Chronic Pain Experiences

I’ve consuslted several doctors about my sciatica; a general practitioner, a high school friend of mine who is now a pain expert practicing in Pennsylvania, an orthopedist, a pain specialist, and finally, last week, the surgeon. Boom. The end of the road. When you get to the surgeon, you’ve run out of options.

I really don’t like going to doctors, especially going over and over for the same problem. Just fix it, I say. Don’t just send me off on a trail to more waiting rooms and different opinions and lots of wasted time. But the surgeon is the end of the referral trail. He’s not generally going to send you anywhere but the OR.

I had a very difficult neck surgery 10 years ago, when a degenerated disc was replaced with a titanium “Prodisc.” After that experience and the very long recovery, my dread of surgery, my horror of the miserable way you feel when you wake from the anesthesia, all the aftereffects are still vibrant in my memory. I wanted to leave the house, to resume my life activities, but I was frozen by pain and instead found myself reading or watching T.V.

Despite the long and painful recovery, and the risks automatically associated with anyone putting a scalpel on you spine, I didn’t feel I had a choice. The only other options were to have a piece of bone retracted from my own hip, which I was told could be the most painful part of the procedure, or having a cadaveric bone inserted, which had risks of early breakdown. If I didn’t undergo the surgery, I faced a future of pain, and probable disability.

I’m pretty much in the same position now. Based on my MRI results, my herniated discs are not going to resolve without surgical treatment. They are causing the pain of sciatica, as well as left leg weakness, and a condition called “foot drop,” where my left foot often lags behind as I walk and climb stairs. The disability can become permanent if not treated, and time is a key factor; according to my medical team, I have to act soon.

However, I think people instinctively feel that surgery is a big step and should be put off as long as possible. It’s true that my pain has improved a lot in the past weeks.  I regain leg strength through exercise, and couldn’t my disc issues resolve over time?

The short answer is no. If I don’t take action soon, that old woman who drags her foot as she stumbles down the aisle at the theater in the goofy-looking orthopedic shoes could be me.

The procedure itself sounds like a nightmare. The surgeon will make an incision in my back, and remove the bulging disc material from my spine. He will replace it with some bone-growing compound, and some additional bone from my hip. The hip bone is replaced with cadaveric bone. So it’s the worse of all worlds described above.

To secure the whole package, the surgeon inserts screws into the sides of the spine. I already have an artificial disc; how much more artificial equipment can my spine support? The prospect is very scary, at least to me.

Here’s the topper: the procedure calls for five days in the hospital, during which time I’ll be under heavy anesthetic, and three additional weeks before I can drive again. The doctor estimates a total of five weeks before I’m back to myself and my pain level begins to normalize. I’ve never had a procedure that called for so much inpatient time, and in these days of insurance-driven cost savings measures calling for reduced hospital stays (I left the hospital after one night when I had my children; in Europe childbirth calls for a mandated three-night stay), that raises some scary questions, like “Why?” Why would they want to keep me in the hospital so long? What could happen during recovery that scares the insurers more than paying for hospital time?

I’m going along with this plan because I don’t want to have a permanent disability, although if something goes wrong and I have to add permanent back pain to my permanent neck pain, I don’t know exactly what I’ll do. But I can’t tell you how much I don’t want to have such a major procedure and how terrified I am about increasing the amount of pain I already feel every day.

Everything we do is a risk, and every risk can lead to pain. Ralph Waldo Emerson said “He has seen but half the universe who has not been shown the house of pain.” OK, so I’ve seen it. Can’t I go home now?

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