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Scared single mother, Unstable L4 Spondy r/t Workers Comp injury

TrixieMamaTTrixieMama Posts: 64
edited 06/11/2012 - 8:51 AM in Back Surgery and Neck Surgery

I have been reading the boards since injuring myself at work back in November. I am 38 years old and a single (divorced) mother to two under 6. Prior to my injury I worked as a charge RN on a locked adolescent psychiatric unit. One night in November I had to break up a fight between two patients and ended up suffering a back injury.

I went to their doctor who did xrays and referred me for PT, took me off work and sent me to a specialist. 7 weeks later I found out that I had a Grade I Spondylolysis and Spondylolisthesis with bilateral pars defect of L4/L5. 10 weeks after injury my specialist did extension xrays which showed instability and progression of grade to II. I have had only conservative therapy to this point. 10 weeks of PT, 2 epidural injections and I remain off work.

When I saw my specialist several weeks ago he told me that because my spine was so unstable, the only option I have at this point is fusion. I am really scared of having the surgery because in 07 I had an elective surgery that went horribly wrong and landed me in ICU in guarded/critical condition.

When I was first injured my symptoms were debilitating. Now, almost 15 weeks later I have become fairly use to the daily pain. Last week I was bedridden though for 3 days in horrific pain. I have radiculopathy to the right buttock, thigh and on a bad day down to my foot. I have pins and needles on the inside of my right foot and sometimes my shin feels like it's been injected with novicane at the dentists. I also have bad pain with movement on the right side of my spine. When the pain on the right lessens I become very aware of the fact that my left side hurts as well, although not to the same degree. When pain is at it's worst I have had bilateral radiculopathy with pins and needles in the feet.

I am very scared about the thought of having fusion and have heard some horrific stories in my career as a nurse. I am afraid of the restrictions it will have on my ability to carry my 3 year old lets say if she falls asleep in the car. I want what i'm sure everyone here wants, I want to play with my children and live a great life.

My doctor told me that I can never, ever allow injury to my back again. I am just lost at this point. Since this is workers comp, if I refuse the surgery they will likely find me at my MMI and send me back to work. In all honesty, I can't imagine working a 12 hour shift right now. Just picking my kids up from school and going grocery shopping takes a toll on me.

If anyone can share their experiences or help me find some positive in this, I would greatly appreciate it. Also, how do you know when it's time to have surgery? I'm just so confused about this whole thing. Thank you so much <3


  • HI trixey,

    First let me say welcome to spine-health. Have a look around and you will find many dealing with lumbar issues as yourself. You will also find many here on work comp and dealing with the frustration that comes with it.

    As far as your question as to when to have surgery, that is hard to answer. Surgery is a very personal choice, and only you can make that decision. But I like to say you will know when the pain is so bad you would rather cut your leg off than have it attached any longer.

    But here are some things to think about. Have you looked at possibly completing a master program so you could teach nursing, if the worst case was you could go back to the physical side of nursing? Something if you decide to do surgery you might look at doing that while your down. Or a maybe you could be one of those mean nurse case managers whom goes around with injured workers refusing them care, just kidding. My point is maybe there are other positions that aren't so demanding.

    The one thing to keep in mind is you will read some pretty hard stories here on the forums. But we have had many successful fusions come through and are living normal busy lives. So who knows maybe you will be one of them.

    The other thing is I would without a doubt get a second opinion. Even though you are work comp you do have that right. Sense you work as a nurse you know all about getting a independent medical opinion as well.

    Another thing you need to think of is if you decide the surgery route is whom will be helping you with the children. It will be sometime before you can bend lift and twist(blt). So you will need plenty of help with a little one running around.

    Anyway just thought I would stop by and welcome you to spine-health Please keep us posted on what you decide and how you get along. Take care.
  • TrixieMama said:
    Now, almost 15 weeks later I have become fairly use to the daily pain.
    I empathize with you and understand what you are saying, and I am sorry you are having to go through so much as a single mother. To be sure you are adjusting to this life of pain, and it may be because you see a light at the end of the tunnel, but can you imagine adjusting to this lifestyle change and pain for the rest of your life. I know that this is a WC case, but can you go to another Dr., one of your own choosing and get another opinion?
    In my opinion you are much too young to have to adjust to a life of CP, but spine fusion is serious too and should only be done as a last resort. You are between a rock and a hard place, but cannot let them force you into having surgery before you are ready, and know (feel) if it's the right decision for you.

    On a positive note, everyone here can understand and many have gone through the same thing as you, or similiar, and have had to make difficult choices so you are not alone, and we are here to offer support. Welcome to Spine-health!
  • Thank you TamTam for welcoming me :)

    Last week the pain was so intense if the doctor would have said, lets schedule you, I would have screamed "YES". It was totally debilitating and in many ways worse than the initial pain when I was first injured. (possibly from my pain tolerance changing?)

