New kid on the block

[dshobbies]

Hi J and welcome,

Sorry you had to jump through hoops to get a diagnosis but most of us have similar stories.

TBI has a very good reputation. I do have a question though. Is there a specific reason your doctor recommended a 2 level fusion as opposed to an ADR on top of a fusion?

The reason I ask is two-fold. First, ADRs are specifically motion preserving and you move alot from L4/5. Second, with a 2 level fusion, L3/4 would have to take on the burden for L4/5 not moving and a common occurance would be that disc going bad too. This could also happen with and ADR at L4/5 but not as quickly and perhaps, in both cases, not at all - just more llikely with a fusion.

J, you have one chance to do this. Please ask your doctor why he recommended as he did. Since he said you could go in both directions - there seemingly are no contra-indications for an ADR so the question why is an important one.

Good luck, Dale

[TiredofPain]

Hi Dale,

Thanks for your response and very important question. I will re-ask that question, but as I remember the situation it was that the subluxation above 4/5 was small concern or mention because of the motion. If I'm not mistaken, the ADR would possibly cause additional problems in the future because of the mis-alignment, thus fusion the better of the 2 options. Additionally, my insurance will not cover the approx $21,000 for the ADR. Again, I will re-direct the question. He shared A LOT of info with me and I may have something twisted here. No pun intended.

[Maria]

J,
First of all~ no one can guarantee the outcome of surgery so I'm sure you're aware of this and secondly different people have different surgical outcomes even with the same surgery and different healing timelines. Don't expect your timeline to be just like your friends or better just because you are 20 years younger. Hopefully it will be a good outcome and a smooth/good recovery for you and whatever procedure you have done.

My recommendation however would be to get a 2nd surgical opinion (and honestly I'd get a 3rd consultation as well).

The reason I say this is if for whatever reason the surgery fails or doesn't end up so well you will at least feel like you got several opinions (not from same doctor or someone in same practice) and did your homework/research.

I hope you will do as well as the surgeon hopes you will w/o any unforseen complications or problems however I do feel it's best to get a few opinions even in the most straightforward of cases.

Good luck. BTW I've had 2 spine surgeries and had 3 discograms and had at least 3-5 recommendations for ADR at 2 levels and/or ADR and fusion or multi level fusion. I had a long history of back pain and back probs and by the time this surgery was actually authorized again (WC) I felt better so didn't have another surgery.

Although I'm used to having flare ups with a day and half down time and don't think anything of that as I've had flare ups that used to last one to two months and spent that much time in bed (and that was after my 2nd spine surgery failed).

I'm not knocking surgery for those that it's indicated just recommend several surgical opinions. Good luck!

[TiredofPain]

Maria,
Thank you for the response and recommendations. I certainly understand and do not expect the same outcome or recovery as my friend. It is just a positive re-inforcement for me as to my decision to move forward in a more aggressive manner. And a close personal friend of 10+ years sharing the experience of the process is comforting. Also, the unfortunate reality is that there are no gaurantee's as to what the outcome will be for myself.

You are 100% correct about getting 2nd and 3rd opinions. I have looked up some other spine specialists in the area and will be calling them tomorrow. I just wonder how willing they will be to see me if I tell them up-front that it's for the purpose of a 2nd opinion. I have the CD's with the results of my recent MRI and the CT-scan after the discogram. I would like to think that they would willingly review the material and give me their professional opinion. Thank you very much for bringing that to my attention, as I had tunnel vision of the light at the end of the road.

Sorry to hear that you had 2 surgery failures and continue to have flare ups that put you down. Hopefully, they are few and far between.

Thanks again.
J

[jsewell]

Hi,
well my last 2 surgeries were pretty much no brainers, they had to happen. The last one in Jan (i am still in a neck and back brace) my head had actually fallen off the train .
In dec i could barely lift my head off my chest, my spine had taken a 90 degree turn and it was painful to try to lift it. I have to say that was a way risky procedure, the surgeon told me the OR staff told him they never want to participate in that type of surgery again. The surgery was totally successful in getting my head up (not to normal abililties but almost) and my pain down.

