Eep...facing my back-surgery-phobia head-on (help!)

Miscellaneous and Personal Stuff I Must Share
1

Those of you who have been down this path, or a similar one, before…please share your experiences and help ease my anxieties. This is, pun partially intended, unnerving.

Two years ago a neurologist looked at my MRI and said plainly, “This concerns me. You can expect major problems in the future, and don’t be afraid of surgery.” :eek: The MRI showed dessication at L5/S1, a 4mm herniation (posterior) displacing the sacral nerve root, and a second bulge at L4/L5.

I get active. I exercise regularly…riding my horse. Before you freak, proper riding develops the muscles that support the back (the “core/center” as it’s referred to in riding). It’s similar to balancing on the large exercise balls; you strengthen your abs, thighs, upper back, lower legs, etc. while balancing against the horse’s movement. If you don’t know how to ride, then yes, riding around and getting your ass slapped in the saddle will hurt your back, and badly. I put more than 400 hours in the saddle over the next two years, am in the best shape of my life, and my back pain is all but gone.

Then I have a baby.

All was fine until I was seven months pregnant. Too large and awkward to ride anymore, my muscles weaken from lack of exercise. The baby, meanwhile, has grown large enough to pull heavily on my lower back; one of the two tendons supporting the growing uterus connects almost exactly at my injured site. I shave my legs one morning and feel a twinge; by evening I literally cannot move without severe pain (truly, it was worse than labor). I am put on early maternity leave and get physical therapy twice a week until delivery. It helps–I’m nearly pain-free by the time the baby comes.

He comes 2 1/2 weeks early, and I deliver him without pain medication (I didn’t want any needles anywhere near my spine, and just wanted to avoid any medication that wasn’t necessary). We are all healthy, happy, and exhausted.

Once I got home, the back pain returned–but different this time. It wasn’t the whole-body, sharp, severe, crippling pain from before; this time, it was hot, dull, and very, very localized. Now the area is tender to the touch–before I would beg hubby for a massage, now I can’t bear him touching it. Sitting is excruciating, but I’m nursing my son and must sit 45min at a time 8-12 times a day. Getting up from a seated position is worse–I’m fine for 3-5 steps, then the hot wave of pain buckles my knees.

I see a physical therapist, get some treatment, and once healed enough from delivery–I get back on my horse (carefully). I ride with great care, listening intently to my body, and perform exercises designed to strengthen my “seat” (core muscles and balance). After 8 weeks of pain, I awake to find myself in about half the pain I’d been in all that time. It’s still there–this is the longest I’ve been in back pain, ever–but I can function now. Three weeks have passed since this improvement, with no further changes.

I’m now referred to a pain specialist. He wants to load me up with opiates; I flat-out refuse and explain plainly I want nothing to do with medications designed only to mask symptoms. If there’s a problem, and it can be fixed, I want it fixed. I’d rather live with the pain, at least for now, then numb myself to it. If it gets unbearable, I’ll ask for the pain meds. He is a bit put off, but then warms up to me and refers me to an MRI and biofeedback (whatever that is).

I had the MRI this morning. The technician was warm and friendly, and wrote her notes as she asked about the pain before leading me to the machine. I lie under it quietly, listening to the muted serenading of Sade through the supplied ear plugs. When finished, the technician has a subtle, but still notable, change in demeanor. There is a mild element of surprise in her face. “I hope you feel better soon,” she says. “Yeah, me too,” I say, adding how curious I am about what this MRI will show versus the one from two years ago. “Well,” she says, “I can’t say anything…but…some people have higher pain thresholds than others, it seems. Some patients come in here and can hardly walk, and there’s nothing.” She pauses and looks me right in the eye. “Your pain is warranted.”

So now I’m wondering about the surgery the neurologist had mentioned two years ago. Vertebrae in my father’s back were fused 40 years ago, and it caused him a remaining lifetime of pain. Nowadays, they can do things like remove the section of disk pressing on the nerve, or increase size of the canal for the affected nerve. Three people I know have had surgeries that has removed their pain forever (or at least, until now). But I’m still afraid. I’m only 33; I fear something happening now that will worsen my condition…but I also fear doing nothing and my back completely wigging out on me and leaving me in severe crippling pain.

