Anyone have a microdiscectomy?

Thank you for relating your experience Slickrock.  Hopefully, you're doing well now.

I believe "micro" is the arthroscopic method you alluded to.  Did you have the entire disc cut out or just a portion of it?

I appreciate your general advice about what will happen if I don't get it done ... and realize it's a bit of a "slow-motion emergency" in that nerves that are impinged will eventually be permanently damaged & have a better chance of working again the sooner the compression is relieved.  I knew this right off based upon my prior experience with c6/c7 that left my tricep not fully 100% after 5.5 months of waiting for the procedure. 

I know the clock is ticking, but have been trying to give it a chance with injections, PT, and a little time ... and just as you've mentioned, fabes, things have almost always "healed" in past flare ups.  I've had back issues most of my adult life and looking back, I've probably had at least 50 flare ups of various degrees; with at least half of them being relatively severe.  In all cases but one (c6/c7 in 2015) the flare-up subsided over time.   I did have an injection two weeks ago to date, but aside from the immediate relief that day for 6 hours from a numbing agent delivered with the cortisol, the steroid's effect was minimally / moderately effective over the following few days, then slid entirely backward to pre-injection state over the last week.   Still, there was a good diagnostic value in knowing the numbing agent worked on what was likely the culprit disc area.

There have been a couple of flare-ups over the past decade or so that I was convinced wouldn't heal on their own, but they eventually did ... although they didn't involve muscle weakness.  So, I've been trying to walk a fine line to give it a chance, yet be ready for surgery.  I have a consultation appointment with a surgeon on Nov 7, but somewhat fearful that I'll get roped into more injections that only provide a temporary reprieve due to the underlying pathology of the physiology. 

That's great that you can walk several miles fabes.  Unfortunately, I'm much more limited on that front ... although can get on bike and allow my good leg to do most of the work and get some exercise / rehab (even though my affected quad still has a limit before it becomes "fatigued").    Curious if your pain managment protocols includes pain killers?  I've been on oxycodone for a few weeks; prescribed from my primary care physician, but I think the end of the road on that front is coming soon with a follow-up on Friday.  Not sure if she's going to refer me to another outfit that only deals with this sort of thing or try to get me to stop entirely.  The pain was off the charts the first 2-3 weeks 24x7, but has gotten better ... although it's STILL enough to make it so I can't sleep through the night and have a hard time functioning with daily tasks/work.     Regardless, hopefully the injection(s) and PT help you!

I'll second your notion that we both get better, fabes!  I know what you're saying about how an event such as not sleeping in the right position or being in a car for too long can send me backwards too.  It doesn't take much actually; and I can sense the weight of my torso creating instability while sitting, standing, or walking.  This sense of instability had gotten noticeably worse about a year ago.  Have you tried "dry needling"?  My PT does it and I think it definitely helps to get the knots out of some of the muscle groups that are in spasm.  I did try flexeril at the beginning and it helped a bit, but not the pain so much.    Unfortunately, all the gains I make at PT are somewhat erased in short order ... even though I try my best to not piss off the nerve for as long as possible after a session (or otherwise in general).

I appreciate the words of caution about opiates, Highnote, and sorry to hear Mrs Twang had to endure so much!   While I respect the potential for negative crap / abuse, and certainly don't consider myself immune, I've never really had an issue with opiates.  It's just not my "drug of choice"; partly due to the reasons you allude to.  I haven't picked up my guitar in 6 weeks, food doesn't taste as good, and basically all "good things" the senses deliver are significantly muted.   Also, my personality / demeanor is so laid back anyhow that I'm not a fan of exacerbating this part of me.  I'm acutely aware of these things and look forward to the day I can return back to my baseline.  I believe I've been on a relatively low dose (5mg oxycodone 3-4x per day), so not concerned about having to pass through a "sweats / shakes /etc" stage when coming off of them ... which I'd taper as well.  Still, if I'm looking at moderately severe pain levels until a surgery in 4-6 weeks, I'd likely be willing to stay the course with pain meds until the surgery.   If it's a long term proposition, it's an entirely different story and would place greater emphasis on my respect for not being immune.  Regardless, I do appreciate the warning!

