It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Back Problems Message Board

  • No change after second surgery

  • Post New Thread   Reply Reply
    Thread Tools Search this Thread
    Old 02-13-2019, 06:37 AM   #1
    Sigmili
    Newbie
    (male)
     
    Join Date: Feb 2019
    Posts: 5
    Sigmili HB User
    No change after second surgery

    My first post, I have a herniated l5-s1 for years recently moved to LA area had 2 hr commute which just killed my back, saw a Neuro Surgeon who set me on a path, I received 2 spinal injections did not help at all, then had surgery microdiscectomy In August 2018, never really improved much r leg sciatica and a wicked pirisformis problem, repeat MRI showed aslight reherniation, (also l4 and l3 showing 2mm herniation it was also on previous) I agreed to one more injection did not help, had second surgery 1/17/19 immediately felt differently than last surgery in a good way everyday was feeling better, then ~3 weeks after pirisformis kicked in and sciatica, I was religious about watching my body mechanics, log roll etc , my Feet feel pins and needles on bottom and right 3 toes, numbness up r leg, also feel weaker in r leg and knotted muscle in thigh and calf r leg, . I see my MD next week (I saw him post op after second week when I reported cautiously optimistic).

    My question is is there anything else that can be done? I looked into laser spine people and don’t have spare 12 grand laying around. I know that they can do a fusion but don’t know much else about the implications of that, ALSO forgot to mention I have old 2004 gastric bypass that prevents me from using steroids, NSAIDs so Tylenol and cyclobenzaprine and tramdol are the only pain option. I tried Neurontin didn’t work,

    Last edited by Administrator; 02-13-2019 at 07:46 AM.

     
    Reply With Quote
    Sponsors Lightbulb
       
    Old 02-13-2019, 07:38 AM   #2
    teteri66
    Senior Veteran
    (female)
     
    Join Date: Nov 2010
    Location: USA
    Posts: 9,136
    teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
    Re: No change after second surgery

    Welcome to the board. I feel your frustration, having myself endured several lumbar surgeries before finally getting some relief from ongoing symptoms/nerve compression.

    You will be told it is much too early in the game to be making any decisions regarding the recent surgery. You may still have residual inflammation from the 1/17/19 surgery. Was it also a discectomy?

    Did you ever have a flexion/extension X-ray to check for a spondylolisthesis? Usually it can be picked up just from viewing MRI but in some cases, it is subtle and can be missed. I spent the first year of my sciatic pain journey being told things looked OK for someone of my age...meaning most people over the age of 40 show some disc bulging....but when I went to my first appointment with an ortho spine surgeon, he took one peek at the MRI and immediately sent me across the hall for the flexion/extension xrays, which clearly revealed a spondylolisthesis at L4-5. In the space of five minutes I went from believing my spine was fine to hearing I needed a one level fusion. This was such a shock to me that I spent the next year going from one specialist to another, trying to find a less invasive procedure that would resolve my sciatic pain. (Without any luck, I might add!)

    Am I correct in getting the impression that your symptoms are mainly on the right side and include sciatic pain, or pain running down leg into foot, some tingling in foot, etc? Do you have lower back pain? Any other symptoms?

    It may be that there is some instability, in part created by the two micro discectomies. There could still be inflammation from the surgery itself. It could be that the surgeon had to tug on the nerve a bit to free it up and it needs time to recover and regenerate...and will send out signals of “nerve pain” until it does.

    Three weeks is also the beginning of a time frame where you could be dealing with issues coming from scar tissue. As you can see, the possibilities are endless!

    There are many things that can be done...but first it has to be determined what is causing the recurring symptoms...and that is the million dollar question. Don’t worry about not having the money for laser spine...you don’t want to go that route. A fusion would be done if there is some instability. It sometimes becomes necessary when multiple discectomies have been done and the disc keeps reherniating.

    The most important thing you can do is to keep working on good spine “hygiene”...being super careful to avoid bending or twisting at the waist, no lifting or carrying anything heavier than about ten pounds for now, not sitting longer than 15 minutes before getting up and moving around a little bit, etc. Most importantly, take frequent short walks. Walking is the single most important activity you can do to stretch out the spinal nerves after a lumbar spine surgery. It helps to prevent scar tissue from attaching to a nerve as it forms and fills in post surgery. It is important to walk on a level surface, at a reasonable pace that is comfortable for you. You are not walking at this point to build up endurance, or for aerobic activity.

