To fuse or not to fuse

[annapurna]

Maria,

I seem to be like you in that sitting and standing are painful, while walking and (for me) vigorous exercise can actually relieve or at least not cause pain. I've summarized my typical pain level vs. activity and duration as of right now:

driving a car: < 1 hour = 3-5, > 1 hour - 5-7
sitting at my desk: < 1hour = 2-4, > 1 hour 3-4
walking: < 1 hour 2-3, > 1 hour 0-2
standing: < 1/2 hour 2-3, > 1/2 hour 3-4
fast hiking on flat ground or downhill: < 1 hour 2-3, > 1 hour 0-2
vigorous uphill hiking with a pack: < 1 hour 0-2, > 1 hour 0-1

Unfortunately, in our automobile-intensive, automated world, we do lots of sitting and standing and very little walking. Because of this, I have lots of "functional" limitations in that I can't drive for much more than an hour, and have trouble sitting at my desk or standing around observing a process at work. On the flip side, crawling around under a piece of machinery at work, running up the side of a mountain, and spriting through the airport with all of my luggage on my back (in a properly-fitted pack of course) typically relieves at leat some of my pain.

Guess I'd do better as a "hunter-gathered" than an engineer.

Hope this gives you another point of reference in asessing your own situation. Maybe we're more similar than we are different.

Best,
Laura

[fuzzy]

Laura,

Your pain profile sounds much like me. continuous no load moving, flexing actually reduces pain for me and any static load increases pain. Sitting and standing being the big one and holding an accelerator pedal is really bad on my back and foot.

May I ask, what is the situation with your back, do the facets cause this pain? I would stay away from fusion.
How was it before the charite, did it improve your situation (for a while?)?

[Maria]

Laura,
You are much better off than me re pain and no use of meds!

Sitting an hour or more can escalate to quite a pain level like 7-9.
Standing in one place for more than 30 mins can escalate anywhere from a 3 -an 8.
Bending over repetively can bring on a "have to lie down think my back is out type of spasm"

By far the absolute worse is sitting and I don't know how well surgery would address that issue and not bring on a whole host of other symtoms..

Oh yes, just packing can kill me and land me in bed prior to a trip ~ running about in the airport is fine w/o wearing my backpack tho as that would be a big showstopper for my spine.

Hiking.. haven't tried it but am thinking I will in San Diego~ more hilly terrain there and at least I can do some uphill climbing and reeducate my spine to that and see how it holds out. Got so used to flat terrain here in LA county and while able to walk quite well, I'm still by far not as in shape and able to get around as you w/or w/o backpack!

Truthfully if your pain levels are that low and not keeping you flat in bed or nearly bedridden or unable do do anything you love, maybe just readjusting your activity level and modifying how you perform your duites at work will change the course of action you think you are have as an only option and allow you to wait a bit longer for a better solution..

Keep us posted on your thinking as your engineering mind is a good one to have functioning on the forum and especially DRUG FREE (at least for now)!

[ans]

A: As someone who used to work out - a lot, I'd give anything to do what you do. I would be very cautious in risking losing this, for your psychological/physiological health - despite your immense pain problems. - Allan

[annapurna]

Maria and Allen and everyone - thanks so much! When you're feeling like you're going downhill, it's very easy to think that you MUST do something in order to be like "normal people". Some of this stems from our odd pain patterns, i.e. walking around reduces pain while sitting in a chair and "taking it easy" increases it. You don't know how many times I've said that I have spine problems and been offered a wheelchair at the airport when what I really need is to either lay down or walk briskly. It seems SO difficult for people to understand that I can't drive a car long distances (and where I live, EVERYTHING is long distance), but I can hike up a mountain.

You all have made me realize that I've been contemplating a double-level fusion in large part because of "peer pressure" - darn, and I complain about teenagers being silly. THANKS!!

By the way, I definitely DO take meds, just not the "heavy duty" ones yet. I cannot even begin to sleep without my tizanadine and sometimes a tramadol. I now have to take tramadol every other week or so at work if it's a long "sitting day". Luckily, not being on them around the clock, I'm hoping not to tolerance any time soon.

I also like the idea of modifying the activities that HURT. Up until now, "activity modification" meant giving up the things like hiking and skiing that DON'T hurt very much - how silly! Why not rearrange my work schedule so that I'm out on the floor more observing processes and take frequent breaks and walks when I'm at my desk writing reports or analyzing data? My plant consists of lot of buildings spread out over a seven mile square area out in the desert for heaven's sake - I can take a beautiful walk right out the door of my office. Next year my state will be gettin a commuter rail that will, hopefully, will allow me to quit doing so much driving when I need to get to a big city (and save gas to boot). Biking and/or walking short distances also reduces painful car-time and keep me trim as a plus.

Life will probably never be "normal" for me in that there will alway be things that I cannot do without pain. At the same time, irreversible surgical decisions should not be made lightly - especially given the rapid advance of new technology. Facet replacement devices may be five years away, but, five years isn't really that long if one's pain is well managed and one can exercise and do things that are meaningful to oneself.

Thanks again for straightening me out. Ya'll are wonderful!

Best,
Laura

[Maria]

edited as necessary

[annapurna]

I agree completely Maria!

For someone with some significant spine issues, I'm doing quite well. My problem is, I allow myself to feel pressured to be 110% healthwise - maybe because I live in a very young community? I have SO many friends and family members who just can't understand that I cannot sit in a coach airplane seat for five hours, cannot drive across the state in one day, and cannot sit at a desk uninterrupted all day. My family is still giving me grief about getting an ADR as they think that if I would simply give up walking - the one thing that doesn't hurt - I would be just fine. Either that of they accuse me of being a malingerer and using my spine problems to justify a "lazy" lifestyle, i.e. only working 40-50 hours per week instead of 80-100 hours.

Your perspective really helps me to put all these comments and accusations in their place. I think that I need a self confidence spine much more than I need a physical spine, so to speak. You've helped me grow one. Thanks very much.

Best,
Laura