follow-up with Dr. Dobecki

I met with Dr. Dobecki to discuss my back. I also brought up my recent (approx. one week) neck pain....

• virtually no improvement from facet injection. ok, now we know that my low back pain is likely primarily discogenic

• my pain does seem to be worsening somewhat, so he would prefer that i increase my medication dosage, rather than drinking alcohol as i've been doing. he suggested doubling the tramadol (ok up to 400mg/day) and the gabapentin (up to 4000mg/day!, better at night because may cause drowsiness). he is giving me refills, plus a vicodin prescription for "emergency" pain relief

• he is concerned that my neck pain could be disc related as it is radiating to my left armpit and also causing numbness in my left forearm and hand. he is ordering an MRI and also a cervical steroid injection

• i showed him my latest MRI of the low back, and he was able to pull up a printout of the verbal description from imaging healthcare which he photocopied for me. looking at the images, he said everything looks about the same, except for increased inflammation at L5 and also some spondolysthesis (sp?) (slippage) at approx. Grade 1 severity. we talked briefly about how if that gets much worse, it could preclude a disc replacement(!)
  

• he said that i should mention these new factors to Delamarter and also to Dodge when I see him regarding my neck. He says that Dodge would order an MRI for my neck anyway, so it's good that we are already getting that in motion.