Spondylolisthesis and DDD

Posted by red3 @red3, Nov 5, 2019

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?

@red3

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. :).

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@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

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@red3

Jennifer, your reply provides a wealth of information for me. Yes, Andrew K. Metzger…he is the surgeon I am considering.

I too, have deep seeded anxiety over the surgery. Going to see doctors and talking about it is one thing. Actually committing to a surgery date is another thing. A simple thing I discovered recently is people on YouTube talking about their spine fusion experiences. That has been helpful.

I found your article on Myofascial release enlightening. I used to be a massage therapist so I am familiar with the technique and used to practice it myself. I gave up doing massage 16 years ago after I had my 3 kids. I have not started up again because of the pain.

So yes, I feel like I am on the right track to seek answers. Thanks so much, I will keep you all posted!

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@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/

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@artscaping

@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

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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!

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@jenniferhunter

@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/

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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. ­čÖé

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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…

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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??

the

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@peggyn

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??

the

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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…

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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>

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@peggyn

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>

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Liking the surgeon only counts when you're conscious.. when you're out competency and track record of the surgical team is all that counts.. my spine problem was a structural bone problem… vertebrae partially out of the stack.. pulling that L5 back in place and stabilizing the spine so it doesn't turn into a snake in a few years is critical …

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@peggyn

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??

the

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Peggy, I can commiserate with you about being overwhelmed with your physical issues. I also have other stuff going on but the back pain trumps all. My neighbor is fresh off a spinal fusion surgery of L3, L4, and L5. She spent 5 days in rehab. and got home 2 days ago so I haven't spoken with her. However, I spoke with her husband and he said she experienced relief from the pain as soon as she woke up from the anesthesia. An Orthopedic surgeon specializes in the musculoskeletal system, the bones of the spine. A Neurosurgeon specializes in the nervous system, brain and spinal cord. From what I've learned either one can do spinal fusion surgeries.

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@ken82

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…

Jump to this post

Ken, thanks for relating your story. It is heartening to hear that after all this time your hardware is still intact. I live in Albuquerque, NM. and while I'm aware of Mayo Clinic in Phoenix, AZ. and also Baylor hospital in Texas where I know there is a very good neurosurgeon, I believe that I have found a super good surgeon here in Albuquerque. I just have to do a bit more research, something that Jennifer was very helpful in supplying the links for me. A P.A. also told me the same thing that I would know when it is "time". I now feel that it is time. I avoid social situations where any standing is involved. I love to hike and cannot do that for any length of time. Yard work, same thing, working in the kitchen wears me out. Every day it's cycling thru taking Nsaids, wearing my brace, ice/heat, Biofreeze, and sitting down as much as I can though I am not a sitter. I was also interested to hear that your recovery time was not so time intensive. You were able to get back to teaching in a short period of time. I'd like to think I could do the same…thank you for sharing your experience.

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@red3

Ken, thanks for relating your story. It is heartening to hear that after all this time your hardware is still intact. I live in Albuquerque, NM. and while I'm aware of Mayo Clinic in Phoenix, AZ. and also Baylor hospital in Texas where I know there is a very good neurosurgeon, I believe that I have found a super good surgeon here in Albuquerque. I just have to do a bit more research, something that Jennifer was very helpful in supplying the links for me. A P.A. also told me the same thing that I would know when it is "time". I now feel that it is time. I avoid social situations where any standing is involved. I love to hike and cannot do that for any length of time. Yard work, same thing, working in the kitchen wears me out. Every day it's cycling thru taking Nsaids, wearing my brace, ice/heat, Biofreeze, and sitting down as much as I can though I am not a sitter. I was also interested to hear that your recovery time was not so time intensive. You were able to get back to teaching in a short period of time. I'd like to think I could do the same…thank you for sharing your experience.

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@red3 Thanks for the nod, Ruth Ann. It sounds like you have found your path and are taking charge of your future. This is a very big decision, and all the things you are doing to learn all you can will surely help. I know for me, I needed to understand in detail what the surgeon can do, and also what I can do that will help achieve success. That is a good way to overcome the stress, and gratitude will also help you overcome the fear. It helps you find your way from the fears of an unknown, and then to find a plan for your future and the doctor who can give you that. It is a team effort, and I viewed my own situation as being a part of my surgeon's team to solve a medical problem. That gives you some sense of control and a positive outlook. Recovery and rehab will be part of this, and believing in a positive outcome and a successful procedure will help you recover. Make sure your surgeon knows how much you appreciate their help. They can have very stressful jobs, and the same other life stresses that anyone can have. Expressing gratitude to your surgeon will help them focus on you and getting everything right. Right before I went into surgery, I held my surgeon's hand and thanked him for helping me, and reminded him that we had agreed on no hardware for my single level fusion. That would be an easy thing to miss if most of his cases involved hardware. Making that effort on my part gave us both peace of mind and I could relax knowing that I was in good hands. You need to have that level of trust when you are the patient on the table.

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