Tuesday, September 3, 2013

Aw, crap - disc re-herniation...and other fun news

I've been avoiding this topic for a while because, well, I figured there's not a lot to done about it.

I had a bilateral L5-S1 discectomy in January; it brought me great relief from severe sciatica pain. Instantly. Over the last 8 months the normal post-op numbness had been retreating down my left leg to just above my left foot; there was a chance that my ankle and foot would remain numb because of damaged nerves. That was fine.

But over the last month, my left leg  started to go numb, the sensation creeping back up my leg to just above my left knee. My leg was also markedly weaker again. I was afraid that I had somehow re-herniated my disc (though I am careful about lifting heavy objects) so I went to my surgeon and he had an MRI done.

Got my results today and it was a bit surprising -- I have re-herniated, but on my RIGHT side:

There's a lot of technical jargon up there, but essentially, the surgeon explained that the probably cause of the symptoms on the left side is from the general degeneration of the disc, or as he said "it's probably shot -- fragmented and compressing/collapsing." The only solution for this is fusion.
Lumbar spinal fusion is a type of back surgery in which a bone graft is inserted in the spine so that the bones in a painful segment of the spine fuse together. The fusion aims to stop the motion at a vertebral segment, which should decrease the pain caused by the joint. After the surgery it will take several months (usually 3 to 6, but sometimes up to 18 months) before the fusion is set-up. This surgery has been improved over the last 10 to 15 years, allowing for better success rates, and shorter hospital stays and recovery time.
Right side, reherniated (the bubble you see see).
Another view -- I may not feel pain on the right because the prior surgery created space, relieving pressure (white space).
I'm not in what I consider acute pain, just a lot of numbness and general discomfort. My leg drags a bit. The surgeon and I agreed that it's not time for surgery. Walking long distances for exercise has become painful again, recovery from the pain inflicted from impact is draining.

From the left side, the murky area full of scar tissue;
notice the compression in that disc vs. healthier 
one above.
Well, in my case even if I did want to have surgery I couldn't -- I don't have enough FMLA to cover the recovery time. Yes, that's right. I have to work with a herniated disc until it becomes an emergency situation, as it did for me back in August. 2012. He said it's hard to get Blue Cross/Blue Shield to approve a fusion otherwise anyway.

Regarding the issue of the herniation on the right side, it makes no sense to operate unless there is acute pain involved, and there is not --  I'm asymptomic on the right side, save the neuropathy that pre-dates the spine injury.

So my options from his POV are PT, pain medications and/or epidural steroid injections, until the disc degenerates enough to require surgery. I'm going to tough it out with Aleve and occasional pain meds I use for my RA.

Not sure how this will affect my travel (I have a couple of upcoming trips and they will do me in re: my RA anyway; nothing like wondering if you're going to re-herniate yourself into the ER. But I cannot live trapped by the "what ifs".

* Back to work...butthurt begins in the chair
* Cleared to go back to work!
* Working my way back to trek across the Brooklyn Bridge for my big 5-0
* Milestone: tanking up...and a good day for PT walking (finally)
* RA rears up and says "don't forget about me."
* Can put on jeans again!
* Not so fast, young lady...your back is still f'd up
* Post-surgery update: tail end of flu; may need another MRI
Week 3 post-spine surgery, week 2 of the flu
Week 2 post-L5-S1 slice and dice: good news, not so good news
News on life after the L5-S1 slice and dice

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