Fusion surgery over.....

[martyusa]

1st day back from the hospital and I must say, it's all a different pain. Dr. Gerald Foti did what appears to be a great job thus far. I was told it went flawless and better than expected. I was also told the MRI' did not do the damage justice and was glad we went with the fusion instead of the ADR. Dr. Foti told me if I had gone with the ADR, there was a very good chance we would have been doing the fusion not long down the road.

The leg pain is gone, nerve pain is gone and as far as that goes I feel great. I do have the surgery pain, but this is to be expected. The brace is nice and snug and doing it's job well. The days are definitely getting easier as they pass as long as I keep moving and doing as I am supposed to do.

Surgery date was August 1st, 2008. I was up and walking the next day with a walker, slow and gingerly. They took my walker away the following day and gave me crutches and they seemed to work better for me for the flow of walking. By Monday afternoon the crutches stayed against the wall and I was on my own power for a few strolls. I seem to be doing better than I could have ever expected and part of it was due to the prep before hand. I really focused on the core muscle groups as well as my legs, to the best of my ability considering my condition.

It's going to be a long recovery, but it would appear this was the best decision I could have made. Great support from family and neighbors with everyone giving a helping hand where they can.

I'd like to thank Mark for all of the indecisiveness in my decision making and tolerating an up and down attitude. He and the board have been very supportive and I thank you all.

The procedure used was the CD HORIZON® LEGACY™ PEEK Rod System. I am very pleased thus far.

Medtronic Sofamor Danek, Inc

[dshobbies]

Great news Marty! So glad your pain is gone. Making the right decision for you is difficult and something we've all been through. It sounds like you made the right one. Good for you.

Keep up the slow rehab and keep us posted.

Wishing you all the best, Dale

[Maria]

Thanks for updating us on what you did and how you're doing. Sounds like you are doing well to date & progressing nicely.

With respect to decision making and getting to the point where you actually choose a surgical option (if more than one is offered)~ it doesn't surprise me when people question/think about/sound out what path/option to take but rather when they don't.

Thanks as well for mentioning the name of the procedure, and type of system without having to ask.

Wishing you continued excellence in your recovery

[ans]

You sound great/articulate and have a realistic long-term idea of what to face. I guess your fusion was at L5-S1 - better this than an ADR lotsa people say. Heal well.

ans

[martyusa]

Originally Posted by ans

You sound great/articulate and have a realistic long-term idea of what to face. I guess your fusion was at L5-S1 - better this than an ADR lotsa people say. Heal well.

ans

Actually L4-S1 are the vertebrae that were fused. L5-S-1 was completely obliterated and L4-L5 was well on it's way to follow. As Tom Petty sings, "the waiting is the hardest part."

[mmglobal]

Marty... such great news. I love to hear, "the leg pain is gone... the nerve pain is gone... You know that the indications were correct and your pain generators are addressed. Please take care... heal well... and apprecate each minute you get without the pain that you knew too well.

You are very welcome for small part in your story... What I do is very rewarding and the best part of it is hearing about the restored lives.

All the best... please keep us up to date....

Mark

[martyusa]

Thanks everyone!

It is getting easier, physically. However the mental aspect is a different story. As some of you know I am a competitor and play sports year round. It's kind of a catch 22, LOL. In 1 case, I'm glad I have the Olympics to watch while I am down and out. And on the other hand, I can't wait to get back out there and at least have a catch with my son. So, we'll have to play this smart and conservative so recuperation is as perfect as it can be.

I have spoken to 1 of my M.A. instructors who had an older but similar procedure. She tells me the same thing everyone else tells me. That is I am not to screw around with anything for the first 6 months. Don't play, don't think that I am recovered yet and the most important thing is to let the fusion take and heal. She had had her titanium rods removed and is in constant pain because she pushed the envelope. She is setting up for corrective surgery just to ease the pain level.

I've started getting some numbness in my big toes and a few other, but nothing to crazy. I feel it could be from too much walking, or sitting a bit too long. However, it does ease up after I get a good rest. Sleeping is getting better as I am getting a good 6 hours now before I wake up for whatever reason. i.e pain, bathroom or my body is done sleeping for now.

I am really starting to feel my knee now. For over a year I have been putting most of my weight on my left side just because it was easier due to the simple fact most of my pain was on my right side. Ironic how the Hammy tear and radicular pain were both on the same side. We'll take a look at the on Monday to see what going on in there. Getting old really sucks......

