The tough decision

Post #359,590 by drook 6/26/12 2:38:21 PM Reply	The tough decision If I recover well enough that I'm pain free, do I go for the surgery anyway and risk the complications? Or do I live in fear of doing this again and avoid doing things with the kids? -- Drew
Post #359,600 by Ashton 6/26/12 3:38:18 PM Reply	I no advice, there.. Suggestion, though: I'd want to see a 'scorecard' on the medico doing the surgery and--if possible--talk to one or more whose situation was comparable, had the surgery, etc. There's no Consumer Reports re medico Actual performance--and their massive Trade Union ensures that it stays that way; we see the implications. Luck on flipping That coin--intelligence only goes sooo far in such matters. Fingers/prehensile-tail crossed..
Post #359,644 by dmcarls 6/26/12 11:11:00 PM Reply	Re: I no advice, there.. >>> "There's no Consumer Reports..." There may be in the future. Some sites are dabbling in this type of thing: http://www.ratemds.com/ http://www.vitals.co...rk%2C+il&x=64&y=8 http://www.healthgrades.com/ I expect this type of data to evolve over time, things cannot stay like they are now. (Can they?)
Post #359,647 by drook 6/26/12 11:42:18 PM Reply	Sure they can stay this way #1 Studies show most in-hospital medical complications -- including nearly all infections -- are entirely preventable through standard procedures. One doc instituted a checklist (set of lists, actually, one each for various situations/procedures) that he's been advocating for over a decade. http://www.newyorker...e?currentPage=all Pronovost and his colleagues monitored what happened for a year afterward. The results were so dramatic that they werenÂt sure whether to believe them: the ten-day line-infection rate went from eleven per cent to zero. So they followed patients for fifteen more months. Only two line infections occurred during the entire period. They calculated that, in this one hospital, the checklist had prevented forty-three infections and eight deaths, and saved two million dollars in costs. Every hospital that implements the checklist cuts complications by two thirds and infections by more than that. Doctors hate the lists. They don't want to be told what to do. Some physicians were offended by the suggestion that they needed checklists. Others had legitimate doubts about PronovostÂs evidence. ... Tom Piskorowski, one of the I.C.U. physicians, told me his reaction: ÂForget the paperwork. Take care of the patient.Â Here's the funny thing: In the Keystone InitiativeÂs first eighteen months, the hospitals saved an estimated hundred and seventy-five million dollars in costs and more than fifteen hundred lives. The successes have been sustained for almost four yearsÂall because of a stupid little checklist. They'd save more money if they did it. But they won't. #2 Someone built a diagnosis app, based on the same type of algorithms Amazon and Netflix use for recommendations. You put in some symptoms, it starts asking questions. At the end of the process it suggests several possible diagnoses, along with prevalence, accuracy of match to symptoms, and the correct tests to confirm or rule out each option. Hospitals won't use it because "no machine can replace years of experience" though figures show it clearly can. But the method they use to keep them out is to accuse the creator of the system of practicing medicine without a license. Doctors hate being told what to do, and they're currently very well funded and well connected. It ain't changing just because it ain't working. -- Drew
Post #359,601 by Another Scott 6/26/12 3:39:55 PM Reply	I threw my back out a couple of months ago... I was bent over trying to shift the base some heavy shelves that were stuck in the linoleum. Bad move. It wasn't as bad as what you went through (I was never confined), but it was painful. I had to move very slowly to get out of a chair or out of bed, and getting into and out of the car, and using the clutch, was very painful. It slowly got better though. By 3 weeks, I was back to normal. If you can wait, and feel back to normal in 3 weeks, I'd strongly consider putting it off. The trouble with the physicians is they only see the X-rays and so forth after you have the pain. Who knows what it looked like before - maybe it was the same, maybe it was only a very little different. They don't know. Physicians don't know much about muscles and how they interact with all the nerves and other stuff. They may indeed fix you up just fine, and the likelihood of complications is low. But surgical techniques and other treatments do advance over time. Maybe in 5 years they could do the same repairs with less cutting and less recovery time. The main reason why I say use caution is (as I've mentioned here before) that J has had lots of pain issues in her jaw and upper torso as a result of an old car accident. Some of her physicians were saying she needed extensive dental work, some were saying she needed jaw surgery, some were saying it was the stenosis in her neck vertebrae. The thing that has helped her the most is having someone work on the knots in her muscles. But take this with a grain of salt. If you couldn't get out of bed, it was much more serious than what I went through. :-) In any event, make sure you get a second opinion, of course. Good luck! Cheers, Scott.
