It’s Been a While: I’ve Had a Micro-Discectomy and Other Things.

I have been silent. I have had writers’ block. I have had reduced pain. I buried my head in the sand and stopped wanting to talk about my bloody back pain; talk about a pain in the back. I have plodded, and managed with lower level pain. Not disappeared pain, but bearable ‘let’s pretend it’s ok’ pain. Stoic. Just waiting for a date for my L5/S1 Lumbar micro-discectomy.

I stopped taking Tramadol about a month ago. How about that? It’s been worrying me, using this drug, and I feel fine without it. Great in fact. It’s been R’s 40th birthday; we went out for wine tasting and I wore heels; we had a party/gathering and I wore Fly London Wedges. I looked fantastic that night with my new dress, new haircut (even if I say so myself, as did others), and red glowing sunburn; I drank alcohol as I had no opiates or nerve blockers in my system, and it was great as alcohol dulls pain; I got drunk; we went out for post partying breakfast and I struggled to bend down to pick something up from the floor. And that was the end of the ‘good phase’. I could not get out of the car coming back from breakfast and we holidayed in a yurt for the following five days, up a steep hill, with a LOT of painkillers and the lovely diazepam to keep me going. It was actually fab, but despite backpain (you got to just get on with these things right?).

On Tuesday, having returned from holiday to just one day’s work before going off sick again, the neurosurgeon’s secretary called me; “How would you like to have your surgery tomorrow morning?’

So, this is what happened

Tuesday 18th June in the morning, I was called by the secretary, a simple yes or no, she will call me back with details. In the afternoon I got the details of where I need to be and what time. A mad rush followed, sorting out new jimjams (didn’t bother), cleaning and drying my finest pants (I had to take em off, waste of effort) and supervising R cleaning the bedroom so it was lovely when I came home. We organised childcare etc and I spent a little bit of time trying to calm down a very worried little Summer Girl, ‘what if you sleep for too long mama? I don’t want you to go!’

On Wednesday 19th June at 6:20am I said goodbye to my tearful Summer Girl, my slightly nervous R, and a Winter Boy who wanted to wave at the mini cab taking me to the hospital – there was no point disturbing the children’s routine, and it was last minute so who could have them at that time in the morning? It wasn’t an emergency so R did school run as normal – by 6:45am I was stood in a queue of dozens of other people waiting for their ops. ‘Fucking Hell’ I thought, ‘I won’t be seen first that’s for sure.’

Wrong! At 7am I was booked in, 7:15am wristbands put on me, a million questions asked by a student nurse (including, ‘are you pregnant?’ about 10 times). At 7:25am I was seen by the Registrar who told me I would be having a bilateral micro-discectomy and I signed the consent forms. I changed into the very fetching gown and stockings provided, keeping my lovely clean M&S knickers on. At 7:45am I was seen by the anaesthetist who kindly let me know he will ensure I will be provided for drug wise when I wake up. Not reassuring, as that suggests I will be in a lot of pain! I missed seeing the Consultant as I was busy contemplating whether or not to keep my pants on as I got changed when he looked for me.

At 8:43am and having been told my neurosurgeon prefers his patients with their knickers off, I was answering the following important question in the anaesthetist’s room: What Makes a Perfect Manhattan?

Next thing I know, it was 12:30pm and I was fucking freezing lying on my side in the recovery room. Not for long, as I got warmed up by a lovely blanket thing that blew air all around me. (I need one for home, but apparently you can’t buy them).

AND NO PAIN IN MY LEGS!!!

Thursday at 3:30pm – I left the hospital, having been discharged as ready and desperate to get home, with one of my best friends in the world having brought me a proper take away coffee for the journey home.

I am still waiting for the pain to return. I have done too much today, and so am actually hurting a little, and in truth I do have a little pain in my legs, but it’s throbbing pain which I think may even be referred pain. There are no stabbing pains as I lay down or sit, so feelings that my leg will snap off, no pins and needles (a little fuzzing). There is some numbness in my toes and that might never go away, but. FUCKING YEY!

The Technical Bits

No fusion! I had a left sided decompression, instead of the anticipated bilateral decompression as the surgeon didn’t want to remove bone from both sides; he said this would leave my already unstable vertebra even more unstable and the risk of fusion would increase significantly. Apparently this means a slightly increased risk of right sided prolapse in the future and need for further surgery, but he felt that was a better risk than doing it now when right sided pain was minimal. I agree. Actually.

The incision is Tiny. Really tiny. Hardly even hurts.