[mmglobal]

Numbness in both big toes? Was that a pre-op symptom that you are feel again? You mentioned leg pain... was their numbness? Both sides?

[martyusa]

Originally Posted by mmglobal

Numbness in both big toes? Was that a pre-op symptom that you are feel again? You mentioned leg pain... was their numbness? Both sides?

No, just the right side for the pain. Which is the side I had most of the problems with. Pre-op symptoms on the right side was numbness in all the toes and even into my heal when I drove for long periods. The left side didn't come until about 1 month before surgery, but it is not giving me any problems as of yet. But it's different pain......I'll talk to Dr. Foti at my follow-up on Monday.

The last MRI showed L5-S1 disc pressing against the nerve on the right side, which is the same side the doc hit with the pin during the nerve root injection.

[mmglobal]

It's still so close to your surgery and your activity level is probably on the way up, so you may be flaring things. You are probably not on NSAIDs because of fusion. Stay cool... let yourself heal and increase your activities slowly. If you discover limits... dial it back a little.

I'd let the doc know anyway... onset of new symptoms is something you should let him know about. They may blow it off and may not want such detail... but err on the side of caution. When do you see her next?

Mark

[ans]

"Getting old really sucks....."

Yes, but consider in two years that you'll be able to face off again against George St. Pierre.

Take care - ans

[martyusa]

Originally Posted by ans

"Getting old really sucks....."

Yes, but consider in two years that you'll be able to face off again against George St. Pierre.

Take care - ans

LMAO........The best part about getting older is getting wiser......

Although I would love to hop back into the ring, common sense tells me otherwise. I'll stick to training my kids.

[ans]

You are a wise man and I wish you well.

Btw, I'm a Silva fan - not that you asked.

Do you have youtube videos of you fighting? I love this stuff except when somebody gets hurt bad.

Best, Allan

[martyusa]

Originally Posted by ans

You are a wise man and I wish you well.

Btw, I'm a Silva fan - not that you asked.

Do you have youtube videos of you fighting? I love this stuff except when somebody gets hurt bad.

Best, Allan

Na, no video of me fighting. Back when I was heavily involved it was P.K.A. and K.I.C.K. rules. I didn't get involved in MMA until it was too late for me to compete on a professional level. All of my fights were local and regional. I realized real fast that I needed ground game and by the time Ricardo Mugel was done with me, I missed the window. I was just too old to make a difference with these young boys that heal in 2 days and not 2 months. So now I just teach, when I'm not laid up. But man what a blast I had while it was good.

Although I must admit, I do get amped up watching it.

[ans]

You had your fun and you must have been in great condition. Too bad you didn't train with the Gracie's then. Wonder if they had much Muy-Thai then too.

Never liked seeing people getting hit in the back of their head.

(Remember the one where Royce got his arm broken before submitting?).

Oops, off-track. Be well, ans

[martyusa]

It's easy to get off track and hijack your own threat when it come to that stuff......


So, back on track.

Had my follow-up today and played a great joke on the PA when she came out to get me. All she saw was my shorts and a Phillies shirt and she kinda looked at me weird. So I came right out and said, "I got tired of that damn brace and don't need it anymore." Now the whole reception area was in on it and when she started going off, I lifted my shirt and there was the brace. Worked perfectly and they all loved it as the other patients roared. Gotta have a good sense of humor, if not, I'll go nuts....Man if looks could kill, I thought she was going to rip my face off if I didn't have that brace on. LMAO

Anyway, I was told everything looks great. I went over some of the symptoms and it was accredited to too much activity and a bit of irritation. But I am told to keep an eye on it and not do too much. He tells me about 10 more weeks 24/7 with the brace, then we can start on some PT. I am feeling better as the days go by. But it's almost and exponential kind of success thus far. This is where my mind and common sense will have to come into play.

But things have been great other than those few minor problems and I look forward to a full 100% recovery. They want to get me some type of bone stim machine to aid in the fusion process.

We'll keep everyone posted.

[martyusa]

I had to share this....

This is how messed up our medical system is.

I have been receiving those little notices we get from the insurance company. Ya know those notices that tell you how much the medical offices are charging for their services.

