| Author | Topic |
plamena
ICELAND
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 Topic initiated on Friday, December 24, 2004 - 2:30 AM 
I need urgent advice from the doctors of the board
Assalamu aleikum,
I am in urgent need to receive an advice from the doctors. 10 months ago my husband was in a work accident in which he hurted his back seriously. After many X-rays the doctors found 2 things wrong. 1) Bolging Disk L5-S, left ,2)Deformated/Missing Facet Joint L5-S, left.He has done and continue to do phisiotherapy, took few injections with steroids, wore back belt, and drings very strong pain killers with bad side effects. Unfortunately so long nothing seems to help him easy the pain and numbness he feels in his low back and down his left leg. He is in waiting list in countries biggest rehabilitation center but also the hope that the pain will stop to exist after compliting the treatment is minimal. Now, which is very sad my husband is still young and he used to be very active, even he not complane often I can see how at times the pain became unbearable. His doctor talked about operation which might help him, but he said there is not garanty more that 60% that the operation will be succssesful. And we are not sure how much of a person he is going to be after the surgery. Now my question is : As you have information up about his condition and X-rays, would you recommend for him to go under the knife or if he is better off with the pain and numbness for the rest of his life? Is this oper. dangeruos and is it possible there are worse complications after it? Or is it save and there is better result after undertaking it? The doctor is the best around here, but we are not sure what are our options and what we have to do? Please I need to get as much as possible answers from you, dear doctors!
Jazak Allahu Khairun! |
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hkhan
UNITED KINGDOM
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 Posted - Saturday, December 25, 2004 - 12:35 AM 
w'assalaam sr
Nice to hear from you but may Allah help you in this regard amen as I can imagine your situation along with young children.
Indeed everyone is facing a different trial in life but may Allah keep it easy for us and lead us to the Paradise which shall be free of all these worries and sadness amen. May He give us hasanah in dunyah and aakhirah amen
I have to fwd your query to the doctors on our list as they may not always check forums spontaneously. Hopefully someone will come up with a satisfactory reply for you
As per my limited knowledge in this regard, spinal surgery is always a tricky one with unsure results and doctors do leave the ball in the patient's court in these cases to decide whether they are willing to take the risk.
regards |
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waseem
UNITED KINGDOM
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Posted - Saturday, December 25, 2004 - 10:30 AM
Wa'alaykum Asallam.
I am not an orthopedic specialist or a neurologist but a gp. I enclose my views.
My understanding is that your husband has a disc prolapse at L5/S1 level.he is getting numbness and pain down left leg which in layman's term is called sciatica.
Sciatica is a pain caused by pressure from a bulging disc or bone on sciatic nerve. It supplies the leg and thus due to the pressure on the nerve, he is getting pain and numbness.
Disc prolpse can occur in a younger age.Normally, pts are given approx 6 months for recovery by conservative. (non-operational) treatment.this entails physiotherapy, local injections and pain killers.
If by that time recovery is not occuring then,surgery may have to be considered.
Spinal surgery is done as a last resort and not as a first option.when all other measures fail.by this time I would presume that your husband has had an MRI scan to confirm nerve root irritation and pressure ie the nerve is under pressure from the disc.
At this stage the surgeon considers the option of a spinal operation called spinal decompression ie taking the pressure off the nerve,by removing the disc and spinal fusion; fusing the adjescent vertebrae.
There are two other points to consider.Firstly,you have written that your husband is young.If the operation is not done then persistent pressure from the disc can lead to permamnent damage and weakness of nerve in future, thus delaying the operation or not having an operation not only means that his pain and suffering will persist but it may get worse and the likelihood of spontanous recovery after 10 months seems unlikely. Secondly! whilst you have given general information. every case is an individual case with its own complexities.Whilst we can discuss general pros and cons,my adv is that I would be guided by the orthopedic specialist. If he/she feels that an operation is required then I will put my trust in him/her.
My understanding is that spinal specialists do not offer operation if they feel it is not required.
I agree that spinal operations carry higher risk then ordinary operations like appendix or hernia or gall bladder,but they are performed by skillful specialists.
If I was the pt, then I would feel that after 10 months my chances of recovery without operation are very remote. I would discuss with my orthopedic specialist and if he/she suggested operation ,I would put my faith in them.
Kind regards |
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hkhan
UNITED KINGDOM
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Posted - Saturday, December 25, 2004 - 7:02 PM
many thnx Dr.Waseem j.k. for the detailed reply which I hope shall give some idea to the sr.
