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L5-S1 extrusion in Apr, have had discectomy, epidural injections, PT and am losing hope.

My story in a nutshell-I am a 44 year old flight attendant who was very active and healthy before I tried to catch a 300 lb beverage cart in turbulence in April. I ended up at a work Comp clinic who refused to do an X-ray or mri for the first 6 weeks in level 8-9 pain where I was given Advil and sent to 12 sessions of PT. They wouldn’t do an X-ray or mri claiming it was a pulled muscle and treated me like a drug seeker when I would tell them I couldn’t bear the pain. On week 3 I lost feeling in my two little toes, back of calf , thigh and buttocks and could no longer point my toes or raise up on tiptoes. Told the Dr about it and he recommended ice and heat, but still no imaging or medication. On week 6 I fainted at my sister’s house and found out at the ER that my blood pressure was 195/145. The first thing the ER Dr asked was if I had a serious inquiry or was dealing with severe pain. 

The ER Dr gave me my first dose of real pain medication and I laid there and cried all night in relief. Subsequently my BP was back in the normal zone in under an hour. He then ordered an mri for the next day and kept me overnight with IV pain meds. The next day after the MRI the Dr came into my room and told me I had a 14mm extruded disc-L5-S1-and would require surgery ASAP and referred me to an Neurologist. 

10 days later I had my discectomy and recover went very smoothly. One month of rest then 2 months of PT and then work comp ordered me back to work even though I was still making gains in PT. My pain was still around a 4/5 but it was better.

I returned to work with no restrictions and within a week the pain was up to a 6 and now a month later am at an 8 again. My neurologist ordered another MRI with the expectation of reherniation, but kept me on full work duty with a 15 lb lifting restriction, sitting or standing for pain as needed and no more that 2 hrs on my feet per day which is not actually possible as a flight attendant. I’m out of sick time at work but I need the money so I continue to work. 

My biggest fear is that I am continuing to worsen the reinjury by continuing to work and also afraid of what kind of issues I’ll have because my dr’s restrictions don’t match my duty requirements for full duty and he’s on vacation until after New Years. My attorney is aware of the problem but he’s also out of the office until the 3rd. 

So I guess my biggest question is what will come next if it is herniated again? He’s already said he won’t do another discectomy due to the amount of scar tissue I produced after the first one, so would the next option be fusion? The other thing mentioned was a spinal cord stimulator but that won’t help the herniation from creating more nerve damage which I’m already experiencing. Since returning to work I’ve now lost feeling in my entire heel, most of the sole of my foot and lost feeling in another toe. 

I have always been a very optimistic and cheerful person and the pain has taken that away from me. I’m also losing my home, my social life, my independence and my dignity as I’ve always been proudly independent and resourceful. I’m having to move in with my sister and her family so I’m not homeless. I can’t do any of the things that used to make me happy like hiking, traveling and playing with my nephews. I’m starting to realize that I will be having severe back problem for the rest of my life, with no real relief from the horrible pain and just can’t deal with the thought of 20 or 30 more years of this. This injury has stolen my life and I feel it very wrong that the work comp system doesn’t allow employees to sue either work comp or their employer for pain and suffering when the reason for not being able to continue your chosen career is because of the employer saving money and work comp’s negligent rules on treating back injuries. 

Sorry, I know this is very long and veeerrrryy despressing but I feel a bit better just getting it off my chest even if nobody reads or replies, so if you got this far in the post, thank you. Today is my birthday and I am alone in a hotel room in the middle of a very busy flying week, in pain, mentally and physically exhausted tonight  so I needed to decompress a little bit. 

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Comments

  • UpNtheAir - firstly Happy Birthday to you, Happy Birthday to you, sorry I really can’t sing very well.  Second welcome to the forum and you’ll be greeted by some wonderfully smart and compassionate folks here , give them time to respond. 

