When is Surgery the best choice???

M

Megss

New member
I need some advice. I posted a thread last night stating that I have spondylolisthesis plus 2 herniated discs. I was diagnosed with spondy 2 weeks ago, but was told yesterday, by my chiro who swore she is an expert at reading MRI's, that I have 2 disc herniations as well. After seeing my orthopedic this morning, I learned that there are no herniations. The good news is that my problem is a little less complicated. The bad news is that all the pain is coming from my spondy, and spondy is a lot more complicated to fix than herniations. I was given options today. We are going to try the steroid injections first. This will not heal anything, but will (hopefully) temporarily ease the pain. The Dr. told me that he has a patient with spondy who comes in every couple of months to have the injection for pain management. My other option would be surgery.
Here is my issue. I am young, 27, and have a lot of life left to live. I have a 13 month old daughter, and we were planning to try for another baby this spring. Obviously that won't happen. I know the spinal fusion operation is a nasty one, but I am thinking that I would much rather fix this now so I can move on with my life. I can't get pregnant until my fracture is healed and my vertebrae is sitting in the right spot. My spine could never take that pressure, nor could I handle that pain. I don't want to lessen the pain and live with it, I want to get rid of it. Getting injections every couple of months seems like a huge hassle, and I would have to deal with the pain every time it came back. Plus I am under the impression that I will eventually need surgery anyway, its just a matter of when. My grandmother had spinal fusion surgery a few years back in the same spot I will need it. She waited and waited to do it, but says her life is so much better now. So lets just say I have the surgery next month, it would be at least a year from then before I could get pregnant, right? My slippage is currently at about 20-25%, and I am already in massive pain. I have missed 3 days of work in the last couple of weeks due to this, and I have needed help in the evenings with my daughter (hubby works evenings). That is unacceptable to me.
So I need some advice, badly.
Thank you!
 
Some doctors use sedation and others do not. If they have told you to have a driver, I suspect they are using sedation. Personally, I did not find the injections to be painful during the procedure and I did not have sedation for the epidural injection but about 24 hours later, I did have an increase in pain for 3/4 days which is very normal. Then hopefully after 3/4 days, you will see a marked improvement.

I would be sure to tell the doctor who is doing the injection, usually an anthesiologist, about the pain going on the other side and he may go ahead and inject that area too.

That sounRAB like a great idea to give it until April so that you will have benefits for disability just in case you should need a little longer than the expected time to recover. This will also give yourself some time to heal and allow your daughter to be a little older so that she can clirab up in chairs and the car seat easier and even get in and out of bed by herself.

Good luck and I pray that things go well for you.
 
I found out that I will not be sedated, but they nurab the area, and they want you to have a driver incase the nurabness affects your legs. It's just a precaution. I also am only allowed 3 injections in my whole life, so I hope this works. I am not having an epidural injection, it is a steroid injection. The nurse on the phone today also told me that I would only need to wait 6 months after surgery to get pregnant. In my personal opinion however I would wait the full year! She also said that, if I didn't have surgery and got pregnant, then they could help keep me comfortable. NO THANK YOU! I can barely handle this without a 9 lb baby in my tummy!:) I have large babies. Would you happen to know why they only give you 3 injections total in your whole life time?
 
Hi Meggs,

You are facing a very hard decision. I had my first fusion when I was 18 and had excellent results and led a very pain free life and then an injury in 2004 at the age of 42 has caused me lots of problems and I have had 3 additional surgeries since. In fact, I am contemplating a 5th surgery. So I guess you might say that I feel well qualified to answer this question. ;)

Anyhow, I think anyone who is considering spinal surgery neeRAB to:

*have a second and possibly 3rd opinion. I know it is a hassle especially with a little one but later on you will be glad that you did obtain one. If the 2nd opinion agrees with the first, then I think you can move forward if your pain warrants it. If you get a different opinion, then you need a 3rd opinion.
*you should try everything non-surgical (physical therapy, tens unit, epidural shots, etc.) first. Once you have surgery, you potentially open yourself up for additional surgeries.
*follow your heart. You will know if you are ready - for me each time there has been no question due to the pain that I should move ahead. I exhausted all methoRAB of pain relief and the pain was getting to difficult to manage without the use of narcotics each day.
*have a discogram to confirm that the levels being operated on are in fact the levels causing the pain. I can't recommend this enough. Sometimes the surgeons are so sure of the culprit and an innocent disc can truly be the culprit.

