update: MRI, neurosurgeon, surgery

Discussions related to Sciatica and Leg Pain
cygnet
Posts: 42
Joined: Sun Dec 24, 2006 10:46 am

update: MRI, neurosurgeon, surgery

Post by cygnet » Wed Feb 07, 2007 8:01 pm

A lot has happened recently...had an MRi last week which showed a very
large L4/5 herniated disc. Then, I had an appointment with a
neurosurgeon on Tuesday. I went expecting to get injections and a
referral to physical therapy. When he examined me, the doctor
discovered that I had lost strength and function in the toes of my
left foot - I couldn't move them very well. He called it "foot drop".
I knew the sciatica was getting worse, but thought it was just in my
head. So now, surgery is not optional - it's necessary to prevent
permanent loss of function in my leg.

That was Tuesday, and then the surgery was scheduled for this Friday,
just three days later. It's all happened very quickly. I've never been
a hospital patient before. This will be my first time.

Wish me a speedy recovery and a successful outcome guys...

Once I am able, I will be diligent in doing the back exercises every day from here on out.

krd
Posts: 143
Joined: Thu Jun 30, 2005 11:41 am
Location: New Jersey

Good luck....

Post by krd » Thu Feb 08, 2007 6:56 am

Hey Cygnet

I am sorry to hear about your upcoming surgery. Good luck and hang in there. We will all be pulling for you and thinking of you. RYB does work, albeit slowly, however, it does beat the alternative.

I am sure that you will be in good hands with your surgeon.

Ken

Steven
Posts: 112
Joined: Sun Jun 05, 2005 10:00 pm

Post by Steven » Fri Feb 09, 2007 12:55 pm

Hi cygnet,

I've enjoyed your forum posts... especially the NY Times articles. Sorry to hear that you're going to need surgery after all. In some situations it is unavoidable and you just have to listen to your doctor. Like Dean says, if the nerve problems start to rapidly digress, then surgery is probably your only option.

Like Ken says, we'll all be pulling for you and anxiously waiting to hear how it turns out.

Steven

cygnet
Posts: 42
Joined: Sun Dec 24, 2006 10:46 am

Post by cygnet » Sat Feb 10, 2007 12:16 pm

I'm scheduled for surgery on Monday - in two days. Originally it was set for Friday, but the hospital didn't have enough staff available for the Friday date.

Before I saw the doctors, the nurse was there, asking me questions. I told her I was hoping to get injections and PT. She assured me that the doctors are very conservative in recommending surgery and always try to use conservative therapies whenever possible.

I really don't want to go through with it. It happened so fast. I saw the neurosurgeon on Tuesday, he reviewed my MRI and did diagnostic tests on my legs - and said that I have "partial foot drop" and should have surgery. The first doctor in the group, who did the first exam, asked his colleague to see me and do another exam. The colleague is the surgeon who would be doing my operation. His exam was the same - I have partial foot drop and need surgery. The Physicians assistant told me that it would not get better on it's own. The herniation is large.

The test that showed I have foot drop was to hold my big toe up, and resist when the doctor pushed down on it with his finger. I didn't have any strength in the toe to resist the pressure. I can still move my toes, and I can still walk on my heels and on the balls of my feet. I feel some numbness in my left foot, but it's not totally numb. The top of my foot over the ankle, and my toes feel slightly numb - the way it feels when you get novocaine at the dentist, and it has worn off halfway.

I've had bad sciatica for over nine weeks now, and haven't been able to walk or stand much. The pain has been unpredictable. On Monday through Wednesday this week, it was very bad, but yesterday and today it has been mild.

Has anyone here had these same symptoms and healed them without surgery?

I'm pretty scared to have to get surgery. I want to back out.

randolph
Posts: 429
Joined: Thu Oct 27, 2005 12:05 pm
Location: Wilkesboro NC

Post by randolph » Sun Feb 11, 2007 7:43 am

Hi Cygnet

What you are going thru sounds very, very similar to what I went thru in April '06. Same symptoms: loss of strength in that big toe, numbness in the toes and other places in the leg/foot, large disc herniation L4-L5 revealed by MRI.

