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Old 08-10-2012, 07:13 AM   #1
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FEEDBACK/advise on BACK issue. DECISION time and I dont know what to do

Coming to that crossroads where I need to make a decision and I just do not know how to. I feel such mixed emotions about it, and not because I am scared of surgery, I am not. I would be concerned about making the problem worse. So here is my story:
Last summer I had extremely bad lower back pain. I have had back pain in this area in the past to some degrees but never as bad as this. After suffering for a month with it I had an MRI and was sent to see a spine specialist. The MRI showed L1-2 There is a posterior disc herniation with mild to moderate stenosis. No foraminal stenosis. L2-3 There is a mild disc bulge. There is no foraminal stenosis. L3-4 There is a mile right lateral disc bulge with mild right foraminal narrowing. No central stenosis. L4-5 There is a posterior central annular tear. No ventral canal or foraminal stenosis. L5-S1 There is a moderate posterior disc herniation, S1 nerve root impingement on the left and mild central stenosis. There are type 1 degenerative endplate changes. After many visits with him, physical therapy and two injections.. I put my mind at getting better, strengthening my core. I re-started working out at the gym and really tried to be back smart. I put the pain at bay, never gone but not as excruciating. Just when I thought things were improving I had another bump. March of 2012..I felt what I thought was a stiff neck for weeks. The pain was not getting any better, in fact the pain was so severe it would bring me to tears and take my breath away. (and I do have a high pain tolerance) The pain ran along my shoulder blade and down the back of my arm..of course tingling and numbness developed in my hand. I have done physical therapy and one injection. The pain is actually better then it was all of March,April, May and some of June.. but not gone. I have that constant ache, pain across and down my shoulder.. like I have just given someone a piggy back ride all day..and pain now that is actually going down lower in mid spine. (hopefully in response to what is already wrong and not something new!) The tingling and numbness is pretty much gone, just occasionally and it seems maybe my grip is not as good. This is what the MRI said about my cervical: Straightening of the normal cervical lordosis. Disc disease is worse C4-5, C5-6, and C 6-7. C2-3 Normal (thank goodness) C3-C4 Mild disc bulging, endplate ridging, mild foraminal naorrowing. C4-5 Disc osteophyte complex with a broad based central protrusion. Mild to moderate spinal canal narrowing with mild bilateral foraminal narrowing. C5-6 Disc osteophyte complex with right pericentral and proximal foraminal protrusion. This results in moderate spinal canal narrowing with sever right foraminal narrowing and impingement on the right C5 nerve root. Mild left foraminal narrowing. C6-7 Disc osteophyte complex with endplate ridging. Left pericentral protrusion with mild spinal canal narrowing. Mild left and no significant right foraminal narrowing. So my questions... since my PAIN has somewhat decreased but is still present each and every day in one form or the other, either lower, upper or both.... do I do surgery yet.? And which one.? Do I fix the cervical issue since it is more current, I havenít seen my lower back doc for almost a year. Even though the past couple weeks that has caused more pain than the cervical. Do I try to find out HOW and WHO would do these both at the same time? Where do I even start with that.? I just donít feel fixing one and not the other would make any sense. I have debated this issue for months now and really would like some help and advice.! (If anyone has bothered to read this novel I have just written.!) I am 39 and have parents who are in their 70's and due to back problems are very limited to activity and live with pain every day. I want to live life and enjoy it.! Pain free. (But what if I do the surgery and it wasnít absolutely necessary and it makes the issues worse.?) PLEASE HELP IF YOU HAVE ANY HELPFUL ADVISE FOR ME.!

 
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Old 08-10-2012, 04:49 PM   #2
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Re: FEEDBACK/advise on BACK issue. DECISION time and I dont know what to do

Back surgery is the very last resort, after everything else has failed. If you want to live a normal and pain free life, back surgery likely won't help you achieve that.

Last edited by Administrator; 08-10-2012 at 10:22 PM.

 
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bluebird21 (08-14-2012)
Old 08-11-2012, 12:40 AM   #3
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Re: FEEDBACK/advise on BACK issue. DECISION time and I dont know what to do

