Laser Spine Surgery

Hi Spine Sufferers!

Billy's comments on Post Op pain is not uncommon. I have been told by some people who have had spine surgery whether Min. Invasive or Open Back that their post op pain was excruciating.

In my surgeon's Post Op Report, he stated that upon completion of all of the work he had done "he covered the area with "Pain Paste". Haven't the faintest idea of what "pain paste" consists of. I can say that when I woke post op, I just had ache and stiffness in my back. I was up and walking in the hospital immediately. The actual time I was in the hospital was less then 48 hours although in the way the financial department counts it they say 3 days. "I thought that was a joke."

When I got home it was 4 days (my way of counting) when I felt real pain from the surgery. Yes it was real pain and I had a few spasms that went out from L 4 that really kept my left leg from wanting to move forward let alone climb a step. I learned that I just could not sit down for 20 min. and then walk. That is also when my husband asked Dr. McLain to order Visterol for me. Visterol is a muscle relaxer. (Dr. Berg had me on that when I was in the hospital but I did not go home with an Rx for it. Once I took that for about 4 days the spasms disappeared. I also would not sit for very long right before I knew I was going to take a 15 minl walk or climb steps.
Let me emphasize that this pain was from the surgery. The pain I had in the back, buttocks and legs caused by the stenosis was entirely gone and I have never experienced that type pain again. But from the type discomfor I had post op, and after reading the Surgeon's Surgical Report, I understand even more about what I am recovering from in regard to the surgery itself. Boy am I glad I chose my surgeon instead of the aggressive doctor who wanted to do 8" incision, rods and two discectomies. I asked the surgeon why he chose not to do anything with the buldging disc at the L4 &5. That's where my major problem had occurred. He said he did not believe that was the cause of my back pain.
He said he believes that for the patient, "Less is better." Once they chip away at the disc, it can herniate at a later time and the patient is right back into back problems again. I, frankly, don't understand enough about why some discs cause some people more problems then others.

I can't tell you how grateful I am the my surgery was Min. Invasive and not Open Back. I can say that my incision was not 1 to 1 1/2 inches. It was 3 inches. I also lost less then a cup of blood. I told Dr. McLain on my first post op appointment that my left side felt like it had been through a War Zone. He said, "My dear, it was in a war zone."

5 Weeks post op, I take two Tylenol Extra-Strength twice a day. I could take less, but I have found that taking this 2 x daily helps with the stiffness around the site where the Fusion is located L4 &5. I had Fusion Insitu....that means there was no rods.

I am still building up my physical strength by walking.

Rich, I never knew I was so old as I have felt post op. My Doctor keeps assuring me that I will be up to snuff in a few more months. I do hope so.Of course up here we are having this horrible weather of ice, snow, cold etc.

'Course, I must admit I kind of like my husband doing the cooking and helping with the laundry. Togetherness is good.

Marie B.

Rich, Beside your interest in gardening, do you do any specific type exercises or physical therapy to keep your back muscles strengthened?

I'm not to do any physical therapy at this time, but once the my fusion is secure, I think I will be put on some type of strengthening exercises.

Marie B.

If you are talking to Carol. Tell her I have a friend who had Min. Invasive Surgery at the L4 -5 for stenosis. She had Anterolisthesis at the same locale. That's spine slippage. Her surgeon did not address the slippage...and hers was a high grade slippage. The disc was completely uncovered with spinal canal impingement caused by the slippage. I think she did not want the Fusion.
That was 3 years ago. She is now in big trouble with herniated discs from L1 through S 1. She has started a series of Lumbar Injections and they are scheduled two weeka apart. That surprised me because my injections were scheduled a month apart. I don't think I will ever understand the decisions that are made in this field by doctors.

Marie B.

I found this info on an informational site provided by Cleveland Clinic.
One ingredient in the pain paste is "morphine."


