Chickened out!

[davidj8121]

HI everyone,

Had an appoinment for tommorrow at TBI, but chickened out on Friday due to fear of the discogram procedure and the fear of a bad outcome after ADR. I keep hoping to read more on this site about great outcomes but I don't. Seems only those having problems post messages seeking help. Maybe all the good ones are so good they forget about the whole thing. Don't know. Is the discogram procedure really that bad? Can anyone tell me exactly how the procedure works, time frame, pain level?

thanks for any help.

Dave
DDD entire LL
Considering ADR

[chasswen]

david
ive had a good outcome and have posted it telling how it is going. but my leg pain can not be compared to others as i had NO DISC LEFT so i have major distraction pain.
as i my case i saw a unstable spine. this needed to be corrected i choose to pay out of pocket for adr with dr bertagnoli instead of being picked up off the floor one day and them fusing without me having a say in matters. i do understand your concerns its all very hard to deal with. but when you have had enough your choose will come much easier but don't wait untill theres nothing there or recovery will be much harder.
chuck

[Alastair]

Hi David,
We all have different experiences with discography, many surgeons now giving a good local anaesthetic prior to the procedure being done.

If you really need disk replacement, then the Discogramme is a walk in the park for many.
Best,
Alastair

[Justin]

Hi Dave,

Sorry to hear you chickened out.

I am a successful 2-level ADR replacement. My ADR surgery was close to 3 years ago and I am doing great. I am working out with weights 3-5 times a week and I also do a lot of cardio. I have no pain in my legs like I did prior to surgery (I had 95% leg pain). I only get muscle soreness here and there and some IT band tightness--no spine-related pain however.

Discogram procedure:

Discogram to diagnose low back pain

Similar to an SNRB and facet joint block, a discogram is a test to determine the anatomical source of low back pain for the patient. This procedure is most frequently used to determine if degenerative disc disease is the cause of a patient’s pain (discogenic low back pain). Discograms are also performed to assist in preoperative planning for candidates for a lumbar spinal fusion.

In this procedure, the discographer inserts a needle in the patient’s back into the center of the disc. Radiographic dye is then injected into the disc, and if injecting the dye recreates the patient’s normal pain (concordant), it is then inferred that the specific disc is the source of pain for the patient. If the pain is unlike their normal pain (discordant) it can be inferred that even though the disc may look degenerated on an MRI scan, it is in fact not the source of the patient’s pain. The test itself is painful, but the patient needs to be awake and aware in order to tell the discographer what kind of pain is generated by the injection (see Figure 1).

As the discogram injection is not for treatment of pain, a steroid (anti-inflammatory medication) is not injected. However, sometimes a discographer will inject lidocaine (a numbing agent) into the disc to decrease the pain of the procedure. Often, after the discogram is completed, a CT scan is performed to check the morphology (anatomy) of the disc.

There are a limited number of risks involved with a discogram. Disc space infection is a serious but rare (<0.1%) potential complication. Because the needle passes close to the nerve, there is also slight risk of nerve root damage with the test.

http://www.spine-health.com/Topics/diag/diag08.html

My pain was replicated at 2 levels--10/10. The procedure was painful, but do know the pain was short lived during my procedure. Once the discs were pressuized enough to get a "conclusive" reading, the pressure in the disc is relieved and the pain subsides. Some patients do experience higher than normal overall pain levels after a discogram due to irritation of the disc (which is producing pain), spinal nerves, etc.

Good luck on the road to feeling better. Don't hesitate to contact me via email / private message.

Justin

[Lisa M]

Hi David,

I had adr surgery on Sept 13, 2006 and I was just like you before I had the surgery, my biggest fear was the discogram beleive it or not. The reason I went through the discogram is because I had the worst upper spine pain, you can't even imagine or maybe you can. The doctor told me that it is unusual to have upper spine pain the way that I was. L5S1 usually has symptoms of lower back and leg pain, well I had upper spine pain,lower back pain and also leg pain that just wouldn't stop. So I wanted to find out for myself if I did the discogram (needed a lot of convincing ) if that upper spine pain would be reproduced if it didn't that meant I also had something else wrong. The doctor who preformed the discogram knew that I was extremely nervous so he sedated me just enough to keep the edge off and prodcedure began and it reproduced all the pain I have been experiencing including upper spine pain, the discogram wasn't as bad as I thought. Then came the choice what do I want to do with sugery,fusion or adr another tough choice being this would be the first time my surgeon had done adr surgery and this being newer surgery in the US, I ended up chosing ADR because I wanted to preserve the upper disc above because there wasn't anything wrong with them. Long story made short went through with ADR L5S1 level and the upper spine pain I was having is gone, currently I have nerve pain in my left leg and some burning in my lower back but hopefully with time and pt this will also stop. My doctor ask me to take it very slow don't try to rush recovery it will come.

