So maybe I'll "postpone" that back surgery, eh?

[Spiky Bugger]

Here's my deal...please comment!

For 10+ years, my (usually left side) SI joint gets wonky and I'm in constant pain of the 6-7 out of ten variety.

I go to a day surgery place near where we used to live--far from here--get a fluoroscopy-guided injection (sometimes two injections, two weeks apart) of marcaine and depo-medrol I think, and I'm golden for anywhere from six months to over two years. Until this May.

In May, I got the first injection, but as soon as the marcaine wore off, I was in more pain than I was before the injection. It became 8's and 9's out of ten. (I'm saving 10 for burns.) In June, I got the second injection and there was no improvement. (It can take a couple of weeks for the steroid to work.)

I opted to get a new ortho--spine specialist--closer to home. Got additional injection in early August. In there somewhere there was an MRI.

DIDN'T learn much about the SI Joint, but it didn't matter because THIS pain was not in the same place. It was a pain that sneaked up out of nowhere and caused a startled scream in agony from me. The MRI says I have an existing compression fracture and one that is starting, up in the T's, where I feel no pain at all.

And I have spinal stenosis. Radiology report also says I have "Multilevel degenerative disc and facet disease...At L4-5, there is moderate to severe left foraminal and subarticular recess stenosis likely resulting in some degree of L4 and L5 neural impingement."

The particulars are listed, but it looks not so good at L1-2 and gets progressively worse as we move to L5-S1.

So here I sit with paperwork for Spinal Laminectomy and Fusion on 9/5. Confused.

Apparently, all of the nasty stuff that goes along with this surgery is, for some people, worth it for relief from constant lower back pain. And the MRI "sounds like" I might have constant lower back pain. But I don't...and haven't had...yet, anyway...constant back pain and no pain radiating down my legs.

This is a big old nasty surgery. With, for the laminectomy, about a 70% success rate...BUT...
satisfaction seems to drop over time and if fusion is involved, may result in more problems.

See Wikipedia "failed back syndrome."

Further complicating things is that I'm in far less pain than I have been. I'm very careful. When this started, I was on Percocet 10mg, asking how long it had been since my last pill at about the three hour mark. Last night, I took one at midnight and the next one at 10:00 a.m.

I'm still sore...sore that is unlike my ten year history with SI Joint Dysfunction. I'm so afraid of making things worse.

 

[hilary1617]

Spiky Bugger Sorry you are going through this. I have no experience or advice here, but wish you well.

 

[Larra]

Would talking to the spine specialist about a repeat MRI be helpful? At least letting him know that you're doing better and asking if something more bad might happen if the surgery is postponed too long? It sounds like you need more info to make an informed decision.

 

[Spiky Bugger]

Spiky Bugger Sorry you are going through this. I have no experience or advice here, but wish you well.

Thank you.

 

[Spiky Bugger]

Would talking to the spine specialist about a repeat MRI be helpful? At least letting him know that you're doing better and asking if something more bad might happen if the surgery is postponed too long? It sounds like you need more info to make an informed decision.

Last one was only six weeks ago...you don't think it's too soon?

 

[southernlady]

I had the same odds going into my first fusion in Mar 2006. I’ve never been a 0 pain but for a long time after, my pain level was a 3 which I can pretty much ignore. It was Oct 2013 before I had to have the one above it fused to the others.

But I was losing my ability to stand and walk in 2005/2006. Made the choice much easier.

 

[Larra]

Beats me! That's why I think the next step is to talk with the specialist again and let him know that your pain has improved, see if he still feels going forward with surgery right now is your best choice.

 

[Spiky Bugger]

I had the same odds going into my first fusion in Mar 2006. I’ve never been a 0 pain but for a long time after, my pain level was a 3 which I can pretty much ignore. It was Oct 2013 before I had to have the one above it fused to the others.

But I was losing my ability to stand and walk in 2005/2006. Made the choice much easier.