I know there are a lot of other things the specialist will want to try before surgery. He mentioned cortisone injections, acupuncture, and biofeedback. The injections are off-putting to me because my father developed scar tissue from the multitude of injections he received over the decades, but the others have me curious.

But beyond all this, I’m just tired of the pain and want it fixed. I also want another baby eventually, but fear what a toll it take on my body.

What new hope is out there about disk pain? Who has been down this path before? Anything will be helpful…

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I’ve had 2 different kinds, open discectomy and micro discectomy. The open was first, and they told me then that the next disc up would need operation in 10-15 years if I didn’t have the discs fused. Sure enough, 13 years later I had the micro. Same doctor did both. Then I had a little scar tissue removed, not really back surgery.

I was in maddening pain the first time. I really was close to going crazy I think. I just couldn’t take it any longer. Couldn’t walk more than a few steps at a time. Couldn’t, stand, sit, lay down, anything without incredible pain. Had to roll out of bed and crawl. Had the surgery and walked to the bathroom the next morning without so much as an asprin. Happy? Yeah, just a little. That one took a while to recover from. My leg muscles had atrophied and I had a lot of the disc gone, but I made a full recovery and felt great.

The micro was a lot simpler. I knew what to expect, hadn’t gone so long pinning my hopes on therapy and chiropractics, the rupture was much smaller,and the procedure isn’t nearly as rough. Just a few weeks to recover this time.

The first surgery, I shared a room with a guy scheduled for the same procedure. I was so relieved to have some hope (neither of us had been operated on yet), but he was really scared. So scared they were afraid he’d have a stroke so they sent him home. After I got out of the hospital (one week stay on the first one), I called him and told him how it went, really helped his outlook. The second one I was only in the hospital a day or so after the operation.

My dad had a collapsed disc in his neck and was scared to be operated on since he knew a guy who had been paralyzed in a back operation. In 1936. Dad’s operation was in the late 70’s and he was fine, fused neck vertabrae. The same doctor (neurosurgeon, actually) did my first one in '83 and did my second one in '96.

So there’s 3 different surgeries that worked out great.

3

I had a microdiscectomy done in 2001. My doc said “One week, you’ll curse me. After that, I’ll be your best friend.” He was right.

My L5/S1 actually had some of the disc pinched off, irritated my nerve, and then grew a bone spur. I was in pain-- and in a wheelchair-- for 6 months. I had acupuncture (helped somewhat), physical therapy (didn’t help much), cortisone shots (no scarring, they use very fine needles these days, and it helped the pain quite a bit but still had to be in wheelchair.)

Three days after the surgery I was up and walking for the first time in months. Sure the surgery site hurt, and I was sore, but it was NOTHING compared to having that flaming sword o’ pain shooting down my leg. A week later, I was walking around the block. A week and a half later, I was back in bed somewhat sore after cooking a 3-course Indian meal. I called the surgical nurse about it and the first words out of her mouth were “overdid it, eh? Don’t worry, it happens to everyone.”

Back surgery has come a long, LONG way from how it used to be. Laparoscopic techniques and refinements in technology have made fusion a lot less common. In fact, they’re starting to use artificial disks with a lot more frequency now. I’d predict that in a good five years or so fusion will be a thing of the past.

Go get yourself evaluated by a surgeon. Knowledge is always a good thing.

4

Ivylad has had a laminectomy, emergency surgery for a spinal fluid leak, and L4-5 fused.

He now has a morphine pump and is in constant pain with limited mobility.

May you have tons better luck than he had. I don’t mean to scare you, but that’s our experience.

5

Ruffian, I must apologize. I fear my reply was brusque and rude.

Every situation is different. I would suggest you explore all non invasive procedures first. It may work for you. Surgery is drastic and permanent. I think you did the right thing by steering away from someone who wants to mask the pain with drugs. Ivylad did that and turned into a virtual zombie. He has such a high tolerance now for opiates that Oxycontin is like candy to him.

Good luck. Your back is your life, and you don’t want to mess around with it.

6

I had surgery for L4/5 rupture several years ago. Mine was very successful–some twinges now and again, but nothing too bad.

A year or so after my surgery, L5/S1 ruptured. It was painful for a few weeks, but by the time I had the MRI, it was feeling better, so I opted not to have surgery. My doctor was surprised that it quit hurting and kept asking me if I was incontinent (not a symptom I would miss, really), because it was a big rupture. I have since learned that sometimes what looks terrible on the MRI is terrible, but sometimes not. Likewise, the MRI may show not a lot, but the person is in pain.

