Re: to fuse, or not to fuse...that is the question! long

December 4, 2008

Have you considered that you may have multiple issues that need attention? That

both surgeons are correct? You may need both the TLIF and some work on the brain

issue. I had no disk left between L4 & L5 and bone was hitting bone compressing

the nerves. I had no choice. I do wish however that I had this dome during

warmer months. Anytime I go pit in the cold my muscles seize up. I limit for now

my outings to doctors appts and PT. Warmer weather would allow you to do the

required walks outdoors but I just pace indoors with my walker. The brain issue

sounds like something I heard about years ago related to amusement park rides;

that some people get what is called brain shearing. This is where the membraim

that attached the brain to the skull separates. You may have two separate

issues that may need to be addressed.

Thanks!

Rhonda

On Dec 3, 2008, at 11:51 PM, NCGorgeous1963@... wrote:

My whole world just got flipped upside down yesterday. It took me until now

to process everything and try to get grounded.

Since my rear-end fender-bender on 7/12/07, I have seen multiple doctors

ranging from chiros to neurosurgeons. I've had 14 sets of x-rays, CTs and MRIs

of my cervical and lumbar regions, and 1 surgery in each area (the neck ACDF

C5/C6 was successful; the L5/S1 discectomy was not). I've been on narcotics and

muscle relaxers for 17 months, which have essentially become ill effective.

I am scheduled for an L5/S1 TLIF on 12/15/08.

Just yesterday I met a neurologist that I'd been referred to from another

neurologist (who couldn't diagnose me); having been referred to the 1st

neurologist by my neurosurgeon because he couldn't diagnose me either! For the

last

17 months I have been going out of my mind with extensive numbing and

tingling of my hands/arms and feet/legs. I felt good after my neck fusion but

the

symptoms came back 4 months post-op.

It just so happened that I smacked my head on the headrest REALLY HARD upon

crash impact. The whole nine...birds chirping, dancing stars around my head,

and instant nausea. In fact, if I hadn't have vomited an hour later, I

probably would have skipped driving myself to the ER. But I took that as a sign

to

not ignore the potential bodily damage I may have suffered. Wow. Good call.

Anyway, the ER did their usual thing - x-rays and CT w/out contrast of head

& neck and lumbar. Told me to see my PCP within 3 days. I had a migraine for

about 2 weeks but just figured it to be whiplash/concussion related and it

would go away. About 3-4 weeks post-wreck I noticed trouble finding vocabulary

and forming sentences or enunciating properly, unable to concentrate or pay

attention, irritability, etc etc. The vocabulary speech impediment thing lasted

the better part of 6 months.

All this time, every doctor I've seen has zeroed in on either my neck and

shoulders or my lumbar, but never the head/brain. I got better with the above

symptoms after my neck surgery in Feb 2008, but after about 4 mos, I noticed a

bunch of symptoms returned - sciatica, lumbar pain, numbing/tingling in all 4

extremities and brain fog.

I started asking EVERY dr that's treated me so far to tell me what's causing

the numbing and tingling and how can we fix it. I've been bounced to over 14

doctors with no resolution until I met the neurologist yesterday.

He is the only one who, within 10 mins, said, " I can't understand why all

these doctors have treated you for everything but the obvious. Your brain has

suffered a minor injury. Minor defined as not comatose or vegetative " . He went

on to explain about white and gray matter in the brain and how it's attached

to the skull by " strings " , which during impact were stretched like rubber

bands and potentially broken - which constitutes soft tissue injury and wouldn't

show up on x-rays, CTs or MRIs. He spent 3 HOURS with me explaining about

pain and receptors, how the spinal canal is designed and functions, how

surgeons are too eager to cut because that's what they learn in school and how

people like me with unexplained additional injuries fall through the cracks and

are never treated properly, being left to suffer on their own with drugs or

life-long pain.

He is also dead set against me having the L5/S1 fusion until he has enough

time to gather everyone's notes and images to determine that it is my absolute

last resort. (Guess I didn't realize that there is an apparent ego thing

going on between neurologists and neurosurgeons)! In any event, he asked me to

at

least consider postponing the surgery until he has seen the notes.

So I'm trying to figure out why, after 17 months - but 10 days before a

major surgery, God decided to send me a doctor who absolutely nailed my theory

of

brain damage (because that's what I've been thinking all along and he just

came out with it on his own); and now I have to make a decision on what to do!

