Discectomy - After the Operation

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Hi all,

I am booked in for a discectomy on 4-11-2010, after 10 years of sciatica and lower back pain. I have tried all the other options available to me and I have now decided to go for the surgery. My slipped disc is at L4/L5 and I have been reading the post operative postings on here with interest, I will add mine as and when I can. I am not looking forward to the anesthetic but my pain has reached such a stage now that I am biting the bullet going for it :0) Although in my current job as a caretaker at a Civic Hall for the local authority can be quite physical, lifting and moving tables and chairs etc, I am hoping to get back to work in January as I only have 2 months sick time on full pay available to me. I would love to hear of all your expirences in 'getting back to work',

regards

Kipper
 
I remember my first time and how I dreaded the GA in particular. However I now don't mind these and have become quiet used to them. Sometimes they ask you to count backwards but all I remember is a cold sensation running along my arm and then the next thing I remember is waking up in the recovery room. Although my last op was 8 hrs long the process of falling asleep and waking up in the recovery room seemed instant. Obviously when you wake up you feel abit disorientated and the GA does cause an unpleasant taste in your mouth.

I will say this though based on my experiences. How you feel when you wake up from a GA largely depends on the length of time your under the GA. For example when i've woken up from a discectomy which took 2hrs I didn't feel too bad at all and fully awake. However because my last Op took 8hrs I felt as though I had taken a damn good kicking!

I don't know if your discectomy is open or microdiscectomy. If open I can assure you it isn't as bad as you think. Obviously you feel sore for the first 24hrs especially turning over but its remarkable how much easier it becomes. You should be up and about walking around the ward about 24hrs after the OP. I will also stress that the more mobile you are the quicker you will recover. Many nurses have told me that smokers generally make the quickest recovery because they are that desperate for a cigarette they are very eager to get out of bed. If your Op is Micro then it will be even easier.
 
You cannot divide surgery technique to open or microdiscectomy. Microdiscectomy is open spinal surgery. There is a technique called micro-endoscopic discectomy which is less invasive version of traditional open surgery (aka microdiscectomy).

Different between discectomy and microdiscectomy is just using of microscope during surgery. This is important to avoid and to note bleeding.

However, booth of this methods are traditional open surgeries.
 
A microdiscectomy is open surgery. However the incision is still smaller, around 1, 1 1/2 inch. Now the discectomy operations that I've had the incision was around 6 inches. So my point is correct because for obvious reasons a smaller incision means less trauma to surrounding tissues.

Stil like I said in my previous post I can only pass on my own personal experiences. The main point in my post was to try and ease the fears of having a GA. I still remember the sheer terror of my first GA but now they don't bother me at all.
 
Thanks Ogothorpe,

I dont know which op I am having, I go for a pre-op assessment this Thursday so I will ask. I have been told that it will be in the day surgery unit and will be allowed home the same day. All this is new to me, any ideas on what questions I want to be asking at the assessment?

cheers,

Kip
 
Yes, you are right, incision is smaller...and damage is also much less. However, in the end, recurrences and FBSS are very high with booth procedures, unfortunately for all of us.
 
Dear Keano, Your words are very true. However, it is also very difficult to convince someone to change or look at dream alternatives when they are already in the system, waiting queue for an operation, or for that matter even bring up about minimally invasive surgery, to someone in pain that doesn't have money for a privately funded operation?

In fact in many ways just mentioning the alternative to traditional open-back surgery can be enough to cause doubt and fear and worry in those that are already booked for an op?

Now if we all refused and said MISS or we rebel, what might happen then?

I know my own true heart beliefs mean that I could never ever willingly undergo such a brutal butchering operation as open back sugery. The preparation reminded me of a butchering technique. But many do, and some very successfully too. Look on UTube for some of the major teaching hospital videos showing the hammer and saw ops, and then look at the minimally invasive techniques. This is one site that has videos http://www.spine-surgery-croatia.com/category/animations-videos/

I wonder if this board is divided in two sometimes, for and against MISS lol? And what right do we have to cloud people's confidence in their surgeons? Hmm, it is the surgeons who do not use MISS whose confidence we need to cloud!
 
Yes, you are right, and this is why I am very sorry to hear that public hospitals don't offer MISS in UK.

