Spondylolisthesis

When Should Some Form of Surgical Intervention be Considered with Spondylolisthesis? Top Four Factors

2013-06-03T04:23:00.000-07:00

When should some form of surgical intervention be considered with Spondylolisthesis? - Top Four Reasons

While it's important that any kind of surgical intervention be a last resort, there are many factors to consider when it comes to the decision of, if & when, to have spinal surgery for one's Spondylolisthesis slip. If you wait until you literally can't walk, or your ability to use your extremities (upper and/or lower, dependent upon where the slip resides in the spinal column) is lessening to some palpable degree, the nerve damage is more likely to be severe enough that a surgery may not save your full ability to move and feel your lower extremities (or upper extremities) and eliminate any & all nerve-involvement on a permanent basis. The longer the damage exists and settles into your nerves and spinal cord, the less likely there may be a full & complete recovery on the horizon (not that it's impossible).

*Please keep in mind that every person and every case is different - No one fits perfectly into a box.

So, the big questions remain: Should I have surgery? And if so, when should I have some form of surgical intervention?

These questions are a frequent topic on the group page, so I thought it might be helpful to provide what I consider the top four reasons or factors to consider when making this big decision.

In addition, I also address the matter of finding the best surgeon (or surgeons) for you & your particular case, located at the bottom of the document.

Some of the bigger factors (top four reasons) which play into having surgery are the following:

1) The GRADE of a Slip:

What grade is your slip?

Higher grades (usually considered grades 3-5), or complete slips (beyond 100% & called Spondyloptosis), are typically the more severe cases, especially when it comes to the spinal cord itself & the many nerves which branch out from the spinal cord. As a slip moves, it often places an increasing amount of stress and general impingement upon both the nerves - which branch out from the given vertebrae - and of course, the spinal cord. The further out of alignment the vertebrae become, the more likelihood that the spinal cord & vital nerves may be directly affected by the slip - which is an issue that is obviously best to be avoided if at all possible.

When a slip progresses to a higher grade, it often becomes a greater challenge (and literally technically more complicated) to reduce the slip, as well as to stabilize & fuse. Complexities include avoiding nerve damage (whether it be in the upper or low extremities), in addition to other issues of this nature, which may affect the bladder and/or bowels (this is witnessed in cases involving the lower region of the spine). Reduction of a slip does carry additional concerns and possible complications, although for some with high grades or complete slips, reducing the slip to some degree becomes a necessary piece of surgical intervention. Avoiding the need to reduce a slip at all is one of the reasons it is important to consider some form of surgery prior to the condition increasing so dramatically in severity. Often times, the greater a slip progresses, the higher the likelihood for some degree of nerve impingement to present, as well as the possibility of nerve damage, which sometimes may be permanent. In VERY rare and worst case scenarios, an extreme slip with these factors can, and may result in permanent paralysis, as well as loss of bowel and bladder function/control.

2) The STABILITY/INSTABILITY of a slip:

Is your slip considered stable or unstable?

A slip which is considered "stable" is one which does not show much, if any, movement. This factor of a Spondylolisthesis slip is important to know and understand because of it's usefulness in analyzing one's degree of overall pain and severity of the slip, but most importantly, it helps to determine the possibility of future progression of the slip to a higher grade. The stability, or rather instability, also provides some idea of how vulnerable the region of the Spondyo may be. When a slip is considered "unstable," this ultimately means that it's rather mobile - which it shouldn't be. This type of movement (instability) may be viewed through a series of x-rays. A slip which lacks stability, is one that should be carefully considered for some form of surgical intervention. Even when it comes to lower grades, surgery may still be considered due to the likelihood of any progression of the slip. Stabilizing the slip through fusion may be one's best bet to avoid future complications - both with the condition itself, as well as with surgical intervention.

Your doctor must determine your degree of stability or instability through x-ray imaging. If you do not know your stability factor, please request that your doctor order a series of standing x-rays. In order to most correctly estimate one's degree of stability, it's important for at least three films to be taken and reviewed. These x-rays include the following: Standing x-ray (shot to your side), while you're standing straight, standing x-ray in full flexion position, and standing x-ray in full extension position. You may also read more about diagnosing Spondylolisthesis (how to determine grade and stability), in another document under the files section. Please note that It's much harder to determine stability, and even sometimes the correct grade, through x-rays laying down, or via MRI films.