The average person would probably just advise me to postpone it, but my

neurosurgeon is adamant about going through with it on schedule because I've

been

b*tching at him about horrendous pain for over a year - and because I've

been treating my L5/S1 for nearly 10 yrs with every other option available, to

the point where nothing else is working any more.

I'll spare the report details, but in summary, the ER's report of 7/12/07

said:

" There is marked degenerative change at the L5-S1 interspace noted....marked

degenerative change L5-S1 with near complete obliteration of the joint

space. MRI may be helpful to exclude disc pathology " .

An independent MRI was performed on 7/27/07, which said: " L5-S1: Moderate

right lateral recess stenosis from right parasagittal disc osteophyte

formation. Correlate for potential right S1 radiculopathy. There is mild left

lateral

recess stenosis as well. There is moderate to severe bilateral foraminal

stenosis from combined facet arthropathy and marginal osteophytes, right greater

than left. Correlate for potential L% radiculopathies. "

Then I had 2 double epidurals that lasted roughly 9 months. My failed MetRx

discectomy was 9/29/08. The latest MRI of 10/26/08 stated:

" L5-S1: Interval laminotomy on the right. There is a right paracentral

protrusion with enhancing marginal fibrosis. Mild mass effect evident on the

thecal sac. Small nonenhancing fluid collection evident at the laminotomy site,

exerting no mass effect on the thecal sac. Facet arthropathy and right foraminal

disc bulging stable moderate right foraminal narrowing. "

OKAY, so the question is, to whomever can interpret these findings: is it

evident that a fusion is, in fact, necessary at this time?

The problem with postponing the surgery is 1) new year = new insurance

deductable, 2) hubby is able to take 2 wks off to help me recover in Dec and is

prohibited per his company to take any time off until March 2009, 3) I HURT

24/7!

Any opinions and comments, board posted or private (_NCGorgeous1963@..._

(mailto:NCGorgeous1963@...) ) are WELCOME!

Hope everyone's feeling better today.

Best regards,

Patty A

--------------------------

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December 4, 2008

Patty,

The brain injury you are referring to is called a coup counter coup injury

and comes from the force of the brain hitting against the

skull.....wow....that is a tough position you are in....but I must say the

neurologist is making sense,....additional surgery is not always the answer,

The fact of it for me...has your neuro surgeon ever spent that much time

with you? If I were you.....see if you can get in to another neurologist

for an emergency consultation. Surgery is never something to be rushed

into....I will say that you could have 10 patients with your exact MRI. I

am trying to remember the exact number but I don't....but roughly 75 percent

will not even complain of back pain period.....that is why you will have

patients with completely normal MRI's that have horrendous pain and those

with horrendous MRI's and absolutely no pain. When dealing with a

back.....when it comes to surgery less is more, less is best. Ultimately,

other then inconvenience and having to reschedule stuff.....and your

deductable (when was the last year you didtn meet the deductable-so you

probably will have to spend the money anyway) and hubby even if the company

he works for is a bunch of jerks, he can reschedule utilizing FMLA

leave.......Patty this is my two cents......it sounds like you neuro is a

caring doc.....I guess another question is do the two docs know, and dislike

each other....that would be the only way I would worry about ego's. I hope

that you can be comfortable with any decision you make.,.,.I think I just

said something funny (comfort=pain free)

Deb RN

From: spinal problems

[mailto:spinal problems ] On Behalf Of Rhonda

Sent: Thursday, December 04, 2008 6:14 AM

spinal problems

Subject: Re: to fuse, or not to fuse...that is

the question! long

Have you considered that you may have multiple issues that need attention?

That both surgeons are correct? You may need both the TLIF and some work on

the brain issue. I had no disk left between L4 & L5 and bone was hitting bone

compressing the nerves. I had no choice. I do wish however that I had this

dome during warmer months. Anytime I go pit in the cold my muscles seize up.

I limit for now my outings to doctors appts and PT. Warmer weather would

allow you to do the required walks outdoors but I just pace indoors with my

walker. The brain issue sounds like something I heard about years ago

related to amusement park rides; that some people get what is called brain

shearing. This is where the membraim that attached the brain to the skull

separates. You may have two separate issues that may need to be addressed.

Thanks!

Rhonda

On Dec 3, 2008, at 11:51 PM, NCGorgeous1963@...

<mailto:NCGorgeous1963%40aol.com> wrote:

My whole world just got flipped upside down yesterday. It took me until now

to process everything and try to get grounded.

