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DivingForGold 3 days ago

Male scheduled for my 3rd epidural with steroids next week for on-going spinal stenosis, relieves pain for a few days, then back to pain.

Will go for minimally invasive micro laminectomy next, tired of treating symptoms and not the root cause.

In that procedure surgeon will remove parts of lower vertebrae that is pinching the nerve bundle, nerves that progress down each leg.

Success rates of better than 70%, it's a gamble. But willing to accept that rather than end up on addictive pain pills for life.

3 to 6 months recovery period before active lifestyle again, cannot risk disturbing the "fix". Giving up flip turns in lap swimming for quite a while. Supplemental covers the other 20% that medicare won't pay.

Cash paying patients suffer $35k to $45 K for the procedure.

Medicare pony's up only about $6,500, which the surgeon must accept, no extra cash changes hands.

Supplemental covers the 20% that medicare will not pay.

complianceowll 5 hours ago | parent | next [-]

I understand everyone has different beliefs, and personally, I fall extremely short of what I should be, but I just took some time to pray for you and your procedure. I really hope the root cause is fully resolved.

PeterHolzwarth 4 hours ago | parent [-]

[flagged]

protonbob 4 hours ago | parent | next [-]

Instead of saying words to one of the many tens of thousands of religious comments that would presumably annoy you, you could also help research on this topic instead of dumping on someone trying to be encouraging who already hedged that not everyone agrees with them.

economistbob 4 hours ago | parent | prev [-]

The maker of the universe is not "one of many tens of thousands of gods". You proclaiming that your house has no architect because you read about ancient kids playing with block buildings changes nothing about the architect of your house.

In computer terms, you conflate by ref with by val. An idol is by val. The maker of the universe is spoken of by ref, and not by val.

Learn the difference.

brookside 6 hours ago | parent | prev | next [-]

(While it's clear you've done a ton of your own research for your own case.)

Steve Kerr's advice after his own back surgery complications (albeit microdiscectomy, not a laminectomy) make me hesitant:

"If you're listening out there, if you have a back problem, stay away from surgery... Rehab, rehab, rehab. Don't let anybody get in there."

amluto 2 hours ago | parent | next [-]

The heuristic I found when researching this a few years ago was slightly more nuanced than your quote: back surgery is very likely the wrong solution for back pain.

But if you have nerve problems caused by an issue with your spine, you probably want to address them before they become worse or irreversible, and back surgery may end up being the only option.

ortusdux 5 hours ago | parent | prev | next [-]

I helped a friend through a microdiscectomy, and it could not have gone better. Laparoscopic procedure, short recovery, lifechanging reduction in symptoms. The biggest hurdle was that their insurance required PT/rehab prior to authorization, even though all the experts involved agreed that it would not help.

vitally3643 6 hours ago | parent | prev [-]

This kind of comment is only marginally better than "well, I asked ChatGPT and...."

You acknowledge the parent commenter knows more than you, but you decide it's somehow helpful to post contradictory information anyway sourced from someone else who also likely knows more than you.

matwood 5 hours ago | parent | next [-]

You don't have to listen to Steve Kerr. Every back doctor I have seen has said the same thing - surgery is the absolute last resort. I was fortunate that the epidurals worked for me, because it was the worst pain I have ever felt.

BrandoElFollito 3 hours ago | parent | prev [-]

It's a good idea to ask a few AIs to get extra feedback. They may be wrong, your doctor may be wrong -- it is better to have a set of inputs and, to some point, check it against sources.

rythmshifter 5 hours ago | parent | prev | next [-]

My mother had this surgery and advised me to never have it done due to complications

thelastgallon 5 hours ago | parent | prev | next [-]

Go for surgery if you have neurological symptoms (loss of sensation, motor function, etc). If its pain, try your best to avoid surgery and find the right physiotherapist to help you be pain free. Spine surgery is risky and there is a risk of cascading failures.

Don't completely trust any anesthesiologist (pain management) or neurosurgeon (for surgery) or chiropractor or random folks advice to do yoga/stretch. Spend quite a bit of time understanding the anatomy, read up on everything and maybe you will find the right set of exercises to help relieve pain. Troubleshooting disk/spine/nerve issues is very hard and most doctors don't have any time to investigate it deeply. They just look at MRI. There are lots of people with the same problems showing up on MRI, but they are pain free.

wiz21c 5 hours ago | parent | next [-]

why "not" yoga/stretch ? I understand it may not be the right thing for every kind of pain but the way it is usually presented (your body needs movement) sounds convincing. (I don't practice yoga but taichi)

thelastgallon 4 hours ago | parent [-]

[dead]

thelastgallon 4 hours ago | parent | prev | next [-]

I don't understand the downvotes. If you have any counterpoints, please do share so I can learn instead of downvoting.

causality0 5 hours ago | parent | prev [-]

I have to cautiously agree with you, with the caveat that many physios don't seem to know what they're doing either and the effectiveness of therapy can differ wildly based on which therapist and what regimen they use. Speaking as someone with a herniated disc that went through a discectomy which re-herniated immediately following surgery. Frankly I've only just now started getting relief by reducing the amount of weight pushing on the disc by way of treatment with semaglutide. Could've saved myself thousands of dollars in medical costs and rehab if I'd just done this a year ago.

thelastgallon 4 hours ago | parent [-]

> Speaking as someone with a herniated disc that went through a discectomy which re-herniated immediately following surgery.