    Finally I highly recommend you do the following “exercise” twice a day. It is a natural form of traction that helps to take pressure off the discs, to realign the spine and to reset the parasympathetic system (when the breathing is done correctly).

    Lie on the floor on your back with knees bent, feet flat on floor. Place arms close to the sides, palms facing up. Be sure your body is in a straight line and that pelvis is neutral. When in position, relax and breathe deeply and slowly from the belly, so you can see it rising and falling. Continue for 2-5 minutes.

    Try to relax and be patient and not panic that you aren’t healing properly. Good luck!

     
    Reply With Quote
    The Following User Says Thank You to teteri66 For This Useful Post:
    Sigmili (02-13-2019)
    Old 02-13-2019, 08:15 AM   #3
    Sigmili
    Newbie
    (male)
     
    Join Date: Feb 2019
    Posts: 5
    Sigmili HB User
    Re: No change after second surgery

    First off , thank you soo much for your response! Sometimes I feel this is all in my head because some practitioners have seemed at best skeptical. But no it’s not . Correct both were microdiscectomy , Never had a flexion/extension X-ray, on my MRI at l3-l4 had acute tear in annulus fibrosis and 2mm disc protrusion , 2mm disc protrusion l4-l5 and l5 s1, that’s before second surgery after first one. You are correct about my leg symptoms, back pain also right side of l5 , also I think ur spot on about the 3 week scar tissue thinking back on first surgery after 3 week was when The pirisformis issue raised its ugly head the difference was I never felt quite right after first surgery, 2nd one I did see improvement but now this.
    I will try the exercise you mentioned, I haven’t started PT yet, This Fri I start. My wife is my field Marshall in keeping me aware of posture lifting et al. The frustrating part for me is work, work seems to think I’m on a vacation playing into my guilt about leaving my coworkers in a lurch, so for me it’s a cycle of pain, guilt, self doubt and rinse and repeat.
    But I can’t thank you enough for your insight.

     
    Reply With Quote
    Old 02-13-2019, 11:25 AM   #4
    teteri66
    Senior Veteran
    (female)
     
    Join Date: Nov 2010
    Location: USA
    Posts: 9,136
    teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
    Re: No change after second surgery

    Ah, the curse of “looking ok” so you cannot have anything “seriously” wrong with you....back problems are tricky because (1) everyone you meet has/had back pain/back surgery, knows someone who had back surgery, and is therefore an expert on your issues! (2) believes your issues are just the same as theirs and can be cured with sufficient ibuprophen!

    I would urge you to be very careful with PT. It is difficult to find a PT that has more than very basic knowledge regarding spinal issues and they tend to offer very one size fits all rehab/exercises. If anything you are asked to do hurts, do not continue on. No pain is no gain absolutely does not apply in this situation. Anything that increases your sciatic pain must be avoided!

    The discectomy was at L5-S1? Was any consideration given to doing other levels? Sounds like L3-4 was at least as bad!

     
    Reply With Quote
    Old 02-13-2019, 11:37 AM   #5
    Sigmili
    Newbie
    (male)
     
    Join Date: Feb 2019
    Posts: 5
    Sigmili HB User
    Re: No change after second surgery

    No, but I will when I see him next Tuesday 😁

     
    Reply With Quote
    Old 02-14-2019, 07:30 PM   #6
    teteri66
    Senior Veteran
    (female)
     
    Join Date: Nov 2010
    Location: USA
    Posts: 9,136
    teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
    Re: No change after second surgery

    Please report back after you meet with the doctor. Will be interesting to hear what he has to say.

     
    Reply With Quote
    Old 02-19-2019, 05:03 PM   #7
    teteri66
    Senior Veteran
    (female)
     
    Join Date: Nov 2010
    Location: USA
    Posts: 9,136
    teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
    Re: No change after second surgery

    How was your appointment?

