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    Old 11-07-2005, 06:06 PM   #1
    eaglelake
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    Thorasic Disk Herniation

    I have been having back problems for over a year now. I had an MRI last November which showed that I had a herniated disk at T9 and other problems at T7. I have tried Chiroropractic and Physical Therapy with no success. A back surgeon told me that surgury was so extensive that I should learn to tolerate the pain unless the nerve damage gets so bad that it affects my balance.
    The pain I endure each day is sometimes nearly intolerable. I do have relief during the night while I am sleeping but when I awaken and start walking or sitting, the pain starts and continues throughout the day.
    I went to a neuro-surgeon today who wants to have another MRI and a follow-up with another specialist before he goes ahead with possible surgury.

    By the way, surgury requires opening the chest, removing a rib, moving the heart out of the way, deflating a lung and moving it aside then repairing the damage to the disk, then inflating the lung, moving the heart back into place and then closing up the chest and starting recovery.

    Does anyone have any input on this matter. Any suggestions...

    Last edited by eaglelake; 11-07-2005 at 06:07 PM.

     
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    Old 11-07-2005, 09:43 PM   #2
    Tirzah
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    Re: Thorasic Disk Herniation

    Welcome Eaglelake, there are not very many of us that have t-spine problems. I have compression fractures at t5,6 &11 and a burst fracture at t9. I have not had surgery. There are not very many drs that will attempt it.
    If you do a search for thoracic spine here on this board I know that there is one person for sure that has had surgery.
    Tirzah

     
    Old 11-08-2005, 06:23 AM   #3
    Monty44
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    Re: Thorasic Disk Herniation

    Hi Eaglelake. I had Thoracic surgery in April of 2004. The operation nearly killed me. If it hadn't been for an alert IC nurse, I would have died from acute respitory failure. The operation is so dangerous that there are only about twenty surgeons in the country willing (or qualified) to perform it. Notice I said IC nurse. You spend five or six days in Intensive Care, not in a regular ward as you would after a typical back or neck surgery (I had those too). The post op pain is the worst I've ever encountered. It literaly hurts to breath. Also, there is a very good chance that the nerve for your chest might get cut. I was warned by the surgeon that this could happen and it did. Now on top of my back and neck problems, I suffer from Intercoastal Neuropathy. The doctors at Johns Hopkins think that I will have to deal with that for the rest of my life. And to top it all off, the disc above and below the fusion have now both herniated. Absolutely nothing was gained! If I could choose again, I would not op for the surgery. The pain I had before the surgery was bad, but it could be controlled with meds. Now I live in Pain 24/7 and the meds (Morphine) don't help nearly enough. My advice. Unless you have lost control of your kidney and bowell function, Don't consider this Surgery. I really do wish you luck. God bless, Monty.

     
    Old 11-08-2005, 10:04 AM   #4
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    Re: Thorasic Disk Herniation

    Monty, I was truly touched by the awful experience that you have gone through. I had a 2 level lumbar fusion 23 years ago. Simple right. Well back then it was a little harder on us but for me it turned out horrendous. I too nearly died. Fever of 105 and excessive loss of blood. Surgery should alway be the last resort and thoracic surgery the most dangerous of all. I couldn't agree with your advice more.
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    Old 11-08-2005, 10:48 AM   #5
    Tirzah
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    Re: Thorasic Disk Herniation

    Monty- I was just reviewing some of your old posts and you mentioned that you had a balance problem. Do you think it was due to your cervical or thoracic problems? Do you still have trouble with your balance? Since my accident I have had a balance issue. My husband says that I walk like a drunken sailor. The drs. have been so concerned about my t9 burst fracture that I haven't been able to get them to look at my cervical spine. My neck does hurt and I know that I do have a "small" herniation at c4-5.
    I have learned a lot from your posts--thank you.

    Tirzah

     
    Old 11-08-2005, 01:46 PM   #6
    Monty44
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    Re: Thorasic Disk Herniation

    I'm fairly certain the balance problem comes from the herniations in my thorasic spine.

     
    Old 11-08-2005, 05:04 PM   #7
    eaglelake
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    Re: Thorasic Disk Herniation

    Quote:
    Originally Posted by Monty44
    Hi Eaglelake. I had Thoracic surgery in April of 2004. The operation nearly killed me. If it hadn't been for an alert IC nurse, I would have died from acute respitory failure. The operation is so dangerous that there are only about twenty surgeons in the country willing (or qualified) to perform it. Notice I said IC nurse. You spend five or six days in Intensive Care, not in a regular ward as you would after a typical back or neck surgery (I had those too). The post op pain is the worst I've ever encountered. It literaly hurts to breath. Also, there is a very good chance that the nerve for your chest might get cut. I was warned by the surgeon that this could happen and it did. Now on top of my back and neck problems, I suffer from Intercoastal Neuropathy. The doctors at Johns Hopkins think that I will have to deal with that for the rest of my life. And to top it all off, the disc above and below the fusion have now both herniated. Absolutely nothing was gained! If I could choose again, I would not op for the surgery. The pain I had before the surgery was bad, but it could be controlled with meds. Now I live in Pain 24/7 and the meds (Morphine) don't help nearly enough. My advice. Unless you have lost control of your kidney and bowell function, Don't consider this Surgery. I really do wish you luck. God bless, Monty.
    It sounds like you have gone through a lot. I appreciate the info on the surgury procedure and the recovery time. For now, I need something to help with pain management. Any suggestions?
    Did you ever see that episode of Seinfeld where Elaine is paranoid about going to the Dr. because her file is getting so thick and it seems that the Dr.'s all think she is making up her symtoms? That's what I feel like. I have seen so many Dr.'s and I don't have a lot of confidence in them at this point.

