The end of life as i knew it. (Introduction)

[nomorecdl]

Hello, Im new to this forum, although ive been poking around on it and reading about other peoples experiences for a couple weeks. Im a 25 year old male who's always been very active, before my injury i was working for a very good company as a mobile service technician/truck driver in western Pennsylvania in the gas & oil industry and loving life. Here's my story...

On the morning of July 10, 2014 I injured my back severely. I was at work, and i attempted to move a large electric motor and vacuum pump assembly that was sitting on a wooden pallet laying on the ground. I wrapped my arms and hands around it and pulled backwards at an angle attempting to rotate it and get it out of the way. I only needed to move/rotate it 1-2 inches. I was pulling rather hard and was about to give up when suddenly the motor and pump assembly slid off of the wooden pallet and onto my right foot.

(Thank goodness i had steel toe boots on or it couldve done some serious damage to my foot) When it slid off the pallet it happened very quickly, and it then pushed me backwards with a lot of force and i fell, but my right foot was trapped and held firmly in place so i couldnt just fall to the ground in a normal manner. My spine bent backwards and i felt a strong pop in my lower back. My foot was still trapped and i was in no position to get myself out of the mess i was in.

My coworker came over and asked if my foot was crushed and/or damaged and i told him my steel toes saved my foot but i was stuck and to my surprise he got in his truck and drove away. He's a 60 year old man, and like many people sometimes do, he heard what he wanted to hear and not what was actually said and immediately shut his ears off paying no regards to the fact that i needed help and left me there as i was focused on finding a way to get my foot free. This all happened very fast and i hadnt yet felt much pain and must've had a large amount of adrenaline going through me at the moment.

Luckily for me there was a guy at the neighboring business who was outside repainting a large propane tank and when he saw that i was stuck and my coworker was driving away he yelled over and asked if i was ok then came to my rescue. He managed to pick up the assembly enough that i was able to wiggle my foot free, but as i wiggled it out from underneath the assembly it fell and now his hand was stuck. I helped him pick up on it as best as i could and he got his hand out.

In shock from the events i still hadnt realized that i was seriously injured, and my coworker was completely oblivious to the entire situation and had already driven away. I walked over towards where the truck i was supposed to be delivering equipment with later that day was and thought about the pop i felt and thought that maybe my hip or something else moved out of place, unsure of what to do and still not in much pain, i bent down to my knees and bent myself forwards to try and get some movement and felt some serious discomfort.

I walked over to the truck i was to be leaving in soon and climbed up into it and as i climbed i knew things were not good in my back and decided to park the truck. This truck is a Ford F650 medium duty flat bed commercial truck, not a pickup truck, and has steps to climb onto to get up in. When i got out of the truck and stepped my way down to the ground that's when i began to start feeling the pain and became overwhelmed with and overfull of adrenaline and panic.

I started to unload the things i had packed in the big truck to transfer back to my company pickup truck and gave up and called my depot manager and let him know i was hurt badly and was taking myself to the hospital and the pain was too much and that i wouldnt be able to wait for an ambulance to get to me and load me up and take me to the hospital. I took the pickup truck and drove as fast as i could to the hospital that is only 15 mins or so away from my workplace. My legs began shaking on the way there and i was very nervous, I made it to the driveway of the hospital and my right leg/foot became unresponsive and my left foot/leg was very numb. They were both painfully numb, and burning&tingling but my right leg was worse it and felt like someone had drilled a hole in my foot and jammed a lit road flare into it, and i could not move it.

I called 911 for help and told the operator what happened and at first she thought it was a prank call when i told her i was stuck in my truck 1/3 of the way up the driveway to the hospital and needed an ambulance to come rescue me and get me the rest of the way there. I reassured her i was not joking and an ambulance was sent.

At this point I was completely terrified, and while waiting for the ambulance i called my father and told him what happened. He was working, but stopped and came to me immediately. The ambulance came, and got me out of the truck and onto the stretcher and the rest of the way up the driveway and into the hospital.

They asked what happened and examined me, i went in for Xrays, an MRI, and not even sure what else but I ended up in the operating room where a laminectomy was performed later that same day. When i came out of surgery, both of my parents were there, and after a little while the surgeon came in to talk to me. He said i herniated my L4/L5 disc and also my L5/S1 was bulging and a nerve was being pinched which is what led to the sudden pain in legs/feet and loss of movement in my right leg/foot. He also said that it is the worst herniation that he has seen in his career and the jelly out of the disc had squirted all over and there were broken bones he picked out of the area.

