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Surgical Outcomes and Blogs Discuss L5S1 Prodisc-L in the Main forums forums; SURGERY DATE: 5/26/09 AGE AT SURGERY DATE: 39 SURGEON: Dr. Artur Pacult SURGERY LOCATION/CLINIC: Roper Hospital, Charleston ...

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Old 06-04-2009, 12:10 PM
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Default L5S1 Prodisc-L

SURGERY DATE:5/26/09

AGE AT SURGERY DATE:39

SURGEON:Dr. Artur Pacult

SURGERY LOCATION/CLINIC:Roper Hospital, Charleston South Carolina

DEVICE(s), LEVEL(s): Prodisc-L, L5S1

COST = $59,278 (Still waiting for final bills, but this is what quote was)
AMOUNT BILLED:
INSURANCE ALLOWED: United Healthcare Refused to Cover
OUT OF POCKET:$58,278
TRAVEL: 0
EXPLANATIONS?Refused Coverage by UHC, lucky that I have local Doctor that had my utmost confidence. Going to have a hell of a lot of reward points on my credit cards!


ONSET OF LUMBAR PROBLEMS, DATE OF INJURY, CAUSE, ETC...: Original problem resulted from injuries on a trip to Kenya in 1990, re-aggravated in 1992 and then 1996. This was followed by 9 uneventful , blissful years. In 2005 pain just moved in after 2 year old son jumped and landed with his butt square on my lower back. Non-stop pain ever since (maybe 14 non-consecutive days of no distracting pain in 4 years).

PRIOR SPINE SURGERIES AND PROCEDURES (IDET, ESI, etc...):9 or 10 Epidurals, Chiropractic, Acupuncture, Physical Therapy three separate times running a few months each time, rejected as candidate for IDET by 2 doctors.

PRE-OP MEDICATIONS:Hydrocodone daily, Parafon Forte (best mild muscle relaxant), Tramadol, Percoset, Flexeril

PRE-OP DIAGNOSTICS (discogram, nerve root blocks, etc...):2 Discograms, 9 or 10 epidurals

PRE-OP NEUROPATHIES (what, where, & degree of pain, numbness, tingling, sexual/bladder/bowel symptoms, etc.):Lower back pain out to end of hip bone and down to thigh, numbness and tingling when exercising

PRE-OP CONDITION (Please include %leg pain/% back pain, pain levels, type of pain, ability to work and function, disability status, etc.... be direct, but be as verbose as you need to): 95% back pain, 5% leg pain, pain often like someone's knuckle digging in and constantly pressing, sometimes burning, sometimes shooting down leg under kneecap and ending in toes. Never missed more than one day of work in a month, but was only able to do that by taking pain medication everyday.

TIME POST-OP AT ORIGINAL POST HERE: 10 Days Post-op

DESCRIBE YOUR SURGICAL EXPERIENCE:Got to Hospital at 6:00 AM for 8:00 AM surgery. Waited in surgical prep area for Doctor's and Anesthesiologist, after given initial anesthesia no memory of anything until I woke up although I was told I was "conscious" when they wheeled me into operating room. Woke up in hospital bed and spent the next 2 days in hospital. Incision was glued instead of stapled. Surgeon said procedure went perfectly as did vascular surgeon.

RATE FUNCTIONALITY / SATISFACTION AT INTERVALS BELOW:

FUNCTIONALITY:

6. Excellent: no limitations. If I walk to far though I feel it and have to be very patient.

SATISFACTION:

5. I'm very glad I did my surgery, but still have a realistic wait and see attitude. Some days since have been rough, but usually because I pushed myself to walk further than I should have and paid a dear price with pain in back and front.
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Old 06-09-2009, 02:49 PM
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Default 2 Week Update -- Doing Good.