     
    Old 11-09-2005, 09:43 PM   #8
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    Re: Thorasic Disk Herniation

    Hi, So sorry to hear of your T-spine problems I also have them along with the rest of my spine, I have cord comp. at the T-7-8 and have been told no surgery unless it happens on an emergency basis and I have had my film and records reviewed by some of the best.
    I can say after all I ave researched surgery is not a option I'm willing to deal with anyway.
    What kind of PM are you getting now?
    Have considered the pain pump?
    Linda

     
    Old 01-14-2006, 08:06 PM   #9
    Rustella44
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    Re: Thorasic Disk Herniation

    Can I join the 'Elite' Thoracic disk herniation club?? There are very few of us!

    I fell off an exercise machine at the gym last year and now know (after over 60 physician visits, therapy appointments, diagnostic tests (3 MRI's, 2 EMG's, 2 discograms), and 7 steroid injections), and a broken foot because of numbness and decreased coordination) that I have a bulging disk at c 5-6, and two herniated thoracic disks (a central herniation at t 10-11 and a herniation that is placing pressure on the right spinal nerve at t 9-10). At the time of my fall, I was running 20-30 miles/wk and worked out at the gym 5 or so times/wk. I felt fit, ran in 5 K races with my husband and kids and could just about do anything (even at age 43!).

    Initially I had significant right scapular pain, but could still run. Gradually, I found that sharp pain at the base of my neck on the left side made running impossible. So I started walking, but have done less and less of that since mid-back and right chest wall pain kicked in in April-May. Now I am in constant pain that is only partially relieved by using vicodin and my activity consists of trying to work at my desk job and hanging out in my recliner. My left hand has been numb for over a year and I have intermittant numbness in both my legs, worse since a 4-level discogram last month. My balance/coordination seems to be really off. Lately I had to leave work early one day and work at home on alternate days because of the pain (I am very thankful that I work for a nun!). I'm a QI/Education nurse at a hospice. My symptoms have been worsening gradually and it is getting pretty discouraging.

    I have a cervical nucleoplasty scheduled for next Thursday. After all of the steroid injections haven't worked (3 of the injections were cervical), I'm glad to have a minimally-invasive option to correct the bulge. I've seen a neurosurgeon twice to discuss options for my thoracic spine, but he wants to wait to do anything until the neck is done. At my last visit, I got the feeling that he really didn't want to do anything, but the quality of my life has decreased so much. My thoracic spine injury seems to be about 85-90% of my impairment. One of the earlier posts seems to have had a really bad experience with thoracic disk surgery. It is likely that I will need a 2-level diskectomy. Are there other members of the 'Club' that might be willing to describe the type of surgery they have had and their experiences with it?

    I am working with three separate docs (physiatrist, microsurgeon and neurosurgeon) at a university-based spine program. They currently don't seem to have an expert in thoracic microsurgery on staff. Can anyone recommend someone? Thank you.

     
    Old 01-14-2006, 11:49 PM   #10
    Quietcook
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    Re: Thorasic Disk Herniation

    Welcome to the boards. Sorry you are experiencing such problems.

    Not knowing what area you are from, but am assuming the US. As an individual who has had 8 spine surgeries, I notice you mention three doctors, but do not indicate that either of these are true spine specialists. I'm not talking just neuro surgeons, who of course work on the back, just as do ortho surgeons. When referring to spine specialists, I'm speaking of either ortho or neuro who has completed an extensive (preferrably 2 year) spine fellowship and then dedicates their practice to just the spine, instead of doing brain surgery as a neuro or working on other areas, such as knees, shoulders, arms, etc as we all know that the general ortho and neuro surgeons do. These doctors may spend 20-25 percent of their time on the spine, and are not often totally up on the newest and latest techniques for the spine. The spine specialist who spends all their time on the spine, have tons more experience, plus are most frequently involved in the clinical trials plus implement the approved newer procedures sometimes 3-4 years before the general neuro surgeon may implement.

    People often say their back doctor, just as I did when I was being treated by an ortho neuro surgical team. However, once I wound up temporarily paralyzed and lost lower body functions, I was out on the preverbial limb and did my research to locate a true spine specialist. Now, I know that had I not done that I would not today be leading an active life, and I am considerably older than yourself.

