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Old 01-25-2005, 08:34 PM   #1
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StMishl HB User
Worst Case Senerio

OK, I know i'm being WAY pessimistic, but I do way better knowing the worst case senerio. I know some on here have failed fusions. I know at 6 weeks its too soon to tell, but my last x-rays show no fusing yet. TLIF fusion 12/13/04 (pedicle screws & rods), with BMP and my bone marrow, i'm 33, with osteoporosis (taking fosomax). I just experienced 18 hrs with no pain pills (accidently) and realized that my 4-5 on the pain scale is really a 8-9 (I literally couldn't catch my breath it was so bad).

I have a few questions if anyone can help:

1) At what point do they decide you "should" see signs of fusion on an x-ray... if i'm panicing too early, then when should I?? (I keep reading of others who are fusing already, and feeling great - in all honesty I feel pretty poopy, and there is still all "white mist" on my x-ray - no fusing yet per dr who is repeating x-rays every 2 weeks). He hasn't said he's worried yet, but has kept postponing PT until he sees signs of fusing. At what point am I a failure

2) I wear a corsett brace 24/7 and a bone stim... (dr's orders) is there anything else at this point I can do to encourage this thing to work?? I think I've followed the rules What am I doing wrong??

3) IF (again, realize i'm likely being pessimistic here) I don't fuse - then what?? More surgery? What? Will I just walk arount with a back missing bone??

4) I did not ever have a discogram (discograph? the test to see what is the pain generator) - my dr decided from MRIs and x-rays and ESIs that my pain trigger was L4-L5 (DDD, herniated and nerves a total disaster) and that L3-L4 was slightly herniated and neves compressed adding to it. During my surgery they fused L4-L5 then removed the protrusing part of the disc from L3-L4 and did a laminectomy (I think?? Where they open the space up to let the nerves move more freely??) of L3-L5. But I'm only fused L4-L5. In hindsite how bad of a mistake was not having the discogram (graph??)? I trust my dr. (both pain dr and orth spine specialist came to same suggestion) but now wonder. If things don't improve soon, can they do the disco-whatever still?

Okay, clearly I am freaking out a bit. I am really happy for everyone who is doing well, but I honestly feel like a hit a wall at 3 weeks (now 3 1/2 weeks ago) and haven't improved since. I try to have a good attitude, even went to work PT starting yesterday (sitting at a desk), but why isn't this getting any better???
Everyone (my mom, my husband, my boss) expect me to be normal now, and 90% plus healed... "its been SIX weeks!!" But I feel as if i'm stuck, or even going backwards!! HELP!

Sorry I wrote a novel... This is just about the only place I can have "real" feelings.
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StMishl Failed Bk Fusion, facet joint/hip issues & RA -Wish I could Jump like him!

Last edited by StMishl; 01-25-2005 at 08:38 PM.

 
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Old 01-25-2005, 09:18 PM   #2
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misery HB User
Re: Worst Case Senerio

Did you say you went back to work already? Every BODY heals at adiffernet rate and you have had a very major surgery, You aren't far enough into it to be worried yet.I didn't show bone growth for 4 months,so don't start to panick.You also need to have a great frame of mind,for your recovery.Please don't let your friends and family make you feel like somethings wrong because it isn't.besides they are not going through this you are. To me your pain level sounds quite normal,it's different for each one of us.AS far as diskograms yes I had one before my I-det Surgery and one after because the I-det didn't as far asI know you can have one at any piont (I could be wrong on this piont).The diskogram is very painful and that is the piont of the test, to recreate your pain so they know wich disks are causing you grief.So knock on wood that you haven't had to have one yet.
Again please don't let people make you feel like theres somthing wrong because your not on there time table,my mother inlaw tried this with me because she head back surgery 20 yrs. ago. So she doesn't see what the problem is,but she didn't even have the same type,I just keep telling myself that she does't know what she is talking about.
I hope this helps take care.H

 
Old 01-25-2005, 11:03 PM   #3
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mel1977 HB User
Re: Worst Case Senerio

I also would wonder if the osteoporosis could affect your healing that is a great question to ask your dr! I think that is where you should start. But I have heard it can take up to 18 months to heal. I wish I had something to share. I had a discogram first but that was to determine if I was a candidate for surgery, and to be sure the discs were causing the problem. I think they only show degeneration though, not bulges or other issues. So, unless that disc is degenerating, I don't know if a discogram would be good or not. I truly have no idea though, this is just a thought. Why don't you write all these down and drop it off to your dr and see if he can call you to discuss them. OR, see if you can get in soon to speak with him or if you can walk in. I wish I could help, I just don't know.

 
Old 01-26-2005, 02:59 AM   #4
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Losy HB User
Smile Re: Worst Case Senerio

The reality is that you r only 6 weeks post op and recovery and evidence of bone growth (succesful fusion) can take longer than this. I think its important that u remain positive and do as your dr has asked. Each of us heal at different rates. It took me close to 12 before I had returned to a normal lifestyle - full time work etc.

Im a little confused as to why you have returned to work only 6 weeks post op. It took me much longer than that. I would think that sitting in the work place would not be ideal for u and would explain why u r experiencing an increase in pain.

I think u would be wise to slow down and expect less of yourself. As for the expectations of others, ignore them or if you have the energy educate them. They dont appear to understand what you have been through and what recovery from sugery of this nature entails.