Since my rear-end fender-bender on 7/12/07, I have seen multiple doctors

ranging from chiros to neurosurgeons. I've had 14 sets of x-rays, CTs and

MRIs

of my cervical and lumbar regions, and 1 surgery in each area (the neck ACDF

C5/C6 was successful; the L5/S1 discectomy was not). I've been on narcotics

and

muscle relaxers for 17 months, which have essentially become ill effective.

I am scheduled for an L5/S1 TLIF on 12/15/08.

Just yesterday I met a neurologist that I'd been referred to from another

neurologist (who couldn't diagnose me); having been referred to the 1st

neurologist by my neurosurgeon because he couldn't diagnose me either! For

the last

17 months I have been going out of my mind with extensive numbing and

tingling of my hands/arms and feet/legs. I felt good after my neck fusion

but the

symptoms came back 4 months post-op.

It just so happened that I smacked my head on the headrest REALLY HARD upon

crash impact. The whole nine...birds chirping, dancing stars around my head,

and instant nausea. In fact, if I hadn't have vomited an hour later, I

probably would have skipped driving myself to the ER. But I took that as a

sign to

not ignore the potential bodily damage I may have suffered. Wow. Good call.

Anyway, the ER did their usual thing - x-rays and CT w/out contrast of head

& neck and lumbar. Told me to see my PCP within 3 days. I had a migraine for

about 2 weeks but just figured it to be whiplash/concussion related and it

would go away. About 3-4 weeks post-wreck I noticed trouble finding

vocabulary

and forming sentences or enunciating properly, unable to concentrate or pay

attention, irritability, etc etc. The vocabulary speech impediment thing

lasted

the better part of 6 months.

All this time, every doctor I've seen has zeroed in on either my neck and

shoulders or my lumbar, but never the head/brain. I got better with the

above

symptoms after my neck surgery in Feb 2008, but after about 4 mos, I noticed

a

bunch of symptoms returned - sciatica, lumbar pain, numbing/tingling in all

4

extremities and brain fog.

I started asking EVERY dr that's treated me so far to tell me what's causing

the numbing and tingling and how can we fix it. I've been bounced to over 14

doctors with no resolution until I met the neurologist yesterday.

He is the only one who, within 10 mins, said, " I can't understand why all

these doctors have treated you for everything but the obvious. Your brain

has

suffered a minor injury. Minor defined as not comatose or vegetative " . He

went

on to explain about white and gray matter in the brain and how it's attached

to the skull by " strings " , which during impact were stretched like rubber

bands and potentially broken - which constitutes soft tissue injury and

wouldn't

show up on x-rays, CTs or MRIs. He spent 3 HOURS with me explaining about

pain and receptors, how the spinal canal is designed and functions, how

surgeons are too eager to cut because that's what they learn in school and

how

people like me with unexplained additional injuries fall through the cracks

and

are never treated properly, being left to suffer on their own with drugs or

life-long pain.

He is also dead set against me having the L5/S1 fusion until he has enough

time to gather everyone's notes and images to determine that it is my

absolute

last resort. (Guess I didn't realize that there is an apparent ego thing

going on between neurologists and neurosurgeons)! In any event, he asked me

to at

least consider postponing the surgery until he has seen the notes.

So I'm trying to figure out why, after 17 months - but 10 days before a

major surgery, God decided to send me a doctor who absolutely nailed my

theory of

brain damage (because that's what I've been thinking all along and he just

came out with it on his own); and now I have to make a decision on what to

do!

The average person would probably just advise me to postpone it, but my

neurosurgeon is adamant about going through with it on schedule because I've

been

b*tching at him about horrendous pain for over a year - and because I've

been treating my L5/S1 for nearly 10 yrs with every other option available,

to

the point where nothing else is working any more.

I'll spare the report details, but in summary, the ER's report of 7/12/07

said:

" There is marked degenerative change at the L5-S1 interspace noted....marked

degenerative change L5-S1 with near complete obliteration of the joint

space. MRI may be helpful to exclude disc pathology " .

