Intro - Calgary, AB - L5-S1 pain
 

Hi All:

I'm 45 y/o from Canada, currently spending the winter in California. Was leading a moderately active life, practicing hot yoga regularly, enjoyed hiking, gardening and down hill skiing. In 2011 had first onset of lower back pain during yoga. Treated with NSAIDs, muscle relaxants, massage, chiro, physio, inter muscular needling and rest without success. X-rays were normal.

In Dec 2013 paid for MRI which showed moderate degeneration at L5-S1 and modal end plate changes. At the same time got referral to Caleo Spinal clinic. Conservative treatment not effective. Was referred on to surgeon for potential ADR. Currently on wait list for surgery with 6 - 12 month wait.

Current status: as long as I am relatively sedentary the pain is low to moderate. Forward bending, lifting or exercise bring the pain level up significantly. I keep active by golfing a couple times a week (walk the course) and some light hiking.

For pain relief I limit myself to Aleve, heat pads - cyclobenzaprine when pain is bad. Relaxation techniques also help.

I am quite nervous about surgery. Recently tried some limited hot yoga and gardening which brought on a good amount of pain/stiffness and gave me new resolve that surgery is the only option to get Bach into an active life style.

Susanne

Golf and yoga may not be suitable activities for spine issues. The axial wind up and loading on a long drive off the tee, ouch. And yoga can create severe stress on discs. Just an FYI. Sorry about your problem. Be careful. You have reached the critical age for life transitions. Be moderate in all things.

I understand that activities like yoga, golf and alpine skiing are not ideal for people with back problems. However, walking just does not cut it for me as an activity. As my spinal doctor put it, there is s find line between physical and mental well being and the risk of depression with chronic pain is increased. If a day on the slopes or out on the course is important for mental well being he recommended to go ahead and pursue the activity with caution and pain killers in hand.

I find also that bring sedentary has given me a false sense of how much my back problems affect my life. My husband would commonly hear me say that it's not that bad and surgery is too great a risk. It is not until I pursue my favorite activities and become almost incapacitated that I realize that it is THAT bad. I do not want to be a couch potato at 45 and surgery appears to be my only chance. I keep going to the range to hit balls and practice light yoga to keep this realization with me while I am waiting for a surgery date.

Hope everyone has had a good Thanksgiving! Doing a lot of reading on this forum and seeing many success stories and some not so successful. It has been interesting seeing how any people are going to Europe for surgery. I currently spend a good part of the year in Cali and concerned that my surgery will be in Alberta for follow up. Going to another continent for surgery had not even occurred to me given possible complications, follow ups etc.

I had thoracic surgery in my 20s to remove part of my lung. Apparently one of the most painful surgeries to recover from. At the time the surgery was a choice between life or death and it didn't require any decision making on my part. Still have some mild issues 20 years later.

Having to make a decision about elective surgery that could have significant complications and long term effects that could be worse than what I am going through now is tough. I find the pain I know more easy to accept than the unknown.

Having said all that I am still giving ADR surgery in Canada a green light. However, thanks to this forum I have a few questions prepared for my surgeon.

Cudo's to the many who have braved the uncertain outcome of ADR surgery and thank you for sharing the good, bad and the ugly. Hoping that you all will find relief from your pain!

Hi,

I'm from Winnipeg and had a 3 level lumbar surgery with Dr. Bierstedt. One thing i learned from my research was that Germany was 30 years ahead of any other country in doing ADRs. Last summer my wife and I were invited, as a past patient, to a supper with past patients of ONZ. I thought great, 6 to 12 past patients that I would meet with, to my surprise there were over 60, and just from southern Manitoba! So they have the skill and history to know what they are doing. When I was in rehab in Germany after my surgery I ran into a gent that had a cervical ADR done 7 years before and was doing great, he said before he couldn't raise his arms above his head.

Thanks for the post, Boris. I was born in Germany and immigrated to Canada as a teenager. I remember medical care being more advanced there than in North America but tend to forget after so many years. I am impressed how many Canadians travel to Europe for surgery!!!