The osteopathic surgeon and nurse that were scheduled to operate on me were also very patient and didn't use any intimidation. They repeated their belief that things wouldn't get better for me without surgery, and how they also conservatively recommended surgery.

Things got better for me without surgery. I cancelled my appointed for microdiscectomy surgery 2 days before it was scheduled, mostly because I was very uncomfortable with going thru with it.

I personally think your OD is well intentioned, but trained for a bias toward advocating surgery.

If I'm reading you right (BIG if), I was in the same position you are in, (and VERY scared), and opted out of surgery. So with those caveats, yes, I had your symptoms, and yes, I recovered without surgery.

If you'd like to talk about this, give me a call 336.902.4299, or e-mail.

Randolph

cygnet
Posts: 42
Joined: Sun Dec 24, 2006 10:46 am

Post by cygnet » Sun Feb 11, 2007 7:53 am

Randolph,

I will give you a call today (Sunday). I have just 24 hours before I have to go in...


cygnet (Leigh)

cygnet
Posts: 42
Joined: Sun Dec 24, 2006 10:46 am

Post by cygnet » Sun Feb 11, 2007 8:50 pm

Update:

Surgery has been postponed for now. Although it was Sunday, I called the doctor's office, and found that they did have an answering service. My surgeon happened to be the doctor on call - so I was able to leave a message for him saying that I had a few questions before the surgery tomorrow. He returned my call, and I was able to ask him this:

Q: Is this surgery urgent, or would it be reasonable to wait a while and try conservative treatment such as injections and physical therapy?

A: We scheduled you quickly for surgery because you were in so much pain (I was) but if you are feeling better, it would be fine to wait a while and see how it goes. Your pain may return when you become more active, or may not. When you feel you need surgery, give us a call. (He also mentioned that they have a pain specialist who does injections, but I will wait on that and do it only if the pain comes back).

Q: You diagnosed me with "partial foot drop" and I also have some numbness does that mean that surgery is required and should be done quickly to avoid serious neurological damage?

A: If the foot drop progresses - becomes worse - you'll probably want to get surgery to prevent it from becoming permanent. Can you walk on your heels and toes (A: yes), then you can wait and see if it improves on its own.

Q: Can the numbness and partial foot drop heal on their own? Can herniated discs?

A: Sometimes disc herniations do heal on their own. The numbness will go away eventually, will take a month. The foot drop may go away or may not.

Those were the main questions I asked. The doctor, when I was finally able to talk with him, was informative. I cancelled the surgery and am waiting to see how it goes for now. Because I do have weakness in my toes on the left side, I am going to try to check in with my doctor weekly to monitor my condition.

Avoiding surgery isn't guaranteed for me, but I will not do it until it's either absolutely necessary to prevent permanent damage, or as a last resort.

The surgery was originally scheduled for Friday, but the hospital was understaffed, and they moved it to Monday. If it had been Friday, I'd probably be post-op by now. Also, I was in really severe pain just last week - Monday, Tuesday and Wednesday. But Thursday was better, and Friday, Saturday and Sunday I've been virtually free of sciatic pain. I have no idea why. If my pain had been severe straight through, I may have gone ahead with the surgery. Although I generally don't think like this, today I've thought that maybe I do have a guardian angel.

I've been staying at a relative's house for three weeks. My stepmother. It's been hard on her with all the pain I've been in, and the surgery and insurance dramas. When I cancelled surgery today, she was quite upset with me. She told me I have to take the train back to the city tomorrow. Not what I'd hoped to do, but I'll manage. I wanted to stay with her rather than be alone in my apartment. She said that my problem will come back and I will eventually need surgery, and when I do, I cannot stay here next time. She really lost it. I hope she isn't right about surgery.

