Howdy fellow SBers.
I'm soliciting advice and questions for my surgeon for an upcoming evaluation/planning appointment in 2 days.
Summary:
I'm dealing with L3 L4 disk herniations and (some ?) stenosis resulting in radiculopathy (pinched nerves - Sciatica) affecting my right side from the top of the pelvis to my foot.. After total incapacitation for 8-days, two rounds of Foraminal (spine) Injections, I can sit, stand, hobble/walk a limited amount, with increasing discomfort with time and without any narcotics..
I'm seeing my ortho-surgeon (spine specialist) to discuss surgical appropriateness, options, prognosis, etc.
From his initial evaluation notes: "... I would like him to get an emergent L3-L4 right-sided block and see if that helps him it would be an option to try to get him better if that does not help he is going to need surgery which would include a right-sided L3-L4 facetectomy foraminal decompression. ... but I really think in the long run he is going to need surgery he has a large herniation ... "
Goal:
Frankly, I'm looking for full restoration of function with the expectation that I will need to exercise ongoing, reasonable caution to prevent re-injury.
My top priorities are:
1) Full restoration of life function - including diving to Tech-lite levels (AN/DP/Heliotrox). - I don't expect to be carrying twin water heaters and 6 stage bottles)
2) Minimization of the potential for recurrence and structural weakening.
...
?) Reducing surgical pain, invasiveness, recovery time/effort would be great, but only secondary to function and long-term stability.
Questions:
Understanding that in general surgical scarring may present DCS risk ...
What specific risks are caused for diving by the following procedures:
- Microdiscectomy
- Foraminotomy
- Facetectomy
- Disk Replacement
- Open vs. Laparoscopic approaches for the above
What specific questions should I be asking my surgeon about the impact on my diving?
I'm open to relevant anecdotal experiences in addition to expert opinions on the different procedures.
Very long-winded background to hopefully fully frame my situation should you are bored:
I was undergoing Chiropractic treatments starting in January for misalignment in my back stemming from some ill-executed maneuvering of some heavy items in December. Starting in January, around the beginning of my treatment, I had some annoying Sciatica at my back across the pelvis and over my hip that made me hobble a bit and maade standing upright uncomfortable. My Chiro and I discussed getting the sciatica evaluated and I had an appt with my primary for a few weeks out (guy is busy). Until my last chiropractic appointment, the treatments did not seem to affect the sciatica for better or worse. At my last chiro appointment (Feb 4, in for a final "tweak"), I was almost unable to walk after the appointment and had to stop and sit several times on the way out.
Fortunately, I was able to get a cancellation slot with my primary that evening. At that point the sciatica had increased notably, now affecting down to my right thigh and I was moving around on crutches. He evaluated me, pain level, range of motion, etc. Said I was going to probably need an MRI, but had to get X-Rays first.
I got the X-Rays the next morning, driving myself and in and out on crutches with serious, but manageable pain. Mid day I made a short drive (maybe 5-6mi round trip) to pick up my wife's car from the mechanic's and by the time I (barely) returned home, the pain had exploded radiating down the leg to my foot, leaving me in neurological overload and unable to move for a half hour.
For the next 8 days, I was unable to be in any position other than carefully on my back or left side. No solid food. Pain was slightly moderated by Percocet.
X-Ray-results were not informative and the MRI was ordered. After the MRI results came in, my primary referred me to the ortho surgeon for evaluation.
The ortho surgeon, evaluating my incapacity, pain level, and MRI sent me IMMEDIATELY across the hall to the outpatient surgery center for foraminal injections and said "See me when you need surgery."
The first round of foraminal injections gave me enough relief to be able to sit-up for short periods and resume eating within a couple days; eventually being able to move around reasonably with crutches for limited distances
The second round or foraminal injections 2 weeks later, allowed me to come off the narcotics and I can now sit-upright, stand, walk/hobble for a limited time after 1-1/2 weeks.
At this point I would estimate I am between 50-60% functional. My ability to work is reduced and unsustainable for the long term, but I have been working around it as best that I can for now. Obviously, any diving would be "with disability" at best at this point.
FWIW, I've read through the following threads:
Neck Pain keeping me from Diving
Post surgery diving
Herniated Disc
Got vertebral degenerative changes? Your risk for spinal cord DCS may be elevated.+
Back or Spinal Surgery and diving
Need some advice, herniated disk at C8
I'm soliciting advice and questions for my surgeon for an upcoming evaluation/planning appointment in 2 days.