An independent MRI was performed on 7/27/07, which said: " L5-S1: Moderate

right lateral recess stenosis from right parasagittal disc osteophyte

formation. Correlate for potential right S1 radiculopathy. There is mild

left lateral

recess stenosis as well. There is moderate to severe bilateral foraminal

stenosis from combined facet arthropathy and marginal osteophytes, right

greater

than left. Correlate for potential L% radiculopathies. "

Then I had 2 double epidurals that lasted roughly 9 months. My failed MetRx

discectomy was 9/29/08. The latest MRI of 10/26/08 stated:

" L5-S1: Interval laminotomy on the right. There is a right paracentral

protrusion with enhancing marginal fibrosis. Mild mass effect evident on the

thecal sac. Small nonenhancing fluid collection evident at the laminotomy

site,

exerting no mass effect on the thecal sac. Facet arthropathy and right

foraminal

disc bulging stable moderate right foraminal narrowing. "

OKAY, so the question is, to whomever can interpret these findings: is it

evident that a fusion is, in fact, necessary at this time?

The problem with postponing the surgery is 1) new year = new insurance

deductable, 2) hubby is able to take 2 wks off to help me recover in Dec and

is

prohibited per his company to take any time off until March 2009, 3) I HURT

24/7!

Any opinions and comments, board posted or private (_NCGorgeous1963@...

<mailto:_NCGorgeous1963%40aol.com> _

(mailto:NCGorgeous1963@... <mailto:NCGorgeous1963%40aol.com> ) ) are

WELCOME!

Hope everyone's feeling better today.

Best regards,

Patty A

--------------------------

redistribution outside this list without express written permission is not

permitted.

**************Make your life easier with all your friends, email, and

favorite sites in one place. Try it now.

(http://www.aol.com/?optin=new-dp

<http://www.aol.com/?optin=new-dp & icid=aolcom40vanity & ncid=emlcntaolcom00000

010> & icid=aolcom40vanity & ncid=emlcntaolcom00000010)

December 4, 2008

Hi Patty,

I'm sorry that you are hurting 24/7. If I read the reports correctly,

there is nothing that indicates that you cannot wait for surgery. I

would postpone the surgery and let the new neuro take over. JMO but

you are being saved from having a surgery that may not work. If the

first surgery failed, why would you think that the second one will be

any better? Wait and talk to the new neuro and then take it from

there. Surgery did not help me at all. I would have been much better

off had I not had the first two surgeries. I was not given that

option and wish that I had been!!!

>

> My whole world just got flipped upside down yesterday. It took me

until now

> to process everything and try to get grounded.

>

> Since my rear-end fender-bender on 7/12/07, I have seen multiple

doctors

> ranging from chiros to neurosurgeons. I've had 14 sets of x-rays,

CTs and MRIs

> of my cervical and lumbar regions, and 1 surgery in each area (the

neck ACDF

> C5/C6 was successful; the L5/S1 discectomy was not). I've been on

narcotics and

> muscle relaxers for 17 months, which have essentially become ill

effective.

> I am scheduled for an L5/S1 TLIF on 12/15/08.

>

> Just yesterday I met a neurologist that I'd been referred to from

another

> neurologist (who couldn't diagnose me); having been referred to the

1st

> neurologist by my neurosurgeon because he couldn't diagnose me

either! For the last

> 17 months I have been going out of my mind with extensive numbing

and

> tingling of my hands/arms and feet/legs. I felt good after my neck

fusion but the

> symptoms came back 4 months post-op.

>

> It just so happened that I smacked my head on the headrest REALLY

HARD upon

> crash impact. The whole nine...birds chirping, dancing stars around

my head,

> and instant nausea. In fact, if I hadn't have vomited an hour

later, I

> probably would have skipped driving myself to the ER. But I took

that as a sign to

> not ignore the potential bodily damage I may have suffered. Wow.

Good call.

>

> Anyway, the ER did their usual thing - x-rays and CT w/out contrast

of head

> & neck and lumbar. Told me to see my PCP within 3 days. I had a

migraine for

> about 2 weeks but just figured it to be whiplash/concussion related

and it

> would go away. About 3-4 weeks post-wreck I noticed trouble

finding vocabulary

> and forming sentences or enunciating properly, unable to

concentrate or pay

> attention, irritability, etc etc. The vocabulary speech impediment

thing lasted

> the better part of 6 months.

>

> All this time, every doctor I've seen has zeroed in on either my

neck and

> shoulders or my lumbar, but never the head/brain. I got better with

the above

> symptoms after my neck surgery in Feb 2008, but after about 4 mos,

I noticed a

> bunch of symptoms returned - sciatica, lumbar pain,

numbing/tingling in all 4

> extremities and brain fog.