    You can’t worry what may happen with you IF you reherniate.  You have a grueling job and are in a tough position but you can only take it a step at a time and follow process as much as possible/practical.  Pain is so difficult on the body as you have found, but I believe it’s harder on the mind and psyche if left unchecked. I had roughly 4 weeks of 10/10 pain 24/7 before I had a smidgen of relief from unfortunately what ended up being way too many pain meds. Take the time you can to perform PT tasks, and use natural ways to deal with the pain, but don’t let it go on.  use that ER card immediately if you have major problems with bowel and bladder function, or if you get nowhere within your health care program boundaries and need to jump start treatment when the pain is unbearable.  I had to go twice to ER just for pain treatment post surgery, and the third time lead to a second surgery to add instrumentation. Each time I was super careful not to come acrossed as a med seeker.  After that, had my surgeon not gotten me to a good pain management doctor, I’d be in a gutter or worse by now   I also highly recommend a pain focused psychiatrist to talk through issues you will find it a release also, if nothing else   

    Hopefully wiser heads will prevail in your medical treatment team, and since you have a lawyer it sounds like you just need a respite to get through past New Years.  Be safe and wise, this too shall pass, and good luck, please keep us posted.  

    L3-S1 ALIF Feb 2018 and 

    L3-S1 PLIF Laminectomy and Fusion March 2018

  • dilaurodilauro ConnecticutPosts: 13,303

    Any spinal surgery takes time to fully recover, some longer than others.  For some details read this  
    Recovery, the most important phase   From some of what pain you describe, it sounds like nerve pain healing.   Nerve pain takes much longer to heal than the actual spinal (disc) surgery.   I have had multiple spinal surgeries and most of the time, I felt very good after 3 or 4 months.  But I continued to deal with nerve pain for almost 15 months.  (But that is my situation, after having many spinal surgeries)

    Its not all that unusual to see that there are limited restrictions, the weight limit (15lbs) may be something that you might have for a long time.  Many long term patients have a 40 lb limit.

    In terms of your work situation, your lawyer will provide you with the best information.  Many times, a company may identify the requirements of a particular job position and if a person can not meet those, that could be grounds for being dismissed.   Your profession, just the fact that you are on your feet most of the time can be demanding.

    It can be difficult to re-herniate a disc.  So many members here talk about it, the pain they have after surgery and worries about that happening.  I would say that almost 95% of the members here that worried or thought that they re-herniated a disc, did not and they were just dealing with the ups/downs of recovery from surgery.

    As far as the future, I would not concentrate on thinking the negative sides, but look towards the positive.  There are so many people who have had spinal surgeries, even multiple surgeries can continue to have a productive life.  There might be restrictions, or limits.  We have had members here who after spinal surgery returned to activities they did prior to surgery.  Such as motorcycle riding, being a professional referee in ice hockey.

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
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  • L4_L5LL4_L5 Posts: 1,392
    edited 12/28/2018 - 1:07 PM
    Do you have a comp doctor who is your physician of record (POR)? If so how often do you see him or her and are they a specialist of some sort?

    Many states allow you to choose a new comp doctor if you’re not happy with the one who examined you on the initial encounter.

    Do you have an impairment rating? You and I have a lot in common although I haven’t been offered surgery and I haven’t missed any work despite bad pain 24/7.

    I’ve been on “light duty” for almost three years.

    I personally know a 49-year-old woman who initially had a microdisectomy at L5-S1 and then later needed a fusion at L5-S1.

    I’m happy to report this woman has been doing wonderful since that fusion five years ago. Very little to no pain and she vigorously exercises two hours a day, 5-7 days per week, with no issues.

    Maybe ask your lawyer if there’s a pain management worker’s comp. doctor who’s in your neck of the woods, and who you can see on a monthly basis for medication and to help you regularly submit new paperwork related to your claim. 

    I’m surprised the doctor who told you that you needed surgery ASAP referred you to a specialist who doesn’t perform surgery (a neurologist). 

    Please keep your head up. I have a very good feeling based on the woman I referred to above (as well as other people I know who have had single-level fusions) that you’ll someday — like them — overcome your current symptoms.

    Good luck at your next MRI. I’m so sorry you have to wait so long. Please keep us posted and feel free to ask any questions.
  • First I’d like to say thank you SO much to Joel, Don and L4 for the encouragement and also the advice! The world of work comp back injuries is a lonely place. I try to keep under the radar at work so that it doesn’t come off as if I’m complaining about work comp or my employer. I am hoping this will give me a better chance of keeping my job after the settlement. 

