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Old 12-01-2003, 08:51 PM   #1
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Is fusion an option at 24 yrs old?

Hi everyone,

I was just wondering if anyone knows if doctors will do a fusion at age 24? I had one surgery at 23 on L4/5 but it is now re-herniated along with two other discs (the one above it and the one below it). Every doctor I go to is apprehensive and says "You're so young" but I am hoping that that might mean that I might heal a little better? I don't know if I can wait like this just to get old enough. I have a ENG this Wed. and then my follow up with my surgeon next Monday.

I'm just getting impatient and scared that I may not have any options and that this is it. Can't bear to be in this much pain for much longer so we have to find something.

Would be greatful for any suggestions.

Thanks,
Ribbit

Oh and I also meant to ask, does anyone know how long a fusion can last? Is it permanent or does it wear out like a total knee replacement? I would think it would be permanent since it is your own bone but then again maybe not?.?.?.

Last edited by ribbit; 12-01-2003 at 09:05 PM.

 
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Old 12-01-2003, 10:36 PM   #2
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Re: Is fusion an option at 24 yrs old?

Dear Ribbit,

Fusions are definately permanent surgery as once the bone solidifies its as if it were always there. If anything it's what can happen to the surrounding discs (such as is the case with you) that doesnt stay the same.

I am 24 and am 5 weeks post op from an L5S1 Fusion. My surgeon is very good and my age was on my side and i think any surgeon should give this opinion as it's just logical. The human body had such better capabilites of healing than at an older age. Your age is one thing that is definately in your favor, do not be disheartened because of that.

Perhaps the one thing i dread most is that a herniation of the discs above would occur and i dont know if that is something that naturally happens or varies depending on people's circumstances or what. You've had a fusion before and how did you go after? recovery wise? What did your surgeron say to you when it was found that there is a herniation? Did he say well thats just a risk of previous surgeries?

I'm here if you need to chat,

Love and hugs
Brooke

 
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Old 12-02-2003, 07:54 AM   #3
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Re: Is fusion an option at 24 yrs old?

Thank you so much for your kind words and your response Brooke! I'm very sorry that you had to have a fusion, but very glad to talk to someone my age about this!

The surgery I had was just a discectomy and they didn't fuse yet. My surgeon told me that this was probably in the future but they have always been worried about the levels surrounding the worst herniation which was at L4/5. At the beginning of all this stuff (when I nievly went in because I thought I pulled a muscle in my back ) the MRI showed a bulging disc at L3/4, large herniation at L4/5, and slight herniation at L5/S1. I asked the surgon why he couldn't just fix everythigng while he was in there operating on L4/5 and he basically explained that if they weren't the cause of my problems then he didn't want to bother them. I guess that make sense... don't fix something that isn't totally broken!

Well to wrap up a long story, I am a year and a half after the discectomy and thank the lord I did get function of my right back leg, however the other "tires" in my back seem to be blowing. They just did a discogram last week that showed a complete herniation at L3/4 (I guess it got tired of bulging and wanted to join the other discs in their party?), a reherniation of L4/5, and a large herniation of L5/S1. Ummmmmm.... Hummm... what now. The doctor that did the discogram, whom I highly respect along with my surgeon, was a bit surprised and basically said he was not sure what options I would have but that fusion would be one of them... he thinks. But he said the dreaded words..."But you're so young" I told him I can be older if he needs me to be.

I hope your recovery is going well. If your discs above where they did the fusion are in good shape, I don't think you have anything to worry about herniation of those. It is a possibility, but if you keep good movement in them and good blood flow to them they will be stroing and pick up the slack for the others.

Thanks again for listening! I hope you have a wonderful day ! I'm trying to figure out what time it is in Australia, but my map with time zones is at work and I'm not yet. Well, enjoy your day/night and I will look forward to hearing from you.

Love and hugs back,
Ribbit

 
Old 12-02-2003, 09:16 AM   #4
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Re: Is fusion an option at 24 yrs old?

Hi Ribbit,

First of all I wish you to recover soon and back into action.

