My appointment with the surgeon today...

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damgalnuna
Regular Member


Date Joined Aug 2010
Total Posts : 77
   Posted 11/15/2010 7:35 PM (GMT -6)   
I had my first appointment today with the orthopedic surgeon that my pain management doctor referred me to. He's suggesting that all three of the discs below my scoliosis fusion be removed, and that the scoliosis fusion be extended all the way down my spine. He also wants me to come back for a discogram before the surgery. This would be major surgery, and that terrifies me. Has anyone on here had this type of operation before? I'm feeling a bit lost as to what I should do.
Scoliosis fusion w/rods (92); herniated disc (96); partial removal of rods (97); microdiscectomy (97); sudden inc. in pain (08); tried the various non-pharm treatments and currently take the following meds: lyrica, baclofen, vicodin, topomax, tramadol, welbutrin, ativan, ritilin.
I design jewelry to distract myself from the pain: www.beadedrelics.com

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16796
   Posted 11/15/2010 8:00 PM (GMT -6)   
If I am reading your post correctly this surgeon is talking of completely fusing your lumbar spine, is that correct? If this is true I do know few drs will ever do this except in extreme cases. I do hope that you will get a 2nd opinion and maybe even a 3rd opinion before making any decisions. I just think its better to be safe than sorry. It never hurts to get other opinions thats for sure. May I ask why he is wanting to do a discogram? If he is wanting to fuse your entire spine a discogram would be useless in pinpointing what disc is causing the most pain. That is the purpose of a discogram is to pinpoint the problem disc. What they do is try to recreate the pain caused by the bad disc. I can sure see why you are feeling as you are and I think before doing anything I would educate myself about this surgery and get several opinions. You only have one back.

Please keep us posted on how you are doing. Hugs coming your way.
Moderator Chronic Pain Forum

breezyP
Regular Member


Date Joined Nov 2010
Total Posts : 85
   Posted 11/15/2010 8:56 PM (GMT -6)   
damagainuna, I was just wondering what you think of the tramadol and the lyrica? I am taking those and find that it is not helping. I know all drugs affect us all differently but I was just wondering. I am sorry to hear that you will be needing a big surgery. I hope all goes well. I am new to the forum and don't have much to contribute when it comes to dealing with chronic pain and such.
Lyrica-tramadol hydrochloride-Zopiclone
Waiting for bone scan 23rd nov
Waiting for epidural cervical injections
Not yet diagnosed.

damgalnuna
Regular Member


Date Joined Aug 2010
Total Posts : 77
   Posted 11/15/2010 10:03 PM (GMT -6)   
Straydog, yes, you are reading my post correctly. I'd have to go back and reread my previous medical records, but if I went through with it I'd be fused from approximately T2 or T3 all the way to the bottom. I current portion of my fusion, which extends down to L2 (I believe) was done in 1992 to correct for severe scoliosis. Four years later I herniated a disc below the fusion in a dance class (I'm still upset that I was told it was safe to go back to dance class). The discs below the fusion, three in total, have gotten progressively worse since then. A second disc herniated, or at least became severely herniated, a little over two years ago. The third one happened this year. The second and third herniations weren't brought on by a specific injury. Instead, I believe they were brought on by a combination of continued degeneration of those discs, plus the added strain to my back that came along with becoming a mother. My daughter is now 3.5 years, so it became hardest on my back once she reached 9-12 months, and continued until she got close to 3 years old. It's getting a bit easier now, mostly because I rarely need to carry her.

This surgeon said that there's nothing else he could recommend that could help. I've tried all the conventional conservative treatments, e.g. injections, PT, TENS, meds, etc. It does seem weird that he wants to do a discogram first, but he basically said that he always does that first basically as a final confirmation that that is the source of the pain. So basically, since all three discs below my current fusion are herniated, he doesn't think treating one but not the others would work. That's why he suggested the full fusion.

He asked me at the end of the appointment if I wanted to go ahead and schedule the surgery, but I told him that I couldn't make such a big decision on the spot like that, which he totally understood. He suggested I go online to get more information about the surgery, and that he could also put me in touch with former patients of his that had the same surgery if I want.