I've always been independent and have never had a serious health problem before. The past two months have completely changed my perspective on life. You realize that stuff can just happen, out of the blue, that turns your life upside down and wreck your plans. Even people who (like me) are healthy and youngish and active, can be completely vulnerable and dependent on others for help when a crisis like this happens.

This back stuff can make you and people around you crazy. I feel like I've been to hell and...well I won't say I'm back yet, but I'm hoping for things to start on the upswing soon.

Today and for the past three days, I haven't had sciatic pain - for the first time in nine weeks.

Randolph and Dean, thank you very very much for your input. Your feedback along with other friends who were concerned about my rush into surgery helped immensely.

It's been an exhausting day. I'll post another update on my situation soon.

randolph
Posts: 429
Joined: Thu Oct 27, 2005 12:05 pm
Location: Wilkesboro NC

Post by randolph » Mon Feb 12, 2007 6:56 am

I admire your courageous decision, Leigh, to think clearly about your scheduled surgery, in spite of the lack of support from your stepmother, and regret that you've had to go thru that painful family drama in addition to the sciatic pain and disability.

Thankfully, your OD was cooperative and informative. Thanks for sharing your questions and his responses. Very good to read that it will be OK to postpone surgery and give PT another try.

Also being a usually independent sort, I can relate to your discomfort of being in a position of needing help, and grappling with the crazy stuff that comes up in others when you communicated that need. For whatever it's worth ... call anytime on my dime. But by all means, thanks for your latest post and continue to keep us informed here. Hugs would be better right now (imagine how nice it would be to be able to send them electronically :D )... but, I'm sure, we'll do what what we can.

Randolph

Steven
Posts: 112
Joined: Sun Jun 05, 2005 10:00 pm

Post by Steven » Tue Feb 13, 2007 9:50 am

Hi cygnet,

I am glad you decided to postpone the surgery. I'm sorry that your step mom wasn't more supportive of your decision. In time, she will realize that you made the right choice and will be happy that you didn't go under the knife.

The most important thing is that your surgeon was agreeable to this plan of action. That alone should give you the peace of mind to know that you made the right decision. If the surgeon had been dead set against it, that would be reason for concern. But since he is on board with it, I think you made a wise choice.

Keep us posted on how things are going.

Steven

krd
Posts: 143
Joined: Thu Jun 30, 2005 11:41 am
Location: New Jersey

Ditto that....

Post by krd » Tue Feb 13, 2007 12:37 pm

Hey Cygnet

I too am glad that you held off on the surgery. We all know that the pain and discomfort will make us do anything. I opted for the epidurals just to appease my family. I was going to try to "tough" it out, but I couldn't even get out of bed for 7 weeks.

The epidurals were amazing for me and I am now completely pain free and active again. Remember, this forum is always there for support when you need it most. I know this for sure. There are good people here who are completely concerned about your situation.

Your family, in time, will also be supportive. Remember, it is as tough on them as it is for us. They have to watch us move around in pain, and not be the social people that we were. Don't be too hard on her. Keep us posted.

Ken

Dean
Site Admin
Posts: 329
Joined: Mon Jun 06, 2005 7:13 am

Post by Dean » Tue Feb 27, 2007 9:48 pm

Hey Cygnet,

How are things going? Are you making progress? Any news... good, bad or otherwise? We're all thinking about you and hoping that you're hanging in there.

You don't have to go through this alone. We're here for you.

Dean

kshum88
Posts: 11
Joined: Mon Feb 26, 2007 6:25 pm

Post by kshum88 » Thu Mar 01, 2007 1:11 pm

Ken,

During your Epidural Injections period, did you continue to do the exercises on Dean's book? or did you totally stop and wait after the steroid work their way? I am getting my third Epidural injection tomorrow and wondering if I should stop the exercise for awhile or not.

By the way, how is the inversion table been helping you? Do you think it is effective in the long run? I brought one and have been using it for two weeks now. It is comfortable while I am at it but I am not sure if it is been helping me or the exercise or the Epidural Injection.