Sorry to hear about re-herniation. Thats what I am concerned about. I have multiple disc herniations, one with cauda equina. Multiple neurosurgeons have recommended surgery, but each is going to do a different procedure. I understood as they don't fully understand whats the root cause, everyone wants to do the procedure they are comfortable with and what they've been doing. One wants to cut the disc, another remove lamina, another fusion and something else. I decided its not worth taking the risk when they don't know what they are doing. There are so many reports of failed back syndrome, revision surgeries, cascading failures (because it increases pressure on adjacent discs).

> with the caveat that many physios don't seem to know what they're doing either

Yes, this is true of nearly any profession. We just have to spend significant time researching and troubleshooting with an engineering mindset.

WarmWash 5 hours ago | parent | prev [-]

Honestly surgeons should be paid hourly like technicians. $800/hr or something like that. For a 2 hour procedure, $1600. Another $5k for facility and support staff. Looks like medicare is on point...

Broken_Hippo 5 hours ago | parent | next [-]

I'm with you until I remember how expensive medical school plus internship is in the US. If doctors cannot pay back their student loans, it doesn't matter. The majority of folks in medical school have family that can support them now - not fixing education will make this even worse.

Don't get me wrong. I support state-sponsored health care, especially after moving from the US to Norway over a decade ago. Just the peace of mind not having to worry so much about financial ruin because of health issues relieves so much stress - even stress related to just keeping yourself healthy is less (If I get hurt while jogging, it isn't a big issue, for example) But fixing the US system is bigger than just payments or insurance for all. Gotta fix things like education costs, the burden of unpaid internships, and things like that, too. I wish it weren't such a complicated problem and I wish there were the political desire to do such a thing.

tptacek 5 hours ago | parent [-]

Medical professionals in the US make multiples of what the same professionals make in Europe.

Calavar 5 hours ago | parent | next [-]

This gets said a lot and it kind of irks me. (I am a physician.)

US software devs also make 2x what their European colleagues do, but that never gets called out as bloat. Plus US software devs make that 2x pay without taking our additional loans for medical school at the rate of $75k per year or doing years of low pay residency where their salary doesn’t give them the means to pay off those loans.

kasey_junk 3 hours ago | parent | next [-]

> US software devs also make 2x what their European colleagues do, but that never gets called out as bloat.

Of course it does. And it gets acted on. Every major corporation in America has explored or implemented moving to European or other foreign developers to save costs.

Developers also don’t have the advantage of a trade group that prevents this practice, requires particular education or limits the number of people allowed to get that education.

mook 4 hours ago | parent | prev [-]

Don't forget the insurance, plus the hospital has costs that must be paid for too. A surgery with _just_ the surgeon and no support staff isn't one I'd want to be in.

(Not in the medical field at all)

connicpu 4 hours ago | parent | prev | next [-]

But in Europe the state also tends to cover their schooling to become a doctor.

Cyph0n 5 hours ago | parent | prev [-]

And the best of the best of medical students the world over compete to enter the US market. Being US board certified garners the highest pay even outside the US (eg GCC).

It’s kind of like our industry - the higher comp is a big reason behind how the US attracts talent from all over the world.

Novosell 4 hours ago | parent | next [-]

Just wanna point out that this sort of statement only really applies to the anglosphere. As in "medical students the world over can generally only speak english and their native language, so they can either apply for studies in their home country or an english speaking country, and some try to go to the US".

Not every country is in contention, as even if, for example, Hungary has the best medicine program, very few people are gonna learn Hungarian just to attend the university. The same argument applies for every country which requires a non-english language for admission.

BrandoElFollito 3 hours ago | parent | prev [-]

This is not the case in Europe. You would not gain anything by being a doctor from the US vs the local ones. You may even be in a worse position due to many differences between the US and the host country.

ak217 4 hours ago | parent | prev | next [-]

Good surgeons are a bit like major airline pilots. They have more pricing power than you think.

notnaut 5 hours ago | parent | prev [-]

Medicare for all fixes a lot of the problems with the US health system!

5 hours ago | parent [-]
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