Hi Everyone. It's been 2 weeks since the surgery and all in all, I feel great. Not that I am not without limitations. I went to a movie on Sunday ("UP", it was really good especially if you are with a 4 yr old and 6 yr old) and it was a LONG time to sit down. I had to keep lifting my body up a little with my elbows on the armrests to take the pressure off my lower back. If I had it to do over again I also wouldn't have drank the 55 gallon drum of soda that came with the popcorn. I was sore after and exhausted from walking to and from the car, but it felt more like muscle soreness. I still have some back pain, but nothing like what I had before. Still have to take pain meds once or twice a day, but have reduced the amount by 75%. I have had some bad days, but I just shut it down for a day and do nothing and I am back to feeling good the next day. One of the crappy things about having back problems is that every time you try a new therapy or treatment you have to "buy in" for it to work. If it doesn't work there is a period where a little voice starts whispering in your ear that it might not be working and slowly but surely you come to the realization that you have reached another dead end. This cycling of hope and disappointment takes a heavy toll over time and at some point you get gun shy about hoping too much. It's like and old bluegrass song "I'm always on a mountain when I fall". So I am starting to hope and I feel better than I have felt in a long time. I feel horrible about some of the stories I have read from other people who have not had such a good experience. My heart goes out to all of you and I feel a little guilty writing such a positive account when so many are struggling. I was a perfect candidate for this surgery and I think that patient qualification is essential with ADR. Maybe I am just lucky. I'll try to keep up with the updates.
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Old 06-09-2009, 04:42 PM
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Two weeks out is still VERY early and if your body is telling you that sitting through a movie is too difficult, you should probably pay attention. Exhausting yourself walking to and from the car is not as beneficial as smaller walks.

It's a normal impulse - once your old pain is gone, you want to resume your 'normal' life as soon as possible, even before your body is ready. We've all paid the price of pushing too hard and for the most part, did no real harm. However, that doesn't mean it's not possible to hurt yourself and though I may be more cautious than most, everyone who has been through this surgery agrees on one thing SLOW AND STEADY WINS THE RACE.

Be kind to your new back and let it get used to itself, Dale
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Severe nerve damage in left leg, still working on it
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Old 06-18-2009, 01:14 PM
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Default 3 Week Update

3 Week Update

Well yesterday was 3 weeks since the surgery and I still have good days and bad days. On Monday I went for the follow-up with the Neurosurgeon and had x-rays taken. He told me everything was perfectly placed and wanted me to keep taking motrin for another 2/3 weeks as an anti-inflammatory. He said that they have seen artificial discs "lock up" before and the general thought was that the anti-inflammatory would alleviate this possibility. I asked about the discomfort that I have that I believe to be mostly muscular and he told me that it is an adjustment for the body to make and it takes time for everything to settle down. I went to work after the appointment and worked for a while. When I woke up on Tuesday I was very sore and had enough pain to take a painkiller, which annoys the hell out of me because I want to END IT with the pain pills. On the other hand, being in pain doesn't help anyone so... After about 1:00 in the afternoon I rested for a while. I also got a good night sleep and felt much better today. Discomfort, but no need for meds. Still feel like I am progressing well. Doc also told me that the anesthesia stays in your system for a while and contributes to the problem of getting tired easily. If anyone has any specific questions, just let me know.
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L5S1 Herniation and Annular tear
Over 10 epidurals,
DDD, 2 discograms (positive),
Countless attempts at conservative therapy.
Surgery date 5-26-09
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Old 06-18-2009, 03:44 PM
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I know it seems like a step backwards if you take pain meds but you're right, being in pain does no one any good.

Just fyi, some of us need anti-inflams on a permanant basis. I have been able to get off every med (except as needed) except Celebrex. I have tried every year and my pm agrees it worth a try but we may be partners for life.

I do hate the need for all my meds but at the same time, am grateful they are there. I feel like I ingest a medicine cabinet every morning and night. It is what it is.

Take what you need when you need it and don't worry about it. Keep up the good work and listen to your back. It talks!

Dale
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Dr. B in Bogen, Germany
Severe nerve damage in left leg, still working on it
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Old 06-18-2009, 04:44 PM
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My lumbar ADR was an amazing success. My short term post-op recovery was way worse than average. I think that about 3 times in the first 6 months, another time in the next year and again at 2 years post-op I had setbacks that worried me so much I ran to the local orthopedic surgeon's office for xrays... "fit me in today!"

