It figures. No sooner do I decide to retire when wham, back problems struck. I’ve always been healthy but I have to admit that I’d let myself go. Work, kids, life just got too busy and I stopped exercising. I’m pretty sure this is what lead to my herniated disc and associated sciatica pain that immediately followed. I’m posting my Microdiscectomy Story in the hopes I can help others considering the surgery make the best decision for themselves.
It all began last February when I started having pain while moving from a sitting to a standing position and vice versa. I’d get shooting pains in my right butt cheek and down the back of my right leg. If they were really bad, they’d go all the way down to my heal. It hurt bad enough that I’d immediately stop what I was doing to catch my breath. I quickly learned to use my arms to lower and raise myself to and from any chair…. including the porcelain kind. :). Getting in and out of a car was very painful and became an ordeal every time I needed to go somewhere. But like every other health issue, it usually takes care of itself and I figured this would self-correct too.
The Diagnosis
I’d heard of this type of leg pain before and had associated it to Sciatica in my head. I poured through the online articles for sciatica and learned that’s most likely what I had and that most cases resolve in a few weeks without intervention. So, I kept on going but the problem just kept getting worse. After about 3 months, and about 1 month before retirement, I decided to get it checked out. After a few quick leg bending tests in the doctor’s office in late May the doctor diagnosed me with Radiculopathy – a fancy name for Sciatica and referred me to Physical Therapy to take care of it. The doctor also me assured that 90% of cases resolve without the need for surgery. Since I’m terrified of surgery, I was glad to know that the non-surgical success rate is so high.
Road to Recovery
Physical Therapy was a mixed bag. I was finally doing something about the sciatica problem, but the results weren’t great. I’m still not sure I got the “A” team in PT since the care I received seemed very generic and not at all targeted to either my progress or changing pain. After four weeks, I felt much worse. At the start of PT, I was able to mountain bike and hike with discomfort but not outright pain. By the end of four weeks of PT, even simple motions caused a lot of pain. Since I didn’t improve, everyone (the doctor, physical therapist, and me) started to doubt the original diagnosis. “Maybe it’s Piriformis Syndrom”, “Maybe it’s a pulled muscle”, “Maybe it’s …..”. They were guessing and I didn’t like it.
Our Effed Up Healthcare System
When the doubt started to bubble up with the “professionals”, I was always asking to get an MRI to really see what was happening. With every request, I received the same crappy answer. “Insurance won’t pay for an MRI since the vast majority of these cases resolve with PT.” OK, but mine isn’t resolving. It’s getting worse. A lot worse. I used to be very active, now I hobble around like an old man (I’m 49) and spend half my day laying on my stomach since that’s the only position that’s comfortable!!!! I’m also popping Ibuprofen like candy just to sleep. WTF!!!! This isn’t how my first months of retirement was supposed to go!!! Let’s get the damn MRI and start treating the problem not the guesses at the problem.
The Thing About MRIs
I started calling around to see how much a “Lumbar MRI without Contrast” cost if I paid cash. I was expecting $2,000 – $3,000. Nope. $400. $400 effing dollars – and that included the radiologist review and writeup!!!! I was living like this for $400 effing dollars? I called my doctor and asked her to order the MRI and that I’d be paying cash. The MRI was scheduled 3 days later. The procedure was simple – about 20 mins in the tunnel. I’m mildly claustrophobic but wasn’t too wigged out. Best of all, I walked out with a CD of all my images.
The Real Diagnosis
I popped the MRI disk into an old desktop computer (nothing else I own takes a CD). After a few minutes figuring out how to navigate the included image viewing software, I had my answer. OK. I’m no radiologist but this don’t look good. Looks like a big damn herniated disc. Googling “lumbar disc herniation mri images” pulled up hundreds photos that looked a lot like mine. Yikes!!! Well, at least I knew the root problem and could now plan a course of action to get relief.
This Aint Good. My L5-S1 Herniated Disc
Better to be Lucky than Good
The doctor that originally ordered the MRI received a copy of the radiologist’s report the next morning. I only received one, quick, short message back from her. “No way is PT going to fix this. You’ll need to see an Orthopedic or Neurology Specialist for your next steps.” No Shit! I texted a good friend with the results to commiserate a bit. Luckily, he’s well connected in the medical community. He knew a great Orthopedic surgeon that specializes in spines and works guess where… the Spine Institute. Even better, I had met him several times through this mutual friend but never remembered that he was a spine surgeon. And even better than better, he was a top rated surgeon in our city. A couple quick texts and I was on his schedule for his next day in the clinic.