>

> I started asking EVERY dr that's treated me so far to tell me

what's causing

> the numbing and tingling and how can we fix it. I've been bounced

to over 14

> doctors with no resolution until I met the neurologist yesterday.

>

> He is the only one who, within 10 mins, said, " I can't understand

why all

> these doctors have treated you for everything but the obvious. Your

brain has

> suffered a minor injury. Minor defined as not comatose or

vegetative " . He went

> on to explain about white and gray matter in the brain and how it's

attached

> to the skull by " strings " , which during impact were stretched like

rubber

> bands and potentially broken - which constitutes soft tissue

injury and wouldn't

> show up on x-rays, CTs or MRIs. He spent 3 HOURS with me

explaining about

> pain and receptors, how the spinal canal is designed and

functions, how

> surgeons are too eager to cut because that's what they learn in

school and how

> people like me with unexplained additional injuries fall through

the cracks and

> are never treated properly, being left to suffer on their own with

drugs or

> life-long pain.

>

> He is also dead set against me having the L5/S1 fusion until he has

enough

> time to gather everyone's notes and images to determine that it is

my absolute

> last resort. (Guess I didn't realize that there is an apparent ego

thing

> going on between neurologists and neurosurgeons)! In any event, he

asked me to at

> least consider postponing the surgery until he has seen the notes.

>

> So I'm trying to figure out why, after 17 months - but 10 days

before a

> major surgery, God decided to send me a doctor who absolutely

nailed my theory of

> brain damage (because that's what I've been thinking all along and

he just

> came out with it on his own); and now I have to make a decision on

what to do!

>

> The average person would probably just advise me to postpone it,

but my

> neurosurgeon is adamant about going through with it on schedule

because I've been

> b*tching at him about horrendous pain for over a year - and because

I've

> been treating my L5/S1 for nearly 10 yrs with every other option

available, to

> the point where nothing else is working any more.

>

> I'll spare the report details, but in summary, the ER's report of

7/12/07

> said:

> " There is marked degenerative change at the L5-S1 interspace

noted....marked

> degenerative change L5-S1 with near complete obliteration of the

joint

> space. MRI may be helpful to exclude disc pathology " .

>

> An independent MRI was performed on 7/27/07, which said: " L5-S1:

Moderate

> right lateral recess stenosis from right parasagittal disc

osteophyte

> formation. Correlate for potential right S1 radiculopathy. There is

mild left lateral

> recess stenosis as well. There is moderate to severe bilateral

foraminal

> stenosis from combined facet arthropathy and marginal osteophytes,

right greater

> than left. Correlate for potential L% radiculopathies. "

>

> Then I had 2 double epidurals that lasted roughly 9 months. My

failed MetRx

> discectomy was 9/29/08. The latest MRI of 10/26/08 stated:

> " L5-S1: Interval laminotomy on the right. There is a right

paracentral

> protrusion with enhancing marginal fibrosis. Mild mass effect

evident on the

> thecal sac. Small nonenhancing fluid collection evident at the

laminotomy site,

> exerting no mass effect on the thecal sac. Facet arthropathy and

right foraminal

> disc bulging stable moderate right foraminal narrowing. "

>

> OKAY, so the question is, to whomever can interpret these findings:

is it

> evident that a fusion is, in fact, necessary at this time?

>

> The problem with postponing the surgery is 1) new year = new

insurance

> deductable, 2) hubby is able to take 2 wks off to help me recover

in Dec and is

> prohibited per his company to take any time off until March 2009,

3) I HURT

> 24/7!

>

> Any opinions and comments, board posted or private

(_NCGorgeous1963@..._

> (mailto:NCGorgeous1963@...) ) are WELCOME!

>

> Hope everyone's feeling better today.

> Best regards,

> Patty A

> --------------------------

transcription or

> redistribution outside this list without express written

permission is not

> permitted.

> **************Make your life easier with all your friends, email,

and

> favorite sites in one place. Try it now.

> (http://www.aol.com/?optin=new-

dp & icid=aolcom40vanity & ncid=emlcntaolcom00000010)

>

December 4, 2008

Patty,

God bless you. After carefully reading what you wrote, I would wait. I think

you must try every avenue first. A new doctor thinks its best to reassess.

Whatever you do, we are all with you every step.

ivan

From: NCGorgeous1963@... <NCGorgeous1963@...>

Subject: to fuse, or not to fuse...that is the

question! long

NCGorgeous1963@...

Date: Wednesday, December 3, 2008, 11:51 PM