Hang in their, be patient and it will happen

good

Luck

Losy

 
Old 01-26-2005, 05:59 AM   #5
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Rhonni HB User
Re: Worst Case Senerio

At 6 weeks for me they could only see very faint smokieness of fusion starting.. not even enough to report on. Then, at 4 months, I was 100% fused. Don't worry. It's not time to worry yet.

Of course your pain shoots up without your pain meds... you just had surgery!
Have you been taking extra strength tylenol to hold you over or have you just been without meds entirely?

I can tell you, for sure, that much of your current anxiety is from coming off those pain meds for 18 hours. It's a symptom of withdrawal.

You're doing fine, really. Just do what your discharge papers have told you to do, and anything else your doctor has told you since then. You can't rush this, nor can you sit and fret about it...remember positive attitude goes a LONG way.

If you find that you're still fretting over this, call the doctor's office. I did (and it was at about week 6 if I remember correctly). The PA relieved me of all my worries and I was able to continue along the healing path in the right frame of mind.

 
Old 01-26-2005, 06:57 AM   #6
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StMishl HB User
Re: Worst Case Senerio

Thanks guys.
The pain pills must have finally "caught up" and I feel much better today. I only worked 2 hours today, and may talk w/ my boss today about waiting until next week to try again - maybe I did push it a bit...


thanks for the support - Still worried, but less panic-y now that i've got meds and theyre working again

You guys are great.
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StMishl Failed Bk Fusion, facet joint/hip issues & RA -Wish I could Jump like him!

 
Old 01-26-2005, 11:38 AM   #7
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injured betty HB User
Re: Worst Case Senerio

[COLOR=Magenta]1) At what point do they decide you "should" see signs of fusion on an x-ray... if i'm panicing too early, then when should I?? (I keep reading of others who are fusing already, and feeling great - in all honesty I feel pretty poopy, and there is still all "white mist" on my x-ray - no fusing yet per dr who is repeating x-rays every 2 weeks). He hasn't said he's worried yet, but has kept postponing PT until he sees signs of fusing. At what point am I a failure [/COLOR]

Everyone's body is different. My husband did not show evidence of the beginning process of fusion until the twelveth week. I would say that if you don't fuse by 18 months, you might be a failure.

[COLOR=Magenta]2) I wear a corsett brace 24/7 and a bone stim... (dr's orders) is there anything else at this point I can do to encourage this thing to work?? I think I've followed the rules What am I doing wrong??[/COLOR]

Walk, walk, walk. You can take long walks, or a lot of short walks, but walking is essential. If you smoke, drink soda, or eat chocolate, give them up. Everyone starts out with an 80% chance of fusion. I am not sure how they come up with those statistics but that is what I have read time and time again. You want to be in the 80%.

[COLOR=Magenta]3) IF (again, realize i'm likely being pessimistic here) I don't fuse - then what?? More surgery? What? Will I just walk arount with a back missing bone?? [/COLOR]

They took out a disc, so you would just be missing a disc, which is not bone. You would be a member of the FBSS club. They would talk you into another surgery. They usually save the *illiac crest graft* surgery for last, just in case the BMP or your own bone marrow or a cadaver bone doesn't work. Using your own illiac crest bone is the gold standard of fusion, but it is usually used for last. That is what you would, in all likelihood, be offered.

[COLOR=Magenta]4) I did not ever have a discogram (discograph? the test to see what is the pain generator) - my dr decided from MRIs and x-rays and ESIs that my pain trigger was L4-L5 (DDD, herniated and nerves a total disaster) and that L3-L4 was slightly herniated and neves compressed adding to it. During my surgery they fused L4-L5 then removed the protrusing part of the disc from L3-L4 and did a laminectomy (I think?? Where they open the space up to let the nerves move more freely??) of L3-L5. But I'm only fused L4-L5. In hindsite how bad of a mistake was not having the discogram (graph??)? I trust my dr. (both pain dr and orth spine specialist came to same suggestion) but now wonder. If things don't improve soon, can they do the disco-whatever still? [/COLOR]

Discograms are controversial. I would never have one. My husband didn't have one and he had a fusion. Hindsite is always 20-20 and second guessing yourself will drive you crazy and intensify your pain.

I think that you are jumping the gun, so to speak, give it time.

[COLOR=Magenta]Okay, clearly I am freaking out a bit. I am really happy for everyone who is doing well, but I honestly feel like a hit a wall at 3 weeks (now 3 1/2 weeks ago) and haven't improved since. I try to have a good attitude, even went to work PT starting yesterday (sitting at a desk), but why isn't this getting any better???
Everyone (my mom, my husband, my boss) expect me to be normal now, and 90% plus healed... "its been SIX weeks!!" But I feel as if i'm stuck, or even going backwards!! HELP![/COLOR]

Going to work was a good thing. It should help pick up your spirits. Healing takes time. It took awhile for you to get to the place where you needed surgery and it will take some time to heal. Positive thoughts

Your mom, husband and boss need to walk a mile in your shoes. Just take a deep breath and try to move on. Don't let the get you down. I knew that when my husband had his fusion, the most important role for me to take was to be supportive and positive towards the entire process. Together, you will make it through this.

take care,

 
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