My discogram results + thoughts - input welcome

[Cirobi]

Hi Everyone,

I thought I ought to stop by and post my results for those who have given me support since I started on this adventure here as well as for info for those looking for more experiences to read.

Two weeks ago was my Discogram procedure and today I got my results. They did the dye injection at four levels and the discogram was positive only at the L5/S1 level. My MRIs previously showed herniation also at L4/L5 but a further look showed that to not be a factor. There is a small tear in the L4/L5 disk but nothing that is causing a problem and my doc said that's often normal to see such a tiny tear.

My doc says I'm an excellent candidate for a 1 level disk replacement and my insurance defintely covers it on the one level. He referred me to his colleague who would actually be performing the operation and the colleague is one of several doctors in the practice who were part of the early trials for the prodisc model which is what my insurance would cover. They've been doing the replacements for 5+ years and have had a 95% success rate in the replacement relieving the patient's problems.

I asked my doc if there was any non-surgical options he could think of that could have any affect on my condition and the only thing he said he'd recommend based off of what i've already done was something called a heat wire but that it's not covered under my insurance.

While I know I should go get more opinions from doctors at other practices, I'm highly tempted to just bite the bullet and get the replacement over with. In my mind, I feel like I've dealt with it for so long and been so affected by the back pain and problems since high school (approx 8 years or more) that I want to get on with life again. Having to stay so minimally active and adjust every little thing I do is mentally and emotionally draining. The thought occurred to me the other day that I'd be in trouble if my boyfriend and I ever ran into a problem and broke up because he has become my strong shoulder to lean on and does many of the things I've found irritate my back (like carrying the laundry to the basement to be washed, carrying cases of beverages in from the car, helping carry groceries, etc). What scares me more is the fact that i have started experiencing pinching pain and pressure pain more often, particularly my left side but not isolated to my left side. i guess that's sciatica or however that's spelled? either way, i don't think i could handle that getting worse.

What do you guys think? Grin and bear it a little longer and get one more opinion or let my gut tell me to bite the bullet and get it done before I start having even more problems.

The only twinge of fear with thinking about getting a major surgery done like this is the fact that I currently can, while just half ignoring the pain, can still do most of the things i used to do such as swimming with flip turns (competitive swimming style turn for those who don't know). i know that with a disk replacement i wouldn't be able to do them right away again due to recovery time and healing but once i've recovered i should be able to do stuff like that with less pain problems. my one fear is that something could go wrong and i wouldn't be able to do them at all. i suppose that kind of fear is natural since things can always go wrong unexpectedly.

the other fear is the anesthesia which thankfully i could avoid for the discogram but i doubt there'd be anything less than knocking me out would be possible for something like this.

in any case, my next step so far is to make an appointment with the doc my current doc is referring me to. still waiting to hear back from the appointment people but that should happen by the end of the day today.

thoughts and impressions from those more experienced in the way of this crazy back pain adventure are always welcome. i can take bluntness so if needed you can verbally smack me upside the head and bring me back to reality. *grin*

Thanks everyone!

[annapurna]

You have not said anything about the condition of your facets. If your doctor didn't discuss them with you, run to get a second opinion. Knowing what condition your facets are in is a critical factor in deciding if ADR is acceptable for you and if you doctor failed to assess them or failed to discuss the assessment with you, that indicates bad things about him/her.

[Harrison]

Yes, a signature too...please; like annapurna's.

[Cirobi]

Well, I'll actually be seeing a colleague of my current doctor's to go into more depth on the surgery possibility so I'll definitely ask about facets there. The individual I'll be seeing is Dr. Balderston who I just noticed is on a list of ADR docs in the FAQ.

What exactly are the facets and why does that make a difference? If there's no problem with these facet things, why would my doc have brought it up anyway?

[Cirobi]

hm, i may have to change which of my email addresses i use unless i can convince excite that you're not a spammer! checking the PM now.

[annapurna]

Your facets are the 'spiney' part of the spine out behind the cord. Until ADR, no one looked at facets because you either fused and didn't care or didn't fuse and couldn't do anything to fix facets. Most radiologists still fail to even look at the facets and doctors forget that heavily damaged facets are a contraindication for ADR. How much damage is too much is hotly debated but you certainly should know how much damage you have prior to the surgery. If your doctor didn't mention them, that means that either he isn't telling you his full thought process or isn't thinking and both are bad signs.

[Cirobi]

Thank you for that explanation. I'm going to see what happens at my next appointment which is with the doc who actually DOES the ADR procedures. My guess is that he would be much more informed as to what is and isn't good for an ADR. However, if he doesn't mention the facets I'll definitely bring them up because as much as I'm leaning toward just having the procedure done, I don't want to do it if it really truly isn't advisable.

Are there any other things you'd suggest I ask about that I may be too clueless to think of? My brain is getting toward the point of information overload on all of this thanks to having a real diagnosis on my back problems and diving deep into any and every piece of info I can find on the topic.

I really appreciate all the thoughts I have gotten so far because who knows what potential mistakes I could have made in my choices from not knowing anything at all.

[Harrison]

Cirobi, I sent you several private messages, concerning the aforementioned technical issues with your ISP. Please respond to those PMs so I can delete your registration; allowing you to re-register with the same screen name (for continuity).

[annapurna]

My advice is to schedule a follow-up with the ADR surgeon about a week or so after the first appointment. Write everything down you can from the first meeting, go home and research everything you can, then come back armed with questions. Practically speaking, you have too many potential conditions to know enough going in. Once you know what your surgeon thinks you have, you can heavily research those and make sure you're ready with the questions. I would expect any doctor to be able to talk contraindications, expected success (not as a firm precentage, run from anyone who does that, but as a general prognosis), and general recovery path off the top of their head. Details beyond those basics depend on too many things to predict.

[Lisibug]

I am very pro-ADR and have 3 of them. I've also had a fusion and found the ADR surgery to be much easier to recover from. HOWEVER, from what I've read, many and maybe even most people who have ADR at L5-S1 have problems and end up needing another surgery because the ADR moves more than the actual joint, thus causing a lot of problems.

My back isn't terrific, but if I ever need surgery, I'll opt for a hybrid - fusion at L5-S1 and ADRs above it.

Please research this for yourself, but I have read a lot regarding problems with ADRs at L5-S1.