Glad your back is currently in decent shape Slick, and thanks for explaining further about the nature of your procedure. Part of me likes the idea of not having to have fusion and having the same mobility as you've alluded to, but the skeptical side of me wonders whether the remaining disc material will eventually ooze out and do it's thing all over again. However, I keep coming to the conclusion that a fusion would still be an option. It's great to have had a surgeon who you knew was top notch. I was lucky to have had a great surgeon for my artificial disc replacement at C6/C7 who happened to be known beyond his practice in Durango, CO. In fact, I believe he may have somehow worked or interacted with Bill Walton ... there were some news stories and his jersey was hanging up in a room. Unfortunately, he retired at the beginning of Covid, but I found a surgeon in Grand Junction who trained at the Cleveland Clinic and apparently gets high marks.

It's amazing how much a bed can help or hurt, fabes! It's always been the big divots / body impressions that wind up killing my back ... so settled on an all cotton 6" futon matress that I can rotate and flip when body impressions begin to materialize. I also wonder about how a weakness in one area will create a "domino" effect into other areas. My PT believes the weakness in my quad has created an instability in my knee that's resulting in a secondary issue / pain. I've had a similar experience in so far as the the C6/C7 impingement affecting my arm. I used to have a very good arm, but struggled to throw a softball 30 yards when I happened upon a foul ball while walking back from a hike this past summer. But yeah, it's because of having gone through this with my arm that I'm also acutely aware of the potential of permanent issues with leg ... which I've come to respect as being "more important" in so far as mobility!

Your PT is correct.  My time on the stationary bike and the elliptical has really strengthened my leg muscles and my balance is improved. Use to be a question mark standing on one leg to get pants on. No more. Knees still ache after working out but more an arthritic condition, I think. I use CBD cream on those. The increased muscle mass in my thighs and calves has really helped support the knees.<<<<<

Glad your PT efforts have paid off!   Can you get CBD cream in Utah?

It started out immediately as referred pain in my knee (and other parts of my leg) that responded well to CBD / THC balm applied directly to my back, so it seems like there are two things going on at the same time now.   While I can't walk very far, I can get on my bike and ride a couple of miles on slight inclines without feeling like I'm overdoing it ... since I'm able to distribute more workload to my good leg to increase the duration to at least get a chance to exercise and get my heart rate up; while also using the bad leg as much as possible.  Unfortunately, the nerve to the affected muscle groups isn't firing at 100% so it's not ideal for rehab, but at least it's something to keep other muscles doing their thing in order to keep all the dots connected to some extent.  The bad leg is actually my "back leg" for snowboarding ... and was noticeably overdeveloped compared to the other one - akin to a tennis player's forearm.  I'm expecting it to atrophy, and not sure where I'll be on the other end of a possible surgery, but still hopeful.  

CBD is legal here (nationally?), and I have a medical card from the state for THC needs. But I've been getting  my homemade CBD cream from a woman in OR. Cheaper than the stores, and I support her<<<

I'm in the dark about whether CBD is legal nationally.  In fact, I was skeptical about its use before trying the 1:1 CBD:THC balm I've been using (also made locally by a small independent outfit / person).  I am now a convert and it's part of my current quiver to relieve pain.   There's another issue with Colorado law that I'm still not 100% clear on, but there appears to be a regulation that limits dispensaries to carry a product that contains CBD at a ratio greater than 50:1.   The staff at the dispensary I've been going to recommended I find a source other than a dispensary to locate a CBD product with a higher concentration, but haven't taken the time yet.

Today I go back and I am assigned another therapist who is from another office and is filling in. He takes some time reading my file from the previous day and had me do about 3-4 stretches, exercises, and movements to work on strengthening my balance. Each one was really good at relieving pain, and I could feel the muscles in my hips and legs responding in the balancing movements. I also found out a couple of stretches that I had been doing were actually hurting me more than helping. I guess my worries about the first therapist were off, and he took his time to convey the right info in my file to give me a good positive experience today
 

I am really hoping the positivity continues, and I can cancel the shot. <<<

Glad the PT shuffle landed in a good spot for you.   It's typically a good sign when stretches / exercises appear to provide immediate relief or improvement.  In general terms, I've learned that listening to your body to avoid nerve pain is a decent guardrail.  At one point in a flare up a number of years ago, I learned that trying to "stretch through" nerve pain can make things worse; instead, I was told to do "nerve glides" until I could stretch without pissing off the nerve, but would ask your PT about it first.