A method, apparatus and kit for preparing and performing a surgical procedure includes providing a medicinal composition having an autologous tissue medium and a therapeutic agent. the medicinal composition is then delivered to a surgical site in a patient before closing to reduce postoperative pain, provide an interpositional membrane to prevent or inhibit the formation of scar tissue, and/or promote hemostasis. The medicinal composition is suitable for use in a variety of types of surgery, and has particular application in bone or tissue grafting and orthopaedic surgery, expecially spine surgery.

Inventors:
Biscup, Robert S. (US)

Marie B.

Hello Marie,

Before lunch I had your one post to respond to, and now there are three. I had better hurry up before there are more.

All kidding aside Marie, you really touched not only my "nerve", but also my spine, for which I thank you.

Such phrases as "Boy am I glad I chose my surgeon instead of the aggressive doctor who wanted to do 8" incision, rods and two discectomies." "He said he believes that for the patient, "Less is better."" "I can't tell you how grateful I am the my surgery was Min. Invasive and not Open Back. I can say that my incision was not 1 to 1 1/2 inches. It was 3 inches." Marie, I really needed to quote your entire post, but needed to quote your salient statements that "jumped out" at me.

And last August my spinal surgeon was talking about a 12 inch incision and two fusions with screws and rods and more. That hit HARD. And YOU have confirmed my concerns. WOW you had and have one FANTASTIC spinal surgeon!!!!! I remember my doc saying in late spring that he was concerned, because of my age, that to do all that they really needed to do on my back they were not sure I would be able to "tolerate the surgery". From what you have said, I now better (though uncompletely) understand what he was talking about.

Marie, I am so happy for you. Happy that you found a FANTASTIC surgeon. Happy that you had minimally invasive surgery. Happy that the surgery was a success. AND happy that you are now recovering well.

Your post has even made me "happier" with the words of my surgeon last week - "It seems best we let well enough alone at this time."

AWWWWwwwww Marie, each day you will become younger. It won't be long and your husband and family will be having a hard time trying to keep up with you. LOL

To your 2nd post - Yes, I do have PT exercises that I do, especially now with little time spent gardening. I know I have to keep physically active or my back is going to complain.

Understanding doctors - More impossible to understand doctors than it is for us guys to understand you ladies. LOL In all seriousness, it IS concerning the vast differences in doctor's OPINIONS, for it seems there is little "science" connected with their opinions. Oh yes, we humans are one diverse species, HOWEVER -------. I almost feel we have never left the days of "alchemy" and "witchcraft". Just seems like part of the medical "puzzle" hasn't been put into place. Perhaps no different from any other discipline - There are those who are outstanding in their field, those who are so so and those who are total zeros.

I have not corresponded with Carol for some time. I have been thinking about doing so, though I know she is very busy. You have given me the "shove" I needed, so next off is an E-mail to Carol to ask how she is doing and to relay your message to her.

About the "big trouble" - Yes, that too haunts me because of the slippage I have at L5-S1, and a multitude of other things. A good thing I had a math course in college about "Probabilites". Helps in making decisions that give you the best odds.

YES, morphine CAN be used to reduce pain, but as you know it must be used very wisely. Wisely such as in the paste. Not in a manner in which one would become an addict.

Again Marie, thanks SO MUCH for your thoughts, insight, wisdom and food for thouoght.

Have a Wonderful Day in your recovery.

RichT

Hello Everyone,

Just noticed that we are on page 34 with a total of 664 posts, and 18267 "views".

AWESOME!!!!!! What an incredible spiney family we have here.

Rich, Can you be more descriptive of the type of PT exercises you do in your present condition on a daily basis?

I'm not going to say that I am going to imitate you but my doctor says he will consider PT after my next surgical review. He believes that the areas that I say ache will begin to feel better after I begin mild stretching exercises.

I figure, with your back problems from top to toe, you can't be doing some of those crazy exercises you see these "youngies" doing.
I am keeping my walking on a treadmill at 30 min. going a slow at a slow number Two. Even at that, my husband worries that I am going too fast. But I do feel better on walking and after walking. Now if my muscles around my thigh joint and connected to my hip joint and my muscles of my foot bone connected to my ankle bone would stop acting like unused muscles I would push my walking time to at least 45 minutes...but I'm not going to rush it.

