L5-s1 disc extrusion

[Damo77]

Hi i am a 32 yr old male living in Sydneys south. over the last 3 months i have had really bad pain going from my glut all the way way down my leg to my feet lately some pins an needles in my feet. the worst times are while rolling over in my sleep getting up in the mornings to go to work getting in and out of a car and when i sneeze and cough the pain is unbearable. at first i went to a massage therapist for a few weeks but felt nothing was being acheived i then went to an osteo she seemed to think i have a disc bulge and after the first teratment felt a lot better, but it plateaued out after the first month i have persisted with the osteo as sometimes it works for a few days sometimes it doesn't we have been doing a fair bit of dry needling and i have been on anti-inflamitories for the past 2 1/2 months . About 3 weeks ago we decided it was time to get an xray and see a Gp, i went to the Gp and he thought it best if i go have an MRI to see the full scale of the buldge the report is as follows "there is a disication of the lower lumbar interverebral discs. At the L3-4 there is a shallowcentral disc protrusion, and at the L4-5 a shallow disc protrusion and annular tear. there is mild flattening of the ventral aspect of the thecal sac at both levels but no central stenosis or foraminal nerve root compressive lesion. At L5-S1 there is a left sided disc extrusion with significant displacement and compression of the left S1 nervr root as it courses towards the latteral recess. There is mass effect on the left ventral aspect of the thecal sac but no significant cental stenosis. There is no foraminal nerve root compressive legion. There is early lower lumbar facet joint arthropy. The major abnormality is at the L5-S1 where a left sided disc extrusion produces significant mass effect on the left S1 nerve root. I took this report and films back to the Gp and he then sent me to have an epidural cortizone injection which i had in the last couple of days and i feel has not done anything, is my next step to go and see a neurosureon and discuss surgery or keep up with the osteo.
I am a metal roofer an am continuing to work through the pain, i am or should i say a very active person before this pain occured i surf,run,play touch,oztag,squash, swim,go to the gym etc. And i am going mad not being able to do any of those things it is getting me down profusely to the point of bouts of depression. So if any one has any thought,opinions or past experiences on this matter it would be muchly appreciated thank you.

[inenigma]

Hi,

I'm in pain, but, I don't think anywhere near what you are in. I would recommend going to see a specialist. I have seen 2 specialists so far and have appointments to see another two. I have seen the orthopedics spinal specialist Dr Ashish Diwan at St George who has also referred me to the pain specialist Dr David Gorman (who works with Dr Diwan at his Spinal Clinic in St George). Dr David Gorman has been able to relieve the worst of my pain, but, that is only a temporary solution. I have also subsequently done a lot of research and have also booked appointments to see Dr. Peter Bentivoligo at St. Vincents & Dr. Mark Coglin at Randwick. I hope you have health insurance as these guys are expensive.

[tia-maria]

Hi Damo 77,
Sorry to hear yout going through so much suffering, ( I was in your situation but had the surgery 11 months ago) that was the best decision I done on L5/S1 spinal fusion /bone graft plates screws.(no more pain)
So if I was you I would definately seek an Neurosurgeon at RPA were I went because when you start getting pins and niddles (which happen to me also) that means things are realy getting very seroious
and need to act asap.OK.
Sorry mate I would not be working especially on a roof position.
My advice to you mate you must be very happy with your surgeon/hospital and that will make you feel confidence and relax in your self.
Get a referel from GP either Royal Prince Alfred or St. Vincents are the best hospitals if I was you.
If you need any more help dont herisitate to ask me OK.
cheers
tia-maria

[tia-maria]

Hi mate,
I went through public system paid for specialist APPOINTMENT /bulk billing for surgery.I have notice you didnt try RPA neurosurgeon? also one of your surgeon is Dr Bentivoligo who is a orthorpodic surgeon
Have you decided on the specialist who you like to do your surgery???your lucky you have health insurance as some of us cant afford it.
good luck on your decision as your surgeon is a personal choice and you must feel very comfortable with the specialist/hospital for excellence result.
Its been 12 month in March since my operation at RPA.
cheers
tia-maria

[Damo77]

hi inenigma
yeah the pain is no fun i feel for you also, my gp has referred me to a dr mark davies but when i get into see him is another matter, apparently he is fairly hard to get into see even with a gp referring you . A friend of mine's sister had a disectomy done last year with dr diwan and she said he was great and that her sister is fine now and pain free. I have also heard good things about dr bentivoligio and coglin, in the little research i have done. No health insurance never really thought i would need it, am slowly changing my mind on that though.

[MissMarple]

Dr Peter Bentivoligo is a Neurosurgeon (I think his brother could be an Orthpedic Surgeon) at St Vincents. Dr Marc Coughlan is at POWP and not sure if he operates in the public system so best you call the office and ask first, otherwise you pay for the consult and still have to find another surgeon to do the job (unless you are very rich and can afford to pay private). Mark Davies operates in both the public and private system at St George campus. Remember though as an uninsured patient in the public system your operation date is never guaranteed and can always be changed for a more urgent case also the surgeon although in the theatre does not always do the complete surgery him/herself and the registrars do some if not all of the surgery under supervison. Not much point in joining a health fund now as you would have to wait 12 months because you would have a pre-existing condtion. Also something to be aware of even if you are in a health fund I am lead to beleive a lot of doctors do not "gap cover" and you will have an out of pocket expense. I beleive this could be another reason why it is so difficult to see Dr Davies as he does "gap cover" for most health funds. Good luck!

[Mischap123]

Damo,
Not a nice spot that you are in. No-one will doubt your disc extrusion but I found it interesting that you said that the worst times are rolling in bed. Most disc pain sufferers are worst in weight bearing positions but the fact that you are having this non-weight bearing leads me to believe you may also have a sacroiliac problem too. These play up heaps when rolling in bed. Get the Osteo to check it out.

[Damo77]

thank you all for your suggestions. Just a lil update on my situation. I have been to see Dr Davies an am booked into to have a lumbar discectomy on the 23rd of april. I was continuing to work trying to make it to my surgery date, until last tuesday when i got up with really aggressive pain and then proceeded to walk out to have breakfast when i didn't even make it 5 metres before the pain was so bad i had to lay down on the spot. I am now unable stand for more than 5 minutes without the pain becoming unbearable an have to lie down and my foot and calf are half numb(but no foot drop)and alot of ins and needles. So now i am not working, in pain and taking 6 nurofen plus ,6 panadene extra, 2 polarimine and about 150 to 300-mg of lyrica a day,with the lady at the chemist suggesting i ask my Gp about a script for a morphine patch. But i still seem to be in a fair amount of pain. I am wishing my life away for this operation to come quickly even though i am fairly worried about this operation it is really playing on my mind.

[blakestar85]

Hi Damo

Thanks for sharing your story... I find myself in a very similar situation to what you were in while you were still working.. I have just had the X-rays and CT scan and my Dr has advised me to see a neurosurgeon, and one of her suggestions was even Mark Davies.

All the very best for your surgery, please let us all know how it turns out...

cheers - Blake