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Lumbar Fusion L4-5 and L5-S1

From: mj2762 - on 06/09/2010 10:33am

I have suffered with lumbar pain since I have had my children 28 year ago. In July 2008 I had C5-6 fused successfully as my insurance company refused to approve the artifical disc replacement. This has caused further degeneration of C6-7 along with bone spurs and pain. I am treating this right now with pain meds and patches. My bigger issue is my lumbar. I had a snowmobile accident in Jan where I landed on my tail bone and the pain has been increasingly getting worse and prgressing down my leg. I returned to my spine surgeon and he confirmed I have degeneration in L4-5 and a tear in L5-S1. I started with pain meds and two epidural injections. Both failed. He then suggested that I meet with my pain management doctor and have a Lumbar Medial Branch Block. I have had two of those injections and both have failed. The pain has now radiated down my left leg into my left foot leaving three of the five toes numb and painful. I use to go to the gym 5 times a week and now it take everything to get myself there a few times a week just to ride the bike and walk the treadmill. It is painful to get off the recumbant bike and after walking on the treadmill on a level 6 incline, which I use to do 18 incline I am in a lot of pain. The pain management doctor said the Radio Frequency Treatment will not work on reducing any pain in my leg or foot and it may help the pain in my butt but he does not suggest to do it. He has suggested i go back to my spine surgeon and have a Discography done and then surgery. I know my surgeon originally didn't want to do lumbar surgery, but how can I keep up like this. I am now on stronger pain meds and I just want to know has anyone had L5-S1 surgery that has been successful? I see the surgeon tomorrow mornng so I would like some feedback for any of you prior to going to see him. Thanks in advance.

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on 06/10/2010 1:37am

Sad to hear your problems.. I can sympathise but my experience is that I had L5/S1 fusion 9 months ago to stabilise slippage - that was successful but my R sciatic nerve is trapped worse than before the surgery and so my pain is worse. I am taking more pain meds and ani inflams than before the surgery and I have an appt to see a pain mgmt specialist in 5 weeks time. Is Radio Frequency Treatment from a TENS machine? I have a portable one and it is the only thing that gives me some relief. Good luck - I'll look out to see if you post again. Best wishes.

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on 06/10/2010 7:52am

Hi there

I just read your post and wanted to reply before you go to see your specialist/surgeon. I have had L4/L5 and L5/S1 disc problems including a ruptured disc - at L4. Recently I had another rupture at L3. I have been on Oxycontin for quite some time and whilst it doesn't relieve my pain completely - it allows me to get out of bed (even though it takes some time to kick in).

Whilst I'm sure some people get some relief from Spinal Surgery/Fusion - I visited a Spinal Specialist a couple of years ago with a view to possible surgery - he told me that he could not offer any guarantee of success. He also told me that spinal fusion for lumbar vertebra was NOT a good option as once fused - the pressure shifts to the other vertebra and they in turn risk degeneration.

Reading your post I see that you have already experienced this in your cervical vertebra and I know the pressure on lumbar vertebra is much higher than on the cervical vertebra as the lumbar spine supports all those above. I have not had surgery for this reason and whilst I am far from an expert - I just wanted you to read my post.

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on 06/10/2010 8:06am

Dear Tippysnail... how much Oxycontin do you take? I also take it as well as Tramadol, but I don't get much relief. Thanks Anney

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on 06/10/2010 8:37am

Thank you for your responses. It is good to talk to people who understand what I am going through. I agree that my surgeon also said that it could lead to further pressure on other discs after having fusions but I don't know what else to do. I have done chiropractic manipulations which made me collaspe when I stood up. Physical therapy and that didn't work. Epidural injections along with Lumbar Medial Branch Block injections and my pain management dr said that RV treatments will not help. I am going to request stronger medication because the oxycodone is not even helping. I am taking two at a time just to to help take the edge off and I can only take this when I am home from work because I won't drive with them and I can only take 4 a day. I am getting so depressed! This pain is consuming my life! My left leg feels so heavy and the pain in my foot is getting worse. I told my boy friend I don't like to talk about it because I feel people are just going to say I am complaining and I don't want that to happen. I talk to my daughter about it as she works in the ER in the trauma unit at a major hospital here and she said she totally understand but she is far worse off than I am as she has crohn's diease and is in flare up and we can't get her in remission and I don't feel like I have a right to complain about my pain when she is so bad off. I just want my life back the way it was!!!

