Seeking advice on Back Surgery. - Page 2

JonK · #11 08-10-2006, 07:47 PM

Quote:

Originally Posted by titanx5

Hey, if you are really thinking about back surgery, you should probably at least see a neurosurgeon. Although both orthopods and neurosurgeons do spine surgery, trust me I would ask a neurosurgeon first.
Regarding the possiblity of fusion and you had prior surgery, it all depends on what kind of surgery you had the first time such as Diskectomy vs Microdiskectomy vs laminectomy vs foraminotomy and partial vs total.
The standard of care for disk/back problems is always conservative first with few days of rest then out of bed and mobilize plus anti-inflammatory, and it that fails then surgery. Also, you symptoms now might be due to a different level disk. It is true that if you are young and you get fusion then in time you can get level crep where the adjacent levels will be prone to more force and damage. But there are many people who had fusions in the 20's due to other reasons (trauma) and not have any problems 20 years later.

Another thing is that depending on the cause of your problem, which your MRI will show the level, and if due to disc if it's one side or not. Because now there is an artifical disk that can be placed. It's in the market now but of course only a few spine surgeons do it and very specific indications.

Reading the previous reply, just want to say that what other people have gone through will be totally different than what you are going through and it's hard to get an opinion about medical issues. Also, laminectomy is not surgery on the disk.

You being in Socal, you have access to some of the best spine surgeons in the country. I can give you a few suggestions if you want.

Wish you luck

Thank you for the info. 4 years ago I had Microdiskectomy prior to that I had seven months of agnizing pain. First I went through GI doctor for my bowl problem realated to pressed nerve, an Accupucturist for pain management, and I got two steroid shots on my spine, I forgot the exact term, none of them did me any good. I have a very high level tolerance for pain, but it was too much for me. Prior to surgery I consulted a neuro-surgeon, well he charged my insurance 1G for talking to be for 7 min. , he told me it was about your choice whether I want to carry this pain for rest of life or not.

I am on Anti-inflamatory Med., Bextra worked a miracle on my post-op pain but they are no longer available. I personally trust my doctor to advise me the best for me. I sure will be equipped with information in case he doesn't.

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titanx5 · #12 08-11-2006, 01:01 AM

If you only had a microdisk then the disk wasn't that bad when you first hurt it. So just because you had one surgery on the disk will not mean you need a fusion now, acutally most likely not unless you now require a full diskectomy.

When you get your MR results you should then consult with a spine surgeon ortho or neuro, your PCP will not be able to read it and radiologist can interpert the films but cannot tell you surgical options.

Bextra might be off the market, but there are other cox2 NSAIDs on the market. Of course I am not advocating you should take a Cox 2 NSAIDs or not which you need to talk to your doctor about.

BTW your surgeon billing your insurance 1G most likely yield him $150 or so. Actual reimbursements is very low.

Be interested in how everything goes and let me know if I can help you in anyway.

X5Flyboy · #13 08-11-2006, 05:06 AM

Just before moving out to Idaho, I had herniated the disc between L4/L5. Mind you, at the time I had thought it was only a slipped disc. For over 5 weeks, I'm in you-know-what kind of pain, seeing both my internist and chiropractor, packing up, driving to ID from NJ. Finally, I see a back specialist here in Idaho Falls and learn about ruptures. My drug was Vioxx. Within one day, I was dancing with NO PAIN! A 3 week course of 50mg for one week, 25mg the next two. I hope it comes back on the market again, BECAUSE IT WORKS! I see a physical trainer once a week and my routine is spine-neutral to strengthen the lower back without putting strain on it. Acouple minor twinges for the next 18 months, but since then so-far-so-good.
I still can not stand for more the a few seconds with my upper body tilted forward or a few minutes standing still upright. And there are good golf days, and there are bad ones.

From what I've been advised, fusion is last resort. Bad news is, you are going to have to adjust your exercise. And hope that we can have "Better Living through Chemistry" again. (to borrow the Dow Chemical slogan)

Mr. D · #14 08-11-2006, 06:33 AM

I've had two laminectomy's on L5(first one half, then the other). I feel the problem is that Dr's fix the problem, but don't tell you how to prevent it. You don't need to do fusion yet! Just prior to my second, I got Finally found a good Chiropractor. It has made all the difference in the world! My hips were so off that since my 20's I had been getting my pants hemmed two different lengths(I'm 42 now). I am completely balanced now. I go to water aerobics 3 times a week for the past three years now. I'm the youngest by 20 years, but who cares. I have also been involved in Pilates since last November. Now it is a daily regimine for me to do stretching....I never want to feel pain like that again. I wish you luck and hopefully some of the tips help...off to water aerobics!

benathon · #15 08-11-2006, 04:02 PM

No advice here, but I wish you the best.

PeteG · #16 08-13-2006, 09:23 AM

Quote:

Originally Posted by Mr. D

I've had two laminectomy's on L5(first one half, then the other). I feel the problem is that Dr's fix the problem, but don't tell you how to prevent it. You don't need to do fusion yet! Just prior to my second, I got Finally found a good Chiropractor. It has made all the difference in the world! My hips were so off that since my 20's I had been getting my pants hemmed two different lengths(I'm 42 now). I am completely balanced now. I go to water aerobics 3 times a week for the past three years now. I'm the youngest by 20 years, but who cares. I have also been involved in Pilates since last November. Now it is a daily regimine for me to do stretching....I never want to feel pain like that again. I wish you luck and hopefully some of the tips help...off to water aerobics!

