Conference vmszoo::medical

    
    Hello,
    
    I have recently been for an MRI scan of my spine after months of pain
    in my legs and countless unsuccessful visits to my GP. He eventually
    decided to send me to an orthapedic specialist after several stints at
    the physiotherapist failed to relieve the pain. What the scan showed
    was that the bottom 2 disks in my spine were dehydrated and that the
    2nd bottom disk was bulging and pressing against the sciatic nerve,
    hence the shooting pains in my legs. The specialist (who is a surgeon)
    has recommended that the bulging disk should be removed. I have asked
    for advice from my GP to see if there is an alternative to surgery, but
    what he has told me is to go with the advice of the surgeon. He says
    that no chiropractor or physiotherapist will be able to help as the
    damage is too severe and beyond repair. 
    
    In the UK, the only treatment available, from what I have been told, is
    disk removal. They are currently working on laser surgery but it is
    still on trial and not available.
    
    What I would like to know is whether anyone knows of any other way
    around having the disk removed, I feel this is pretty drastic and I
    would only consider this as a last option. The past few weeks have been
    hell for me, even walking has been difficult, but over the last couple
    of days it has started to ease off a little. It will probably go away
    for a couple of weeks, but most likely will reappear at some point.
    
    I would be grateful for any advice.
    
    Thanks in advance,
    
    
    Gavin
    
    

    I know where you are coming from. I was not at all keen on the rather
    drastic surgery they had in mind for me. However after watching my
    world shrink to just my small apartment I decided to go along with the
    doctors. In my case the sole alternative to the operation was death. So
    I agreed to be considered for a heart transplant and now I'm not 100%,
    but I am alive and happy.

    I would advise against waiting on "experimental treatments" becoming
    available as this can take years.

    Jamie.

    
    Thanks Jamie. What the surgeon suggested was to go away and think it
    over for a while. I have to make up my mind as to how much the problem
    is affecting my lifestyle and whether I can live with it or not.
    Unfortunately you did not have any alternative but to have surgery, it
    is not critical in my situation. It would be advisable for me to have
    it done while I am still young enough to make a quick recovery from it,
    that might not be the case a few years down the road. Like I said, if
    there is no alternative, then I am going to have to seriously consider
    it as my only option. I have been plagued with it for around two and a
    half years now, I don't relish the prospect of it dragging on much
    longer.
    
    
    Cheers,
    
    Gavin
    
    

    Find a good Neurosurgeon and get a second opinion.  My wife's bulging
    disc problem is being treated via a home traction device.  Seems to do
    the job.

    I had L4-5 removed in the winter of 91-92
    
    It was probably the best thing I ever did...
    
    I previously had the guts (technical term) sucked out of that disk. It
    did not work
    
    Find a good surgeon!
    
    
    Steve

    
    Having tried to find alternatives without any success, I have decided
    to go ahead with the surgery. I just need to talk to the surgeon over
    the next couple of days to find out the exact details of the procedure
    and what preparation I should be doing beforehand. I also need to know
    what happens directly afterwards ie what aftercare treatment I will
    need, like physio or hydrotherapy etc, when I will be safe to drive
    etc.. I just want to be as well prepared as I can before I get it done.
    
    re Steve  Can you give me an idea of what to expect after the surgery,
    any help would be appreciated. As you can imagine, I'm a bit
    apprehensive about it.
    
    
    Thanks
    
    
    gavin
    
    

    I had a back brace that was hard in the back and like a corsett in the
    front.
    
    I was operated on at about 8:30 AM
    
    I woke up in bed in a regular room. The Dr came in and rolled me over
    and proceded to press the sides of the incision to see if any pus? came
    out. I am sure they heard me in the lobby...
    
    That night they had me get out of bed. This was quite the trick as I
    needed to put on the back brace. The pain level was quite high because
    I needed to hold my weight off of my back when sitting up and also
    needed the same 2 hands to fasten the back brace. 
    
    Walking. My 1st steps were about 1/2" at a step and they were quite a
    pain literally. They had me on self medicated something intraveniously.
    
    I was in the hospital 2 or 3 days. My steps slowly became larger than
    1/2". Going home was a trick with the seat in the car fully reclined.
    
    Recovery took a couple months. I would walk every day a little more.
    Every day, the pain became less. After about 3 months I went back to
    DEC.
    
    Hope this helps
    Steve
    
    PS: You will think that you will never walk again right after the
    surgery. It does come back. I can do virtually anything I want to do as
    far as lifting etc. The only things I cannot do are: jogging even with
    the brace on and running off of the pavement and sleeping on my stomach

I also wish you luck.

I have been having back trouble over several periods 
over the last 6 years or so. My Physio. think I also
may have a bulging disk that is pressing against the
sciatic nerve. My GP  has put me on diclofenac which
does help by taking the egde of the pain. Diclofenac
is a Non-steroid anti inflamitory drug (NSAID).  She
has now said that I really should see the consultant
and he may send me for an MRI scan. Luckily my bouts
of back trouble are usually fixed with physio.  Hope
this is the same this time.


