Post by thungyijun on May 12, 2014 13:34:34 GMT
Hello Everybody! I'm here to share about "slip disc". Slip disc is actually a cartilaginous disc between vertebrae in the spine that is displaced or partly protruding, pressing on nearby nerves and causing back pain or sciatica (pain down the leg). As the picture below suggests, my case is more of a "Herniated Disc".
Prologue
I am a guy currently 21 years old this year. I used to lead quite an active lifestyle. I used to participate in triathlon and gyming. People whom do triathlon knows that you have to clock mileage for the three different discipline - swim, cycle and run. My life was not perfect but it was really fulfilling. I even intend to sign up for Special Forces Selection after I complete my Air Force OCS training with my friend.
The First Moment of Pain (Day 1)
I remember that day was a Friday when I was doing some deltoids lifts in the gym and all of a sudden, I felt like I had twisted something down my spine. The pain came from the back of my left thigh. The pain only worsen when I try to bend forward. Pain was like 3/10. But I still could lift and so I went ahead. "Mind over body" you know. Two weeks went by and the pain was still there, I initially thought I had pull my glutes or something. But I still went on with my running and gyming.
The Day My World Crashed (Day 14)
Hoho the most painful day of my life finally came. I remember it was a Sunday, I went to do a couple of intense laps in the pool and booked in to my camp as usual. When I woke up the next day, I couldn't even stand up straight. There was this GODZILLA pain coming from the lower part of my spine and it worsens 1000 times literally when I tries to stand up. Even if I'm lying down the pain's still there. I can't spend one minute standing up and showering was a freaking beast killer. I spent the next few days lying in the bunk before my commanding officer decides to intro me to this physiotherapy clinic in town, where he got his back problems fixed.
The Physiotherapy Phase (Day 14-75)
The pain I was feeling after Day 14 was still the same, I still had the constant GODZILLA back pain 24/7. The only relieve was when I was sleeping and I'm only painless in my dreams. I seriously wondered how I managed to survive five days before I had my first physio appointment. I went to book a medical appointment with Changi Sport Medicine Centre (because I was an ex patient and I didn't want to go in as a private patient due to financial reasons) and the next available date was close to two weeks time. So while waiting for the CGH appointment, I did like six physio sessions with my physiotherapist. Each physio lasted about 45 mins and cost $90. What the physiotherapist did for each session was "Deep Massage" (aka deep tissue release) and a little of back strengthening. Holy crap, it was freaking working.
Before physio:
1) Pain 24/7
2) Can't even stand up without pain
3) Can't even bend forward, furthest I can go is my knee before I hit the GODZILLA again.
After six sessions of physio:
1) Pain no more 24/7, overall pain lessen by 20%
2) Can tahan standing up longer like five minutes even though I feel pain standing up
3) Can bend forward, slightly further than my knee until I feel pain
So generally after six sessions of physio, the back pain decreased by 20% but it was still there.
The Day CGH MRI Report Was Out (Day 75)
I finally met up with a sports doctor in CGH Sports Medicine Centre, did an MRI and the result was I had a L5S1 Disc Prolapse aka slip disc. He couldn't do much but only could refer me to an orthopedic surgeon in another hospital as this is not his area of expertise. So I got an appointment in Tan Tock Seng Hospital like three months later (because all the orthopedic slots are full). At Day 30, I was no longer experiencing pain 24/7 (not sure if my body got used to the pain), but only when standing up. I would rate the pain 8/10. Walking tends to ease the pain by a little. My body was slowly starting to slouch towards one side because I experience pain whenever I try to stand up straight and it was not good. The CGH doctor also gave me some "Arcoxia" medicine, which is basically painkillers and that help to ease the pain by 40%. So in the meanwhile, I decided to visit a paincare clinic A in Singapore while waiting for the TTSH appointment. Seriously at this point of time, I don't know what is happening e.g when am I going to get better bla bla bla.
The Initial Pain Care Clinic A Visit (Day 75-105)
I saw this article in a magazine whereby this triathlete had a slip disc and after going through this "minimally invasive procedure" (I will explain more later), he was able to get back to triathlon and still manage to secure podium positions. I was like "Wow! I'm going to be like him!" And so I went to this paincare clinic A. After looking at my MRI and assessing me, the doctor offered to give me some medicine to try first before I decide whether to go ahead with surgery because he says that some people's condition might gets better with medicine. I took "Arcoxia" once a day, "Ultracet" slowly increasing from once to twice a day and "Lodotra" twice a day, slowly decreasing to once. All these cost like >$130 a month.
