L4-L5 DDD, cannot sit, burning feet

[Hooch]

Gday, I went the fusion and disc replacement 5-6 months ago, on how I am now I should've done it 3 and a half years ago. Very tough recovery tho... lost awareness of pelvic positioning due to pain etc.. being switched on re physio is important.

I was at the point where mentally I couldn't go on in that state anymore and wasn't going to work. I don't know what would have happened to me.

I know you don't need me to tell you how debilitating your condition is, to my mind when I was like that it was quite clearly time for surgery and just hope like hell things improve.

About physio, you need to look at transverse abdominus, pelvic floor, multifidus activation, gluteal dominance over hamstrings.. there is a good book by Jemmet called Spinal Stabilization. It's the basis for pilates. At least that way you can rehab without breaking yourself down.

If you're considering surgery you've probably got a good chance of a good outcome, considering how bad you are and one level blown. Not exactly a risk taken lightly tho.

[Maria]

If you live in the SD area and want a good consultation try Dr.Frank Coufal (he's a Neurosurgeon). At the time I saw him for a 2nd surgical opinion (WC) re 2 level ADR he didn't perform lumbar ADRs, rather fusions altho he went along with 2 level ADR recommendation.

I'd also recommend talking to Mark here (mmglobal) GPN Artificial Disc Replacement ADR

He accompanied me to see Dr.Delamarter, Dr.Regan, and Dr.Coufal. Definately worth talking to Mark.

[dshobbies]

James,

You have suffered for too long. There is help out there but you need to understand where your pain is coming from, what procedures might help, and the pros and cons for each. Only when you have full knowledge of all these things can you make an informed decision. But I will tell you that living like this is a waste of your time, your life.

You are not experiencing anything unique. Too many of us have walked in your shoes.

The first thing is for a consultation, actually second and third opinions too, with a top surgeon. You didn't mention where you live but perhaps someone can make a recommendation. We also don't know your insurance, financial status if your insurance won't cover and ADR surgery - not that this is your only option. So far, it seems you've only seen one doctor who recommends fusion, which I think you rightfully declined. You also said PT didn't work which might indicate that surgery is your only option. But you still need guidence.

All this is assuming you are willing to have a surgery. Some are not and would rather live with the pain regardless of the disability.

And as Maria, a good starting place is with Mark. He has helped so many of us.

Please tell us more about your circumstances and perhaps we can make some recommendations.

Good luck, Dale

[Maria]

I had put this on the other surgical thread that was Jamie's so wanted to put it here~ re understanding that you have doubts, concerns and so forth plus then seeing surgeons who state that the MRI doesn't show anything.

There are other diagnostic tests that might reveal the pain generator(s) so it is important that if your life is that limited to get to the root of the problem as best able because as you're lying there resting your spine to protect it from further pain/harm the rest of your body is suffering the consequences of inactivity.

That might not seem like much right now but years of this adds up w muscle mass loss, osteopenia/osteoporosis possibly and other consequences of inactivity.

Here are my recommendations:
Call Mark to see if he can help you find someone in your area to see.
Consider Pain Management to see if being on some type of medication can enable you to be more mobile in the interim.
Keep an open mind with regard to the process of trying to find out what's going on and what might possibly be done about it. You always have the last say about surgery so even if you find out you can have it doesn't mean you have to have it.

As stated we've walked in your shoes hence getting to where we each have individually today. Good luck and thanks for taking the time to post and tell us about yourself/your pain.

[james]

Thanks for your attention!

I live in San Diego. My MRI shows disc tear, degenerated disc and slightly degenerated facet joint.

I was unlucky w.r.t to the doctor and the physical therapist, I met at the start of my problem. No one told me what to do and how to treat my problem.

At the start of my back pain, doctors basically told me "you do not need surgery now, go and come back when we can operate you!".

By the time I realize what to do and how one should treat back pain, it was too late. Now I am here with pain and disability.

The last doctor I met (Ramin Bagheri, San Diego), basically said he is interested in patients that he can operate on, if I don't want to be operated on, better not to waste his time!

I have had epidural injections and take pain medication, but they don't help much other than making me sleepy. I also feel disconnected to my environment, when I take them.

I will have my 4th MRI soon.

My back is extremely fragile. Any sudden or harsh movement puts me into pain, which lasts for months. Recently, I have started using ice pack.

[Maria]

Come back when we are ready to have surgery... and how do we know that? I'm sorry but Dr."I'm too busy" should be getting paid for a consultation/opinion whether or not you are going to have surgery however I know how busy surgeons can be (worked with Neurosurgeons for a number of years back in the late 70's and early 80's) my strategy was to seek opinions with the idea in mind that if findings so indicated I would definately consider having surgery. I never stated to anyone that I didn't want any surgery. I mean we have to at least let the person we're consulting give his or her opinion so I go to the appt. with my "I want to know what's wrong face and see what you say."

Ok so you've tried meds. Have you had an injection of Toradol 60mg IM for muscle spasms? You can request this and see if it helps. It's often offered in Urgent Care or ER for muscle spasms. While I don't think all of your problem is muscle spasms at least in part it could be such as when disc material leaks out on nerve and then you go into muscle spasms as protective mode. I'm only suggesting this for very temporary relief and/or to break a cycle up. Worth a try.

Re SD area again I recommend Dr.Frank Coufal, Neurosurgeon for a consultation. He's in La Jolla. If you can see him with Mark going along that'd be even better. I think Dr. Coufal just gives you straight up what is going on and what some possibilities are surgically if one is a candidate for any surgery that might help. I also think he'd listen to whatever you have to say. Nice fellow and on the younger side (like in his 40s I think). Very thorough and doesn't have that "God" like complex that I have seen in many neurosurgeons of his calibur.

My PM is in SD at well as Scripps Mercy (Dr.Kevin Toliver). I have been seeing him for 7 years now and really like him.

I had that feeling of instability or fragile-ness for a long long time and that's when I mostly was in bed or lying down as I thought it was helpful and actually I just couldn't tolerate much else so I do understand what you're saying.

[james]

I will schedule an appointment with Dr.Frank Coufal. One more Dr. wont hurt.

I will also contact Mark.

I have united health care insurance. I am not sure if it covers back surgery/fusion/ADR.

[james]

Originally Posted by Hooch

Gday, I went the fusion and disc replacement 5-6 months ago, on how I am now I should've done it 3 and a half years ago. Very tough recovery tho... lost awareness of pelvic positioning due to pain etc.. being switched on re physio is important.

I was at the point where mentally I couldn't go on in that state anymore and wasn't going to work. I don't know what would have happened to me.

I know you don't need me to tell you how debilitating your condition is, to my mind when I was like that it was quite clearly time for surgery and just hope like hell things improve.

About physio, you need to look at transverse abdominus, pelvic floor, multifidus activation, gluteal dominance over hamstrings.. there is a good book by Jemmet called Spinal Stabilization. It's the basis for pilates. At least that way you can rehab without breaking yourself down.

If you're considering surgery you've probably got a good chance of a good outcome, considering how bad you are and one level blown. Not exactly a risk taken lightly tho.

Thanks. Got the book. I try to go through it with my trainer.

[james]

took the 3rd MRI with contrast on Saturday. I have one from 2007, one from 2009 and one from 2011. I am going to schedule app. with Dr. Coufal.

[james]

Got my MRI results. L4-L5 stenosis and small facet joint degeneration. I guess they meant DDD.

I probably want to go for epidural.

Does anybody now about this:

AccuraScope™ Procedure for Back Pain Relief


Thanks.