My Plan
I met with the Surgeon in his office and we went through the MRI together. He said I was a 5 out of 10 but agreed my condition wasn’t going to get better with PT and exercise. I was also glad to know that I wasn’t a complete disaster and my herniation was treatable. I really only had three options. 1) Keep with the conservative approach and hope it gets better. 2) Try a nerve block steroid shot and hope the inflammation goes away permanently. 3) Microdiscectomy surgery where the herniation pressing on the nerve is removed. I knew option 1 was a no go. I had been doing that for months. After a long discussion, we decided on 2 and 3. I’d start the process to get the surgery authorized which takes 3-4 weeks. In the meantime, I’d get a steroid shot to relieve the symptoms. If the steroid shot worked, then we could consider canceling surgery. If not, we wouldn’t have to wait 3 weeks to find out the shot didn’t work then another 3-4 weeks to get the surgery preauthorized. After 3 1/2 months of no progress, at least I had a plan and I was glad.
Action
The steroid shot was scheduled for the next week and I couldn’t wait. I was tired of the pain, tired of popping Ibuprofen to sleep at night, tired of gimping around like someone 30 years older than me. The procedure went well despite my almost passing out on the table. I have a propensity to faint and almost did. The staff handled it like pros and the procedure was deemed a success. It took a few days to know if it worked and by day 3, I noticed a difference in my pain level. The pain wasn’t gone and it still hurt to do certain things. The best way I describe it is that the edge was taken off. It was a dull ache rather than a shooting pain. I still had some stabbing pain but it was more occasional and not as severe. Even though repeated steroid use isn’t good for you, I was glad to have the reduced pain and increased freedom. One thing that really stuck with me from the procedure was a discussion I had with the radiologist. He thought my herniation was a 6 or maybe a 7 out of 10. Then he said, “you can get up to 4 of these injections a year until you decide to have surgery.” Wait, what? People usually do this then have surgery anyway? Then why not just do the surgery and be done!
To Be or Not to Be
The effects of the steroid shot peaked at about day 3-5 then plateaued. Now came the big decision. The pain wasn’t that bad anymore. Is it bad enough to still consider surgery? I was reading tons of articles that scared the crap out of me and had me doubting surgery altogether. I was also reading lots of success stories where people were back to their pre herniation activity levels in a matter of 3-6 months. Almost all cases people were glad they did the surgery. But there were those few cases that I couldn’t get out of my mind. Permanent numbness, very difficult recoveries, spinal fluid leaks. All of these were real possibilities even if the chances were small. And, I’m a sissy when it comes to pain. I just don’t tolerate it well. This was turning out to be one of the hardest decisions I ever had to make.
Pre-Op Meeting
I walked into the pre-op meeting armed with a list of questions. How many Microdiscectomy procedures have you done? What’s your success rate? Your complication rate? Infection rate? Dural tear rate? etc. The surgeon was very patient and answered all my questions. I was glad to know him personally before I went in there. He knows I’m a very active person and that I retired early to enjoy life more. He knows I’m an avid skier and that the season was quickly approaching. In the end, he gave no guarantees but gave me stats on how he expected things to go based on treating disc herniations for years.
The Decision
He said that the steroid shot would likely wear off in a few more weeks to maybe a month leaving me back to where I was mid-summer. He indicated that most people with my degree of herniation end up having the surgery after a few rounds of steroid shots, just like the radiologist said. He also indicated that he’s done over 1000 of these procedures and he personally has a very high success rate and a lower than average complications rate. He thought I was a great candidate since I was relatively young and in decent shape (I had started swimming every day to get some pain free exercise). But most of all, the likelihood of pain-free activity would far outweigh the small risks of surgery. That was it. My decision was made.
I wish I Would Have…
I’m now 5 days out of surgery and so far, I’m EXTREMELY pleased. I’ll write a more detailed post about my surgery and recovery but I’d call it a success. Looking back, I wish I would have done things a bit different. First of all, I wish I had not waited 3 months to see a doctor. I’ve always been healthy only go to a doctor when I know something is really wrong. I just thought this would eventually go away. Second, I wish I would have pushed for the MRI much earlier. My doctor was onsite with my employer and looking back, I swear she had a goal of reducing our healthcare claims. I hate to write that because I really liked her but now I feel she was more of an advocate for my insurance company than for me. Finally, I wish I would have gotten different recommendations for PT. The folks I went to were just plain bad. They followed a regimen that anyone could google then would collect a copay to watch me do the same exercises that I would do at home. Often, they wouldn’t even watch me and would talk to each other until my timer went off. Live and learn.