Idet

[hayzer912]

ok, sorry havent updated since my surgical consult on the 24th. Ive had to "digest" what went down.
My wife and I met with my surgeon on the 24th to set the date for my hybrid surgery and to discuss details from my recent discogram. Our last visit was pretty cut and dry and the surgeon said I would need the hybrid.

Wellllllllllllllllllll, I went into the room and the surgeon told me we will NOT be doing the hybrid next! I was loss for words as our last meeting said we were. I spent weeks preparing myself mentally and emotionally and now we are a no go.......for now.

He stated that the discogram would NOT reproduce my leg pain so that was a good sign. He suggested an IDET Procedure be done. I sat there in shock not knowing what to even ask him. I asked him about the IDET and he thinks the IDET will help me. Well, I did know some about the IDET as I ran across it during all my research over the years. Also, in 2003 was told I am NOT a candidate for the IDET. Now the new discogram suggests I am. I also discovered since that appt that the IDET most often gives temporary relief at best. My concern is why even mess with the IDET if he still thinks I will need the hybrid eventually????? I gotta say I am quite loss for words at the moment. My head is spinning no doubt.

[2 Young 2 Hurt Like This]

Hey,

I had an IDET done a couple years ago and it did nothing but increase the amount of pain I was in. Wearing the hard turtle shell type of brace was a pain in the butt. I'm not going to blabber on with how horrible and pointless it was for me. My Back hasn't been the same since I had that done.

I personally think that's a drastic jump going from the hybrid HUGE surgery down to the IDET. When I Had mine I was in a turtle shell for a month fallowed by what should have been 3 month PT but ended up to be more cause I wasn't improving. Just some food for thought.

I'm wondering what his reasoning's were as to why the IDET would work for you now when in 2003 you were told you were not a candidate, what changed? Even though the Discogram didn't reproduce the leg pain do you still have leg pain and if you do how is that a good sign?

I can completely understand where you are coming from. I also accepted/prepped myself for a 2 level ADR then was told by a different doc to try something else, (MicroDiscectomy- which is mainly used to help relieve leg pain/numbness and not so much back pain when I have BOTH and feel its only a half solution.) This has now lead me to get a 3rd opinion. That would be my best suggestion for you is to get another opinion or go with your gut, cut to the chase and get it over with.

Unfortunately there are no right or wrong answers when it come to this. I've been doing my research for about a year now and I am still unsure of what I should do for myself. A friend of mine told me that you have to take care of yourself and not rely on others to do it for you. When it comes down to it we know the most about our own bodies. Yes, doctors know the mechanics and how things should work but in the end its up to us. Everyone is different which I am more than sure you already know.

Do what you feel comfy with and keep digging around until you've found what you feel will work best for you.

Hope this helps,
~Liz

[hayzer912]

Thanks for your reply. Well, I havent heard of anyone aving a beneficial outcome to the IDET in all honesty although I am sure they are out there. Im not sure why I am now a candidate and wasnt in 2003. Ony thing I can think of is different doctors. This current surgeon said, "look I can do the hybrid surgery and we can hope for the best or I can try this less invasive and see if this helps. Why would we bypass this step and jump to the big surgery?" I told him, look your the experienced surgeon and I value your expertise. He said that not being able to replicate leg pain is a great sign that the pain I get is discogenic in nature.

Problem is I am fortunate in that I dont get constant leg pain. I move a certain way and wham I get hit with it down my leg and it last few minutes and normally fades away. I do have leg weakness and numbness in areas of my right leg. I think the surgeon is leaning towards the IDET because I dont have CONSTANT leg pain all the time.

Very Very hard to decide on whats best as it seems treatment of back injuries, etc is a crap shoot at best. You hold your breath and do a procedure hoping it helps. Again, the problem is it has the potential to make a person worse. In my case if it makes me "worse" so to speak I was prepped and primed for the hybrid anyways. I think hes trying to buy me some time before the big one now. This recent discogram has changed EVERYTHING in his approach. I still think he feels I will need the hybrid because he insisted I drop some weight around the midsection in preparation for the future (his words). Sounds as if he feels I will need the hybrid in time.....just trying to buy me some extra time I suppose. I have alot of questions that need to be answered before we do ANYTHING more now though.

Liz, can you tell me about the IDET and how things went? Is it a painful procedure like the discogram? I'm putting it all in the good Lord's hands. I'm confident he will point me in the right direction. Thanks again!
Kelly

[Jack]

I had an IDET done as well and it did noting but drain my checkbook and increase my back pain. After reading up on the procedure, the anatomy of the disc itself, the only type of pain it could possibly help would be those dealing with just the disc itself as the disc has nerve endings. The guy who did and recommended mine had a heck of a time getting insurance to pay for their part as they felt the odds of success were slim. Since ours was top shelf insurance, they ultimately went along with it.