     
    Reply With Quote
    Old 02-21-2019, 06:20 AM   #8
    Sigmili
    Newbie
    (male)
     
    Join Date: Feb 2019
    Posts: 5
    Sigmili HB User
    Re: No change after second surgery

    Sorry for not posting sooner , been crazy last couple of days . So I brought up the other herniated discs l3 l4 he said the symptoms I am experiencing wouldn’t be caused by that “nerve root” . I asked if it was possible that they might be impinging on the l4 root somehow he said if things are not better in a month we will repeat MRI and evaluate again. Another thing in equation now is I saw my regular PT , she has been excellent in helping me thru this process. She did a pt eval and compared to 1st surgery vs second and will I might think I’m worse off from pain, ROM wise I’m in a better place. So I report all that toMD and he feels it’s an SI joint issue now and started me on Celebrex, (due to my gastric bypass I can’t take steroids and mostNSAIDS. but Celebrex is supposed to be gut sparing) I’m gonna try it. If in 2 weeks it’s not better he wants to do another epidural in SI joint for pain relief. He also assured me I wasn’t malingering and that back issues are never the same from patient to Patient and that he was encouraged by the PT eval comparison. As far as work is concerned we both agreed it’s not in my self interest to keep my 2 hr commute in am, soo I’m looking for new job as well. He did say if i reherniate he would do a fusion

     
    Reply With Quote
    Old 02-21-2019, 10:43 AM   #9
    teteri66
    Senior Veteran
    (female)
     
    Join Date: Nov 2010
    Location: USA
    Posts: 9,136
    teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
    Re: No change after second surgery

    Good lord. A two hour commute is enough to keep you from healing! I hope you can find something much closer!

    I have to disagree with your doctor regarding the L3-4 herniation being the “wrong” spinal nerve to cause the symptoms you are experiencing. Yes, if we were all put together like an inanimate object and the dermatomes laid out clearly just as they look on paper, I would agree! But they don’t and we aren’t. Maybe it shouldn’t be possible, but I can tell you based on 4 lumbar surgeries that my sciatic-type pain did not get better until my issues at L3-4...which several doctors kept telling me could not possibly be the cause of my symptoms...were addressed!

    I would agree that if the 2mm herniation is the only issue at L3-4, it should not be causing you pain and other symptoms. I just am a firm believer in not overlooking anything when it comes to resolving lower lumbar/SIJ/ sciatic issues!

    I have spinal stenosis at L2-3. The rest of the way down the central canal, it is open and OK. The amount of narrowing at L2-3 is enough to cause sciatic type pain and on occasion has caused both legs to go completely numb and “paralyzed” for a period of about a half hour (per “episode”). I have some SIJ issues as well, but they are secondary to this problem at L2-3.

    You have to be a little careful in wanting to assign blame to either “piriformis” or SI joint dysfunction for causing your symptoms. They may be contributing factors, but are most likely not the major cause of your pain. Piriformis syndrome and SIJ dysfunction have become the new darlings in PT circles, etc. over about the past 5 years, or a bit more...one of those catch-all’s where things that aren’t easily diagnosable are placed!

    Most important thing for recovery is to keep walking...a sensible pace, and stride, on a level surface and never tiring yourself out! Better to walk twice a day shorter distances! Try to do that exercise I mentioned twice a day as well. It takes a couple weeks until you may notice a change and your body will start to crave the position! You might want to invest in a far-infrared heating pad if you do not own one. The heat penetrates deeper than a regular heating pad and I have found mine to be a godsend at various points in my spinal adventures.

    Stay positive and remember that recovery is a long, slow process. Do not be too quick to rush into other theories about what may be causing your symptoms.

    I have taken Celebrex for years and years. It helps with inflammation and is generally well-tolerated. Sorry my response is a bit disorganized and rambling today!

     
    Reply With Quote
    The Following User Says Thank You to teteri66 For This Useful Post:
    Sigmili (02-26-2019)
    Old 02-26-2019, 07:33 AM   #10
    Sigmili
    Newbie
    (male)
     
    Join Date: Feb 2019
    Posts: 5
    Sigmili HB User
    Re: No change after second surgery

    Thank you soo much for all your insight, and I have another Doctor friend who knows my surgeon I’ll explain things to her and maybe she can put it in a format he will accept.

    Last edited by Administrator; 02-26-2019 at 10:02 AM.

     
    Reply With Quote
    Old 02-28-2019, 08:22 PM   #11
    teteri66
    Senior Veteran
    (female)
     
    Join Date: Nov 2010
    Location: USA
    Posts: 9,136
    teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
    Re: No change after second surgery

    Well, don’t get discouraged and keep fighting to get what you need! You might want to get another opinion from an orthopedic spine surgeon for comparison.

     
    Reply With Quote
    Reply Reply




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is Off
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 06:33 AM.





    © 2019 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!