Update: Should I Have Back Surgery?

Unrecognizable Woman Showing Pain Spot On Back In Doctor Office

Recently I wrote a blog about the chronic injury I live with and how, for the first time, I’ve begun to seek surgical options. My first appointment with a highly respected neurosurgeon did not go exactly as I had hoped. The MRI showed several degenerated discs, the worst being the L5. Even my untrained eye could see the shadow on the MRI that made it look very different from the other discs. My hope didn’t last long, however. The doctor explained that although it appears that my L5 is the worst effected disc, it is not necessarily the disc causing the pain. He told of patients where the wrong disc was fixed and the pain stopped, or that the right disc was fixed and the pain returned.

He also said that the most effective surgery to help with this type of pain is usually a fusion, but fusions cause extra pressure on the other discs in the back, as they make up some of the mobility that is lost when the degenerated disc is fused and rendered immobile. The problem with my spine is that the other discs are also degenerated, and the added pressure would just make them worse, leading to future fusions and even more immobility.

At this point in the appointment I was basically trying to hold back big fat ugly sobs. I wanted to beg this man to please find some way to fix this daily pain I am in. He sent me for two more tests – an MRI of my middle spine and a CT of my lumbar spine. We made an appointment for me to return shortly after the tests were complete.

A few weeks later, the doctor reaffirmed all the same diagnoses I’ve had for years – scoliosis, degenerated discs, two herniated discs, a large spinal column (he said this is just an abnormality and shouldnt interfere with pain), arthritis, etc. He still would not offer me surgery as it would likely cause me more harm and more pain (I question if it’s possible to be in more pain – it feels like I am walking around with a fractured bone every single step I take).

He has referred me to a disk replacement surgeon to see if I might be a candidate to simply replace my L5. In order to do this, I need to have a discogram – to me that sounds like a kick ass retro night club – but it is actually a procedure that involves purposely making each of my discs hurt one at a time so we can determine which is the worst disc. It basically sounds like hell.

In the meantime, my pain management doctor has graciously agreed to do the discogram even though he is out of network with my insurance. I pay extra out of pocket to use Dallas Pain & Spine and Dr. Khan, even though they’re out of insurance, because I wanted a doctor who would consider my whole health and not just prescribe opiates. I’m glad I have, even though in the short-term, popping a few Vicodin would certainly help me get some much needed relief – but at my age and with my problems I am at high risk for addiction and Dr. Khan understands that I’m not interested in risking my whole health to relieve back pain.

Great, you think – she is getting the tests she needs! Yes, yes I am, except the disc replacement surgeon that my neurosurgeon recommends is not in network with my insurance either. Next, I’ll need to go to my primary care doctor to get an out-of-network referral to the disc replacement surgeon and hope that my insurance company will agree to pay enough of a percentage of the surgery that I can afford the rest on a payment plan. Aaaand now I’m in tears, fearing that it might deplete my family’s savings to get the medical care I need.

This is exhausting. Just exhausting.

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