He wanted to do a fusion, that day. He said about the fusion and my parents both said they'd rather not see that happen and i was briefly filled in with what that was exactly and the future consequences and told the surgeon i do not want a fusion. He thought about it for a little and said he'd have to sleep on it and see how his other board members felt about it and get back to me tomorrow. I was kept in the hospital that night and the next day he came back and said a fusion will be necessary at some point in my future, but since im only 25 years old he thinks trying to hold off on the fusion for now would be best and try some other treatments and therapies in the meantime. I was sent home with a custom fit back brace, and given a lot of restrictions, and was to follow up with my primary care physician in a few days and then with the surgeon later the next week.

At home, i was very sore from the surgery and not able to do much of anything. Just getting myself to the bathroom was a major event. I went to all dr appointments as instructed and much attention was paid to incision and i had not been allowed to shower since the day of injury/surgery until July 28th, 18 days with no shower just added to my misery. The surgeon had me come see him for many follow up visits and wrote me a prescription for aquatic physical therapy 6 weeks after the surgery.

At this point my pain levels had not reduced much if at all, and pain was something i experienced all day long. Standing, sitting, laying, were all uncomfortable, and maintaining any position increased pain. Part of my aquatic therapy included a gentle form of traction, which consisted of my putting a flotation device under each arm and allowing my body to hang vertically in the water stretch out my spine.

All of the therapists there talked about how that was supposed to produce feelings of relief and comfort, and some of the patients chimed in and said that they loved it and it felt so good, but it was anything but pleasurable for me. It felt as though pieces of my spine were being pulled and pried and stretched apart forcefully and was painful. I found it odd that everyone else loved it. I am still in physical therapy currently, still 3x a week, but transferred on Oct.10th to a closer place where im doing land therapy because the therapist where i had aquatic therapy was 45 mins away from home and i couldnt tolerate the long drive there anymore.

[colorado babe]

If I were you, I would go get a referral to see several Ortho/nureo surgeons in your area. There are several really good surgeons in the U.S. I am guessing you have insurance. Have you considered Artificial Disc Replacement? the reason why I ask is because I spent 16 years on an off with Physical Therapy and never got the relief that I needed, in addition, massage, chiro, crystal bed, acupuncture, restorative yoga with no help.

If you could let's us know where your located, we could give you recommendations of U.S. doctors who are the best in the U.S.A. This way you won't have to get the run around like I did until I found my surgeon by accident.

Here's hoping that you get relief soon. It might not be necessary to get a fusion but if you do, you want the right surgeon performing it. I am praying for you for a fast outcome.

[drewrad]

This was quite painful to read. And although we cannot commiserate with everything you said since no one is the same, to the degree that we can, we do. You are so damn young, and may God bless you and uphold you, young man!

I second CB's admonition. You need some other minds on this right away. Get as many as you can but not enough to confuse you. In the midst of them, look for the consensus view. I prefer getting both orthos and neuros involved.

Now, for my own off the cuff remarks. Take them for what you will. I am no physician, just a lay person. First, the fact that acquatic traction not only provides no relief but actually sounds as if structures are separating, your doc may be right. He may need to fuse your elements just in order to provide structural integrity. It sounds as if you were BADLY damaged. I feel bad for you so much, and felt your situation dearly the way you described it.

I don't know the degree to which that lami was successful or not and you may not know either, but I would waste no time in getting reimaged, perhaps this time urging for a CAT Myleo.

The way this injury happened you may only have a two level issue. At 25, so young, you may want to consider your full range of options but you may be limited as far as what your HMO can provide you with. I don't know. Ask the doc to tell you why he is recommending fusion at L5/S1. I think I already know why. But have him give you the gist of it. But if that is the route, the area needs to be seriously cleaned up first since it sounds as if your disc didn't merely herniate, but exploded! My suggestion, perhaps, would be fusion L5/S1 and ADR above that since they would already be in there, why not get at both? Just my two cents.

[nomorecdl]

Im in the Pittsburgh Pennsylvania area

[nomorecdl]

I like the idea of ADR. From a mechanical point of view it seems to make the most sense, especially from the reviews I've read about the new M6 replacement disc from Spinal Kinetics. Its a shame, its made here in the usa but not able to be implanted here. Glad that aviation parts arent in the same predicament.