In some countries MISS is available booth in public and private sector, but for some reasons surgeons don't want to tell that to patients. Recently my friend had disc extrusion and sequestration. Surgeon 1 told him that he must be opened and cut, and that he is not candidate for MISS. I checked this with Surgeon 2, who confirmed that disc extrusion and sequestration is one of possible indications for MISS and confirmed that EVERYONE is a candidate for MISS (but not everyone for same technique). Now, this guy had open surgery, COMPLETE DISC REMOVAL (?!?), just had an infection and wound opening, and now most probably suffers from discitis. Terrible! Just because he told him "You are not candidate for MISS".
 
Have to be honest i've never heard of a discectomy performed in the day surgery unit. All my operations have followed the same timetable as I will describe below.

Tues, admission day.
Wed, operation performed in morning.
Thurs, Drain is removed and im allowed to get out of bed.
Fri, physios come round.
Sat or following Mon im allowed home.

Im very curious what technique your surgeon is going to use.

When you go the pre op assesment this is mainly done by a nurse who asks many questions and checks your general state of health. This is done to make sure there isn't any complications with the GA. They will also ask what medications you are taking and will also check for MRSA. This is done by using a swab in the mouth or up your nose.
 
After MISS discectomy or decompression, there is no hospital stay (or maybe overnight stay after endoscopic surgery).
However, after open surgery, at least 2-3 days of hospitalization is needed...
 
I had a microdiscectomy over 2 years ago. Surgery in the afternoon, up and about 3 hours later and home the next afternoon!! It is open surgery but is not as invasive as discectomy. It is not as brutal as some on this site believe. Surgery was 45 mins and nothing apart from the damaged part of the disc was cut or removed. I only have a 1 inch scar. I am back to total fitness and mobility and have no pain anywhere. I followed the rules, had no physio as my surgeon does not agree with physio for spinal patients and did my exercises religously. I ate well, rested well and did nothing stupid in my recovery time to jeopadise anything. The surgeons job is only part of the process, the rest is up to you!!
Good luck Kipper Banjo, Hope all goes well for you. There are a lot of success stories on this site who had the same surgery as me so it's not all bad!!

Let us know how it all goes

Fitbird
 
Some very good advice there,

As for the microdiscectomy I fully agree with you. I wish I had been offered this instead because it would of been a doddle in comparison. The main cause of my discomfort following the operations has most certainly been due to the larger incision causing more pain and a slower recovery period.

I fully agree with your other comments about looking after yourself. A large majority of patients undergoing their first operation for a disc prolapse have an excellent chance of full recovery with no further problems. Unfortunately their are some patients who suffer further disc problems despite looking after themselves but these are definiately the minority.

I shall repeat what I said many posts ago. If you are suffering from extreme pain caused by a prolapsed disc and you haven't had previous spinal sugery then go for the operation. However if you suffer from further episodes then avoid further surgery especially avoid having numerous operations. The problem is the formation of scar tissue makes life very difficult for the surgeon. Also scar tissue can cause similiar pain to a prolapsed disc if its pressing on the nerves.

I will finally say to Kipper Banjo that if you read any posts saying having the microdiscectomy was agony then I would be rather sceptical of these comments. I imagine only having a 1 inch incision wouldn't cause too much pain to be honest. The fact you can start walking just 3hrs after the Op and allowed home the same day suggests this. Im now annoyed why some people had this type of operation and why it wasn't offered to me!

I would also like to mention that during my stays in hospital i've noticed a massive difference in how patients react to the same operation. I was told by a nurse that some patients go into invalid mode as soon as they arrive. These patients tend to make the slowest recovery and quiet frankly seem to enjoy being a patient. You then get the other extreme when some patients cannot wait to get out of bed and get discharged ASAP. These patients always make the quickest recovery and in my experience its the smokers who do this!
 
Spot on ogothorpe, I was up and out of that hospital in record time....and I smoke (not a heavy smoker either!) . Its also true that everyone is different, I felt completely cured following the microdiscectomy, but patients are often injected with a pain reliever to help with mobility. I was slightly concerned when the surgeon informed me he 'had to take most of the disc away' so I'm not completely surprised to have relapsed 4 months later. BIG NEWS: I have an appointment at the back clinic next month....after suffering since March 09 I am now allowed to get the lumbar problem looked at..I hope!

