2nd Back Surgery Or Not?

[dav_marine72]

Hi Everyone,

Not sure if this should be posted here or not but I am looking for advice from other Vets with back issues. I seemed to kill all my lower discs in the Marine Corps. I got out in 95 and by 2000 I had desiccation and large herniations at L3-4 and L4-5. L5-S1 had a disc bulge. No one wanted to touch me because my back and leg pain were not concurrent with what my MRIs and discogram showed.

Finally a neurosurgeon at Yale agreed to do surgery. He wanted to do a fusion but then backed off and decided to only do discectomies at L3-4 and L4-5. While he was in there he ended up doing hemilaminectomies also. In 2001 I was service connected 20% for my back retro to 2000. I only got worse after that and ended up on Zoloft, ativan and buspar three times a day because the pain was causing panic attacks and anxiety. I am service connected 30% for the mental.

In 2005 I finally couldn't take the pain anymore. I was given mostly NSAIDS until that time. I left the VA for a PCP (I work) and he started me on Vicodin. He sent me to a pain center and I moved up to Percets three times a day. I received many nerve blocks and steroid shots since then for my L3-4 and L4-5 discs. I graduated to Oxycodone about a year ago, which I take 30mg 3 times a day now. I still take the zoloft, ativan and buspar three times a day but the ativan and zoloft was increased. The pain has gotten so bad I am crying all the time, can't sleep well or very long, have numbness in both legs, and have frequent nausea. I have small children and I yell at them all the time because I can't take any stress. My wife of course wants to kill me. Somehow through all this go to work everyday. The pain care doctor had me go to a neurosurgeon with a new MRI (2006) and he recommended no surgery. The MRI showed really the same as the MRI after surgery in 2000. Scar tissue at both levels he operated on and desiccation at L3-4 and L4-5. There was a small bulge at L5-S1 impinging the thecal sac.

As sleep was less and less for me my VA shrink put me on sleeping pills. Quite a cocktail.

The pain doctor wanted me to try a spinal stimulator trial for a week. I did it and had some severe pain from one of the incision points and had one of the LEDs move on me. Go figure my luck is always so good. Needless to say the trial was questionable. I felt I got some relief but with all the issues it was hard to tell. I finally decided to move forward with the spinal stimulator implant because I felt I had no other choice for anything. The doctor they referred me to for the spinal stimulator thought the trial was a little shaky and asked if I wanted a full work-up done. I said sure what can it hurt. I needed to get a new MRI and x-rays taken while bending forward, side-to-side, and backward. The MRI showed minor changes since the 2006 MRI. The changes were mainly at L3-4 and L5-S1. Overall report was that L3-4, L4-5, and L5-S1 are all desiccated and degenerated and I have increasing spinal stenosis. The x-rays showed that my spine is moving and I am rubbing at multiple levels. Here is the dilemma:

The surgeon has told me he has done many complicated surgeries involving multiple levels. My pain doctor says he is a great surgeon. He wants to fuse me from L3 to S1.

I know the horror stories and issues surrounding multiple level fusions. I just feel like I have to do something. I'm only 36 and I don't think I can live like this for the rest of my life. The pain is so bad even the oxy only gives minimal relief for a small amount of time. To top it off the BVA in March 2008 decided that my appeal for my back from it's original rating was worth only 20% for ortho and 10% for neurological. I'm at the court now. I don't know what to do. I can't take all these drugs forever. I can't go on working with this kind of pain and numbness. I honestly don't want to live like this forever. I can't play with or hold my kids. I feel like any chance of relief is worth it.

Any comments or advice?

[rdnkjeeper]

Oh man I feel for ya. I am in a very similar situation....except my back is all over. We are of similar ages and stuff. If you need to just talk pm me your number and I'll give ya a call. I would be interested to compare situations if you are up to it. I am sorry I can't be anymore help, but I am in the middle of this too.

[rentalguy1]

That's a tough one, but I can relate. I am in pretty much the same shape minus the previous surgery. I'm 35 and had to stop working last October. Most of the docs don't want to touch me because of my age. They don't seem to care about the pain, and tell me they will do surgery when I am faced with a wheelchair. I started developing a right sided foot drop last year, and now the left leg is having numb spells. It might not be long before I need that wheelchair. I can honestly say that giving up work and taking care of myself has done more good than anything thus far. I can sit, stand, lie down whenever I need. If I am having a real bad day I can pop an extra Darvocet and be as loopy as I need to be without having a boss or co workers question me. I have a mood disorder due to my spine conditions too. Now when I am pissed at the world I can lock myself in the house and not have to confront anyone. Most days I have the whole house to myself for at least a few hours, and that helps my mind.