Given there are only 4 or 5 surgeons Canada who perform ADR you'd think they would have a sufficient number of surgeries under their belt. Going to check with Dr. Bouchard to see how many he has actually done. Also which device he is able to install. I was a bit taken by surprise in my last appointment in that I thought there would be further diagnostic tests. Instead he put me directly on the surgery list. I did not have my list of questions ready.

Aparently only one device is approved in Canada but Dr. Bouchard has special permission to use a device approved in Europe. M6 I assume? I plan on calling his assistant next week to get more info.

I hear that it takes quite a bit of time to get surgery in Canada but I managed to get an appointment with the surgeon in 6 months rather than the usual 24 months. From there the delay has been on my end, trying to decide whether to proceed.

I will keep everyone posted on progress and decisions.

Coincidence or just that age? I practice hot yoga regularly for about 6 years and got back into skiing with my teenage daughter and her friends when the back pain started. Too many moguls? Too many forward bends? It all seemed to start at once: cramping of my calves and toes during yoga practice, snapping hip syndrome while walking up or down stairs, knee pain, back pain. Ruptured Achilles while playing with my dog in the back yard last year was putting insult to injury (pun intended).

Had no serious falls skiing, apart from a couple of dives into cushioned powder. However kept up with the teens taking on double black diamonds, moguls and jumps. Was in the best shape of my life when the pain started. Listening to the various doctors telling me to go to yoga and Pilates to build core strength was a bit of a joke. Interestingly, I've since read that strong abs in the absence of similarly strong back muscles can cause problems with posture and result n back pain.

Now four years later, any exercise (including house work) short of walking triggers stiffness and pain. Not gaining weight and keeping fit has become a constant challenge that I am holding on a teeter totter. One of the reasons I have been able to see a surgeon so quickly in Canada is that I have managed to keep reasonably active and weight down.

I think I have a good level of pain tolerance put once it becomes chronic and any little activity sets it off it starts becoming old quickly.

Still working 4 days a week in front of a computer. Taking few pain meds the past couple of years. Limited to Aleve a couple times a week and the odd cyclobenzaprine. Keeping up the motto that as long as I can feel pain I am alive.

Hi,

The best pain doctor I've been to moved from Winnipeg to Burnaby, he was the one that did Prolotherapy on me, on my upper back. After he got my upper back, mainly between the shoulder blades, under control he did start moving into the lower back area, but he then moved away. Perhaps a less invasive methodology might be indicated before surgery? My current pain doctor flipped out when I told him I was going to Germany for surgery, I was basically unable to walk due to lower back pain. That doctor stated that he did presentations with a Candian orthopedic surgeon in which they deterred any back surgery. So, IMHO, in Canada, your taking chances with back surgery. One reason I went to Germany over the US is that I got a more or less guaranteed price quote whereas the US doctors where very vague about the cost, since I would be paying out of pocket that meant a lot to me. Also, Dr. B. works out of a full hospital rather than a clinic so should complications arise they have access to a wide range of other doctors.

One other thing, Aleve can raise your blood pressure, I found about this the hard way when my BP spiked.

Thanks for the heads up on Aleve causing high blood pressure. My SO recently bought a home blood pressure device and low and behold mine has crept up a bit. Unfortunately (or fortunately) my stomach only tolerates Aleve in small doses. A friend of mine tried lidocaine patches for back pain but with little or no relief. I've tried them and they work quite well for me. I use them while golfing or after doing housework. The drawback is that when the lidocaine wears off the pain comes back quite suddenly and generally feels stronger than before.

I have tried other conservative treatment with little effect. The stiffness and pain is progressively getting worse. At this point I feel that my age (45) and fitness level (5'6" and 125 lbs) is something I have going for me as far as surgery is concerned. Fast forward 5 or 10 years and my fitness level will surely decline and so will my body's ability to heal. If surgery is inevitable I'd rather bite the bullet sooner than later and be able to, hopefully, enjoy life more fully with less pain.

Hi Jonesie13,

There are a few of us on ADR Support from Calgary as well. You should be able to find our stories via the search button. I've pm'd you as well.

Good luck with your journey!

Cheers,

-Brett

Thanks, Banhorn, for the PM. I just read through your journey. Congrats on he successful recovery!

