Struggling with Post-Surgery Pain: A Young Woman's Journey

Q: Struggling with Post-Surgery Pain: A Young Woman's Journey

Hello, Miss： <br>Regarding your condition of herniated disc, the current treatment approach primarily focuses on long-term rehabilitation. <br>Given your situation, having undergone two surgeries and experiencing inflammation, you also have neurological symptoms in your right low

Lower back pain can be excruciating!

Doctor: Hello! I am a 22-year-old girl experiencing weakness.
Since undergoing surgery for a herniated disc on April 1st of this year, I feel like my life has turned black and white.
Why is that? After the surgery on April 1st, I have been experiencing significant pain at the surgical site.
Upon referral from my family, I consulted a physician at a medical center.
Initially, the doctor suspected discitis, indicating inflammation at the surgical site, along with elevated white blood cell counts.
I was advised to be hospitalized for antibiotic treatment, which began on May 17th.
The week prior, I felt much better and thought I could go home, but to my surprise, the pain gradually returned a week later.
After two weeks, the pain intensified, requiring pain injections every 1-2 days.
Strangely, after receiving the pain injections, I would feel sleepy and sleep for 3-4 hours, waking up feeling very fatigued.
The doctor noted that my condition seemed stagnant and arranged for an MRI.
The results showed a significant protrusion of the disc, clearly visible.
The doctor recommended another surgery, which took place on May 30th.
After the surgery, my right leg was very numb and weak, making it impossible for me to walk independently; I had to rely on a crutch.
The doctor briefly explained the surgical outcome, stating that the surrounding nerve was encased and swollen like a thumb.
He cleaned around the nerve, and the numbness in my right leg should gradually improve.

The doctor's conclusions were as follows:
Diagnosis: DISPLACEMENT OF INTERVERTEBRAL DISC, SITE UNSPECIFIED, WITHOUT MYELOPATHY.

Diagnosis details: A case of right L4-5 herniated intervertebral disc status post two operations (first at a local hospital).
Second operation: including L4-5 discectomy and foraminotomy two weeks ago, now experiencing pain again with aggravation likely due to immediate post-operative adhesion of the nerve root.

Diagnosis conclusions:
1.
DISPLACEMENT OF INTERVERTEBRAL DISC, SITE UNSPECIFIED, WITHOUT MYELOPATHY.

2.
LUMBOSACRAL SPONDYLOSIS WITHOUT MYELOPATHY.

3.
FASCIITIS, UNSPECIFIED.

These are the conclusions made by the attending physician.
During several follow-up visits, my condition has shown little progress, and I still experience pain, which makes me very sad.
Why did I develop this condition at such a young age? In July, I underwent a neuroablation procedure, and again in September, with no significant improvement.
Recently, I have been experiencing severe numbness and pain below my right knee, sometimes with cramping pain, which is very bothersome.
Additionally, when I have a bowel movement, my right foot experiences significant pain, especially when straining, sometimes to the point of tears.
Is this due to nerve compression? This never happened before; it started after the second surgery.
I have also recently developed pain in the left side of my lower back (the surgical scar is a straight line, and the pain is to the left of that line).
Has it now shifted to the left side? Sometimes my left leg feels numb.
An orthopedic surgeon suggested another surgery, stating that there is no chance for a posterior approach anymore and that it should be done from the front, specifically through the left side of my lower back, which would be more complex and of high surgical difficulty.
Is this true? Why approach from the left side? If I undergo another surgery, will it alleviate my pain? Doctor, please provide guidance on how I should proceed with treatment or any advice you can offer! I am begging you to help me!

Xinyu, 20~29 year old female. Ask Date: 2002/09/22

Dr. Huang Junxiong reply Surgery

Hello, Miss:
Regarding your condition of herniated disc, the current treatment approach primarily focuses on long-term rehabilitation.
Given your situation, having undergone two surgeries and experiencing inflammation, you also have neurological symptoms in your right lower limb.
Due to multiple spinal surgeries, the presence of nerve and spinal pathologies (referred to as post-operative adhesions) makes further surgery inadvisable and likely ineffective.
The treatment direction should emphasize conservative therapies, such as rehabilitation and neuroablation, for your consideration.

Dr.
Wang Zikang, Chief of Orthopedics, Hsinchu Hospital

Reply Date: 2002/09/22

More Info

I'm truly sorry to hear about the challenges you're facing following your surgeries. It sounds like you've been through a lot, and it's understandable to feel overwhelmed and frustrated. Let's break down your situation and explore some potential avenues for relief and management.

Firstly, it's important to recognize that post-surgical pain, especially after spinal surgery, can be complex and multifaceted. The pain you're experiencing could be due to several factors, including inflammation, nerve irritation, or even scar tissue formation, which can occur after surgery. The fact that you have undergone multiple surgeries, including discectomy and neurotomy, suggests that your condition is being closely monitored, but it also indicates that your recovery may take longer than expected.

Your diagnosis indicates that you have a herniated intervertebral disc (HIVD) at the L4-5 level, which can cause significant pain and neurological symptoms, such as numbness and weakness in the legs. The fact that you are experiencing pain in your right leg, especially when using the restroom, could suggest that there is still some nerve involvement or irritation. This is not uncommon after spinal surgeries, as the nerves can take time to heal, and any pressure or strain can exacerbate the pain.

Regarding the recommendation for another surgery, it's essential to weigh the risks and benefits carefully. Surgery can sometimes provide relief, especially if there is a clear anatomical issue that can be addressed. However, it also comes with its own risks, including the potential for further complications or the need for additional surgeries in the future. The suggestion to approach the surgery from the front (anterior approach) rather than the back (posterior approach) is likely based on the surgeon's assessment of your specific anatomy and the location of the problem. Anterior approaches can sometimes provide better access to certain structures but may also involve more complex recovery.

In terms of managing your pain and improving your quality of life, there are several strategies you might consider:
1. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around your spine, improve flexibility, and reduce pain. A physical therapist can tailor a program specifically for your needs and monitor your progress.

2. Pain Management: Discuss with your doctor the possibility of a comprehensive pain management plan. This could include medications, nerve blocks, or other interventions designed to alleviate pain.

3. Lifestyle Modifications: Incorporating gentle exercises, such as walking or swimming, can help maintain mobility without putting too much strain on your back. Additionally, practicing good posture and body mechanics can prevent further injury.

4. Alternative Therapies: Some patients find relief through acupuncture, chiropractic care, or massage therapy. While these should be approached with caution and discussed with your healthcare provider, they may offer additional pain relief.

5. Mental Health Support: Chronic pain can take a toll on mental health. Seeking support from a mental health professional or joining a support group can provide emotional relief and coping strategies.

6. Regular Follow-ups: Continue to have regular follow-ups with your healthcare team. If you're not seeing progress, don't hesitate to seek a second opinion or discuss alternative treatment options.

It's crucial to communicate openly with your healthcare providers about your symptoms and concerns. They can help you navigate your treatment options and make informed decisions about your care. Remember, recovery from spinal surgery can be a long journey, and it's okay to seek help and support along the way. You're not alone in this, and there are resources available to help you manage your pain and improve your quality of life.

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