So please let me know what you are doing. I can then discuss them with my doctor and see which he O.K.'s and which he nixes. I really don't want to have to get in my car, drive to a PT place and listen to the person tell me what to do and then I have to do it in a corner in one of those crowded PT places. I hate those places. I don't want to spend any more money on that stuff either if I can do the exercises at home. Better to stay at home rather then go out on these icey and snowey streets. That's all I need is a slip...worse....a fall.

Marie B.

Hello Marie,

Yes, I do stretching exercises. Unfortunately, that is all I will tell you. Each person's situation is different. Even for myself, depending where and how it is hurting will determine which exercises and treatment my physical therapist will do on me and which ones I should do at home.

Marie, I REALLY believe that it is important that you receive physical therapy from a recognized respected PT center. I'm with you, I don't like those "big" open rooms with one table next to another. I lucked out in that my doc for my rotator cuff tear recommended a place that has mostly private small rooms. A great place and fantastic therapists.

The wonderful young lady who helps me can demonstrate an exercise, I can then do it and she will correct me so that I do it right. Three days later I'll go back and do that same exercise and she will tell me I need to do this or that differently. That has happened numerous times. It IS important to not only do the right exercises, but also to do them correctly.

Do yourself a big favor and go to a PT center. Check them out. I have done that. YOU decide which one you like, and of course that your doctor approves/recommends.

Now be patient. It takes a long time for the body to heal itself. Far longer than the mind thinks it does.

No playing doctor or physical therapist on yourself. Okay.

Take care.

RichT

Hi everyone!

I just spent the last hour or so reading posts from page 30 -34!! I’m feeling so guilty for not staying in touch! Thanks to Marie and Rich for the nudge I needed. But, wow! So much has been going on! Whew! First of all, welcome to the new posters! What an excellent addition to fabric of Rich T’s awesome thread!

Marie: My spine twin no longer . . . for you are on the mend!!! I’m so, happy for you! I’ve read with amazement at your tenacity and spunk!! You go girl! And none of this nonsense about being old! If you’re old, than so am I! On my worst day, I prefer to think of myself as chronologically challenged!! Rich T and Fran are right . . . take it a bit easier. What are you crazy shopping all day??? Who even likes to do that w/o back pain?? But seriously, thank you for continuing to share your story and wisdom! I appreciate the info. regarding your friend’s post op progress. There are no guarantees no matter what we decide to do. I hope she gets some answers soon. I’m still pretty much in the same boat as Rich T. I’m doing the shots, as long as the shots are effective, (I got 4 mos. relief from my last one.). I have a conference in Jacksonville FL, in June. It was/is?? my intention to morph that trip into my surgery hiatus @ Bonati. But who knows . . . we weigh all the stories and experiences that are posted on the thread, (so that’s how many of us make our decisions . . . through the help and insight of others!

Speaking of wisdom . . . Fran you are a medical resource extraordinaire!! Keep the info. coming!

Best Dad award goes to Innovator!! What a privilege to read your posts. Best wishes to your son! Glad to hear the facet surgery went well.

Carrianne: Re-hab already!! Good news! Glad to know our prayers worked!!

MJ & Lonestar Guy . . . I’m thinking all is going well with you two, too? Anyone hear from Abracadabra? Dave, and of course Joebob??

Anyway! Ho! Ho! Ho! Merry Xmas! It sounds like it will be a good one for all! Back to the rat race!
P.S. to Marie: I don't believe ALL of Rich T's exercise is in the garden!!
C

Carol, your mentioning getting relief for 4 months from one injection is amazing. If I could have had that kind of relief I would never have looked into surgery.

I really don't understand PM decisions. Here they schedule you automatically for a minimum of 3 injections. Since I left my local area and went to the big city for my injections, my PM doctor did the injections a month a part. I don't know if it was because when I would go back and say "I'm still having pain" that I would be then sent in for an injection or if the PM would say "We will wait and see how long this will work." if I had no pain. I never got the chance to really see just how that system works in the various areas from which our posters come.

