Outcome of September Neurosurgeon appt

So, after having a relapse mid August, I got to see the neurosurgeon in September.

In the mean time I had gone back to phsyio and massage team, had seen my doc again, had tried some more cortisone injections.

After close to an hour of talking we had settled on a two track approach. The surgeon was hesitant to go straight to the fusion - it had only been about 6 weeks since the major pain relapse, and he wanted to wait and see how much it would improve. So we tried another round of cortisone injections. Also during this period I pursued a pretty aggressive approach to the pain and hit the gym at work every day for stretching and core work.

The second track to take was the fusion option. While doing everything in the first option, I put the extra paperwork in for the hospital for the fusion and submitted a request in to the Department of Veterans Affairs (it is for my old Army injury after all) to help out with funding it.

Personally, I wasn't happy with some of this. I wanted the surgery ASAP. In hind sight the surgeons advice is right, try one more time, if it doesn't get better then we'll really know. It was always going to take time to organise things - approval, hospital, DVA etc. I'm glad we didn't rush into this and that they don't hand out this type of surgery like its candy.

By the time the surgery was all booked in and approved, the date was 02 November 2012. I had been in pain for close to 3 months, it wasn't going away. I was so keen to get it over and done with at start the recovery.

2012 relapse and images

After an awesome 18 months post microdiscectomy - BAM - it fell off the cliff. I had even managed to go overseas for 6 months with no drama. How the hell could this happen.

What brought me undone this time? A bad chair. Pathetic I know.

I had a training day and sat in a terrible chair for the day, I was sick with a really bad cold, was fatigued and I think I just couldn't have a decent posture. I reckon it was the straw that broke the camels back (really bad pun that). I'd come home, everything was fine and I went back to some bad old habits. I was exercising as much as I could have been and wasn't proactively taking care of my back.

I couldn't put one foot in front of the other, I couldn't walk. I could lift my legs up. The pain in my lower back was excruciating. After about 2-3 days like this, then the leg pain returned - that felling of your legs being on fire, on the inside, but cold, with my feet going numb.

Back to the Dr's - cortisone injections onto the S1 nerve root and some MRI's

It was so disappointing to see the disc protruding back out - I had just had this cut off!!! It had been so good.

In September 2012 I got in to see the neurosurgeon.

2012 scans - disc bulging out are beign trimmed off 18 months ago via micro discectomy

2011 - Microdiscectomy

The pain was unbearable. It wouldn't go away. I couldn't sleep, I was tired, cranky and irritable.
After a long talk with the neurosurgeon it was decided to go for the less serious microdiscetomy. Fusion was discussed as being possible in the future, but for now, we decided to go for the microdiscectomy. This was based on numerous things, probably the most of which was the severity of the leg pain I was suffering in comparison to back pain

For info try
http://www.spine-health.com/treatment/back-surgery/microdiscectomy-microdecompression-spine-surgery

Or for an animated version of the surgery try this one
http://www.spine-health.com/video/microdiscectomy-lumbar-microdecompression-spine-surgery-video

I underwent the surgery in April 2011. I took 4 weeks off work and then came back under a graded return to work program (i.e. 3 days at 3 hours, 3 days at 6 hours, 3 full days, then 4 full days, leadign to 5 full days - over about a 10 week period).

It was a huge success. The first 7-10 days were hell. I could hardly move. If it wasn't for my wife looking after me I would have been screwed. I walked 3 times a day - it took me 12 minutes to walk my drive way the first time I tried. Each day I went a little further and a little faster.

I managed to get back to the sports I loved, could go the gym. I took up scuba diving. It was great. It was the best my back had been in 10 years. The leg pain was completely gone too.

2011 update and images

The beginning of 2011 was ridiculous. My back had stiffened up so much I could hardly move it. If I played any sport - like trying to kick a footy - I could hardly move the next day. But worst of all was the leg pain. Unbearable. It was like my legs where on fire, on the inside, but they were cold, and numb if that makes any sense. Nothing could take the pain away - not physio, massage, chiro, stretching, or core workouts. The only thing I found was acupuncture, but the gains were short lived.

 Again in the side profile you can see the disc sticking out and putting pressure on the spinal canal and nerve roots. The disc itself continues to degenerate.

This is where the bigger difference can be seen.

From the top, you can see that there is no space left for the nerves to come out the side. They are constantly under stress - hence the leg pain that doesn't go away.

Its great to see it next to a good disc (the second image is from L4 I think). The disc looks in better condition (black outside, with a gel centre). There's no pressure on the spinal canal and there's room for the nerves out the side.

At this stage, my doctor (who is an amazing sports doc by the way) and physio team started talking about surgery. We tried once more with some CT guided cortisone injection into the facet joints and onto the nerve roots. But this only aggravated it more.

So neurosurgeon it was.

2010 update and images

By 2010 the pain had really started to ramp up.

I could no longer do the sports and activities I was used to and my back pain was starting to impact my lifestyle. I was working my physio and massage team pretty hard and we were holding back the tide, but it was inevitable that it was just a matter of time until the pain became too much. The cortisone injections weren't working as well as they had, nothing seemed to be able to reverse the degeneration of my condition.

2010 Side profile

From the image on the left, you can see the disc is sticking out a little more than in 2009 and there is more of an impact on the spinal canal and nerve roots

It's a good shot as you can see the rest of the spine is in pretty good condition. Especially the other discs. They are black on the edges (due to the harder wall of the disc) and a nice 'creamy' white in the centre which is the gel that cushions everything(see right). The L5-S1 disc is much darker and has hardly any gel left.

The top down shot on the right gives a great picture of the change since 2009. The spinal cord is crushed a little more and there white space between the disc and the facet joint is smaller. This is key, because through this space is where the nerves travel - the nerves out of here, S1 - travel down your leg and give you the leg pain we all now about.




This was the begining of a sharp decline in my back.

2009 update and images

After about 7 years, my back was holding on OK. The disc hadn't protruded much more, and it was still in an acceptable condition. I was exercising enough to keep it in check, was seeing physio, chiropractors and massage therapists to keep my back working. I also had some good results from some CT guided cortisone injections on the facet joints. It was not however cool to watch these injections happen 'live' on a TV. Seeing those needles get placed with such precision, so close to spinal cord and nerves, was not an easy experience.

2009 Side profile

2009 Top down.  Disc bulge is about the same as 2002

Background to my injury - 2002

"I think the best way to tell this story is by starting at the end, briefly, then going back to the beginning; then periodically returning to the end, maybe giving different characters' perspectives throughout. Just to, you know, give it a bit of dynamism . Otherwise it's just sort of a linear story."

- David Ershon in The Other Guys 

http://www.youtube.com/watch?v=vk7OGX-s0aI

No seriously, I was medically discharged from the Australian Army in 2003 due pain in my back that I just couldn't shake. I tried for 12 months flat out - physio, doctors, drugs (the prescribed kind!!) I just couldn't do the army thing anymore. Standing was the worst - so drill and parades were just not going to happen.

This is what it looked like in 2002

Why am I writing this blog?

I don't really read blogs, or write them for that matter.

However, when I knew I'd be needing some pretty serious surgery with a tight deadline for recovery, I found myself seeking answers. Particularly with regards to other peoples experiences and recovery.

The more I looked, the more negativity I found. For every forum or comment section there would be 20 negative comments to each positive. That or it was just a stack of people asking questions like myself. These people came across like myself; nervous, scared, anxious, uninformed.

In the middle of all this I found two stories.


http://excusemefuseme.blogspot.com.au/
and
http://insanum.com/blog/spinal-fusion.html

I hope to make this a third...