the groove. It is very frustrating. And having to deal with my ankle flaring up every night for the past three weeks has not been helping me. All I wanted to do today was work on this paper but after I read what I wrote I just felt defeated. I don’t know if there is any salvation in what I wrote. I do know that my own criticism of the paper is what is getting in the way. I think it is stupid and doesn’t have any merit, but then I think all my “good” papers are that way. Today I got a good review on my psychological pain paper that I wrote in college. I am still trying to work out how I can go back to school. I want to be able to finish my degree. I am just working very slowly to actually getting up the nerve and doing it. I just hope that I still have time for my credits to still be worth something. It has been four years since I left college due to a psychotic break. Talk about being psycho. Books, email, and the radio were “talking” to me. I was utterly convinced that every song on the radio had a hidden message for me, that all my emails were somehow going being linked to the biggest asshole in the hospital I worked at and he was going to get me fired. While I was reading books or papers, the words were “dancing” and speaking to me in different languages that only I could decipher. Not to mention the voices I was hearing and the paranoia I was feeling from the asshole. Then when the normal meds were still not working, I had to go into the hospital again to get things sorted out because I developed another delusion that a coworker was going to kill me. I was sincerely convinced that she was. But once my meds were on board and I had to take them, it made thinking difficult for me. I no longer could distinguish my thoughts from the voices and when things were silent, I just couldn’t function. I have been hearing voices since I was five years old. I learned to adapt to keep them a secret but when you take meds that are meant to control them, everything stops and you just cannot think. I had a hard time reading and writing. I found that I would read the same paragraph over and over and not comprehend what it was. Words lost their meaning. It was a very difficult time for me and so I decided that school was causing me a huge stress and had to be cut out. I just had to focus on my jobs and getting back to good. Unfortunately, this still hasn’t happened. But I am hoping that with me not working, I can finish my degree. I just am fearful that I will become psychotic again from the stress of deadlines and exams.