Spondylolisthesis and DDD
I am a 52 year old female with no prior surgeries. I have suffered lumbar pack pain for 30 years. It started out hurting from time to time. Now I have constant pain and have trouble getting out of bed in the morning and can barely get the dog walked. Doctors have told me I need spinal fusion of L5-S1 and possible L4. Also, disc replacement of L5. I have seen an Orthopedic surgeon and a Neurosurgeon for opinions. The neurosurgeon wants to do the surgery. The orthopedic surgeon said his goal is to keep me off the operating table because I am opening myself up to a whole host of problems if I have the surgery. I decided to see another spine doctor. They currently have me on Gabapentin, 2 capsules a night which has made zero difference in my pain. They want me to work up to 3 capsules a night but I'm not happy about taking it. It makes me dizzy and has other negative side effects. My question is: Should I have the surgery? Or do I need to accept my condition and learn to live with a decreased quality of life?
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Hi Chris, I am not familiar with Robert Weldon Trout. Most of my family that I know of is in Michigan and there are a fair amount of them. I was adopted by Caroline and Jerry Trout when I was six years old. Most of my research on family has been for my birth name. "Franskoviak". Trout sure is an easier name to have. :).
Hi Peggy, Dr. David Barnett at Baylor Hospital. He is a neurosurgeon. I haven't seen him but might if I decide to get a fourth opinion. He was recommended to me by a woman I met who had a very successful spine fusion, the same surgery I need. (PLIF) She really sang his praises...did you like Alexander Ropper?
@red3, Are you up for a bit of humor? Here goes. When I was reviewing my last divorce papers, the judge wanted to know what name I wanted given there were 4 choices. I chose Trout. Why? Best of the lot and goes well with Chris. Have some joy today. Chris
@red3 Hey Ruthann, your body is probably telling you there's a problem, and your brain is saying, hey not so fast! I've been through something before and I don't know what to do about this. May I give you a few suggestions to start a conversation with yourself?
I did a lot of things that were my way of talking to that scared child inside me. I started by making a list of the adverse events in my life that made me feel afraid, and they were things with similar feelings of medical or dental procedures and why I felt the way I did. I looked at that list and saw a pattern, so I knew why my need of spine surgery was triggering anxiety. What was common to all of my fears through childhood is that I didn't have emotional support, and at a young age, I didn't know how to understand it all, so I was alone with the burden of my fear and anxious about the next time I would be afraid.
I also realized that children are not born with fears. Fear was driving up my blood pressure and I asked myself why I was doing this to myself. Fear is learned somewhere along the way, and I decided that I could deprogram my fears if I understood them. My childish way of looking at this was my attempt to protect myself when I was vulnerable, but it wasn't serving me well now as an adult with an important decision to make. I also reached out to people I knew who had overcome a lot of medical issues that were more serious than what I faced. I knew them because our paths had crossed through my participation and experience with music and connecting with other performers. Both had written books about their survival experiences, and I re-read those books looking for words that could build my courage. Because of my spine problem, I was facing the loss of my ability to do my art work, and I sent a message to one of the authors, my friend Wayne Messmer, whom I had performed with in a community band. At first, I didn't know that I'd been part of his recovery. I had met him at a time in his life after he had survived a gun shot wound to his throat, and he had just regained the ability to sing. The invitation to sing with our band was the first since his recovery and his voice is his gift that he uses to sing the national anthem for a few of the Chicago sports teams. I had the most wonderful response from him telling me that even though I was facing an unknown, it was worth the chance to save my talent.
I also asked for permission to be afraid. Through my early years, I had been expected to just endure, and was teased about my fears, so I knew better than to talk about it, but as an adult, I needed to do that, and to find a way to tell that little girl that it will be OK, and I'd be with her through everything. I also asked one of my doctors who had heart surgery, and he told me that he was afraid too. If a doctor can have fear of a medical intervention, then it must be OK for me as a patient. It helped me to know that, and to realize that they are human like the rest of us. They also have to cope with the tragedies that they see in their profession. Doctors and patients are a lot alike.
I used all the life experience I had to address this and my knowledge of biology, and I needed to understand in detail exactly how surgery would help me. It all made perfect sense, and I was making a choice to go forward. I had already lost the ability to control my arms and the strength to hold them up. I knew that my spine would get worse, and that I was lucky because I had a choice to avoid a disability if I chose to have spine surgery, and with that, I chose the very best surgeon I could find.
I also used music, art, and humor as my therapy to distract me from thinking about surgery. I learned to lower my blood pressure by using deep relaxed breathing while I listened to music I loved, and that became a skill that I could call up in my mind when ever I needed it. I had been measuring my blood pressure before and after my music therapy and could drop my numbers by at least 15 points. I drew pictures of my doctors because I wanted to like them. I didn't want to see them like those who had provoked my fears when I was young. I built on that by looking at pictures of my surgeon while I was listening to music to associate him with all that good stuff. I also watched TED talks about fear and funny videos.
