The Cost-Benefit Equation

As any of you who deal with chronic pain knows, there is a simple rule that defines much of what we do physically: I like to call it The Cost-Benefit Equation. If we are mindful of our condition, we carefully weigh each activity we do with the thoughts "If I do this, what will the effect on my back be? Will it be worth the pain?"

Sometimes my personal limitations make me feel like saying, "What the heck-- I'm going for it!" Like yesterday...

...in a flurry of love and affection for my five year old, I picked her up and swirled her around, and around, and around... her giggles made my heart swell at least three sizes. She could definitely appreciate the moment saying, "Mommy, you can pick me up now?!".


In moments like these, I am not always thinking about The Cost-Benefit Equation. This morning, I feel The Cost of that wonderful moment-- I feel like someone has taken a baseball bat to my back and right leg. Fun? Not so much. But the pain, I am told, will always be there. It will be a lifelong journey of "managing the pain". The choice to engage in certain activities will be, thoughtfully, mine.

I will always choose the swirls and the giggles. The Benefits from these moments are immeasurable.

Internet Back Pain Resources-ADR

This list was sent to me by a family friend, Gary, who one year ago flew to Germany to have Artificial Disk Replacement (ADR)surgery. His research helped me help myself, so I am passing it on to you.

Back Pain Support Group http://www.backpainsupportgroup.com/

Discussion group for disc replacement (ADR) patients http://www.adrsupport.org/
5 level ADR http://adrsupport.org/eve/forums/a/tpc/f/7501036081/m/8581054602

Spine Universe article on ADRs http://www.spineuniverse.com/displayarticle.php/article1683.html

http://www.spineuniverse.com/displayarticle.php/article1671.html

Spine-Health.com article on ADRs http://www.spine-health.com/research/discupdate/artificial/artificial01.html

Info on spine regions and associated effects http://www.thefhcc.com/nervechart.htm

MedlinePlus back info http://www.nlm.nih.gov/medlineplus/backpain.html

Lumbar Disc types Charite, Prodisc, Maverick, flexicore

Charite disc http://www.charitedisc.com/charitedev/domestic/

more Charite info http://www.depuyacromed.com/about/about.press.asp

FDA paper on ADRs http://www.fda.gov/bbs/topics/ANSWERS/2004/ANS01320.html

Artificial Discs http://www.artificialdisc.com/

SpinalNeuroSurgery info on ADRs http://www.spinalneurosurgery.com/artificial_disc_resources.htm

Facet Joint replacement info http://www.spine-health.com/research/discupdate/artificial/artificial06.html

Disc nucleus replacement http://www.spine-health.com/research/discupdate/artificial/artificial03.html

Facet joint disorders http://www.spine-health.com/topics/cd/facetjoint/facetjoint01.html

Dr. Sutcliffe's info (ADR surgeoun recommended in GB) http://www.londonspineclinic.com/FRAMES2.HTM

Dr. Bertagnoli (highly recommended ADR surgeon in Germany) http://www.adrbertagnoli.com/

Pro-Spine (Germany, Bertagnoli) http://www.netplosiv.de/pro-spine/cms/front_content.php?idcat=1

Stenum Hospital: a place where they do ADRs http://www.stenumhospital.com/about/index.asp

Details on ADR types http://www.getadr.com/

Global Patient Network

Tips for that first month following a lumbar microdiskectomy

I wanted to pass along a few things that have helped me immensely as I was recovering from my first lumbar disk surgery:

1. We installed a second railing on each flight of stairs.

2. We installed grab bars in each of our bathrooms (to help me even now get up from the potty) and outside of the shower- to help prevent a fall.

3. We purchased a raised toilet seat from Robert's Medical Supplies. It made a HUGE difference.

4. We purchased a bedside commode- which is helpful in the first month esp. at night.

5. We put a refrigerator next to my bedside.

6. We use the phones as an intercom system- crucial for pain management in the first few weeks post-op.

7. We buy milk and other liquids in several smaller weight containers instead of a full (heavy) gallon.

8. We placed plastic plates in a position where I could easily reach them. I learned I was not supposed to reach up over my head (and am still not supposed to) for anything.

9. I use a special chair (from Sweden) to eat at the table with my family for about the first two months post-op. I now use it to sit on when we have company over and are sitting around chatting, or when doing the computer. Basically the chair redistributes the weight away from my back.

10. I use the seat heater in the car when driving or riding (it acts as a heating pad).

11. I got an elastic belt that velcrows around my waist to hold ice packs (necessary the first few weeks post-op). The belt was given to me at the hospital. Worth asking for. I use it all the time.

