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Friday, October 1, 2010

hope in the field of chronic back pain

When it comes to the back pain that has become
part of my life, a thorn in my side,
what causes me not to live the life I want,
I have tried and "seen them all"
or so I thought.
I have seeked the opinion of orthopedist,
chronic pain doctors, family doctors, physical therapists.
I have gotten opinions from chiropractors, spine specialist and even
took a trip all the way to Tennessee to hear what
specialist on the subject of survivors of childhood cancer
had to say about my issues.
I have read books on the subject and am even seeing
a counselor trying to accept this part of my life.
On a pretty good day, I can live with the fact
"such is my life" but on a bad day my mind always
believes there has to be something that can be done.
It is on those days that I grasp at straws and look for
another opinion different from the ones I have gotten before
which basically all say there is nothing that can be done
but take pain medications, exercise, loose weight
and wait for the day that you are no longer able to do your job
and retire. I was almost resigned to the fact that this
is what I needed to do but Dr. Cowen at the spine center
convinces me that before I resign to this I need to at least
hear what a neurosurgeon has to say.
Another doctor to add to my list but being the ultimate
optimist, what do I have to loose.
Yet this visit yesterday is different.
Not to mention that Dr. Donner is very knowledgeable in
his field and has a very good bedside manner,
he is also very handsome.
We first discuss all that has been done before
and my frustration over accepting that this is my fate.
He kind of chuckles when I tell him I am seeing a counselor.
I am not sure why but this seems to be the reaction
most often when I mention this.
He has reviewed my brand new MRI and talks
about am I really ready for this huge back surgery
for scoliosis that is really not that bad.
I question whether the MRI showed the spondyolisthesis
that many say are part of my severe pain and he admits
that the MRI does not show this.
I then show him the report of the CT scan that I had
in 2007 and as he reads this his whole facial expression changes
and he brings me to his office to pull the films of the CT scan
to view them together on his computer.
He sounds energized as he says and shows me,
"Here it is, here is the cause of the pain you have"
Wow, I see it. He gives me a quick lesson on bone formation
and what has happened as my bones formed.
There is a slippage of two bones that have causes
the spiny portions of the outer spine to not only
rub together but from the constant friction have
caused fractures in the spiny bones that are on the
outer part of the spine.
A Pars defect that can be surgically fixed.
He is confidant that this is the cause of the majority of
my pain and he is insistent that this can be fixed.
we discuss a lot in the half hour I am there.
I talk of my fears of back surgery and that I don't
know many people who have back surgery who still
need pain and what if my pain is more due to the
radiation I received.
He matter of factly explains that he knows the majority
of my pain is this problem he is not saying that the other
issues do not cause some pain but the severe pain
is this. Unlike what an orthopedist has talked to me
about a while back there will be no big cuts no big rods,
no trying to straighten a spine that is crooked.
He would simply go in and fix this Pars defect
and fuse the spinal fracture so that there would no longer
be this slippage that he shows me a few times on scan.
I love this doctor, he is the first one I have ever spoken to
who offers me some form of pain relief and speaks
with the confidence I need. I also had a bone density
so I question whether the bones are strong enough to
handle a fusion and he says although there is bone
thinning as seen in osteoporosis he reminds me
that the elderly who fracture their hips are most usually
caused from brittle bones and yet rods and healing take
place with these people.
Yes, he is right, I can heal no matter how weak the bones are.
Then he sits me down and gets to the real "nitty gritty"
part. His best prognosis patients are the ones he can
do via the abdomen. It is on the side of where the defect is
and patients have a better outcome when the surgery is done
this way and out of all the patients he does this way,
50% have complete pain relief, are off all pain medications
and are able to resume a full time job after recovery.
Out of the other half, most still work and some need pain medications
but the pain is minimal to what they experienced before and
all work. Very few do not have improving of their quality of life
but those he doubted, because of their mental thoughts and
having a narcotic issue, would do well anyway.
He says that someone with my optimism should do well.
The big doubt though is whether or not he can do this surgery
via my abdomen due to all the scar tissue and intestinal issues,
it may make this impossible to do the surgery in this way.
He sets me up to see Dr. Marino who is the general surgeon
he works with and who happens to be the doctor who follows
my bowel obstructions to make the decision as to whether
the surgery can be done this way.
He assures me that if we proceed with this type of surgery that
Dr. Marino would also scrub in as assistant in case the bowel
becomes a problem.
If he feels this cannot be done then we will talk again about
whether or not I should do the repair going through the back.
His reasoning for this is that this way of doing the surgery
does not have the better outcome that he would want for me.
There is a harder recovery and most patients are still left
with chronic pain issues. It may not be as bad as it is now
but he wants to be honest with me as we discuss and prepare
to move forward with this surgery.
He relieves my mind when I say I so want to be healthy and
I have been frustrated because Physical therapy, chiropractics
has not helped me and I know if I lost weight I would have less pain.
He reminds me that this problem will not be resolved or
pain will not be lessened by any of those things.
Because there is this defect and this fracture,
it is like having a broken bone that will not heal
and after so many years of stressing on it, the pain
is there. I leave there with a hop in my step
because this is the best news I have had in such a long time.
When I shared with him that just saying that I may never
nurse again makes me cry he explains that this is his
number one reason for doing back surgery.
When a patient expresses to them that their quality
of life is being affected, he decides it is time to do
surgery. So this morning I am trying not to get my
hopes up too high but very very optimistic in this news
and what this doctor has offered me.
Sorry for the long post but so much easier to
post it here one time than telling my huge family this
so many times.
Wish me luck as I move to a new adventure
and the belief that I can be well, I can have pain relief.
Oh what a good day this Friday is becoming!!!

1 comment:

  1. Oh, my WONDERFUL LIL!!! THIS IS THE BEST NEWS I'VE HEARD IN A LONG TIME!!! YOU WILL CONTINUE TO BE IN MY PRAYERS!!!

    I LOVE YOU,
    TIFFY

    ReplyDelete