I wish you luck and I know what your going through even the day of surgery I was thinking of changing my mind as I was being prepped for surgery, but the surgery was well worth it.


Lisa

[Harrison]

David,

Thanks for posting and welcome. Here’s my 2 cents on some of your concerns.

Some people have discograms from “hell.” Most suffer a “little” and a minority does “OK” and experience tolerable pain. I think the fear of the procedure is worse. In my case, the pain mgt doc was exceptional, and the injection of lidocaine with the dilotid gave me a surprisingly acceptable experience. And for 5 days afterward, I felt great! But I doubt too many patients have such luck.

And it sounds like you did not read this important post about trying to judge outcomes from anecdotal events from this board. Please see:

http://adrsupport.org/eve/forums/a/t...1/m/8361017112

Lately, you may see stories that seem bad. And yes, they do happen, perhaps more than they should. And that is sad, but we support these people, as they support us by helping us be more cognizant of complex issues.

Thanks for expressing your concerns. Sharing the good, bad and the ugly is what this forum is all about!

[Bionic Michelle]

Ask that the procedure be done under conscious sedation! You go off to sleep, but just enough that you don't know what's going on until they wake you up and ask if it hurts. My pain was about 12 on the 1-10 scale, but I was awake with it for less than 5 seconds. The procedure was absolutely nothing to fear that way!! The anticipation is the worst part. Really!! Now I'm about 2 days shy of 4 weeks post op and thrilled with my ADR. I'm now taking less than a third of the narcotics I was preop, mostly just a mild ache in my spine that decreases every day that I don't overdo it. I would really recommend this procedure. The discogram is nothing to fear, and ask your surgeon for patients you might be able to talk to about their outcomes. You might get a little better feel for the success. I know your spine is different from anyone else's but my surgeon gave me an 85% chance that he could significantly reduce my pain. He was right!! Keep looking into this-people with positive stories have moved on with their lives and aren't seeking support anymore!!

[LouG]

Like Michelle, I insisted on conscious sedation and had no awareness or sense of the needles insertion. I was then awakened and the pain that was created from the injection really wasn't much worse than what I live with every day.
After reading all of the reports of discogram pain, I was nervous and reluctant about the procedure. It turned out to be no big deal. It was performed by a specialist in a major ADR group who has probably done a thousand of them. In an expert's hands, I was surprised at how easy it went. If you trust your doctor and he is calling for the test, go fo it! Insist on the initial sedation. There is no need to be conscious until they inject the dye.

[livjoyful]

I didnt get any sedation for my discogram. Didnt think at the time to even ask for it. I had no disc left at L5/S1 so they only tested L4/5 and it wasnt that bad, but only because it is not a pain generater. That being said, I fainted AFTER my test because i was so scared of how much it was going to hurt. I guess it was relief? adrenaline? As soon as they said it was done i sat up and out i went...lol. They were scared then..oops.
i guess why I'm telling you this is that I dont think most things are ever quite as bad as we envision them. This discogram may be a walk in the park, it also may be very painful. But from the sound of these posts, with sedation the pain is minimized and very short lived. A disco is a very neccesary step on your way to ADR. maybe take someone with you who can hold your hand so to speak, or make you laugh. My husband kept asking me if I'd brushed up on my "disco" moves because the test would require me to dance. Corny but it made me laugh.
I wish you the best and the strength you'll need. need a cheerleader? " IF DAVE CANT DO IT>>NOONE CAN>>>>>>GO DAVE!"

[bobb0]

David, if you want to properly investigate the source of your pain and your practioners have suggested a discogram, then my suggestion is to bite the bullet and get the test. It may be very painful, or not, but if you opt for some kind of surgerical intervention without the discogram, you may be shooting in the dark.

If you exhaustively investigate and determine your pain generators, you arguably stand a better chance of having a successful pain resloution outcome by picking the most appropriate surgical intervention. There exists the possibility of doing everything right and still not having a good outcome. This frustrates the heck out of some people in the community, but no amount of explanation or looking at statistics can remove this wildcard.

bob