[Spinal Fusion / Lumbar] Outcome to L4-S1 interspinous fusion, and why I haven't been around

[daveinaustin]

Thank you for all the PMs, encouragement, and worries about me. Although I've been a long-time member and contributor to SPS, I haven't been on much lately. I'll explain why shortly.

Pain Issue
As many of you know, I've been suffering increasing strong pain directly between L4-5, and some of the top doctors throughout the world cannot pinpoint on the reason why. They state that neurogenic pain can be very tricky, and we plainly don't have the right technology to detect my issue.

From July, 2008 to January, 2009, the L4-5 fusion pain was subsiding as expected. From then until now, the new pain directly between there has been continually increasing, to the point I could no longer work. Even being off of work since August, the pain continued to increase until the latest surgery. Also, I've been mainly on bedrest or light swimming. Even on Christmas, I could only be out of bed for one hour.

I had an SCS nerve stimulator implanted in August. But still, the pain kept on increasing. I even took a Psychological test to ensure it wasn't in my head!

Thanks to Mark-Perth, I had the honor to meet Dr. Pimenta from Brazil. He is the first doctor to provide good conjecture and advice.

Dr. Pimenta provided tests for my Austin doctors to perform. They believed they narrowed down the issue, and my orthopedic surgeon performed an L4-S1 two level interspinous fusion (Medtronic SPIRE). My surgeon also found movement from the L4-5 ALIF fusion, and performed a BMP-based bone graft.

Surgical Outcome
For the first 5 days, I was feeling better. The specific spot no longer hurt, and I only felt surgical pain. Unfortunately, since then, the same exact L4-5 pain returned!! I'm nervous.

My surgeon thinks I'm nuts, and says nobody can tell the difference within the first two months after surgery. I feel my heart pulse and pain at that exact spot, and the pain is much greater than the surgical pain. It was and still is a pinching pain, like a thorn, or pinching your palm with your nails. I only feel this when I stand or sit.

However, my surgeon said he removed the interspinous ligament and soft tissue between the spinous processes; therefore, I shouldn't feel that pain. Then again, nerve pain is very difficult to exactly pinpoint the root cause and where you actually feel the pain.

Worst News:
Around Christmas time, I could feel my wife's waning love and compassion. That's why I said I had to go on sabbatical. Unfortunately, I was not in a good spot to try to fix our relationship.

Three or four days after my latest procedure, and on 120 mg of Morphine, my wife of 20 years of marriage said she no longer loves me. She is giving me a chance to try to fix it. But, a couple days later, I pretty much blew it. I became irrational, and had a big fight in anger. She was ready for divorce that day.

Fortunately, she is still giving me a chance, but the chance for success is much slimmer, and my fear has grown. However, I am going to restart therapy on Wednesday to help.

We had problems, as every relationship, before my pain of the past 11 years. However, the severe chronic pain of the past 3.5 (and especially last 6 months) is really taking a toll. Chronic pain is such a magnifier of life's problems.

She wants me to try to focus away from my pain, depression, medication, news, any pain site, and any contributor towards my pain and depression until I can cope with things better.

But, I'm living every moment in fear that my desire to try to make things right for my family actually might cause me to lose everything I've worked so hard for the last 20 years. I've created a downward spiral.

There is strong fear, and this comes across as being needy, and somehow I need to be strong. I was much stronger before the chronic pain, and more of a typical Engineer.

I love my wife and children more than anything, and want to save the marriage out of my love and admiration for her, not out of weakness. Although there are some big issues, I thought we had a strong, stable marriage until she pointed out otherwise.

Unfortunately, I keep on having the irrational fears overtake reality. I am trying not to create a "self-fulfilling prophecy." But, am trying to be strong.

This is why I have not been on lately, and cannot be until I get my life in order. I need to build my own internal strength again, before helping others. I am so sorry for dumping this burden, but owe it to others to understand. I'm sure many of you can relate to this.

One word of advice, listen to your partner. If they tell you that you need emotional help and should see a therapist -- Do it. Don't be a "dumb guy or woman." There is only so much they can take, and they constantly see you at your weakest.

This was hard to admit. God bless all of you.

-Dave

[sportsnut3007]

I dont think I have ever messaged you on here, but I wish you the very best with everything. Take care and God bless

[ajj1001]

My surgeon thinks I'm nuts, and says nobody can tell the difference within the first two months after surgery. I feel my heart pulse and pain at that exact spot, and the pain is much greater than the surgical pain. It was and still is a pinching pain, like a thorn, or pinching your palm with your nails. I only feel this when I stand or sit.

Why don't surgeons believe that we can feel what is going on with our own bodies????

Rooting for you and Mrs Daveinaustin to make it through this hard time. If either of you need anything let me know.

alison x

[KenG]

Hi Dave
I cheer you from, not Japan but hotel bed in Germany.
I just had surgery and hoping to see a light, little bit of light.

Ganbarou

[linda]

Dear Dave,
Thank you for sharing your story. You sound like a very strong guy and I know you will get through this. I'm also sorry for the excruciating stabbing pain that you are still having and hope that it subsides soon. I haven't had a relationship in several years and one reason is because I know I would be a downer with my chronic pain/depression issues and they probably wouldn't stay around very long. Anyway, I will continue to pray for your recovery and wish you the very best.
Linda

[Justin]

Surgical Outcome
For the first 5 days, I was feeling better. The specific spot no longer hurt, and I only felt surgical pain. Unfortunately, since then, the same exact L4-5 pain returned!! I'm nervous.

