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Surgery or medication?

AnonymousUserAAnonymousUser Posts: 49,002
edited 06/11/2012 - 8:25 AM in Back Surgery and Neck Surgery
I saw my PM doc yesterday, who told me that according to the discogram, two discs (L4/L5 & L5/S1) are involved in my pain. The discogram really irritated nerves, and I was in worse shape than ever before. I had so much pain in my right leg, from the hip down to my feet. My knee was in excruciating pain and I could only walk with a limp. The PM doc gave me the okay to increase my dose of Opana-ER, and she gave me a Medrol pack. So today, I am finally feeling normal again.

Anyway, she said that the surgeon would probably suggest disc replacement or fusion surgery. I see the surgeon on Monday.

Now, with the 20mg Opana-ER that I am feeling better. But I'm not really doing anything, just lounging around the house. So, I don't know yet if the meds would make it so that I can return to my normal, pre-pain level of work and activities. But if the meds can do that, should I consider surgery at all? I sort of dislike the idea of having to take pain meds for long term. But surgery is also extremely risky.

I'm very conflicted about this. I have been in constant pain now for 2 years. What are your feelings on this? The pros/cons of each option. Granted I will know more when I talk with the surgeon, but as the PM doc put it, she has nothing to offer me except meds (and injections which haven't worked).


  • Make sure you get a second/third opinion. You would not to wait if you risk the chance of permanent nerve damage. I was in your boat and I finally couldn't take enough medication and still work and drive let alone be a wife to my husband. Meds make you someone you aren't, they blocked my emotions and spaced me out sometimes. The steroids in those injections also concerned me. I was needing to many and then they stopped working thus leading to increased pain meds. I finally met the right doctor who did my surgery. I had an L4/L5 fusion with an anterior disc replacement on 11/10/2008. I know it is early but I feel really good! I was out of the hospital the next day and never looked back. I got better everyday, although the first day I was pretty sore. Whatever you decide, Good Luck
  • I'm glad you're feeling better with the increase in meds finally. I agree with Pika on getting 2nd and third opinions before surgery. That's a difficult decision to make. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
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  • And you may need to talk it thru with your surgeon a couple of times before you decide, I know I did.

    I can only speak to my own experience, which is that I've been treating my pain conservatively for a year now, and I made the decision some time back that I would not do the surgery unless my situation declined, or my quality of life was compromised.

    Being 38, with hopefully a long life ahead of me, taking 5 meds a day, side effects from the meds, still having pain, all contributed to my decision. However, I know that surgery is no guarantee, and it is a risk I have decided I will take, as I am otherwise a strong and healthy person.

    Every situation is different. What are the elements going into your situation? (Any other health issues? Insurance? Okay to take the time off from work? family or friends support right now?) I scheduled my surgery in November for January, in part because I ha some work issues to take care of, and meds could hold me over. Can meds hold you over until you are ready to make the surgery decision with conviction? Something to think about.
    Jan 2009 L5-S1 ALIF
    May 2017 ALIF L4-L5 with PLF rods added L4-L5-S1
  • If meds take away the pain, then stick with the meds. Fusion should be the last option. Narcotics really don't take care of nerve pain... So unless you have weakness and numbness then I wouldn't worry that you're at the point of having permanent nerve damage. Sounds like you just need meds and continuing physical therapy. That's just my opinion. Surgery isn't a guaranteed fix, and with surgery, you still may be on pain meds for a while. I'm almost 3 months out and still on the same amount of Percocet I was on pre-op. And I go through phases of not doing much, and then doing lots... For me, it doesn't change anything. Still need the pain meds or I can't stand up straight.
  • Geez, there is so much to think about, isn't there.

    So, I will get all the information the surgeon can give me. Ask if he thinks I would be better off waiting or having surgery sooner. And of course right now, I don't even know exactly what he recommends.

    I guess this is really the first time that I have even had medication get me to the point of feeling this good. So it kind of surprised me. And after reading some surgery information on this site, it is a little scary and overwhelming.

    As far as family, yes I have my boyfriend to help me and look after me. I could probably also get my Mom to come down to help me out, she is retired. But she has a hard time getting up and down stairs, she is overweight, she had a knee replacement last year and her other knee sometimes causes problems.

    As far as time off of work, I think that my boss would be all right with it. He is a physician, and has been extremely accommodating and supportive. I have some sick time, and vacation time right now. And as of now, I don't plan on taking any time off for the holidays. But I could probably wait until I was able to accumulate more time. Then there is FMLA, I need to find out more about that. We also have a program where people can donate their unused time off to people who have need (I can find out if I qualify for that program - it might only be for the hospital staff, not the university staff).

    Thanks for the advice and opinions.
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  • It's a shame you had to suffer with insufficient meds before the discogram. Ask if you wait longer for surgery will that compromise nerves or any damage to tissue. I don't know if you have numbness or pain in you limbs? Good luck. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Pain management gives you the option of waiting until the time is right for you to have surgery, if that is what you decide you need. You probably will need the surgery, so figure out when the best time is in iterms of support, insurance/finances etc. For me, my pain was getting worse and worse earlier in the day, until it was waking in the middle of the night with pain - that made me decide on the surgery. My regret isn't having the surgery, its not planning better for it. Oh, and BTW some insurance companies might start not covering fusions for discogenic pain - Medicare made that ruling a couple months ago and likely other insurance companies will follow.
  • I am 4 weeks post-fusion--

    The recovery is very hard. The hardest part is not the pain--the hardest part is not knowing whether or not it worked. I don't like uncertainty. Today, 4 weeks post-op, my pain is worse then it was on my worst day pre-op. However, there are others who come out of surgery without any pain. Mind you, the doc and PA tell me I am sailing through with flying colors--so if they say I am doing great...that doesn't give me a lot of hope. I would look at the axial lif. I wish I had given that procedure more consideration. As I posted elsewhere--it is FDA approved for two levels--it is 1/4 the cost, and minimally invasive. At least check it out.

  • This is one of those things where you have to get all the facts and then weigh you options. Taking pain medications for a long period of time can have some unpleasant reactions. I personally had to make the decision for surgery because my quality of life was horrible. I feel like I have failed as an employee, mother, wife..etc. I am so limited in what I can do and the only relief I get is from bedrest. I am 39 years young and before I had back issues I was an active person, always on the go. So I had to ask myself do I want to be a walking pharmacy or do I want to take a chance on getting well. For me, I chose faith over fear and I am scheduled for surgery in 5 days.

    As far as the insurance company goes....I had to fight. My initial surgery date of 11/5 was denied by my insurance the day before. My surgeon did a peer to peer with my insurance's doctor and it was denied. My 24 hr expedited appeal was denied. It wasn't until my 3rd appeal where I gathered all records for failed non-surgical routes (chiropractor, physical therapy, steroid injections, pain management) where my surgery was approved. So there is a lot to think about. I hope this helps. I'm sure you will make the right decision for you. >:D<
  • I suffered for 7 years and when the injections stopped working for me I had to turn to more pain meds. After having to take 5-6 pain pills a day I decided it was time to throw in the towel and have the surgery. Now I wish I hadn't waited so long. My surgeon had been doing this for 27 years and he did a fine job. I got my quality of life back and now do everything I use to do when I was younger. I still avoid things that I think might hurt me but all in all things are great. The folks that have surgery and get better move on and don't return to the forum so don't let some of the things you read scare you. Find the right Dr. that you believe in and do it. I was out of work for 14 wks then returned to my job which is in production. Hang in there and good luck.

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