Getting a second/third opinion is probably a good idea. Is the best kind of doctor for me an orthopedic surgeon, which is what I saw today, or should I consider seeing someone in a different surgical specialty?

If any of you know of any good resources for information about this type of surgery, I would be very grateful if you could point me in the right direction.

BreezyP: Tramadol was the first medication I was given when the pain dramatically worsened two years ago. It helped, but it's not that strong. It's actually hard for me to tell how much it's helping now since I have taken it 3x/day for 2 years, so I don't know what I would feel like without it. The Lyrica did help with the sciatica in my legs, but unfortunately caused a significant amount of weight gain, which was not good for my back pain. My PM doc recently switched me to Topomax (I don't think I updated my profile, sorry), which is actually helping a bit more than the Lyrica did. Unfortunately, Topomax had the side effect of causing extremely nausea at first for me, and continues to cause decreased appetite and has even made certain foods that I used to love completely unappealing to me. It's very strange. But for the sake of my back, this has resulted in a 20 lb weight loss so far (~2 lb/week). I told my doc about the side effects, but he said that as long as I could live with them for now, it would be better to stay with the Topomax for now since it has been helping more plus the weight loss should also help my back. One added benefit is that Topomax is much cheaper than Lyrica.


Damgaluna I had to edit one word. As keeping with the forum rules we have to keep the language clean as we never know the ages of some of the readers here at the forum since it is a public forum.

Post Edited By Moderator (straydog) : 11/16/2010 12:15:39 PM (GMT-7)


Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9664
   Posted 11/15/2010 11:24 PM (GMT -6)   
I agree with straydog/susie, please seek out a second or even thrid opinion
as this would be major surgery and I wouldn't go thru with a discogram
at this point for what she also said, seems like this doctor wants to do
more testing to get money and not to help you..
Hope you can get a low pain day soon..
((((((((((((((((((((((((((((damgalnuna)))))))))))))))))))))))))
healing hugz
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* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc (Lower Lumbar S1-L3 and Cervical C5,C6, C8 and T1), Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's, Ocular Migraines, mild carpel tunnel, ect.... "Would be nice if we could use the edit button in real life"...

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Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 11/15/2010 11:34 PM (GMT -6)   
Looks like you have a consensus of opinion in getting a 2nd and even 3rd opinion about the surgery. Beyond that I do not have any advice for you as I do not know anything at all about fusions and even less about what your doctor is proposing.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

breezyP
Regular Member


Date Joined Nov 2010
Total Posts : 85
   Posted 11/16/2010 11:34 AM (GMT -6)   
damgalnuna, Thank you for getting back to me. I was given all samples of the drug because I am not covered but I heard it was very expensive. Hope you have a good day
Lyrica-tramadol hydrochloride-Zopiclone
Waiting for bone scan 23rd nov
Waiting for epidural cervical injections
Not yet diagnosed.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16796
   Posted 11/16/2010 2:13 PM (GMT -6)   
Damgaluna I personally would have a neurosurgeon for any type of spine surgery over an orthopod. The reason is they are much more experienced in dealing with the nerves in that area over an orthopod. The orthopod's general expertise is in the bone structure, but we have so many nerves and nerve pathways in the spine, a neurosurgeon is my choice for that reason. When I worked I was in the legal field, doing worker's comp and personal injury work. I saw thousands of clients over a 20 year span have every type of spine surgery there was. It gave me a real eduction believe me, lol. Not only did I learn about various surgeries, I knew which ones had a better outcome and what ones to avoid at all costs. I knew who the good drs were and who were the quacks. I saw better outcomes in spine surgeries done by neurosurgeons over the orthopods too.

A very good web site for spine problems is SpineUniverse.com. They are a very reliable site and updated on their information. I would give them a look if I were you. Knowing what I do about surgeries involving the spine, I would plead with you to get a 2nd and 3rd opinion. I don't blame you a bit for being upset over the dr telling you it was ok to go back to dancing, what was he thinking. You know once they fuse your spine completely you will lose all of your range of motion and your back will basically become like a broom stick. I do know of a few people that ended up with a completely fused spine. Mostly their problems was from disc above or below blowing out from the stress of surgery. Thats pretty typical to happen over time. These people were much older than you too. You will have a permanent weight lifting restriction that you will have to adhere to. You should have had one from the prior surgeries.

