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It was good to hear that you are happy with your surgery
I am trying to figure out the best path for me. Almost everyone seems to have waited to have surgery until their pain was out of control but never mention their diagnosis. I have a bad herniated disc (L5-S1 is out 2.0 cm at the base and extending posteriorly approx. 8mm) and thus far have not been in major pain except when I try to walk; I have pain running down the left leg which turns to numbness in two blocks. My concern is that at some point I will suddenly be put into great pain. The doctors I have spoken to so far can not believe I am not in more pain.

I have been through approx. 30 sessions of decompression therapy and followed up with another MRI which showed no improvement. It seems like microdisectomy is the only answer from what I have learned on the internet.

Are their any other alternatives that anyone would suggest? How do you get an unbiased opinion? If you go to a surgeon it seems to me they will only suggest surgery just like the chiropractor thinks he/she can work miracles. Any help is appreciated!
Hi kbworm,

[I]Did it get steadily worse, or getter better, then worse intermittently? [/I]

[COLOR="Blue"]It got steadily worse, but I had “good” days followed by “bad” days. My “good” days were never that good – I wouldn’t be able to stand up or walk without discomfort. On the “bad” days, I wouldn’t be able to lie down without pain and I was lucky to get 5 hours of uninterrupted sleep because I’d wake up in pain. I never had the feeling like I was making any progress, as the “good” days would only last a day or so, and from week-to-week my symptoms were generally the same.
[/COLOR]

[I]Just when I think I can't stand one more minute of pain, it goes away for a bit, or back down to a level 1-2 pain for a day. I think part of the problem is that I have this trainer (Olympic long jumper) whos says she had the same injury as me and fixed it with excercise and releasing the psoas muscle. She does this by pressing on my stomach muscles very hard while I try to contract the muscle and then immediately release it. At first this seemed to aleve the pain, but now I'm not so sure. She began having me do side bends with 45 lb weights. This too released the pain right after doing it, but I've been so up and down with pain, I'm wondering if this does more harm than good. I'm sure you know, you'll just about do anything to get rid of the pain.
[/I]

[COLOR="Blue"]I would try a wide variety of exercises. Have you tried back extensions where you lie on your stomach and prop yourself up on your elbows? This exercise is supposed to help with herniated discs but it did not help me. Some people have success with this exercise in alleviating sciatica. If you google “exercise for sciatica from a herniated disc” you will find some suggested exercises you can easily do at home. I also had a therapist work my psoas muscle (it’s a little weird) but it did no help me. Side bends with 45 pound weights sounds a little aggressive, but if it helped relieve the pain, even temporarily, that’s probably a good sign. Physical therapy did nothing for me. I had a trainer that tried to help me with specific exercises and stretching but that didn’t help either!
[/COLOR]

[I]I am meeting with a neurosurgeon December 09th. If anything, I'll at least get an idea of what options I have if I need to go that route. Did they recommend the injections to you before surgery? What do you think of that? I leave for a family wedding in South Africa December 22-January 13. This involves 24 hours of flying. Ugh. I though maybe I should get the injection before I go if I'm not much better before then. Just in case the pain is horrific. Of course, I'll stretch and things on the plane.
[/I]

[COLOR="Blue"]An orthopedic surgeon recommended the epidural injections, and I had three of them. The first shot helped a little bit but the next two did nothing at all. I would not recommend them. I’ve never heard anyone that’s had the injections say much positive about them. The third one hurt like hell during the procedure. Try to get an aisle seat for your flight and get up and walk around as much as possible!
[/COLOR]

[I]I will do the suregery when I get back in January if there is not marked improvement. Where do you live? I am in Los Angeles and was recommended to a Dr. Larry Khoo. I looked him up online and he seems pretty impressive. What kinds of research and questions did you ask your neurosurgeon?
[/I]

[COLOR="Blue"]I live in San Diego. I forget my surgeon’s name but I had the procedure performed at Thornton Hospital, which is a teaching hospital associated with UCSD (with an outstanding reputation). For all I know, the surgical resident who assisted with the surgery could have performed the majority of it. I didn’t even think to ask before the surgery if a resident might be performing all or part of the procedure. I don’t remember exactly what I asked the surgeon prior to the surgery. I do remember asking if he thought I could eventually resume running after the surgery and he answered with an unequivocal “yes”. I was mainly concerned with his opinion on whether or not he thought I should have the surgery and what kind of outcome I should expect. Ask your surgeon what the risks are if you [B]don't[/B] have surgery. Ask how many microdiscectomy surgeries your doctor has performed on people your age and level of fitness and what outcome you should expect.[/COLOR]

[I]I know! My dr. keeps asking if I'm taking the vicodan she gave me. Why the hell would I do that? Then I wouldn't know what was making the pain better or worse.
[/I]

[COLOR="Blue"]Taking Vicodin to manage pain for more than a few days is a horrible idea. It won’t work long term. You will develop a tolerance extremely quickly. I cannot take Vicodin more than twice a week without developing a tolerance that makes it useless. Even so, I would have to take 3-4 times the normal therapeutic dose for it to have any effect on the pain. If you are in extreme pain that will only last a day or so, then it might be useful. I can’t believe doctors prescribe it regularly to be used daily.

