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Old 05-21-2007, 08:23 AM   #1
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Help ,please, with decision

I have had a sciatica problem for the past 9 months. It involves aching pain and paresthesias in my foot which sometimes extend up the leg. The pain is seldom if ever sharp, but I do seem to spend much of my time thinking about it. After NSAID's,physical therapy, chiropractors, epidurals, accupuncture etc. I was told to see a surgeon. I actually spoke with three, at major spine centers here in Northern California. The consensus was that the problem was probably being caused by foraminal stenosis at thr L5/S1 level and that a laminotomy would have a 60-80% chance of helping the problem,a 20-30% chance of not changing anything, and a 10% ish chance of making things worse(not to speak of lower probabilities of infection, really severe permanent scar tissue induced pain, etc !). They all said that the procedure was elective, given the fact that i had no loss of fuction, and that I would have to decide on quality of life grounds. I'm still trying various nerve pain drugs and trying to use meditation.I am able to walk 7 miles with manageable pain. In fact, if I manage to ignore the very bothersome aches, I am able to do almost anything that I did previously. The condition seems to be getting a bit worse , but maybe not..
So the question is: Are most people who opt for back surgery, in worse shape or do people accept the risks of an operation with the kind of symptoms I have? I need some perspective! Thanks

 
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Old 05-21-2007, 08:26 AM   #2
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Re: Help ,please, with decision

Hi
I had surgery 16 year ago and although it took off the edge of the pain,my surgeon warned me i would get arthritis later on...after my 2nd child,sure enough i did...now a disc further down is breaking up,i may need more surgery!

its such a hard decision

Joanne

 
Old 05-21-2007, 09:02 AM   #3
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Re: Help ,please, with decision

Hi, if it's not life threatening or not causing something serious like paralysis or major nerve damage, it's really a personal decision. It depends how bad the pain is, how you can personally deal with it; You have to think of in what ways it's affecting your every day life and how much longer you can deal with the pain, weigh the risks against the benefits, etc. But sometimes you don't know how bad it may get or if it will cause permanent damage in the future. If it's not too bad, some people just live with the pain. It can be a very tough decision.

For myself, before I had surgery for stenosis, I went 3 1/2 yrs with progressively worsening pain and symptoms. My quality of life became horrible, and I was almost house bound b/c I really couldnt walk anymore. I finally gave in to surgery...everyone I knew plus my rheumy, spine surgeon, and PT's all urged me to have the surgery b/c they saw how badly my condition was affecting me. I had already tried every other non-surgical treatment, so I finally made the decision to go for it and I am sooo happy I did it. Thing is, there is never a guarantee it will work and you can always end up with more problems later.

 
Old 05-21-2007, 09:40 AM   #4
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Re: Help ,please, with decision

Having surgery or not is a personal decision. Quality of life is just as important as having it for astronomical pain levels.
Since each of our back problems cause different pain levels, compromise our quality of life at different levels, it's hard to say what you should do.
It's a decision that only you can make.
I had my fusion both because of the pain levels but also because of the affects that pain was causing in my day to day life. It was making me miserable.
As a rule, most surgeon's tell you that surgery generally does not improve back pain but does bring some relief of leg pain. And it is always an elective procedure unless you have a medical emergency type situation with your back.
Good luck , with whatever you decide. You might want to consult with another surgeon and see what they tell you.
Sandi M

 
Old 05-21-2007, 10:58 AM   #5
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Re: Help ,please, with decision

They all said that the procedure was elective, given the fact that i had no loss of fuction, and that I would have to decide on quality of life grounds. I'm still trying various nerve pain drugs and trying to use meditation.I am able to walk 7 miles with manageable pain. In fact, if I manage to ignore the very bothersome aches, I am able to do almost anything that I did previously. The condition seems to be getting a bit worse , but maybe not..
So the question is: Are most people who opt for back surgery, in worse shape or do people accept the risks of an operation with the kind of symptoms I have? I need some perspective! Thanks[/QUOTE]


i think everyone here has said you will know when its time, and its very true. you will know when you cant take it anymore. i think if you can walk that much w/manageable pain, you seem ok to wait until its not manageable anymore. i cant even go around the block, and am now seeking surgery, b/c i know i cant take it anymore. it has to be worth the risk, and you will know when its just too much to take. i know everyones pain is different, and so is how well you can deal with it. i wanted to ask you, where you live. we're in santa rosa...are you near by?? and if so, what surgeon are you looking into? i hope we can help you here, i may not have been much help, but you will know when its worth the risk.
good luck in making this hard decision!

 
Old 05-21-2007, 01:10 PM   #6
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Re: Help ,please, with decision

Hi and welcome to the board.
May I ask if you've had an MRI?

Seems like lami's don't last long and increase the chance of de-stabilizing the vertebra. They are making a small window in the lamina.

On the you tube there is a video of another way to reduce a stenosis.
Looks like a roto-rooter plumbing job.

Who were the doctors or places you consulted with?

 
Old 05-21-2007, 04:07 PM   #7
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Re: Help ,please, with decision

Hi there,

Its a tough one...I was probably where you're at now around 18mths ago. I couldn't really walk through the pain - I wiould just have to sit, but anyhow it was quite episodic - bothering me one day but being able to walk all day in the hills the next. I waited until it became pretty much every day until I went to the docs...as time progressed, waiting while I had scans, xrays, injections, the pain got worse and worse (sitting, standing, walking ... you name it). I had a operation for foraminal stenosis 7 weeks ago and unfortunately it hasn't changed a thing. I don't know yet if its because the nerve was so swollen that its just taking a longtime to settle down, if its because the actual narrowing cause hasn't been found and removed or what. All I know is that I wish I'd sought treatment much much sooner...especially if the lack of success so far is due to long term nerve compression..