I have had 6 spine surgeries and 1 major complication of nerve damage . That is the nerve that controls respiration (no where near your lumbar spine) So i was left with only 45% lung capacity. I am going to see the one specialist i could find in the country who has done lots of research on this nerve on wed.
i have spent countless time in physical therapy so my therapist has asked me where i want to sit at his children's weddings (they are 2 and 7)!!!
Mostly helps after surgery, never did keep me away from it.
But i do say go for it. Keep us posted here to let us know your thoughts and how you do next month.
judy

[Maria]

Generally it's standard practice re surgical recommendations to get a 2nd and whatever opinion. In fact when covered by insurance it's called "2nd surgical opinion" and most insurances do cover it but won't tell you that as they'd probably be happy if you didn't get it (use the coverage).

Most of my opinions knew they were 2nd surgical opinions (have had 2 spine surgeries). You can be up front or not. If you're using your insurance go ahead and inquire about 2nd surgical opinion and in network coverage or out of network coverage as if there is not an in network provider that can give a second surgical opinion it's usually covered to go out of network although if you're concerned about coverage/payment and/or the office is you'd want to make sure about that.

Good luck! You sound like you're ready to move forward. BTW actually my first surgery didn't fail just it left the discs above it in a weakened position (putting load on adjacent discs) and guess at least one (L4) probably had something going on and just was in a weaker position to carry the load. L3 had an anular tear that I have no idea what's going on w/it now as I've done much better with no surgical intervention since '92. Much better than where I was after the 2nd surgery failed that is and hence my decision re no more surgery yet. My flare ups are nothing like they used to be (thankfully!)!!! I'll "reevaluate" when my functioning is severely limited or I have neurodeficits or strong reason for surgery as perhaps you have now.

[TiredofPain]

Hi All,

I had a 2nd opinion done on Wed. I arrived early to make sure paperwork was done, I had the results of my MRI and CT-Scan with me. Great office staff, then it was into the exam room. Put on the paper shorts that are provided and waited for the Dr. He came and and was very quick to get it done. He was not aware at that point that the purpose was for a 2nd opinion to surgery. He is also a Specialist in Neck/Back/Spine. He did the normal exam, touched here and there, the bend forward/back/side-to-side, reflects and the needle test to check for feeling. He then told me that he had reviewed my MRI and CT-Scan. Showed me the spine model and explained my situation. He said without the results of the Disco-gram he could not make a 100% recommendation, but his 35 years of experience would indicate that I needed a 2 Level Fusion at L4/5 - L5/S1. I was going to mention to him that those were the discs that were positive during the disco-gram. He stated: "You have nothing to say about the disco-gram, you were there but you were too heavily sedated to understand what was going on, so you have nothing to say". He said this while waving his index finger in a NO-NO fashion. He then said "You have obviously seen a specialst or these tests would have never been completed, why haven't they done anything?" I explained that there are alot of treatment options and that I was evaluating them before making a decision, a 2nd opinion. He said "You have mine, call me if you need me." and proceded to walk out. Well, I considered that a little rude, but it was ok. He had confirmed the problems that are present, and mentioned doing the same thing that I have scheduled. I had an appt with a phsyciatrist this morning. TBI requires all paitents to be interviewed prior to surgery because of the potential outcome and discuss fears and such. The jury is still out on that requirement, but I'm more inclined to think that it's a good idea, because of the potential emotional side effects during recovery, and the fact that it may not work. Additionally, because of the opiate based drugs that are used for many people during the recovery phase that may take months. Just my 2 cents about that. At any rate, I have one more appt scheduled for Tuesday. I consider myself VERY FORTUNATE to live in an area that has a large pool of specialists that I can go to. After Tuesdays appt, I will solidify my decision, which is leaning more towards having the L4/5, L5/S1 Fusion completed on 26 April. Then it will be on to questions about prepping for the surgery and recovery. Oh, by the way I'm also a smoker and will begin Chantix in order to listen to this Doctor was very convincing that it's in my best interest. Thanks again for all the info provided up to this point. It's appreciated.