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Neuro: "Surgery was a success" Me"Umm hello, I'm still in the same amount of pain" Uggg

ouch2oouch2 Posts: 1,270
edited 06/11/2012 - 7:55 AM in Back Surgery and Neck Surgery
Hi All, I went for my post op appointment with my neuro. He asked me how I am doing, and I explained that I am in the same amount of pain or more than before my surgery 7 weeks ago (2 level discectomy/laminectomy) He said that he went in and freed up the nerve by doing the discectomies and then removing alot of bone. He said that it was successful.

He said that my facet joints are a mess and I also have stenosis, which I knew. He told me to go for physio in a couple of months and then try facet joint injections. Then shook my hand, wished me luck and that was it, case closed.

I have been trying to be optimistic about my recovery, but now I am feeling so down. The neuro feels that he has done all that he can. I also have an orthopedic surgeon who I also see. Do you think that ortho docs are better for facet issues? In eight months (disc was impinged for a year) I went from no facet problems to moderate 8 months later) That MRI was 4 months ago, so who knows, at this rate probably severe.

He also did not think that it was good that I am on long acting narcotics, short acting, and valium. He thinks that I should take advil as narcotics are addictive.I know that I should try an anti inflamitory but advil ??, how does he think I can go from what I am on to that when even with my pain meds I am in alot of pain. My ortho prescribes my meds.

I just don't know what to do at this point. Any ideas on how to deal with facet issues, is there any real fix for that, as I know injections only work sometimes and then not for very long, from what I have read. Also when you have stenosis (that I assumed was "fixed?" with surgery), does that come back? I also have other bulging disks that could get worse.

Any ideas would be welcomed, as right now, I am just being felt like I have been tossed away by my neurosurgeon.

Hope everyone else is doing well

>:D< Karen

>:D< >:-D< : Karen
L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
discectomy/lami July 2011-unsuccessful
adr L5-S1 Feb 2012
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Comments

  • Hi, sorry to hear of the disconnect between you and your surgeon. Similar thing happened to me. So we agreed to meet up at 10 weeks post ops. Technically he needs to cover yo for 3 months post op...or at least that is how my coverage worked.

    I didn't have facet issues or stenosis. I basically told my ortho that this surgery was anything but gratifying (which was the term he kept using when telling me my surgery was a success). I told him that I would be mad at myself if I didn't ask for another MRI to make sure I didn't re herniate. After much back and forth, he agreed. I Re herniated

    Can you contact him to see if he is willing to get a post op MRI?

    I ended up switching doctors once I learned I had more issues.

    Not sure if any of this helps. But I do understand your frustration.
  • ouch2 said:
    he shook my hand, wished me luck and that was it, case closed.


    This happened to me with one surgeon I consulted with. However, I did not let go of his hand and kinda gently pulled him back in to the room.
    Sometimes these guys see tons of patients and we are just another one to get thru.

    Facet joints can be removed and replaced by new ones, but as you can surmise, it's a radical surgery.

    I figure scar tissue and calcium can grow where the bone was removed.

    Don't stop beating down doors until you get what you want. I truly believe there is a right surgeon out there somewhere that has the solution to your particular set of circumstances, just gotta find him.

    Sorry you are in still in pain. Sucks. :<
    -----------------------------
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • Sorry you are basically being 'disconnected' by your surgeon. Been there, done that...

    As was said on here before, do you have neuro problems causing neuro issues, or (as I have found for me) Ortho problems causing neuro problems?

    You might want to look into seeing an Orthopedic spine specialist given the facet issues? So sorry you are hurting as bad as pre-surgery. *HUG*

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • oh dear sorry to hear that,they really dont care do they,ur just a statistic.im not seeing my neuro until november!that 13 weeks post op.im not prepared to put up with the pain for that long and neither should you be!fight your corner!i spoke to my gp today about my neuro appt and how long and how i felt she said as my physio has been brought forward to this friday(bonus)to speak to her as they are really the best placed to do referrals as they have direct access to the surgeons.she said see if she thinks its just muscular and if she thinks there something else wrong she can and will chase for a repeat mri or quicker referral.if you have been referred for physio chase that!tell them your in agony(im lucky i was having pt b4 the op and been referred same place and as they noticed id been re referred they could give me quicker appt than if i was completlely new and im seeing the same women so thatll help she knew how i was pre op so will see the huge difference)gp told me to take my diazapam 3 times a day which im loathe to do 1 coz theyre addictive and 2 because they make you feel spaced out all the time im bad enough now taking 2xdyihydrocdeine 4 times a day and naproxen 2 a day i have a constant headache!i wish you luck in pushing for answers and gettin urself sorted asap!!!!
  • Karen,

