Hey all... so as some of you know I have 2 herniated discs at L5-S1 & L5-L4 & and have had one neurosurgeon opinion that I will need a fusion at L5-S1 7 maybe just disectomy at L5-L4.
He has said it needs to effect the quality of your life b4 he will operate but my question is if I am not going to get better (which I won't since this has been going on for over 20 years) why should I wait to get more severe symptoms (drop foot, etc) that based on these boards usually don't clear up even after surgery for most people?
I've done all the preventative things and can still work & do most household tasks but every major episodes brings on worse symptoms that don't go away. I can't workout, run, play golf, bowl.
Any thoughts would be great!.. Dave
PS: I am planning a second opinion with an ortho surgeon soon. Oh and I'm 48 yrs old too.
I had the same thing my first back surgery. (Wait until the quality of life gets bad) Only to be in the hospital 6 months later with drop foot and bladder problems. Went through 5 years of failed back surgery, and the same thing with the surgeon. (Quaility of life crap for the next operation) Finally, I got tired of pain and then drop foot on the left leg, I walked like I was in the mud. Finally I just kept changing doctors. I found one who understood that I was the provider of my house, and having me down would cause great problems. I was down to not being able to walk to my car from my house. Now 1 month from my first surgery, I will have 1 or 2 more surgeries in the summer (I am a teacher) I have learned to tell them what I expect and not being submissive to them. I wish I could have went back 5 yrs ago, loss the loyalty to doctor thing, and demanded to be fixed instead of just giving me drugs and waiting. It's tough you want surgery to be the last resort, but you get tired of doing nothing when you are in pain. Good luck
Did they ask you about the quality of life changes..for example mine did..they would say on a scale of 1 to 10 how would you say this has affected your sleep, your work, your relationships, your ability to care for yourself etc.
I know we have to be our own advocates and you are the only one who knows if your at the point where your ready to bite the bullet or whatever the saying is.
I wish I would have had surgery within a couple of months of L5-S1 herneation which happened in May 06. I worked hard at PT and got enough improvement that injections and conservative treatment was used. It was the PT that helped (or compensated) though. I still have not gotton pain and activity to an "acceptable" level. After 6 months of conservative treatment, the surgeon was finally more than willing to do surgury and told me to call for an appointment. That was a couple of months ago, and I am stuck like a dear in the headlights. I go back and forth with myself, which is probably what you are doing. I am getting by at a physically active job (not hard labor, but bending and twisting). I cannot afford to make things worse. Thinking like a family provider aside, I don't expect to be able to run well or bowl, but I would like a chance to wrestle around with my two boys again (before they are strong enough to whip a healthy me), and to have less painful and more frequent good times with my wife of 17 years. It's not only my quality of life that is affected.
An EMG last month showed "moderate/severe L5-S1 radiculopathy". Because there are disc fragments that could make things worse, I finally called to schedule the discectomy. Now, because it has been almost 9 months, I need to get another MRI. This makes sense, but its frustrating that now that I want the surgery (like I did 7 months ago), the costs will go up and more time will pass, more trips out of town, and more time off of work. In addition, I wonder how much the pain and nerve damage will improve, if any.
I am sorry I waited and did not force the issue earlier. That being said, here is my opinion on why to wait. There is no guarantee it will help. It may cause new problems, like additional instability of the spine. You will have time off of work. Surgery is serious, especially if you have a family history of blood clotting, anasthesia issues, etc. It has already been a long time for you ... if you have nerve compression, doesn't the length of time a nerve is compressed affect its chances for working again?
However... with hesitation for the above reasons, I am considering going forward with the surgery because if I do get worse, I will always wonder if further deficit could have been prevented with surgery. There is a chance I could get better with surgery, and I would rather chase hope than dodge depression. I am holding my own now because of light daily excercises (morning, lunch and evening). If I were to catch the flu or the like causing me to be sedentary (or sneeze a lot!), well, I'de rather not think about it, but I'm pretty sure I would loose ground quickly. So, like you ask, WHY WAIT?