[nomorecdl]

I'm definitely willing to go wherever I need to in order to get the best treatment. I actually went to a spine injury seminar recently, and the doctor who reviewed my MRI there said there is a procedure that may be the answer that involves using a laser and sealing the herniations in the damaged discs, and clearing out the area (by removing bone) around my "out of shape" discs and showed me the difference between discs in my back that are healthy and the nice white color they have and have a kidney bean shape to them in front vs. the injured discs that have lost their white color and are now black, and have formed into a more circular shape closing off space for my spinal cord.

In the latest MRI, the jelly in the discs that came out is still visible in front of my spine and i was told its ok to leave the nucleus pulposus thats splattered out all over there indefinitely. There was no mention of fixing the actual placement of my spine, and/or restoring any lost height. Knowing how leverage and joint angles work in mechanics, Im concerned that this could lead to further problems.

Ive been looking around at the different options as far as ADR, and have found a small handful of German surgeons as well as a surgeon in Spain. The doctor in Spain seems to have a pretty good success rate. And the one surgeon in Germany does not use the M6, and instead uses the Prodisc. (you probably know who I'm talking about) My question is if the surgical procedure is supposed to be superior then why does it seem that the equipment used is not whats claimed to be the latest greatest technology in artificial discs? Are there complications with the M6, that the older versions of discs dont have? All of the surgeons in Germany that I've found seem to have a nice easy setup as far as getting a us citizen to germany and to the hospital and seem to have a very easy to understand "package deal" that make planning the trip for the surgery very easy.

I've noticed that alot of people include in their signatures that they have had procedures with Dr.Clavel, and it seems that most everyone is happy with his work, however I've not found planning a trip to go see him in Barcelona to be as easy as with some of the German surgeons. Not that I have a problem with arranging my own taxi from the airport, and hotel stays, etc.. But how did the planning/trip part of it go for those of you who have gone through it? And most importantly, how do I go about choosing the best surgeon for my particular situation? What should I be most concerned about as far as what questions to ask?

[drewrad]

I can speak in re to Clavel in Barcelona. Don't worry about Bergnatoli's 'package deal'. Clavel has a great touch base with his American patients A to Z. Obviously just work with a travel agent for the rest, but once you're there you're good to go. That should not be the number one concern.

My only concern with M6L as well as any ADR for that matter are sizing issues since everyone is different and for real big people, I would, in my opinion, stay away from ADR. Again, just my opinion. ADR works well for most however. But if you are a giant of a man, the loads will be substantial compared to lightweight individuals. I'm short, 5'7", about 190 lbs. if that gives you any indication. And I feel pretty good. L5/S1 fused. Two M6L above that fused level.

[Throttlejockey]

Dr. Clavel's office will handle all arrangements for you (hotel, taxi, etc etc etc) all you need to do is buy RT tickets. Just email Anna Bausells, International Coordinator at Barcelona Spine Center:

anna@bcn-sc.com

She will take care of the rest. She will ask you to create a dropbox account and then "share" all your MRI, XR, CT Scan, Reports, etc. for review by Dr. Clavel. Cost of the Review, Consultation and Skype video conference session (approx. 1 hr. but he will give you the time you need) is 180 Euro.

TJ

[nomorecdl]

Im 6ft, 250lbs. So i dont know if im too "big" for ADR surgery or not.. Before i got injured I was 200lbs (and still 6ft, lol), but this huge lifestyle change has led to me gaining alot of weight very quickly. Im sure once im able to do things again that it'll be a matter of just a few months before im back down to around 200lbs. On another note, Can anyone speak of any unknown risks associated with ADR surgery(particularly in Germany..) I was reading some things about people going to Germany for ADR surgery and not surviving through surgery. Its hard to always tell whats true and whats not, especially on the internet, but that is something definitely worth asking about.

[colorado babe]

IMHO I don't think you would be a good candidate for ADR surgery. I think your weight maybe an issue. Another thing to think about if you smoke you can pretty much guarantee a surgeon will not do it. the surgeon I went to said he only performs ADR on patients who are within a health weight standard. Perhaps you should think about fusion. I just had a fusion on my Lumbar and ADR at my neck and both feel great and I can't tell the difference between the two. If you find the right doctor who is well know for fusions and there are plenty in the United States, you will be fine. I see no need to go to Europe for a fusion and have to pay out of pocket when most insurances that I know pay for fusions.