Summary:
I'm dealing with L3 L4 disk herniations and (some ?) stenosis resulting in radiculopathy (pinched nerves - Sciatica) affecting my right side from the top of the pelvis to my foot.. After total incapacitation for 8-days, two rounds of Foraminal (spine) Injections, I can sit, stand, hobble/walk a limited amount, with increasing discomfort with time and without any narcotics..
I'm seeing my ortho-surgeon (spine specialist) to discuss surgical appropriateness, options, prognosis, etc.
From his initial evaluation notes: "... I would like him to get an emergent L3-L4 right-sided block and see if that helps him it would be an option to try to get him better if that does not help he is going to need surgery which would include a right-sided L3-L4 facetectomy foraminal decompression. ... but I really think in the long run he is going to need surgery he has a large herniation ... "
Goal:
Frankly, I'm looking for full restoration of function with the expectation that I will need to exercise ongoing, reasonable caution to prevent re-injury.
My top priorities are:
1) Full restoration of life function - including diving to Tech-lite levels (AN/DP/Heliotrox). - I don't expect to be carrying twin water heaters and 6 stage bottles)
2) Minimization of the potential for recurrence and structural weakening.
...
?) Reducing surgical pain, invasiveness, recovery time/effort would be great, but only secondary to function and long-term stability.
Questions:
Understanding that in general surgical scarring may present DCS risk ...
What specific risks are caused for diving by the following procedures:
- Microdiscectomy
- Foraminotomy
- Facetectomy
- Disk Replacement
- Open vs. Laparoscopic approaches for the above
What specific questions should I be asking my surgeon about the impact on my diving?
I'm open to relevant anecdotal experiences in addition to expert opinions on the different procedures.
Very long-winded background to hopefully fully frame my situation should you are bored:
I was undergoing Chiropractic treatments starting in January for misalignment in my back stemming from some ill-executed maneuvering of some heavy items in December. Starting in January, around the beginning of my treatment, I had some annoying Sciatica at my back across the pelvis and over my hip that made me hobble a bit and maade standing upright uncomfortable. My Chiro and I discussed getting the sciatica evaluated and I had an appt with my primary for a few weeks out (guy is busy). Until my last chiropractic appointment, the treatments did not seem to affect the sciatica for better or worse. At my last chiro appointment (Feb 4, in for a final "tweak"), I was almost unable to walk after the appointment and had to stop and sit several times on the way out.
Fortunately, I was able to get a cancellation slot with my primary that evening. At that point the sciatica had increased notably, now affecting down to my right thigh and I was moving around on crutches. He evaluated me, pain level, range of motion, etc. Said I was going to probably need an MRI, but had to get X-Rays first.
I got the X-Rays the next morning, driving myself and in and out on crutches with serious, but manageable pain. Mid day I made a short drive (maybe 5-6mi round trip) to pick up my wife's car from the mechanic's and by the time I (barely) returned home, the pain had exploded radiating down the leg to my foot, leaving me in neurological overload and unable to move for a half hour.
For the next 8 days, I was unable to be in any position other than carefully on my back or left side. No solid food. Pain was slightly moderated by Percocet.
X-Ray-results were not informative and the MRI was ordered. After the MRI results came in, my primary referred me to the ortho surgeon for evaluation.
The ortho surgeon, evaluating my incapacity, pain level, and MRI sent me IMMEDIATELY across the hall to the outpatient surgery center for foraminal injections and said "See me when you need surgery."
The first round of foraminal injections gave me enough relief to be able to sit-up for short periods and resume eating within a couple days; eventually being able to move around reasonably with crutches for limited distances
The second round or foraminal injections 2 weeks later, allowed me to come off the narcotics and I can now sit-upright, stand, walk/hobble for a limited time after 1-1/2 weeks.
At this point I would estimate I am between 50-60% functional. My ability to work is reduced and unsustainable for the long term, but I have been working around it as best that I can for now. Obviously, any diving would be "with disability" at best at this point.
FWIW, I've read through the following threads:
Neck Pain keeping me from Diving
Post surgery diving
Herniated Disc
Got vertebral degenerative changes? Your risk for spinal cord DCS may be elevated.+
Back or Spinal Surgery and diving
Need some advice, herniated disk at C8