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on 06/10/2010 10:41am

Hi I now take 50mg twice daily - morning and night, Endone 10mg midday, Diazepam 5mg up to 3 times daily and now Brufen 400mg twice daily also - it doesn't cure my pain but certainly makes 'most' days bearable.
It was increased over five years as I resisted the increase. I have listed below how it was increased.
M = Morning and N = Night

20mg M + 20mg N
20mg M + 40mg N
40mg M + 40mg N
50mg M + 50 mg N

As I said it's not perfect but generally it reduces my pain 75 - 85% most of the time

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on 06/10/2010 12:29pm

Well just got back from the doctor. He is unable to perscribe any stronger medications so I have to see my pain managment doctor next week for that and he will also be doing the discography. He also has me getting an EMG on the 28th from my neurologist. He doesn't believe my pain and numbness in my leg is from my siatica as there is alot of blood flow around it. He believes that the discs are leaking which can cause this same reaction to the nerves that is why the additional two tests are being done. In the mean time nothing is helping and I just get deeper and deeper into a depression because of this pain.

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on 06/10/2010 12:30pm

Just one more thing. He advised the artifical disc is approve for only one level and being that I have two levels I am not a candidate.

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on 06/10/2010 2:22pm

Please do not even think about giving in the the depression you feel on this.... there are many of us in the same position and we can help to support each other. BL**dy doctors - when they saw they they CAN'T prescribe anything else - they have NO IDEA what having this kind of pain is like on an ongoing basis... they choose not to prescribe anything else - that is why I am going to a pain specialist as soon as I can get in to see him and I'm going to be very firm about my needs. Please remember that you are not alone!

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on 06/10/2010 2:30pm

Sorry Tippsysnail .... I'm a bit lost on your meds - mine are 2 x Tramadol 200 a day - every 12 hours, 3 Endone(Oxycontin) 5mg (usually one in the morning and then 2 together in the afternoon, and a Voltaren 50 after each meal.

How many 5mg Oxycontins are you taking every day.... I feel that i need to take a lot more than I do now before I would make a good dent in the pain. At the moment I struggle just to be able to move around in confined quarters, and I was a fit person not so long ago...

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on 06/10/2010 2:56pm

Hi

I think because of the different medication names the confusion arises. I take

50mg twice daily of slow release oxycontin and 2 x 5mg of the ones you are on around midday. The slow release are better as the ones you seem to be taking are the normal fairly short acting ones. i'll look up the different names and get back on to you so we can reduce the confusion

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on 06/11/2010 12:27am

Dear Tippsysnail - I'm very happy to have found you - I am an Aussie too! and my GP is cautious about meds.... I have had the Tramals for about 3 years and they are synthetic opoids, GP said prior to surgery that they were the strongest he could give me. Since surgery my sciatic nerve is worse trapped that before, so the pain is worse and the surgeon started me on the Endone 5s in hospital and I have been able to get the GP to carry them on - but he has never mentioned the slow release ones that you are taking. Sounds like they could be a lot better than the Tramals for me. I am seeing a pain management specialist on 12 July and I want to be as well informed as I can before I get in there. I will check out the slow release Endone 50s - thanks SO MUCH :)

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on 06/30/2010 1:47am

Hello mj2762, I had Anterior Lumbar Fusion Surgery on my L4-L5 and L5-S1 on Feb 24, 2010. I totally understand where you are right now because I was there, depression, severe lower back pain and then it started down my leg ,the pain and heavyness was so bad I could no longer take it, it had totally consumed my life. prior to my surgery I had 3 epidural injections, 1 lumbar block all failed. I had so many MRI's, CT scans, Bone scan, EMG test finally my N-Surgeon said there was one more test we could do a Discogram my pain management doctor did that and after that N-Surgeon agreed to do my surgery. My surgery is a success because the pain I have now is different yes I have back pain but it is different It's from healing no more leg pain, It is just a very very slow recovery but at least I am on my way to my prior life. I am so glad I had the surgery because there was no other way to go I just could no longer live the way I was living it really was not a way to live. How long have you been going thru this? I hope my experience helps you.