But the friend I mentioned in a previous post who found out she had a lot more problems in her back and her pain was increasing is now being treated first with injections. The injections she is scheduled for are 3 and they are two weeks apart. NOt only that but she is put to sleep for the injections. I was never put to sleep. I was just given a sedative and I never felt a thing when the procedure was carried out.

In my locale it seems as though 3 injections are done...no matter what. I don't understand the injection system or how decisions are made.

Marie B.

Hello Carol,

Glad Marie's "encouragement" to me to communicate with you worked. SOOOooo very nice to receive your E-mail and your post here.

Please do not feel guilty at all. I can't even imagine having the things you need to do in 24 hours when you really need a 48 hour day. You are simply amazing. YES, "kill two birds with one stone" as they say. Hope your conference in Jacksonville this coming June goes well and that you are able to check out Bonati Institute.

Four months on your injection is "right on time". The so called max of three epidurals a year puts you right on target. SOOOOooo glad it worked for you, and hopefully they will continue to do so. I know, it seems the medical community has all sorts of "interpretations" of the three shots.

Best Dad award - YES, I couldn't agree more, it definitely goes to Innovator!!!!

YES, the experiences and thoughts shared on this thread are a major "rock" on which to build ones decisions. I know it is for me.

And what is this "I don't believe ALL of RichT's exercise is in the garden!!"? Carol you broke me up on that one. Lets see, does walking up and down the stairs 15-20 times a day count? How about taking the garbage and recycle things to the landfill? Oh and of course a few other "exercises". LOL

I wish you the very best in your writing. That takes a tremendous amount of dedication and perseverance. BRAVO!!!!

Have a WONDERFUL Christmas.

RichT

Hello Marie,

I'm with you - I don't think it is possible for two doctors out of "X to the nth power" to agree on anything, let alone epidural injections. There are these so-called "rule of thumb" guides we hear about, and they all seem to break it.

My PM doc said "We will try one injection and see how that works. Then if after two weeks no pain relief I'll give you a second injection" I remember saying to him "But doc, I can only have a max of three a year" To which he mumbled some reply. I get this feeling we are all on some experiemental study but they don't tell us about it. What's the generic terms - "guinea pigs"?

What do you mean Marie "put to sleep? Sorry but I had to laugh on that one. No putting me to sleep, just some lidocaine mixed with the Kenalog corticosteroid. That is all I received. No sleeping, just wide awake. Honestly though - no complaints. My ole PM doc is SMOOOOTH!.

In all seriousness, I become very concerned about people receiving all those injections one literally after another. Corticosteroids are fantastic anti-inflammatory chemicals, BUT too much is not a good idea.

Take care.

RichT

Yes Rich, I agree about the "being put to sleep for an injection. I told my friend that I was never put to sleep. I was busy chatting to my doctor and a second doctor on fellowship everytime I had an injection. I got the same mix as you did and when they were injecting I never felt a thing...not even pressure. When they pushed the cart you were on in what was the "recovery room" I began to look forward to the gingerale and crackers that were usually provided for a refreshment post injection. One did have to fast from midnight to the day of the injection which for me was always around 10 AM. Yep, gingerale tasted really good after no liquids or foods.

I was told that the series of 3 was always given and when I questioned why I kept being sent in for another one, they said I had 2 Lumbar injections and when I went in for the third, they did a transforaminal...And they gave the injections at both L4 & L5. and I got three transforaminals. I was told that they considered these as "different locations". They just couldn't find any way to relieve the pain.
My surgeon told me, post op, that he doubted with the mess I had that any injection would ever give me relief.

I wish Joe Bob would check back in. I would like to know about the stiffness that he used to talk about. I remember him saying that walking relieved that, but I think he said for a long time that stiffness would return. I wonder if that is a post op symptom that he is still experiencing.

Marie B.

Marie B.