Best of luck to you whatever you decide to do.

7

You’re my hero. Well, along with Marie Curie and some other people, hope you don’t mind company :smiley:
When I was 10 or so, my mother started spending a few days in bed after the Christmas season. She’s always had bone problems. Those bedridden periods came because her back hurt too badly to do much more than transfer to an armchair and back.

The periods in bed got longer and longer.

Until the winter I was 16. God, what a year! Dad had been fired two months before, thus ending the period that by Mom’s standards was “the best of his career” (i.e., when he got the highest paycheck). So that time the pain combined with depression. She got in bed and didn’t get out for months except to go to the bathroom or to the doctor. I was (with help from some adult friends that I’ll never thank enough) finishing high school, badgering Dad into studying for the government exams he’d decided to take, badgering my bros to study and feeding the whole lot. No, the house wasn’t ultrameganeat, but nobody died from it :stuck_out_tongue:

The doctors attributed the pain to a worsening of Mom’s arthrosis. She was put on stronger-than-usual painkillers and muscle relaxants which did nothing to ease the pain but did turn her into an insulting bitch. She spent a month in traction at the hospital (right before finals). She was sent back home and put on corticoids (she gained a lot of weight that she’s never been able to lose).

Did I mention my bros were 8 and 10 at the time? The youngest says (where Mom can’t hear) that to him I’ve been more of a Mom than she… I can see his point.

Dad passed the exam in July. On a Thursday in September, they went to an appointment with a new doctor who saw Mom walk in and said “discal hernia, surgery. Uh, I’m sorry, your name would be?” He took her off all the pills and scheduled her for next Monday only because they were from out of town - if we’d lived in the capital, where he was, he would have gotten her admitted right there.

She was terrified. My reaction and my bros’ was “oh, cool, now that they know what it is and how to fix it, everything will be ok!” She was still depressed, now starting withdrawal, in so much pain we had to help her go to the bathroom, and afraid she’d die during the surgery.

As I understand it, what the doctor did was scrape some extra bone off her vertebrae (her bones grow where they shouldn’t) and put back in place a disc that had been too compressed and sort of slipped out. She spent several weeks in the hospital; the stay was longer than usual because they figured that, being from out of town, it was better to keep her there until she was ready-ready to go home than to send her home and then get her back in an ambulance because she’d over-reached (this was in Spain, no hospital bill to be paid). I handed in a couple papers at school in the wrong kind of paper, or handwritten instead of typed, because they’d been given to us on Friday and we’d go from school straight to the capital; I hadn’t been able to pick stuff from home and hadn’t had time to go paper-shopping :stuck_out_tongue: It was a pretty crazy time.

Mom was out and about within a month of coming back. Getting out of withdrawal took longer than beign physically able to walk, even though the long period in bed had weakened her muscles.

Can’t imagine why I was dying to go as far as possible for college :rolleyes:

8

Thanks for the stories, all. I intend to do as much noninvasive treatment as possible before going for surgery, and even then, I want to see if I’m a candidate for endoscopic (tiny incision, no stitches, no cutting through muscle, etc.) surgery before I let them fillet me.

I rode my horse last night. My back was very sore at the beginning of the ride, but once the muscles warmed up, the pain faded and actually everything improved. I dismounted in less pain than when I had initially arrived at the barn. I’m really curious why that is, physiologically speaking. But curiosity aside, I’m just glad something works.

9

It’s a small incision. Even on the first one I had it was only maybe 3" long, the 2nd one was maybe 2" long, 13 staples worth. It was right on top of the first one, looks like just one scar today.

If you can ride a horse then you might be able to avoid surgery. I’ve heard of people who were put in “traction” (I’m not sure it was the same traction like you see in the movies) and decompressed their back long enough for it to heal. If it’s just a bulging disc and not a rupture, threapy might be the way to go.

With a rupture, at least mine, the doctor described it as being like a tube of silicone sealant. The disc was like cured silicone, and the rupture let out a squirt of gooey, uncured silicone (not really silicone of course) that then set up around the nerves. After that happened, the “cured” bit had to be removed from the nerve canal, and cutting it out was the way to do it. I’m sure that’s an over-simplification, but that’s the gist of it.