My heart goes out to you as you figure out what is the best thing for you to do but I can't state strongly enough that if you move ahead with this surgery you truly need to have some help with your little one after surgery. You will not be able to lift your little one for some time afterwarRAB and it will pull at your heart strings especially if the little one falls and is bleeding/injured. You will not be able to pick them up and kiss those injuries. You will have to have them come up on a chair, couch or table to your level.

My Mom and family came from out of state and did shifts. I had someone for the first 12 weeks and I suspect you will need help for that long as well. You are young and will recover but you have to look at this recovery as an investment in your life and future. You have a long life ahead of you and you can't afford to not do it correctly and do something such as bending/lifting that will cause you problems down the road. I don't mean to sound negative but I feel I need to be honest with you. This is a major surgery that can take upwarRAB to 6 months to a year to fully recover from. (I find that not all doctors are honest about the recovery process.)

I wish you much luck and success in your decision and want you to know that I as well as others on the board are here for you to help you/guide you in your decision process. I will subscribe to this thread so that if you respond I will check back on this post. Good luck.
 
Thank you so much for your response!

I know the surgery will take a very long time to recover from. I do have lots and lots of help. I have so much family right here in town, and my mother does not work, so I know she would really be there for me.
I have also done lots of research and have read different medical studies, and have found that most patients who choose the conservative approaches lessen their pain after 2 years, but do not get rid of it. The surgery patients were living a pain free life 2 years later.
What is a tens unit?
Wouldn't the epidural injection, or steroid injection that I am having next week, just be a way to manage the pain? They wouldn't heal my problem, but take the pain away for a period of time. I am correct?
I am already to the point that I am taking narcotics every day. I cannot sleep unless I do, because the pain is just to much. Even then, the pills do not take the pain away, but merely take the edge off and make me drowsy so I can sleep.
My job is a big part of the problem. I am a product rep for Silestone and drive 50-100 miles a day visiting accounts. Driving seems to really aggravate my pain. I'm sure the vibrations and bounce of the car are making things worse. People may not understand this, but I cannot leave my job. I make good money, more than my husband, and we really depend on that income. Also, we are on my benefits, which are free believe it or not. My company pays the full amount, for medical, dental, and vision. We have no deductibles on office visits, x-rays, and labs. Loosing that would add $400-$500 to our monthly budget. My position also allows me to work almost half of my day from home, which is the best I can ask for, since my dream would be to stay at home with my daughter.
Since my MRI, I have had 2 instances where I swear I could feel my slippage increase. Both times, I lifted my daughter out of bed, and felt this horrible stabbing pain in my lower back. I had to yell to my husband to come take the baby and help me because it felt as though, if I moved an inch, something really really bad would happen. It felt like bone on bone. The pain was relieved once I bent forward.
I am just so confused and scared. I can't believe this has happened to me. My plan as of right now is to have the injection next week. I am supposed to meet with the Dr. 2 weeks after the injection, and I will discuss all of these concerns with him. If the injection doesn't work, then we will go to option 2, which is surgery. If the injection works, then I will wait for the pain to return, and then discuss options again.
My biggest concern right now is to get my life back to normal. The injection may do that for awhile, but what then?
 
I have heard that you should have no more than 3 epidural spinal injections in a year but not in your lifetime. In fact, I have had way more than 3 injections in my lifetime. The reasoning from what I understand behind this is that the steroiRAB are very strong and can a side effects such as: bone loss, changes in your sugar levels if diabetic, facial flushing,
anxiety, decrease in immunity, increases in appetite, nerve injuries, etc.

The most important thing is that they are doing these injections under fluroscopy which is xray guided injection so that they see where they are placing the steroiRAB. The steroid should be injected directly around the nerve roots so that they are bathed in the steroid so to speak and the inflammation is flushed out.

Sorry I did not get back to you yesterday, I have been dealing with a asthmatic child. :(
 
You are so fortunate as I was to have help. PRAISE GOD. I really feel for those who do not have support or help after surgery. It sounRAB like you do understand that it takes a long time to recover from this surgery and whenever I post I try to make sure that someone considering surgery who has little ones clearly understanRAB this. Sometimes you can find out more from a board such as this as far as the recovery then from doctors. They don't always tell all.

A tens unit may or may not help you. I would ask your doctor what he thinks. Basically multiple leaRAB are placed around the site of pain and it senRAB electrical impulses to the brain that raises the natural pain killers produced by the brain. It may or may not help prevent pain messages from being transmitted to the brain. Some people have enough temporary relief that they can manage or cope with their pain. This unit definitely does not correct the underlying problem. It is just a mechanism to cope with the pain.