Post #359,607 by drook 6/26/12 3:55:22 PM Reply	Re: before / after When the open MRI came out and all the top hospitals started converting, there was a glut of old-style closed ones. (And speaking of claustrophobia, I don't have it but good God would that thing test it. Kept my eyes closed for the whole test.) Clinics started popping up that bought the older systems and offered a full-body exploratory MRI, and of course offering followup on whatever they found. Even leaving aside the financial incentive to find and treat something, it turned out if you scan anyone over the age of 30 you'll find a half-dozen things that would be concerning if there were associated symptoms. After some analysis, it turned out the risk of complications from exploring and/or treating asymptomatic anomalies was higher than the risk of one of those anomalies being meaningful. But of course every clinic tells the story of the one-in-a-million case where someone identified cancer early. All that being said ... the condition I have is congenital and familial. My father's near-identical experience convinces me this isn't just what they found to explain what I did, it's the underlying problem. In theory, removing some bone to create a wider channel sounds eminently reasonable. But my lizard brain thinks, "Open up my back and chisel around my spinal cord?" and I get the willies. -- Drew
Post #359,610 by Another Scott 6/26/12 4:12:56 PM Reply	Understood. Good luck. :-)
Post #359,646 by dmcarls 6/26/12 11:28:50 PM Reply	On pain... http://forums.xkcd.c...c.php?f=7&t=70070 (smile)
Post #359,648 by Another Scott 6/27/12 12:07:24 AM Reply	:-) J's father said his was "15" once. ;-)
Post #359,649 by static 6/27/12 12:19:13 AM Reply	I've heard a relative say "11". She used to be a nurse and was trying to kick the staff into giving her Something NOW for her damaged back (yep - herniated discs at L4/5). Wade. Just Add Story http://justaddstory.wordpress.com/
Post #359,650 by drook 6/27/12 1:10:22 AM Reply	On Wednesday right before the shot I said I was about a 4 But told them I had just recalibrated. A week earlier I would have called it a 7. -- Drew
Post #359,947 by Another Scott 6/29/12 4:34:08 PM Reply	Louis CK Pain Chart. http://25.media.tumb...qz6f9yo1_1280.gif (SFW) :-) (via ThisIsntHappiness) Cheers, Scott.
Post #359,950 by drook 6/29/12 4:58:47 PM Reply	Excellent -- Drew
Post #359,611 by hnick 6/26/12 4:22:17 PM Reply	In November I had a lumbar laminectomy I had a synovial cyst on my spinal chord (about the same place as yours) that compressed the nerves going to my feet and I couldn't walk properly and the pain was excruciating. Vicodin has absolutely no effect on nerve pain by the way. There was also some stenosis. I was in the OR for 3 hours and went home the same day. When I was still in the medical dodge, a lumbar lam kept the subject in the hospital for several days to a week. It's gotten way better. My results have been excellent. It's only been since November, so I can't speak to long term results. I thought my surgeon was excellent, if you want his name or maybe for a second opinion. You really should have a second opinion. Surgeons are surgeons because they like to cut. Good luck with the pain. It rarely gets better on its own.
Post #359,615 by drook 6/26/12 5:02:12 PM Reply	Yeah, speaking of Vicodin ... Why the hell would anyone take this stuff recreationally? Aside from not doing a damn thing for the nerve pain -- by the way, thanks for confirming that -- I didn't feel anything except possible sleepiness. And maybe some excessively vivid dreams, though with the amount of time I spent drifting in and out of (bad) sleep, it's hard to say what those were from. I'll definitely hit you up for your doc's name for a second opinion if it comes to that. I've been researching, and I see the outpatient endoscopic procedures. I didn't know that existed. Maybe not as much to worry about, with a good chance of relief. -- Drew
Post #359,617 by hnick 6/26/12 5:15:45 PM Reply	cool. let me know. usernameATatt.net
Post #359,654 by mmoffitt 6/27/12 8:10:41 AM Reply	Seconded. I was fortunate in that a fellow pilot had just had the operation himself by the same physician. I was down for about 2 days after the surgery (apparently, I was in much worse shape than my buddy - he got up and walked out post op). Ditto on the Vicodin for me - doubled up the dosage and I still couldn't sit up. But, like I said, I've been virtually pain free ever since. It's a tough call and every case is different. I wouldn't tell you that you should have surgery. It's just that I had a TON of people telling me not to do it and they turned out to be wrong. I guess what I'm trying to say is keep your options open. And definitely get multiple opinions. Good Luck!