Ultracet: Ultracet contains a combination of tramadol and acetaminophen. Tramadol is a narcotic-like pain reliever. Acetaminophen is a less potent pain reliever that increases the effects of tramadol. Ultracet is used to treat moderate to severe pain.
Lodotra: Lodotra modified-release tablets contain the active ingredient prednisone, which is a type of medicine known as a corticosteroid. Prednisone decreases inflammation by acting within cells to prevent the release of certain chemicals that are important in the immune system. It is used to treat moderate to severe pain in adults.
The Lodotra was especially good. Seriously after taking all these drugs combination, the pain decreased to 2/10 when I was standing up and I could manage a little running. During this period I was going through the OCS Commission Parade rehearsals and I had to carry the SAR21 rifle and march for like two weeks consecutively from 8am - 5pm everyday. And this medicines save my life seriously and help me survive this grueling three weeks. However, I knew medicine is not a long run solution so I decided to try out chiropractic after I commissioned.
Chiropractic Phase (Day 105-225)
Honestly I think the whole parade made my back worst and the pain went from like 2/10 to 6/10 even with medicine. So while waiting for the TTSH Appointment and with a pinch of hope in my heart, I went for this chiropractic in town that cost $85 for one session. Basically one session will last for like fifteen minutes. When you get there, the assistant will ask you to stand on some slanted stand so that it will help you stretch your calf muscles. When the doctor come in, he will ask you to lie on a "dentist looking" kind of chair/bed and he will start cracking your back by twisting your legs at a certain angle and then pressing down your back. Sometimes he will crack my neck too. Seriously the cracking is quite shiok but the money wise, not shiok. I was still eating the paincare clinic A's medicine.
Before chiro:
1) Back will start to pain after standing for five minutes. Pain 6/10
2) Can't bend forward beyond knee without pain
3) Can manage a little running but jumping will cause pain.
4) Sneezing and coughing induce pain.
After chiro:
1) Back still pain after standing for five minutes. Pain 5/10
2) Still can't bend forward beyond knee without pain
3) Can manage a little running but jumping don't cause pain
4) Sneezing and coughing no longer induce pain
However I've decided to give up chiropractic after almost four months of treatment because the progression was reaching a plateau.
The TTSH Appointment Day (Day 130)
Half way through the chiro treatment, I went for the TTSH appointment. After an MRI, the doctor say the only treatment was via open surgery. The risk is that I will have a longer period of recovery and I will have to live my whole life with nails screwed to my spine to keep the disc in place and can't do sports anymore. Obviously it was a no no so I decide to consult an alternative paincare clinic B.
The Remainings (Day 225-360)
Paincare clinic B offered a minimally invasive treatment whereby the surgeon will manually remove the "protruding disc" and insert soft fluid into the disc area to increase the "content" of your disc (Because once the disc protrude out, it cannot be replaced. So your disc will shrink in size). However the cost was $25,000 - $35,000. Hey I'm an NSF, how can I ever afford that? And this is a private clinic somemore. So I decided to go back to paincare clinic A where they offered $16,000 for a laser endoscopic decompression procedure. What they will go is they will open an opening at the lower part of your back, and insert a laser tube into my spine where the laser will "burn' off the protruding part and TADA!!! I'm a new guy again.
After Operation (Day 360 onwards)
_
Honestly the surgery was not really a success. As you can see from the pictures above, the laser only managed to "burn" away portion of the bulging disc because the disc is too big. And the road to recovery was like crazy. Felt like I had a new pairs of legs that I have to train from scratch.
Pros:
1) No more back pain
2) I'm back to running and swimming. Haven't try cycling though.
3) I can stand up as long as I like without back pain.
Cons:
1) Surgery was not completed completely as there was still a portion of disc left protruding out of the disc. This is due to the laser unable to burn finish the whole disc. This meant the surgery was not a complete success.