    This is one thing that always concerns me following a surgery, is how the post-op care will be. Your situation is not uncommon, either. If you have a ortho, use him/her to help you. which sounds as though they are. When you tell someone you are still in pain and they just walk away, my opinion says it is for the better. See if your ortho will get a new MRI, and it might be a CT that is needed. Keep in mind a MRI, will detail soft tissue better, while the CT will pick-up more on the bones. It might even be you need a myelogram followed by CT to see what is going on. Be your best advocate. Don't settle for anything less than a "A", when it comes to your health care. Of course it is all in how you speak to them, in getting them to help you.

    Make a plan and stick with it. For example journal your pain so you have the best knowledge of the type and kind of pain you have and location. You need to give the doctors the best information possible. Maybe some good quality PT is all you need, but then maybe not. Ask about doing some Aqua therapy to start, and see if that helps. They can also work on scar tissue that might be forming. If you can't get past the Aqua therapy, to a land program, then it is time to begin looking for the source of the pain, if they don't look sooner. Plan out your meeting with your ortho doctor, and have someone go with you. You might even let that person help you. look in the FAQ section at the articles on talking with a surgeon, so you hit direct questions. You know your body better than anyone and you know if something is wrong or not, and what your able to do and not do. I am not fond of the wait and see approach while things get worse, been there done that and now have lots of permanent nerve damage to match that process.

    So this surgeon told you to have a good life, so I would be done with them. I am not fond of that attitude and your probably better off that happened. While it is depressing, pick yourself up dust yourself off and do what you need to do, to get yourself better. Remember every surgeon is not for every person, and there are more of them out there to help you. There are plenty of other caring doctors, who can help you. Sounds as though your ortho is helping you, so give him/her the best information possible and let them help you the best way they know how.
  • everyone. I have had almost a day to reflect and to read everyone's helpful comments. I knew before I had this surgery that it would not "cure" me, and the neurosurgeon was very forthcoming in letting me know that it probably would't help my back and the nerve damage in my foot probably wouldn't go away.

    When I had the surgery, I was at the end of my rope, grasping for any sort of relief for my pain. I was hopefully that I would at least get some relief in order to help me cope with what was left over.

    Dnice, you are right about asking for another MRI. Luckily I do still have my wonderful ortho in my corner. He is the first surgeon I saw and recommended fusion, but he does not perform them any longer. He has met with me all along my journey, and is setting me up for another MRI in November. I am very thankful for him.

    Paul, I didn't realize they were doing surgery to replace facet joints yet. Although, it does sound radical, and hope it doesn't come to that, it is something to learn more about. Do fusions not help with facet issues?

    Brenda, thanks for the hug, needed that. Cat I am sorry you too are having so much trouble after surgery.I am going to try physio and like you will have the same one as pre op. Hoping the best for the both us.

    Tamtam, I have never had a CT or myelogram, but maybe that would be something to talk to my ortho about, thank you. I am going to try PT as well as facet injections as he suggested.

    It really hurt to be passed off like he did, as well as his comments about my meds, and how I should only take advil for facet problems. I wish I only needed advil. I feel that if facet pain is usually dealt with with only advil, then I definately must have something else going on. I am going to read more on the site about stenosis, but does it usually come back and get worse?

    Thanks guys, looks like I am back at square one again, starting with PT injections and MRI.

    Hope you all are having a good day.

    >:D< Karen
    >:D< >:-D< : Karen
    L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
    discectomy/lami July 2011-unsuccessful
    adr L5-S1 Feb 2012
  • Any chance you can get that MRI sooner? I know they like to wait 3-months and the do one with/without contrast...but November is a ways off. I'd call to ask him to move it up.

  • I am going to make an appointment with my ortho (who I adore). I just wish that he had been able to do the surgery that he said I needed almost a year ago. Maybe I wouldn't be in the pain that I am in.

