[rosedee]

12 days ago I had ADR of Active L at L3/4 by Dr Zeegers at Alphaklinik. If it wasn’t for the fact that I have seen the pictures of it and have a large stomach incision, I wouldn’t know I’d had it done! Literally no effect whatsoever….which makes absolutely no sense, given what surgery involves. The level of pain and impaired mobility were evident immediately I got up in recovery room, with Dr Zeegers there. He has described it as a “nightmare” and is unsure what to make of it/suggest. Technically the surgery went perfectly and he can’t believe it. He said he hasn’t had an outcome like this before – no improvement, no deterioration, no nothing…….. I have to say that his response of wanting to determine why this had happened and what is really going on with my back is reassuring and unlike anything I’ve ever had in UK. 90 minute follow-up with surgeon?!

We agreed I would try facet injections at L3/4 (which had been negative in May) and at L1/2 (which had been positive at discogram too, but is too high to a/c for the degree of pain lower down). These were done on Monday and today and have had no noticeable effect, which at least reconfirms that the pain is not coming from them.

Dr Zeegers had always said that I was very difficult to diagnose because of my long history and previous surgeries and symptoms, but agreed with other surgeons that L3/4 was the central pain generator. He had suggested Micro surgery/abrasion at L1/2 could be a backup plan, but Dr Hoogland here has said that he doesn’t think it would have a significant effect and is not worth trying. A neurology assessment with Dr Baumbach in June had indicated additional problems at C5/6, C6/7 and thought it was the interaction between neck and lumbar problems that accounted for the degree of pain and impairment. Dr Zeegers does not see how cervical problems could account for my lower back problems in the light of the failure of the ADR to do anything.

Last week Dr Z suggested that it may be worth considering removing the metalwork from my previous fusion surgery – this had originally been suggested in London by one surgeon (disagreed with by 2 others), but previously Dr Zeegers had said this would be a big mistake given nothing obviously amiss with it and that there is no evidence of bony fusion on CT scan. He is now saying that, ”maybe pedicle wall failure L4 right side: screw L4-5 probably perforating pedicle right side, both screws very medially located, relatively big screw-diameter in relation to pedicle.” Dr Hoogland has said he doesn’t think it is worth removing metal work.

Anyway, I am due to see Dr Zeegers again on Thursday to review the (lack of) effect of the facet injections and think more about what to do next (if anything).

My return flight to UK is booked for Saturday, so unless anything emerges on Thursday, this will be my last meeting with him.

If anyone has any thoughts/ideas about all this I would be very appreciative of them, particularly before Thursday if possible.