Its a tough decision, I know, and I think I'd have been reluctant to go under the knife 18mths ago, but if I'd known how things would have progressed...hindsight really is 20:20.

only you can make that decision. Maybe I'm just one of the unlucky 10% someone mentioned, or maybe I'll be in the 70% before too long...either way, I'm still glad I had the operation. I'd tried everything else.

Good luck
Jinks

 
Old 05-21-2007, 06:13 PM   #8
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Re: Help ,please, with decision

hello my friend,

I can totally relate to eactly what you are going through. I had surgery scheduled and doc cancelled for me saying I am not in as much pain that would warrant surgery , but it is totally up to me . I have been battling sciatica from a herniated disc for over two months now and still have pain and numbness that I dont know if it will ever go away. I hate taking pills for it changes my mood of course expected... but I am wondering if surgery would even help me . I can get around pretty good but am always thinking about my numbness and pain wich is not that bad but it is there. most people who I have spoken with say you will know when surgery is right for you.. like everyone said it is a personal decision and I for one cant make a decision right now, but want to get better . I hope you find the right answer in the near future. and wishing you the best in whatever you decide , its a tuff one I know.........

 
Old 05-21-2007, 08:38 PM   #9
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Re: Help ,please, with decision

Since surgery has been offered to you, the choice is up to you and you must make it with peace in doing so.

Sounds like you may have the luxury of some time to think on this more.

I gauged mine on my pain level and loss of quality of life. I tried everything non-surgical to help and nothing worked. So when surgery was offered, I openly said YES! I was more than ready to try and get a chance at ending my pain or at least lessen it.

I was right. I am still having some pain issues, but I also still have a bulging disc that was not fused (because I've had since age 18 and by discogram it did not seem to generate pain under pressure). My pain level is low compared to what it was before and I am regaining my life back again. Recovery has been a bit slow but that's ok. It takes a while to really recover from major spine surgery.

I have no regrets to have my fusion surgery at all. Will do it again if needed.
__________________
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L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
Solidly Fused Nov-2006
A Success, but still improving!

 
Old 05-22-2007, 04:30 AM   #10
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Re: Help ,please, with decision

I understand to. About two years ago I was still living on vicodin but could still manage but in great pain. I was walking four miles a day, as they told me walking was best, I was doing pilates. I was working, but forcing myself through work everyday and it was killing me, and then it got worse, I couldn't do any of the above, even drive.

I had been waiting for the artificial disc, I do not know if this is an option for you, but what I would have chose over the fusion personally. So the FDA approval finally came, and then I was ruled out cause my vertebrae started slipping.

I was giving 70 percent odds, but he said that doesn't' gaurantee I will be one of the sucess'es even thought I looked like the perfect candidate. It was a rough decision and very nerve wracking, what I figured was the quality of life, all the pain meds that I was pouring into my body that I had to keep increasing cause they quit working after time. And then I figured if this is my only chance of getting better, then I am taking it. I was off work for a year and still hadn't gotten better just worse.

We are all scared during these times, hang in there. I am ten weeks post op and surviving. My legs are 95 percent better and I am walking two miles a day. My back is having alot of pain still but that's probably normal.

vette

 
Old 05-22-2007, 10:50 AM   #11
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Re: Help ,please, with decision

[COLOR="Navy"]My surgery wasn't optional. My surgery was a three level fusion. I had postponed surgery twice until my surgeon informed me that he could no longer buy me any time. My daughter in law was going to drag me into surgery by herself at this point..I'm 5'9" and she's 5' nothing as she says.
I have permanent nerve damage in both legs and have been informed by the surgeon that my best friend will be the pain management doctor for the rest of my life.

All of us react to pain in different ways. If sugery was given to you as an elective, then if if was me, I would consider it just that, an elective. When you get to the point that you will need surgery, you will know. Your body will tell you in no uncertain terms that it needs surgery. Walking 7 miles with just a slight twinge of pain doesn't seen a reason for surgery in my books....but to each his own. You will know when you feel the need to do something other than what you are doing....

hang in there.........[/COLOR]

 
Old 05-22-2007, 12:27 PM   #12
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Re: Help ,please, with decision

I agree with peole who say that it is a personal decision. It all depends on your pain level and on quality of your life. Usually surgeries you suggested have much higher sucess rate than fusions. But we still go and have them done knowing that we may not be so lucky and suffer for the rest of our lives. But when you in pain you are willing to try everything and anything. Don't think now about scar and other side effects if you are really can't leave like this. You just hope for the best outcome and the better life after the surgery. But their responsibilities is to tell you about all the possible side effects, this is does not mean it will happens to you.

It has to be your own decision. If you are not sure,i learned, the best thing to do is to go for second opinion and make sure that all tests were done to determen your damages (like MRI, discogram, myologram, EMG, etc.)
Good luck to you.

 
Old 05-23-2007, 03:35 AM   #13
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Re: Help ,please, with decision

I can relate to what you are feeling. I was offered surgery in Oct 2006 and put it off until the end of Feb 2007. I did epi shots and a nerve burning to buy me time.

The deciding factor was quality of life. I could not even pull open a door at a store or walk great distances. I also had a leg that dragged.

I have alot of issues with my back and my surgery took care of the worst and I did get relief from my leg pain. I was given a 60-40 chance. Now would I do it again. You bet I would. I am still in pain and still on pain meds but my life is managable and I my quality of life is better. Will I ever be 100 percent probably not. But I will take what I can get.

Good luck and keep us posted.

 
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