I have some questions for you,

1. Didnt you take care of your back after the first surgeory,to avoid further herniation of other Disc's?

2.What did you do yourself to get your back injured in that way?

Even I have been diagnosed of having a Disc Herniation at L5-S1 and Disc Bulge at L3-L4. for which I have been doing couple of excercise's and not taking any medications. After Seeing your Instance I have started fearing what would be my fate.

BTW I am 22yrs Old

Thanks
Bhasi

Last edited by bhasi; 12-02-2003 at 09:17 AM.

 
Old 12-02-2003, 12:47 PM   #5
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Re: Is fusion an option at 24 yrs old?

Dear Ribbit,

You are most welcome, anything i can do at all, although it seems my story is nothing compared to yours, yet we're all individual.

So is the surgeon saying its time to fuse L3 through to S1? but he's not sure if he 100% needs to, but wont know if its fixed the problem until he does it so wants to fuse but says 'but you're so young?'? Is that right?

I think with these things, as my surgeon says you really wont know until you do it and unfrotunately that is a huge gamble and you would expect that scientific screening like MRI's and the years of training these surgeons have, that you would be able to get a somewhat more definate response.

As you said you cant bear the pain and i can somewhat share with you how frustrating and limiting it is.

On your side is that the lumbar spine is only responsible for forward and backward flexion and extension so thats what you'll lose. On the safe side you'll be fused and not much can go wrong in terms of internal damage from there once the bone grafts. So any disc issues and therefore pressures on surrounding nerves will be relieved. On the other hand as im sure you know, leaving these kinds of things can mean permanent damage to the nerves etc..

Its a massive decision with a huge recovery and so you have to be in the right frame of mind to do it. You cant go into a surgery of this calibre thinking you've done the wrong thing. I also suggest you check out the strand 'good fusion outcomes wanted' Its a huge strand on this site and im sure you will hear from people who may have had your proposed surgery.

Just remember though, yes you're young to have this surgery because people normally let it go until they're much much older. By then its too late and a lot of damage has occurred and their bodies just dont handle the recovery as well. You will handle the recovery because of your age.

In the meantime do what you can to get yourself fit and healthy so your body is strong to help deal with what ever decision you make.

As always i'll be here.

Love and hugs
Brooke

Oh yeah, its 7am in Australia now, i think its getting late at night over in USA prob about 8 or 9pm, not too sure.. sleep well.

 
Old 12-02-2003, 09:13 PM   #6
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Re: Is fusion an option at 24 yrs old?

[QUOTE=bhasi]Hi Ribbit,

First of all I wish you to recover soon and back into action.

I have some questions for you,

1. Didnt you take care of your back after the first surgeory,to avoid further herniation of other Disc's?

2.What did you do yourself to get your back injured in that way?

BTW I am 22yrs Old

Thanks
Bhasi[/QUOTE]

Hi bashi,

Well, when all of my back aches and pains began I really thought I had only pulled a muscle. Very quickly I began to lose function in my right leg and foot. Fortunately, everyone's discs are different and injure differently. Depending on just exactly the disc bulge or herniation depends on what the symptoms will be. It sounds like yours can be managed very well with exercises.

I started out with exercises but because I lost so much function so quickly (about 60% in 2 months) they pretty much had to do an emergency surgery to try and save the nerve that was being compressed. Basically the way in which the disc herniated and how far it went into the spinal canal put too much pressure on the sciatic nerve and it began to paralize my leg. Because nerve damage can become permanent quickly they (the doctors) could not wait.

When I went into surgery I already had a bulging disc at 3/4, a large herniated one at L4/5 and a herniated one at L5/S1. The doctor could and would only operate on L4/5 because it was the most crucial at the time and he said it would be too much to do all at one time.

I did take very good care of my back and still do after the surgery, unfortunately the extent of the damage was already there and I'm just taking it one step at a time for now until hopefully it can be repaired to the best of the doctor's abilities.

