An 88-year-old female who has lived in the UK for nearly 50 years having worked for the NHS in England as a nursing sister was referred to me by her medical specialist son-in-law (reputed senior physician in Colombo).
She attended my ‘London Pain Clinic’ together with her daughter who grew up in England. She presented her pain issues to me and I must say the communication was fantastic and I felt like I was back again in an English clinic. She handled the Queens language so articulately. Presentation was simple and straight forward without beating round the bush.
Her presenting symptoms were lower back pain which was unbearable. She also had pain running down the legs. She suffers with osteoarthritis and osteoporosis. She was on a mixture of mild to moderate pain killers.
 Caudal Epidural |
The daughter’s request was to keep her mother pain free. She had a MRI scan which showed multi level disc degenerations plus disc bulges in the lumbo sacral area plus enlarged facet joints (facet joint hypertrophy). Facet joints keep the vertebrae in place. Joint itself is made up by the vertebrae itself lying over each other. These act as the shock absorber in the spine.
I listed her for a Caudal Epidural plus an Epidurogram under c ray guidance and L2/L3 L3/4 L4/5 L5/S1 bilateral facet joint injections.
The procedure was carried out in a hospital theatre setting (Asiri Central).
I sedated her for the procedure. Procedure was successful and uneventful despite her age (88 years).
Following are some pictures of the procedure.
https://lh3.googleusercontent.com/Ljk7gf1637JSXgrpISMlDjsYxGTkl4qSMKMBF6... Epidurogram
I received a couple of what’s app messages from the grand old lady that she was doing well. I also received a text from the daughter after 2-3 weeks that the mother was doing well and pain free. Does not use pain killers other than the odd paracetamol. I attach the messages without any names to maintain patient confidentiality.
I wish the lady very best of health and pain free life. Facet joint right L2/3 injection
https://lh3.googleusercontent.com/C-m2NyYbhsGqCnAlE25fK_gWykvjWaPsKenald...
I quote Good morning
Dr. Namal
My mother in much less pain... managing with just the paracetamol. Sometimes doesn’t take that either Yesterday she had a hair cut.
My brother and family are arriving from Germany today and she is joining them in Negombo for four nights.
Just wanted to update you. Lots of blessings to you. It was very sad to see her suffering. Quote ended.
This is what medicine is all about.
https://lh6.googleusercontent.com/W7Zm1-kdETsn4haU2j2PPxLjVZbv1Y9VZzpmms...
The writer is Dr Namal Senasinghe MBBS, Dip in Pain Med, FFARCS, FFPMCA Consultant in Pain Medicine (In the specialist register UK (GMC) and Sri Lanka (SLMC)) as a specialist) London Pain Clinic
31, Horton Place
Colombo 7
Sri Lanka
Tel - 0767155716 (Clinic)
E mail - [email protected]
