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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hello- I Am A 56yo Retired Psychiatrist- D/t Complications Following

Hello- I am a 56yo retired psychiatrist- d/t complications following a c-spine decompression by posterior approach laminectomy (for severe cervical stenosis) which resulted in tetraplegia. Imaging after procedure revealed a new 4mm probable myelomalacia at c4-5. Myelopathy has progressed with multiple injuries( fracture and replacement of right hip and right shoulder as well as 8ribs, left clavicle. Left shoulder already impaired d/t injury-with unsuccessful rotator cuff surgery in 2011. Also HIV +(well controlled) but with osteopenia/porosity and severe DJD throughout, possibly a sequlae of chronic inflammation. Also htn, elev chol/lipids, hypogonadism on androgen replacement. Hx of testicular CA and orchicectomy(1985)- which may be influencing below question from surgery effecting tissues of abdomen.

My question- I suffer TERRIBLE constipation chronically with ongoing need for straining-despite rigorous bowel regiment- to be able to have BM. For time being I need to continue high-dose opiates d/t intractable chronic pain. Factoring in presumed connective tissue degradation 2nd to chronic inflammation/HIV, for the past two months I have inguinal hernias rapidly develop. Initially one sided now b/l. Currently reducible but more difficult to do as hernia enlarges. No pain or evidence of strangulation. B/l repairs to be scheduled.

Have had recent baclofen ITC pump installed and therefore I need to aggressively stretch and exercise to maximize acute benefits of GREAT reduction of SCI induced spasms.

Want to know if certain stretching or exercising of LE (or any activities)would be contraindicated until surgery can be scheduled.

Thanks!
John
Sat, 1 Oct 2016
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Hello- I Am A 56yo Retired Psychiatrist- D/t Complications Following