With the bad press this procedure is getting lately, I am surprised it was recommended to you.

I would tell your current surgeon you need three total consults from docs not working together before you have a procedure done.

[2 Young 2 Hurt Like This]

Kelly,

I had my 3rd opinion yesterday. From the symptoms I told him I was having and the results from the Discogram they didn't match up. He along with other Docs have told me you cannot fully believe the results from a Discogram. I've heard of people having a MRI clearly showing an issue with a disc and then getting a negative Discogram. They are not full proof but when its works it can be the most painful useful tool to helping someone on their next step.

You mention that you think the surgeon is leaning towards the IDET due to the fact you don't have constant leg pain. When I Had mine done it aggravated EVERYTHING. Back pain and ALL leg issues. My leg pain was on and off through out the day but now its constant to the point I feel like my legs are trapped in something and I have to kick my way out. Almost like constantly being wrapped up in the sheets of my bed which I personally cant stand feeling trapped. Not sure is that make's sense.

When I went in for my IDET I remember waking up crying. I was in so much pain. I wasn't able to eat or drink anything going into the procedure. I remember the lady in recovery telling me I was going to be ok and handing me a couple pills to help with the pain (they did very little to help.) Trying to drink something after all that time to swallow a pill was hard lol.

I kept asking for my boyfriend and they finally went to get him to help me get dressed. The car ride home was horrible! I remeber spending 3 days in bed. Moaning and groaning eveytime I had to move. The other days were spent with me laying/sitting around the house in to much pain to be bothered with doing anything else.

We have a stand up shower and my boyfriend would have to help me get the shampoo because we put it on the floor of the shower. While we were at the store we got a little corner shelf for me to start putting my shower stuff in so I wouldn't have to worry about bending and he didn't have to baby sit me anymore. (regardless of IDET I suggest everyone getting a little shelf for the shower if they don't already have one.) Things that should be so simple ended up being a pain in the back. Do you notice when you hurt the most that's when you find yourself dropping everything on the floor? lol

Anyway, I went in for my 2-4 week check up. Told the doc my back/legs were WAY worse than it was before the IDET. He told me that was normal and from his experience people who hurt more end up doing better. He also told me that he liked how procedure went over all. He started me on PT and that was a living nightmare. So much pain.

Knowing what I know now I would never ever agree to having the IDET. If I would've benefited from having it done I would've felt like it was wroth all the pain and discomfort. Seeing as how that IS NOT the case it turned out to be cruel and unusual punishment.

Like I said before my back has never been the same. Before the IDET I was able to get by with 500mg Vicodin in the morning to get out of bed and one at night. Now I've been upgraded to Vicodin 7.5 (750mg) and I struggle through the day not to take one or a half of one in the middle of the day. I also started taking Advil PM to help me sleep at night. It helps me get to sleep quickly so I'm not just tossing and turning which only leads to my back hurting more. I still wake up all hours of the night from pain. lately I've been having to take half or a whole Vicodin in the early morning hours.

I understand that you need to buy some time to lose a few extra pounds. When I was told back in 08 I would most likely be needing a 2 level ADR I weighed 276lbs. I told the doc I wanted to lose weight before surgery for obvious reasons and he sent me to a weight management doc. I've lost 75lbs in 9 months and got to my surgery weight still have 30 more to get to goal weight. I've been lagging over the past few months. Life happens and it gets harder to lose weight. The weight loss has done nothing to improve my back pain. Just gets more aggravated from exercise. If you want some info on how I've done it I have some print outs from my doc that I can e mail to you. Its mainly just a NO CARB diet. The only carbs I'm allowed to have come from fruits and veggies. That's the hard part for me. I've always loved my breads and pastas. I make home made breads for my boyfriend to make his lunch for work and it nearly kills me. lol

Ok anyways, sorry I'm finding myself rambling a lot. So if you are trying to buy some time there are other options out there that I have been told to try but seeing how I am in a time crunch for trial I'm skipping to the good stuff and going to have the surgery.