Hi Dave,

I completely understand why you are nervous. However, you are still very early post-op (you're only a little over two weeks post-op [Surgery Date: 01/07/09]).

My surgeon thinks I'm nuts, and says nobody can tell the difference within the first two months after surgery. I feel my heart pulse and pain at that exact spot, and the pain is much greater than the surgical pain. It was and still is a pinching pain, like a thorn, or pinching your palm with your nails. I only feel this when I stand or sit.

However, my surgeon said he removed the interspinous ligament and soft tissue between the spinous processes; therefore, I shouldn't feel that pain. Then again, nerve pain is very difficult to exactly pinpoint the root cause and where you actually feel the pain.

According to past research and some recent ground-breaking publications, it has been suspected that chronic pain "reorganizes" the brain. Thus, patients can have the "painful stimulus" removed and still experience pain (the type of pain [nociceptive, neuropathic, etc.] complicates this to an even greater degree).

Your body may have changed during your operation, but the brain doesn't change overnight unfortunately.

This is why I have not been on lately, and cannot be until I get my life in order. I need to build my own internal strength again, before helping others. I am so sorry for dumping this burden, but owe it to others to understand. I'm sure many of you can relate to this.

One word of advice, listen to your partner. If they tell you that you need emotional help and should see a therapist -- Do it. Don't be a "dumb guy or woman." There is only so much they can take, and they constantly see you at your weakest.

This was hard to admit. God bless all of you.

-Dave

Dave, family comes first and we wish you the very best with your wife. Chronic pain creeps into every facet of one's life and can really take a toll on the "healthiest" of relationships. Thank you for opening up and please know that we care about you. I wish you the very best with your family and your back pain.

[daveinaustin]

Everybody, thank you so much for your understanding and encouragement! Also, for showing me that I do have inner strength.

Justin, thank you for the research. I will be optimistic. Hopefully, it's the brain's synaptic organization for the chronic pain (i.e., "wind up"). It is so odd to feel my heartbeat and pain from the same spot. I was sleeping, had little pain, and shifted. Next thing I know, I feel the throbbing pain and heartbeat again from the same spot.

It's kind of strange for me to be opening up on the opposite end of things. Before, if I asked questions, they were generally more "Engineering-like" looking for information (afterall, I am an Engineer). And most of the time, I provided strength, encouragement, "dumb guy" advice, conversation, and laughs for many who needed it.

However, I had my fears and doubts, which two close friends helped with. Thanks guys!

"This too shall pass." I will either get over the pain or learn to deal with it. I love my wife, and will work on saving our marriage, hopefully I will. This time, though, I'll do a much better job actively listening to her than talking!

I say time and time again, SPS and its community is by far the best spine group I've known. Justin is simply amazing with his strength, compassion and willingness to help. Although we each have our own issues and fears, we come together instead of fighting among ourselves.

A much more humbled "dumb guy,"

-Dave

[Katie]

Justin, thank you so much for that explanation; it makes so much sense. Is that something like 'phantom pain' with an amputated limb? It also is something else to tuck into what is left of my memory bank in case I run into the same thing post surgery.

Dave, as you know, pain takes many forms. Mental, physical, on and on. And unlike a bad wound, none of them are visible or obvious to most of those around us. It is easy to dismiss or for people to forget about throughout the day. Meanwhile it eats away at us 24/7. Even this causes friction unfortunately.

It sounds like you have had a very strong marriage, and are held together with two beautiful children. They are a strong glue, and with a lot of prayers and hard work, they can work miracles with a relationship.

My thoughts and prayers are with you and I hope that everything works out well, both with your surgery recovery and your relationship. I hope you can keep us updated on your recovery.

[Fuzzy]

I wish you the best, Dave. And hope that the pain does improve with time. I feel you have a good chance.
I hope also that you and your wife can work through tough times. You have done it for so long now would be the time to stick together. Pain does change ones whole perceptiion of everything arround you. The idea to take a break from these boards and try not to think about the problems too much might be worth a try. We sometimes get a litle hung up on things. I do know about the "engineer menatility" .
I remember when I became painfree at some point that it was very surreal to actually not have the pain. Very different. Even though my spine has been fixed twice now I still have many problems it seems to be totally repaired with no more problems is a miracle. I do hope they are right and your pain resolves.

I once had a nurse hit a nerve with a needle causing a strong lightning strike in my arm with following numbness in my thumb. It took 3 years to improve to just a junny feeling in that thumb. Nerve injury heals but very slowly, I learned.

[runagain]

Dave,

When I was recovering from my first surgery and started to feel good and got off the meds and then I felt lightening pain when I was in PT, I knew something was wrong and I knew it was probably bad.
I kept at the doctors until they finally knew what it was.
Trust your instinct. We don't usually have pain to have pain, it is a warning system used by the body.
Keep the faith.
And i know about the marriage problems and chronic pain. I have been married 21 years and it is difficult and the problems are multiplied because of my medical bills and the disability. Not being able to work has put a strain on our marriage.
This has been going on for almost three years but it feels like forever.
Like I said, Keep the faith.
I will pray for you.

Runagain