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Old 12-07-2012, 06:08 PM   #1
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Question Doc said L5/S1 won't heal on its own

I saw my neurosurgeon yesterday for my initial appointment. After doing the physical exam, he went over my symptoms & reviewed my MRI with me. He pointed out the L5-S1 is collapsed, causing severe nerve compression at the left neural foramen and referred to it as smashed. He acknowledged this was causing all the pain in my legs, hips, pelvis & feet. I have some other issues at L4-L5, but he's most concerned about the latter.

I asked the doc if it would heal on its own, and after saying no; he discussed doing a lumbar fusion surgery. He strongly cautioned me about what a big deal the surgery is, and once you have this done you will never be the same. I'm not the same now? He was telling me this because he thinks my age is on the younger side (44 yrs). He wants me to try injections for a month, and come back in 6 weeks. If I'm not feeling enough relief by then, well discuss the fusion further.

I'm going through with the injections, but I'm concerned about the possibility of nerve damage due to the severe compression. It figures that I'd have this question & more after I leave the Dr office. :/ I'm also concerned the injections won't keep me from going on another medical leave in 3 months or so.


I'm resigned to the fact I'll always have back pain, but on/off disability scares me.

Any thoughts or advice would be very helpful at this difficult time.

Thanks,
Christie

 
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Old 12-07-2012, 06:32 PM   #2
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Re: Doc said L5/S1 won't heal on its own

I forgot to mention I have difficulty walking, sitting, standing, sleeping, driving without pain. & heavy legs, Not to mention interfering with my daily life.

 
Old 12-07-2012, 07:46 PM   #3
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Re: Doc said L5/S1 won't heal on its own

I would suggest you make an appointment with another spine specialist, either an orthopedic spine surgeon or neurosurgeon who limit their practice to issues of the neck and back for a second and even third opinion before agreeing to surgery.

It may be that a fusion is necessary, but even if that is the case, there are different ways to do a fusion and different surgeons may have a variety of suggestions for you. And unless you have severe symptoms like a loss of bladder or bowel function or sudden loss of muscle tone like foot drop, you can afford to wait a bit to make a decision. Even though you are in a lot of pain, this is not a medical emergency.

It is a big surgery and it is important to find the best trained, most experienced surgeon that is available to you, that you are comfortable with and whom you trust....this will be your most important decision after deciding to proceed with surgery....

Since it takes awhile to get a first appointment don't wait to call until after you finish the therapy.

No one can tell you how long it is "safe" to wait -- if your nerve or nerves were so badly compressed that the bladder or bowel function were affected, you would probably have surgery immediately. Otherwise, doctors cannot tell who will develop permanent damage and who won't...and once the nerve is relieved of the pressure, who will recover completely and who will be left with residual issues. The nerves remain one area of the body that still contain some mysteries.

 
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Old 12-08-2012, 02:26 PM   #4
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Re: Doc said L5/S1 won't heal on its own

Some on here insist that bulges/herniations can heal on their own and I believe them but that has never been the case for me, and I as you, recently suffered an injury that showed mine as completely "crushed" also, my vertebrea collapsed on each other basically. That no, it cannot be "healed" once the disc is completely collapsed due to being dried up and crushed.
I'm sorry you are hurting.
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Old 12-08-2012, 07:11 PM   #5
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Lightbulb Re: Doc said L5/S1 won't heal on its own

[QUOTE=teteri66;5100919]I would suggest you make an appointment with another spine specialist, either an orthopedic spine surgeon or neurosurgeon who limit their practice to issues of the neck and back for a second and even third opinion before agreeing to surgery.

It may be that a fusion is necessary, but even if that is the case, there are different ways to do a fusion and different surgeons may have a variety of suggestions for you. And unless you have severe symptoms like a loss of bladder or bowel function or sudden loss of muscle tone like foot drop, you can afford to wait a bit to make a decision. Even though you are in a lot of pain, this is not a medical emergency.

It is a big surgery and it is important to find the best trained, most experienced surgeon that is available to you, that you are comfortable with and whom you trust....this will be your most important decision after deciding to proceed with surgery....

Since it takes awhile to get a first appointment don't wait to call until after you finish the therapy.