The roller coaster is not uncommon. Take it easy. If you have a sudden onset of new symptoms... you need to let your doc know. You need to keep them in the loop and let them decide what is normal recovery and what needs to be investigated. Having said that, you sound like you are way better than I was at 3 weeks. At 3 months, I was playing tennes. See the 'life after surgery' website linked in my signature file below.

Good luck... please keep us posted. All the best,

Mark
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1997 MVA
2000 L4-5 Microdiscectomy/laminotomy
2001 L5-S1 Micro-d/lami
2002 L4-S1 Charite' ADR - SUCCESS!
2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova
Summer 2009, more bad thoracic discs!
Life After Surgery Website
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Founder: www.iSpine.org
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Old 06-30-2009, 05:07 PM
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5 Week Update

I missed last week's update because I was busy at work, which is good and bad. I went into work last week with the intention of working 1/2 days, but it's pretty hard for that not to slip and slide into a full day and then some. I think that this caused me a lot of discomfort and pain as the week wore on. By Thursday and Friday I was really uncomfortable at night and didn't sleep well at all. Surprisingly, I felt pretty good on Saturday and again on Sunday. I think the problem with work is staying in one position too long (in this case sitting). I feel I am getting flexibility back to some degree, but I am not pushing it. As far as meds, I am down to 1 pain pill a day or 2 at most and some days none. Still taking some muscle relaxants as the muscles are not done adjusting to everything and are still a little ornery. Also, daily ibuprofen. In general everything is very good which is not to say I have no pain. It is not constant however and while a little more sharp when I do have it, I can alleviate it by changing positions. If anyone has any questions, just let me know. Good luck everyone.

Last edited by Dulishun; 06-30-2009 at 05:12 PM.
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Old 06-30-2009, 05:18 PM
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Sounds like you're listening to your back but not paying attention
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Severe nerve damage in left leg, still working on it
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Old 06-30-2009, 05:36 PM
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Perhaps, but I think it is a constant balancing act. Yesterday I worked 1/2 day and I will leave today at 2:00. There is a big difference between being sore and being in constant pain like I was before. When I wake up in the morning I do a basic diagnostic in my brain on how everything feels and if it's good then I go in. If I feel like there is discomfort, I can do most of my work from home. It is tricky though. In reality, if I sat at home all day I would probably be uncomfortable there too. I am going to keep listening and hope that my body slowly but surely stops talking! Thanks Dale.

-----------------------------------------------------------------------------
L5S1 Herniation and Annular tear
Over 10 epidurals,
DDD, 2 discograms (positive),
Countless attempts at conservative therapy.
Surgery date 5-26-09
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Old 06-30-2009, 08:08 PM
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It sounds like you are doing pretty good. I was lucky in that I had paid leave time, so I don't have to work. I can instead focus on resting, taking walks, letting my body recover and now I am starting to reduce the pain meds (new problems all together). But I am hoping to go back to work in a few weeks. I can't go back to the same job, they had to fill my position when I left, but I am guaranteed a position with the same company due to FMLA. Next week will be 6 weeks post-op for me, and will be the first time I am forced to drive myself. Have to get my hair done, before having a face to face interview for a job, and then the next day going for the interview.

I just went to a movie on Sunday, but purposefully chose one that had been out for a while, so wasn't expected to be crowded. We sat near the back, so I could get up and stand in the aisle, without disturbing anyone. I did get up once to stand for about 5 minutes, but I also pushed up on the armrests too. I am hoping that by July 15th, I will be ready to sit through an entire movie, so I can go see the new Harry Potter movie.

We had our surgeries on the same day, though mine was in Germany. It seems like we are both doing very well. I know how you feel, about not wanting to have to take the pain meds anymore. But with the length of time I was on them, I know realistically it will take some time to taper off. When I went down in dose the first time, it took about 3-4 days of feeling just a little ill, before I felt normal again. I am hoping the next step down will be easier to handle.

I hope you don't mind the long post in your journal, but I felt like I had a lot of similarities to share with you.

