Low dose Amitriptyline Vs CAA?
Thread Starter
Amitryptilene, spinal fusion and back pain
I've been chatting with our company medical advisor (a non-pilot) about back pain and sciatica problems and he has mentioned the possibility of a low dose (circa 10mg/day) of this anti-depressant as a short term trial against pain and associated sleeplessness.
Any ideas as to what the UK CAA are likely to say? I'd hate to start something like this and then find out that the advisor/doc had prescribed something on the no-no list.
Glucosamine Sulphate and honey are not banned substances. I've already checked!
Any ideas as to what the UK CAA are likely to say? I'd hate to start something like this and then find out that the advisor/doc had prescribed something on the no-no list.
Glucosamine Sulphate and honey are not banned substances. I've already checked!
Last edited by blue up; 16th Aug 2014 at 14:24. Reason: Title change to more reflect issues
Thread Starter
I've had a reply to the message I sent them. They've suspended my Class 1 medical in anticipation of me collecting my prescription this afternoon.
I'm reminded of the opening lines by Hugh Grant in "4 Weddings & A Funeral"
I'm reminded of the opening lines by Hugh Grant in "4 Weddings & A Funeral"
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Similar stuff here.... http://www.pprune.org/medical-health...le-flying.html
Guess only the CAA can give you the definative answer, they get nervous about such drugs- it's worth mentioning that the dose we use for pain relief, is a fraction of that we use (d) for depression.
Guess only the CAA can give you the definative answer, they get nervous about such drugs- it's worth mentioning that the dose we use for pain relief, is a fraction of that we use (d) for depression.
Thread Starter
For the benefit of anyone finding this thread in the archives in years to come...I've had the best 2 nights of sleepin a long time! I managed about 2 miles of walking without any noticeable pain. The downside is that my mouth tastes like I've been chewing cardboard all day and I have to lay off of the booze. I'd say that it represents a fair trade-off.
The UK CAA want me to have been off the stuff for 2 weeks and to see an AME before I get my medical revalidated.
MRI scan booked on Monday. Fingers crossed.
The UK CAA want me to have been off the stuff for 2 weeks and to see an AME before I get my medical revalidated.
MRI scan booked on Monday. Fingers crossed.
Thread Starter
Just been to look at my MRI scans.
2 discs bulging aftwards and the vertebra between them is shoved forwards. He also thinks the vertebra looks fractured. Words uttered included something like "Spondidlyosis" and "Parrs fractures". I'm off for a few hours of Googling!
Injections, an epidural or fusing surgery. Any suggestions or personal experiences?
2 discs bulging aftwards and the vertebra between them is shoved forwards. He also thinks the vertebra looks fractured. Words uttered included something like "Spondidlyosis" and "Parrs fractures". I'm off for a few hours of Googling!
Injections, an epidural or fusing surgery. Any suggestions or personal experiences?
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I didn't have the fracture, but had one bulging disk and one ruptured. L3 was displaced. Much pain initially due to muscle spasms; these died away but I lost a lot of strength in my left leg due to nerves being pinched. L2-L3-L4 were fused and some stenosis cleaned up. I'm all better now (almost three years out).
Note I had been having mild spasms for a few years before the disk gave way. When this happened, there was NO DOUBT what the problem was. Many people have this operation too early, when the cause isn't very apparent. The results in these cases aren't always very good. You're past that point, like me.
Use the drug to carry you until you can get the surgery.
Note I had been having mild spasms for a few years before the disk gave way. When this happened, there was NO DOUBT what the problem was. Many people have this operation too early, when the cause isn't very apparent. The results in these cases aren't always very good. You're past that point, like me.
Use the drug to carry you until you can get the surgery.
Spinal surgery is a speciality in itself and one that is rapidly advancing
Please do not use this site to get advice. Anyone who gives advice without seeing your MRI (and being able to read it) should be ignored
All I can advise is to ensure you get seen by a specialist who does nothing except spines.
Please do not use this site to get advice. Anyone who gives advice without seeing your MRI (and being able to read it) should be ignored
All I can advise is to ensure you get seen by a specialist who does nothing except spines.
Thread Starter
I'm not actually asking for someone on Pprune to come round and glue my back together. I think it is safe to ask on here if anyone with actual experience of this matter can advise on post-op pain levels, recovery times, personal improvement in the short and long term etc.
I asked my wife about the epidural she had and her response was that it was fairly painless. Not sure I trust her.
I asked my wife about the epidural she had and her response was that it was fairly painless. Not sure I trust her.
