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Surgeon not providing guidance


Please see my signature for my history. Currently treating most recent herniation with PT. Very glad that after 7 weeks it seems to be healing on its own.

Since first meeting my surgeon I have seen him about 8 times including the surgery dates. The first time he met me he said I should avoid high impact activities and I "wouldn't want to become a jogger." I hurt my back riding horses and he was neutral about me returning to that (crazy right!? I was expecting a flat out no!). Then when I had my second surgery he was clear that he did not recommend me returning to CrossFit/weightlifting, which is how I ended up needing a second surgery. Funny thing- that time he said I could jog if I wanted to after the 2nd surgery (I needed to lose a lot of weight so maybe he thought jogging was worth the potential weight loss?). I had a bad recovery from my March 2012 surgery. It took 8 months for me to have 3 days in a row with no back pain. I still deal with intermittent low back pain, though it is much better since I lost 50 pounds and continue to lose.

THIS time, I reherniated L4-L5 lifting a bag of horse feed. I was in shock because I felt I had been safe with my lifting technique. Pain didn't develop until the day after. I'm very lucky it is healing my itself. I explained to my surgeon my rough recovery from the last surgery (had 2 post ops and he basically told me take Aleve and shoved me out the door) and my battle of exercising to prevent injury, but getting pain from the exercise and my concerns about that.

Basically, he says no to some things, yes to others, changes his mind or is neutral. He acts like I should be able to be "normal" again, but I have been back in his office once a year with a new injury for the past 3 years. Clearly I need to change what I am doing, but I can't get him to say ANYTHING. So frustrating. I want some guidance!! Has anyone else had a surgeon like mine? My concern is that I am 22 and injury prevention is very important considering my history and age. Am I being too demanding/specific? I have a follow up in 8 weeks and I want some better answers this time.
I am a very active person- walking/jogging/hiking, some horse back riding, strength training, have a job at a barn, outside work etc. Surgeon knows this and still seems to have no comment. I am willing to limit things if only I could get him to give me some limitations. This whole "your back is fine until it's not" way of living is getting old!
25 years old: Herniated L4-L5, L5-S1 December 2008. L4-L5 microdiscectomy Sept 2010. L5-S1 microdiscectomy March 2012. Redo L4-L5 microdiscectomy Sept 2013. Redo microdiscectomy Oct 2015.


  • SpineyKD23SSpineyKD23 IllinoisPosts: 89
    edited 05/19/2013 - 4:05 PM
    I'm not sure if my signature is being displayed. If you can't see it in the first post here it is:

    22 year old- herniated L4-L5, L5-S1 December 2008. L4-L5 microdiscectomy September 2010. L5-S1 microdiscectomy March 2012. April 2013 reherniation of L4-L5- conservative treatments successful so far.
    25 years old: Herniated L4-L5, L5-S1 December 2008. L4-L5 microdiscectomy Sept 2010. L5-S1 microdiscectomy March 2012. Redo L4-L5 microdiscectomy Sept 2013. Redo microdiscectomy Oct 2015.
  • You need a spine specialist you trust so perhaps its time for a second opinion.
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
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  • SpineyKD23SSpineyKD23 IllinoisPosts: 89
    Well, I have no reason to doubt his surgical abilities. He comes highly recommended and I travel out of state to see him. It's not that I don't think he is good- I'm not sure really. He just doesn't seem very helpful once I am not surgical. Since I am currently improving from my flare up and am not considered surgical I would have to wait until I end up becoming surgical again (I know that will happen at some point) to get in with another neurosurgeon. My neurologist isn't really helpful either. Every doctor I go to just refers me to another. I know a lot of things that I need to do/avoid are common sense, but I'm still hoping for more guidance. Hopefully I will get it when I go back in 8 weeks.
    25 years old: Herniated L4-L5, L5-S1 December 2008. L4-L5 microdiscectomy Sept 2010. L5-S1 microdiscectomy March 2012. Redo L4-L5 microdiscectomy Sept 2013. Redo microdiscectomy Oct 2015.
  • RangerRRanger on da rangePosts: 805
    hi SpineyKD23,
    I tend to agree with AllMetal, it's not that you are doubting your surgeon, you are just asking for another opinion. When I first entered this arena years ago, I believed in my neurosurgeon, never doubting his abilities. As time went on my surgeon left the clinic/hospital facility and is far away now but I still stayed with the same facility. I even second guessed myself later for not getting another opinion and found out that even my new surgeon advises his patients to do that as do the insurance companies, and a lot of veterans here that post on this site. It really gives you added confidence that you are making the right decision being just a bit better informed.
    Take care and be safe,
  • dilaurodilauro ConnecticutPosts: 11,348
    I am sure that you will find your time on Spine-Health very rewarding. This site is a powerful and integrated system that is dynamic and continues to grow.
    Here are just some of the highlights:

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    - Under the Resource tab, there is a section Doctor Advice Health Center which can be invaluable.

