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Should I have surgery, and what would I be looking at?

djw2112ddjw2112 Posts: 9
edited 02/12/2013 - 1:53 PM in Back Surgery and Neck Surgery

I'm a 21 year old male college student that's been suffering with chronic back pain since before my 18th birthday. As of May (though I need new diagnostic imaging), my diagnoses consist of degenerative disc disease, hyperkyphosis, lumbar stenosis, and herniated discs at L3-L4, L4-L5, and L5-S1. In addition to these issues, I had an incident a couple years ago that has put me on a cane to get around. I went to PT for 3 months straight and my condition didn't improve (might have had something to do with the fact that I didn't get into PT until about half a year after the incident). I should be off the cane, I know, but I'm in too much pain to get myself better if this makes sense.

I have had success using painkillers in the past, but due to a suicide attempt that I made this past summer, I was cut off of my meds, and have just recently gotten into a psychiatrist, but as far as analgesics go, I'm looking at a few tramadol a day. I'm very tolerant to painkillers, so this is almost like drinking water for the pain. She has mentioned referring me to a pain management physician, but since the suicide attempt, the ones that I've tried getting into wouldn't treat me because of it - guess I'm more of a liability than a patient.

That being said, I'd need to continue seeing this psychiatrist for several months so that she can build a good enough rapport with me before I get treated by one of these doctors it seems, and I'm tired of wasting away in the same recliner I've been sitting in for the past 2 years. I can barely get through classes, it's causing me to have panic attacks more often, I can't sleep, and it's worsening my depression.

Despite all this, I'm deathly afraid of going under the knife because of the possible complications, and the risk of making the issue worse. I've been fighting to not have to resort to surgery, but my parents are just pushing and pushing, and I'm starting to think this might be the only way that I have a chance. I've tried just about EVERYTHING conventional there is to offer. I've just been told by medical professionals as well as people I've known that have gotten back surgeries themselves that I would be very wise to put off surgical implementation as long as possible. I've also got a low pain tolerance and I fear that I'll get the surgery, it will go fine, but then I can't handle the PT needed to recover from it.

And now finally my questions; sorry for the rant.

While I really, really don't want to have surgery, does it sound like my only option? Does it sound like my current issues necessitate such an extreme intervention, even?

I know none of you are probably doctors, and even if you were, you wouldn't be able to give me a good prognosis, but regardless of the feedback regarding the above (on if it seems like having surgery should be a priority of mine or not), I would like to know what I would likely be facing in terms of procedure(s), the severity and length of recovery, and the amount of time that would need to lapse before I could resume attending class.

Because of how badly Obama's Healthcare plan is affecting our insurance when our year starts over in April, my mom is suggesting that I get have the procedure over spring break, and just go back to class, but from the research I've done today, that sounds like a really bad idea lol.

Any constructive advice would be greatly appreciated. I'm just tired of being an old man lol.
I am not a medical professional, and everything that I say should be taken with a grain of salt. No diagnoses or truely medical opinions can be drawn with out a physical, face-to-face doctor visit.


  • I am so sorry to hear about your struggles and the chronic pain.
    What people dont understand a lot of times ( if you havent experienced it yourself) is that chronic pain can really mess with you.
    Is it possible for you to get in with a pain management clinic/spine clinic despite the problems with getting narcotics prescribed? At my pain clinic they have everything under the sun for treatment options and pain killers is only part of the treatment, not all it is.
    Also, the insurance companies as well as the surgens today are on strict protocols for when surgery becomes an option. If its acute they will do the surgery, but if its for a chronic condition that worsens slowly, they usually follow a step by step protocol for treatment before you end up having surgery. Basically they have you try all the non invasive treatments first, before surgery is determined an option. And that is good! Maybe something less invasive will help a great deal.
    Maybe you can research and try to find a pain clinic that will treat you with all their non invasive options, and until you are cleared for narcotics they might be able to give you other things for pain.
    Dont give up! Get a second opinion if you feel like doctors leave you hanging. You have the right to get pain management so you can live your life outside the bed or recliner (been there myself).
    Best of luck!
    Cause: car accident & genetics
    Effect: herniations C4-7, stenosis, osteoarthritis, myelopathy, neuropathy
    Non-invasive Treatment: everything under the sun
    Invasive Treatment: 2 level ACDF, C5 & C6, May 2012
    Moving Forward: SCS
  • djw2112ddjw2112 Posts: 9
    edited 02/12/2013 - 7:58 PM
    I realize that narcotics aren't the only part of pain management. They're just the one thing that has been useful to me, thus far, and I'm tired of draining my parents for treatments that don't work. Any suggestions on non-invasive treatments other than the following?