What is considered a "stable slip" typically should not be touched surgically unless there are other concerns involved. If one has a stable slip, it becomes very important that the patient stays on top of alternative therapies and other forms of treatments - in order to both lower pain levels, and ensure continued functioning and stability of the condition. Even with a stable slip, it may be vital to alter one's physical activities to some degree in order to avoid any further damage or future vulnerability. If your slip is considered stable, the last thing desired is for it to become unstable. It's vital with both cases (stable and unstable) to create a "support system" for the back; specifically through strengthening of the core muscles. The main muscles upon which to focus in order to create more support for the spine include the abdominal, the lower back muscles and the Psoas (*The Psoas are the muscles located under the abs and in front of the spine). Because the entire body is literally connected, it's also important that other areas of the body are strengthened as well, specifically the legs, hips and buttocks, as these muscle groups do play a part in supporting the spine as well. It's important to be cautious while exercising, while you want to do your best to avoid any further injury in your attempts to improve your overall muscle support system. Pilates (performed utilizing some of the alternative moves offered, if things are uncomfortable or are too challenging), and various forms of exercise in the pool (including swimming itself), are two of the best workouts available to strengthen one's core, yet avoid any physical damage. You may find additional exercise ideas and suggestions in another document under files, as well as listed on the group page (To easily and quickly located some posts related to this subject, use the "search" box, which is labeled by a symbol of a magnify glass, and is located on the upper far right-hand side of the group page).

3) The Degree of NERVE INVOLVEMENT:

Do you experience any form of nerve involvement as a result of the condition?

The amount of nerve impingement, and therefore nerve-related symptoms, play a part in determining when surgical intervention may be one's best option. If one's Spondylolisthesis is a low grade, and is considered stable, nerve pain and other symptoms caused by nerve impingement may be able to be treated by medication and various forms of alternative therapies and western medical treatments. Often - in such a case as mentioned above - it could be that another condition is also partly to blame, for example; Spinal Stenosis. This condition, and several others, are fairly common in combination with Spondylolisthesis. If this type of pain, and other nerve symptoms remain an issue, and are not controlled or decreased through non-surgical means, it may be important to consider the option of surgery. This would be especially true if there's a constant or dramatic increase in the degree of nerve pain (burning pain, shooting pain, electric pain, pins and needles, etc) and symptoms one is experiencing daily. Some nerve-related symptoms, aside from pain itself, include weakness in the extremities, numbness, loss of mobility and so forth.

Typically, when it comes to a Spondylolisthesis slip itself (not taking into account other conditions like Spinal Stenosis), there are two main sources for this kind of pain and other nerve complications - Specifically the little nerves which come out of each vertebrae, and then the spinal cord itself. When it comes to higher grade cases with nerve involvement, the spinal cord is, in many ways, being severely or completely impinged. Actual spinal cord impingement is dependent upon where the slip is located. Those with slips in the most common area at the L5/S1 will not experience actual spinal cord impingement, as the spinal cord itself does not extend past the L2. In this region, the multitude of nerves which branch down from the spinal cord may be affected in the same manner as explained with the spinal cord. *Please take a look at the "photos section" to view high grade and complete slip (Spondyloptosis) cases. You will be able to see just how one's spinal cord & nerves would be significantly affected by a severe slip of alignment - Imagining how the spinal cord & nerves run through all of the vertebrae, and with a dramatic misalignment, may very well end up coming out of the vertebrae which has slipped, squeezes in-between the two vertebra involved, then twists back into the remaining vertebra below. Unfortunately, the longer a slip remains this way (untreated and un-stabilized), the harder it is to retain normal functioning of the nerves involved, as they literally become accustomed to this "new" arrangement, if you will.