There you go. General Practitioners cover all 
When the Neurologist would operate to free an entrapped nerve between the discs, there is a risk of nerve being damaged causing paralysis; but I guess this is where our trust in Lord comes as well.
We need to balance the situations and decide whether the present quality of life is worth continuing as such or would it be worth taking the other risk and then after discussing with experts pray to Allah, trust in Him and take the option which would give us the better quality of life.
but if one feels the present situation is better than the expected paralysis, one may stick to this? It is inded a difficult decision and may Alah finally help you to decide the best as he is the knower of the past and the future.
I feel it is different to the condition when we have to save a baby's life by caesarean section which although has 1000 times more risks to the mother compared to normal delivery but we suggest her to go for it to save the baby's life; rather she happily takes every risk to save the new life inside her or when we have to get rid of a cancer in an ovary or uterus which yet has not spread all over and although patient would give consent to accept damage to surrounding structures in her abdomen and pelvis, but it would be worth.
As I have requested our drs that presently we do not have a neurologist or orthopaedics surgeon in our Communities list but if you have a colleague you know would like to join us, do pass it on plz.
Our anaesthetist colleagur Dr.Mujahid is away nowadays otherwise would have been worth to have his advice as well.
Shall write to him and see if he could afford to, although very busy on a trip.
wassalaam |
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plamena
ICELAND
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Posted - Saturday, December 25, 2004 - 11:04 PM
Thanks, dr.Waseem and dr. Khan!
As I understand from your replies, if he doesn't make an operation he is going to have the pain all his life and probably it will become worse in the future. Am I right?
And if he deside to operate he can either finish with complete paralisys(you mean weelchair) or he is going to be fine. How much fine - is he going to be the same like before the pain started, working and caring his kids or he is just going to be free from the pain and numbness, but not be able to do a lot of the things he used to do?
And how long time he needs to recover after the operation?
You know this is not our home country here but as we understood from the orthoped there are 60% possibility that the operation would be succsess and the other 40%? And in those cases how is succsess defined?
Please disscuss a little bit more and thank you very much for your time, help and efforts! |
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hkhan
UNITED KINGDOM
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Posted - Sunday, December 26, 2004 - 12:39 PM
w'assalaam sr
I can understand your desperation and worry and am trying to get hold of our hospital orthopaedic surgeon who specializes in back surgery. Shall try to email you his contact if he was happy otherwise will post you his opinion insh'Allah.
In the mean time do visit
http://www.spine-surgery.com/FAQ/faq.htm
where you will find useful info as follows and much more. Also our prayers remain with you and family. May Allah give br. the patience of Ayyub(peace) while he awaits solution to his problem. amen.
3. I have been told that I have lumbar Degenerative Disk Disease. Do I need surgery?
Degenerative disc disease means wear and tear changes in the disc. All of us have it to some degree. Nearly everyone has signs of degeneration of lumbar discs after age 40. Some people show evidence of changes much earlier. Most of us are relatively asymptomatic with these changes. Others have backaches. A few people have severe pain or even nerve compression causing loss of muscle function. These changes are seen on imaging as narrowed disc spaces with osteophytes on x-ray pictures or dark disks on T2 MRI.
The usual course of treatment is TLC. If there is no relief from bracing, PT, pain meds, anti-inflammatory meds, low impact aerobics (walking and swimming) then fusion may be an alternative. Surgery is indicated for intractable pain or a progressive neurologic deficit.
Before considering a fusion or any surgery, you should exhaust all non operative methods of treatment. Fusion techniques will vary with the surgeon.
A good reference paperback book is Dr. Augustus White's book "Your Aching Back" published by Simon & Schuster and is available at your local bookstore or you can order it online at www.amazon.com. |
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plamena
ICELAND
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Posted - Wednesday, December 29, 2004 - 5:03 PM
Dear doctors,
I am still in need of your answers and opinions about my husband's current medical situation. Please, be kind to spare some time and help us out deside what is the best solution!
Jazak Allahu Khairun! |
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hkhan
UNITED KINGDOM
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Posted - Wednesday, December 29, 2004 - 6:38 PM
Dear sr, w'assalaam
After mutual discussion we have come to the conclusion that all the possible options are now available on the links I have given in the above posting and what Dr.Waseem has mentioned. My dear sr. you two have to decide now along with the available dr who is going to treat you there.
However if you have plans to visit another country for the same, please let us know so that we can check the references there.
Our prayers remain with you.
regards |
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hkhan
UNITED KINGDOM
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 Posted - Friday, April 1, 2005 - 11:38 AM
| sister has informed in an email that her husband's rehabilitation has started a while ago and she requested for prayers. |
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