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Sever pain before/after microdiscectomy

AnonymousUserAAnonymousUser Posts: 49,899
edited 06/11/2012 - 8:25 AM in Back Surgery and Neck Surgery
Hi everyone, I'm asking some questions on behalf of my 24 year-old brother who is 3 days out of his second microdiscectomy (first was performed a year ago I think) and in severe and debilitating pain.

Prior to this second surgery he was taken to the hospital because his pain was unbearable. He was treated with a morphine pain pump with almost no effect. Almost all forms of medication he was given were not working so well on the pain. Finally they found something they could give him, but I can't remember what it was called. He was sent home after 2-3 days. His original surgeon, a pain managament specialist and the hospital doctor all gave him recommendations and it was even discussed that he need an emergency fusion right then and there! He was in such severe pain that he passed out more than once when he was trying to get an MRI done.

He was able to gather the strength to take a plane out of town to a spine specialist in Texas and finally made the decision to have a second microdiscectomy. After looking at his new MRIs, they found that the first surgery did the job it was supposed to but now a new disc had herniated and ruptured. The second surgery was scheduled but his pain got so much worse that he tried to check into two different hospitals, but none of them would admit him for the pain and had him escorted out by security as he was screaming in pain and shaking.

The second surgery was finally performed, the doctor found very large fragments, removed them and believes that everything went fine and it's quite possible that he will not have to have a fusion or disc-replacement in the future.

All was fine the day he went home, but now he is again in severe, severe pain. He is crying out in agony, and it hurts me so much to seem him this way. He is crying and screaming when he gets up or tries to sit down. He lives in a third floor apartment and he's using a walker right now. He told us he needed to go to the hospital and to call while he starts to go downstairs. We put in a call to his doctor and they told us not to bother because they won't admit him and that if he's not having new pain, numbness or loss of bowel control there is no emergency.

He'll be getting an MRI in the morning if his condition doesn't improve. He's on valium, which he has been on since the first hospital visit and some other pain meds. Before the surgery he was taking the valium, pain meds and a really strong pain control patch. The doctor's are dumbfounded that the pain is not being controlled with the strong medication he is on.

Anyways, after all that explaining, I want to know if anyone knows what might be going on. Is this a reherniation or is it just the expected pain of recovery? We asked if he had strained any while using the bathroom and he said that it might have been straining for someone who had just had back surgery, but under normal circumstances he wouldn't consider it straining, but the pain started hours after that. He said it hurts even more than before the surgery. I understand that the nerve was inflamed and irritated, is the nerve just going haywire while trying to heal?

I'm trying to find out also if anyone else has been in a similar amount of pain, maybe your experience is similar. I just really feel for him and it really upsets me to see him like this, the screaming and the tears are tearing me apart. I've been hospitalized for a severe back muscle spasm which took me at least a year of recovery and the right combo of medicine to get over. I know what it feels like to be in a ton of pain from your back and if his is more severe than mine was, I don't even want to think about what that might feel like.

Any help would be appreciated, explanations about the healing process would be great too.

We are in the Austin, Texas area if anyone wants to point me to a physician, pain management doctor or anything.

Thanks so much!
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Comments

  • how sorry I am that your brother is in such pain, and it must be horrible for you to witness. Pain is such a personal thing and it's hard to evaluate another's pain. Sounds like your brother has a low tolerance for pain and a high tolerance for medications. Has he been on prescription pain meds for long? What medications did they send him home with? Is his pain coming from the incision or down his leg or can he differentiate between where the pain is coming from? Surgical pain is terrible. Does he get any relief at all from the pain? When he lays in the bed, is he on his back or on his side? Is there any relief if he lays quietly?

    What a good sister you are to be so concerned for him! Since he has an appointment for an MRI this morning, try to keep him as calm as you can and comfort him. Have you tried a heating pad or ice packs? Sometimes these can bring relief, if just for a little while. Alternate the heat and ice every 20 min. Do what you can to reassure him that he will be okay. The calmer he is, the easier it is to bear the pain.

    Please keep us posted, ok? And you hang in there, sis!

  • I agree with Joy. Sounds like a low tolerance for pain combined with a high tolerance for medication. If he was on something like the Fentanyl patch, then of course a Morphine drip isn't going to work for him. The lady I roomed with in the hospital after my fusion, she was normally on the Fentanyl patch, so they had her on a Fentanyl drip. Sent her home with patches.

    For his MRI, they can give him something much stronger than Valium, Xanax. Xanax can calm him down and help him stay still. I'd say a good 2mg MINIMUM. Xanax is by far a lot stronger than Valium when it comes to relaxing and calming someone down. It isn't a muscle relaxer, though. It's an anti-anxiety med. They give it to me before MRIs because I get claustrophobic. Last MRI I had was an emergency MRI at night, and I didn't have time to get any Xanax from my primary care, and they had to constantly repeat images because my body wouldn't stay still. Never had that problem before, and I've had plenty of MRIs.