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on 06/30/2010 8:16am

I have had lower back pain since I have had my two children and my youngest is going to be 28 in October. I Jan I had a snowmobile accident where I landed on my tail bone. That was the final straw. I just went through the discogram a week ago Friday and it was the most painful thing I have ever gone through. It determined that the L5-S1 is at 20% and there is degeneration in L4-L5. I had the EMG on Monday and there is nerve damage in L5 and S1. My surgeon originally told me that he did not think this was my sciatica but that it was leaking fluid from the disc, but my EMG proved the opposite. I see the surgeon today at 10:00. All I know is I can't take this pain much longer. The thing is, I have just gone through 4 interviews with my company for a new position and I don't want to lose out of this new job because of my back. I just talked to HR and she said once I discuss surgery with the surgeon I need to tell the hiring manager. If this causes me to lose out on a position don't you think that is discrimination? How long has your recovery been? Are you back at work? How long have you been out of work? Did they do surgery through the front or through the back?

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on 06/30/2010 9:24pm

I have been off of work since 4/10/09 because the pain was so bad during 4/10/09 and 1/2010 I was having all the test done, yes the Discogram was extremely painful. I had my surgery 2/24/10 so it has been 4 mos of recovery so far my doctor told me from the start "it would be 3 mos but he said realisticly 6 mos to get back to work and 8 mos to a year before I would really start feeling almost totally well" at this point if I really needed to go back to work he said I could on modified duty my surgery was thru the front. I will tell you one thing I feel so much better then before the surgery, when I say recovery is very slow it's because just can't over due on sitting, standing and laying down for to long no bending or twisting during the healing process but I would do it all again in a heart beat as for your job I would tell them your doctor has not told you how long you would be out of work because everyone is different-fo for it and get this new position you may be able to go back sooner on modified duty-short days. Oh I start P/T tomorrow and I really feel this is going to help my recovery and make me feel better and they will let me know what excercises I can start doing. Hope this helps and if I didn't answer all your questions please let me know. What did your doctor tell you today?

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on 07/01/2010 8:33am

Well my doctor said I have exhausted all other options and that he suggests I have the surgery. We are going to be doing it from the front and back because I have been a smoker and in order to make it stronger they will put the screws thru my back. He said that I will be out of work for 2 months, however he just did one on a nurse recently and she was out for only two weeks. I have a sitting job so I know I won't be back in two weeks. I know what you are saying too much laying, sitting or standing just doesn't work. He reminded me that this surgery is not guaranteed but he doesn't feel I have any other options. I asked if I can wait to have this done at the end of August and he said that I could wait for 10 years if I like it is not a life and death surgery which I totally understand. He said it is totally up to me and I just want to not be laid up the rest of the summer. My decision was made when he said I can go back to riding the Harley and snowmobiling. Not that I care so much about snowmobiling but if I couldn't get back on the bike I wouldn't have had the surgery until I couldn't move any more. I am going to talk to HR today as I have to tell them no matter what because of FMLA and disability and tell her if she believe she needs to tell the hiring manager out of courtesy that would be fine. I have a meeting with her at 3:30 today so we will see what happens. You are giving me much open as far as your surgery working. I am just wanting the pain in my butt, leg and foot to go away! If I don't talk to you soon have a Happy 4th of July!

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on 07/01/2010 9:58am

I wish you lots of luck, there is no telling if the surgery will work lets keep our fingers crossed but when the choices are : countine to live with this severe pain which is not living or do the surgery which offers a possibility of getting our life back....I know for me surgery was it and I am so glad I did because the pain is different much less and leg, butt and foot pain is GONE now its just knowing I am and will be getting better I see a light at the end of the tunnel. You will see and soon be on that Harley. Please keep in touch and let me know how things go, any ?'s just ask. Happy 4th

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on 07/01/2010 10:12pm

Good luck to you all... mine hasn't worked but I am getting ready to do it again soon to try and get some relief from the sciatica which is much worse now - 9 months after the surgery.