Sorry I didnt make myself clear
Without looking at your scan and taking a history I can't tell exactly what is wrong nor what operation you need so I haven't a clue what your postoperative course might be
For example some fractures can be left, others treated with an epidural, some with an operation taking ten minutes under local anaesthetic that provides instant relief but others need multiple open operations and weeks in hospital
That is why asking other people who may have had a totally different problem is misleading
Without looking at your scan and taking a history I can't tell exactly what is wrong nor what operation you need so I haven't a clue what your postoperative course might be
For example some fractures can be left, others treated with an epidural, some with an operation taking ten minutes under local anaesthetic that provides instant relief but others need multiple open operations and weeks in hospital
That is why asking other people who may have had a totally different problem is misleading
Thread Starter
Likewise, I guess I haven't explained myself properly. What I wanted to know is if anyone here has had injections in the back, if they hurt, if the CAA frowns upon such things, if Epidurals need you to be admitted overnight or if you are likely to go straight home, if you can drive home after an epidural, if it treats the symtoms or the cause etc etc. Personal experiences. What sort of things might I expect.
Spinal injections or blocks are normally done under sedation as a day case
You will be in hospital for 2 hours
You need to be accompanied and cannot drive that day or go out
You can return to work the following day unless you are a pilot as you need to notify the CAA
15% of patients have flare up of pain for a few days, 15% have immediate relief and the remainder have some benefits
Relief can last for several months and you can have several injection,s over time.
You will be in hospital for 2 hours
You need to be accompanied and cannot drive that day or go out
You can return to work the following day unless you are a pilot as you need to notify the CAA
15% of patients have flare up of pain for a few days, 15% have immediate relief and the remainder have some benefits
Relief can last for several months and you can have several injection,s over time.
Thread Starter
Quick update. Had bilateral Pars blocks and a Caudal epidural. They gave me Rohypnol for the op and I can recall the juice going in and then the bloke (can't spell anesthesiologist) saying that it would start to take effect in about 30 seconds. Next thing I remember is having a cup of tea in my hand, sat up in bed. No idea at all about what happened in between but I was awake for the whole thing, so they say. Scary stuff, Rohypnol!
12 hours of feeling a bit doped up and then 48 hours of total relief. Next few days have been reasonable with a return of the tremors during the morning and backache whenever I've been exercising the back. Pins and needles have remained throughout. Fingers crossed that I'll be back flying soon. Next appointment in 3 weeks and then a few weeks without meds before a CAA visit.
The pic above shows the displaced vertebra and the 2 discs either side which are slipped aft.
12 hours of feeling a bit doped up and then 48 hours of total relief. Next few days have been reasonable with a return of the tremors during the morning and backache whenever I've been exercising the back. Pins and needles have remained throughout. Fingers crossed that I'll be back flying soon. Next appointment in 3 weeks and then a few weeks without meds before a CAA visit.
The pic above shows the displaced vertebra and the 2 discs either side which are slipped aft.
Thread Starter
5 weeks since the injections. Backache has returned to the pre-injection levels so I'm back to where I was before. Next step likely to be a bit more invasive. Still taking the amitriptyline and will continue to do so until the pain has gone.
Psychophysiological entity
A subject close to my heart.
Be clear, this is just general conversation between you and a retired pilot.
I'm puzzled about why it is thought the vertebra is displaced per se.
Significant Edit:
The front looks in line, with no sign of significant spurs. The 'leading edges' of L5 and S1 are naturally very pronounced.
I can only assume the hollowing in at the rear is the intervertebral foramen - on the red cut scan line - viewed from the opposite side . It will show as white.
Be clear, this is just general conversation between you and a retired pilot.
I'm puzzled about why it is thought the vertebra is displaced per se.
Significant Edit:
The front looks in line, with no sign of significant spurs. The 'leading edges' of L5 and S1 are naturally very pronounced.
I can only assume the hollowing in at the rear is the intervertebral foramen - on the red cut scan line - viewed from the opposite side . It will show as white.
Last edited by Loose rivets; 17th Apr 2012 at 22:40.
Thread Starter
Thanks for the input. The rest of the images also show that same vertebra misalignment to the rear.
I went along today for a check-up and he agrees that I'm back to where I was a few months ago and that the only real option now is Fusing. He showed on his whizzy computer program where the sticky-out bits of the rear of the spine had broken away and allowed the front of the spine (where the disc sits) to slip. Quite clear when he pointed it all out.
The op requires 5 days approx in hospital and 3 months off work, minimum. They have to go in from the front AND the back to remove the damaged disc bit and the then screw in some titanium to hold the bones together. Only got back 20 minutes ago so will be Googling tonight, with the approval of the surgeon.
Anterior lumbar interbody fusion
And, YES, it will make the security machine go PING!
The only other option is to join you in retirement at the age of 43.
I went along today for a check-up and he agrees that I'm back to where I was a few months ago and that the only real option now is Fusing. He showed on his whizzy computer program where the sticky-out bits of the rear of the spine had broken away and allowed the front of the spine (where the disc sits) to slip. Quite clear when he pointed it all out.
The op requires 5 days approx in hospital and 3 months off work, minimum. They have to go in from the front AND the back to remove the damaged disc bit and the then screw in some titanium to hold the bones together. Only got back 20 minutes ago so will be Googling tonight, with the approval of the surgeon.
Anterior lumbar interbody fusion
And, YES, it will make the security machine go PING!
The only other option is to join you in retirement at the age of 43.