The process of reducing a slip which is severe in grade is much more complicated when it comes to the nerve involvement, as it likely took a number of years to reach the high grade or complete slip, allowing some time for the nerves to 'adjust' to this particular positioning. Therefore, reducing a slip in one relatively short surgery, in comparison to those years, can and may be highly traumatic and literally shocking to both the nerves themselves, as well as to the spinal cord. It may be helpful to think of any nerve involvement (any of the symptoms discussed above), as a "warning sign" of sorts. If these issue continue to increase, whether in number or severity, it's important to immediately speak with your doctor, determine the exact & direct cause, and consider your surgical options.

Nerve involvement resulting from a Spondylolisthesis slip does not mean just pain & issues with your extremities. Our spinal cord, encased and protected by our vertebrae, may be considered one of the more important foundations of our body's. Our nerves - which branch out from the spinal cord and then each vertebrae - all have a very specific "job," and when those areas are damaged or affected by a slip, the result may be impeding upon the given job they are meant to perform. For example; for those with slips in the low back region (mainly at the L4, L5 & S1 vertebra), as a slip progresses in grade there's an increasing chance for areas like the bowel and/or bladder to be directly affected to some degree. In worst case scenarios, some lose full control and function over both regions. This is why it's vital to report and address any concerns you may have involving your slip and symptoms which may indicate some problems connected to the bowel and bladder.

Nerves are a part of our bodies which are hard to fully understand and address. When it comes down to nerve damage resulting from a slip, there's opportunity and possibility for complete recovery, as well as the unfortunate outcome of little to no nerve repair, following the onset of obvious involvement and damage. Again, this is why nerve involvement itself is something with this condition which is not to be taken lightly or ignored. Sometimes one of the best options is to take preventative measures prior to nerve impingement presenting as too severe, therefore again, it's important to consider surgery as one of your options when your nerves are at risk ... especially when symptoms are increasing in number, frequency and severity.

Bottom line: Please do not wait to have surgery until you are unable to walk!

4) The QUALITY OF LIFE:

What would you consider your overall quality of life to be as a result of this condition?

Quality of life is a big factor that plays into the decision of when to take that next big step (& leap of faith), and move forward with having surgery (or surgeries) to stabilize a slip, release nerve impingement(s), as well as possibly reducing the grade of a slip.

In a nutshell, what 'quality of life' comes down to, is how this condition (and any additional related conditions), interfere with, and seriously affect your day-to-day functioning; your basic survival (everything from taking basic care of yourself, relationships, work, school, daily basic tasks, etc), in addition to your ability and 'willingness' to endure any amount of chronic pain you may be experiencing (both nerve-related & otherwise). If you are spending the majority - or all of your day - in a good amount of pain, you find yourself unable to function on a decent level, have trouble doing day-to-day activities, have trouble sleeping due to pain & general discomfort, have no energy & are constantly fatigued, experience changes in appetite, as well as new or worsening conditions like anxiety and depression, etc., please note that these are all problematic in nature, and are all clear 'warning signs' that your quality of life has decreased a large degree. This is no way to live! ... You are purely 'existing.' And, in my opinion, this factor, in and of itself, plays a big role in making the decision to move forward with surgical intervention.

Of course, the three reasons listed above should be considered along with this final reason. For example, if you know that your slip is stable and not likely to progress (being sure to avoid certain high-risk activities which may result in sudden & unexpected progression), you do not experience any nerve-involvment (nerve pain in the extremities, nerve-related symptoms, issues & other concerns involving matters like your bowels & bladder, etc), and your slip is considered a lower grade, it's important that you make an effort to seek out as many forms of therapies & treatments (both alternative & western medicine based), as you feel comfortable pursuing. In doing so, you may find that with the 'right combination,' you are able to improve your overall quality of life, and therefore, live and function with this condition without requiring any surgical intervention at this point in time (and perhaps ever). I do want to note that if this is the route you take, and you find the right balance to improve your quality of life - including pain concerns - that you continue to keep a watch on your Spondylolisthesis slip over time. Being sure to monitor it's status once every few years (at minimum), via some kind of diagnostic films. And, should you begin to experience new symptoms and/or an increase of pain, that you immediately visit your spine specialist to ensure all is well.