Cause: well, still kind of unknown. I worked on a rehabilitation unit in a hospital with stroke and spinal cord patients for a year. I did everything from bathing to lifting to transfering patients from bed to wheelchair and wheelchair to toilet. Things like that. I'm pretty sure this happened from microtrauma from catching falling stroke patients. No matter how many lifting technique classes I had there is really no safe way to catch a grown up as they fall to the floor.

Anyway, wouldn't trade the experience I had with all the patients for anything, but I am sad now that I will never be able to do that kind of work again.

Please don't think because of the way my story has worked out (and I definately could be worse!) that your back will end up with the same fate. Many many people have bulging discs that don't even know about them. I am so glad that your exercises are controlling your symptoms and strengthening those muscles around your abdomen and spine may be all that you have to do. And watch what you lift. Every spine is different and every injury is different. Just take good care of your back and when it begins to hurt, stop what you're doing and let it rest.

I hope this helps and that you are feeling better.

Sincerely,
Ribbit

P.S. Sorry about such a long response.

 
Old 12-02-2003, 09:23 PM   #7
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Re: Is fusion an option at 24 yrs old?

Hi again Brooke!

You are so right... it is a massive decision and one that I am going to have to be patient about. I love working with children and working in the medical field and it is just breaking my heart right now to not be able to physically do it. I have always been very athletic so not getting to run, lift weights, etc... is a big change for me.

I think one of the things that scares me was that the reason I had to have the first surgery was because I lost function, reflexes, and movement in my right leg. (I wrote about it in the post before this one) I don't think I have ever been so scared to wake up and not be able to drive one morning because I couldn't life my foot off the gas pedal. (I would have just been driving very very fast everywhere. hee hee) Anyway, I don't want whatever is going on in there to be permanent if I wait. But then again, as you say, the surgery is very risky too.

I think you are right and I have talked to several people who injured their backs and said they waited until too late and wish they would have not been so scared to just go ahead and do the surgery. And then of course there are others who are on the flip side.

If you don't mind my asking how did you hurt your back? And how are you feeling? Are you doing well after your fusion?

I have been thinking about you and your healing back today and hope that you are getting stronger and stronger each day!!

Hope to talk to you soon. I go for a nerve conduction test in the morning (it's about 11:15pm here so I think it's 4:00am there? Who knows. Anyway I'll be back on tomorrow after work.

Have a wonderful day,
Ribbit

 
Old 12-02-2003, 09:27 PM   #8
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Re: Is fusion an option at 24 yrs old?

Hi kaz06,

I am so sorry to hear that the fusion didn't take. Isn't it crazy how something that is supposed to help you like your immune system can turn against you too? Kind of stinks! I'm sorry that you have to face more surgery and that you're still in pain. I know a little about how that feels because sometimes I feel like the surgery wasn't worth all the pain I went through. I hope you get relief soon and that your second surgery goes better than the other.

Ribbit

 
Old 12-02-2003, 10:41 PM   #9
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Re: Is fusion an option at 24 yrs old?

Dear Ribbit,

I was always a very active child. In Australia there is an organisation called 'Little Athletics'. Its where all children enrolled meet each Saturday and 'compete' in a series of athletics events. Its all good fun and there are trophys at the end of the year and stuff for achievement. I was involved in this from when i was five to twelve years old. I was very good at Discus (a throwing event involving a lot of twisting and force exertion), i used to compete at little athletics and at school often going through to state championships etc so i trained as well till i was 18 and left school. On top of that i love horses so i rode horses regularly from ages 5 through to 20. I got my own horses when i was 17 so i would ride often twice a day and do all the heavy work with them too such as lifting feed bags (weighing 70kg plus more than my weight). Because i loved all these activities i didnt even consider for a second how my body would handle the wear and tear, it didnt even cross my mind because i was having too much fun. I was being a kid.