No one can tell you how long it is "safe" to wait -- if your nerve or nerves were so badly compressed that the bladder or bowel function were affected, you would probably have surgery immediately. Otherwise, doctors cannot tell who will develop permanent damage and who won't...and once the nerve is relieved of the pressure, who will recover completely and who will be left with residual issues. The nerves remain one area of the body that still contain some mysteries.[/QUOTE]

I'll make an appointment Monday. It'll give me peace of mind. I have a question. When I see the 2nd surgeon, should I tell him he's the 2nd opinion, or don't tell him I'd already saw someone else?

Thank you!
Christie

 
Old 12-08-2012, 07:25 PM   #6
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Re: Doc said L5/S1 won't heal on its own

[QUOTE=workinmom572;5101211]Some on here insist that bulges/herniations can heal on their own and I believe them but that has never been the case for me, and I as you, recently suffered an injury that showed mine as completely "crushed" also, my vertebrea collapsed on each other basically. That no, it cannot be "healed" once the disc is completely collapsed due to being dried up and crushed.
I'm sorry you are hurting.[/QUOTE]

Thank you for the honesty. Its encouraging to get input from others in a similar situation. I have a question. Did injections work for you, and if so for how long?

 
Old 12-08-2012, 10:09 PM   #7
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Re: Doc said L5/S1 won't heal on its own

Thanks for the update. I wanted to share that my husband did have his first injection on Wednesday 12/5 and has had some relief. The day after he had no pain at all and was walking around faster than he has in months. The last 2 days just mild pain in his low back. He is walking, sitting, and sleeping without pain and tingling in legs and feet. His pain went from an 8 to a 4-5 almost immediately after the injection. He has a follow up on Tuesday and should have his next injection in the next 2-3 weeks at most. Good luck with your injections and hopefully they give you enough pain relief until you get another opinion. We are optimistic that these injections will be doing the same for my husband until he can get in with a specialist.

 
Old 12-09-2012, 08:36 AM   #8
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Re: Doc said L5/S1 won't heal on its own

[QUOTE=ItsMeG;5101373]Thanks for the update. I wanted to share that my husband did have his first injection on Wednesday 12/5 and has had some relief. The day after he had no pain at all and was walking around faster than he has in months. The last 2 days just mild pain in his low back. He is walking, sitting, and sleeping without pain and tingling in legs and feet. His pain went from an 8 to a 4-5 almost immediately after the injection. He has a follow up on Tuesday and should have his next injection in the next 2-3 weeks at most. Good luck with your injections and hopefully they give you enough pain relief until you get another opinion. We are optimistic that these injections will be doing the same for my husband until he can get in with a specialist.[/QUOTE]

Thank you for sharing. I'm hopefully the injections will help me get back to work! I'm not expecting a miracle, but enough relief to get me off disability.

 
Old 12-09-2012, 09:20 AM   #9
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Re: Doc said L5/S1 won't heal on its own

I think most spine surgeons assume a person is going to get more than one opinion. I personally do not tell someone it is a "second" opinion. In my mind, I don't think of it that way either. I think of it more as a job interview. I am presenting myself to the doctor, along with my MRI, relevant testing, etc. and I am a blank slate to him. It's up to him to do what he'd do with any new patient.

I want a fresh opinion. I don't want to run the risk of doctor # 2 asking what doctor # 1 told me and then rubber-stamping it. To me selecting a surgeon is more than just the diagnosis. I am influenced by a variety of subjective things too.

 
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Old 12-09-2012, 04:29 PM   #10
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Re: Doc said L5/S1 won't heal on its own

Hi all. im 34 and this is my first post. ive had back pain goin on 10 years. ive had 9 epidurals and 3 facet injections. none worked. ive been on work comp 9 weeks now. one month ago i had an epidural thats lasted 4 days. i got a double epidural 3 weeks after the first and that is wearing off as we speak. my now option is a microdiscectomy. l4-l5 and l5-s1 are herniated and pinched sciatic nerve. im afraid im not gonna be able to return to ,my physical labor job. also im getting addicted to percocets. ive had a small problem with them in the past. are there any percocet alternatives? im taking 4-5, 7.5 mg a day and taking them when i dont really need them.

