5 months post ADR & Fusion-big problems
 

Hi everyone,

Im new to this site so please go gently with me! I an 33 and had an accident at work 4yrs ago, which after many investigations and injections lead to a disc decompression in 2006. My surgeon is Mr Lam in London who I have great faith in.

At the end of Jan last year I had more problems with my back, and again after lots of investigations at the end of August (08), I had a Fusion L4-5 (I am congenitally fused L5-S1) and I had a prodisc inserted L3-L4.

I was really positive about recovery and was looking forwards my life being more active again, and getting back to my job, I had been posted in the office and very much looked forwards to going back to clinical work when recovered again, but sadly after about 6 weeks my pain increased considerably, and I was given nerve root blocks S1 due to nerve pain and my leg 'giving way' this did help.

Sadly my pain continued to increase and at my 4 month check my surgeon decided that I would need revision surgery, and in April I am having the legacy rod system and more screws in my fusion site as I am hypermobile and not fusing due to this,and there is risk of me breaking the hardwear. Again I was positive about this helping.

Unfortunately it has just been discovered through my pain clinic consultant that I have problems with my facet joints, my surgeon and I expected this to be at the fusion level, but when looked into its at the ADR level, I had facet joint injections two weeks ago, whilst the local anaesthetic was in there my facets felt wonderful!! and I realised just how much pain they were causing me, sadly this has not lasted and I am in a great deal of pain again. I am really worried about the future, and after reading a great deal about facet problems at adr sites, I do not feel positive at all, I am really worried about being left in this sort of pain, and going back to my job, which is very active and involves alot of activity, bending etc, so I also have to be fit to go back to work (Im a nurse).
My work is not being supportive, and I dont think it will take them long to start discussing ill health retirement. I worked so very hard to get where I am in my career, and at the moment everything in the future seems so uncertain.
Ive been with my partner for 12 years, and he is very understanding and wonderful, but I worry so much that he will just get fed up with it all.
Im sorry for moaning, im usually such a positive person, however this is all very overwhelming for me at the moment.
thanks so much for listening.

hugs,

sarah
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Welcome
 

Hi Sarah

Welcome:)
I know people will chime in on your problems.

Gil:)

Thanks Gil,
Its always nice to find a place where people understand,
sarah :)

Sarah,

Sorry for your problems.
I am a nurse too (critical care) and know the feeling of not being able to work at the bedside.
It really hurts when you can't do the job you have trained long and hard for.
Anyway, good luck and I hope things work out for you.

Runner

Hi Runner,
Im really sorry to hear that you are in the same position too, Im an intensive care nurse, so it sounds as though we come from a similar background.
Are you on sick leave from work due to back problems at the moment?
I get really sad having to think about the options ahead of me, and I cant believe that I am in this position and at 33 having to discuss ill health retirement. It is such a shame, and I would so love to be able to go back to being a nurse.
Thanks for posting, my thoughts are with you too.
hugs
sarah

Sarah my heart goes to you what an awful situation but there must be hope you must never give up hope. The facets can be regularily injected 3 times a year I belive and they are usually successful like you experienced so that means just 3 months of pain and wait and see what happens there are many new approaches so hold on you are not alone and this is manageable!! what meds do you take?? Marion X

Hi Marion,
Thanks so much for your kind message, its the kindness and support of others that gets me through some days.
I take oxycodone, slow release and quick release, as well as amitriptyline, co-codamol and Im on citalopram too (anitdepressant). ive tried a few times to take meds such as gabapentin and pregabalin, but my body does not react well to them so ive not been able to carry on. I do have the option of increasing the does of my oxycontin slow release and that may well soon be an options for me.
Sadly the injections didnt last for me for more than a few hours, but I do keep positive mostly. This is how life is at the moment, and I just try to take one day at a time (with the odd off day!).
I will probably feel a little better once my surgeon has a full picture of what is going on and he can then think more about options.
again, thank you so much for your kindness, it really means so much at the moment.
warmest wishes
sarah

what kind of fusion did they do? is the integrity of the contruct suspect or did everything fit together nicely. BMP? Allograft? ...???

Is it possible that congenitally fused L5-S1 is overloaded since they fused 4-5 and is now painful?

Hi There, I had bmp with my fusion, but due to previously being hypermobile L4-5 because of the congenital fusion L5-S1, I remain hypermobile and therefore will not fuse without more hardwear being inserted, and as everything is unstable, I have pain from the screws at the moment currently flaring up nerves and scar tissue etc.
Hopefully tightening the fusion area together will offer some relief at the bottom of my spine centrally,
Then its just all about finding some help for the adr and facet issue, this is causing a great deal more pain to me than the fusion issue, and the problem that concerns me the most at the moment.