I was always too slim and muscular and from about 18-now i regularly went to gym etc and love weights training etc... When i was 21 I was wrestling with my boyfriend at the time and my back really began to hurt. I had experienced pain in my back before but nothing that i needed to lie down over or anything, but this time it was a little worse. I am very stubborn so didnt want to lie down. Instead we went shopping for the day and all that kind of stuff. Later that evening the pain was worsening so i decided to go to the doctor. He ran through all the normal tests and everything looked ok, and besides, back pain is so common... then we got the x-rays back and he told me he would be addmitting me to hospital that night. I was like 'Sorry...what did you say?' I dont remember much of what he said at the time because i was in shock and so wasnt in the absorbing mood. At the time I lived in Queensland and my parents lived in Sydney. I was living with my best friend and we were studying law together.
I called her and she very quickly came and took me to the hospital and called my parents who flew up. It was all a panic because they thought i had fractured my back that day. What i eventually found out (and this wasnt until a couple of months later) was that i had a spondylolisthesis. My L5 had slipped forward, only 25% (which i later also found out is not a big slip). At the time the doctors said this kind of injury was managable with exercise. So I went to rehab and tried all that. This managed it for a while, pain would come and go in bouts but nothing major. Within this time i had decided to move back down with mum and dad and put my studies on hold and focus on my health.
Over the next couple of years the bout of pain were getting more frequent despite the exercise i was doing (i was told to cut down by my physio and see if that helped), it didnt. I began to get strange pains in my legs that i still have trouble describing.
My physio said to me that she thought there was nothing more that could be done, i was very fit and healthy and still it worsened along with the pain in my legs. She said it was time to see a neurosurgeon and that surgery looked to be the option from here. I was never once worried about the surgery i dont think.
I eventually (1 year later) got into see the top neuro in Sydney (maybe elsewhere too, he is great) and he took MRI's etc and said that my sciatic nerve was slowly becoming further and further compressed by the disc buldging at L5S1. He said it would only worsen with the risk of permanent damage lingering.
I had suffered enough frustrations with limitations (days in bed from pain) etc and i knew even before he gave us his thoughts that what ever he suggested we would do because he was who he was. So on October 29 of this year i had a PLIF L5S1. I was so excited. I remember saying to my parents who came to the theatre door with me ' i'll have a new back when i wake up'. It is 5 weeks today and the improvements just keep on coming. Each week i am doing so much better. Whilst i am not feeling the best this is from medication overload. I have a small frame at medium height so my body is not too keen on all the medications and i have been very moody and upset of late so have cut out the medications all together to try and get things back on track.
I am also now in my second year of a new degree. Given my medical situation at the time I decided to study exercise science. I figured, i'd have to be active for the rest of my life, so i might as well learn all about the body so i can help myself and others. I am loving it.
Currently I go to hydrotherapy 3 times a week and walk every day (well try to). I am hoping in a week or so i can start riding a stationary bike or maybe some light weights to get back into shape. I have to basically start my resistance and cardio training from scratch because of the time i had off and surgery, but one step at a time i'll get there.

Like I said, i'll be here to help you make any decisions you need to or just to chat. Have a lovely day and a good nights sleep.

Love and hugs
Brooke

 
Old 12-03-2003, 09:49 AM   #10
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Re: Is fusion an option at 24 yrs old?

I have already started The treatment from past 10days, and going on with couple of excercise which were taught by Ortho..But my problem is pretty strange as I dont have pain or sharp shooting electric shock kind of experience all the times, its pretty periodic. Pain comes and goes and also I have not really Bed ridden (Thank God) Still I drive to office on my Cranky Two Wheeler and sit for 8-10 hrs at work. Ayurvedic Doc has asked me to undergo a specific therapy which needs me to get admitted for 10days.. As for I have heard about it. Its deals with some Oral Medicine and some Oil bath to lower back with Medicinal properties. Planning to go ahead with this at the last week of december.

However Ortho had given me Vioxx and a Muscle relaxant which I have stopped completly.

Right now I am only reling on Ayurveda Medicine, one a kind of Tonic (Which is so Bitter in taste I had to Vomit it, initially I started taking it. But Now I just Pop a pich of Sugar after taking the tonic)

Also I have been prescribed with couple of Pills.

But I really dont know whats the magnitude and seriousness of my Problem. I have posted my MRI Report in my Old thread, if any can tell me whether I the problem is small or really serious. It will be most helpful to me.