Hello Marie,

Yes, I too hope Joe will check in. I'm most interested in how he is doing. But also I know there are some who have recently joined our Spiney family who would like very much to communicate with him. Come on Joe check in. (We know you are at the ice hockey rink. LOL)

Marie, they gave you GINGERALE AND CRACKERS?!!!! Good grief, I never received anything. You sure rate better than I do. LOL Heck, I had to get myself up on the table and turn on my stomach. When the injection was over they had me sit on the edge of the table for a few minutes and then try and walk to the waiting room. Fat chance of that. The Lidocaine really upset my equilibrium so both times they would rush and get me a nice comfortable chair to sit in so they could wheel to another room. After about 45 minutes the ole mind cleared up enogh so that my wife and I could walk to the car.

To be fair, I didn't have to "fast" the night before. I ate my regular breakfast before my wife drove me to the institute.

Now what the heck is going on with the medical establishment? There ISN'T any science in it is there? Frankly, I see it as a HUGE problem with the medical establishment (at least so in the U.S.). Here you and I communicate on the internet be we from any place on planet Earth where we have access to the internet. When are doctors going to get their act together and communicate in a similar manner. What's the issue? Too much ego?

Okay you doctors reading this, when are we going to see some REAL SCIENCE? When are you going to run extensive double blind studies on all the variables talked about here on epidural Kenalog injections? I for one am getting tired of this "black magic" you are practicing. Get your act together!!!

Yes Marie, as someone said a number of months ago - "Do you know why doctors/we call what they do a "practice"? Because they are still practicing." I thought their "practicing" was done at medical school.

Time to cool off with a beer.

RichT

P.S. - Here come the attack planes. No worries though, we spineys are a tough bunch. LOL

Hi:
I just tried to post a reply and lost it. I guess I just can't type fast enough. I won't retype the whole thing, but essentially I received all my injections under light anaestetic or what they called a twilight sleep, similar to an amnesia like state. You can respond to questions etc. Someone needs to drive you home. I sleep like a baby afterwards and yes, Marie I've been fortunate that they have lasted this long. But I guess I should say, that all the pain is not gone. It's a good day if I'm experiencing a 3 or a 4 out of 10! I really try hard to convince myself I'm not hurting. Mind over matter I guess, the problem is that I think I'm losing my mind, can't remember a darn thing!!

Hats off to you and your ability to start walking . . . as Matthew McConoughey said, "patience darlin' patience!? You'll be like the bionic woman!!
C

Hello Carol,

Sorry you lost your post. For your info the Admin has set the automatic "log off" time at two hours. Within the two hour time frame you should not lose your post.

Carol, I must admit I cringed when I read "3 or a 4". Not near a 10 I know, but with the injection I would have hoped your pain would have been less than that. I'm generally between 0 and 2 from my perspective. Can I bump it up higher than that? You bet!! All I need to do is stand and not move and within a few minutes the pain level starts rising. Even standing in line and taking a step forward and back is not good enough to get the pain level back down. I have to walk, and walk fast, or sit down in a comfortable chair.

I know you are in a difficult situation with work, but it concerns me when you say you try to put the pain out of your mind. I suspect that in reality that is not working so well. Is there some way you can change your body's position to get the pain level back down? Hope so.

Well, I'm off to my recliner and the heating pad to try and work my current pain level back down where it should be.

Take care

RichT

Richt/Carrianne:

I just felt compelled to give you an update on my son. I am writing this from the Bonati. My son is here for physical therapy today. He will also meet with Dr. Moffat today and also the pain management Dr. a Dr. Lemonte.
We are now 5 days post op. Up until Sunday he still had pain on the right side. When he woke up Sunday he had intermittent pain on the right side.
For the lat two days he has been pleasantly pain free.

As I stated before he had facet embridement surgery in six locations total ; three on each side. This is similiar to having a root canal in a tooth where they kill the nerves. A second surgery was planned for a large herniation at L5/S1 but Dr. Moffat does bot want to do the surgery as my sons' leg pain has disappeared though he still has some numbness.
He says he can live with the numbness.
One thing they have told us here it is possible for the nerves to regenerate. If this occurs we would definitely come back.