    I Just find it hard to believe that the discectomies/laminectomies have not given me any relief whatsoever. Could it be possible that my facet joints are the sole pain generator for me? I assume with the laminectomy, it would have taken care of the stenosis pain.

    Judging by the neuro's response that the facet pain should be controlled by advil, can it actually just be my facets causing the pain that I have that I need to take MS contin,120 mg a day, 4-5 percs and 1-2 valium. I must really have a low pain threshhold, or else something else must be going on. Either that or facet pain is Horrible.

    I am going to see if he can move my MRI up, and try to start physio. I still walk quite slow, with a cane, and have a hard time after about 500 feet.

    Come on sunshine, going to try to get out and do some walking today, hopefully will lift the spirits.

    Hope everyone is doing well.

    >:D< Karen
    >:D< >:-D< : Karen
    L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
    discectomy/lami July 2011-unsuccessful
    adr L5-S1 Feb 2012
  • They can block the facets out and see if it is the issue or not. However, your issues seem to still be that of radicular pain in nature. What about a new EMG study, to see if that is active denervation or not? While EMG studies are not full proof they do help in some cases. Also lami's don't work for everyone and fusions have to be done. Let the ortho do the exam and hopefully he will have a better answer as to what is going on. Ask him which test would see the facets the best.
  • Bullnanny! I'm so sorry to hear you got ditched by your surgeon. It seems like conflicting ideas from him. He tells you it takes 3 months to declare your surgery unsuccessful, you're still in immobilizing pain, and he declares your surgery a success?! And then he sends you out the door with no viable suggestions?! What an audacious man.

    I really hope things work out with the ortho. You should def push to get as many tests done as quickly as you can. There's no reason for you to be in so much pain when there are options out there.

    Best of luck to you, Karen. Keep your spirits up. You've certainly helped me through some of the hard times with your positive words. I can't help but believe that you will find a solution, and soon!

  • Thanks Tam Tam and Andrew(Vitale). I have been in a funk this week since my appointment, but now it's time to pull myself up by the bootstraps (ouch that might hurt lol)and get some answers.

    I am going to go and sit down with my ortho and see about getting the ball rolling again, even if it means starting all over from the begining. Great idea TamTam about facet block and the EMG studies.

    Andrew, thank you for the boost. You have been a real inspiration for me, I know you too have had your ups and downs, keep up with your journal, it really helps myself and others.

    Going to try to get to the pool next week and try some walking in the water. Till then, going to try to keep up with the walking. Over did it yesterday, went for a walk with a friend, farthest I have gone yet, very sore this morning.

    Onward and upward. Hopefully they will figure out what is going on and I will eventually get some relief. Thanks again everyone, don't know what I would do without you guys! >:D<

    >:D< Karen
    >:D< >:-D< : Karen
    L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
    discectomy/lami July 2011-unsuccessful
    adr L5-S1 Feb 2012
  • for the record...I got zero relief from my 1st Microdiscectomy. But I ruptured the disc and it was a hard hit when it happened (won't get into the details)...the doctor convinced me that it might take a few weeks to feel improvement but that the surgery was a success and should be gratifying.

    He expected me to be begging to play golf before week 6...but I wanted to just cry.

    MRI revealed I lost another large piece which was impinging the nerve along with new scar tissue.

    2nd surgery...I didn't get relief right away either but didn't really need pain meds/muscle relaxers. I did take them 2x/day as a precaution and I was able to walk more in the first few weeks. So, I guess I did get relief right away without really realizing it.

    I'm over a year out from 2nd surgery. I cannot say I am 100% or even 80%, but I can say I'm 70% better.
    - I got strength back in the leg
    - I can stand on my tip toe
    - I can push up on the tip toe (lost this ability when I herniated)
    - I can sit for 1-2 hours (though try not to)
    - I can sit on the couch and watch TV with my husband (I do use a pillow behind my back)
    - I can go for 5 mile walks and not limp and actually not sleep the rest of the day
    - I can drive up to 1 hour without having to get out and walk around.

    Glad you have an Ortho that is willing to work with you. Keep us posted.
  • Hi; and sorry for your continued pain, and not getting the answers you are looking for.

    All the posts before mine are great and i cant add nothing on, except to wish you the best of luck.