Thanks
Bhasi

 
Old 04-04-2004, 04:12 AM   #11
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Re: Is fusion an option at 24 yrs old?

[QUOTE=ribbit]Hi everyone,

I was just wondering if anyone knows if doctors will do a fusion at age 24? I had one surgery at 23 on L4/5 but it is now re-herniated along with two other discs (the one above it and the one below it). Every doctor I go to is apprehensive and says "You're so young" but I am hoping that that might mean that I might heal a little better? I don't know if I can wait like this just to get old enough. I have a ENG this Wed. and then my follow up with my surgeon next Monday.

I'm just getting impatient and scared that I may not have any options and that this is it. Can't bear to be in this much pain for much longer so we have to find something.

Would be greatful for any suggestions.

Thanks,
Ribbit

Oh and I also meant to ask, does anyone know how long a fusion can last? Is it permanent or does it wear out like a total knee replacement? I would think it would be permanent since it is your own bone but then again maybe not?.?.?.[/QUOTE]


Hi Ribbit,

I had my first fusion (L3/S1) at 15, I am now 28 and have cracked my fusion (one hard women, some people say).

So to answer your last question, no fusions don't always last, my X-ray showed that it was solid, but then I had a bone scan (Scintigraphy - I think they called it), only to find that my fusion had cracked.

Keep your chin up though, I know at the moment, things may seem glim and the pain unbearable at times, but there is hope. After my fusion I was active for quite a few years. Even though I am looking at surgery again, I am trying to take each day as it comes. I have to wear a TLSO brace with leg extention for the next 3 - 6 months, but I'm trying to make the most of the situation.

Over the years I have learnt different techinques to deal with the pain, and I have tried to look at the positives rather than the negatives. At the moment, even though I'm stuck in this brace and can barely move (not to mention the pain), I try to look at the positives (I don't have to get up early to go to work, I can still walk, see, hear, talk, I don't have to do heavy house work, the list is endless). When the pain seems unbearable, try to remember it will pass (even if only for a brief while). Also learning to use different methods to reduce the pain (i.e massage, heat, accupunture, visulisation, breathing, and pain killers).

Let me know how your ENG and specialist visits go (that is if you haven't had them already).

Take care
Emma

 
Old 04-04-2004, 05:55 AM   #12
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Re: Is fusion an option at 24 yrs old?

Wow,

This thread is real old, well i mean it hasnt been around for a while.

Well, I was 5 weeks post op at the time of my last post. I am now 5.5 months post op, I am 25 this year and my fusion has been deemed a failure. There are a lot of reasons why it failed. 30-40% would perhaps be my own doing because I kept a journal during the entire time and i remember that my menatlity at the time was, if i am feeling better I must be better which means i can do more activities - not so where back surgery is concerned. That couple with the remaining 60-70% being anatomical issues. The angle of my L5 and S1 even when brought back into alignment is not good - they are simply slipping off the screws. The bone graft isnt having much luck solidifying because of the amount of movement between the two vertebrae, connective tissue has grown between the graft site and so on and so on..

I have a CT late May and then the final decision is made. Lets hope there is some change between now and then.

Brooke

 
Old 04-04-2004, 09:42 PM   #13
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Re: Is fusion an option at 24 yrs old?

[QUOTE=Brooke79]Wow,

This thread is real old, well i mean it hasnt been around for a while.

Well, I was 5 weeks post op at the time of my last post. I am now 5.5 months post op, I am 25 this year and my fusion has been deemed a failure. There are a lot of reasons why it failed. 30-40% would perhaps be my own doing because I kept a journal during the entire time and i remember that my menatlity at the time was, if i am feeling better I must be better which means i can do more activities - not so where back surgery is concerned. That couple with the remaining 60-70% being anatomical issues. The angle of my L5 and S1 even when brought back into alignment is not good - they are simply slipping off the screws. The bone graft isnt having much luck solidifying because of the amount of movement between the two vertebrae, connective tissue has grown between the graft site and so on and so on..

I have a CT late May and then the final decision is made. Lets hope there is some change between now and then.