Gratitude also helps combat fear. Being thankful for all the goodness in your life, and making sure that you surgeon knows you are grateful for their help also goes a long way toward helping you feel better and more in control of your situation. Surgeons do have stressful jobs, and I felt as a patient, that I could reduce that stress with gratitude and that it would help my surgeon help me. I made a point to meet him right before my surgery so I could thank him for helping me, and also to reconfirm that I didn't want hardware used in the procedure as we had agreed upon. By this time, I was calm and interested in what was going on around me.
All of this was a process, and I learned a lot along the way. Am I immune from fear now? Of course not, but I can recognize it earlier when it sneaks up on me, and get on top of it sooner. I also compare a new situation to what I have already faced and how I can now handle it, and I realize that I can do this by taking apart the problem and examining the parts. If you can control fear, pain will be a lot less, and my fear had been the fear of pain all of those years. I thought spine surgery would be really painful, but it wasn't. It was tolerable to me even without painkillers. The pre surgical pain was gone immediately, and I did have surgical pain, but none of that compared in intensity to a pain that I had because of a spinal injection which was the worse pain I ever felt in my life before I came to Mayo. I had sucessfuly managed to get through that and stop myself from passing out by using my breathing, visualization and music techniques in my mind, and other things by comparison were not as bad as that was. After surgery, the pain medicines made me nauseous, so I didn't take them at all after I left the hospital and I did just fine. I rested and slept and gave my body time and peace to heal.... and when I was ready, I picked up my brushes and painted my surgeon with his blessings. When I was nervous before my surgery, I drew pictures of him so I could be comfortable and think about him as a person instead of a doctor, and that naturally led to my desire to put into a painting what my words could not say. It was done in gratitude for him, but also for me because I needed to regain that ability by setting the goal, and now he has a painting he loves, and he learned something from me, his patient. I know I've already shared my Mayo patient story with you, but for anyone else who is now joining the conversation, here it is.
https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/
Chris, HAHA! Yes, When doing business and someone asks for my last name..I always say "Trout, like the fish". My husbands last name is, I kid you not. "van Bloemen Wanders". He's always wanted me to have the same last name as him but I am not willing to give up "Trout", it's so easy...you too have a wonderful day!
Jennifer: given the pain, most days I would be ready to lay it down for surgery immediately if I could. It's finding the right time. I am the care taker of my family and 2 dogs and I have my standards. I'm afraid that if I'm laid up we'll be eating fast food all the time, dirty laundry will be laying all over the house, dogs won't get walked...yadayadayada. So my concerns are mainly practical. But my mind is coming around to scheduling the surgery and I am thinking June when the kids are out of school. We won't have school and soccer schedules to maintain. 🙂
I don't know where you live.. but There are Mayo's in AZ, FL, and MN.. I had my surgery in OKC with Dr. James Odor.. He may be retired now as my Surgery was 25 years ago ... My local Primary care physician referred me to him.. both reputable without question.. That spinal fusion of 3 lumbar vertebrae was my first time in the hospital.. at 58... The surgeon after he saw me and my x-rays etc. told me I would know when it was "time" ... I traveled for enjoyment.. so a month or 2 after the visit I was in NYC watching the Thanksgiving Parade...NYC is for walkers.... I was convinced by that trip that quality of life is the key factor.. I was a Univ. Professor.. I turned in my 1st semester grades... and went to the Hospital... I was back teaching at the start of the 2nd semester.. my can handy... but rarely needed... within another week I was normal.. few folks knew any difference in my walk ... or my height... (lost a little) ... but that surgery from a really good surgeon --and do not settle for any one you have not the highest regard for... Check without fail ... you are betting a lot (your happiness) on the success of the surgery.. k...
My spondylolisthesis is closer to a grade 4 . Sometime I can hold myself up straight, but I can't keep it. I totally walk sideways in the morning when I get up and If I set for a long time. The surgery would be spinal fusion of L3,L4,L5. Clean it all up and release nerves as I have stenosis also. My pain is not sharp pain. I have a burning in the back. I'm trying to avoid drop foot as I already have a lot of damage. The main reason I would like it done is the burning pain in my feet from nerve damage. I would only hope and pray this would help it. They say 4 or 5 days in hospital and I would be wearing a back brace. I also need a hip replacement on the bad side. All of this is very scary. The neurosurgeon for the back is a dr at Baylor college of medicine. My primary care said he is very good and has corrected many back surgeries that did not go well. What to do ?????? What is DDD and do you have the nerve damage and burning??
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DDD is Degenerative Disc Disease. My fusion operation was because of an accident .the surgery team worked on me from noon to beyond supper time. I never had to wear a metal back brace, elastic bracing for a short time...I didn't experience burning sensation in back, legs or feet. Aches and fatigue, yes . I had a second opinion from a neurologist but went to the orthopedic spine surgeon. I'm not familiar with the medical reputation of Baylor... Although my Ph.D. is from Texas A&M, I did go to Cardiologist at St.Lukes in Houston...
When mine was first discovered it was with a mri. They asked about trama to my spine.
I'm 72 so I know recovery will take longer. Baylor is with St Lukes now and that is where my surgery would be. I really like the neurosurgeon, .
Do you mind if I ask why you chose the spine surgeon instead of a neurosurgeon??
All 3 of my children graduated from Texas A & M>