    I also would stay with your Ortho, and dismiss seeing the Neuro.
    People get stronger meds when they have a tooth pulled, then your NS is willing to give you, and thats wrong in so many ways.

    Best of luck to ya.
  • So sorry to hear that things are just not getting better....I so understand your pain and frustration.

    I also have issues with my facets as well as my SI joints.....

    On of the best "quick and easy" things you can do to self identify if facets may be a pain generator is to stand up straight and then bend backwards. Also bend backwards and at an angle......if this causes pain......facet joints are most likely putting pressure on the nerves.

    SI joints can also be huge pain generators. Often my SI joints hurt when I am in the car as the seat back pushes on them. They often hurt when I wear moderate low rise jeans especially if the pockets are detailed. But most definatley, I jump out of my skin :) when pressure is put on the joint itself.

    The SI joints are usually located just to the side of the top of the gluteal crest.

    I know that for me, this time aorund (my 5th~ugh) the EMG/Nerve conduction study and the myelogram were the deciding factors! They really showed that L3-4 is bone on bone with the nerve compressed inbetween. Within 4 days of having the myelogram followed by a CT scan, surgery was scheduled.

    I hope this helps! Hang in there! We are all here to help support you thru this journey!

    Take care! Wishing you the very best! Shari
  • Thank you all for your continued support! It has been a tough week for me. Attempted to go out for supper with family the other night. What a nightmare. Between the chair I was sitting on and the length of time we were there, it was not an enjoyable experience at all, and I barely ate a couple of bites.

    The next day was horrible. Called my ortho and I am going in early next week to get things rolling again. Definately want to try some blocks to see about my facets. Thank you Shari for the bending backwards test...yikes, not a good feeling at all.

    Leaning backwards in a standing position brings on alot of pain. Although leaning back in a recliner or in a car is my preferred way to sit, leaning on hip.

    What is the best way to test SI joints? I have only had an xray of sacrum area and am going to see if during my MRI they will look lower (sacrum, coccyx) Is a CT myelogram better for diagnosing facet problems and SI, coccyx problems or MRI?

    Dnice so happy to hear that you have 70% pain reduction =D> wonderful!

    Hope you all have a wonderful pain reduced day today!

    >:D< Karen
    >:D< >:-D< : Karen
    L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
    discectomy/lami July 2011-unsuccessful
    adr L5-S1 Feb 2012
  • Hi Karen,

    Sorry to read that you are having a rough time of it. What is it with these surgeons? I am sure they have no idea what pain is like. Advil indeed!

    I agree with what others have said in that you have to keep plugging away until you get someone to listen to you. I know that I was sort of lucky in that I had the infection that helpfully flared up at the right time, but I did intend to keep nagging away until something was done.

    I was also trying all the "therapies" that had been suggested - so I did useless physio, took useless naproxen, walked, swam etc. I thought that if I had done all the things that were supoosed to help but had no improvement then at least I had done "my bit" as it were.

    I really hope someone listens and takes you seriously soon.

    Wishing you a good day

    Helen
  • I swear I could have written this post myself, except thankfully my NS hasn't signed me off yet. He IS, however, deeming my surgery a success because it helped with A LOT of the pain I was having on my right side. Well, two weeks after the surgery I developed left-sided pain, which appears to be related to the disc directly above. My NS put me on a round of oral steroids, my third since the surgery, and wants me to try an ESI. I'm going for the ESI on Tuesday. I also went back to my PM doc/physiatrist (he will be doing the ESI), and he wants to do an EMG due to sciatica that has developed over the course of the last few months.

    I, too, went into this surgery expecting to at least feel a little better. Granted, the original pain I was having prior to the surgery has subsided a great deal. However, the new pain I am having is much worse than the previous pain...much more debilitating. I can't be on my feet for very long before the pain sets in, and it quickly wraps around my ribcage to the front. My issues are with my t-spine, so it's a bit different.

    My facet joints are also a mess as well. I've been told I have "multi-level facet disease." I had a facet block prior to my surgery, back in March, but it did nothing. That is how they determined that the pain was disc-related and not joint-related. If your pain is, indeed, caused by the facet joints, then yes, the orthopaedic doc would be best to treat that.