2) Nerve in my left calf was damaged during the surgery and now I have yet to regain sensation feeling of my lower left calf and left outer feet. Meaning you can use a needle to poke me in those areas and I'll probably will still laugh.
3) Can't carry weights anymore in my life
4) Occasional minor back ache
5) My left feet can't land properly when running and requires a new pair of insoles to aid in running. Probably due to muscle weakening of my left leg throughout this one year and damage in nerve.
Lessons Learnt
1) In view of my nerve damage problem, paincare clinic A referred me to paincare clinic C. Which at the end of the day, I realised clinic C offers a cheaper and better alternative surgery, which is to manually use the hands to "slice" off the protruding disc, that can probably remove the whole protruding part. This is also a minimally invasive procedure whereby they don't have to cut open your spine to fix the disc and then screw your spine back again.
2) My protruding disc was a little too "big" for the laser endoscopic decompression procedure offered by paincare clinic A to work successfully. So the procedure offered by clinic C will probably suit me better and solve the whole issue.
3) I mean obviously anyone would want to try all others means before going for the last resort - surgery. But in my case, if in some way or another I could predict the future, probably I could have channeled all resources to the procedure by clinic C.
4) There are different stages of slip disc and not all stages require surgery. Surgery is definitely the last resort. The doctors will always ask you to go for an op, but you don't have to listen. I have a friend whose disc is slightly bulging and initially caused occasional back pain. The back pain went away with physio and he's now living a healthy lifestyle. So I encourage you to try all resort first before surgery because there is always a risk of nerve damage during surgery. And also, TRY to get more reviews from people about the doctor you are visiting (this is very hard because I tried).
5) Chiropractic did help me ease my pain but whether it solves the root problem, I'm not sure though.
6) Private hospitals and surgeons are definitely way more expensive, but not always better. I spent like 18K SGD on my op and I can only claim like 2K plus from medisave and another 1K plus from insurance (I never buy insurance, my fault lah ok). I think I need more stories from others whom have slip disc because I have not done my op before in a government hospital so I'm not sure if they're good.
So after five months from surgery, I am still working my way back to triathlons. I manage to currently do 3 x 2.5km run, 2 x 20 laps swim, as well as pushups, pull ups, abs exercises and leg exercises every week. I hope my story allow you to foresee what could happen and what you can expect when your back is feeling even a slight tinge of pain. So start looking after your back properly and appreciate health is wealth!
Prologue
I am a guy currently 21 years old this year. I used to lead quite an active lifestyle. I used to participate in triathlon and gyming. People whom do triathlon knows that you have to clock mileage for the three different discipline - swim, cycle and run. My life was not perfect but it was really fulfilling. I even intend to sign up for Special Forces Selection after I complete my Air Force OCS training with my friend.
The First Moment of Pain (Day 1)
I remember that day was a Friday when I was doing some deltoids lifts in the gym and all of a sudden, I felt like I had twisted something down my spine. The pain came from the back of my left thigh. The pain only worsen when I try to bend forward. Pain was like 3/10. But I still could lift and so I went ahead. "Mind over body" you know. Two weeks went by and the pain was still there, I initially thought I had pull my glutes or something. But I still went on with my running and gyming.
The Day My World Crashed (Day 14)
Hoho the most painful day of my life finally came. I remember it was a Sunday, I went to do a couple of intense laps in the pool and booked in to my camp as usual. When I woke up the next day, I couldn't even stand up straight. There was this GODZILLA pain coming from the lower part of my spine and it worsens 1000 times literally when I tries to stand up. Even if I'm lying down the pain's still there. I can't spend one minute standing up and showering was a freaking beast killer. I spent the next few days lying in the bunk before my commanding officer decides to intro me to this physiotherapy clinic in town, where he got his back problems fixed.
The Physiotherapy Phase (Day 14-75)
The pain I was feeling after Day 14 was still the same, I still had the constant GODZILLA back pain 24/7. The only relieve was when I was sleeping and I'm only painless in my dreams. I seriously wondered how I managed to survive five days before I had my first physio appointment. I went to book a medical appointment with Changi Sport Medicine Centre (because I was an ex patient and I didn't want to go in as a private patient due to financial reasons) and the next available date was close to two weeks time. So while waiting for the CGH appointment, I did like six physio sessions with my physiotherapist. Each physio lasted about 45 mins and cost $90. What the physiotherapist did for each session was "Deep Massage" (aka deep tissue release) and a little of back strengthening. Holy crap, it was freaking working.