Whose Life Will You Affect?

I saw the title for this Blog on an ad for the Red Cross today. It struck me. Many people have affected my life in such positive ways. I am hoping that some of the resources in my blogs will affect others experiencing back pain in a positive way.

One of the main resources I have used starting at the beginning of my journey through back pain is the Rehabilitation Institute of Chicago's: The Back Pain Book (Revised 2nd Edition). It is a "Self-Help Guide For Daily Relief of Neck and Low Back Pain" by Mike Hage.

When I initially read through this book, I did (as suggested) write down notes in the back of the book. Under Hage's heading in the Notes section
List below the positions or functions that you suspect most often aggravate your pain (see chapters 3, 4, and 5 for ideas), I wrote the following list:
1. unloading the washing machine
2. vacuuming
3. pulling the garbage can out to curb from the garage
4. walking uphill
5. lifting groceries out of the cart
6. lifting my youngest out of the carseat
7. bending at the waist
8. reaching across my body- right arm over left hip
9. walking across mulch
10. unloading bottom rack of dishwasher
11. taking "heavier" items out of the oven
12. driving for long periods (over 25 mins.)

I also found that the following things brought some relief or were helpful:

1. a removable shower head massager
2. whirlpool jets
3. cold on initial days of inflammation (ice)
4. heat (I have a buckwheat pad that you microwave for two minutes... a great gift from Germany)
5. supportive furniture: aerodynamic Swedish chair for computer and eating at the table; new mattress; new couch
6. I was outfitted for a corsett for instability but quickly learned not to use it for long periods of time as the goal is to strengthen the core muscles in my case
7. I found out a walking stick keeps me more upright than a cane


After visiting with many, many doctors, reading, and researching, I came up with an abundance of information that has been helpful to me. My purpose is to help others know what type of resources are out there, but is in no way intended to replace the medical advice of your physician. Please work with the medical team that knows you and your condition. Your comments are highly valued.

Making the decision to have an implant

Looking back over the past 6 months, I am grateful to Rasheed Siddiqui and Preston Grice for giving me the option to have a neurostimulator implanted. I struggled with the decision, and decided to at least do the one week trial. That was tolerable, and I learned that I could walk without a cane and have to use significantly less medication.

I had the surgery done at Winchester Medical Center in VA. What a great facility! I had a private room-- which was nice as I spent four nights in the hospital following my surgery.

Five weeks out from surgery, I was able to go on a short hike with my family using a walking stick.

In November, I hiked four miles round trip with a friend to view a waterfall in the mountains.

This implant has given me my life back-- something I am aware of each moment of each day.

I am not without pain, but I certainly can function again. I would love to hear from others who are experiencing chronic pain and are considering, or have had an implant.

A Journey Through Back Pain

I fell in 2006 and herniated a disk in my lower back. Initially misdiagnosed with a torn hamstring, I spent a lot of time in and out of the ER for indescribable pain. After trying the usual conservative approaches: NSAIDS, oral steroids, and physical therapy, I agreed to have an injection. I have tried Neurontin and Trileptal medications to change the way my brain interprets the pain signals. However, it was the doctor that gave me that first injection who would over the course of the next three years, change my life.

I had three lumbar disk surgeries in 2006. (L5-S1) In the midst of all of this, I had MRI's and CT/myelograms. I have even had a nerve conduction study done (EEG).

I have undergone physical therapy, used a personal trainer, read a lot of resources on dealing with chronic back pain issues, and have had countless selective root block injections.

Still, I deal with back pain.

As of Sept. 2008, I had a spinal neurostimulator implant. It has changed my life!

Mine is a spinal stimulator from St. Jude's Medical Company (formerly ANS). Several companies have a spinal neurostimulator implant for chronic back pain/radiculopathy. Medtronics company also offers a spinal neurostimulator.

Eon Mini Neurostimulator

I've had the newest battery put in for the spinal neurostimulator made by St. Jude Medical company. It gained approval from the FDA in April, 2008 and became available in the third quarter of 2008. My surgery was in Sept. 2008. I like how compact the battery is, but feel intense heat when trying to recharge it with the stimulator on. I use a high level of electrical stimulation, so have to recharge every five days or so. If I turn the stimulator off, I immediately feel pain and heaviness in my right leg and back. So, do I have to suffer for the hour and a half that I have to charge the battery with the stimulator turned off, or is there a way for St. Jude's engineers to make this battery better so the patients don't feel like we are burning from the inside out when it is on and charging?

Have any of you had this surgery and found useful tips for this problem?