Simon

    
    Cheers Simon, I'll need it!  :-)   Can't say I'm overly excited about
    the whole thing, short term it's going to be difficult, but I've
    managed to come this far, so if it means I'm going to be so much better
    off in a couple of months after the surgery, then I think it's worth
    it.
    
    
    Steve, how long was it before you could drive after the surgery??
    
    
    Gavin
    
    

    I think it was ~4 weeks before I could drive my automatic car. The
    big bouncy trucks took a little while longer.
    
    I started by driving myself to town so that I could walk. I live on a
    hill and town is flat. I think I did this for a week then I started
    going up the hill ~100 ft after which it is up and down gently. I would
    walk to the bridge about a mile away. During all this time I used the
    back brace. I cannot remember when I stopped using that. Three months
    later I was crawling around under my trucks again 8-)
    
    The scar is difficult to see on my back. The most painful thing long
    term was my hip where they took the 'stuff' (technical term) to pack in
    between the vertibrae. That bothered me for many months after my back
    was better.
    
    Do you understand how they do a fussion? They remove the disc and grind
    the adjacent vertibrae down to the marrow. They then pack the area with
    marrow from someplace else (my hip). Your body sees marrow to marrow to
    marrow and thinks you have a broken bone. Your body then proceeds to
    heal between the two vertibrae and fuses them to become one bone.
    I think you actually become a little shorter.
    
    
    Steve

    I was in a Naval Hospital for my back and got to know the doctors
    quite well. While there, I was allowed to watch some back, brain,
    and bone surgery. It was nice because the two main rooms had a 
    second floor that had a viewing window above the tables so you
    didn't have to scrub and look over the doc's shoulder. One case I
    saw, the individual had messed up about 4 or 5 vertibra and the 
    disks. In this case, they wired the back to a piece of metal pole
    that was laid next to the spine. Small pieces of bone were taken
    from the back of the hip to fuse the vertibra together. I saw
    many disc operations, bulging on all sides (compressed), sticking
    out from one side and the back was twisted. The three things I 
    noticed that made the surgery successful were:
    1. The skill of the doctor.
    2. The skill of the doctor.
    3. The skill of the doctor.
    
    Pick one carefully and look at their track record. The ones that
    were good had less complications, faster recovery and high
    success rates.
    

    TLC on TV has shown this type of operation on OPERATION.  You
    might be able to call the station and see about getting a copy
    of the tape for a price.  The case they did was a young woman
    who injured herself as a horsewoman.  In the operation they
    ran into some un-expected complications but showed how it all
    worked.  They are pretty good about editing for blood and guts
    types of things so you don't feel squeemish and queezie.

    justme....jacqui

    
    
    I have my appointment with the surgeon this morning. I have spent the
    weekend making up a whole list of questions that I would like answered
    before I make my final decision. Up until the last couple of weeks I
    had been blissfully unaware of what the situation involved, but now
    that the decision has to be made, I need to know as much about it as I
    possibly can.
    
    Thanks for all your advice, I wouldn't have thought of half the things
    that I have been told about without your help. At the very least I will
    be well prepared for my chat today. I just hope the surgeon is
    forthcoming with the information otherwise I will have to have a
    drastic rethink about the whole thing.
    
    I'll let you know how it goes
    
    
    thanks
    
    
    Gavin
    
    

    A tip.

    Get a small notebook. Write one question per page and leave space to
    jot down the answers. Also take notes on any points he makes.

    Most people's mind tends to go a complete blank in the presence of a
    doctor, especially if there is an element of stress involved.

    Jamie.

    
    Well folks, here's the deal. Out of sheer curiosity, I called the
    physio that I had treatment from last year and explained the situation.
    She suggested dropping by to talk to her before I went to see the
    surgeon. Basically, she was very skeptical about the surgeon's decision
    and suggested that know we know what the problem is, a course of physio
    might help. It certainly wouldn't do any harm. She suggested that I put
    this to the surgeon and see what he thought.
    
    So, having spoken to her, I went to see the surgeon. I had my list of
    questions ready and they were all answered well. I then asked him what
    he thought about giving some physio one last chance. He didn't see any
    reason why I shouldn't at least give it a go. If, after the 6-8 weeks
    of physio are completed, I have seen no noticable differenc, we will
    reassess the situation and discuss surgery once again.
    
    I feel a bit more positive now, my first appointment is tomorrow
    lunchtime, I will get 2 sessions per week for a 2 month period.
    Combining the physio with swimming and getting back to the gym will
    maybe help. I haven't given up hope yet. I am going to the gym tonight,
    explain everything to the instructor and get him to work out a training
    program that suits me. It's all down to me.
    
    I think having a positive attitude towards this will go a long way to
    aiding my recovery. I must admit to feeling more than a little sorry
    for myself over the past few weeks thinking that I was going to have to
    go for the surgery, but now I feel a lot better about it and have some
    idea as how to go about getting better.
    
    At the very least, I have dodged the scalpel for a couple of months! 
    
    Thanks for all your help and support, I will keep you posted on my
    progress.
    
    
    
    Gavin

    Give the physio a chance but don't believe in miracles. I tell people
    to give physio 6 months max from the 1st onset. If that doesn't work,
    it ain't gonna work. Next!
    
