Herniated disc

Good Luck. Hope all goes well.

@ktgirl I wanted to give you some feedback about epidural injections. They are not approved by the FDA, and it is true that there can be serious complications. I had a bad reaction to an epidural and it caused a stabbing electric shock pain in my hand and any time I moved, it stabbed me again. I was convulsing in pain right after the injection. I had to lay down and prop my arm on a pillow and not move. It took a couple months for the pains to stop. There was no improvement for the first week, and then the stabbing pains started getting farther apart. It happened because the injected fluid had nowhere to go and just increased the pressure. This was in my dominant hand and I didn't have pain there before. I refused to do anymore. The injections don't fix anything, they just lessen the inflammation from the problem. They do interfere with getting good MRI imaging, and I had to wait 6 weeks after the injection to get a new MRI. They may also interfere with healing. Healing a fusion and bone growth depends on inflammation to start the process which is why after spine surgery, doctors tell patients not to use anti-inflammatories.

Which vertebrae were involved in your injection? Mine are C6-C7. Did you have the injection done at Mayo Clinic? Do you think having surgery would have been a better option for you? I watched a video last night from Mayo Clinic radio with a Dr. Mohammed Bydon. He talked about minimally invasive surgery. I guess I’ll find out when I see the doctor on the 23rd. Dr. Bydon is not the doctor I will be seeing but the one I am seeing has great credentials so I hope he is good.
Thanks so much for the update.

Sorry. I just saw your earlier post. That answers my questions. I’ve been to Mayo before in 2012 for a total shoulder replacement. That went fairly well. I’ve been there twice since for evaluations. I wish I lived closer. We’re about 4 hours away. It will be a long drive but I’m glad to be going there. We stay at the Hilton there so we can walk to Mayo. Yes I enjoy hearing the piano playing as well. Thanks again.

Oh my goodness! Thank you so much for sharing your article with your paintings! Brought me to tears. I’m so grateful for your support. I’m a quilter and have a hard time doing any of that now. I’ve been off work for over 3 weeks. I keep thinking about how many quilts I could have done in that time! Hopefully soon I’ll be able to again. Thanks again!

@ktgirl The spine injection was done as a diagnostic test by a local surgeon who later decided not to offer me surgery. Sometimes they do that to avoid surgery. I did not have any more, and no one at Mayo suggested an injection. My surgeon offered to fix the problem. For me it was a 5 hour drive to go to Mayo, and worth every mile. If you have spine surgery, the recovery is long. The first 6 weeks are the worst, but not that bad really. When I woke up from surgery, all my pain was gone, except for the incision and throat pain from the surgery itself, but all the pain from the spine problem was gone. I was nauseated from the drugs, and tried doing without the pain medicines and I did fine. The pain was tolerable, so I didn't take any after I left the hospital during my entire recovery. After 3 months, I felt good, but a bit weaker, and after 3 months in a neck brace I needed rehab, but doing that let me avoid having hardware on my spine. I slept a lot during my recovery.

I'm glad you enjoyed my story. I am still amazed by the whole experience and what the success of it meant to me. After you have your evaluation, I hope you'll share your experience. I guess you know how good it is since you have already been a patient there. I wish I had come to Mayo first, but I tried to get help for 2 years locally. I'm not planning on more spine issues, but Mayo is the only place I will go for that. If you have fusion surgery for C6 C7, it likely shouldn't affect your range of motion for turning your head, etc. Most of that is done by C1 & C2, and C3 & C4 also help. My range of motion is the same as before with a fused C5 C6 except that I can't tuck my chin to my chest all the way.. .it's close, but doesn't touch like before. We have an art for healing discussion here, and some people do quilting or crafts. You can post your quilts there and join the discussion. Here is the link. There are some more photos of me with my surgeon and the painting in my post on the first page in that discussion. https://connect.mayoclinic.org/discussion/art-for-healing/

Thank you so much. Sounds like it’s definitely a long recovery. I was hoping it wasn’t that long. I don’t really have any short term or long term disability insurance so I’m not sure what I will do. But it will all turn out somehow. I’ll know a lot more when I get to see the doctors there as to what I have to look forward to. I really want to go back to work but who knows what will happen. I will let God be in charge. Thanks again.
Carol

Hi Jennifer. I wanted to reread your post. My back is feeling better but my hand is still numb and tingling. Do you think they will do another MRI when I get there? I’ve had one I think on August 16th. I don’t know what to expect. I feel like my primary care doctor is upset that I chose to go to Mayo instead of waiting the the doctor from summit orthopedics to come here. I would have had to wait until October 17th. I had to get some forms filled out for me to get FMLA approved. She didn’t answer all the questions so I had to have her redo it and then she was crabby. I’ll be so glad to have this taken care of. It’s so stressful not knowing what to expect. If you have any suggestions for questions I should ask the physiatrist and surgeon I’d really appreciate it. As the time gets closer to going there I get more nervous. Thanks for your help.

@ktgirl Hi Carol. This is a long post. Let me know if you have further questions. Your responsibility is to look out for yourself, and your doctor should be supporting your decisions to get the best care that you can for yourself. As patients, sometimes we think a person is upset, but in reality they are not, and you won't be the first patient to get another opinion somewhere else. Getting other opinions is common and should be encouraged by your doctors for major surgery. There are a lot of referrals in house to try to keep a patient within a hospital system that is run for profit. That's different at Mayo too as everyone is an employee. They will refer you to other specialists as needed, but your physician doesn't profit from your care. They are paid a salary as an employee and are not an owner of a medical group. It's a big decision when you chose to have surgery and you'll get different opinions and different answers sometimes and biases because of possible profits. It's up to you to chose the path to the best possible care and outcome. If your doctors are not putting your needs first and assessing all the connected issues, they are not really focused on you. It will be different when you get to Mayo. I think you made a great choice to go there for an opinion.