Brooke[/QUOTE

Hi Brooke,

Thanks for your reply, to be honest I didn't even look at the date, just saw that someone around my age, was going through similar experiences.

I am soooo sorry to hear that your fusion did not take, I had the same mindset as you (i.e I'm feeling better, so I must be better), but as you said that is not the case. I had a posterior insitu fusion from L3/S1 back in 91 for grade four Spondylolisthesis, luckily I had no hardwear put in at the time. I am now 28 and have just found out that my fusion has cracked and may be facing more surgery.

So what sort of surgery does your specialist have in mind? Are you still in a lot of pain? Can you feel the hardware? Sorry to fire a million and one questions at you.

Would love to hear more about how things are going with you, as from the posts you have written you seem very positive, which is what I try to be most of the time.

Hopefully, I will speak to you before May to swap war stories and to hear what you do for the pain, etc.

Take care
Em

 
Old 04-05-2004, 02:09 AM   #14
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Re: Is fusion an option at 24 yrs old?

Dear Em,

Im here every single day, this is my home away from home.

My surgeon is proposing to do the exact same surgery again (if it needs to be done again, prob about 80% chance it will). We are waiting till May 20 to have a CT and he will decide from there. I have defered from uni and cut down on work so i am resting a lot. This is my last chance at a fusion though he had said at 5 months there was not much sign of a fusion and so time wont mean much, it prob wont happen if it hadnt happened at 5 months.

I originally had 4 screws into my L5 and S1. The graft was taken internally from my hip. The same procedure will be done again though this time a substance will be used with the graft. It costs $7000 for a small vile of this stuff and its success rate has been great (although its not been used in Australia yet), we're hoping to have approval to use it by my expected surgery time (June sometime). The hospital stay is a month inlcuding rehab hospital which i want to be at. The first couple of weeks out of hospital were a bit much for me and i was quite sick as well so i would feel more secure this way.

I must look forward, there's no time to be upset or anything, i need to stay positive. I chose the path of surgery (on my surgeons strong recommendation) and once you do that there's no turning back, if it doesnt work you are in trouble and the only way out is to keep pushing further. My friends and boyfriend and workmates are great and have praised my positive attitude which makes me happy.

My pain is like it was before the first surgery. It aches and occassionally i get nerve pain, just as i used to. I dont take pain killers because i want to know whats going on to tell the doctor.

Fingers crossed for June!

How was your surgery performed if no instrumentation was used?

Brooke

 
Old 04-05-2004, 11:12 PM   #15
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Re: Is fusion an option at 24 yrs old?

Hi Brooke,

Like you, Iím starting to make reading everyoneís posts a daily exercise. I have found a lot of valuable information, but what I value most is talking to people who are going through similar experiences.

I really hope your surgery goes well in June, I will have my fingers crossed for you. The magic vile you talk about sounds interesting (you wouldnít know what itís called?). I live in New Zealand and find the specialists over here a little backward, and Iím hoping that ACC will pay for my surgery in Australia (you never know we could end up in the same hospital, as I should find out about May, June if I need surgery).

I had an insitu posterior fusion to L3/S1, they were supposed to put in hardware, but because of my small frame they decided not to, something about the screws piercing through my stomach lining. Luckily for me my fusion took, but 13 years on my fusion has now cracked at L5/S1, so like you I am probably facing more surgery if it does not mend after spending 6 months in a body cast. Iím hoping that it will, but deep down inside I know that I will be facing more surgery, which is a scary thought, but as you say there is no turning back once you have opted for surgery. I have an 85% slip, so if I leave it there is a very high chance I could end up in a wheelchair.

I agree that you need to keep a positive frame of mind, it doesnít get you anywhere feeling sorry for yourself. Friends, family and work mates are definitely a great help for keeping a positive attitude. Keep up that winning attitude.

You mentioned you are still working, thatís amazing. I have been off work for three months now and couldnít imagine going back to work right now (even though I would like to).

I really admire your strength.

All the best and I hope to speak to you soon!

Take care
Em

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