    I have considered going back to school quite seriously! There are a lot of opportunities out there if I weren't able to return to my field, it's just so overwhelming to think that i worked so hard for this career only to have the possibility of it coming to an end before retirement. I got a good chuckle at the thought of being a WC nurse mgr. I think i'm too caring and nice, LOL. I prefer to help people, not hinder them <3 My mom however thinks it could be a calling to be that one flame that stands out and brings change to the industry but that my friend is a tall order to fill.

    I do want to get a second opinion and likely at this point need to get an attorney. All of a sudden my employer has gone out of their way to send me flowers and the president of the hospital called me as well as the director of nurses. Maybe it's all standard WC mumbo jumbo, I don't know but I have so many questions that I can't answer so it's probably time for an attorney.

    Thankfully I am SO blessed to have an amazing family support network. I have my grandparents (81 and 82 God love them and still going strong) and my parents and sibling. We all live within 5 miles of each other. They have even begun coming to my house and rearranging furniture/bedrooms in anticipation of their needing to come stay with me for awhile if surgery is necessary. Without my family, I would be lost.

    Thank you again for the warm welcome, it is a blessing to have found this board so I can talk with others as I take this journey.
  • HI Robin,

    Thank you! I honestly cannot imagine going through life in chronic daily pain or on pain pills for that matter. I can get a second opinion however it has to be through a doctor of my employers choosing, at least that is my understanding. There is a lot about WC that I don't understand and at this point probably need to seek an attorney in addition to a second independent opinion.

    I am stuck for sure between a rock and a hard place :SS

    Thank you so much for responding and for welcoming me to the board!
  • As one that has dealt with extremly painful back pain for almost five years, I wanted to write and let you know that there are sucess stories out there. I had a 2 level fusion done for torn discs in Dec 2008, and only had 2 fused, when I should have done all three that were torn. Started to help the pain and then it got worse. I had my 2nd 2 level fusion on the discs above the first one in Dec 2010. I am healing nicely and am finally feeling the best I have in 5 years! If I would have had all 3 discs fused initially, it might have avoided the 2nd surgery. But I was afraid of a 3 level, so that is the chance I took,
    That being said, get another opinion, preferrably a spine surgeon at a spine center. That is where I had my 2nd surgery, and it was a minamlly invasive, was much easier to recoup from than the PLIF I had the first time. Spine Clinics can be much more advanced in the surgery they preform I have found.
    A good family support will help you. Dont be afraid to go after it and get your life back. Just make sure you have the right surgeon and a positive attitude. It is a long recovery, and takes lots of paitience. But trust me, it can and does work. Good Luck, and if you have any questions, please feel free to PM me. I have been through every test, MRI, CT, Myleogram, 3 Discograms and every type of shot they can inject in your back, also nerve ablations. So I can honestly say, fusion was the only thing that has helped me. But that was after 2 1/2 years of searching for the answers to my pain. Dont give up, the sooner you decide, the sooner you can feel better. Hugs, Robin
  • Hi there,

    Here are a few things to consider regarding your situation;

    First, get a second and possibly a third opinion. I had a two level L4-S1 fusion four years ago. Recovery took quite a while and there have been ups and downs. Ultimately, the pain my surgeon said was going to be gone was in fact, gone. Unfortunately, I have other pain as a result. There is no way the doctor could have predicted that, but I'm living with it.

    Since you are a worker comp (WC) case, you have certain things to consider. Much of what is available to you depends on what state your in and how they work WC cases. I'm in KY and have learned the process well. Here, they have "multipliers" depending if you can go back to work doing the same job or not. So let say your settlement offer is $50,000. They may add an addition 25 - 75 K onto that if you are not able to return to the same line of work. That could be used for going back to school (which they encourage) to pursue a different avenue.

    If you choose to go back to working a floor as a nurse, you will need to be very careful. Something as simple as assisting a patient from bed to bed could cause problems. You will probably be able to do it again, but you will need to be careful. There was a member who used to post here all the time who went by the name "ERNURSE". I don't know if she still checks in or not, but she could give you a better idea of the nursing aspect.

    I think the best thing you can do at this point is to educate yourself regarding your injury, treatment options and workers comp process for where you live.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Hi Kim,

    Definitely arm yourself with a reputable Worker's Comp Attorney. Companies change their attitudes when certain monetary threshholds met. Don't let them force you into a surgical decision if you aren't ready to take that step either. Having an attorney, let's them know that you are serious about your injury and how you are willing to be treated.

    Good Luck,

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