I am moving! I am walking! I can’t sit for too long, or stand for too long. I have a granny seat on the loo. I am trying really hard not to do too much, but I feel…NORMAL! Apart from nagging pain, which is healing pain so it’s good pain.

A success! I do have to wait and see, as it’s still early days, but I am pleased with my microdiscectomy surgery!

The misaligned L5/S1 vertebra is a backwards misalignment and could have been caused by injury to the vertebrae.  The Clever Mumsnetter, DillyTante, uncovered the likely cause of my back trouble, especially as this is NOT degenerative in my case, and all information since continues to point toward this being right.

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SURGERY! (How Sad That I’m Pleased)

I am not going to moan about how much pain I am in today, or how slow the NHS system is. I am not going to complain that I have spent 18 months banging my head against a virtual brick wall to get someone to fix me. I am not even going to gripe about having to spend all day today at hospital, after a 9am neurosurgery appointment was late by 20 mins, and then having to wait 1 hour for an unplanned x-ray, having to wait for what I was told would be 2 hours in the planned assessment team, but turned out to be 4 hours. I am certainly not going to bang on about not being to go to work at all having told them I would be in at about 10:30am, or using up all my mobile phone battery reading mumsnet posts and not being able to call my husband to get me (had to use a payphone, how old fashioned is that?).

No. Not moaning. Because, I have FINALLY been put on my neurosurgeon’s waiting list for discectomy. Finally, someone has said they can do something to fix me. YEY! Ok, he has not given me guarantees, but the odds are pretty good though I think – 80/90% chance of an 80/90% improvement in leg pain. But, only a 15% chance of any improvement in my back pain.  That’s not so good, but I was expecting him to tell me something along those lines so not a surprise.

I liked this neurosurgeon. He was pleasing on the eye which is always helpful, and spoke to me, not at me. He was pretty honest, but was interested in my view about it all. I didn’t feel rushed and ignored like I have with so many other health professionals, a number on a list to be spoken to and ticked off/kicked out. I was expecting to be talked over and the decision already made; pleasantly surprised.

The recent MRI shows that the vertebrae of L5 (the top one of the L5/S1 section) is out of alignment, something called Spondylosisthesis – it’s sort of pushed forward over the top of the vertebrae below and this is probably why the disc prolapsed. He doesn’t know why this misalignment happened – could be injury, could just be the way my spine developed/a joint stopped working so well. The disc is now bulging into the nerve space, and there is still an annular tear which may well have been the shower curtain hitting my back (read my previous post about the theory of how the tear got there), but the disc would probably have already been bulging at that point and so an ‘easy’ target.

Mr Neurosurgeon said he would not normally enter into the idea of spinal fusion with a prolapse such as mine and right at this moment he is not intending to do so. He does not believe the success of fusion generally is good enough to put someone my age through that trauma, and that back pain itself can be caused by many many things and so fusing is too random. However, this vertebrae that is not in the right place, along with the fact that the entire rest of my spine is in perfect condition with little sign of degeneration, indicates that there is a large enough coincidence between me having severe localised back pain, my back ‘going’ regularly and the potential instability of the vertebrae. For that reason he is considering fusion.

So I have had some x-rays on my spine with me moving around in different positions (ouch!) to see if the segment is moving at all. Pretty undignified it was too, dressed in the silly gown with a gaping back, and having to reverse into the loo else show my butt to the very full waiting room.  If the segment moves, he will review his decision and consider fusing the vertebrae when he preforms the discectomy, if no movement, he will wait and try the discectomy first. If the back keeps going after the op and recovery (a good amount of time) he will fuse the spine. AND he told me how he would do it. OUCH again.

Recovery is quick for the discectomy – 4 weeks if I’m lucky!  If all goes well, I could be bodyboarding within 8-10 weeks – maybe even this summer!

A Little Bit of Positive

After my miserable ramblings last night I have some good news. Well, I had that news yesterday but it did not feel so great at the time of my posting as I was wallowing!

Yesterday morning I got a call from the hospital, or rather their outsourced team, to offer me a short notice MRI on saturday (tomorrow). How about that! So, 9:20am and I will be thrust into a huge metal tunnel for 20 mins. I quite enjoyed it last time, gave me a chance to relax without children jumping on me!

It will take about 10 days or so to get the results in, and Mr P the Spinal Pathway practitioner has to then speak to the neurosurgeon and spinal orthopaedic surgeon about the results, so I am not expecting any appointments for at least a month. But, it’s closer than it was last week.