Yes, sometimes a steroid injection is used to manage pain but it may be just enough to allow your back some time to recover from the injury or reduce the inflammation in your back to allow your spine time to recover. Personally, I have never had success with them and I have found a few people that find relief for up to 6 months. One never knows if it will work for them or not but in my opinion it is worth a try.

I too have to take narcotics every day and I used to be scared to death about needing medication everyday BUT please realize, I did not in the beginning of my journey, that many people do take meRAB around the clock for their pain every 4 hours, 365 days a year, for many, many years.

I am sorry that the medications do not take the pain away. Have you relayed this to your doctor? Sometimes drs are hesistant to prescribe and sometimes if we can just break that pain cycle, it will allow us enough relief so that our bodies can begin to heal. There are medications that can be prescribed that are long acting - meaning they last up to 8 to 12 hours.

I have read about your job. It sounRAB like it is part of the problem and I do understand that you are a family who relies on the income to live and for much needed benefits. My husband, PRAISE GOD, carries our insurance and we could not afford to lose this or we would be up a creek especially with my long term spinal problems. I pray that you can figure out a solution to carrying those samples so that you are not causing yourself additional pain.

That is very scary when your back locks up and you can't move. I know your daughter is very young and it must be extremely difficult and painful lifting her.

It sounRAB like you are suffering alot and I want you to know that I fully support whatever final decision you make. Also please know that I am simply trying to point out a few things that I have learned along my lifetime journey with spinal pain. I feel that the only one who can make this HUGE decision is you. No one else can feel your pain or walk in your shoes. We all have different factors or case complexities which will influence our decision and outcome of our surgeries. I will pray for you and your family and remeraber that I am here for you as well as many others on the board. Good luck.
 
Okay, I think I have this figured out. I have spent a lot of time today soul searching and talking to family and frienRAB. I am going to do whatever it takes to manage the pain until April. That includes spinal injections, pain meRAB, PT, whatever. In April, my disability benefits kick in, so I will be allowed a big chunk of time off with my full pay and benefits. Thats when I want the operation. I really hope the spinal injection works so I can have some relief until then.
I want to get the operation over with, because I know that someday I will need it anyway. The sooner I get it over with, the sooner I can get on with my life, and the sooner I can have more babies. If I do the surgery in April, then I will have to wait until the following April to try to get pregnant again. That means the gap between Grace and the new baby will be over 3 years, closer to 4, which is more than I wanted it to be, but that is okay.
I know not all surgeries are successful, but most are, and I truly believe that it is my best chance. The pain gets so bad over the course of the day that I get sick a lot. I am so tired of this!
I am a little worried about the injection itself. I was looking at the referral sheet that my Dr. wrote for the day surgery place that will be preforming the injection. He said to do it only on the left side. The left side is where the majority of my pain is most of the time, but lately, it has been on both sides. Last night when my back locked up I had pain only on the right and not on the left at all.
I have also heard the injection hurts a lot. Do they sedate you at all for this? They told me I needed to have a driver with me.
Sorry for all the questions. Thank you so much for being so nice and supportive to me!
 
No problem! I hope your child is okay.

Yes I misunderstood. It would be three injections per year. I really really hope this relieves my pain. I have very sharp pain in my low back, in the middle, and I am concerned about the injection not helping with that. Oh well I guess I will find out!
 
I know it's been a while since anyone replied to this thread, but I'm in the same boat! I was wondering how you've been managing and if you're proceeding with the surgery?


***REVISED***
I was officially diagnosed with the spondy 4 yrs ago this March after having LBP for about 15 yrs before that. and am scheduled for surgery on 2/4/09! I'm scared to death, but I guess it's the best thing for me at this point.

Anyway, I'd love to hear how you're doing! **REMOVED**
 
Hi!

Good luck with your surgery! You have been dealing with this for way too long, so I think you are doing the right thing.

I am seeing the surgeon for my third visit with him on Tuesday, and I would be surprised if he didn't schedule surgery. I have tried 2 injections, and PT, and nothing is helping. I had a discogram done in early deceraber which showed that my pain is also coming from my L4-L5 and L5-S1 disc, so the surgeon said at my last appointment that I will be needing a two level fusion.

I am still dealing with horrible pain so I think this is the best choice for me. My pain is basically the entire lower half of my body. Lower back as well as in my groin, buttocks, and down both legs. I was put on disability from work a month ago, so I need to get this taken care of asap. I am only 27, way to young to be disabled!
 
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