Bone growth stimulator - 3000.00
Anesthesia - 5000.00
Cardiologist consultation while in recovery - 1500.00. I never talked to one, ever, while in the hospital
Hospital charges for the fusion - 165,000.00

Now along with this notice came the other notice. If I don't fill out the questionnaire the insurance company won't pay for the procedure. Everything was already pre-approved. They want to know if I have any other insurance. The ironic thing is this is the 3rd time I've filled one of these out.

I can't wait to see the rest of the charges........What a gimmic

[mmglobal]

I had a client with only one hand... born that way. When he woke up in recovery room after multi-level cervical... he called the nurse over and said... "what did you do to my hand?" I don't think anyone thought it was very funny.

When my son had pneumonia and spent 4 days in ICU, we saw the bills go by for $30,000. The allowed amount that the hospital was happy to accept for $30,000 worth of treatment was $6,000. If we did not have insurance, they would have come after us for the full 30K. This all makes sense to someone.

I've seen many cases of fusions with billed amounts in excess of 150K and allowed amounts around 50K. I've also seen payout amounts in excess of 100K for both disc replacements and ADR. The worst case I've seen was a multi-level fusion that was done on a speculation basis. Someone I know has a lien against his lawsuit for more than $275K for a 2-level fusion that was poorly done. He's still disabled and pretty much bankrupt. If he ever collects anything... the first 275 will go to pay for a 60,000 surgery. This is not right.

[ans]

Oh is this so wrong. What outrageous prices for fusion. Also, for the short stay for pneumonia (must have been scary).

Imagine being stuck for #100K for an approved fusion. I'd contemplate jumping over Half Dome and providing fertilizer for trees.

[mmglobal]

What a coincidence Allan.... jumping off of Half Dome is on my list of things to do too!

[martyusa]

Originally Posted by mmglobal

300 Neurontin a day is not very high. I usually took 900/day and only occasionally took 1200. My pain doc wanted to ramp me up to 3600, but I could hardly tolerate the brain fog on 900. We don't call if Morontin for nothing!

I ceased taking the neurontin I was taking as I am trying to cut back on this crazy amounts of meds I am taking.

I am still getting a little bit of nervy back pain, but nothing like it was. I am assuming this is due to some damage done to the nerve root, either from the disc pressure or the doctor hitting the root during one of the injections with the pin.

However, I have been feeling very lethargic and my legs have been feeling like rubber over the past few days. I spoke with the PA and went over everything that has been going on. She will speak with the doctor and call me tomorrow. I'm not sure what has been causing this, but I have a feeling it's something else I am taking causing this. I'll wait on his call but I have a feeling it's my Toprol XL. We'll see what he has to say.

[martyusa]

After you have back surgery, Learn how to sneeze and cough a whole new way.

Leaning back a little bit, for me, saves me the sharp pain in my lower back and dropping to one knee after the surgery.

[martyusa]

Almost 3 months post op and I'm back to square 1 and then some. I have always had numbness in my toes during the onset of the sciatic pain down the right leg, but for the first time the past two weeks have been pure hell. My calf and the arch of my foot feels like a muscle cramp. However, the muscle is not tight and is not cramping. My big toe is has gone past the tingle and now hurts like crazy. I have started to develop some pain in the front of my leg for the first time. My back is always at some type of pain level, either dull and achy or sharp and burning. While it is sharp and burning, the pain shoots down the glutes and into the foot rather quickly and it's right back to bed to lie down. I am also having some overcompensating issues, but that is to be expected as well as some atrophy and muscle cramping/spasms thereof.

I am hoping that this is part of the recovery process, but I am beginning to doubt that with the symptoms getting worse as the days go on. I have my next followup Nov. 3rd with x-rays, so I would imagine that would be the indicator. We'll see what he wants to do and maybe PT will help. I can deal with the pain if I have the right combo of meds and rest, but that is no way to live my life. Now on the other hand if this is the way it's going to be, so be it. Just tell me the deal with no fluff and I'll adjust. I think I am past broken promises part.

I did question the Doctor blasting my nerve root during one of the
root injections and I was told that it would heal over time. I can't see how that would lead to the increase of pain now, unless it's easily irritated due to a combination of the injury and the little doctor mishap.

If anyone has any incite at all, I would love to hear it. Just no fluff, please. I'll will keep the board posted as we progress.

Thanks all and good luck.

[martyusa]

Well, I'm not coming out of the brace just yet. He would rather ween me out of it for a few weeks. CAT scan is schedules for more detail to see what is going on in there. The X-rays came back ok, but does not tell the whole story according to the doc.