    - As a bonus, Spine-Health provides these patient forums. Here is where you can meet thousands of other people who understand and can relate to your situation. You will soon become part of the Spiney family who provide comfort and the advantages of a Support System. You are now part of this family that is approximately 20,600 International members and growing daily.

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    Ok, now back to your concern. What Ranger and AllMetal posted is very valid. I have also found that many neurosurgeons, once their patient is no longer a surgical candidate (for that time), they are not as "interested" in that patient. I keep coming back stating that a Physiatrist is the type of doctor you want to see to manage your total well being. when it comes to spinal related issues.
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
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  • SpineyKD23SSpineyKD23 IllinoisPosts: 89
    edited 05/22/2013 - 1:31 PM
    Thanks for the advice. I don't think I will get another surgeon's opinion at this point, but I did look up a local physiatrist. I am switching to a new primary doctor in a month so when I go to that appointment I am going to discuss my concerns with him and if a physiatrist is someone I should consider seeing at that point. I think it is time I give up on trying to get non-surgical treatment advice from my surgeon. It is clearly not his thing.
    25 years old: Herniated L4-L5, L5-S1 December 2008. L4-L5 microdiscectomy Sept 2010. L5-S1 microdiscectomy March 2012. Redo L4-L5 microdiscectomy Sept 2013. Redo microdiscectomy Oct 2015.
  • charlie6017charlie6017 Posts: 412
    edited 05/22/2013 - 2:45 PM
    Hi Spiney,

    I can understand where you are coming from, but I would keep in the back of your mind that while this surgeon may be highly recommended, he may not be the best doctor for your needs. Most definitely do what you think is the right thing for you, but if push comes to shove, another opinion isn't necessarily a bad thing.

    Good luck and Welcome! :-)

  • Wow ! I d almost think we had the same Dr . Mine is exactly the same way . I can t get a consistent straight answer out of him . He s a highly recommended NS and was really helpful before surgery but after, ,,, not so much . At every appointment he says something different and won t give me any specific details on what I can safely do or even how I m progressing w fusion, etc. I feel completely lost and have ever since I had the surgery almost 5 months ago . It s difficult to wait 4-6 weeks for an appointment, drive two hours by yourself to get there and then get nothing from it, and go home more confused about what to do than when you went .
  • may be that you are asking your surgeon outside of the normal window of his care. Surgeons are usually seen pre op when surgery is being considered and in the acute phase of the post op period. Generally, after three months or so, you return to either physical therapy, or your regular doctor, or possibly a physiatrist or pain management doctor for ongoing care.......and those people are the ones that might be better equipped to ask about long term prevention techniques and how to lessen the risk of further injury.
    At least that's what I have found to be more helpful and then there are changes that we all need to make about our lifestyles once an injury has occurred and it's a good idea to at least discuss your activities and physical demands with a physical therapist/sports medicine therapist who can work with you on some better lifting techniques and the right equipment for running, or other sports.
  • My primary care doctor warned me of that ahead of my appointment with a neurosurgeon next week. She made a gesture like she had blinders on, and said that surgeons are very specific about what they do, and they don't see outside the blinders. I think she was warning me that a visit with Dr. S won't be like a visit with her...to expect someone more abrupt and highly focused on whether he'll need to do surgery on you or not.

    I agree with Sandi that I wouldn't really expect my surgeon to do a lot post-op. I am curious whether I can have an occupational therapy session if I have surgery, to ask things like how do I use the toilet without twisting? How do I tie my shoes without bending? What's the best way to put pants on after a fusion? How do I adapt in the shower? Those things are more appropriate to OT.

    For physical limitations and allowances, I'd be focused on a physical therapist for sure. I don't think a surgeon would want to spend time answering those questions, not because he doesn't care, but because he's only part of a larger care team. Once he does his part, others come after him with their own set of skills to best care for you at your current stage.
    (see profile for medical details)

    I *heart* my TENS unit.
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