    Trigger-Point Dry Injections with TENS stimulation (These actually, while very unpleasant, did work on MUSCLES, but that won't help the main issues.

    UV Therapy


    TENS Unit

    Massage (provides temporary relief, but pain is back very quickly)

    I started a bout of injections/blocks, but had my incident the very night of the first one I had, and wasn't up to getting around for the next 2.


    Progressive Muscle Relaxation

    Tai Chi (well I tried doing that at an inpatient facility; it didn't go too swimmingly to say the least lol)

    Art Therapy

    Hot/Cold Therapy

    Heating Pad

    There was this on machine at one of the chiropractors office that I tried once. It was like a mechanical bench that you lay on that would drag you over the wheels as it went back and forth.

    Part of my problem might be that most of these therapies are targeted toward muscular pain, though I've been wrong many times in the past.

    And as far as medications go, I will say I do also get lyrica from my psychiatrist which slighly helps. Benzodiazepines are a god-send (though I have panic disorder and am highly social phobic, so that could be indicative of improvement), but same issue with the opioids. I can't take NSAIDs at all due to GI problems unless their IV and that won't help me at home lol. Other than that though, I've tried multiple drugs out of every class of meds used for pain: SSRI's, SNRI's, SARI's, TTCA's, TCA's, topical lidocaine, (as far as non-narcotic muscle relaxers go, Skelaxin just made me into the angriest me I've ever been, Flexeril would somewhat work for a little bit, but it would quickly loose efficacy and I'd have to take a drug holiday, Was given Norflex IV in the ER once in a cocktail of drugs). That's everything off of the top of my head, but I'm sure there's more I can't remember. My Vyvanse allows me to focus, which might take my mind of the pain, I guess. Sorry for throwing this much stuff at you; I just want it be known that I am open to treatment options; that I haven't tried and not had luck with. I was always told the definition of insanity is doing the same thing over and over again and expecting a different result.

    If you have suggestions, things I haven't tried, I would love to know.

    The reason I've started allow myself to slightly think about surgery, is that it's the only thing I can think of, and I can find a surgeon pretty easily on my own and don't need a PCP (which I'm currently in between: the previous one was the one that I was with this summer.

    And sorry if I seem kind of whiny. For the past 3+ years, I've been going to these doctor's and doing what they tell me over and over and over and not seeing results. I'm trying to be proactive and find out what actually might make some kind of difference.
    I am not a medical professional, and everything that I say should be taken with a grain of salt. No diagnoses or truely medical opinions can be drawn with out a physical, face-to-face doctor visit.
  • Ms PixieMMs Pixie Posts: 154
    edited 02/13/2013 - 2:08 AM
    I am sorry if my post came through as thinking you havent had any non invasive treatments, that was not my intention. It looks like you have tried a lot of different types of treatment, and like you say a lot of it targets muscles. Nothing wrong with that but if it only gives you partial relief and drain your or your parents funds, maybe not so great in the long run, no.

    There are still other non invasive options to have for spinal degeneration and possible nerve damage or nerve inflammation, which is fairly common when you have disc problems. Epidural steroid injections, facet joint injections, medial branch blocks, rizotomy, spinal cord stimulator among other things.

    I think they do factor in your age when they try to stear you away from surgery. I was 39 when I opted for my fusion and my doctors said I was too young and healthy to have this kind of degeneration of my spine. Well I did have it, regardless of my age. So at age 21 I can see that they want you to hold off.
    Also, my surgeon said that he doesnt see pain as a prime reason for surgery, since pain can persist after a fusion. He said evidence of nerve and spinal cord damage and further degeneration is reason to do something. It can be irreversable damage done with loss of sensation, muscle tone and even paralysis.

