First off I'd like to say thank you to Harrison and everyone for the wonderful information on this site!

I am 36 yrs young and I have had back pain for the last ten years. A few years ago, I was diagnosed with DDD in L4/L5 and since then I also have DDD in L5/S1 with a bulge.

I have SI joint pain, lower back pain, and some radiating pain in the thighs. It hurts to sit and lie down. I feel great when I walk.

I have had four nerve block shots (2 on L4/L5, L5/S1, and on the SI joint), tried PT (exercises, traction, and the TENS machine), and medicine (percocet, valium, oxycodone, gabapentin, etc) but they all relieved the pain for a little while and then stopped.

My othopedic surgeon mentioned fusion but said that he didn't recommended it. He said my best bet was to travel to Europe for ADR, because the only insurance that covered ADR was for Federal employees. However, I see that my insurance (Aetna) does cover it as of late November.

He says that he is going in for training on ADR very soon. Since he hasn't done any, I'm researching other places that perform the procedure. There are a few close places that do the Charite disc but I'd like to look into the ProDisc, since there is a possibility that I'll need multilevels. I'm in North Carolina.

I'm thinking that my best bet is to look into TBI, since it sounds like they have a good reputation.

My othropedic surgeon wants me to do a discogram to find out which disk(s) create the pain. Should I have his office do it or TBI (which would require another trip to Texas)?

I'm not looking forward to the discogram because I think I got a feel for the pain that I am going to feel when they did my L5/S1 nerve block. I think they hit a nerve or the disk itself. I hurt so bad that I screamed out an obsentity and I rarely swear. I wasn't prepared for that pain since the other nerve block shots didn't hurt.

Any help that you can give me is appreciated.

Thank you.
Paula

Anybody have their back condition enter into their dreams?

Last night I dreamt that I was walking down a very short almost non-existant 'slope' and I slipped. The pain that I imagined in my back woke me up.

I know in my 'healthy back' days that slope wouldn't have been an issue.

Anybody else have these kind of dreams?

I just called the local neurosurgeon and they only do the Charite disc, so far. One of the surgeons has done 70 lumbar and 60 cervical disc replacements and has trained others to perform the surgery.

The clinic research dept claims that he is the most experienced surgeon in the South East. She also admitted that the TBI is very good

I'm leaning toward getting a local surgeon to perform the surgery because it would be better for the travel before/after the surgery, routine follow up visits, medication requests, and in case there are any issues. He also may be able to do the surgery sooner than TBI.

Is 70 lumbar ADR surgeries considered good (enough) experience or should I have it done at TBI?

In my opinion you want it done as close to home as possible unless you know someone in texas close to the hospital that you can stay with for 2 weeks. Regardless of the disc involved, spine surgery in general is dibilitating and you will require assitance for at least 2 weeks.

Taking a trip from TX to NC (by air or car) right after major surgery is not recommended.

Another thing to think about is the amount of experience the doctor has. Of course, the more the better. However, some surgeons are so good, that their first 25 operations will be sucessful.

I stayed in San Francisco cause I wanted the prodisc and it wasn't being offered in Oregon or Washington by experienced surgeons. My surgeon was part of the FDA trial and has a lot of experience even if he hasn't had 100% success rate. I took a chance and it paid off so far.

At this point in time most of the US is only offering the Charity Disc. From what I have read, if the surgery is performed by an experienced surgeon then it doesn't matter if the disc is charity or prodisc.

I'd focus on your pain management and how much longer you think you can tolerate the pain. It will probably take 6 months before you can get an operation date. You also need to take into effect your insurance. If you go out of state your insurance might not cover as much as if you stayed in your home state. I know my bill would've increased greatly if I went to a different state.

I went to NY for my surgery and flew home to Texas after... my insurance company, Aetna, paid the same amounts in NY as in TX. I did this because I couldn't wait any longer for the surgery and I liked the doctor in NY a great deal. I was able to get a surgery day within a month.

The thing that killed was the cost of the hotel and flight. I had to stay in the city for 10 days post-op which really added up.... Plano, TX (where TBI is) has a lot of decent priced hotels that you could negoiate a good rate with for your long stay. If you do travel, you must have someone with you the entire time and you need a hotel room with a fridge. The 4 hr flight home was horrible....

Also, you will have to find a local doctor in NC who is familiar with the disc to do your post-op's. Your local guy may not be willing to help if he doesn't do the surgery. Instead of flying to NY every few months for my post-op's I drive from Houston to TBI.

It's a lot to consider... 70 sounds good to me... I don't think many doctors have done more than a hundred.

Good luck!

I still can't figure out whether blue shield of california sux or if it's just average. They've given me flack about presriptions and out of state medical care, but authorized my ADR operation while I know others have been denied.

Well, my discogram is tomorrow. I am not looking forward to that at all.

I'm pretty sure I found some advice about asking for a particular meds for the pain during and after the procedure. All I could find was a reference to amnesiac drugs.

Anybody recommendations for the pain and know what the amnesiac drugs are called?

Thank you!

Versed.
-Jef

cant sit,

I was lucky the FIRST diskogram I had the dr prescribed vicodin for the pain afterwards. The SECOND diskogram I had ...with a new pain mgmt dr...I knew to ask for vicodin. I now take Tramadol on a daily basis...I wasn't on it at the time I had the diskograms but I don't think it would have been strong enough for the short term huge spike in pain following the diskogram.

I also was partially sedated during the diskogram. I remember feeling pain during the procedure but not as bad as those who've described diskograms without any sedation. Can't imagine it.

I was "okay" getting out of the office immediately following the diskogram...but after the local and sedation stuff wore off...I was in aweful pain at home and couldn't move an inch in bed without the vicodin. Remember it's only temp increased pain and the information gained is well worth what you have to go through. Make sure they do control levels as well as the suspected levels so they can confirm where you have no pain versus were you do have pain.

Have you decided where your going to consult with for a surgeon because that surgeon may insist on their own diskogram...they might not like technique used by another...or they just want it done by someone they are familiar with. That's why I had to have a 2nd one.
It sucks but I'd do it a 3rd time if needed before I can get a surgery...so you'll be fine.

Do you have friends or family in any of the cities with surgeons who are frequently mentioned here? Dr. Yue at Yale...Dr. Bitan in NY, TBI, maybe Dr. Garcia in FL, Dr. Regan or Dr. Delamarter in Los Angeles, and I do believe some clinical trials were done in NC??? I thought Triangle Ortho in Durham was involved in some of the prior lumber ADR trials...and now involved in the cervical ADR trials. have you checked into that? Maybe search this site for North Carolina or NC? At spine-health.com, there is another surgeon's office in Charolette doing cervical ADR trials...might be work calling to see what there lumbar ADR experience is, if any. see www.carolinaneurosurgery.com and www.triangleortho.com.
I've met with surgeons in San Diego, Milwaukee and outside of Chicago. My 1st choice is Dr. Westerlund in San Diego.

Lovely Stuff. You'll hardly remember a thing. The dread of having this procedure done was far worse than the actual event. I had two discs done with the discogram and it was bearable. Good-luck.

Terry Newton