Sarah:

I am so sorry that you are struggling. This is such new technology that it is difficult in determining who is going to be successful with it and who isn't. It holds such promise compared to fusion surgery but, there are so many unknowns. On one hand, I can understand insurance companies, claiming that it is experimental and investigational, to deny payment, as the longevity is still an issue. Some, with facet issues, still do well with ADR and, some do not. I just hope that they can get you back to a decent quality of life, where you can do what you love to do. I am in a similar position of having pain after my ADR surgery. I had SI joint injections before Christmas and am struggling today with pain. I am far older than you but, equally scared of the possibility of becoming disabled, and not able to support myself. I will pray for you that God gives you the healing you deserve as you are a gift to others in pain. It just seems so unfair about who is stricken. We need good nurses in the world, as you care for people when they cannot.

May God be with you and your family.

Terry Newton

Thank you so very much for your kind words Terry, I am really sorry to hear that you are also struggling post ADR. It is a really difficult position to be in, and takes over your whole life. I knew pretty soon after surgery that I had problems with my fusion area, but only found out a couple of weeks ago about the ADR/Facet problems, and it has been a real shock, but I still keep faith, and the kindness of others really does help to keep me sane, so thank you for the kind wishes.
I wish you the very best of luck also,
warmest wishes to you
sarah

5 mo. post surgery
 

Hi Sarah,
I too was a nurse a long time. Injured my low back working as an RN in a Neuro unit long ago, returned to school and got my MSN/NP so that I could stop working shifts and staff work (back then it seemed like the best way to do this). During the time I was employed as an NP I had two discectomies and the latter one failed miserably tho I continued to work another 8 years in rather modified ways/positions.

What I didn't attempt during my employment was Pain Management with pain meds and ESIs... I wasn't offered this so I retired in 2000 at the age of 47.

I surely hope you're able to return to work in some capacity however it may take a bit longer than planned. You'll figure this out as you go along.

Wishing you the best and glad you found this forum. Please continue to be hopeful. This is a great resource forum.

Thanks Maria,
Its amazing how many nurses that Im coming across who have been retired early due to ill health.
Ive spoken to my union, and they are sending me all of the relevent information out regarding the processes that will occur, including pension info in case it is needed.
Hope that you are comfortable,
warmest wishes
sarah

My wife is an RN... had no back problems until 2007 at age 49. Since then, she's had endoscopic discectomy at one level, then 2-level ADR surgery, both lumbar spine.

I'm amazed at how well-represented nurses are among the spiney population. As are police, firefighters, EMT's, horseback riders.

Im sorry to hear that your wife has also had problems, is she doing well now?
My occupational health Dr who I see through work has worked with nurses, the fire brigade, and police force and seen a great deal from each with back problems. It is a hazard of the job I guess, But I was so suprised when my problems started as I was only 29 at the time. However I have spoken to quite alot of people who have problems who are even younger than I was when mine became problematic so you just never know.
I hope that your wifes surgery has been a success for her?

kindest regards
sarah

Terry and Sarh I am so sorry about what you are going through and pray that God sends healing to you. Sorry your facets injections havent kicked in by now Terry have you got s plan B? Sarah I know you are waiting to hear from Mr Lam and hope it is a sollution form him Love M

Thanks Honey,
Ive just realised its you hun!! sending big hugs your way xx

I am doing better. I just had some bad days still post injections. I am still on some of the medication, I was previously on, but I am cutting back again. :) Thank-you for the concern. I have not posted this past week as we were very busy at work and I was getting ready for Elizabeth to have a partial hysterectomy. She had the surgery yesterday and I get to bring her home today. I just hope she doesn't turn in to Loreena Bobbit. :eek:

Terry Newton

Hi Sarah,
Just checking in on you. How are you? I bet waiting is the hardest part of this process and wondering if what we do will work and should we try something that can make things worse. Those are my greatest worries. You have more time to get info and come to a solution. Just thinking about you.
Phylly

Hi Phylly,
Bless you and thanks for thinking of me.
What I find really hard about the next surgery is the difference in outcome, last time I thought that the surgery will solve all of my problems and make me better so it was an exciting thing to be waiting for, but this time it doesnt work like that, dont get me wrong, I do have hope that the rod and srews will help with the fusion area and hopefully eliminate the central lower back pain and nerve pain that I have, but then what next, I will still be chasing a solution regarding the facets at the adr level. At the moment it just feels as though its going to be a long journey with an unknown outcome, and its going with that and adjusting how I feel. I try not to think about it too much, and the days that I do are overwhelming, so I just try to think about the day that im in and no more ahead than that!!

How are you feeling, its getting closer for you now, and must all feel very real, do you feel positive about it all? It must feel very strange for you too.
Are you prepared for your hospital stay and return home yet? Im thinking of you so much too.
sending you warmest hugs and wishes
sarah xx

Hi Sarah did you recognise me by the bad spelling??? Catch you on emil M XXXX

Ha! that did make me laugh! No honey, I recognised you from your kind words.
chat soon xxxxx

hang in - I am in the boat with you
 

I don't know what I would do without this site. I have a lot of the smae things going through my head as many of you. We have to keep on going. Take care and realize that you are not alone - at least here - these people are wonderful