One more thing I would recommend is to try a variety of over-the-counter anti-inflammatories to see which, if any, works best for you. It took me months to discover that acetaminophen works better for me than any of the others if I take it daily. Of course, it’s better to avoid taking any drug long term but over-the-counter anti-inflammatories are a lot safer than painkillers.
[/COLOR]
[QUOTE=jsin;4631316]Hi kbworm,

[I]Did it get steadily worse, or getter better, then worse intermittently? [/I]

[COLOR="Blue"]It got steadily worse, but I had “good” days followed by “bad” days. My “good” days were never that good – I wouldn’t be able to stand up or walk without discomfort. On the “bad” days, I wouldn’t be able to lie down without pain and I was lucky to get 5 hours of uninterrupted sleep because I’d wake up in pain. I never had the feeling like I was making any progress, as the “good” days would only last a day or so, and from week-to-week my symptoms were generally the same.
[/COLOR]
[COLOR="Red"]I'm having a terrible terrible week. Tonight I want to die I'm in so much pain. I used to have days where I had long periods of no pain and a little 2 level pain. Haven't for about a week and it feels like someone' taken a sledgehammer to my right foot. I am lying on my side on the floor typing right now cause I can't sit. Even lying down hurts. Ice helps until it melts and then the pain is back. [/COLOR]

[I]Just when I think I can't stand one more minute of pain, it goes away for a bit, or back down to a level 1-2 pain for a day. I think part of the problem is that I have this trainer (Olympic long jumper) whos says she had the same injury as me and fixed it with excercise and releasing the psoas muscle. She does this by pressing on my stomach muscles very hard while I try to contract the muscle and then immediately release it. At first this seemed to aleve the pain, but now I'm not so sure. She began having me do side bends with 45 lb weights. This too released the pain right after doing it, but I've been so up and down with pain, I'm wondering if this does more harm than good. I'm sure you know, you'll just about do anything to get rid of the pain.
[/I]

[COLOR="Blue"]I would try a wide variety of exercises. Have you tried back extensions where you lie on your stomach and prop yourself up on your elbows?
[COLOR="Red"]I cannot tolerate extensions. It feels like a horrible pinching. and radiates sciatic pain down my leg. I have tried to do them anyway, just not coming up as high, but its still painful. Everyone says that's the only way to get the disc to slip back away from the nerve. That's why I even bother at all. [/COLOR]

This exercise is supposed to help with herniated discs but it did not help me. Some people have success with this exercise in alleviating sciatica. If you google “exercise for sciatica from a herniated disc” you will find some suggested exercises you can easily do at home. I also had a therapist work my psoas muscle (it’s a little weird) but it did no help me. Side bends with 45 pound weights sounds a little aggressive, but if it helped relieve the pain, even temporarily, that’s probably a good sign. Physical therapy did nothing for me. I had a trainer that tried to help me with specific exercises and stretching but that didn’t help either!
[/COLOR]
[COLOR="red"]the excercising used to alleviate the pain for me, but hasn't for a week. Someone said I should try decompression before surgery. did you try that?[/COLOR]


[I]I am meeting with a neurosurgeon December 09th. If anything, I'll at least get an idea of what options I have if I need to go that route. Did they recommend the injections to you before surgery? What do you think of that? I leave for a family wedding in South Africa December 22-January 13. This involves 24 hours of flying. Ugh. I though maybe I should get the injection before I go if I'm not much better before then. Just in case the pain is horrific. Of course, I'll stretch and things on the plane.
[/I]

[COLOR="Blue"]An orthopedic surgeon recommended the epidural injections, and I had three of them. The first shot helped a little bit but the next two did nothing at all. I would not recommend them. I’ve never heard anyone that’s had the injections say much positive about them. The third one hurt like hell during the procedure. Try to get an aisle seat for your flight and get up and walk around as much as possible!
[/COLOR]

[I]I will do the suregery when I get back in January if there is not marked improvement. Where do you live? I am in Los Angeles and was recommended to a Dr. Larry Khoo. I looked him up online and he seems pretty impressive. What kinds of research and questions did you ask your neurosurgeon?
[/I]

[COLOR="Blue"]I live in San Diego. I forget my surgeon’s name but I had the procedure performed at Thornton Hospital, which is a teaching hospital associated with UCSD (with an outstanding reputation). For all I know, the surgical resident who assisted with the surgery could have performed the majority of it. I didn’t even think to ask before the surgery if a resident might be performing all or part of the procedure. I don’t remember exactly what I asked the surgeon prior to the surgery. I do remember asking if he thought I could eventually resume running after the surgery and he answered with an unequivocal “yes”. I was mainly concerned with his opinion on whether or not he thought I should have the surgery and what kind of outcome I should expect. Ask your surgeon what the risks are if you [B]don't[/B] have surgery. Ask how many microdiscectomy surgeries your doctor has performed on people your age and level of fitness and what outcome you should expect.[/COLOR]
[COLOR="red"]All good advice :)[/COLOR]


[I]I know! My dr. keeps asking if I'm taking the vicodan she gave me. Why the hell would I do that? Then I wouldn't know what was making the pain better or worse.
[/I]

[COLOR="Blue"]Taking Vicodin to manage pain for more than a few days is a horrible idea. It won’t work long term. You will develop a tolerance extremely quickly. I cannot take Vicodin more than twice a week without developing a tolerance that makes it useless.
[COLOR="red"]Think I'm gonna have to break down tonight. In so much pain I cant stand it[/COLOR]
Even so, I would have to take 3-4 times the normal therapeutic dose for it to have any effect on the pain. If you are in extreme pain that will only last a day or so, then it might be useful. I can’t believe doctors prescribe it regularly to be used daily.

One more thing I would recommend is to try a variety of over-the-counter anti-inflammatories to see which, if any, works best for you.
[COLOR="red"]They gave me Naproxen 500's 2 x daily. Nothing cuts the pain at all. Today tried advil 800 milligrams 2 x and its not doing anything to help me.[/COLOR]
It took me months to discover that acetaminophen works better for me than any of the others if I take it daily. Of course, it’s better to avoid taking any drug long term but over-the-counter anti-inflammatories are a lot safer than painkillers.
[COLOR="red"]I'll try that tomorrow. My poor liver.[/COLOR]
[/COLOR][/QUOTE]





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