I can see not wanting the injection (for a number of reasons) and would also seek to try PT first.   I'm not sure from your prior posts if you're having weakness in your leg as a result of nerve impingement, but if so and PT doesn't help enough, perhaps an injection might help to mitigate your symptoms and/or as a diagnostic tool.

About three months ago I was sitting with three 40 yo's all who had back problems.   I myself dealing with "Annular tear of lumbar disc.  It demonstrates a small central protrusion at L5-S1 with annular fissure. There is no nerve root compression. The remaining disc levels look good"    And only one of the four of us had had surgery, in particular microdiscecotomy.   Dude swore by it.   He said he walked in hunkered over and walked out like nothing was going on.  He was swimming and running and totally back to normal while the other three of us where trying to get comfortable.   While my doctor has advised to avoid fusion surgery for as long as I can, I haven't discussed whether this is an option but I'm intrigued.   I feel like my life is me managing how to sit or how to sleep and it's just no way to live.   I can do about 20 minutes of pulling weeds before I'll trigger something a few days later.   It's pretty lame.   I've started to look for second opinions but trying to weigh if I'm just looking for a particular answer.   That's not a good approach. <<<

I've heard similar things about microdiscectomy, but have also heard stories about people coming out a bit worse (drop foot) or developing an issue somewhere down the line.   I've been having the same internal debate about whether it's worth the gamble.  It has to say something that most health care providers will try their best to see if non-invasive treatments will "work" before surgery.   I'm not sure, but I think this might say something about the back being such a necessary crux of functionality; in light of how even a moderate pathology of our natural physiology is still a better option in many instances vs. opening up the door via surgery that sometimes (or often enough) leads to complications that are worse and there's no "going back" to the prior state of affairs.

But yeah, looking back I've essentially been a frog boiling in water for the past 10 years;  and especially in the past year or so I've noticed a significant regression / more instability.  So, I now ask myself if the best I can hope for without surgery is a spontaneous recovery of my leg weakness at the moment; only to put the next one off for another 6-12 months and then be subject to who knows what level of injury to my leg as a result of the next flareup that might involve even greater loss of motor function?   The voice inside of my head that is able to analyze my full history says it's not worth it, but I wonder if the surgeon would still say it's not worth the risk of surgery?

Please know Zang that I'm saying all of this in relation to my current situation.  I'm not sure if you have muscle weakness, but I believe it's often deemed to be more of a deciding factor than pain or numbness.  But still, I can see the same argument being applied to chronic pain (if one decides to not be conservative and roll the dice).  Hope you're able to figure it out!

It is a big question to me as well, but everyone has a different situation, so what might apply to one may not to another. 

What's not a question in my case is that if the weakness in my leg does not improve one way or another (either via surgery or somehow otherwise over time), it'll likely result in the persistent potential failure of a partially mission-critical component necessary for full mobility.

Would I still be able to get around?  Yes, but not nearly as well, and with an ever-present vulnerability of falling on stairs, or any activity that pushes my leg outside its window of functionality.  I have my own version of gaslighting myself: as an avid snowboarder of 30 years, there's part of me that doesn't want to let that go.  So, I've found myself questioning whether any decision I make with respect to surgery would be taking this into account and muddy the waters as being a "luxury"?   I've come to the conclusion that while it is a "first world problem of my health", the core issue of basic mobility is still the driving consideration.

There's another part of me that questions whether having one leg at partial functionality nonetheless represents a leg that STILL has an inverted percentage of full functionality.  In simple terms:  if my injury has taken away 25% of my full range of mobility, I still have 75% ... which is a gift in the grand scheme of things.  Do I want to risk having that 75% going down further with a complication from surgery?   On the other side of the coin, it can get worse on its own (that's been the natural trend) if I do nothing and drop to 50% or worse.