Davesport and Crookedback may I say this. Would you think about the new surgeries available. I provide for my family, I went from Physcial labor (HVAC/R tech in NYC/Jersey city) to being a shop teacher. I have had a Microdiscectomy and just had a Minimally invasive operation. I can tell you hands down you will go back to work faster. A ton less pain and they can now after doing the disccectomy repair they cotorize the disc so the inside gel doesn't keep irritate the nerves. I think that was one of my biggest problems after the first one. The second biggest was the scar tissue. I didn't realize that the scar tissue was such a problem. I saw the pics myself. The scar tissue is like thick layers of spider webs and it was grabbing the nerves in the back causing more pain than the disc herniations. It will take me another 2 more months(1 already) to let the nerves repair itself, and I can tell you it is 2x more painful than the back ever was. You can find all the info online. If you can't just send me a shout. I had spent about 6 months weighing in on the decision. (Scared to death) Finding the doctors and getting the correct surgery for my problem, getting the insurance to accept it. Looking back I am so blessed I did this.
Once finding the surgeon thats ready to do the surgery you need. Then your faced with this decision, and that is a nerve racking one. I got really freaked out just making the decision and cried. This crap has been haunting me for so long, I haven't worked in a year and live on meds.- My final thought on it was, what if the surgery worked and I hadn't tried. In my case..its my only hope of this situation getting better....so I decided to go for it. I guess the scary part for me is having fusion...knowing its gonna get alot worse before it gets better eeekkk.
Sorry for my rambling here...didn't you say that you were going for another opinion?
Yep... I will get a 2nd opinion & maybe a 3rd... and I'll tell y'all this... if I could be "guaranteed" that no more damage would occur, I would not have surgery... I understand the risks... unfortunately, my history does not present this... after each herniation (I've had 3) and after the pain subsided, I was left with further nerve damage that does not return.
It has been a year since my last herniation & the nerve numbness/pressure in my feet has not improved & in fact has gotten slightly worse.
What makes it so difficult for me to decide is that I donot have excruiating pain, more like soreness & stiffness...
Man... this is the tuffest physical decision of my life... but i kinda knew it would come to this after my 2nd one at 35...
... after each herniation (I've had 3) and after the pain subsided, I was left with further nerve damage that does not return.
Dave,
Oh that's scary. That's what I'm wondering about too. Will further damage occur if I don't have surgery. I guess even with surgery, it could reherniate...
What do you mean by nerve damage? Did you have permanent numbness or weakness that got worse after each herniation?
Like crookedback, my pain is rarely excruciating anymore. If I do something that hurts that bad with lingering effects, I don't do it anymore. I am stubbing my foot on curbs more when distracted with things like the next task, which is a concern of mine. The addition of testicle pain a few months ago when I relax my back muscles is also a concern.
In some ways, I see numbness as a blessing compared to pain, but hard to say sometimes.
Thanks picnica for bringing up the minimally invasive alternatives. I would need to speek with somebody that does those to see if I was a candidate I suppose. I've read a little on it (internet ads and info), but the surgeons PA says I would be back to work in a month with a 40lb limitation, so I haven't pursued it much since this surgeon is only 40 miles away and has a good reputation. Does that seem like a reasonable time frame for a 39yo with DDD and L5-S1 fragments that will be working right up to the surgery date? This does weight heavily in the decision making. Thanks so much for feedback.
I have spent allot of time doing the research and seeing different doctors. The first back surgery failed. I didn't want that to happen again. So, I did all my homework, but I no longer have to lift for my job. Happy hunting. Feel better
Doesn't that go in the mix of things? With nerve problems and letting them go untreated couldn't it further the chance of never being able to recover?
I hope you can get more opinions soon. I know its not easy making these choices. For me...I thought it was my only chance of healing. Wishing you the best.
When I agreed to my daughter's surgery it was a quality of life issue. She wasn't living the life of a 15 year old. Armed with three opinions and two years of non-surgical interventions we were ready to try surgery. Her surgery was for spondylolisthesis and she was given great percentages for pain relief, in the 90s. Her foot had begun tingling so we knew it was time. Her dr had been treating during all this time so waiting wasn't an issue for him. He had wanted to do the fusion one year prior, but I wasn't ready. A year later I knew it was the right thing to do. You will know when surgery is right for you. cas
To Cythren: After my 2nd herniation (35 yrs old) at L5-S1, I was left with numbness in my outside 2 toes of my right foot & some muscle atrophy of the entire right leg (1/2" diff in size).