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on 11/01/2010 2:44pm

I had fusion lumbar L4L5 surgery in 09/2010, so far the result has been great no more hip and left leg pain. I have however experienced some right leg/foot pain which I was told by the PA was normal during the healing process, I was wondering and no definitive answer was provided to me. "Why" one moment I would be pain free then suddenly I can hardly move again, sitting or walking for long periods of time certainly causes this however even when I am laying down this may occur, so activity is not always the cause. Has anyone else experienced the same ordeal and what was said about it by a medical practioner.

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on 11/01/2010 7:16pm

In 2006 I had L5-S1 Micridiscetomy with a Lumbar Laminectomy. I can honestly say I did very well until this past year, I had pain of course but it was managed very nicely with my PM Dr. I'd take 2 Percoset 10/325 daily and 2 Soma 350mg daily until this past Jan. My PM Dr. did an EMG and ENG which had horrible results so an MRI was next. My MRI shows a new hwerniation t L5-S1 with tons of scar tissue and 3 new heniations above that. My PM Dr. has tried several things to help manage my pain. Lyrica blew me up like a balloon with the 1st pill (no more of that), Elavil broke me out in a rash, and Neurontin has NOT helped at all, so he has increased my Percoset to 4 times a day and Soma 350 3 times a day. Sure I still have pain but its managable for the most part. I see my Neurourgeon next week and I am VERY anxious to see what he has to say about my presaent mess I find myself in. Am I facing more back surgery.... guess its a wait to see him thing. Maybe I just need a new back. Good Luck with your appt tomorrow and everyone else here with similiar issues.

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on 11/04/2010 8:08am

prissy, I had l4-l5 lumbar fusion due to a slipped vertabrae(spelling?) this was in 08, I had little relief but enough that I could grin and bear it. My pain prior to surgery was unliveable, it hurt to walk, stand, sit, lay down. Since surgery, I have gotten worse, I cant stand completely straight, , I cant sit or stand for too long and I seem to be favoring my left side. I have a limp and zero mobility on my left, cant put on a sock or shoe or shave my leg, I just cant reach and if I try its immense pain. The pain in my back is higher than it was before, so Im assuming that the above disc or vertabrae has benn damaged (this is warned about with having lumbar fusion) Im only 46 and am now a grandmother of twins, it hurts to carry them and Im so cik about this pain! I am having a ct to verify what I believe I already know is the problem, I dont want another surgery but cant keep going with life like this so I will try. I will look into the spine institute, Ive seen ads about them doing a less evasive surgery that works...anyone else out there that has had spinal fusion surgery and hasnt gotten better Id love to hear from you on what you did or are doing? thanks, and to all the back and pain sufferers, may God bless you and keep you. Heidi in Florida

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on 11/10/2010 4:08am

I cracked vertebrae and broke peticle bones and started with a L4-5 cage fusion, this did not stabilize the spine over a two year period. I had my last surgery in 2000 a L4-5tos-1 plates and screws fusion. I was 27 when this happened so i am 40 now. Have any of you tried Neurontin,gabapentin, or lyrica? I take Norco and neurontin and ambien when I can't sleep. Neurontin and gabapentin and lyrica were used primarily for epilepsy and other neuro related difficulties. the side effect is that it calms nerve pain and becomes a secondary sodium receptor blocker. This causes the nerve endings and the synapses not to transmit the pain the same way as we normally feel it. Without these meds I could not function in a normal capacity. Talk to your doctor, make an appointment before your meds run out. I have been fortunate, I use a naturopath who prescibes the pain meds and does some in office manipulation, and my pcp takes care of my insomnia needs. My pcp and me have been together for 22 years and i have experienced insomnia for about 20 years. I function day to day and can golf and walk, the DR ruled out skydiving,which sucks because it is on my bucket list! Good luck to all of you, depression,anger,anxiety,these can find you very easily,pray alot, hug everybody you care about when you see them, don't be afraid to say I love you.