Kevin

krd
Posts: 143
Joined: Thu Jun 30, 2005 11:41 am
Location: New Jersey

Epidural

Post by krd » Fri Mar 02, 2007 4:44 pm

Hi Kevin

I was told to wait 10 days after the injections before doing any exercises. By the way, I just was out to dinner with my PT and his wife to thank him for all that he did for me, and he told me that the first day that I walked into his office, he did not think that he would be able to help me. He then said that it is a good thing that I worked through the pain and continued to do the exercises on my own. He was impressed by how well I am feeling and standing. It has been a long road.

The inversion table is nothing more than a good stretch. I feel comfortble on it and it does not create any pain. I use it about 3 times a week.

Ken

cygnet
Posts: 42
Joined: Sun Dec 24, 2006 10:46 am

Post by cygnet » Sun Mar 04, 2007 11:18 pm

Hi everybody! - Dean, Randolph, Ken, Steve, Kevin...

I haven't posted in a while because I've just been in "wait and see" mode. It's now been three weeks without pain, which is great. The day after I returned to NY, I noticed an increase in muscle weakness. That was February 13th. I figured some of it was from the exertion of traveling and schlepping my luggage up to the third floor apartment.

That was true, somewhat, but from Feb 13th on I noticed my left calf and glute muscles were REALLY weak - and it was making me walk with a limp, even though the pain was gone.

So, no pain but I do have muscle weakness - what does it mean? What to do?

I went back to the osteopath doctor (not a surgeon) to see what he advised. He said it was 50/50 whether I needed surgery or not. Not too helpful.

So, to get another opinion, last week I went to a physiatrist who is part of an orthopedic group. He said that surgery only stops the weakness from getting worse, but doesn't reverse the muscle weakness (nerve damage) that has already occurred. He said that if it gets worse, I should get surgery, but if not, it's not necessary. He also said that the muscles will regain strength if I do PT and exercise. Nerve recovery is slow, and there are no guarantees. He said three months from now I'll have more function, and that I should expect improvement to happen gradually over a year.

The interesting thing was, he told me that 20 years ago, he had a herniated disc that caused foot drop - he couldn't lift his foot up at all. He didn't get surgery, and he eventually regained the function in his foot and leg. I think he said it took a year to heal all the way. He said the muscle definition in his bad leg never returned 100%, although it works fine.

Both the osteopath and the physiatrist quoted that study that showed that the outcomes were identical for surgical vs. non-surgical treatment of disc herniations at the 3 and 5 year follow-ups.

So my plan now is to keep a close watch on the symptoms over this month, and to work on strengthening the muscles. This week I noticed some improvement in my leg muscles, although the calf is still weak. If things get noticeably worse, I'll go ahead with a microdiscectomy. Hopefully that won't happen.

I'm doing the RYB stretching exercises every day - especially the cat stretch, hip shrug, the side bends, and the cobra. This week I'm starting on the second stage of exercises.

I also bought a resistance band to use with my foot to build up the strength in my calf muscle.

And finally, since I lost my job when the back problem started, I've been able to avoid sitting at a desk for 8 hours a day. I decided to wait until April before going back to that kind of work environment. I have an interview for a teaching job this month which would be better for my back, and much more fun than an office job. Maybe that will work out.

Well, srry to go on so long, again - but that's the whole story so far. I'll keep posting with updates on my progress. :)

Leigh

Dean
Site Admin
Posts: 329
Joined: Mon Jun 06, 2005 7:13 am

Post by Dean » Mon Mar 05, 2007 12:20 pm

Hi Leigh,

Thanks for the update. I've been wondering how things went with the move back to your apartment and everything. I hope this teaching job (or something similar) will come through for you.

The resistance bands are a good idea. I think it's important to try and maintain as much muscle tone as possible while the nerve heals.

Keep us posted, even if it's just to say, "Hi, I'm still here..." :)

Dean

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