I hope that we both continue to recover well, and look forward to being out of pain in the coming months.
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Cathy

46 years old. 12-15 years of intermittent pain, 2 years with constant pain.

DDD, L4-5 and L5-S1, pain confirmed by discogram.
PT, ESI's, Facet injection and block, Acupuncture - all no help.

2-level (Prodisc-L) ADR surgery with Dr. Bertagnoli, May 26, 2009.

Currently taking Opana-ER (tapering off) and oxycodone
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Old 06-30-2009, 10:24 PM
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Cathy,

Please, don't think twice about the long posts. The feedback is great. I agree about the pain meds. I was on them for about 4/5 years. As I have drawn them down, I have definitely had withdrawal problems such as feeling crappy and insomnia. My approach has just been to try to make progress towards ridding myself of them which has been hit or miss. Generally though it has been positive. Less pain helps a lot. On the work thing, I own a business with about 15 employees and I don't need to go in. I could work from home and if I don't feel right I do. I just want to do my part if I am up to it and it is not physical labor, so I figure sitting at home and sitting at work is a wash. I am going to back it off a little this week. To be honest, I am most uncomfortable at night in bed. I think it is just being in one position for too long combined and the cumulative effects of the day. Do you feel very tight in your lower back muscles and hamstrings? I want to try to stretch a little, but am naturally paranoid about tweaking it. I also considered getting a light massage. My doctor suggested this was OK as long as it was light and the person had some experience with back surgery patients. Once again, I am still gun shy about both.

-----------------------------------------------------------------------------
L5S1 Herniation and Annular tear
Over 10 epidurals,
DDD, 2 discograms (positive),
Countless attempts at conservative therapy.
Surgery date 5-26-09
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Old 07-05-2009, 07:29 PM
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I do feel a little tightness in my back, but like you I don't want to do much stretching. I am going by the rules my doctor gave me, of no bending, twisting or lifting for 12 weeks. And I am wearing a brace anytime I am up for any length of time, which keeps me from moving wrong. But particularly when I first wake up in the morning, I lay on my back and kind of stretch my legs straight, and I can feel a little popping/crunching/something in my lower back. It worries me to some extent, but I am not twisting or bending, so I hope it is all right.

My hamstrings and my quads are very tight now, though my hamstrings have always been tight. But I used to be lay down and put my legs in a cross-legged position, but now I can't. I get a painful stretching feeling down my thigh when I try to do it. So, I keep doing it as far as I can, hoping that over time it will stretch out again.

At 3 months post-op I plan on starting some gentle yoga/stretching to help loosen me up.
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Cathy

46 years old. 12-15 years of intermittent pain, 2 years with constant pain.

DDD, L4-5 and L5-S1, pain confirmed by discogram.
PT, ESI's, Facet injection and block, Acupuncture - all no help.

2-level (Prodisc-L) ADR surgery with Dr. Bertagnoli, May 26, 2009.

Currently taking Opana-ER (tapering off) and oxycodone
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Old 07-07-2009, 08:44 PM
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Cathy,

I just wanted to tell you that the tightness will go away with time and stretching.
I started PT at three months after my ADR and it helped a lot. One of the things i didn't expect was such tightness with the muscles in my body. My hamstrings didn't work well and getting pants on was sometimes laughable. Tying my shoes, out of the question.
Hang in there.
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Old 07-15-2009, 10:00 PM
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7 Week Update

Sorry I missed an update or two, just been swamped at work. Feeling great. No pain to speak of. Occasional soreness, but nothing out of the ordinary. Working full time (and then some). Not a huge fan of sitting for long periods, but who is? Next appt is August 5th. Surgery has fixed my issue so far. I am really optimistic about the future for the first time in years. I am tremendously grateful to have had this opportunity (no thanks to United Healthcare who has put me in semi permanent debt!). Still being smart with lifting, stretching, etc. It is really euphoric to worry about things other than pain.
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Old 07-15-2009, 10:07 PM
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Wonderful news. Keep up the caution and you'll do great.

Dale
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3 level Prodisc adr S1-L3, Oct 12, 2005
Dr. B in Bogen, Germany
Severe nerve damage in left leg, still working on it
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