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2 docotrs with extremely different opinions, confused!!!

Started by soconfused on 08/25/2010 12:16am

Hi! Quick background, I am 37 years old, had a laminectomy with disectomy in March 10 for herniated disc at l5/s1 after all conservative options had been exhausted. Had continuing pain in my hip/thigh area and low back after surgery but was told that was normal. Started physical therapy approx. 6 wks post op, and pain became unbearable to the point of being laid up entire days even with pain meds. Had new MRI in late June which now shows herniations at l3/4, l4/5, and l5/s1. Went for a second opinion because I didnt have much faith in the Dr that did the surgery after seeing those MRI results and finding out that he put in for authorization for a second surgery without even discussing it with me. Any ways I go to the 2nd Dr and he says, there are no herniations (MRI report states 3 levels are herniated) and that anyone who tells me they can tell me whats causing my pain is lying but that a discogram (sp?) may pin point the pain but unless I want to have a disc removal with fusion there is no point in doing the discogram and that my best best at living a normal life at this point is to get off pain meds, and do 35-45 min a day of aerobic excercise. He also said I could go about doing anything I want without any risk of further damage including lifiting up to 40 lbs.
Needless to say I left his office with my head spinning, how could 1 doctor be recommending a 2nd surgery and tell me I can do no activity (which I am in no way sold on doing) and they other say to just go about my life as normal. I am in so much pain I can barely walk the grocery store, and when I do I come home and have to lay down and thats with the pain meds. Can anyone give me any advice on how 2 doctors could see things so differently? Also have any of you had a doctor tell you, its fine to just live normally, lift normally etc and that your not risking doing any additional damage...how is that possible, something caused the damage to begin with right? Thank you in advance for any help you can give!

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HI, Im not sure what you have tried but I can tell you what helped me. I have over 20 years in the Marine Corps and have had back problem for most. About 5 years ago I started having problems with my siatic nerve, it came out to be I had a bulgin disc that was pushing against the nerve. They did physical therapy but did not work. I dealt with pain for the past 5 years. Finally I saw the commercial for the product Back To Life. It is a machine that streches the spine, come to find out it does the same thing Chyropractors do with their machines. I bought this product because it has a 30 day guarentee to work or money back. I used it and for the first time in 5 years my problem with the bulging disc pinching my siatic nerve is gone and I am pain free when it comes to that part of my back. Now I still have back problems because of 20+ years in the Marine Corps and I will probably always have them.

I'm not sure if this will work for you but Hell.. if tit dont work sned it back for refund that was my attitude however it worked for me and I still use it today for soreness and it does help. I believe the only real way you will ever be able to get healed completely is to become a profesional athelete then you can fixed. Just Kidding.. well I hope this helped.

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I would see a physical medicine and rehabilitation doctor, a physiatrist they call them. They do not do surgery, and deal with these kinds of things. If you need surgery, they will make a referral. If they can help you with exercise, PT, injections, etc, they can do all those things. Thats what I would do. YOu need some answers. Sometimes doctors get blinders on. For example, a surgeon sees everything from a surgical point of view. A doctor who does injections thinks everything can be fixed with steroid injections. Thats how 2 doctors can have two opinions 180 degrees apart from one another. Just get your records, and go to the phsyical medicine doctor. Here is the board that certifies them, you can get info and maybe some names in your city.
http://www.aapmr.org/

Good luck. Let me know how it works out.

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soconfused,

Mtsatz100, in my opinion, is correct. You need to find a Dr with a whole new outlook to get a good opinion. Good luck!

MF1989

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Hi,
I just left a second doctor today and each gave different ideas about how to proceed with my l 2-3 herniation and l3-4spur complex. I have bad ddd too. One said surgery for sure because he fears nerve damage in my leg. The other said wait and continue with water therapy. It may decrease inflammation. Then call me in a couple of months if no improvement.this doc saw no urgency in decompressing the nerves.
So my advice is to get a 3rd opinion. That is what I will do. Also, Everyones pain level and quality of life issues differ. You know when you can't stand it anymore.trust your gut. If something doesn't seem to make sense, ask the doctor again. If you don,t get a satisfactory response, don't go back.
Blessings

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Oreo, sometimes waiting on surgery is the wrong thing to do. There is cauda equina syndrome. The cord in the low back splits up like a horses tale which translates to horse hairs or horse tale or simlar. Anyway if these get pressure on them they can cause permanent damage. I know if loss of continence or bowels is considered a surgical emergency but you dont want a surgical emergency. You want to do it before it gets to that point. I guess what I would say is make sure you see a board certified spinal neurosurgeon (they all are trained in spinal surgery but some focus on that, others on brain tumors or skull base surgery etc). Or, make sure you see a bd. certified or bd. eligible spine ortho (or neuro) surgeon. The orthopedic spine surgery is a relatvely new subspeciality. They have done fellowships with training only on spine surgery and that is all they do. No knee surgery etc. I dont know what city you live in, but if a relatvely small one, it might behoove you to visit someone in a larger city. Most neurosurgeons require films/records before they will make an appt for you, so perhaps someone would be willing to review this with you on the phone and at least tell you if it is urgent or can wait to do the water therapy. That would be my only concern if it were me. GOod luck.

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Mtsaz,

Thanks for your response. I did see a neurosurgeon who wanted to do surgery because of nerve damage, possibly leading to loss in leg function. The other was a fellowship trained spine orthopedist who said to wait. I was frustrated in the two very different opinions. And they differed on the technique. Neurosurgeon would do minimally invasive discectomy and decompression with no fusion. The Ortho, if he decided it was time to operate, would fuse l 3-4 in addition.I am going to seek out a 3 rd neurosurgeon opinion. Part of me doesn't want to chance nerve damage. I have had this same issue last January. It seems it is increasing in frequency. The degenerative disc disease won't ever get better.
Thanks!
Thanks!

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I would do what the neurosurgeon says to do. I have never had one say I needed surgery when I didn't. They are usually very very busy and are not looking for patients. Secondly, the minimally invasive is much better than a huge surgery. Who knows, it might solve your problem. If not, you can always wait or go on to the more involved procedure. If you can get in to ssee neuro #2, then go for it, but if its a long wait, I would just proceed. Thats what I would do anyway. Good luck.

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