Just a little run -down on the surgery and after what occurred:

1) My son was scheduled for surgery at 1:30 and we finally got in around 4:30. He was in recovery by 6:00 and home by 7:30 p.m.

2) He was not in much pain that night from the surgery but the next day was in moderate pain including the right side.

3) Day 2 post op was rougher as we had to spend all day at Bonati and he became exhausted just having surgery the night before. He ended up running a fever that afternoon of 103 but Bonati took good care of him prescribing heavier antibiotics and running blood and urine tests to ensure there was no infection.

3) Day 3 - Fever was gone went to physical therapy, had a follow-up check-up with Dr. Moffat due to the fever and was told to rest for the rest of the day.

4) Day 4 and 5 was a weekend and walked a lot at the Gulf Island condos.

That leads us up to today. We have been here 6 days he is doing very well. I have booked him a ticket to fly home on Dec 23rd. We will stay here and due physical therapy through the weekend. We drove here but the sixteen hour drive is not recommended for back patients.

I will drive home Sunday myself as long as he remains pain free.
Next thing is to slowly cut down on his medication and get him off of it.

With our experience here so far I would recommend people with back problems check out Bonati. My son may need to come back here again some day as he does have the herniation and degenerative disk conditions at three locations.

Bonati has fine surgeons, a great staff and a very good process.
Are they miracle workers? No... they are fine surgeons and caring people.
Can they make everyone pain free? I don't know but it is working so far for my son and they have my recommendation as someone to consult with and then you can make your own decision on them.

I chose Bonati for my son over LSI for two reasons : LSI made a critical mistake in reading my sons' MRIs and LSI seemed to me to be more into volume and not the patient.

I have appreciated all the interaction on this site and wish you all well.
I will keep you updated on my son as time goes by. We have a few more hills to climb but so far this has been a great experience for us.
May God bless you all and keep you pain free.

Norm (Innovator54)

Innovator

If a herniated disc is not causing pain, either because of the condition of the disc or if it is not pressing or sitting on a nerve or the cord which can cause the pain, many surgeons will leave it alone. As I understand it, their goal is to relieve the pain by dealing with that situation in the spine that is causing that pain. Sometimes, when trying to clean up the spinal column of areas that are not "normal", a surgeon can create a situation that causes the patient other problems in the future. That is what I have been told.
It is wise of you and your son to now wait and see how things go in regard to what has already been done in surgery.

Just keep re- inforcing to your son that just because he feels no pain does not mean he is completely healed. He must take it easy for a while. Think several months of doing it easy. Walking is good. Walking really helps. Believe me, not only do I have poster friends who keep reminding me about "taking it easy", I also have neighborhood friends who tell me to not be in a hurry to get my life back. Five weeks from surgery and I still have some aches that I could ignore but instead I coddle myself and do the minimum of housework. (Rich, I don't have to worry about gardening, I have 8 inches of snow that is covering everything here.)

Innovator if those areas of your son's spine that are not normal on an MRI and he is going about his life without pain, tell him to don't rush back to the surgeon. The body only gripes at those things it can't fix or accommodate to itself.

Marie B.

Hello Norm,

Thanks very much for your update on your son. As I was reading through your post I was preparing myself for the "shoe to drop", but it never did. WONDERFUL news that you son is doing so very well.

Norm, thanks so very much for sharing the details and all.

Do be careful on your drive back home. Have a safe trip.

I wish you, your son and your families a most wonderful Christmas and Happy New Year. The good Lord has answered all our prayers.

RichT

Marie:
Thanks for the kind words and advice.

We met with Dr. Moffat today and he stated just as you have that we should leave the herniated disk alone because it is not causing any pain.

He has also been restricted for six weeks to 5lbs.
After six weeks he is to begin slowly testing what he can do.

I am glad you are doing well.



Norm