Wednesday, August 8, 2012

My Back Surgery (L4-5 Discectomy)

I haven't been much of a blogger lately. The few of you who know me and actually follow this blog will be shocked to see a post. But I am really writing this post for people I don't know, specifically for people who are having sciatic nerve pain and considering back surgery. When I was in this position, I scoured the internet for other people's experiences with back surgery. Most of the anecdotal reports that I found were horror stories. But every real-life person I talked to had a good story. So I am putting my good story on the internet, in the hopes that maybe a few people searching for answers will find some comfort in my experience.

I am 33 years old, and my back surgery (L4-5 discectomy) was over 3 months ago. My surgeon was Dr. Lynn Gaufin, and he did a perfect job. I knew my nerve pain was completely gone from the moment I woke up from surgery, because I could lie flat on my back without my legs going numb. It was amazing. I did a couple of months of rehab physical therapy, and while I still have occasional lower back pain, and my back is still really stiff and achy in the mornings, I am almost back to my normal activity level. I am so much better than I was before surgery. I know that the next few years are still crucial to determining the total "success" of my back surgery (because there is the possibility of a re-herniation), but for now I am calling it a success.

I am not advocating back surgery for everyone. Most back pain will resolve itself in about 6 weeks. And many people have herniated disks with few or no symptoms. So just because you are having back pain, or just because your MRI shows a herniated disk, does not mean you need surgery. However, I am convinced it was ultimately the best solution for me. Here's where I get super detailed and long-winded, so don't feel bad if you're too bored to go on. I'm hoping the details might help someone in a similar situation to mine.

My problems began in October of last year, as a sharp pain in my lower back, particularly when I bent to lift my 12-month-old baby out of his crib. I had had this sort of pain before, and it usually resolved itself in a week or two. But after a newborn photoshoot I did one day, I found myself unable to stand straight. The next few days were a blur of pain. I discovered that if I could force my body straight (a nauseatingly painful process), the pain would be nearly gone while I stood on my feet. Sitting down brought on sharp pains in my legs, but again, once I sat for several seconds, the pain would mostly subside. After a few days of this, and the agony every time I had to change position (riding in the car was particularly painful, from the jarring motion of the car to getting out at the end of the ride), I became desperate for help. But I didn't know who to go to for help! A doctor? A chiropractor? A physical therapist? Emotional counseling?There is a huge amount of information on the internet, and all of it seems to come down to one truth: no one really understands back pain. The best resource I eventually found was Don't waste your time on too many other websites (especially blogs, where you'll just find anecdotal evidence that may or may not be at all useful....)

So I finally tried a physical therapist, but man, did I go to the wrong one. I picked the cheapest guy in town. He figured it was my SI joint. He put me in traction. Ouch! I was so much worse the next day! After one more appointment with him, I reached a day where I literally could not get out of bed. Lying curled on my side was painful, but any kind of movement in any direction caused shooting pain down my legs to my toes. 1600 mg of ibuprofen did nothing. I finally dragged myself and my baby to the car and got to my doctor's office. He gave me some muscle relaxers, which started working within the hour. Hooray. I was finally able to function. I could sit and stand without excruciating pain. My doctor also sent me to a better physical therapist, who I really liked, but who couldn't fix me. She gave me exercises and we did stretches and e-stim, but after about 6 weeks I wasn't getting any better. At this point the pain, while on muscle relaxers 24-7, was mostly a dull ache with occasional painful spasms.

I decided to try a chiropractor. Again, I really liked him, but he couldn't fix me. He adjusted everything he could, and even had his massage therapist really work hard on my piriformis muscle (in case that was pinching my sciatic nerve). He had me get x-rays in case I had some spondylolisthesis thingy. The pain in my legs was turning into numbness and tingling that was worst when my body was straight (lying down or standing). I was turning into one of those bent-over old people, leaning on my grocery cart. After 6 weeks of treatment it finally came down to, "well, you should be better by now. Maybe you'd better get an MRI, so we can see if it is a herniated disk. But whatever you do, DON'T LET THOSE DOCTORS TALK YOU INTO SURGERY!"

So I went to an orthopedic specialist. He immediately ordered an MRI which showed a very large herniated disk. He said my two choices were 1)surgery, or 2)no surgery. The second choice came with a "we can try a cortisone shot. It might work." So I tried the cortisone shot. The morning before I went to go get the shot, I turned over in bed and tweaked something that caused a horrible burning pins and needles sensation all down my right leg. The shot didn't work. Not even a little bit.

So this is the point at which I decided surgery was my best option, after 5 months of pain that kept increasing, and after trying every other option (besides alternative therapies, which I was open to, but out of patience). I was completely hunched over any time I tried to stand on my feet, and even then, could only stand for a few minutes at a time before the burning, numbness, and pain in my legs became unbearable and I had to sit down. I couldn't take care of my two kids. I was basically useless, and I say that with the utmost respect for people who live without the use of their legs, and do so very gracefully. I don't know how they do it. I'm sure it's harder than I can possibly imagine. I decided, after doing some research and talking to others who had done surgery, to use a neurosurgeon rather than an orthopedic surgeon. I called up Dr. Gaufin's office and they got me in the next day, based on my medical records and symptoms. My surgery was 3 weeks later, approximately 6 months after my initial pain began. I had an L4-5 discectomy, which means they shaved off the herniated portion of the disk between the L4 and L5 vertebrae (the link goes to info about a "microdiscectomy," which I'm not totally sure if I had--my incision was about 2 inches). Since the actual pain in my back was minor compared to the nerve pain in my legs, they did not fuse the vertebrae. This means I will probably always have a moderate amount of back pain, because the disk is damaged and not providing a good cushion between the vertebrae. But like I said before, my nerve pain was immediately gone after the surgery and hasn't returned, and that is good enough for me.

Some thoughts about my recovery. It was about 4 weeks before I could lift my 25-pound baby. I wish I had taken 2 weeks off work instead of just one—and I only work 12 hours a week. If I had been working full time, I would have still struggled to return after 2 weeks. If you have the option of completely taking off 2 weeks and then working part time for 2 more, that might be ideal--although that is understandably unrealistic. Same goes for help with kids—if you can get someone to stay with you for 2 weeks, do it. My mom stayed for one week, which was awesome, but I was still kind of useless for the next few weeks. I had to put my 18-month old in a regular bed instead of a crib, which he wasn't really ready for. I also had to call a neighbor to put him in his carseat anytime I wanted to go anywhere. And he learned really quickly that I couldn't chase him or grab him if he wanted to cause trouble. So that was tough for a few weeks.

One other thing about my recovery physical therapist, Von Hill at Peak Physical Therapy here in Spanish Fork, Utah. If you live in my area, I absolutely recommend Peak and especially Von. I am confident if I had gone to him in the first place instead of the cheapo guy I went to, he would have been able to immediately tell me I had a herniated disk, and he would have given me the best therapy possible. I'm not saying I would have avoided surgery, but I honestly think he would have been my best chance.