Who can tell me about their herniated disc treatment? Asking for DS

[Eos]

My 32 year old DS damaged a disc when he was about 23 and has done physical therapy, steroid injections, and more physical therapy.  He is an ultra-marathon runner and elite athlete, just finished 60 miles and a zillion obstacles in the world's toughest mudder comp in Vegas (this choice of pastime is not hereditary.)   He turned his head and coughed yesterday and is now immobile, unable to drive the 8 hours home for Thanksgiving.  He's got a doc appt for Wednesday but is very down.  When he first did it the doc had told him it's injections and PT until those don't work anymore, then surgery.  If you have experience, please give me some thoughts.  Thank you.

[kbutton]

I haven't kept up with all the developments, but a friend had minimally invasive surgery (very small incision), and she was up and around quite fast. I am not sure whether her problem was long-standing or not. Family members that have had this surgery had it so long ago that things are not likely the same anymore. 

I would want to see someone that worked with athletes before--he needs to know the pros and cons of dealing with it now vs. later (assuming he's "eligible"). I also always want to know if pain is bad and how to know, particularly if they are taking the non-surgical route. I wouldn't want to overlook a new development/worsening problem, nor would I want to assume every pain that seems to be related is scary if it's not really scary. I feel like people can get blown off if their doctor is either too conservative or too surgery-happy and would want the full story, not "I do this because xyz dismissive answer." It's possible to have a strong opinion and be willing to explain it to the patient thoroughly.

 

 

[ScoutTN]

I had surgery 20 years ago and have not had any back pain since.

I am limited in what exercise I can do and of what intensity. I get sciatica, which causes cramps in my feet and/or legs, if I over do it. 

[Starr]

If he’s lucky He may have overdone it and need to start over with ice, rest, PT, muscle relaxer for the spasms , etc

[Alicia64]

I had the surgery for a bulging disc in 2016 at Emory in Atlanta. I was 52. OMG. Most wonderful thing I ever did. I was in the hospital for three days. And recovery at home was not hard.

My only caveat: I wouldn't have the surgery when we lived in Richmond, VA. Nothing against Richmond. I LOVED living there, but they're not big.

I waited until we moved to Atlanta, and got referred to the Mick Jagger of orthopedic surgeons at Emory. (Dr. Heller.)

Tell your son to go to the best of the best.

Let me know if you have other questions. 🙂

[Eos]

30 minutes ago, Alicia64 said:

Tell your son to go to the best of the best.

Let me know if you have other questions. 🙂

Thank you, this is helpful.  How would he know who to go to?  That probably sounds sort of silly but I don't know much about how to learn/compare doctors.  He lives near Albany NY but could travel to Boston where I know the healthcare is really good. 

 

[Alicia64]

8 minutes ago, Eos said:

Thank you, this is helpful.  How would he know who to go to?  That probably sounds sort of silly but I don't know much about how to learn/compare doctors.  He lives near Albany NY but could travel to Boston where I know the healthcare is really good. 

 

That's not a silly question at all. If you'd like me to, I can contact Dr. Heller's nurse and -- through her -- get recommendations from Dr. Heller. He did his undergraduate at Harvard (twelve minutes from Boston). I bet it's a smallish club of top surgeons. He likely can recommend somebody in Boston.

Do you want me to put the call tomorrow morning?

 

 

[Mrs Tiggywinkle]

I’ve taken patients four hours up to Albany Med for spine surgery, and have heard nothing but good things about their spine center. My ex-BIL had minimally invasive disc repair with Dr. German(I just texted and asked) at Albany Med and was extremely pleased. He is a career firefighter and was able to be back on the job within a couple months.

[Eos]

10 minutes ago, Alicia64 said:

That's not a silly question at all. If you'd like me to, I can contact Dr. Heller's nurse and -- through her -- get recommendations from Dr. Heller. He did his undergraduate at Harvard (twelve minutes from Boston). I bet it's a smallish club of top surgeons. He likely can recommend somebody in Boston.

Do you want me to put the call tomorrow morning?

 

 

Oh my goodness, that would be fantastic!  We would both be very grateful.  Thank you!

[Eos]

2 minutes ago, Mrs Tiggywinkle said:

I’ve taken patients four hours up to Albany Med for spine surgery, and have heard nothing but good things about their spine center. My ex-BIL had minimally invasive disc repair with Dr. German(I just texted and asked) at Albany Med and was extremely pleased. He is a career firefighter and was able to be back on the job within a couple months.

Thank you for this name too, I will pass it on to DS.  I am really glad to hear that folks responding here have had overall good results with surgery - he has wanted to avoid it but it actually sounds like a better option than just continuing the way he's been going.  Just got a text from him at the ER, he can't really sit or stand.

