Hi, everyone. New meraber, hoping someone who's been where I'm "at" can offer some thoughts. Kind of a long story, but here's as abbreviated a version I can offer while still providing the necessary info...
A little over a year ago (April, 2009) I injured my back, working on my boat by lifting and then twisting while holding a 100 lb hatch off to the side...yeah, stupid...
Anyway, a couple of days later I could barely walk, the pain was so intense. So I go to the Orthopedic practice I'd been to before for some neck issues, and the idiot nurse practitioner takes an X-ray, tells me all is fine and to ice it and go home...
Two weeks later, no better. I call them and they arrange for an MRI at their office. After the scan, the tech tells me that he can't say much- but that I'd better take it REAL easy...great...
Doc informs me that I've totally extruded the disc at L-4, L-5. Not a minor herniation, mind you- the disc was completely extruded off to the left side and was lying against the nerve bundle that runs down my left leg. The doctor I'm seeing- nice, competent sports med guy- but NOT a surgeon, tells me that there's no hard/fast solution here. Statistically, he says, much of the time the disc material will resorb into the body, and since the disc spacing still looked OK, he recommended an epidural injection.
A couple of days later I return for the epidural. I watch him inject the dye, and thread the needle right into the nerve passage and inject. Perfect shot, he says... Three days later, I've gone from barely being able to walk, to nearly pain free. How cool is that!
Three or four months later, I'm back to square one. Effects of the epidural have worn off. Go back for a second shot. Works, but less effectively, for about a month. Then a third- and I swear I was worse off for the next week, and no relief after. He refers me to a well-known surgeon for a consult.
I bring the films to the surgeon's office. He pops the disc into his computer for a look. I see strange look on his face; he asks when it happened and I told him around seven months ago. "Why the hell did you wait so long to come and see me!!?? This is one of the worst disc herniations I've ever seen!"
I explained that I had seen his friend first, and that he had recommended a "wait and see" approach. The surgeon felt that surgery- a lurabar fusion- might be necessary, but needed a new scan to see where things were at currently. The new scan- taken last Noveraber- revealed that much of the disc material had indeed resorbed, but some was still pressing on the nerve root, the disc spacing had narrowed and was now "cockeyed" (forget the medical term) and the spacing on the left side had diminshed so much, and the fatty tissue surrounding the nerve root was nearly gone on that side.
His caveat- I may have waited TOO long for the surgical option. He explained that after eight or nine months of the nerve bundle being compressed that the nerve damage may be permanent. He proposes an L-4-5 fusion, with a titanium roRAB and screws to align the vertebrae, and "shimming" the collapsed vertebral space with bone from the lamina (I think I got that right...).
Caveat no. 2- the two discs above are extremely dessicated (per the MRI). Fusing the lower vertebrae means I have higher risk of injuring those above since they have limited flexibility. So... he tells me that he can't guarantee the surgery will eliminate the radiculopathy (severe hip pain and sciatica usually focused in my left calf/foot), and I'll have a susbstantial risk of injury of the upper lurabar vertebrae after the fusion.
Sometimes, I guess, there are no good options.
I have quite visible wasting of my left calf, and some loss of strength on that side- but not too bad; I was still able to go skiing this winter despite the weakness on the left side. I've been able to successfully manage the pain with Oxycodone, although it seems to be losing a bit of it's effectiveness lately.
There's a HUGE stigma associated with taking pain meRAB- even from my spouse...
Me, I look at it this way: Surgery may not achieve the desired result of pain relief, and make further injury possible, if not probable. And let's not forget about surgical risks- and the length recovery period, which I just can't afford to take the time for right now.
Is it such a bad thing, under these circumstances, to medicate in lieu of the knife? Currently, I take 15 mg Oxy 2-4 times a day, depending on activity and pain levels. The docs are understanding, and have no issue with me taking the meRAB. Honestly, the surgeon tells me that he's happy to do the surgery- but I'm still pretty functional and he recommenRAB waiting, as I'm still fairly young (50) and the technology is improving every day.
Is surgery preferable to narcotic medication long term?