Canada and MRIs
 

I just remembered an interesting experience re getting a requisition for an MRI. I had been seeing massage therapist, physic and chiro for several months with no relief. I found an awesome chiropractor in Calgary who performed a hybrid of active release and physio. Her and my regular physio gal simultaneously suggested that my back pain was something other than a pulled muscle.

My chiro offered to write me a referral to a private MRI which would cost me about $700 out of pocket. I decided to see if I could get a paid MRI via my GP. Not only did my GP (whom I have seen for 20 years) not see the need for an MRI, but she was offended at the idea of private MRIs and my chiro offering to give me a requisition. She also indicated that the wait list for a paid MRI, if approved, would be about 4 - 6 months.

Needless to say, at my next chiro visit I got my requisition for an MRI. 3 days later and $700 poorer I had my MRI and report in hand.

Welcome to the all Canadian "free" health care coverage.

Quality of Life
 

Jonsie13, I have been avoiding a 3 level lumbar fusion for sometime, years. When I read your post your statement;
"I find also that bring sedentary has given me a false sense of how much my back problems affect my life" , it really hit home. I think if I kept a log on how much each day that I was upright or laying on my bed, reclined on a foam wedge it would really be a few things, like depressing , probably shocking to realize how much over time my activity has lessened and quality of life has been drastically affected. I used to be very active , and still would be if not for my lumbar spine. It seems now my activity would parallel a quite elderly person. I had hoped for a 3 level ADR but was told there was too much curve in my spine for the ADR.
I hope your problem can be addressed successfully!!, if you could get a fusion at L5-SI and a ADR at L4-L5 (a hybrid procedure) go for it. Also lot of people on this site have gone to Europe with great success, also you can send your scans / med. records to several Drs. there for their opinion. I plan on doing this with Dr.Zeegers and of Dr. Clavel. GOOD LUCK!!

Hi beaverc:

Getting your head to the place where you are ready to take the leap to surgery is a process. You can't or shouldn't make that decision lightly. Having said that, since I am a good candidate for ADR I don't want to wait so long that I am no longer a candidate because I now have other problems or get conservative treatment that might cause scar tissue.

I friend of mine had a 2 level fusion in Canada about 2 months ago. She had been putting up with significant pain and was loosing feeling in her legs and getting incontinent. Her surgery was through the same spinal clinic that I go to. They got 2 other opinions and finally decided to use the Canadian surgeon she was initially referred to. She felt that she received exceptional care and that her surgeon had the necessary experience and knowledge. Her recovery has been amazing. Her pre-surgery problems were gone immediately and she is recovering nicely. If there are any second thought she wishes she would have opted for surgery earlier. You'll now if and when you are ready.

It's a process and everyone is different. I am amazed at the posts where once decided, surgery has to be NOW. While I have decided that surgery is my best option at getting active again and I am now on the surgery wait list, I can't say that I am in a great hurry. I know it's about an 8 month wait if I use the Canadian health care system. This gives me lots of time to come to terms with my decision and to get as fit as I possibly can. It is also allowing me to get a second opinion overseas, to do some research and to ask my Canadian surgeon questions.

In the meantime I deal with my pain, but if I am smart, the degeneration of my discs will not get significantly worse. Thankfully I think I have a pretty good pain tolerance and am able to cope pretty well without the use of narcotics. But that's another whole topic of conversation.

Scheduled surgery in Canada
 

I just go off the phone with Dr. Bouchard's assistant. Surgery is scheduled for beginning of May :clap: I could have done the surgery a month earlier, but I would have had to return to Canada from California a month early. This means that I got into surgery 6 months after getting the surgery go ahead. Not really all that bad.

As far as the actual surgery is concerned, Dr. B is recommending the M6 but will have further discussion as we get closer to the surgery date. While the M6 is not yet approved in Canada, he has special permission to use it and with great success. From quizzing his assistant, Dr. B has been doing ADR since 2003. He has done well over 100 ADRs using the M6 alone.

The assistant did caution against going to Europe (Germany etc.) for the surgery as they have had several patients who have had significant complications requiring revisions. They have had incidences of patients receiving ADR surgery who apparently did not have sufficient bone density. Lack of follow up care from the original surgeon once back in your home country also seems to also be an issue.