    But still. Chronic pain can rob you of your life, and yes you are too young to be suffering as you do!
    When it comes to pain relief, narcotics are unfortunately pretty effective. I was just trying to give you some encouragement that you might find pain relief despite not being able to get narcotic pain killers at this time. Are you in the US?
    Here, most pain clinics/spine specialist will treat according to a step by step model until everything is tried. At least thats my experience. When I had my surgery, both surgeon and insurance company made sure I had done everything else before they approved me. And I had been in treatment for closer to 5 years.

    If you feel that you have already been through every option there is and still get no real relief, make an appointment with a surgeon and explore your options. Only you know how much you suffer and what your quality of life is. Also, a spine clinic can oversee different types of treatments for you and will refer you to a surgeon if there is nothing else to try.

    In the chronic pain forum, you will probably find many who have been through the works and maybe they can offer some more insight.

    Stay strong and keep on pushing until a doctor understands how much you are suffering everyday and an offer you some more relief than you have had so far.
    Cause: car accident & genetics
    Effect: herniations C4-7, stenosis, osteoarthritis, myelopathy, neuropathy
    Non-invasive Treatment: everything under the sun
    Invasive Treatment: 2 level ACDF, C5 & C6, May 2012
    Moving Forward: SCS
  • Thank you for the words of encouragement, and sorry if it seemed like I was going off on you. Just when I saw the comment about narcotics being the only aspect of pain management, it made me feel like I had in the past when doctors either accused me of or insinuated that I was drug seeking. I just went into auto-defensive mode, and I'll hope you'll forgive me of that. Guess I'm not used to speaking with people that are in enough pain that they don't feel the narcotic effect of their pain killers. I've had friends that claim to hurt all the time, that will take a Norco for it's narcotic effects, and then call me a drug addict because of the prescriptions I'm taking or the amounts that I'm prescribed, when in most cases I wasn't even getting enough pain relief from them (e.g. I was having to take an equivalent of 100mg of oral morphine/day just for the post-op pain of my wisdom teeth extraction).

    I could see how a surgeon wouldn't want to operate on me either considering I was born in the 90's, but I believe the condition of my current health might weigh against that decision - I'm in horrible shape lol. Trust me, I'm not wanting to go have surgery done thinking that it will be the easy way out. I have already illustrated a few of the scenarios that could unfold that scare the **** out of me, so I won't beat the dead horse lol. I guess I'll copy the original post of this thread and my other response to you and edit it so that it could be posted in the Chronic Pain sub-forum. I would like to leave this thread open though if possible to get further opinions from other members if they so choose to leave them. I know you don't have any control over that, but that last statement was more intended for any moderators that read over this lol.

    Thanks again,
    I am not a medical professional, and everything that I say should be taken with a grain of salt. No diagnoses or truely medical opinions can be drawn with out a physical, face-to-face doctor visit.
  • NHbackNNHback Posts: 35
    edited 02/14/2013 - 9:19 AM
    ...of information you have thrown out in a few posts. I alot of inter-related issues...

    You mention considering surgery - but that you currently don't have a PCP and that you'd have to find a surgeon... so my question is: exaclty what surgery are you considering and based on what? Have you had advice in the past from a surgeon that a specific procedure would help any or all of your specific diagnosis? If not, that is the place to start.

    If so, and you believe in that advice, what is holding you back from having the surgery? Is it just the fear of the unknown and all the possible bad outcomes?

    All I can offer is this: it sounds like despite a rocky recent past, you are working to get your life back, you are willing to fight for it. It sounds like the quality of your life is severely limited by your back issues. If and when you get a solid medical diagnosis of a procedure that can possibly help, you can be the only one to decide that the risk is worth the reward. I understand you perceive the risk to be high, even though statistically its very, very low; I can relate to that 100%. But if you find a medical support staff, starting with a surgeon, that you trust - try to understand the "risks" realistically. I know teh medical staff I had - my surgeon, my PCP, my surgery coordinator - did EVERYTHING possible to ensure my surgery was as safe and complication free as possible. Heck, they delayed it two weeks since at my pre-op screenings I had high BP which Ive had for a while - they would not proceed until I started BP meds and showed that it was under control/normal. Get a medical support team that you know has your best interest at heart and makes you feel an active participant in the process, and I think you will feel more confident about moving forward. Not 100% "unconcerned", but able to make the step forward to improve your life in spite of your apprehensions.

    Good luck!

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