SUMMARY & MY PERSONAL EXPERIENCE COMPARED TO THESE FOUR FACTORS:

Each of the factors listed above are all issues in their own right. And, obviously a combination of these enhance the problematic nature of the condition as a whole, which ultimately may need to be addressed (sometimes sooner rather than later). While I have accumulated knowledge of various individual's stories and experiences with their respective condition and surgeries, I can only speak from what I know on a personal level with Spondylolisthesis. In order to better explain the greater need for surgical intervention as a slip progresses, I will do my best by way of comparing this to my own case below. But, before I continue, I would like to say that I do not share my story & experience in order to increase your anxiety or fears around this condition and having surgery ... Rather, I share a part of my story below in order to state the importance of carefully considering all of the previously stated factors, as well as making a clear case for keeping one's eye on the condition and truly listening to the body and any warning signs it may be presenting - All as ways to best avoid the more severe case scenarios on the continuum of this condition.

My first case of Spondylolisthesis started around the young age of 9, and wasn't diagnosed until I was 14 years old. This particular slip, when finally recognized, was considered a complete slip called Spondyloptosis, and was located at the most common location of the L5/S1. It had a tremendous impact on my lower extremities as a direct result of severe & extensive nerve impingement. While I could still walk prior to my surgeries, I was experiencing a lot of sudden and scary nerve-related issues. These included, but were not limited to: Several types of nerve pain sensations, weakness in my lower extremities, random and sudden loss of sensation, numbness, and occasional inability to move my legs & feet. Prior to my surgeries, these symptoms (aside from the actual nerve pain itself - which remained a constant), would come and go without rhyme or reason. Between the age of 9 when I first recall having pain severe enough to cause worry and halt my sports activities from time to time, and the age of 15 when I finally had my surgeries, my quality of life decreased dramatically. Initially it was gradual, one thing here and one thing there ... It wasn't until the last two years prior to my surgical intervention when I experienced a rapid decline in a number of my physical abilities and a dramatic increase in overall pain symptoms.

Once I was finally diagnosed, I was told that I needed some form of surgical intervention within a maximum time period of 9 months, otherwise they would not touch me/attempt any form of surgery due to severity of my condition, various additional risk factors and other likely permanent complications. It was estimated that I could wake up one morning without feeling or use of my legs (as well as sudden and permanent loss of bladder and bowel functioning). They estimated - with an almost 100% certainty - that within 12 months I would be paralyzed. Surgeons also informed my parents and I at the time, that without intervention, and given the continued progression of my slip, that my internal organs would become so compacted (literally crushed), that the final prognosis was fatal in the sense that the heart & lungs would be affected. It was estimated that I would live for approximately a decade more before the condition killed me from secondary factors involved with this key piece. This case was very rare & severe in nature, but it does provide some idea of how dramatically this condition can affect one's spine and body if left untreated when all of the factors for surgical intervention are present for a long period of time & remain unaddressed. When considering the degree of the slip, and given the opportunity for the L5 to fall even further, the window of opportunity for fusion was rapidly closing. Even at this point in time, my case required a reduction of some degree prior to fusion. My outcome was a reduction to a grade 5, where I am fused now. This was their minimum requirement for reduction of the slip prior to attempting any type of fusion.

The further a slip progresses, as I shared before, the more complications are likely to be involved. This is simply in regard to the basics of the respective operation(s) themselves - not taking into account any possible negative complications. Unfortunately, performing surgical interventions on higher grades, or complete slips, carry more risk factors, even when all goes as planned. One factor that plays into the equation when attempting to fuse a higher grade or complete slip, is causing nerve damage which was not previously present pre op; as a general rule, there's literally less room/space to place the various chosen hardware & create a fusion, therefore, avoiding the many nerves and the spinal cord itself becomes more of a challenge.