I wish I had a answer for you on this, but ultimately it's your choice. You know that back surgery is a 50/50 deal, and it doesn't seem like you had good results the first time. The only thing that is different is that with a fusion, your spine will be fused in a position that impinges the cauda equina the least, and that should help with the pain and radiculopathy. You also know that DDD and spinal stenosis are gegenerative conditions, though, and a all out laminectomy and multiple level fusion isn't going to stop it. It will come back. I personally would start making preparations to stop working. Save as much money as you can, and get as much debt as possible off of you, then it will be easier financially. Then you can file for TDIU, SSDI, and maybe long term disability through your employer.

Good luck, and pm me if you ever just need to vent about it. Sometimes talking to someone else who is in the same shape helps.

[dolfanbls]

I am also having the same problems but not as severe. I am looking into laser surgery as it is less avasive. Her is the link to the web site. I hope this will help with my back and sciatic issues.

http://www.laserspineinstitute.com/

[dav_marine72]

Thanks rdnkjeeper, rentalguy1, and dolfanbls.

Rdnkjeeper I would like to chat and compare our situations. It's nice just to be able to talk with someone that knows what you are going through. I'm pretty busy working full time and with the kids. Maybe we can talk this weekend? Let me know and I will send you my number.

Rentalguy1 thanks for your words as always. I agree with with your advice about working and think that would be the best thing for me. The problem for me is the lag time between TDUI and SS. I can live on the two payments but would need them quick. I have to do what you said and pay my debt down and save enough to cover me. It's tough now with the little ones because my wife doesn't work. If she did it would cost more for daycare. I'll keep your PM suggestion in mind. I appreciate it.

[rdnkjeeper]

I am in the same boat with the $$ thing. Anytime would work for me. I have my cell with me almost 24/7. Just pm me the number and when you want me to call. My name is Bernie.

[Quint7]

Semper Fi Devildog, I was an Amtracer from 88-94 and guess what?

I'M GETTING A FUSION TOMORROW!!!!!!!!!!!

I can't tell you what to do but I will sum myself up with this:

I have had back/leg pain (that I remember!) since an accident playing hoops in the Suck in 93. Was told it was a pulled muscle and went on with it happening over and over til I got out. They never did any xrays or anything.

I'm fighting for SC for IVDS now.

I have no.... I say again NO discs at L4-5 and L5-S1. I saw an highly respected ortho surgeon through my insurance who said he didn't want to operate due to my age and that doing a bi-level fusion would be the end of my career (I'm a firefighter). Did therapy, pain blocks, etc. none worked. He then said that I either continued with the pain, etc. or got the surgery.

Well after 8 months of that I got turned on to a local Nuerosurgeon that gets flown around to operate on pro athletes, did Ted Turners back, etc. He was also a Nuero with the 101st (reservist) in Saudi when we went into Kuwait in 91.

He said "you are missing both discs, no doubt. I can fuse both, no doubt. BUT, I will have to open up the front and back, move all of your guts, do all kinds of crap to fuse all three, etc. But if you look, it is only L4-5 causeing you pain. For someone of your build and history I would actually expect L5-S1 to be gone by your age (39 in a month). Those two bones aren't touching, the L4-5 are and that's where your problem is."

He then ran through the %'s of complications, etc with a bi-level vs. the single level. He also drove home that I should be able to continue my career for 5 more years til I can get a pension (after the regular 3 months of rest and then a usually not needed 3 month intensive phys therapy). He said that the single level fusion would be one incision in my back with 2 screws and one wedge inserted plus a small bone harvest from my hip (through the same incision).

He basically said "that guy is a ortho, he does hips and knees... IM A BRAIN SURGEON".

I gotta say that I made the appt. for tomorrows operation that day.

So I feel for ya hard charger, but get as many opinions as you can and see a Nuero. My guys name was Dr. Paul Maeur and he is outta Rochester NY. I am not even thinking about the VA right now or the fire dept., just getting my quality of life back.

Rental knows his stuff, he will fill you in on VA lingo as far as claims go. I will say that the VA clinic here has been more than happy to help as far as paying for the brace I need postop ($850.00), telling me I can do phys. therapy there when I get to that point (saves me $15 a visit), etc.

I hope this helps and it all works out. I will be offline for a week or so after tomorrow morning so good luck!