Desperate for Relief: A Young Girl's Struggle with Post-Surgery Pain

Q: Desperate for Relief: A Young Girl's Struggle with Post-Surgery Pain

Hello： In response to your question： Your situation is unfortunate, but such cases are not common. <br>Typically, young women with sciatica are treated conservatively, and surgery is only considered if there is a herniated disc that cannot be managed otherwise. <br>Even after sur

Incurable pain - please save me!!!

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, I have been experiencing significant pain at the surgical site.
Upon the recommendation of my family, I consulted a neurosurgeon at Linkou Chang Gung Memorial Hospital.
Initially, the doctor suspected discitis, indicating inflammation at the surgical site, and noted elevated white blood cell counts.
He recommended hospitalization 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, and I needed pain injections every 1-2 days.
Strangely, after receiving the pain medication, I would feel very sleepy and sleep for 3-4 hours, only to wake up feeling exhausted.
The doctor, noticing no significant improvement in my condition, arranged for an MRI.
The results showed a clear and significant protrusion of the disc, leading the doctor to recommend another surgery.
I underwent the second surgery on May 30th.
After the procedure, my right leg was very numb and weak, making it impossible for me to walk without using a crutch.
The doctor briefly explained the surgical outcome, stating that the surrounding nerve was compressed and swollen like a thumb.
He cleaned up the area around the nerve, assuring me that the numbness in my right leg would 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 surgeries (first at a local hospital), second surgery included 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.

Despite several follow-up visits, my condition has not improved, and I still experience pain, which makes me very sad.
Why am I suffering from this at such a young age? In July, I underwent a neuroablation procedure, but there has been little progress.
Recently, I have been experiencing significant numbness and pain below my right knee, with occasional sharp pains that are quite bothersome.
Additionally, I have a problem when I have a bowel movement; my right foot experiences severe pain, especially when straining, sometimes to the point of tears.
Is there nerve compression involved? 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 the issue shifted to the left side? Sometimes my left leg feels numb.
If I undergo another surgery, will it alleviate my suffering? Or would another neuroablation procedure be advisable? Doctor, please provide guidance on how I should proceed with treatment or any recommendations! I am pleading for your help!

Xinyu, 20~29 year old female. Ask Date: 2002/08/11

Dr. Shao Guoning reply Neurosurgery

Hello: In response to your question: Your situation is unfortunate, but such cases are not common.
Typically, young women with sciatica are treated conservatively, and surgery is only considered if there is a herniated disc that cannot be managed otherwise.
Even after surgery, sciatica may persist for several reasons: 1.
Reherniation of the disc 2.
Nerve adhesions 3.
Spinal instability 4.
Disc inflammation 5.
Other factors.
Your case is more complex, and if you are willing, you can visit my clinic for a thorough examination.
I hope to help resolve your issue.

Reply Date: 2002/08/11

More Info

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

First, it's important to acknowledge that post-surgical pain, especially after spinal surgeries like discectomy and foraminotomy, 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 around the nerve roots, which can lead to persistent pain and neurological symptoms like numbness and weakness in your leg.

Your diagnosis indicates that you have a herniated intervertebral disc (HIVD) at the L4-5 level, which can indeed cause significant pain and neurological symptoms if the disc material compresses nearby nerves. The fact that you underwent two surgeries suggests that the initial procedure may not have fully resolved the issue, or that complications such as nerve root adhesion occurred post-operatively.

The symptoms you're describing, particularly the pain when using the bathroom and the increased pain in your left side, could indicate that the nerve root is still being affected, possibly by inflammation or scar tissue. It's not uncommon for patients to experience referred pain or altered sensations in areas adjacent to the surgical site, especially if the body is compensating for pain or weakness.

Here are some recommendations for managing your pain and improving your situation:
1. Pain Management: Continue to work with your healthcare provider to find an effective pain management plan. This may include medications such as NSAIDs, muscle relaxants, or even nerve pain medications like gabapentin or pregabalin. If you're not finding relief with your current regimen, it may be worth discussing alternative medications or dosages.

2. Physical Therapy: Engaging in a structured physical therapy program can be beneficial. A physical therapist can help you with exercises to strengthen the muscles around your spine, improve flexibility, and reduce pain. They can also teach you proper body mechanics to avoid aggravating your condition.

3. Interventional Procedures: If conservative measures fail, you might consider discussing further interventional options with your physician. This could include epidural steroid injections to reduce inflammation around the nerve roots or additional nerve blocks. These procedures can provide temporary relief and allow you to engage more effectively in physical therapy.

4. Surgical Consultation: If your pain persists despite conservative management, it may be worth seeking a second opinion from a spine specialist. They can evaluate whether further surgical intervention is warranted, such as addressing any potential scar tissue or nerve entrapment.

5. Lifestyle Modifications: Incorporate gentle activities like walking or swimming, which can help maintain mobility without putting too much strain on your back. Additionally, practicing relaxation techniques such as mindfulness or yoga may help manage pain and improve your overall well-being.

6. Support Systems: Don’t hesitate to lean on your family and friends for support. Chronic pain can take a toll on mental health, so consider speaking with a mental health professional who can help you cope with the emotional aspects of your condition.

Regarding your concerns about future surgeries, it's essential to weigh the potential benefits against the risks. Each surgical procedure carries its own risks, and it's crucial to have a thorough discussion with your surgeon about what to expect and the likelihood of success based on your specific situation.

Lastly, remember that recovery from spinal surgery can take time, and it's not uncommon for patients to experience ups and downs along the way. Stay hopeful and proactive in seeking the care you need, and don't hesitate to advocate for yourself in discussions with your healthcare team. Your well-being is paramount, and there are paths to relief and recovery.

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