I am in a strange way, pleased that I am in the middle of an acute phase of pain as maybe it will show more than last time. I have been so concerned that they will do the MRI when things are more settled and it won’t show the severity of what I am experiencing. Mr P himself said it is better to do an MRI in the acute phase but due to waiting times it doesn’t often happen. He said the ideal was, an MRI immediately before it ‘goes’ and then an MRI in the middle of it all, and then one when it has improved, to get a good idea of what happens inside the spine area so, I guess this is as close to that happening as it will ever be.

I still don’t understand why no x-rays are being done, or CAT scans, as these show the facet joints and any damage there more clearly than an MRI and he has said there is some chance it is facet joint  related. If the MRI shows less than the pain suggests is going on I will insist on a CAT scan/X-ray. But, we are moving forward, even if it is at a snail’s pace.

Thank you runawaycerbera…

I am writing in response to the fabulous post in ‘comments’ by runawaycerbera on my last post ‘my husband stabbed my leg!’ She has spoken about her own experiences with backpain in such detail, I felt my answer to her was so long and in turn detailed that it should be written for people to easily read. Maybe they will be more aware of how serious a lumbar disc prolapse can be, and what backpain and nerve pain might mean long term if we don’t address it, which neither of us knew before.  Luckily in runawaycerbera’s case it was not too late but for many people it is especially if they experience Cauda Equina Syndrome which is a serious form of nerve damage that can leave you with permanent parasthesia if you don’t get it treated straight away. Check out the NHS website for details if you need more info, it is a really helpful site.

I read everything runawaycerbera has said about the debilitating back pain and the fog it creates and it sounds just like me! I had the caudal injection into my epidural region of the lumbar spine in March, to stop sciatic nerve pain, which luckily for me worked, altough for only or two weeks and was very painful for days afterwards but at least it was not excruciating to go in, just a bit humilating with butt in the air (not even a friday ;-). I was told by neurosurgery team this injection is too random and often goes wrong and is rarely accurate enough to do good. Too late after it was done, although the osteo/gp who administered it advised it was 50/50 success. Funnily the numbness and pain I now have down my left leg is different to the pain I had in my right. The pain shifted once I started physio in August (yes it took that long to get a referral to physio) and started the intense exercises recommended by the spinal pathyway physiotherapist. I went from stooping badly and pain in the right leg, to standing straight with intense pain in my buttocks, thigh, hip, leg, foot. The prolapse is central so I suspect it has shifted in it’s prominence/increased it’s prolapse, as does the spinal pathway team. Or maybe another disc has prolapsed, that is quite common once one goes I have heard.

I so hope I don’t suffer as runawaycerbera  has done, with the bladder problems and in agony for so long, but I have had issues with ‘other areas’ that has been ignored and I am not hopeful I will be spared any of the anguish she has experienced. I was told by many people in the last few months, that I should have gone to A&E at christmas and again in June, instead of accepting that any movement would make me cry and that was ok. The emergency GPs felt it was not that bad, but they didn’t physically see me. If/when it happens again (it is very likely I have been told by the spinal pathway team) R and I have agreed, no calling out of hours doctors for more diazepam and extra tramadol or codeine, I will go straight to A&E.

I just feel that as I am walking and not in the serious acute phase, the medical teams seem happy that there is no longstanding damage. I worry that they will wait untll it is too late before it is sorted. It is not healing itself. It is not getting better. I am just managing the pain better by avoiding living my life how I want, and by taking a lot of drugs. I agree with runawaycerbera that I am not sure how much of my tiredness is drug related and how much is that I am so ground down, yes a lot of it is the drugs, but much of it is not. Like she said, I hurt so often, I don’t think I realise how much anymore.

I am very scared that I am never going to be me again, that I am never ever going to see an end, and that even the brief periods of relative pain-free existance is just a short term until it goes again and this is how I am going to live my life, in fear of the most horrendous agony I have ever experiened returning. It is worse than my experiences of childbirth and I say that having given birth to my son with only entinox as relief and having had a ventouse delivery with my daughter. I simply cannot bear the prospect that my once active life has disappeared forever, that my children see this shell of who I really am, that this is their mother. This is not who I want them to see as their mother, it is not meant to be this way for them.

But runawaycerbera you have given me some encouragement that it won’t be forever, that one day I may find someone will listen and remove the fucking thing. I will, without a doubt being making a trip to A&E at some point in the future. I hope like you, it is not too late when that happens, and the nerves has not been permanently damaged.

ok, that was a lot of me there. an outpouring shall we say! phew. thanks !