    One thing that I hit while dealing with the neuro and ortho surgeons was that none bothered to tell me that all that time I was trying to avoid surgery, the continued compression of nerves was lessening my chance for a full recovery. The spine specialist I decided to work with explained that correction at 6 months of less for severe compression, I had an excellent chance of full recovery, but that it drops to about 75 percent chance at 9 months and 50 percent or less at a year. I was already 10+ months when I found my specialist and was extremely fortunate that I recovered from the continuous pain, but not from all the numbness.

    Also, what the other back doctors had not told me was that we should NOT have more than 3 steroid injections within a 12 month period. Well, jeepers, when you count up the various types of steroid injections done with the diagnositic tests and trying to provide relief, many of us exceed that. That's exactly what happened years earlier and when I took a small tumble, bones shattered like glass because steroids while having wonderful properties for reducing inflammation, in excess make our bones more fragile and brittle. Not once had any other back doctor mentioned such a thing to me.

    Also, the difference in my initial visit with this spine specialist was amazingly thorough compared to other back doctor visits. Granted, not every spine specialist I visited was as impressive, but it was well worth seeing several and finding the one that I knew would treat my pain from beginning to end, because some prefer to refer out to a PM doc, and that's fine for those who prefer that. The spine specialist understands the pain and level of it greater than any others, and I preferred to deal with the one who would be most aware of any slight changes in movement, pain, etc and react accordingly. If I were dealing with a 2nd doctor, all that information might not be passed along, plus another doctor might not feel that some change was as significant as the treating spine specialist would.

    Also, it is good to have a spine specialist who is willing to answer questions and I also found one who does his own invasive tests and injections. Many otho and neuro surgeons use their hospitals anestology dept's for those, and that is exactly why I wound up being paralyzed when having facet joint injections. Later, when this had to be redone so that the spine specialist could see exactly how bad my back was, it was not only done totally differently, but the outcome was 180 degree difference.

    Please consider at least getting an opinon from one or more true spine specialists. If you have any preferences in what you want in a doc as far as pain treatment, bracing or not, early PT and recovery versus more healing time then PT, you can find out all of that before treatment. If you are unfamiliar with how to check out credentials and locate such specialists, I have a post on this board addressing how to find a spine specialist in your local area. You can find it by using the advanced search feature at the top of the boards.

    BTW, I was fused from T-10 through S-3 just 13 months ago. I returned to maintaining my home and one acre yard except for mowing at 3 months, plus I care for an elderly and ill parent. I didn't get to ride the mower last summer, but have been cleared for that this year.

    Wishing you the best.

     
    Old 01-15-2006, 05:44 AM   #11
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    Re: Thorasic Disk Herniation

    Hi. I too have thoracic problems. I have 4 herniations in the thoracic area. But with me I can't say that the pain is constant. I can be fine for the longest period of time then I'll get radiating pain ranging from mild to severe. Just a not I have had cervical and lumbar surgeries already and have instrumentation already in both regions.

    I have to agree that the surgery for the thoracic area is very dangerous. Getting to that area is very difficult, as you said, getting past the ribs, the lung and the heart. And I also have been told that doctors do not like to operate in this area unless the case is so severe. I would not attempt surgery on the thoracic area in my case unless it progresses.

    Good luck.

    Allan

     
    Old 01-15-2006, 03:14 PM   #12
    Rustella44
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    Re: Thorasic Disk Herniation

    Thank you for your comments.

    All three of the docs I am seeing are spine specialists at a regional teritiary university-based spine program--one is a physiatrist who has done the steroid injections and also the discograms. The second doc is a spine microsurgeon--but seems to have the most experience with lumbar problems. The third is a neurosurgeon with expertise in thoracic problems--primarily repair of scoliotic spines and other major spinal surgeries. All three are board-certified and nationally-recognized and work in their specialized areas in a coordinated way to provide the best service to their patients. The problem is that the neurosurgeon in particular doesn't seem to have the experience with some of the emerging thoracic microsurgical techniques (which is reasonably understandable, given the low incidence of thoracic injury).

    I have been treated well by these docs--my physiatrist has spent the time to figure out a fairly complicated problem. He has assured me that he'll advocate for me until I am better and I believe he will only act in my best interest. I don't want to jump into an invasive surgery that may leave me worse off, so I appreciate the neurosurgeon's hesitation. I'm just getting to the point that I think I need to identify the resources out there who can do minimally invasive thoracic surgery because I am getting so uncomfortable and physically-limited. I want to pursue the least invasive options possible. So I ask again--Would anyone out there who has had thoracic microsurgery, would you please share your experiences with me--and if you have had a positive experience with a surgeon, could you please share his/her name?

    BTW--I have heard the limitation is 6 steroid injections in a year's time, if given at different sites.

     
    Old 05-04-2006, 09:30 AM   #13
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    Re: Thorasic Disk Herniation

    Find a good Pain Management doctor. Insist on it for there is no reason for you to be in all this pain without relief. The good PM docs are board certified and come from a anethesiologist (sp) background. Some have had luck with epidural steroid injections but I have not. \

    Good luck,
    Brian

     
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