 
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Old 12-24-2012, 09:20 AM   #11
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Re: Doc said L5/S1 won't heal on its own

[QUOTE=ItsMeG;5101373]Thanks for the update. I wanted to share that my husband did have his first injection on Wednesday 12/5 and has had some relief. The day after he had no pain at all and was walking around faster than he has in months. The last 2 days just mild pain in his low back. He is walking, sitting, and sleeping without pain and tingling in legs and feet. His pain went from an 8 to a 4-5 almost immediately after the injection. He has a follow up on Tuesday and should have his next injection in the next 2-3 weeks at most. Good luck with your injections and hopefully they give you enough pain relief until you get another opinion. We are optimistic that these injections will be doing the same for my husband until he can get in with a specialist.[/QUOTE]

Hi ItsMeG:
I go for an ESI this Thursday 12/27, and want to know if your Husband has maintained relief from his injections? Has he seen the specialist? I recall that his symptoms were identical to mine.
Thank you & have a Merry Christmas
Christie

 
Old 12-24-2012, 02:26 PM   #12
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Re: Doc said L5/S1 won't heal on its own

I would like to pass along a little tip that you will not hear from most doctors. Most will tell you to go home and take it easy for the rest of the day, and then resume normal activities the following day. However, if at all possible you will get the most from your injection if you can take it very easy and stay off your feet as much as possible for 72 hours.

The reason for this is that the injection is just floated into tissue. It does not go into something that would contain the medication like it would if placed into a joint capsule, muscle, etc. If you are up on your feet, walking around, going about your daily routine, your heart will pump faster, which makes the blood flow faster and it will cause the medication to dissipate more quickly.

If you can rest and stay off your feet, the medication will bathe the affected area and stay in that vicinity longer...and thus, you will get more benefit from it.

I have had ESIs from three different pain management.physiatrist doctors. The last one insisted all his patients stay off their feet (except to get food and use the bathroom) for 72 hours. His were the only injections I had that actually helped me, or that I had any reaction to whatsoever.

But, like I said, you won't hear this from most doctors. I asked my surgeon and he said it wouldn't make any difference...but it makes sense to me...and it worked for me as well.

Merry Christmas...and good luck on the 27th.

 
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Old 12-24-2012, 09:55 PM   #13
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Re: Doc said L5/S1 won't heal on its own

Merry Christmas, Christie! Thankfully, he is still doing pretty good. His pain level is about a 3 and considering he felt he was an 8-9 most days he is happy. He is having a tiny bit of tingling and numbness in his left leg and foot again, so he is scheduled to see a neurologist for an emg/nerve study on Jan. 8th. He should be scheduling his second injection in the next week too...hopefully he can get it done by the middle of January. I am so glad you have yours this week....sending thoughts and prayers you get some relief.

Just wanted to add that I agree with teteri. The doc told my husband he could go back to work the next day. Thanks to reading this board I knew better, we were only able to schedule it so he could have the next 48 hours off work. But I do believe that every hour you can take it easy is best.

Last edited by ItsMeG; 12-24-2012 at 10:06 PM.

 
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Old 12-26-2012, 12:21 AM   #14
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Re: Doc said L5/S1 won't heal on its own

I had the same symptoms as you, couldn't sit, walk, stand,lay it didn't matter. My regular md sent me to a orthopedic spine specialist. I had a herniated disc that popped out of place and was sitting on my sciatic nerve. It hurt like heck. The surgery you are looking at is a big surgery. It's been three weeks since my surgery and the nerve pain is crazy and my foot and calf are still numb which they say is normal. But getting a different perspective from another physician might be a good idea. I hope all goes well with you...

 
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Old 12-26-2012, 07:50 AM   #15
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Re: Doc said L5/S1 won't heal on its own

wow teteri66--I wish I had known this when I got 4 injections over the course of this year! I was only told to take it easy the day after. Then I went back to work.

Now that I'm facing the surgery, I've been trying to find all threads that have been posted about microdiscectomy, hoping I'll have a better sense of what to really expect, what to do and not to do etc. Glad I've read this now in the event I have other injections down the road for something....

 
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