I would not agree to a discogram because its not a test that is warranted in your case. Disocgrams are meant to be done if there is a question which disc is causing the most pain. That is the sole reason for a discogram. Your guy is trying to pad his bill they are expensive to do. Not only that but many times a discogram can cause a tear in a disc, thats one of the neat things the drs fail to tell their patients. Thats one of main reasons a lot of drs will not do that particular test. They are not the most reliable one either. Not to scare you but they are pretty painful and most say they will never have another one and don't.

For your nausea ask your dr about giving you a script for Zofran. It works wonders for nausea. I am the queen of nausea, and I have to take it daily. It is available now in generic form as it is really expensive.

I hope you find some answers to your questions. As far as I know none of our members here have a completely fused back just 2-3 level fusions. Take care.
Moderator Chronic Pain Forum

damgalnuna
Regular Member


Date Joined Aug 2010
Total Posts : 77
   Posted 11/16/2010 8:44 PM (GMT -6)   
I'm guessing that I was referred to an orthopedic surgeon instead of a neurosurgeon if they were considering the fusion. It's my understanding that neurosurgeons handle disc surgeries though. A neurosurgeon performed my third surgery, a microdiskectomy, in late 1997. I never liked that surgeon, so I will not be returning to him. I just found out that the orthopedic surgeon that I saw yesterday used to work with the surgeon that did my original fusion (which was done in 1992), as part of his residency. He wasn't working with him at the time of my surgery though. I also can't go back to that surgeon because although he is still practicing medicine, he's at a children's hospital, and he's no longer doing spinal surgery, but instead doing hip surgery only.

I will check out www.spineuniverse.com. Thanks for the tip. I will also be delving right into the case reports and research studies in the medical journals. I'm used to reading these types of things since I'm technically still a biology graduate student, but who knows when I'll actually finish. I still need to do a thesis.

So I'm definitely not making any decisions yet, and will talk with my PM doc and primary care doc, and will figure out what other surgeons would be appropriate in my area (Boston, MA). If any of you know of a particular surgeon, let me know. I live right in Boston, so a surgeon at Mass General, Brigham, Beth Israel, or New England Baptist would be ideal, but I'd be willing to travel further if necessary.

My range of motion is already severely limited. The surgeon went over that with me yesterday, simulating what the change would be like. I barely bend at my lumbar spine as it is, so it won't be a huge change, but it will be noticeable. After my last surgery in 1997, I was given a weight lifting restriction (I don't remember the exact number), but it was for a certain period of time. I was also told not to get pregnant for at least five years since that could negative affect my back. I waited nine. I'm glad I had my daughter when I did, because I doubt I'll be able to have another at this point, or at least it won't be advisable. And while I haven't had an official weight lifting restriction to follow, I have been restricting myself because I know what I can and can't handle. My husband and coworkers have always been great about carrying and lifting things for me so that I don't have to. I avoid it as much as I can. But since I'm a mother, I do sometimes have to pick up my daughter, who is now 35 lbs. It's rare now, but sometimes if she's running out into traffic and won't stop, or just got hurt and I instinctively scoop her up -- the kinds of things where I find myself picking her up before I have a chance to think about what I'm doing.

The discogram does sound like a bigger deal than he made it out to be. I didn't realize that it could cause a tear in the disc. He did warn me that it would be painful.

Thanks again everyone for all of your support and excellent advice. You've been really helpful these past couple of days, as you have been in the past as well.
Scoliosis fusion w/rods (92); herniated disc (96); partial removal of rods (97); microdiscectomy (97); sudden inc. in pain (08); tried the various non-pharm treatments and currently take the following meds: lyrica, baclofen, vicodin, topomax, tramadol, welbutrin, ativan, ritilin.
I design jewelry to distract myself from the pain: www.beadedrelics.com
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