Before physio:
1) Pain 24/7
2) Can't even stand up without pain
3) Can't even bend forward, furthest I can go is my knee before I hit the GODZILLA again.
After six sessions of physio:
1) Pain no more 24/7, overall pain lessen by 20%
2) Can tahan standing up longer like five minutes even though I feel pain standing up
3) Can bend forward, slightly further than my knee until I feel pain
So generally after six sessions of physio, the back pain decreased by 20% but it was still there.
The Day CGH MRI Report Was Out (Day 75)
I finally met up with a sports doctor in CGH Sports Medicine Centre, did an MRI and the result was I had a L5S1 Disc Prolapse aka slip disc. He couldn't do much but only could refer me to an orthopedic surgeon in another hospital as this is not his area of expertise. So I got an appointment in Tan Tock Seng Hospital like three months later (because all the orthopedic slots are full). At Day 30, I was no longer experiencing pain 24/7 (not sure if my body got used to the pain), but only when standing up. I would rate the pain 8/10. Walking tends to ease the pain by a little. My body was slowly starting to slouch towards one side because I experience pain whenever I try to stand up straight and it was not good. The CGH doctor also gave me some "Arcoxia" medicine, which is basically painkillers and that help to ease the pain by 40%. So in the meanwhile, I decided to visit a paincare clinic A in Singapore while waiting for the TTSH appointment. Seriously at this point of time, I don't know what is happening e.g when am I going to get better bla bla bla.
The Initial Pain Care Clinic A Visit (Day 75-105)
I saw this article in a magazine whereby this triathlete had a slip disc and after going through this "minimally invasive procedure" (I will explain more later), he was able to get back to triathlon and still manage to secure podium positions. I was like "Wow! I'm going to be like him!" And so I went to this paincare clinic A. After looking at my MRI and assessing me, the doctor offered to give me some medicine to try first before I decide whether to go ahead with surgery because he says that some people's condition might gets better with medicine. I took "Arcoxia" once a day, "Ultracet" slowly increasing from once to twice a day and "Lodotra" twice a day, slowly decreasing to once. All these cost like >$130 a month.
Ultracet: Ultracet contains a combination of tramadol and acetaminophen. Tramadol is a narcotic-like pain reliever. Acetaminophen is a less potent pain reliever that increases the effects of tramadol. Ultracet is used to treat moderate to severe pain.
Lodotra: Lodotra modified-release tablets contain the active ingredient prednisone, which is a type of medicine known as a corticosteroid. Prednisone decreases inflammation by acting within cells to prevent the release of certain chemicals that are important in the immune system. It is used to treat moderate to severe pain in adults.
The Lodotra was especially good. Seriously after taking all these drugs combination, the pain decreased to 2/10 when I was standing up and I could manage a little running. During this period I was going through the OCS Commission Parade rehearsals and I had to carry the SAR21 rifle and march for like two weeks consecutively from 8am - 5pm everyday. And this medicines save my life seriously and help me survive this grueling three weeks. However, I knew medicine is not a long run solution so I decided to try out chiropractic after I commissioned.
Chiropractic Phase (Day 105-225)
Honestly I think the whole parade made my back worst and the pain went from like 2/10 to 6/10 even with medicine. So while waiting for the TTSH Appointment and with a pinch of hope in my heart, I went for this chiropractic in town that cost $85 for one session. Basically one session will last for like fifteen minutes. When you get there, the assistant will ask you to stand on some slanted stand so that it will help you stretch your calf muscles. When the doctor come in, he will ask you to lie on a "dentist looking" kind of chair/bed and he will start cracking your back by twisting your legs at a certain angle and then pressing down your back. Sometimes he will crack my neck too. Seriously the cracking is quite shiok but the money wise, not shiok. I was still eating the paincare clinic A's medicine.
Before chiro:
1) Back will start to pain after standing for five minutes. Pain 6/10
2) Can't bend forward beyond knee without pain
3) Can manage a little running but jumping will cause pain.
4) Sneezing and coughing induce pain.