    To answer your questions, L4, my primary dr currently is the surgeon who performed my discectomy laminectomy and I see him once per month. He is who work Comp sent me to after my first MRI. I feel like he has been fair and honest with me and seems much more interested in helping me to get whatever treatment would best help my injury instead of just saving work comp money like the previous GP at the occupational clinic. As far as a disability rating, my surgeon hasn’t rated me yet. My attorney sent me to a IME in Dec and he assigned me 25% partial permanent disability. That seemed incredibly low to me, considering this injury has negatively effected every facet of my life and I am in constant pain. When I questioned my attorney about it he assured me that 25% is very accurate. 

    I don’t completely understand all the factors that determine a settlement but in my state-MO-I believe spine is considered body as a whole which is 400 weeks. So I would be entitled to 100 weeks which equals a little more than one year’s income before the lawyer’s cut if that is the way to calculate it.

     Are there other factors that can add to the value of the settlement? I know my lawyer is going to push for an open Medicare account for future medical  but I don’t know much beyond that and he has been pretty vague about the numbers.  

  • L4_L5LL4_L5 Posts: 1,392
    edited 01/10/2019 - 7:01 AM

    25% seems accurate. I’m 15% and in pain 24/7 and can’t exercise or do many things I used to enjoy doing. 

    The reason you’re at 25% is because you had surgery. If you hadn’t had surgery you’d probably be around 15% like me.

    Some people who have had fusions only have 20%. So 25% seems generous.

    There’s 52 weeks in a year so 100 weeks would be almost two years, if I’m reading that correctly.

    How is your pain nowadays? Still a 6 or 7 daily?

    Are you on any work restrictions?

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  • My pain level is a pretty constant 6-7 even with medication (i take 50mg tramadol 2x/day, 800mg ibuprofen 2-3x/day and had 25mg amitriptylene 1x/day recently added). My biggest issue is that with my job being a safety sensitive position under DOT rules I have very few pain med options available to me. My surgeon originally had me on the other approved pain reliever gabapentin and I was so groggy I could fall asleep at the drop of a hat. The tramadol helps a little and knocks it down from an 8-9 to a 6-7. 

    My work restrictions are the bare minimum lifting requirements required for flight attendants which, according to my company mean that I have to be able to lift 20lbs floor to waist occasionally and 35 lbs overhead one time per day which I can physically do but it causes me pain which doesn’t matter to work Comp I was told. They only care that I am able to do it. I have run into a few issues with the restrictions with passengers expecting me to lift their luggage which we are actually told by the company not to do but passengers believe that’s part of our job duty. In the past two months I’ve had to explain to numerous angry passengers that I can’t lift their luggage who assume I am just being lazy which bothers me as a people pleaser. The other issue is handicapped passengers needing assistance walking or being carried onboard which I cannot do and is not required of me, but again, I hate saying no because I want to help them. I have learned to tell myself that if I hurt myself helping someone else, I’m not helping anybody and in the end nobody will help me. 

    The other restriction he gave was alternate standing and sitting as needed for pain which is not remotely possible considering the nature of the job. Some days can extend to 16 hrs of duty and the only time we sit is 2 mins for takeoff and landing. There is no light duty or part time option for flight attendants so it’s all or nothing and I’m afraid if I say it’s too much I’ll never fly again. I love my job and have been doing it for 15 years. I would be devastated to have to take some work comp approved job doing something I hate or risk losing my coverage. I realize there could come a day when I just cannot take the pain anymore but I want to give it everything I have before admitting defeat so I have no regrets later. All I want is my old life back.

  • Oh, I meant to include why 100 weeks would only equate to a little over one year’s pay, lol, because I actually can do math :D Since work comp only really give you 66% of your estimated pay, that weekly work comp check is already very pitiful, but crew also make additional money that isn’t counted. When we are away from home we receive a perdiem which ends up factors into another 40-50% tax free addition to our monthly pay. It is meant to cover expenses while away but most of us are very economical on the road and bring our own meals so most of us consider it additional income. Of course work Comp doesn’t include this perdiem payment when they estimate your pay, so it’s like it doesn’t exists to them. We also get a few thousand a year for on time bonuses. 

    This is also a reason I am trying to tough out the pain to work, because I have completely emptied my savings having to survive on the tiny work comp checks for almost 8 months. I was receiving less than half of what I was used to earning. 

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