I know a young lady who had her second operation to insert rods along her spine, apparently she was in so much pain afterwards she just lay on the sofa and slept...mistake! I think the microdiscectomy sounds worse that it actually is, the important part after that is the recovery period. Listen to your body...know when to push yourself with exercise and when to ease off a bit. We all respond very differently and have to make our own judgements. Just keep everything moving.
 
Hi melza thank you for your advice, as i couldnt get in to see my doctor i decided to wait until yesturday to see the spine physio and show her the diary she asked me to do for two week so that she could see i am in pain day and night. Thankfully she has decided to refer me for an mri to see what is going on, she told me stop doing the exercises that cause me pain but to try another one which brings the pain on worse down my leg but i will perssevere with it and see if it settles down. I am glad i found this site because it has been really helpful and i do want others to know i AM glad i had the op and my consultant has been brilliant,its just i could possibly have permanent nerve damage or scare tissue thats causing the pain but we shall see what the mri shows and take it from there.
 
Well done dollypie, hope it all moves swiftly and you get a solution. And if the exercises still give you grief take a break until you get the MRI done, it could be that you've injured a muscle and the exercise might be aggravating it. It won't cause any more damage if you stop for a short while, but only if its too painful to continue.

Good luck!
 
That sounds nasty! leg pain is most often caused by a nerve being hurt, I think I would be very careful of any exercise that brought on that pain. I was recommended to stop if it hurts more! Do you have the Back Sufferers Bible by Sarah Key? it has wonderful, easy exercises that really help bring relief, they lessen my leg pain
 
I have a question about nerve pain.

When I visited my surgeon a couple of weeks ago I said to him how my leg pain has slightly decreased but the numbness has actually increased. His reply was this is because of the increasing pressure on the nerve.

Now let me explain exactly where my numbness is. The front of my foot is completely numb and so is my leg below the knee. However it isn't the inside of my leg but only the outside and its especially bad on the outside of my calf. I also haven't been able to move my toes since July and cannot move my foot towards me. My surgeon did say i've lost the ankle reflex. The numbness is so bad I could literally pour boiling water on my foot and I wouldn't feel it.

My question is has anyone else suffered from similiar numbness. I have in the past from previous disc prolapses suffered pins and needles and numbness but not to this degree. I should be thankful though because now I have moderate-severe pain+numbness rather than extreme pain that I was experiencing only recently. Maybe this is natures way of helping me through this episode.

I will add that I find nerve problems quiet fasinating in a way. I have experienced the sensation of wearing a wet sock, my leg on fire, sensation of insects crawling under my skin, and these have all been caused by a disc prolapse pressing on the nerve. I will also add that i've found sciatica is far worse when L5/S1 is involved compared to L4/L5.
 
Hi, my spinal neurosurgeon explained this phenomenon like this: When nerve is under pressure, it causes pains. Longer time of compression, the part of nerve that is compressed is dying and then stops causing pains but the compression is still there! That was his explanation to my question.
 
Yep like Keano said, I mentioned to my consultant that the pain was getting better and after nerve testing he said that...

Imagine the nerve is like a length of wire, when it is compressed the plastic outer sheath is irritated causing pins and needles, the more pressure there is then it gets painful as the pain monitoring nerves are on the outside plastic sheath. With more compression the rubbing removes this outer 'pain sheath' and so the pain goes and then we are on to loss of sensation and numbness, more pressure and the little nerves inside that govern movement can be affected, and loss of use or lack of movement.

When the compression is removed the cycle reverts and as nerves are extremely slow to repair we can get more pain as they come back to life and continuing pins and needles etc?

Bear in mind though I am no doctor just a fellow sufferer, but that helped me to understand some of my problems.
 
That nerve stuff baffles me too, I had a spell of sciatica recently, which was great because it gave my nerves a bit of a rest. It's not often I go without burning and numbness in my legs, for some reason the numbness is at the soles of my feet....? I thought the sciatica was going to be a permanent feature but I pampered it and so recovered. It must have been caused by a muscle injury...???...but who the hell knows!

My problem is the L4/5 disc and the pre op sciatica was unbearable, I would never have beleived it could be so painful if I hadn't felt it myself. Healthy friends suggest that I don't really need prescription drugs, its all mind over matter! Oh, how I long for one of them to feel the same pain and manage on paracetemol!

As an ex healthy and fit person, this is a lonely place to be.
 
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