After chiro:
1) Back still pain after standing for five minutes. Pain 5/10
2) Still can't bend forward beyond knee without pain
3) Can manage a little running but jumping don't cause pain
4) Sneezing and coughing no longer induce pain
However I've decided to give up chiropractic after almost four months of treatment because the progression was reaching a plateau.
The TTSH Appointment Day (Day 130)
Half way through the chiro treatment, I went for the TTSH appointment. After an MRI, the doctor say the only treatment was via open surgery. The risk is that I will have a longer period of recovery and I will have to live my whole life with nails screwed to my spine to keep the disc in place and can't do sports anymore. Obviously it was a no no so I decide to consult an alternative paincare clinic B.
The Remainings (Day 225-360)
Paincare clinic B offered a minimally invasive treatment whereby the surgeon will manually remove the "protruding disc" and insert soft fluid into the disc area to increase the "content" of your disc (Because once the disc protrude out, it cannot be replaced. So your disc will shrink in size). However the cost was $25,000 - $35,000. Hey I'm an NSF, how can I ever afford that? And this is a private clinic somemore. So I decided to go back to paincare clinic A where they offered $16,000 for a laser endoscopic decompression procedure. What they will go is they will open an opening at the lower part of your back, and insert a laser tube into my spine where the laser will "burn' off the protruding part and TADA!!! I'm a new guy again.
After Operation (Day 360 onwards)
_
Honestly the surgery was not really a success. As you can see from the pictures above, the laser only managed to "burn" away portion of the bulging disc because the disc is too big. And the road to recovery was like crazy. Felt like I had a new pairs of legs that I have to train from scratch.
Pros:
1) No more back pain
2) I'm back to running and swimming. Haven't try cycling though.
3) I can stand up as long as I like without back pain.
Cons:
1) Surgery was not completed completely as there was still a portion of disc left protruding out of the disc. This is due to the laser unable to burn finish the whole disc. This meant the surgery was not a complete success.
2) Nerve in my left calf was damaged during the surgery and now I have yet to regain sensation feeling of my lower left calf and left outer feet. Meaning you can use a needle to poke me in those areas and I'll probably will still laugh.
3) Can't carry weights anymore in my life
4) Occasional minor back ache
5) My left feet can't land properly when running and requires a new pair of insoles to aid in running. Probably due to muscle weakening of my left leg throughout this one year and damage in nerve.
Lessons Learnt
1) In view of my nerve damage problem, paincare clinic A referred me to paincare clinic C. Which at the end of the day, I realised clinic C offers a cheaper and better alternative surgery, which is to manually use the hands to "slice" off the protruding disc, that can probably remove the whole protruding part. This is also a minimally invasive procedure whereby they don't have to cut open your spine to fix the disc and then screw your spine back again.
2) My protruding disc was a little too "big" for the laser endoscopic decompression procedure offered by paincare clinic A to work successfully. So the procedure offered by clinic C will probably suit me better and solve the whole issue.
3) I mean obviously anyone would want to try all others means before going for the last resort - surgery. But in my case, if in some way or another I could predict the future, probably I could have channeled all resources to the procedure by clinic C.
4) There are different stages of slip disc and not all stages require surgery. Surgery is definitely the last resort. The doctors will always ask you to go for an op, but you don't have to listen. I have a friend whose disc is slightly bulging and initially caused occasional back pain. The back pain went away with physio and he's now living a healthy lifestyle. So I encourage you to try all resort first before surgery because there is always a risk of nerve damage during surgery. And also, TRY to get more reviews from people about the doctor you are visiting (this is very hard because I tried).
5) Chiropractic did help me ease my pain but whether it solves the root problem, I'm not sure though.
6) Private hospitals and surgeons are definitely way more expensive, but not always better. I spent like 18K SGD on my op and I can only claim like 2K plus from medisave and another 1K plus from insurance (I never buy insurance, my fault lah ok). I think I need more stories from others whom have slip disc because I have not done my op before in a government hospital so I'm not sure if they're good.
So after five months from surgery, I am still working my way back to triathlons. I manage to currently do 3 x 2.5km run, 2 x 20 laps swim, as well as pushups, pull ups, abs exercises and leg exercises every week. I hope my story allow you to foresee what could happen and what you can expect when your back is feeling even a slight tinge of pain. So start looking after your back properly and appreciate health is wealth!