    Good luck
    Steve

    At least you get to have the summer "off".  Surgery in the Fall
    would seem to be the best of both worlds.  Good luck with your
    efforts.

My physio. has said shethinks I may have a prolapsed
disc. I see the consultant on Monday. He may request
an MRI scan.

Any comments about a prolapsed disc.

Simon

    
    Simon,
    
    I think that's the term used by the surgeon to describe what has
    happened to my disk. Basically, it means that the disk has become
    dehydrated, ie all the fluidy stuff inside it has leaked out, leaving
    just the tissue behind. It showed up a really dark colour on my MR scan
    whereas the other disks were white, showing that there was fluid
    present.
    
    Once this happens, it is irreversible. Is the disk bulging out? Is it
    nudging the sciatic nerve giving horrible pains in your lower back and
    legs? If so, it's the same as mine.
    
    I have been to the physio twice last week for treatment, the dull pain
    is still there, but it is early days yet. I'm still not gonna give up
    on it until my 2 months of treatment are over. If I'm still no better,
    then I'm back to square one and faced with the prospect of surgery.
    
    Best of luck mate, I know exactly what you're going through.
    
    Tread carefully...........
    
    
    Gav

    Summary of a long, painful story.
    
    March 1995 	Mild pain down right leg.
    
     June 1995  Pain has worsened, first visit to doctor. He prescribes
    		physio.
    
     July 1995  Physio provides only temporary relief. Doctor refers me to
    		consultant.
    
    Fri August 11th 1995   
                Wife takes me to hospital for first appointment with
                consultant. Pain is so bad I can't get out of the car. 
                Consultant admits me immediately.
    
    Sun 13th    MRI scan reveals disc (L5/S1) is prolapsed and beginning
                to break up. Consultant offers no alternative to surgery.
    
    Wed 16th    Disc removed, enough disc material remains between
                vertebrae to avoid bone graft. Operation takes half an
                hour. Dosed to the eyeballs on morphine so I don't feel a
                thing when I wake up.
    
    Mon 21st    Leave hospital.
    
    Oct 1995    Still off work, walking and sitting still painful, mobility
                has stopped improving. Consultant peforms manipulation
                under general anaesthetic.
    
    Nov 1995    Very little improvement. Consultant prescribes physio.
                Physiotherapist avises "learn to swim and lose weight".
                
    Dec 1995    Swimming every day has virtually eliminated all pain and
                I have regained 95% mobility.
    
    May 1997    Still swimming every day, four stone (56 pounds) lighter.
                I still get the occasional twinge from my back, but other
                than that I'd never know it had happened.
    
                 
    Moral(s) of the story? I have no idea. Perhaps lose weight, especially if
    you sit at a desk all day, visit a doctor at the first sign of trouble
    and swimming can be good for back problems. Oh, and never say you're not
    claustrophobic until you've been inside an MRI scanner!
    
    Phil Gilliland.      

I went to the consultant yesterday. He wanted an x-ray, 
they have one there so it was done right away. Pelvic 
and side spine, x-ray showed more than I expected, it was
rude :-) I have a narrowing of two vertibrae. I am now waiting
for an MRI scan. I know what to expect as I had one done on my 
knee a couple of months ago.

Monday was a good day, virtually pain free all day, today isn't so
good, but no where near as bad as it has been.

simon

    One thing that they would give me upon my request (at the emergency
    room) was cortozone shots directly into my spine. I would get into a
    fetal position on my side and they would use a local then a long needle
    with the cortozone. They could tell when they 'hit' the right spot as
    my leg woudl twitch. They would help (if they did them right) for a
    week or so as I recall.
    
    Good luck
    Steve

Well I have my date for the MRI scan.
Next Tuesday at 1050.

Simon

    
    Good luck mate, hope yer not claustrophobic!!   :-)
    
    Seriously though, they are quite straightforward things. The hardest
    part is having to lay there totally still throughout the whole thing, I
    was in for just over half an hour. It is weird. You have to wear ear
    defenders coz the machine makes a hell of a racket. I just went to
    sleep. The scans last for like 6mins, 8mins, 9mins and 10mins, and in
    between they have to tune the coils or something, that takes about a
    minute each time. You start to realise how long time is when you're in
    there!
    
    Took about a week to get the images back, I was amazed at the
    definition on the prints, it's unreal. Mind you, so was the invoice I
    got from the hospital! That's the most expensive sleep I've ever had!!!
    
    Let us know how you get on.
    
    
    Gav

I have already had one for a knee complaint
so I know what to expect, and I got to keep
the scans :-)

The images, at the Royal Berks, were printed 
there and then.

Simon

No ear defenders, noise wasn't that loud. The times for the scans 
were as follows;

2 x 10 seconds  (line up I guess)
1 x 30 seconds  (I think)
1 x  3 minutes
1 x  6 minutes

The scans were on the XUN workstation and he showed me 
them. The images are fantastic, it showed the bone, fluid
nerves etc. Even the nerve that was trapped.

The consultant's sec. has just phoned to say that I can have
an appointment tomorrow at 0815. How about that for a quick
response.

Simon