There is something called the Microdiscectomey which I mention in my 1st post. There are all different kinds of MicroD. From my research its mainly alleviate leg pain but in a few cases it has helped for both back and leg pain. It is more of a temporary fix and might be able to buy you the time needed. I was told by my 2nd opinion that it has a 80% success rate. Here is a link I found helpful.

http://www.spine-health.com/treatmen...-success-rates

Here is something that is still in trail stages. It's called
Disc Nucleus Replacement. I was suggested getting this yesterday at my appointment. My problem is I have 2 levels that are messed up and this can only be used for a single level.

http://www.spine-health.com/treatmen...us-replacement


I hope this is somewhat helpful to you. I also agree with Jack. Get more opinions. As many as you feel you need. I almost jumped into surgery with only one opinion. Even though I am getting what was suggested at that time its more comforting knowing I saw more than the one doctor and have done all the research and looked into all other options before settling into something so serious.

I've learned that Docs are there to work for/with us. They will give us options and in the end it is our job to take their advice, look into it more and come to a decision on our own regardless of what the doctor thinks or feel. If you find yourself struggling with which road to take that's when you know you need a 2nd if not more opinions.

~Liz

[CharlesinCharge]

Very surprised to hear that your doctor recommended IDET, as this procedure (which did have some limited early success) has almost completely gone out of vogue. If you were to consider a minimally invasive procedure instead of surgery (ADR, fusion or hybrid), then Biacuplasty is what is being done today. It still has only about a 40% success rate but uses Radio Frequency to destroy the nerve endings in the disc, rather than a heated metal coil. It is not a long-term solution, but has given patients as much as 18 months of greatly reduced pain (for those that it worked on).

The problem with a Microdiscectomy is that it only helps with nerve compression (leg) pain, i.e. pain caused by a bulging/herniated disc pressing on the sciatic nerve. If your pain is coming from the disc itself (discogenic pain), a Microdiscectomy is useless. You would either have to try the Biacuplasty or have full surgery (ADR or fusion). Be aware that most insurance companies will not pay for Biacuplasty as it is considered "experimental" and the results have not been positive enough. But, the advantage is that it does not prevent you from having ADR or fusion down the road. However, many insurance companies (like mine)will STILL not pay for ADR either and also call that experimental, so that may not be a deciding factor.

It all comes down to how much you want to avoid major surgery, and what you are willing to pay for out of your pocket. Even if Biacuplasty or IDET works, it is not a long-term solution. The only advantage I could see is if it bought someone enough time such that technology improved and a better artificial disc or other treatment (Dascor, stem cells) came out in the meantime.

Good luck,

[2cool4U]

I, too, was surprised by the recommendation for IDET. When I did my preop search, there were many articles indicating a success rate lower than with no treatment at all! I did mention to two of my doctors, both of whom quickly dismissed it as not likely to help. The procedure has really fallen out of favor.

Liz, just for safety's sake I wanted to correct your Vicodin dose comment. Vicodin 5 has 5mg of hydrocodone, Vicodin 7.5 has 7.5, and vicodin 10 has 10mg. There is a second number on the prescription which indicates the amount of acetominophen included with the hydrocodone (an opioid.) I'm not sure of all of the combos, but Vicodin 5/325, 5/650, 7.5/325, etc. are available. This is important b/c it's the opioid that provides the most relief, but in combo with Tylenol relief is better. However, it's the total Tylenol taken per day that limit's the use, not the opioid part. The literature says to stay under 4000mg/day of Tylenol, although I've been told 3000mg/day is even safer.

-tc-

[2 Young 2 Hurt Like This]

thank you for clearing that up for me TC.

[2 Young 2 Hurt Like This]

Originally Posted by tconner94

Liz, just for safety's sake I wanted to correct your Vicodin dose comment. Vicodin 5 has 5mg of hydrocodone, Vicodin 7.5 has 7.5, and vicodin 10 has 10mg. There is a second number on the prescription which indicates the amount of acetominophen included with the hydrocodone (an opioid.) I'm not sure of all of the combos, but Vicodin 5/325, 5/650, 7.5/325, etc. are available. This is important b/c it's the opioid that provides the most relief, but in combo with Tylenol relief is better. However, it's the total Tylenol taken per day that limit's the use, not the opioid part. The literature says to stay under 4000mg/day of Tylenol, although I've been told 3000mg/day is even safer.

-tc-

I had to read that a few times. I never really understood how it worked. I've tried to do some research but its all greek to me. This is what is on the label

HYDROC/APAP 7.5/750 TAB (MALL)

-AKA-

VICODIN ES 7.5-750 TAB ABBO

[Johnny Vegas]

My advice to you is to get another doctor immediately. For some reason (he does alot of IDETs?) your doctor is NOT giving you the straight dope. I had an IDET in 07. It did nothing, maybe made things worse! I then had a disc nucleous replacement in 08 and this has helped tremendously. Good luck and take care.