The appointment

It took me a while once I got home to wrap my head around all that he had to say today. Unfortunately, none of it was good- lots of not so good news, no good news and even worse news.

Anyway, he was going over the images again when I got there.....and we went into the exam room to talk and go over the xrays and other reports first......the good news is that there isn't a ton of movement between the vertebre, but then again, we aren't sure how accurate the xrays are since I can't bend forward or backward very far......that would be the not so good news......

Bad news- there is no fusion from my previous surgeries, although there is a very thin bridge between the 4th and 5th vertebre on the right side- it is very, very thin to use his description of it. More bad news, I have both osteopenia and osteoporosis through out my spine apparently. Even more bad news- the slippage of L3 over L4 has increased in the last month. It went from a first degree spondylolysthesis to a 2nd degree.  Even more bad news- this means that it has increased the compression of the spinal canal some.

Really bad news- it appears that the dura ( covering of the spinal cord) is attached to the vertebre at L3, L4 and L5.....more really bad news- any surgery would most probably result in a tear in the dura, at all those levels. This would mean an attempt to repair the covering- and at least 5 days flat on my back , while they hope that it seals once they repair it. If not, I would be flat on my back until it did. The canal should be about 14 mm wide,  mine at those levels is anywhere from 4 mm to 3.14 mm. They are not sure if they would need to extend the fusion- in ordinary circumstances, they would extend the fusion from L4-5, but it would be from L2-to, at a minimum L5, but most probably to S 1 or S2......because I didn't fuse before, they would prefer not to have to extend the fusion but would try to decompress the spinal canal by removing bone from the canal area. If they had to remove more than 40% of the bone from either side, they would have no choice but to extend the fusion, which means a much more difficult recovery and rehab stay in a hospital for some time post op......even without the extension of the fusion, I may still wind up having to do the hospital rehab for awhile due to the extent of the spinal cord injury.

I asked him what he felt the likelihood of having to extend the fusion was in his opinion and he said that it is probably about 80%.....but that he would try to decompress the spinal cord first and hope that it was enough. More bad news is that what was once my disc between the vertebra is now laying in the nerve root exit and compressing that as welll on both sides at L3 and L4....there is also bony overgrowth from L2 down- and hardening of the vertebre due to the constant rubbing of the vertebre all over each other constantly.

Anyway, there's more, as always, but he said that I can choose to do nothing and hope that things don't get worse for awhile and have someone follow me , keeping an eye out for any worsening of symptoms- but that since I have so much nerve damage as it is, that being able to tell if there is a worsening of symptoms is going to be very challenging at best....

He said that there is a lot at stake, if I choose to go ahead with surgery, the potential for several things to go wrong is huge, and choosing not to go ahead also have huge risks. He would like for me to at least consult with two more surgeons, to see if and what they would recommend before we go ahead with surgery. He wants me to be sure, that no matter what I choose to do, that it is what I think is right for me.

I tend to agree with the idea of seeing a couple of other surgeons and seeing what they think given the reports and the risks involved. I am still not sure what the right decision is, and tonight hasn't really given me any clarity in regard to making one , one way or another.

I talked to my husband , and he would like me to see a couple more surgeons before making a decision. He likes these two doctors, likes that they are looking to do the bare minimum , rather than just jump to the bigger operation, but, like me is understandably scared for and about delaying things while I try to find other surgeons with comparable credentials and skills.

So I am still darned if I do , and darned if I don't......

Sandi

       Morning Sandi!

           Well...it sounds like you were given more than enough information to digest for a while. Tina probably summed up what I wanted to say on her reply to you...so I will simply add a Ditto to it.

    We will continue to follow your news and lift you in prayer. Hopefully the second opinions won't take too long, and then by that time you will have enough information to make a difficult, but well thought decsion, that you can come to terms with. Either way it wont be easy for you, and for that we are sorry.

 SE

Thank you for posting, are you currently being treated for osteoporosis or am I correct in gathering that this is something new?  If it is then you definitely need that bone scan you were talking about getting!  As that kind of explains why your fusions didn't take. But  Sandi correct me if I am wrong,   but until they start treating your osteopenia and osteoporosis,  trying to do any fusion would more or less be kind of futile wouldn't it? I mean without treating your osteoporosis, right now with it not being treated, you are losing bone mass,  and if and when they do a fusion they are literally trying to have you gain bone mass and grow new bone.   How can that be done with out treating your osteoporosis first??

You know it does sounds like you have some very serious decisions to make, I don't envy you at all,  I do commend your Doctor for wanting you to get a second oppinion, and the way he is treating you. But with that said I can only imagine how difficult this all must be for you. Please know that  I keep you in my Prayers Sandi and I hope this all works out well for you!

White Beard

Loretta, if it has been a few years since your last bone scan, just write yourself a note to ask the doctor for a prescription for one and that way you won't forget. I am no one to talk about forgeting things, I do it far more often than not......LOL

Suzanne,

Yes, it sure does seem that I am on one rocky road, but I don't have any other option but to try to handle it.....as best that I can anyway. I don' t know where it is going to wind up, but I will figure out what to do, one step at a time.
Sandi

I haven't had a bone density test ever. They got the osteoporosis from the CT scanning.

I know that my mother takes one of the medications for it, and I talked to my sister, who has osteopenia, but she only takes vitamin D and calcium for it. She said that she is supposed to go for another test next year, I guess.

I had no idea that she had either one of them.....guess it shouldn't surprise me.

I will ask about the Forteo when I see my GP about the results of the testing, once it is done.

Thanks for all the information......

Sandi