I will be starting with 4 wks of PT to start to see if it helps with the problems that I am having now. Hopefully everything will be just fine and we can get back to normal.

[martyusa]

CAT SCAN results:

Impression - Some degree of fusion of the posterior element bony fusion masses are present at L4-L5. The hardware appears intact without evidence of fracture or loosening.

Stable appearance to a right subarticular disc protrusion at L5-S1 touching but not compressing the right S-1 nerve root.

History - status post lumbar fusion from L4-S1

Technique - Axial images of the lumbar spine obtained. Sagittal ans coronal reformats obtained and reviewed

Contrast - none

Comparison - Disogram from 2/27/2008 and radiographs of the lumbar spine from the lumbar fusion of 8/01/2008. Also MRI of the lumbar spine of 07/02/2008

Findings - Alignments: within normal limits

Postsurgical changes: Bilateral rods and pedicle screws are noted from L4 through S1. he pedicle screws show no encroachment on the central canal neural foramina. There is no evidence of hardware fracture or loosening. There is deformity to the left lamina at L5-S1. Area fusion of bone material is seen between the facets and transverse processes at L4-L5 and L5-S1. On the right side there is evidence of fusion of the bone mass in the craniocaudal dimension. It does not appear fused with with the facets and the spinous processes. On the right side, there is partial fusion of the right fusion bone mass.

T12-L1 Within normal limits

L1-L2 within normal limits

L2-L3 Minimal disc bulge and mild bilateral facet hypertrophy. No herniation. No central canal stenosis. The disc bulge causes a minimal degree of inferior narrowing both neural foramina but without impingement of the L2 nerve roots. Unchanged from MRI of 07/02/2008

L3-L4 There is a mild broad-based disc bulge. No disc hernoation. No cantral canal stenosos or subarticular recess narrowing. Disc bulge causes a mild degree of the foramen are both neural foramina without impingement of the L3 nerve root. Again unchanged from MRI

L4-L5 There is a mild broad based disc bulge but no herniation or subarticular recess narrowing. The disc bulge causes mild urinary both neural foramina without impingements of the nerve roots. Unchanged from MRI

L5-S1 There is a broad-based disc bulge with a right subarticular disc protrusion touching but not compressing the right S1 nerve root and right subarticular recess. The disc bulge causes mild inferior both neural foramen without impingement of the L5 nerve root. Unchanged from MRI

Paraspinal soft tissues: Grossly normal


I have been coming out of my brace for a few hours a day. I find it to be a bit uncomfortable at best. I can definitely feel the weakness in the core muscle group and a bit of a confidence problem without the brace. Too much activity without the braces brings on the right leg problems with the sciatica in the glutes, outside and inside on the hamstrings and some serious pain in the calf and big toe. The outside toes still feel numb, but no pain. Also I have been getting quick sharp pains in the left hamstring. These episodes only last about 5-10 seconds but almost bring me down due to the fast intensity of the onset. Only brief on the left side and not getting past the knee. Sitting too long or walking too long still brings on the right leg symptoms with or without the brace.

I will say that the sharp stinging burning pain the back has stopped and is now just a dull achy pain. (I am assuming from recovery and muscle atrophy)

I have lost almost 40lbs weighing in at just under 180lbs. Hopefully the first 4 weeks of PT will help but this all to rest before we move on.

OK, Mark....I need this broken down in English.

Thanks in advance

[mmglobal]

Marty... sounds pretty good. You have a bunch of 'mild this and that'. You have a bunch of 'no evidence of this problem or that problem.' You have a bunch of 'fusion masses forming".

Great news that the sharp burning is gone. I hope to hear that you keep improving week after week... then you won't notice it weekly, improvement will sneak up on you without you realizing it.

I hope that the things noted, disc protrusion touching S1, are not significant in an immobilized spine segment. You'll have to ask the doctor about that. There may be some possibility of chemical irritation even when there is no mechanical irritation, but I would hope the risk of that is low.

"There is deformity to the left lamina at L5-S1" I'd ask the doc to explain this. This may be notation of a normal post-op defect and be absolutely nothing.

I don't understand: "The disc bulge causes mild urinary both" - did you type word urinary wrong?

Obviously... this all comes with the approproaite "I'm not a doctor" qualifiers. I can be way off base on all of this!

