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    29-year old...multiple thoracic herniations
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    Kimjj514 posted:
    Hey everyone! I could really use your help. First, a short intro..I'm Kim, 29 years old, married, three children (10, almost 3, and 18 months). I was working as an RN on a busy cardiac unit up until October 2010. I injured my mid-back lifting one of my daughters into her high chair, and it's been an uphill battle ever since.

    I'll save you the whole grueling story and try to pick out the important parts. MRI in November 2010 showed significant DDD, arthritis, and multiple herniated thoracic discs. I went through all of the conservative measures from PT to injections to steroids to muscle relaxants to yoga to walking to weight reduction, etc. Went for CT myelogram on May 12th and met with a neurosurgeon the following week. He said I have multiple thoracic herniations, which is concerning being I'm only 29 years old and herniations in the thoracic area are not as common. Said sometimes this points to a genetic condition called ankylosing spondylitis, but didn't really get into detail about that. Then proceeded to say that T8-9 and T9-10 were the worst of the herniations and were compressing my spinal cord and recommended surgery. He said it would be a relatively minor surgery and that it would be done posteriorly. Often times thoracic disc surgery involves a much riskier surgery done from the front, which is a MAJOR surgery. So when he said he could do it from the back, I was relieved but decided to go for a second opinion at the University of Pennsylvania dept of neurosurgery. This surgeon specializes in the thoracic spine, and UPenn ranks #15 in the country for their dept of neurosurgery.

    To make a long story short, he agreed with the first surgeon's approach to the surgery, and he felt confident it would help, so I went under the knife on July 6th. I had a two-level posterior thoracic discectomy/decompression. I spent five days in the hospital, which was a little longer than expected due to a lot of pain. He DID say that when he got in there, T9-10 was much worse than it appeared on the images, and it was really pressing on my cord. While in the hospital they sent me for a repeat CT scan. He said the discs he operated on looked fine, but that T7-8 had gotten worse in the two months since the CT myelogram. He said that it wasn't a problem now since I wasn't having symptoms, but that if it became a problem and required surgery, it would be a much riskier surgery because it may require an anterior approach (aka cracking the chest open). I should mention that the two discs he operated on were herniated to the right, which caused right-sided mid-back pain which radiated to the right, around my ribcage, and to the front. T7-8 is herniated to the left.

    So anyway, I get home and things are slowly looking better. Suddenly, two weeks into my recovery, I develop severe left-sided burning pain. It was mid-back and wrapped around my ribcage and to the front. Mirror image of pain prior to surgery, but on the other side and WORSE. They did a round of steroids, high-dose anti-inflammatories, and lots of pain meds. The pain meds and muscle relaxants knock me out, so I can't take them when I'm home alone w/ the kids. And the anti-inflammatories and steroids did nothing. Sent me for repeat MRI and CT scan this past Monday, but apparently they were only looking at the surgical site. The NP from the surgeon's office called today to tell me, "Good news! You didn't re-herniate!" Um, I knew that already because I don't have any right sided pain. So what about this left-sided pain? She said, well, you'll have to wait until your appt on 8/23 and talk to the doc about that. Seriously?! I have the films from my MRI to bring with me, so the doc can take a look. I'm just annoyed that they did all this testing and all they looked at was the surgical site. How about finding out why I have pain on the OTHER side?!

    Not sure what type of advice I'm looking for, but just could use some insight perhaps.
     
    avatar
    bj1208 responded:
    hi and welcome to the support group -

    I know this may sound as though they are ignoring you but they really are not - part of the MRI/CT Scan was to look at the surgical site - but they can also look at the other discs too - and normally the NP's cannot go over the other parts of the test - kinda only the good news -

    so it could be that there are concerns with the other discs being that they have herniated - and this could be from the stress of the first surgery -