I'm a little late to this game, since I've not been around much. (August, you know.

)

I, of course, am in agreement with Mr. D. If the problem is far gone beyond the limitations of matter, then surgery is sometimes needed. That said, if fusion were offered to me, I would turn and run in the other direction. I take care of people every day that have had spinal surgeries, including fusions. The key is to correct and maintain the rest of the spine so that it doesn't deteriorate and continues to function optimally. Many times, the original site (prior surgery) is not the point of the current problem anyway. I believe this was mentioned earlier. In any instance, always go the least invavsive way first.

If you need a referral to a good chiropractor in your area, just PM me. I am well connected to great chiro's around the world. As I stated before, I take care of people in similar situations every day. If we didn't have good results, I wouldn't be doing this.

Go heal up-we're pulling for you.

JonK · #17 08-14-2006, 07:47 PM

Quote:

Originally Posted by titanx5

Bextra might be off the market, but there are other cox2 NSAIDs on the market. Of course I am not advocating you should take a Cox 2 NSAIDs or not which you need to talk to your doctor about.

BTW your surgeon billing your insurance 1G most likely yield him $150 or so. Actual reimbursements is very low.

Thanks for the info.
My OS' nurse practitioner wrote me a prescription for MOBIC , Meloxicam 7.5mg . It seems to help. Says no alcohol, absolutely right. One beer fri. night felt more like ten.

From my last experience, I felt pretty bad how much my surgeon was paid by my insurance then United Health Care. Even though I was sure they will make it up from no insurance patients.

This time they want me to do EKG or EMG test (supposely nerve damage test). This is something new so, I feel iffy about it, thinking is another new way to bill me more fighting against Ins. Company? I hope this new test won't cost me arms and legs, they say it runs 2G.

I use a local MRI center for all the MRI, it was funny that my doctor's hospital takes care of billling this time? Odd?! I am a good-size person but forget MRI if you are very obese. The technician told me freakout rate is 10%.

Most billing dep's they tend to take chances... First time they overbill me, after I contact ins. company to obtain the correct amount, and return to them, they will go 'oops.' It is funny it never occured to me that they ever underbilled by mistake... I am getting fad up with that. What if neither someone can understand the bills nor can speak English.

I was just ranting. I'd take to be in Med. Profession who deals with Ins. Companies nowadays.

statdoc · #18 08-14-2006, 10:37 PM

Quote:

Originally Posted by JonK

Thanks for the info.
My OS' nurse practitioner wrote me a prescription for MOBIC , Meloxicam 7.5mg . It seems to help. Says no alcohol, absolutely right. One beer fri. night felt more like ten.

Mobic is good stuff!

Quote:

Originally Posted by JonK

From my last experience, I felt pretty bad how much my surgeon was paid by my insurance then United Health Care. Even though I was sure they will make it up from no insurance patients.

Actually, most doctors get virtually NOTHING from "no insurance" patients. In my practice, we collect 4% of charges from those without insurance. Name another business that could survive providing their services to anyone/everyone, even those who can't or refuse to pay.

titanx5 · #19 08-14-2006, 11:56 PM

EMG is a test where they stick electrodes into your muscle and record how they react to stimulation. Most of the times they do EMG along with NCV (nerve conduction velocity) and those combined can help differentiate causes. Although I find it slightly interesting that they want this study. Usually EMG/NCV are used for patients with some sort of weakness and usually for some time as it can tell you if it's a peripheral nerve problem versus central (spinal cord) problem because a pinch nerve will give a different pattern vs a pinched spinal cord.
Just curious what are your neuro sx as I can't seem to read what you have
good luck

JonK · #20 08-15-2006, 04:18 AM

Quote:

Originally Posted by statdoc

Actually, most doctors get virtually NOTHING from "no insurance" patients. In my practice, we collect 4% of charges from those without insurance. Name another business that could survive providing their services to anyone/everyone, even those who can't or refuse to pay.

Sorry to hear, Doc. I thought it only applies to emergency med. or happens only when you are dealing with undocumented immigrants. I saw the dateline/60mins on discriminatory pricing (price gouging) on uninsued patients that is what I refered to. 5 months ago I took my family member to a local ER. They put her on the corner for observation for 3 hours, and billed 20k. Thanks god we have ins.

Where would I find a doctor in LA who won't practice discriminatory pricing?
I have a friends who needs to seek medical help fo her cronic night time coughing that persists for three weeks. She says she'd hang herself rather than going to county emergency room waiting in line.

As far as my EMG concerns I am being sent to someone who specializes in Phys. Med. and Rehab, Musculoskeletal Disorders, Nerve and Muscle Injuries. I don't MD written on her business card. The PA told me it is mandatory to get this done. I'll make sure my ins. cover this before I do this.
I hate going to hospital feeling like I am dealing with shady mechanics.

I trust my Ortho. Surgeon and his nurse. I never usually wait in his min. 2 month waiting list when I need them. But Med. goup he works for is a differnt story.

Thank you for posting, WebMDs

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