Herniated Discs, Now What?

[firesgal30]

Hello all! This is my first post here, so be nice to me!

I had been working as an EMT-B for almost a year when I suffered a nasty back injury while lifting a patient on a driveway. I ended up with a bulging L5-S1, and a 13 mm herniation of my L4-L5. I had a discectomy in November, and while my doctor was in there, he noted that I had a huge hole in my disc. This gives me a much greater chance of re-injury in the future. I know that I cannot go back to EMS now, I would just be a liability to my patients and co-workers, as well as myself. I'm upset about it naturally, I loved my job! Additionally, my second career dream of being an ER nurse is also pretty much shot. I'm lost! Has anyone ever experienced this scenario? What do I do now? I can't imagine a job that doesn't let me help people, but I don't know what to do. Help!

[Chief1C]

Instructor? Dispatch? ER Tech? Wheel Chair Transport?

Four years into being an EMT, I protruded and herniated several discs from L3-S1 lifting a patient b/c additional help wasn't a possibility. That was seven years ago, and through exercise, smart lifting, pain management with steroids and time, I'm doing the same thing I was before I was injured. It's possible. Wanna be a nurse, do it. Look into alternative treatments, synthetic discs, etc. Never know what will come along.

[chbare]

I feel for you bro. Had the same problem occur about a year ago. No injury, just a spontaneous situation in my case. I'll write it off as poor protoplasm. You need to work with your doctor; however, many people can recover. With exercise and physio, I do fairly well and continue to work and I do not take any pain medication. Having chronic pain has been an adjustment however. With that, I have come to realise my days of pulling people out of cars and lifting them into an aircraft are over and I am in the process of reinventing myself. Back in school in an allied health programme. Currently looking at sleep medicine and/or diagnostics. It sucks being a poor college student and commuting two hours one way for clinicals; however, we need to do what we need to do.

Take care,

chbare.

[HERBIE1]

WHen I had my disc problems- L5S1- I went through PT(didn't work), and steroid injections(didn't work). The doc told me that the only other option was fusion. I rejected that, saying that unless I was wheelchair bound, nobody was cutting me. It's simply a matter of how much pain you can tolerate. That was 10 years ago and I'm still working. Bad days- yep, but keep up an excercise routine and work on your core(ABS). As was mentioned, look into dispatch, instructor, tech, or better yet, go back to school.

Good luck.

[vincewarde]

After 10 years in EMS - the last 7 as a paramedic, I had a similar injury way back in 1985. My advice to you is to take a long view. I attempted to return to work way to early - and the aggravation to the original injury ended my career. I really loved doing my job, just like you. 25 years down the road, here is my advice:

1) As I said, take a long term view. You have to live with your body for the rest of your life. No matter how much pain you have experienced, it can get worse. I have had to deal with increasing, severe chronic pain. In recent years, I have become disabled as a result of it. After loosing function in my left leg, I had the first of four surgeries. Function improved, pain got worse. These days a neuro-stim implanted in my spine and 4 different daily meds make life bearable - but I can be active for only about four hours per day - on my good days. Please put your body first - after all, jobs change - but your body will be with you for the rest of your life.

2) There is life after EMS. I went back to school and became a minister - I pastored churches for 20 years, and even now I serve as Chaplain to a Civil Air Patrol squadron when my body lets me. I also ran a computer business for several years. Now that I am "retired" I get to spend time with family and especially my grand kids. My primary care provider is a former paramedic who went back to school and became a PA after he injured his back at work. Others have made suggestions in previous posts. EMS is in many ways a calling and a lifestyle, it's not just a job. This can really increase the sense of loss when you can't do it anymore. Hang in there - if you play you cards right, you can have a wonderful life. In spite of everything, I have been through I would not trade places with anyone.

I hope this helps!

Vince

[tniuqs]

The almost accepted occupational hazard so count me in to the L5 S1 club, permanent parastesia down left leg, corresponding nicely to appropriate dematome level L5.

As most I am very sceptical about the knife myself as many friends have had multiple surgeries and are no better in fact far worse, maybe 2 that are improved post surgical intervention. The common denominator being a neurosurgeon not an othopod holding the blade, or that nasty looking device so that they can rip and tear out damaged disk on the anterior aspect (othopods here are not allowed to use the anterior approach.) I have many opportunities to view laminectomy, kinda scary IMHO.