    I had Fusion L5-S1 over 3 years ago - had lots of friends tell me to not to have it as it would cause my other discs to have problems - but I had DDD and a ruptured disc that splintered so it was imperative that I had the surgery - nothing can cure DDD - so now I have 3 more bulging discs and my L4 disc moves 2mm when I bend forward - I have been to 3 Orthopedic Spine Specialists over the last 2 1/2 years and have been told NO to further surgeries - but we are watching the discs - I have MRI's and X-rays done each year along with EMG Nerve Conduction Test (on legs - both have nerve damage) -

    it's good that you got another opinion - you can even go for another one just so you know what all you're up against -

    Hoping and praying that everything turns out ok - keep us posted - take care - Joy
     
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    Kimjj514 replied to bj1208's response:
    Thank you for this information. I guess I figured that with the MRI, they'd be looking to find the cause of the left-sided pain I am having. The pain prior to the operation was on my right side, which was caused by two discs that were herniated to the right and compressing my spinal cord. So for the last 3 weeks I've had sometimes severe left-sided pain. On Friday when I spoke with the NP, I was under the impression they were going to check out the other discs that we know are herniated that could be causing problems.

    As I said, I picked up the films/disk from the MRI, so I'll be bringing that with me. The MRI was of my entire t-spine, so the doctor himself will be able to look at the images and determine if there is another disc acting up. I don't like having DDD at the age of 29. I should be in my prime years now, and I feel like I'm in the body of an 80 year old.

    To make matters worse, my incision is really bothering me. I had my hubby look at it this morning, and he said it looks like the skin towards the bottom of it broke open a little bit. I called my surgeon's office, and since I live so far away, she wants me to see my PCP today. I was able to e-mail a picture of the incision to her, and she said while it appears reddened, she doesn't think it's infected. But she wants me on an antibiotic preventatively. Plus, I believe I may have bronchitis as well, so she wants me to take something for that as well. So now I'm going in at 2 pm to see my PCP. Never a dull moment!
     
    avatar
    bj1208 replied to Kimjj514's response:
    gosh - sorry this is all happening -

    after I had my surgery, they told me when I showered that before and after they wanted me to rinse my incision with HIBICLEANSE (get it at drug stores) - and I also massaged the incision too (they told me that at hospital) this way there wouldn't be any lumps - my scar is a pencil mark now (goes from belly button to way, way down below bikini line) so am glad they told me that -

    well keep us posted as to what you find out - OH DID YOU get a copy of the written report along with the MRI? if it's on a disc you can put that in your computer and open the written report and see what that says -

    take care - Joy
     
    avatar
    Kimjj514 replied to bj1208's response:
    Yeah, they never told me to use hibiclens, but I have a big bottle of it that I bought from when I had my injections. I have a history of MRSA in a wound during one of my pregnancies, so they have me use hibiclens before the injections, just in case. They did give me something to clean with BEFORE the surgery, but nothing for after.

    They put me on a strong antibiotic. My PCP took one look at it, pressed a little bit, and said, "I think it's infected." He swabbed it and sent it to be cultured. I started the antibiotic and spoke with the NP at my surgeons office. She said if it turns out to be MRSA, they'll switch me to an even stronger antibiotic.

    I got both a copy of the written report along with the MRI. The written report only talks about ONE of the discs I had operated on, as well as multi-level arthritis. It makes no mention of any other part of my t-spine. So I'm guessing the doctor specified that they should only look at the surgical site? I'm not sure. But I have the disk and plan to bring it with me to my appt, so that my surgeon can look at it himself and figure out what's going on. My guess is that it's T7-8 acting up. While I was still in the hospital after the surgery, they did a repeat CT scan, which showed that T7-8, which is herniated to the left, has gotten worse in a two-month time period. The doctor didn't specify how much worse, though. All he said was that we'd leave it alone as long as it wasn't causing me symptoms. Two weeks later I developed horrible left-sided pain, which feels identical to what I experienced on my right side prior to surgery. I'm just curious to know what the most recent MRI showed.
     
    avatar
    bj1208 replied to Kimjj514's response:
    hi - again - sorry you are having so many issues -

    when you see the surgeon I think I would give him/her a piece of your mind (being a little nice - smile) and complain about hte PA -

    Please keep us posted as to what you find out - take care - Joy


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