My Bifurcated Spinal Cord
Smorgasbord / Kirt's Cogitations™ #341

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My Bifurcated Spinal Cord, MRI of herniated disc between L4-L5 lumbar spine (Kirt Blattenberger) - RF Cafe

MRI of herniated disc between L4-L5 lumbar spine. Nerve bundle is nearly split into two regions.

In 2012, while moving a heavy safe down some stairs (using a hand truck), something snapped in my lower back that resulted in debilitating lower back and leg pain for many months. Hydrocodone (5 mg) was required to enable normal locomotion around the house, and I couldn't lift anything. After about three months, things returned to normal, with occasional relapses. Since that time, I have tried to be careful to not overexert myself, and kept up a regular regime of isometric and low weight, low impact exercise. Maintaining muscle tone is essential for keeping the skeleton in proper alignment.

As time went on, I became a little bolder in terms of lifting, pushing, and pulling heavy objects, and got away with it until early March of this year when I foolishly used a long pry bar to tip over a huge tree stump. The stump finally broke loose, and so did my back. This time, the pain was so bad that I couldn't walk more than a couple feet without needing to recover, and finding a comfortable position to relieve the hurt was nearly impossible. Even the 5 mg hydrocodone barely touched it; at least two were required. I have always avoided taking any sort of medicine, even ibuprofen or acetaminophen, so a trip to a back surgeon† ensued. An x-ray showed a few bone spurs on some of the vertebrae impinging on my spinal cord, but nothing deemed severe enough to cause the level of pain I was experiencing. My doctor likely thought I was exaggerating, so I requested that he order an MRI. Keep in mind I have no insurance (self-employed and self-pay), so the cost would be all out of my pocket‡. That probably convinced him I wasn't kidding.

Microdiscectomy Procedure (not mine)

The MRI image above is what was revealed: a severely ruptured disc between the L4 and L5 vertebrae. Deformed cartilage was literally splitting my spinal cord into two sections. As Ricky might say to Lucy, "That 'splains it." After seeing the MRI images, Doc had a new perspective on my dilemma. It is amazing that I was even able to walk. After discussing options, which included potentially a lifetime of pain medicine and/or steroid shots into my spine, we settled on a minimally invasive microdiscectomy to remove the offending material. Watching the video to the right makes you wonder what "invasive" surgery might look like - gross.

After two changes in surgery dates due to obligations I had, the procedure was finally done last Friday morning. From the moment I awoke after surgery, all traces of the nerve pain were gone! All I could feel (and still do) is some soreness in the back muscles where the tube was inserted for access. Now, five days later, I find it necessary to constantly remind myself not to lift more than five pounds, drive the car, or do any kind of twisting or bending (including no exercise of any sort). That limitation will be in place until after the post-op visit with the doctor, which is scheduled for early August. I hope he has a photo of the extracted cartilage.

The change is nothing short of miraculous and I never would have believed such dramatic, instantaneous relief possible had I not experienced it. Hopefully, the status will not change and I will definitely be much more cautious in the future. BTW, my doctor says keeping myself in such a healthy condition (other than engaging in stupid maneuvers) with regular exercise, a good diet (eating whatever I like, but in limited quantities), no drinking, smoking or drug use, mental stimulation through reading and doing rather than watching TV, and positive overall attitude, had a lot to do with the recovery.

Joseph D. Stern, MD, FACS, Carolina NeuroSurgery & Spine Associates. I highly recommend Dr. Stern.

‡ My out-of-pocket costs for office visits, x-rays, MRI, anesthesiologist, surgical facility, doctor fees, etc., will probably end up in the $18k to $20k realm. That includes a discounted rate for most services due to being self-pay, for which to qualify I had to submit the full amount up front. Ouch! Insurance coverage for over-50-year-olds has been outrageously expensive since the Obamacare (aka Affordable Care Act, ACA) usurpation of health care in 2010. At age 64, the cost is even worse. Prior to the gift of ACA, we had a very reasonable premium cost with a $1,000 deductible and an 80-20 split (80% Blue Cross pays, 20% we pay). That option disappeared instantly with the new law (remember "If you like your plan, you can keep your plan?"). The promised reduction of $2,500 per family (on average) did not apply to us after monthly premiums and out-of-pocket expenses were tallied, even with a yearly household income of under $80k. The deductible for the lowest cost ACA plan (Bronze - I call it Rust) is around $17k, and copay on medical expenses AFTER the entire deductible amount has been paid is only 50%. If anyone out there who voted for the people that saddled Melanie and me with this financial burden would care to donate money toward my surgery, I welcome your assistance. Maybe you could set up a GoFundMe account to help pay the bills.



Posted July 20, 2022