Post #359,657 by mmoffitt 6/27/12 8:19:36 AM Reply	I just realized I never answered your question. And I still won't. ;0) The best advice I could give you is talk to an orthopedic physician as well as your neuro-guy. I don't know how they do things everywhere, but up here people go see one or the other. I went ortho and didn't regret it. YMMV and likely will. I had to have the surgery - I couldn't sit in a car long enough to get to work and certainly not more than 1 to 2 minutes at a desk in front of a computer. I'm sorry I can't be more help, but this really is an individual decision. FWIW, I've been told that they are beginning to experiment with the artificial disks in the lumbar that they've been using for a while in the C-spine area (haven't looked it up but if that's true, I might go back under for that - most of my lumbar disks are obliterated). In any case, yoga actually does help - especially the Upward Dog position. I do that whenever I feel my back starting to tighten up and it really does help.
Post #359,665 by drook 6/27/12 11:10:30 AM Reply	Couldn't do upward dog until yesterday I've got to say, as much as Big Pharma is a lying cesspool of evil, the right drug for the right reason is fucking magic. I took the first nerve drug -- Lyica -- last night. A half-hour later I was completely pain free and able to stand up straight for the first time in 9 days. -- Drew
Post #359,666 by malraux 6/27/12 11:19:05 AM Reply	Re: Couldn't do upward dog until yesterday That one's for fibromyalgia too. Regards, -scott Welcome to Rivendell, Mr. Anderson.
Post #359,667 by drook 6/27/12 11:55:59 AM Reply	Saw that on the labeling ... have you used it? -- Drew
Post #359,668 by malraux 6/27/12 12:20:02 PM Reply	Re: Saw that on the labeling ... have you used it? No, I don't actually have FM. I have a high avoidance to taking neuro medicines too. Too many side effects. Regards, -scott Welcome to Rivendell, Mr. Anderson.
Post #359,671 by drook 6/27/12 12:56:51 PM Reply	Oh, I don't plan on using it forever I don't believe in lifestyle meds. I want something to treat acute symptoms, fix the underlying problem, then stop taking it. Given the choice between surgery and a daily med, I'll let them cut. -- Drew
Post #359,669 by hnick 6/27/12 12:44:42 PM Reply	Didn't do much for me. My regular doc gave me a scrip for that while I was waiting for my surgery because I was bitching that the Vicodin was useless. It didn't do much, but apparently I was really a mess inside the spine. Glad it worked for you.
Post #359,726 by crazy 6/27/12 9:21:47 PM Reply	Probably a dosage issue I have a bottle of gabapentin (http://en.wikipedia.org/wiki/Gabapentin) from the old days when I popped pain meds like candy. The only reason they invented Lyrica was becuase the patent was running out and they needed their next brand name drug in the family for the diabetes patients (their extremities can be in agony). Of course, at that point, the Pfizer salepeople sold it to everyone for everything. 1 did nothing. Nothing at all. WFT the fuck was those stories about, people waking up in a ditch after driving home from work under it (my sister in law). So I did 2. I woke up 2 days later. Must have been a fluke. I do it again. And wake up 2 days later. No, I don't think I'll be doing this stuff again. Like I said, I have a bottle of it.
Post #359,728 by crazy 6/27/12 9:23:20 PM Reply	Do NOT drive no matter how clearheaded you feel. That drug has an affect like an avalanche when you hit a certain dosage.
Post #359,741 by drook 6/28/12 12:17:35 AM Reply	Thanks for the tip I was planning to do more research over the weekend. -- Drew

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