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on 11/11/2010 8:02am

Angelbrknwing
I had Fusion in March of last year. I too had/have many of the issues that you experience. I knew when I woke up from the surgery that things weren't right. The numbness was there but much much worse. When I walked my left foot was turning out. Now almost two years later, I am in so much pain it is unbearable. I have to wear socks all of the time because I now have RSD. I have to have my husband put my shoes and socks on and a lot of times, he has to help put my pants on because I can't. I am having worse bladder (leakage) issues than ever before. I continue to go to pain management and I go for a new CT scan soon. It now looks as though the levels above the fusion have gone. I don't think that another surgery for me is going to happen. I don't know how I am going to to not do it. Yet I am afraid that if I do that I will end of paralyzed or worse... I contacted the laser spine institute and was told over the phone that I probably wouldn't be a candidate because of the hardware. I may check back into it at a later point. (I am just not so sure.) Pain Management says I will be on meds the rest of my life... Just what I wanted to hear. Good luck

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on 11/11/2010 8:55am

Dana,
Oh my goodness. I didnt even mention my bladder problems getting worse or the fact that I am limping so bad, but that my foot is turning out to the left, I practically walk sideways! Our hardware can be removed, I wonder if then the spine institute would be any help? Wonder what is causing the left side to act that way? It is so, I dare say nice, to talk to someone in my shoes, albiet it is horrible for both of us, all of us! I just want to walk, stand, sit and carry my grandbabies without pain, I pray God can help us make it through the rough days, as I have learned to really enjoy and appreciate the "good days" as they are far and few inbetween. thanks for sharing! Heidi

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on 11/23/2010 7:51pm

I am responding to you who have developed pain causing the inability to walk. Is this occuring after surgery is it associated with extreme leg weakness as well. Before my surgery in Sept, 2010 my pain was predominantly on the left side from my hip/lower back down to my foot. I began rehab one month ago, now more frequently I have had pain in both feet and knees and still severe leg weakness. Has this been an issue with anyone after surgery if so did get better after time or worse. Thank you for your feedback and god bless everyone experiencing this.

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on 11/24/2010 8:06pm

i was so happy when I found this discussion form. I am 1 week out from L4 L5 fusion surgery. I have suffered for about 3yrs now had 2 epidurals also theropy used tens unit tried almost everything I believe because I did"t even want to think about surgery. I finally gave in I was in so much pain and it was effecting my quality of life. oh my goodness this after surgery pain it crazy.
I know it will take time, but my legs are still giving me alots of pain, is that normal.Thanks and any feed back would appreciated.sorry for any mis spells.

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on 11/30/2010 10:22pm

I am 3wks out from having plif, I am having terrible pain in my legs post op my doctor said give it time. I knew I would have post op pain.I am having that but my leg pain seems like same pain as pre op but worse. Is this normal???

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on 12/02/2010 12:34pm

Hi - I know this is a few months too late, but I just joined and read your post. I'm wondering what you ended up doing and how it is working out for you? Did you do the discography? It was horrible for me....but quick.

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on 12/03/2010 12:39pm

I'm feel for all of you who are still in such terrible pain! I've been there. I'm so sorry! I'm 47 and I've had 3 herniated disks (L3-S!) for over 20 years, but with occasional pain meds and exercise until 8 years ago it was managable. I had been on Vioxx for another problem and now we're assuming that the Vioxx was able to help with my back, too, though I didn't know it. It got progressively worse-now the pain was constant, worsening with activitiy, and pain was running down my leg (siatic) as well as searing pain as I walked that made me fall on the floor whereever I was. So l I was sent to Pain Management. With epidurals and other pain meds (Vicodin, Tramadol, Neurontin, and Lidoderm patches) the pain was manageable and I was able to keep working. This lasted about 4 years. About 6 months ago the medicine was not as effective and even after the epidural I was in pain. Having exhausted all my options and a decrease in my quality of life, I went to a neurosurgeon who recommended a 2 level fusion of L4-S1. I was shocked and scared, especially after reading all the surgical failures and all the pain. I went for a second opinion who concurred the first. While it took almost 6 weeks just for the authorization n for an MRI (I never thought of an MRI as a painful procedure until now!). After discussing the pros and cons with my Primary doctor and my family, I decided to go ahead with the surgery. I have never been so scared in my life, but I had to believe in my heart that this surgery would work. At this point my life was crappy-I was short tempered and was unable to perform my job anymore.