    As for looking at the SI joint, an MRI is the best way to go there. I'm actually going to be seeing a rheumatologist in a couple of weeks, as a previous NS felt I have ankylosing spondylitis, which is an autoimmune disease. I have a lot of symptoms that fit, including sciatica. My MRI of the lumbar spine came back completely normal...nothing that would cause sciatica. So the next thought is that it's from the SI joint.

    I'm glad your orthopaedic doc is going to meet with you and discuss options. Don't stop looking for answers.
  • Hi, I am new and am not sure which forum I belong in. I have congenitally small spinal canal, scoliosis, degenerative disc, facet joint arthritis, stenosis and sponylolisthesis. I have been in continuous pain, including radiculapathy, for 5 years. I have been getting radiofrequency ablations (every 6 months) and epidural steroid injections (every 3 months) for 4 years. I have been through 5 PT courses. Two spine "specialists" told me in the beginning to avoid surgery as long as I could. One now says he will do it if my cardiologist agrees. I used to get relief sitting , bending and lying down. Now I have this excruciating pain above my tailbone and nothing provides relief. I know surgery is inevitable because my spondylolisthesis is too unstable for a minimally invasive procedure. I am so scared. All that I read (and the five people I know who have had fusions) tells me I might not be better and may even be worse after fusion. I live in a two story home and have very little help.
  • Nel and Kim for urging me on to not give up! I am seeing my ortho tomorrow and hopefully he will have some kind of game plan for me. I am feeling worse than pre surgery now, so not sure what is going on.Kim I posted on your thread about your ESI, let us know how it goes.

    Cyclegirl, sending you a big warm welcome to spine health! I am so sorry that you are dealing with so much pain. What levels (sounds like lower lumbar) are you dealing with? Is the surgeon recomending a one or multi level fusion? You will probably get responses from many members if you post by starting a new thread, in back surgery, back pain, or introduction forums. Then everyone else will have a chance to "meet" you and give you their support as well. Wishing you all the best, maybe you could even get another opinion as now you have one "yes" for surgery and one still saying "avoid surgery" Please keep us updated on how you are doing.

    Hope everyone is getting enough pain relief to enjoy this long weekend. I am going to try to get out and go for a walk now...see how it goes.

    >:D< to all!
    >:D< >:-D< : Karen
    L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
    discectomy/lami July 2011-unsuccessful
    adr L5-S1 Feb 2012
  • That's how it was for me too. I was treated like a customer and not a patient and when there was no way to milk any more money from the insurance it was adios sucker.

    It's pretty discouraging.

    You don't hear many success stories when fusions are involved. We put a man on the moon is 1969 but we can't fix backs. Maybe there's too much money in not fixing it right the first time. That's how it looks to me.
  • Being on these forums for several years, I disagree you don't hear of successful fusions. Most members begin to feel better and go on about busy normal everyday life and don't hang out on spine websites. I have a successful fusion unfortunately surgery was to late to fix the nerve damage and myelopathy that had occurred. The fusion did stop the progression of the disease though. I think you have to look at the condition of the person going into surgery, and what is a realistic goal for the person. Keep in mind once nerves are damaged we have no successful way of fixing them. That goes for any surgery that involves compressed nerves, be it tarsal tunnel, carpel tunnel, peroneal entrapment and the list goes on. One of the moderators has a story here, while he is no longer a moderator as he is out living a full life now. But besides him I can easily come up with lots of users who came posted, sounded terrible, had surgery, then as they began to feel better slowly dropped off posting and then pretty much gone and living life, which is the goal.
  • That is encouraging, tamtam, but I have a question about nerve damage. With the RFAs the doc burns the nerve, causing damage and scarring which temporarily relieves the pain. But, the nerve heals and the pain returns. I have had about 6 on each side at three levels and am curious why there is not some permanent damage at the burn site that prevents the pain from recurring after a while. So then why can't the nerve heal when the compression is relieved?
  • It was explained to me, that the nerves are damaged at the root, meaning inside the cord. Which of course there is no way of fixing those issues as of current. Some nerves however might be damaged outside the cord, and while the burns help and sometimes hope for long term relief, there is just no guarantee. Have you had a emg study to check for active denervation or is this post surgery? Of course many get the burn done before surgery and the same issues with a disk is still there. But they hope the disc might heal on it's own, if it is not to bad.
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