I've gotten several emails from friends saying (in so many words) that I should man up and have the surgery since that offers some chance of resolving the back issue completely. I thought I'd been clear about where I stand on the options but perhaps not so I've amended a few earlier posts to try and clarify where I stand on that and thought I'd summarize here.
I want to have the surgery. As I said, the idea of six more weeks of pain, surgery then recovery doesn't sound all that great but it does offer the possibility of resolving the problem once and for all. A microdiscectomy is minimally invasive, the success rates are high and the possibility of future problems is low.
However
There is the possibility that I won't have that as an option. I thought I'd explained that sufficiently but the messages I've gotten lead me to believe readers think I'm waffling over whether or not to have it done, which is emphatically not the case.
Here's the deal (explained by a layman - me):
The disc is like a jelly doughnut. The inner part (the nucleus) is the jelly, the outer part (the annulus) is the dough.What happens when you herniate the disc is exactly what happens when you smash a jelly doughnut: the jelly gets squeezed out and the area where the hole is sticks out (protrudes). In the case of the disc, it sticks out into the space where the sciatic nerve exits and presses on the nerve causing pain. The jelly (nucleus) also irritates the nerve.
If it "resolves" itself, that means two things: first, the body absorbs some of the nucleus and some gets sucked back into the disc; second, because there isn't as much nucleus inside the disc it shrinks back to its old position so it's no longer pressing on the sciatic nerve. As a result, you're no longer in pain.
So you're left with a disc in its correct place that provides some, but less, cushioning than it used to. It also has a weak spot (the hole) where it'll want to leak more if it's compressed too much.
As a result, once it "resolves" itself, were they to do surgery all they'd find is a disc that was where it was supposed to be. If they were to separate the vertebrae and inspect the disc they'd find that it wasn't as full of gel as a healthy disc would be but they won't do that because they won't even do the surgery. That's because there's nothing for them to do. While not fully healthy, the disc is in the right place and it's not pushing on anything so there's nothing to cut, snip, widen, relieve, etc.
The process of compressing/retracting will be repeated (as it has been with me over the years), gradually getting worse (as it has been with me over the years) until there's no "jelly left in the doughnut" at which time the vertebrae are bone on bone. At that point, they can either replace the disc with a synthetic one (not everyone is a good candidate for this) or fuse the vertebrae. This is something I want to avoid at all costs. It's a more involved surgery, success rates are lower, outcomes aren't as positive.
So I'm in the position of "hoping" I'll continue to hurt for the next six weeks so I can have the surgery done. Seems like a crazy thing to wish for but that's where I'm at.
So bring on the knife!