I decided just like that, when I realized I might not be able to make the flight.... :angel::angel::shedance::shedance:

Hi Romakis,

The flight has to be tough if you cannot sit for any length of time. Yikes! I don't envy that. How did the flight back go for you? Better than the flight over?

I have a 15 hour car trip ahead of me after the surgery, but we'll stay put for a week or so until I can manage to be in a stationary reclined position for that long. I am still a bit unsure of the surgery still ... even though I struggle with day to day functioning. Working at a desk all day does not help. At least I work from home :)

Been reading through the German spinal forum and, low and behold, they have all the same issues we have: what clinic to go to, whether to have a fusion vs. ADR, lack of communication with their doctor, etc etc. They seem less concerned with the type of device. Also, very interestingly I have read a few posts that say that they will generally not perform ADRs past age 45?!

If there is one piece of advice I have heard from a number of people, it is to get into the best physical shape you can prior yo surgery. For anyone having a fusion done, upper body ie arm strength is of particular importance.

Easier said than done but I will be doing yoga poses every other day and walking, walking, walking ...

My flight back was even more fun!!! My scar opened up and I was bleeding like crazy :) https://www.adrsupport.org/forums/sh...t=13198&page=2
:D:D:D

You've had quite a journey, Romakis! If that had been me on the return flight I would have passed out there might have been an unexpected flight detour LOL Good for you that you were able to get through that.

Sounds like you still struggle with some leg pain. I hope that this is going to resolve itself in time. Any changes or improvements?

L5-S1 Jonesie
 

Jonesie13 That's awesome!!! With an ADR and only one level to do and deal with after surgery as well as with a known ortho, I would say your chances of recovery to 90% / 100% are realistic!! I would assume they are going to use an anterior approach, will they be using a posterior approach as well with only one level? Take it easy during recovery , I have read a lot of accounts of people overdoing it too soon and seems things seem to go south from there sometimes with no explanation as to why. MERRY CHRISTMAS!!! :clap:

Hi Beaverc,

I have mixed feelings about surgery but mostly excited. As for taking it easy, i am at greatest risk for trying to sit at my desk and do work and my boss and HR have already told me "no work for 4 - 6 weeks" and then gradual return as my doctor sees fit. Good to have work on board!

He will be using a posterior approach but will find out more at our next appointment prior to surgery. It looks like would be able to get either an Active L or M6 L but I think I will leave the decision up to the surgeon. Even though i have read all I can get my hands on, I am just not in a position to make the call. Have to have the trust in the guy doing the cutting :)

Merry Christmas to you too!!!

Leg pain is probably due to damaged nerve before this surgery and is probably permanent.

First 3 months were OK, last 3 were downhill, a little upward trend in the last couple of weeks.

Recovery is harder than I have ever imagined.

I hope your upward trend continues! Would be a nice Christmas present :)

Are you unable to manage your pain or do you have incontinence?
 

I just read a German study which suggests that the majority of back surgeries are redundant. Mainly because it is extremely difficult to positively determine what specifically is causing the back pain and surgery quite often does not relieve the symptoms. The study goes on to state that surgery should only be done if pain becomes intolerable and/or there is bowel/bladder involvement.

This s exactly the same thing I heard from my orthopaedic surgeon last year (who was up on the latest studies and medical developments) after I had an Achilles rupture. His words "I would not authorize you to have spinal surgery for the sole reason of relieving pain as we still do not know exactly what causes the pain and more often than not the surgery either fails to relieve pain or causes different pain."

Makes me question my decision for an ADR. :confused::confused::confused:

Hi jonesie,

I was unable to manage pain and have a life... My life became a constant effort to juggle activity or avoid altogether. Although I'm still doing that juggle, I have more hope post surgery... I can finally stand without being in tons of pain. So nice not to have the numb tiNgling. Sitting still not good.

As for incontinence, I never had that. I do think constipation was a huge issue though that was related to the disc/nerve. That hasn't been confirmed by surgeon though. Post surg I struggled lots with urinary retention. It has just gotten back to normal.

I drove myself crazy reading studies...but after trying every possible rehab option, I got too tired. Hence I took the leap for surgery. Was an agonizing decision for me. Good luck with your decision