I don't expect a new MRI to be done of the same area as was done a month ago as long as the images are good. When I came to Mayo with an MRI that was several months old, they didn't redo it, and I asked for MRIs on the rest of my spine to rule out other issues because I had pain all over my body caused by cord compression in my neck. For me, it helped me to understand how the procedures work and to visualize what is done during surgery. Some patients don't want to see the animated videos that explain things, but since I have a science background, it helped me understand how to fix the problem. By the time I got to Mayo, I was relieved and knew that I was finally going to get help after 2 years of being turned away elsewhere. It is stressful to have a medical problem when no one wants to help. Be prepared to explain the details of your symptoms and when it is at it's worst or best, etc.

When you get to Mayo, what you can expect is doctors who care about you. If you do have surgery on one level, it is possible to have a fusion without hardware and stay in a neck brace until bones fuse. That is what I chose and I don't have to worry about possible hardware complications. First, they need to evaluate the problem and create a treatment plan. If you are looking at surgery, here are questions from my list. You likely won't have time to ask everything, so pick and choose what is important to you and bring the list with you. The first question should be with your insurance company to ask if your treatment will be in network. Also ask your insurance company about MRI imaging. My insurance does not want to pay for MRIs at hospitals and wants to have them done at independent imaging centers because they are controlling costs.

My surgeon did the entire procedure except for closing the incision. That was done by doctors in the neurosurgery program (7 year program at Mayo) and they also visited me before and after the procedure, wrote precsriptions, and were on call for any issues post op. My surgery was and hour and a half with just a single level donor bone implant. I could have had an artificial disc, but I wasn't the best candidate for that because of 2 mm of backward slipping C5 over C6. I asked the surgeon's nurse to hold my hand, and she did in the operating room. I was actually curious about looking around in there and I saw my photo on a monitor with my information. I think you will get to Mayo and relax. There is a lot to ease your mind, great art work, piano music, and pretty places to hang out while you wait for appointments, and you'll be busy with the schedule of testing, etc. You can take a favorite photo with you, or a music player.. what ever will help. I consider Mayo to be my happy and safe place. They changed my life. I never felt that way at any of the other places with surgeons who saw me before Mayo; there were too many unknowns, unanswered questions, and attitudes, and I didn't feel welcome. All of that makes a huge difference in having a great recovery. You will be in great hands.

Here is my list of questions:

1. What type of surgery are you recommending? Why? What is the specific anatomic lesion being addressed? Have them show it to you on the imaging.

2. What is the natural course of my condition if it is not surgically addressed? What are my non-surgical options?

3. Why does the surgeon recommend this specific procedure? What are the potential results for this surgery? Why am I a good candidate for this surgery?

4. What is the source of the pain that is being addressed? How do you know this?

5. Please explain the procedure in great detail.

6. What products and implants are used? Is everything to be used FDA approved for this application?

7. What are the chances that the osteophytes will regrow? If so, what will minimize that chance?

9. What are the different surgical procedures that can address my problem? What are my choices?

11. What would you recommend if I was your friend, wife, sister, or daughter?

12. How long will the surgery take?

13. What are the possible side effects, potential risks, and potential complications? Please explain the risks and how they relate to me personally.

14. Do any of the materials used increase my chances of getting cancer? Are there common reactions to implants, metal sensitivities, plastic sensitivities, toxicities? Do I need to be tested for possible adverse reactions?

15. What happens to an artificial disk as it wears? How long would it last? Any not made of metals?
Are the metals used the same or different within the implant?

16. How great is risk of adjacent segment disk degeneration? Are there other discs that show degeneration now that could become problematic in the future? Do you think I will have a problem in the future on adjacent levels?

17. Do I have to have a metal plate on my spine? Is there another way to stabilize the spine?

18. What if, during my surgery, you encounter a different spine issue than you expected?

19. What is the risk/benefit ratio (the chance of a bad outcome as weighed against the chance of a good outcome)?

20. What are the standard safety and cross check procedures to insure my safety during the surgery?

21. Do you use neuromonitoring during surgery?

22. Are you using robotic assistance or free-handing?

23. Do I need to donate my own blood? If yes, why?

24. Do you perform the whole procedure? Will any students and/or other surgeons be doing any parts of the operation? If yes, What are their background and qualifications?

25. What are the long-term consequences of the proposed procedure?

Questions about the surgeon

1. How many times have you done this procedure?

2. Are you fellowship trained in spine surgery? This is more important if the surgery is a fusion, artificial disc replacement, or other more extensive procedure.

3 . If I want to get a second opinion, who would you recommend?

4. What is your personal success rate, and how many of this type of surgeries have you done?

5. How often will I see you after my surgery?

6. What expectations do you have for my recovery?

Thanks so much for your response. I’m definitely going to copy off your questions. I had my shoulder replacement done there in 2012. At that time I had no idea what to ask. I wish I would have had a better idea what I was getting into. The surgery went fine. My sister-in-law works at Mayo and she looked at the incision the day after the surgery and said it was the cleanest incision she had ever seen. However I did therapy back home and I feel like I wasn’t made aware of what to expect. When I went back to Mayo a while later - not sure how long after - I saw a physical therapist at Mayo. I wish I had seen someone there after my surgery. I’ve questioned how my doctor here acted when I saw her. I’ll probably see her again for my annual physical and see how she is then.

Anyway, thanks again for your help. It’s so good to hear from someone whose been down this road before. I’ll let you know how it goes next week when I get to Mayo. I’m so glad my back is feeling better now. It should make the trip there easier.