After my 3rd herniation (Feb '06), I was left with more numbness, pressure & mild pain (3 out of 10) in the right leg & numbess & tingling in the left big toe, outer calf & upper thigh. I also half numbness in my right butt cheek.
I fortunately am not presenting any serious weakness at this time & that is why I am seriously considering the surgery now because that is the next step.
Hope this helps & if you have any other questions don't be afraid to ask!
I've only had one herniated disc, but it's very similar to what you described. It herniated in early December 2006, and the pain went away in February. Now I am left with muscle weakness and atrophy in my left buttock and calf, and some numbness in left foot.
One more question for you - are you saying that each time you had a herniation followed by weakness and numbness, that the weakness/numbness didn't ever get better? Were you able to regain some muscle strength?
Hi Cythren... we could be back problem twins! As far as my history, I did have some slight drop foot (left) the first day of my lastest herniation which did go away in a few days. And, I have been lucky to this point, that although I have had some sensory nerve damage (nerves are like coaxial cables w/the sensory fibers on the outside & motor fibers on the inside) as proven via EMG, I do not have any real strength loss.
But related to the numbness, pressure feeling in right foot (which is actually more severe then the 2nd herniation) & atrophy it has not improved.
You may want to get an EMG if you haven't done so already as this will tell you how much damage has occurred to date.
I have had three back operations. I knew it was right because I felt and told the doctor, Kill me or fix me. That was the point of pain I had had enough. As explained to me by the doctor tonight. I had 8 years of nerve damage, now the nerve is healing rapidly, but wow what weird stuff. First off the hypersensitive leg that if you just blew air on it I felt like razors across the leg. Bad right? Next stage, Burning hot leg. I had burning that made me crazy. (I was already crazy Patches, every med I could take. Neurotin, Perocet, Lidocane patches and then epidural injections with just numming meds. Well that went away and now I am having muscle cramps. My right leg is a rock from the thigh down. I worked out 5 days a week with weights and 5 mile runs, I wish I didn't. So Friday they are injecting me with a nerve block to get me through this stage and I am told I may be over. The numb leg wasn't this bad. Anyway, the longer you wait to repair the nerve damage, you will be in the same boat as I am. Now there is a silver lining. But as all of our post surgical patients, that silver lining seems so far away. The moral of this story, Don't wait too long. The discectomys that are out there aren't that bad. A couple weeks and you have some Not all some relief.
Thanks all... I'm goin for at least 1 more opinion n prolly 2 n then I'm pretty sure I'll be goin under the knife this comin Fall... my gut just tells me it's time even w/o severe pain... it's almost like I'm past that point & the nerve is slowly bein killed off... anyone heard any truth to this thought?
The hardware used in fusion does break down over time which could be why the surgeon is hesitating. You can shop for a surgeon that will do it but proceed with care.
Thanks 2 plus... but what do you mean the hardware does not break down thats why he is hesitating?
Just curious... n yes I am weighing this out very carefully... my biggest sticking point is that it seems like most people in here who have had the surgery are in terrible (6 plus out a 10) pain n on meds 24/7 which am currently not.
Again my fear is future damage an permanent loss of motor function im my legs which is what my neurologist fears as well. She believes most people wait to long until it's too late.
Patches, every med I could take. Neurotin, Perocet, Lidocane patches and then epidural injections with just numming meds. Well that went away and now I am having muscle cramps. My right leg is a rock from the thigh down. I worked out 5 days a week with weights and 5 mile runs, I wish I didn't. So Friday they are injecting me with a nerve block to get me through this stage and I am told I may be over. The numb leg wasn't this bad. Anyway, the longer you wait to repair the nerve damage, you will be in the same boat as I am. Now there is a silver lining. But as all of our post surgical patients, that silver lining seems so far away. The moral of this story, Don't wait too long. The discectomys that are out there aren't that bad. A couple weeks and you have some Not all some relief.