[Tap]

I suggest getting multiple consults. I had 4 consults and revisited one twice (the head of neurosurgery at OHSU in the spine center).

I have a complication with mine, but each doctor told me I only had a 25% chance of success and that they really felt the surgery would make me worse. The reason I had so many consults, was that I went to one doctor for the first opinion, then a second doctor for another opinion. They contradicted each other. So, I went to a 3rd and a 4th.  In the end, I ended up with all of them telling me completely different ways they would approach my back. 😞 I went back to the aforementioned one twice, laid all of the options on the table and asked him to help me decide. He gave me his opinion on why some were poor options and what he would do. At the end of the visit, I asked him --If I was your wife, what would you suggest---he replied "no one would cut on you if you were my wife....you are going to end up worse!". His suggestion was to wait until I couldn't walk and then do it, as a last ditch effort to save mobility. So, I just deal with the pain and when I get stuck on the floor and can't get up, someone eventually comes along and helps me, while we both laugh that I always try to do more than I should. 

One thing to remember, is that he will most likely end up needing a disk replacement. If they do that, disks only last a certain amount of years, So, every 15-20 years, he will have to have it replaced again. Each surgery will create scar tissue and that is where the biggest problem lies. 

Hopefully in 20 years, they will have a lifetime disk, and he will only need one more surgery in his lifetime, but that is always a gamble with disk replacements. There are many people who have had to get hips redone way before they were anticipated, due to poor materials or the body not accepting the replacement as well as expected.

 

 

I do know several people who have had replacements done, and they are elated with the results. So, there are many, many successes out there too! I just really recommend getting multiple opinions so he has all the knowledge possible before going under the knife.

[Harriet Vane]

A different perspective--

Dh and I have successfully avoided surgery for several years now due to aggressive exercise. Dh had a herniated disk and several bulging disks (and couldn't walk and was in horrible pain), and I have bulging disks as well as mild scoliosis and EDS. We did official PT to kick it all off and then have kept going with aggressive core and back strengthening. It's a lifestyle commitment, and it has been worthwhile for us.

[Alicia64]

17 hours ago, Eos said:

Oh my goodness, that would be fantastic!  We would both be very grateful.  Thank you!

I likely won't hear anything back until after Thanksgiving, but I've put the call in!

[gardenmom5]

dh had a herniated disk.  his choices were surgery or chiro.

After some miraculous results from chiro with two of our children, he chose to try it first.

First three days were twice a day, then every day for a week, then every other day, every third, and so on.  I had to drive him for at least the first two weeks.

But it did heal and he didn't have to have surgery.

eta: he's now very conscious of what exercise he does and has had no further problems.

Edited November 23, 2021 by gardenmom5

[Eos]

2 hours ago, Alicia64 said:

I likely won't hear anything back until after Thanksgiving, but I've put the call in!

Thank you very much!

[Eos]

1 hour ago, gardenmom5 said:

dh had a herniated disk.  his choices were surgery or chiro.

After some miraculous results from chiro with two of our children, he chose to try it first.

First three days were twice a day, then every day for a week, then every other day, every third, and so on.  I had to drive him for at least the first two weeks.

But it did heal and he didn't have to have surgery.

eta: he's now very conscious of what exercise he does and has had no further problems.

My great aunt used acupuncture with truly miraculous success for a herniated disc.  I have recommended both it and chiro to Ds but he hasn't yet gone down that path.

[Tap]

1 hour ago, Eos said:

My great aunt used acupuncture with truly miraculous success for a herniated disc.  I have recommended both it and chiro to Ds but he hasn't yet gone down that path.

One problem I have had with both, is that while they *can help with pain, it doesn’t solve the problem. Once a disk is ruptured, you can’t put the goo back in the disk. With surgery they can clear out the extruded goo, but the disk will always be missing its goo. Or they can replace the disk, but that isn’t a one and done for a life time.  For some people the pain is minimal and for some it is excruciating pain. The more disks affected the worse it can be.

 

Treatments like massage, acupuncture chiro, pt, etc help with the muscle pain and relevant nerve pain. But unless the disk is replaced, the problem isn’t gone. That is why some people skip these interventions and go straight for surgery. 

 

Neither is right or wrong. Just depends on the person. I have had hundreds of pt, massage and chiro appointments. And I am a huge believer in them because that is why I am still walking. But at the end of the day, it’s expensive and time hungry and not 100% effective. You can also lose ground quickly if you stop for any length of time (depends on the person). Some therapists make it worse! So, I can understand when people don’t want to go that route.,