I did indeed read your novel and am so sorry you're having to deal with all this. I wish I could say I have enough knowledge to advise you on specifically what to address first. I would agree that, if you are going to go through the ordeal of a back surgery, it may be best to do it all at one time if the doctor thinks it's advisable for you. And I agree with Ravr that back surgery is almost always the last resort. Consider how much is medically necessary to prevent further damage and how much is primarily for pain prevention? Have you first exhausted all other alternatives in that area? I would be concerned about addressing the nerve impingement sooner rather than later. I've never had back surgery myself. But I do know from having had other osteo-related surgeries, that a second opinion is always the best idea, as is choosing a doctor with an excellent reputation for successful outcomes. You may have a good working relationship with your present doctor and like his bedside manor. But what is his reputation when it comes to actual surgeries? As you're nervous about this, I'm sure you're already aware that back surgeries don't always bring the results you expect. Where I live is not a hot spot for reputable surgeons of any kind and I have my own regrets in that area. But my cousin had a back surgery by a local doctor she's seen for years and loved. But, only after she'd had her surgery and her pain persisted, did she realize that knowing what needs to be done and being able to competently do it are two different things. She finally did some research and found a reputable doctor across the state. It meant a second surgery to get the results she should have had from the first one and another extended recovery. My best advice to you is to check into your own doctor first as far as his surgery skills. There are "rate a doctor" sites where you might get an idea for how satisfied other patients are with him in various areas. Second, if you haven't yet done so, is to research other back surgeons in and out of your area and get a second opinion. Often, leaving the area for that is advisable. Choosing a doctor who may possibly have a working relationship or friendship with your own doctor can mean you may not get a full out honest second opinion. If your doctor is a good one, he will understand your need for a second opinion. If you do decide to go forward with a surgery, choose your surgeon carefully. Skill and experience are what will get you the best outcome. Best wishes to you. Let us know how things go.

 
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Old 08-11-2012, 10:59 PM   #4
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Re: FEEDBACK/advise on BACK issue. DECISION time and I dont know what to do

I have lived with back issues-and two major back surgeries in two weeks. It isn't something that you want to jump into just because you aare having issues. Surgery should be the very last thing that you consider, and even then it might not be the right thing.

If you haven't seen a good back doctor, you need to. Any good back doctor/surgeon, will place surgery last on your list of options. There are a number of modalitites that could/should try before you opt for surgery. yoga, PT, accupuncture, medication...and the list goes on. Water therapy is effective because it removes the pressure to your body as you work out.
I would hope that you would try any and or all before you go under a knife.

If your surgeon is quick to offer surgery, get another opinion, which is wise to do even if he doesn't go for the knife first. Remember that you only have one back and any surgery involving it is a major deal.

Good luck and keep us posted.

 
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bluebird21 (08-14-2012)
Old 08-14-2012, 11:18 AM   #5
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Re: FEEDBACK/advise on BACK issue. DECISION time and I dont know what to do

Thank you all for the response, feedback and caring advise. I had posted here and on the back problem board, I was/am new to this. So I had not seen these until just now. First of all I really am touched that people take the time to help one another in this way. In response to some of the questions; yes, I do feel that the Cervical Spine Specialist that I have is very reputable and is known by the doctors I work with every day. I was told that he is not "knife happy" and this has been proven so far to be true. This cervical issue first presented in March, since then we have tried many weeks of physical therapy, one injection, wearing a soft collar at night. I have done yoga, Pilates, core strengthening exercises, water therapy and simply laying low at times..giving it a rest in hopes it will get better. My doc has actually been a contributing factor in my confusion as he has not made the decision for me but is basically leaving it up to me. Last year my lower back doc said the same thing " you are a candidate and you do/will need surgery, it is just up to you how long you want to put up with it. You will know when it's time. Well I guess since I am still debating it, it must not be THAT time yet.? Because I still stand undecided, confused and unsure. Yes, I know it would be wise to seek multiple second opinions but because I thought I was in fairly good health, I opted for the insurance with the lower premium and higher deductable. I am in that hole now where I am paying out of pocket and multiple visits and more scans means more money that I simply do not have. That is why I sought out my "second opinion" here. Someone said to me that "back pain can become so all- consuming"....when you hurt every single day to some degree, it really starts wearing a person down. My spirit is usually is usually happy, easy going, glass half full... but as time goes on and so does my back pain, my spirit is feeling a little sluggish and dim. I try to put that smile on and face each day, but some days I just want to scream because I am so sick and tired of it!!! Even if the pain is not debilitating or excruciating (at times it has been, but most of the time it's pain I can deal with). Even though I feel I am close to needing antidepressants, the pain is minimal compared to what it could be (has been), and what it is for some.... so until I reach that point I guess I learn to live with it, because the risk of the BAD outcome of surgery - being worse than I am now, being in MORE pain, and the inability to do the things I enjoy or do anything for that matter- is the bottom line for me.
Peace, good health and happiness to you all.~

 
Old 08-14-2012, 11:18 PM   #6
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Re: FEEDBACK/advise on BACK issue. DECISION time and I dont know what to do

Most doctors, in these law suit crazy days, will not come right out and tell you what they think you need to do. Ultimately, it has to be your decision. I have found this most frustrating in the two years since a car accident left me with a moderate head injury, a bad tibial plateau fracture and meniscus damage. It's been a long road and you get so overwhelmed with it all, that you just want someone to say, "Do this." And, instead, you get options. But I have learned with time to stop asking, "What should I do?" and instead ask, "If you personally had this injury and were given these options, what choice would you make for yourself?" By taking you out of the question, he's free to give a more guiding answer, because you can't come back at some point down the road and say, "But you told me to do this." Just a thought. It worked well for me.

Last edited by AuntNanc; 08-14-2012 at 11:20 PM. Reason: grammar

 
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