I think I've read that the disc above a fusion soon needs to be fused as well. That also scared me.

I'm such a coward.

 

[Spiky Bugger]

Beats me! That's why I think the next step is to talk with the specialist again and let him know that your pain has improved, see if he still feels going forward with surgery right now is your best choice.

I see him Thursday. I may have a LIST ready to go.

He had started to go for another injection, but I've had three and there appears to be a limit. Of three. But maybe I can limp around for a while? And maybe we can find an exception to that limit?

 

[Munchkin]

My fingers are crossed for you to make the right decision. Wish I knew the right choice but I don't.

 

[DianaCox]

I wish I had wise words or any useful knowledge. As you know, I’ve refused procedures that failed my own cost/risk-benefit analysis. Or time-shifted the decision.

How much improvement can you expect at least 50% likely? How much worse MIGHT it get? If you’re getting fractures without falling, maybe the fusion will overall strengthen the individual weaker bones, exchanging less flexibility for slowing progression?

Calculation is specific for your needs and expectations too. For example, if I couldn’t walk for an hour or two because of pain, I would take more of a risk for getting substantial improvement, because I still have expectations of traveling for 10-15 more years. If I didn’t, I’d not be willing to take as much of a risk, unless I was in intractable pain.

I’ve been recommended to have my coccyx (tailbone) removed to treat the otherwise untreatable pain I’ve been having for several years. I said no. 30% chance of no improvement or making it worse. 6 months of recuperation. I’ll keep looking for other solutions.

My pain is not as severe as yours either. And I can relieve it by lying on my side or standing. But I can’t sit for long drives or plane flights, so there’s that with respect to traveling. In the RV, I can lay on the bed if it gets too uncomfortable, but notsomuch on a plane. More injections I guess, even if they don’t last very long. And I have my MJ card now - I just haven’t gone to a dispensary to find some alternative treatments.

Ask more questions. Don’t agree to surgery until you’re sure.

 

[JackieOnLine]

like everybody else, I don't know. I wish there was an answer! and of course you are scared, anybody would be, I'm scared for you. the chance of making it worse is real.

 

[k9ophile]

More unhelpful words from me: I have no ideas at all. However, I do hope you find relief by any means available. Even if the pain goes from unbearable to bearable that would be an improvement.

 

[Spiky Bugger]

Follow up time.

Saw spine dude. He said that he did not plan to use any hardware as I already have osteopenia and osteoporosis and screwing stuff into weakened bones is not a great idea. But he has four areas with SEVERE stenosis, so a big ole 4-5" incision.

Also...I'm not in significant pain now...that's good...but it could all go south at any moment. Nerves are unpredictable things. Re my fear of c diff, he only uses prophylactic abx on day of surgery.

He wrote an order for phyical therapy, in hopes I can stay where I am right now.

But...he's an anti-opioid Nazi...so I have concerns about whether he will treat post-op pain with much vigor.

I have a "second opinion" appt in a couple of weeks (I need to hang on at least that long) with a wunderkind spine dude at a different location. He has rave reviews and was lured away from an excellent (but farther from my home) spine place to expand and improve the place to which he was lured. He's MiniSue's age, but we're "homies" because we went to the same high school! (Except he went on to Harvard and I didn't.)

I have been functioning! Yesterday, my little sister turned 70! (How the hell did THAT happen?) We went out to lunch and I drove!

Then Mr. Sue and I went to a car dealership because we need to "upgrade." Our car, a 2010 Lexus RX350, has been just fine. (My father was an auto big-shot and taught me to never buy a NEW car, so we get used cars.) BUT...we had a recent repair that would have cost three grand if we hadn't had the warranty...the one we didn't know we had, and which will expire in October.

So, we want a 2015, with about five years of warranty. Before October.

And I need to remodel my bathroom BEFORE I have spine surgery.

Who wants to start the GoFundMe?

 

[JackieOnLine]

I'm glad to hear you are functioning and doing well currently. and that the opioid nazi is not your only option!