    You said he was fine the first day, and now he's in severe pain. Most likely it's the nerve reacting to being decompressed. Nerves healing isn't a painless process, generally. The second day after my MicroD I had the worst Sciatica EVER. It felt like someone had a sledge hammer and was repeatedly smashing my calve over and over and over and over. For hours. It wouldn't let up. I laid in bed and cried all day, and I have a VERY high tolerance for pain. (Along WITH a high tolerance for the pain meds, unfortuantely) They called me in some strong steroids, and by the next morning it was gone. It's very typical for someone to have severe nerve pain after a MicroD or something of the sort. The fact that they are going to do the MRI anyway is a good idea, though. Better safe than sorry. I'd bet it's just the nerve going haywire, but who knows.
  • Thanks so much guys. I was having one hell of a time finding testimonials from anyone that described pain as bad as his with his symptoms and the same surgery. His symptoms did not seem to be abnormal or else we would have heard about it, so the best explanation might be that he just has a low tolerance for pain and high tolerance for medication, not a great combination, and the pain of healing will be just as bad if not worse at times.

    They should be getting the MRI results any minute now. I've been trying to keep him calm and tell him to breathe and do his best but I think combined pain, lower quality of life, etc has really made it hard for him to do that. Everyone here knows how hard it is, and how easy it is to tell someone to bear it when you aren't the one in pain.

    Thanks so much again!
  • The results of the MRI are back and the doctors consulted and found that he did re-herniate, but that the re-herniation was probably not due to anything he did himself, just a complication that sometimes happens. They found that there is still material to be taken out and they'll be doing surgery on him in the morning. They said it should be pretty quick and easy and hopefully it all works out.

    I told my mom, who is with him in the hospital, to ask more questions about pain during recovery and what to expect. But my brother was very good at reading his pain. He said the pain wasn't new and it was just like before but more intense a good indication of re-herniation. But I guess I was being stubborn and didn't want to believe it happened again because I don't want him to go through more surgery.

  • I'm sorry your brother has to endure another operation, but perhaps this will get him finally out of pain! Stay strong! Give him lots of gentle cyber-hugs from us, ok? >:D< >:D<
  • You are doing everything right and everything you can. Just continue to be there for him no matter what, and let him know it will be okay. I really feel for him, and I know he must have a lot of fear because no one can seem to help him with the pain. Please let us know how he is doing, and God bless you for being there for him.

    Haylie
  • Thanks again you guys. He got out of surgery this afternoon and the repaired the re-herniated disc, but also found a dural tear.

    He's still moaning in pain and wanted more medication right now, but hopefully this will all end soon. The surgeon said that if this happens again he will need to have a fusion. Before these last two surgeries it was strongly recommended by his surgeon that he have a fusion, but prior he was really agains the idea and was pushing for a disc replacement. So my brother was confused, went to see another specialist and I'm not really sure what made him decided to scrap those surgeries and go for another microdiscectomy (turning out to be two more surgeries). I guess it's the lest invasive. I'm not really sure.

    I know he is in so much pain, but I wish he could try to calm down and understand that it will get better. But I know from experience that's incredibly hard when you are in a lot of pain and I'm not trying to diminish that at all, just look for a better way to deal with it.
  • You're a very supportive sister! :) I'm sure your brother is very thankful for all of your care and concern.

    I'm a 31 yr old female who has had chronic multi-level disc herniations/DDD (L3-S1) diagnosed in 2002 (pain started in the fall of 2001). I had a 1 level - L5-S1 microdiscectomy on Oct 08,2008 - this was an emergency situation because I was having 'excruciating' pain and bathroom problems all of a sudden in the middle of September. (I had a consult with a neurosurgeon in August 2008 but didn't think much of it because I wasn't planning on having anyone touch my back.) With the emergency situation, my neurosurgeon was great - he saw me @ the ER, got a script for Percocet and plainly gave my surgical options. Before surgery, I did my research and even considered doing the DRX therapy (non surgical traction therapy), but then decided to go with most conservative surgery and 7 1/2 weeks later it seems OK. I'm very thankful for the support of my family - who has been through it all with me. I still have some residual pain, tingling and numbness on my right leg up to my toes but it's bearable compared to Sept. 3 weeks post surgery, I stopped all pain meds to avoid addiction - but this was a bad move as the pain came back. I was told by my neurosurgeon the pain is the result of the nerves healing as they were badly compressed and the healing will take time. So I'm back on the anti-inflammatories. I still have 2 other discs to deal with but I'm not planning on any further surgeries until I really have to.

    Did your brother try other non surgical treatments prior to surgery (PT, swimming, massage therapy, ice/hot packs)? I did all of this for the past 6 years and would say the pool therapy was the best. It's not pleasant when you're actually doing it but the warm water provides buoyancy and you feel a difference afterwards (in terms of flexibility & pain). Post surgery, I was told to walk within hours of the surgery and walk for rehab - but I'm also back at the pool now too. (No bending, lifting, twisting for 2-3 months post surgery. Please encourage your brother to listen to the nurses and docs. I know it can be painful, but they are there to help recover him quickly.) Personally, I would try to taper the narcotic meds down as he can - because there are a lot of stories of addiction which can be very difficult to overcome. I found that music (new age - Enya or classical) may help to calm things down too (when pain strikes). (It may not be his preferred genre, but his body may react well to it.)