I had the surgery on 11/24/10. I was in the RECOVERY ROOM and while in a lot of pain in my back, it was localized to my back again. The surgeon had decompressed all the pinched nerves! Only you guys who have had the terrible siatic (sp) pain know what kind of reflief we hope for. I was amazed and SO relieved!!!

The first few days were VERY tough, I won't lie. But the pain WAS RELIEVED BY PAIN MEDS to the point where I could hold a conversation!

I was out of the hospital in 4 days and now home 6 (a little over a week post op) and I feel pretty GREAT! My pain is managed with pain meds and down to a whisper as long as I don't do too much. I'm walking with a walker around the house. While I can't go upstairs just yet, the visiting nurse says the incision looks really good and she is surprised at how well I'm doing. They're sending physical therapy here next week already. I'M SO GLAD I HAD THE SURGERY!!!

I do have to say that the neurosurgeon claimed that her success rate was very high (80%-90%) because she was very picky about the candidates she chooses for spinal fusion/decompression. She chooses nonsmokers, patients who rarely drink alcohol, patients whose lives are fairly active, and who are a reasonably good weight.

It's a very difficult decision to make. But if you make it, you have to believe with all your heart that it will work. Positive thinking does wonders!

I hope that at some point everyone finds a solution to their problem, whatever that is, and all of you find pain relief.

Good luck to everyone out there!

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on 12/10/2010 11:31am

I am scheduled for L4-5 fusion on Dec. 21, merry christmas to me! I had a fusion at L5-S1 back in Jan of 2008 and did pretty well until april of this year. I have left leg pain but numbness in my right foot. I am exhausted all the time and in pain 24/7. I've been off work since the end of Sept. tried different injections through pain mgmt, did therapy and nothing worked. I'm taking percocet, neurontin, zanaflex and tylenol pm every day but it just takes the edge off. I'm hoping this surgery helps and lasts more than 3 yrs. I'm only 37 but I feel like I'm 80. I also have MS but am doing well managing my symptoms. Has anyone had multiple fusion surgeries with success? I'm always reading the bad outcomes but I really feel like I have no other choice if I want to attempt to get rid of this pain?

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on 12/10/2010 3:12pm

Mj2762: I'm so sorry pain mgmt didn't work for you! Its very frustrating when you're in pain to put your hopes in something only to be disappointed. I have a friend who tried pain mgmt only to be disappointed, partly because the doctor's philosophy was to get a patient OFF pain meds when she had a disease which made her obviously in TERRIBLE pain! So sometimes you may have to interview different ones to find the doctor/ group that can help you the most.

I know how frustrating it is not being able to exercise the way you're used to. I had lost a bunch of weight by being more active and exercising; I was so proud of myself. I also noticed that I was having a harder and harder time being an active person until I finally had trouble even physically getting out of bed and walking without horrible pain. I had worked so hard to lose the weight! I was upset. I was lucky enough to have had a good pain mgmt doctor and that it was successful for about 4 yrs. But the last 6 months or so what had worked no longer worked, and I went through everything they could think of, so all the meds I was taking just like you were just taking the edge off. So I knew I had to do something.

The surgeon suggested spinal fusion I almost fell over. I researched it a lot including this site and I got really worried-all these posts about failures and pain being worse than before. That made my worry even worse. So I went for a second surgical opinion, but that surgeon concurred with the first. I asked about less invasive surgery or disk replacement, but both surgeons nixed those ideas. I was REALLY worried and anxious til a very good friend and my husband said to me that whether or not I choose the surgery I HAD TO BELIEVE IN IT with all my heart. So I did.

I'm 16 days post op today. I believe my surgery was a success so far. I believe part of the reason the majority of the posts are so negative is because the patients whose surgeries were successful are NOT posting but concentrating on their recovery and living their lives. No one can tell you what to do. Everyone has their opinion about whether you should have surgery. But I can tell you how I made my decision. 1). Have I tried everything else to try and get relief? 2). Can I believe in my gut that this surgery will be successful and willing to do everything I had to do to get better? 3). Can I live with the pain as it is now and what is my quality of life now and in the future if I don't have it done?

Whatever you decide, good luck!

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