Mark

[martyusa]

I don't understand: "The disc bulge causes mild urinary both" - did you type word urinary wrong?


That's word for word. I think maybe the doctor may have forgotten a word after urinary.

P.T. starts today. I am sooo looking forward to it.

[Jakea222]

Tell me more about it if you would I have read and it is jumpy. I am facing it now - L5 and S1 Fusion. The rest of my back is great so I hope to get back 90% very soon. SO you pain in your leg was gone right off the bat. or did it just drop a level in the pain....I guess start over for me.

Fusion DAY 1 - to where you are now....

PS I owe you big - I have not read any thinkg as close to this as what I am gonna do...

[Jakea222]

I am very interested in your pain level since I am getting to hit your road. - the pain down the leg has decreaserd by what %....how about the butt cheek whiich kills me out in public grabbibg my glut as I walk and then about the deep pain and the inscision pain...did the meds help you get over the hump of pain and now waht are you on...sorry to ask so many -- but I am right behind you it looks like in procedures

[wavedreamer1@aol.com]

I have had 4 major spinal surgerys and now living with nerve damage in my legs. To keep the use of my legs I have an implanted pain pump (2) the first one go infected. I almost lost my life. I have another one and it is not working very much. In the past month I have started having severe pain in my lower spine and it is hard to set down or lay on my right side. If I fall asleep I have to have help again just to get out of the bed. I feel something is wrong but my doctor just keep goign up on my pump. Which is hard because of the side effect. I need a doctor to help repair the nerve damage. My last doctor want even talk to me. He did not las 2 surgerys . HE STATED THAT THERE WAS NOTHING MORE HE COULD DO FOR ME! Please if there is someone in my shape that can lead me in the right direction. All my prayers to everyone with spine problems. Sandra wavedreamer1@aol.com

[wavedreamer1@aol.com]

Originally Posted by Jakea222

I am very interested in your pain level since I am getting to hit your road. - the pain down the leg has decreaserd by what %....how about the butt cheek whiich kills me out in public grabbibg my glut as I walk and then about the deep pain and the inscision pain...did the meds help you get over the hump of pain and now waht are you on...sorry to ask so many -- but I am right behind you it looks like in procedures

I am still getting over my last surgery, which was months ago. I have the same nerve damage but it runs down my legs also. I have a hard time laying down and getting up after laying still for hours. Do you have that problem? I have been on every medication out there. All they do is help you get over the hump but not the real pain. So becareful. I would love to find a doctor that can help me with my nerve damage. If you know of a great doctor that repair nerve damage from a pinched nerve let me know. Don't let them tell you that nerve that is causing your pain will get better. Maybe it could take a year. Don't believe it. If you are not out of pain in 6 months. Let your doctor know right away. My prayer are with you. I don't know how much longer I can live with this pain so I am reaching out to everyone that might can lead me to a good doctor. Sandra wavedreamer1@aol.com

[wavedreamer1@aol.com]

Originally Posted by mmglobal

Marty... such great news. I love to hear, "the leg pain is gone... the nerve pain is gone... You know that the indications were correct and your pain generators are addressed. Please take care... heal well... and apprecate each minute you get without the pain that you knew too well.

You are very welcome for small part in your story... What I do is very rewarding and the best part of it is hearing about the restored lives.

All the best... please keep us up to date....

Mark

I have had prety much all and plus that you have listed. My nerve pain has gotten worse and in the past month it seems that I am having lower back pain that I can not control. I have an implanted pain pump for the leg pain. Without it I could not walk. If you know of a good doctor that can repair damaged nerves please let me know. I need help, but I am very sorry to hear that you are not doing well. My doctor stated that PT was the worse thing to do if you have nerve damage. So you might want to check it out. My prayer. Sandra wavedreamer1@aol.com

[dshobbies]

Sandra,

As is my other post, you need to find out if anything is still compressing a nerve. The first step is getting another doctor. Perhaps someone in your area can suggest someone.

You also need a pain managment doctor. If you already have one, again, I'd suggest another opinion.

Nerves can regenerate over time or maybe not. Something else that helped me was accupunture -big surprise. But, if you still have cord compression, that has to be relieved before you can expect relief.

It's time for a new set of eyes and brains.

Might you be willing to travel? Then you have more options for doctors.

I'm sorry you're suffering and maybe there is help out there. You just have to find it.

Dale