    I hope for a speedy recovery for your brother! 24 is too young to go through this. Good luck!

  • You're a very good supportive sibling. I hope your brother can heal now after his 2nd surgery. Ice/heat and whatever the Dr. ordered. Stool softeners and milk of magnesia and prunes! Very important when on narcotics to keep things moving softly. I hope you''re brother heals now and pain is more manageable. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Also wondering what someone else has asked... What conservative methods he has tried beforehand? And has he tried anything after his surgeries? Aquatic physical therapy is one of the best for post op therapy when someone is still having pain. It's the least stressful on your body.

    They have minimally invasive fusion techniques these days, so maybe he could look into that! Disc replacements really aren't tried and true yet, so they're still risky because you never know what's going to happen, if it's going to slip out... It's very common for the thing to slide back and forth on the vertebrae... And could require more surgeries on top of the ones he's already had. I think healing from a minimally invasive fusion would be a lot less trauma for him based on his seemingly low tolerance for pain, than a repairing surgery for a slipped disc replacement.

    This is just my take, though... So no one get all defensive... Lol.

    Hope he's doing alright. Tell him a bunch of us from a Spine forum wish him the best and are thinking of him. Even though he doesn't know us, it will be comforting I'm sure, for him to know there are others thinking of him, that understand what he is going through and can sympathize with him.

    Keep us updated on his progress and treatment, please!

    Hope you guys had a good Thanksgiving :)
  • I'm trying to remember how long ago this whole thing started. I know it was some time after my back problems finally stopped, luckily all due to a muscular problem and weight issues which have been resolved.

    It's funny that music was mentioned because I started off as a drummer for a metal band, he soon took over and besides school that is what he does hehe. It involves a lot of heavy movement but he really doesn't want to stop playing.

    He had some kind of fall when him and his band mate were horsing around. My brother is a real jokester and likes to annoy the hell out of people for fun, but his friend got so annoyed that he turned around and I don't know, kicked his legs out from under him, or tripped him and he hit his back on the concrete. And ever since then it was downhill.

    He went to the doctor and ever since, up until the first micro-D, he was doing physical therapy, trying to get a regular exercise regimen going, conservative medications and injections. His muscles are sooo tight that movements that seem like nothing to me are next to impossible for him. That probably has something to do with him compensating for the pain and tightening up over the years.

    There was a point at which the medication just didn't seem to be working and he felt that the physical therapy was not helping, then over the past few months the pain just got to a point where he had to quit grad school because he just couldn't deal with it. I understand that too, especially since the worst of my pain came when I was getting my BFA in Studio Art and I had to stand up and do work almost everyday and put together shows, I almost barely made it!

    I'm very sorry that all of you have had to go through a similar situation but also thankful that I can finally talk to real people that are having the same issues as him. My mom told me that she talked to the nurse about how much pain he was in and if it seemed normal to her. She said it was, that many people are in that much pain and she has seen worse! So, that helps at least me deal with it.

    I guess only time will tell and we'll see how the next few days are dealt with and hopefully we can get him on comfortable and worthwhile road to recovery.
  • It's always nice to get confirmation that something is normal and not to worry.... But sometimes nurses like to minimize people's pain. The morning after my fusion my nurse was a JERK to me about getting up and walking. I had a 360 fusion... Through the front and the back as well... I was on the Morphine patient controlled pain pump that wasn't working at all and they knew that... And they still wanted me to get up and walk. I refused to until I got my Dilaudid like I had been asking for since the beginning (and they should have given it to me, considering it was on my records from the previous surgery as the only med that worked for pain), and the nurse was so rude to my roommate and I. My roommate was in her 50s, and was a day ahead of me surgery-wise... But she told us that everyone is always up walking by the next morning, most the same day, and that they go home the day after that... And we're like.. Ummm... We had 360 fusions... You don't get up and walk the same day unless it was some sort of minimally invasive surgery. On top of that, we both had the same surgeon, and were told we'd be staying 3 to 6 days, depending on our digestive systems getting back to normal, and pain being under control on pills... So the nurse was just condescending. She was like "some people just don't have the pain tolerance others do and can't take as much", but in a rude voice... I have a high pain tolerance, but when I'm telling someone my pain meds aren't working, and I was just cut open through my stomach and stomach muscles, then my back as well, I don't wanna hear that I'm a baby because I want meds that work before I get up and walk less than 24 hours after my surgery. Jeez. The nurses would ignore my calls for meds (cause I was getting injections after I told them the Morphine pump, which was upped 5 times before they reached the max dose and finally gave up on it) and would leave me for an hour or two past my scheduled doses... They would be rude to me when I would request pain medication on schedule, as if I was trying to get high or something. It was ridiculous.

    Pain is pain.. And even if someone else thinks you shouldn't feel it, it doesn't make it any less painful. The only difference is that at least you know that you don't have to fear that something is seriously wrong with your brother, since you know he has a low tolerance for pain, it's just that... That is a relief, knowing that's all it is. It doesn't make him hurt any less, but it does get rid of the anxiety of thinking it's something huge going on and stressing yourself out unnecessarily.

    Hope things work out for you guys :)
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