The things that work for me are:

1- Benzos plus entaric coated ASA (after putting on my left sock and finding myself on all 4's on the floor) this relieves the muscle spasm when its acute.

2- In addition to a lying on bag of frozen peas btw DO NOT EAT after using them multiple times as they get very dry and chewy.

3- I have an supply if needed for Percocdan when it gets really, really, really bad. Yes indeed, they can be extremely addictive, never had an issue with that clear understanding the potential for abuse. I was hesitant when my GP prescribed them but his rationale : Why suffer with pain when the good lord gave Humans the poppy.

4- Stretching is a must, getting out of bed the next day is MANDATORY !

Oddly this more than common malady "in the over the 40 y/o category" is about 40%. But it did not arise until I worked in ICU and not in EMS as the lifting is very different. Being a medic I pitied the tiny little RNS at bedside and gravity sucking their patients (and mine) to the bottom of the bed. The twisting pull on bed-sheets to lift the typical > 100 kg ICU beluga whales that seem to be a more than "common occurrence" in the ICU setting. Monitoring 10 patient's in an hour and constant repetition did me IN ! Did multiple years extricating those trapped in a roll over's contribute, well most likely but when your young you seem to brush that off.

What I do when I have a "issue" about this I visualize and reflect back to the blue haired granny's in the nursing homes with the most twisted like pretzel spines unimaginable i.e. severe kyphoscoliosis. They get out of bed every morning and SMILE as they walk to the breakfast table with their walkers looking at the floor.

So: If they can do it I can too, I tell myself suck it up you woozy (under my breath to myself) not focusing on my little problem. I got shit to do !

<late entry> Keeping extra weight off is essential as well, nothing like lying on a couch and feeling sorry for oneself eating comfort foods to put more stress on the spine. I do have an addiction to potato chips I think its the Irish in me ?

Edited July 18, 2011 by tniuqs

[chbare]

If you look at the literature, surgery doesn't have a great record of success. It appears reasonably effective for neurological problems, but as a method for pain control, the results are pretty depressing. While I'm not going to give medical advice, I do suggest people consider all options, research, get the opinions of several physicians and make informed decisions.

Take care,

chbare.

[hatelilpeepees]

See if you can google or find the show on C-Span last night with Thomas Friedman (National Governor's Conference). He offerred a bleak job outlook for any career that is not specialized, basically saying if it can be outsourced or automated, the career is dead in the US. The reason I say that, is that you might consider some other medical careers that are connected to your skill set, or you may go back to school to gain more skills (Paramedic/Nurse). You could consider teaching EMS, becoming a dispatcher, or doing some industrial first-aid type duties. There are Paramedics who do insurance exams in patient's homes, I know of a Paramedic who worked in a law firm to assist them with medical malpractice cases. There are some options out there; same for nursing (school nurse, clinic nurse, doctor's office nurse, industrial nurse, nurse consultants for JCAHO, nurse consultants for insurance companies, Nurse advice phoneline type of jobs {poison control, refer to a doctor, refer to ER}). The door is only shut if you let it close.

[vincewarde]

If you look at the literature, surgery doesn't have a great record of success. It appears reasonably effective for neurological problems, but as a method for pain control, the results are pretty depressing. While I'm not going to give medical advice, I do suggest people consider all options, research, get the opinions of several physicians and make informed decisions.

Take care,

chbare.

Having been the surgical route, I tend to agree, especially in regards to fusions. Many people are helped by lessor procedures, I was greatly helped by the insertion of my neuro-stim and my fusion at least let me retain use of my left foot. As for multi-level fusions, my surgeon put it well: Don't.

[jinx1764]

Diagnosed with L4/L5 herniated disc in Dec with 8/10 pain radiating to right buttocks and thigh. Today I stay pain free after an initial round of steriods and tramadol to get me moving again. As soon as I was mobile I started advanced core strength training (because I was in great shape already and the low level exerces did nothing for me even at 40+) Within the first day my back felt better and within two weeks my pain was 2/10. But I have to do 2-3 hours of appropriate strength training every week. If I skip workouts or sit too long on hard surfaces I feel it stiffen up and pain sets in. You have to stay on top of staying loose, strong, flexible and ambulatory. Can't be a couch potato or it'll get worse.