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!

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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.