Either way, I hope you get it fixed up. That amount of pain changed me forever. Now I tend to ignore other pain that is probably trying to tell me something, but it’s nowhere as bad as “that pain”, so I just blow it off. That can’t be smart.

10

Holy fuck…I just got my MRI report today. I still have to meet with the doc to go over it, but I have enough knowledge and understanding to know the concluding impression is BAD:

Eek. I’ll be staying off my horse now.

:frowning:

11

whoa nelly, that’s a lot of latin. 8-9 mm is rather big.

it sounds like the muscle strengthening from the riding is what is keeping you somewhat up right. kinda like a tree that has hole in the middle but the outer several inches of tree is keeping it up. it isn’t gonna work forever, and somethings gotta get done… hopefully before a storm (or another kidlet) hits.

12

I had back surgery for a herniated disk in Nov '03. I had been trying everything else for 6 months, but surgery turned out to be my only option. I was very active before I hurt my back- I was an avid runner and did a couple of half-marathons a year and several 5Ks, as well as regular long training runs.

 6 weeks after the surgery, I started physical therapy.  I started feeling better.  6 monthes after the surgery, my dad, who lived 500 miles away from me, got sick.  I made an 8 hour drive every weekend to see him until he died 3 months later.  This was very hard on my back, and I was out of commission for a few months.  I started walking and running very short distances. 

 Now, I am routinely wearing 3 inch heels to work, spinning 3 days a week, and walking or running two days a week.   I can pick up my 50 pound dog long enough to dump him in the tub.  I still have to brace myself on something when I sneeze, though.  

 I am glad I had the surgery, and even though I had some setbacks, I feel like I've recovered nicely.  Do what your doc tells you to, and don't be afraid to be active once you get the OK from your doc.   I highly recommend physical therapy.  If nothing else, it'll get you over your fear of moving after your surgery.
13

rocking chair, I have to wonder if there isn’t something to what you’re saying. Riding seems to be doing some thing. And the thing is…ugh…I want to ride more. I do feel like my back is eggshell-fragile right now, so if I am unseated (she has NEVER bucked, but a stumble or loss of balance on her part can cause an unplanned dismount), I may be in for an entirely new hell of pain. Yet, riding seems to improve my pain. sigh

Katie, I’ve already had many, many rounds of physical therapy–I think at this point it’d just be spinning my wheels. But yes, post-operatively (if they do indeed operate), it would be absolutely vital.

Looking a little more into it, there are MANY treatments that can help shy of surgery. We’ll see what the specialists say.

14

unplanned dismounts are never a good thing, even if you are in perfect health. perhaps one of those huge rolly- polly bouncy things instead of horse

def. check out all you can do without surgery. surgery should always be the last option.

15

Hi,
I’m replying under my husband’s name because when he read this thread, he immediately had me read it. I can SO sympathize with your situation.

I’m 35 yrs old and in 2004, suffered for over a year with severe sciatica from a L5/S1 disc herniation. My orthopedic specialist saw a small 3 mm protrusion, yet what made the pain so unbearable was the narrowing of the foraminal area. I couldn’t sit, lie down, sneeze, cough, without convulsing in pain…all because of 3 mm of protrusion hitting the sciatic nerve that travels down my right leg. I took so much Ibuprofin and muscle relaxants, I can’t believe I still have a stomach lining.

By the end of the year, I was BEGGING for surgery. I’d had months of PT, acupuncture, and 3 nerve root blocks. My surgeon went in and scraped some bone away from the foraminal area, relieving the pressure on the nerve root. After surgery, it took 3-4 months of PT and slowly getting back on my feet to where I could live again. I finally went back to work last July after 1 1/2 years!

I still have to be careful how I bend (I squat whenever I can) and I’m trying to strengthen my core as much as possible. Getting pregnant scares me, because I don’t ever want to feel that kind of pain again—I think childbirth will be a walk in the park by comparison. I can definitely recommend surgery–I’d do it again in a heartbeat.

I’m also in So Cal and went to the Spine Center at Presbyterian Hospital in Whittier. My surgeon, Dr. Melanie Kinchen is FABULOUS.

Good luck, and I sincerely hope you’re pain free soon.