[RWS Dave]

Hi everybody -- after a couple of years of sitting on the fence researching and debating ADR surgery, I've decided to go for it! I'm scheduled to have a two-level surgery next week (Nov 12) with Dr. Bierstedt. A big shout out to Harrison for creating and maintaining this site, and to everyone in this community for all of your many contributions. What a tremendous resource! If this community didn't exist, I'm pretty sure I wouldn't be going down the path to ADR surgery today (my fusion-centric US surgeons would have scared me off a long time ago).

A little background: I herniated L4/5 three years ago. Initially, I had excruciating back pain -- to the point where I couldn't stand for over 24 hours. A trip to the ER and a round of prednisone got me up and moving again. Over the next few weeks, the back pain slowly resolved and I regained mobility ... then the sciatic pain and foot drop (left side) kicked in. Good times. After 8 weeks of worsening sciatic pain and accelerating weakness in my left foot, I opted for a micro-discectomy. At first it seemed to work -- the sciatic pain abated, the strength began to return in my foot. I did have some residual numbness in my foot and toes and developed some new burning/tingling in my little toe and the side of my foot. If things had stopped there, I would have been a happy guy. Unfortunately, a few weeks after the surgery, my back pain returned on the left side. A few months after that, I re-herniated the disc simply by reaching out quickly to grab something -- since then, I've had constant pain on both sides of my back and in my hips and glutes. Some days are better than others, but overall, the pain has managed to really impact all aspects of my life (family, socially, work, recreation) and I am ready to put it behind me.

Over the past 3 years, I've consulted with a dozen or so surgeons and pain management docs in the US and Europe. US docs all over the map; Euro docs generally in agreement about ADR being the best option. I've also tried just about every conservative approach out there to reduce/eliminate the pain and avoid surgery: multiple ESIs, facet injections, medial branch blocks, acupuncture, intra-discal injections (Dr. Derby's "restorative solution" -- a cocktail with glucosamine chondroitin), PRP injections in my facet joints and intradiscally at L3/4 and L4/5, acupuncture, prolotherapy, neural prolotherapy, hypnosis, lots of PT, massage, daily stretching, walking, swimming, inversion table, chiropractors, and a bunch of different meds. I also managed to drop 30 lbs. None of the above did much for the back pain (it didn't help my wallet, either!). Walking, icing and mild doses of Percocet and flexiril have helped more than anything.

I initially thought the issue was coming solely from L4/5, but a discogram I had showed annular tears at both L4/5 and L3/4 (there was also concordant pain at both levels). On my MRIs, L4/5 is clearly degenerating, but L3/4 still looks OK. After discussing it with Dr. Bierstedt (and other surgeons), we've decided that we shouldn't ignore the results from L3/4 (even though discograms are known for false positives) -- since we are going to replace L4/5 for sure, the best approach would be to also replace L3/4 now rather than find out it's a pain generator after the operation and/or have it worsen down the road and have to go back in.

Question for those who have already traveled down this path: how nervous/scared/anxious were you before surgery? I gotta admit, after wiring the money yesterday (ouch!) and as the day gets closer, I'm scared sh*tless and am starting to second-guess myself. Had a hard time sleeping last and am doing my best not to let the doubt creep in any further...