I figured maybe spelling out my thought process might help some of you, but again, everyone is in a unique situation ... although I believe there still exists a somewhat agreed-upon "line" between weakness / loss of motor function and all other symptoms.  At least this was how it was explained to me by the surgeon I mentioned above who did the C6/C7 artificial disc replacement in 2015.   I had an office visit with him in the spring of 2019 about sciatica causing pain and a lot of numbness in my left leg; whereby he stated that neither are typically indications for surgery as long as motor function isn't affected.  So, part of what I'm getting at is there's more to consider vs being in one camp of cut into anything and everything, or another camp of don't cut at all.

^ Yeah, it can be challenging to navigate the waters, and it's important (especially with western medicine) to be one's own best advocate.  I know what it's like being a "frog boiling in water" in a slow passive decline of hoping things just resolve on their own, yet not being fully aware of a slow but sure decline.

Curious if anyone has tried gabapentin or similar?  My primary care physician had me try it in effort to wean away from oxycodone.  I've been on it for a week, and have to say it's actually more effective for nerve pain radiating in my leg.  Unfortunately, it's exacerbated a breathing issue that I've been dealing (I'm not totally sure the root cause, although have had workups to rule out really bad things and have uncovered some less severe possible causes) ... so not sure if gabapentin is for me, but still trying to see if there's a lowest possible effective dosage.  I ramped up from 100mg to 500mg per day in increments of 100mg, now back down to 200mg today ... so maybe this or 100mg will work.

Aside from any useful practical advice any of you might have, I do find gabapentin to be an interesting drug.  Apart from the neuro pain relief, it seems to have a bit of disassociative / psychoactive component to it that I liked in some respects, but also found it to be a bit harsh at the same time for similar reasons.   It's a little bit of a roller coaster ride on this front and can see why healthcare providers might screen people for depression and such.  It wasn't a huge deal for me, but it wasn't something I liked either ... and not sure how it'd play out cumulatively in the long run?

Sorry to hear the spinal fusion didn't work and made matters worse, Rob!  Hopefully, you're still able to find ways to gain relief.

Were any of the procedures microdiscectomies?  

Had the microdiscectomy / laminectomy yesterday.

As far as I can tell, so far so good.  It's hard to tell with 100% certainty due to some pain at then incision site, but the radiating pain on both sides were alleviated ... along with the feeling of "pressure".  The muscle weakness is still there on my right leg, but it feels like it at least has a chance for something close to a full recovery. 

I did try years of PT and it was a long time in the making.  The writing was on the wall as far as further degradation / deadening of the nerve and possible further degeneration.   

I hope you have a quick and full recovery! <<<

Thank you

Look forward to hear the how the healing goes.   Wishing the best and watching closely.<<<

Thank you.  The "short circuit" re: nerve root impingement on right side seems to have been fixed immediately.  I no longer get cramps in right leg and can feel it "opened up" a bit, but I was just over three months so I could also tell the nerve is somewhat deadened.  Still, I was able to put more load on the leg without it buckling.  Haven't put it through the ringer yet, but it seems to be "fixed".  Pain on left side (butt / leg) has cleared up too.  This side was mostly due to stenosis narrowing the opening for nerve to exit vs. disc material putting pressure on nerve.   It's still very swollen at the incision point ... so getting expected pain there, but all the signs look to be good so far.  Time will tell.

Wishing you fast healing, Face. It sounds like you tolerated the procedure well.<<<

Thank you.  The recovery pain is actually a bit more than I expected, but it's nothing off the charts and believe my expectations were a bit off on the front end.

Get Well FOM! best wishes for a full recovery<<<

Thank you

I hope your healing and recovery go well, FOM.

If you're a dancer I hope you're moving with renewed strength and fun. If you're not a dancer, you might be one now.<<<<

Thank you.  It's funny, the question of whether or not I'll ever snowboard again was my big "functional question" as first world health concern beyond just getting around and such, but dancing is definitely a runner up and similar in the sense that all bets are off as far as how my body responds when the "music plays the band".  So, might have to figure out a way to temper things down while still allowing the energy to flow freely!