When it comes to trying to reduce a slip (to some degree or another) prior to the actual fusion, there may be other nerve-related complications involved - Specifically that, it likely took several years (or longer) for the slip to progress to that point, which, while unpleasant and problematic in it's own right, this slower progression is less damaging to the spinal cord & multitude of nerves. Reducing the slip - whether performed during a surgery or through slower traction over days and/or weeks - is rather shocking & truly overwhelming to the spinal cord & nerves. By all intents & purposes, the spine is literally being "stretched." This stretching process is where there's a higher likelihood of permanent nerve damage post op, especially when faced with a higher grade slip. While I did not experience nerve deficits from the actual surgeries themselves, I did witness permanent nerve damage resulting directly from the reduction of my slip. Even though we chose to proceed with the less aggressive option of full body traction (in order to best avoid additional 'shock' and permanent damage to the nerves and spinal cord), the reduction process was simply too much for my many nerves, and unfortunately, caused permanent foot drop and other nerve-related complications. Although, I must admit that I am still very thankful for this outcome, as I whole-heartedly believe (and feel), that had we gone with the more rapid reduction, the resulting damage would have been much more dramatic in nature, most likely paralysis.

*If anyone has any questions about what I've shared above, or if I've made a mistake, please let me know. And, just to cover my bases again, I am not a doctor nor a specialist of the spine. But, most importantly, I am also human and I make just as many mistakes as the doctors (lol - yes, docs make MANY mistakes - they just have difficulty admitting to them it seems!).

What I've shared above is based on my personal understanding, knowledge, experience, research and education about this subject.

I hope this document may be helpful to anyone who may be contemplating surgery for this condition - Those whom have questions about when to proceed and when to wait on surgical intervention.

SUGGESTIONS FOR FINDING THE BEST SURGEON FOR YOU & YOUR CASE:

Surgery - no matter what kind - is a big deal! Spinal surgery, like that of open heart surgery and brain surgery, are operations which reside on another level, as they are very much the 'foundations' of our bodies! So, when dealing with, and facing an operation of this nature, it becomes incredibly vital that we seek out as many surgeons as needed & possible. I would encourage anyone in this position to consult with at least 3 different surgeons - and at the very least, please do get a second opinion, even if you feel fully confident with the first physician you located. With this thought in mind, it is also important to seriously consider seeing several types of surgeons; most importantly with this condition, the specialities of Orthopedic Spine & Neurology.

Finding a surgeon to follow you through treatment - whatever that treatment may entail - can be a challenging task in and of itself. I recommend the following factors to best determine if a particular physician may be a good fit for you & your case. While some feel strongly that Orthopedic Spine Surgeons are the best for Spondylolisthesis cases, others feel equally as confident in Neuro Surgeons. Just as there are several factors for deciding upon surgery itself, the same goes for the matter of Ortho verses Neuro. A deciding factor may very well come down to your specific case, situation, and any complications you have pre op. Some physicians will work on cases together, combining their respective expertise during surgical interventions, which if possible, is an awesome route to take in my opinion. In some cases, patients have the fortune of additional surgeons expertise on their case and in the operating room.

Here are a few questions to consider & ask yourself when choosing a Specialist and/or Surgeon:

- Do you trust & respect this Doc?

- Feel confident & safe with this Doc?

- Is this Doc compassionate & caring?

- Does this Doc truly listen to you, hear all of your concerns, and address them appropriately/to your liking?

- Does this Doc have a good record/history with patients & throughout his/her medical practice? (i.e., any malpractice lawsuits, negative surgical outcomes with serious permanent complications, if so, how many & why? etc)

- Do they have a good amount of knowledge & general understanding of the condition itself, as well as any other related conditions which may need to be addressed during treatment?

- Have they dealt with similar cases to your own?

- How much experience & expertise do they have in relation to the condition itself, the type of surgery you would undergo, and what have the outcomes looked like in past cases?

- How many operations have they performed specific to this condition and your particular situation?

- Do you feel 'bullied' or 'cornered' by this doc (in any way) in regards to your treatment/surgery? (i.e., They state there's only one option for surgery, that other surgeons would do the exact same, or that you must do the given operation right now & have you move forward out of fear, etc)

- Is the surgeon advising the best surgical intervention for your particular case, or, on the other side of the spectrum, are they 'pigeon-holing' your case because they are only capable of performing a specific kind of surgery?

- Do they give you positive or negative 'vibes?' (i.e., does something feel 'off' or 'wrong' about them or what they propose to do? Does your gut instinct tell you not to proceed forward with this Doc's plans?)

When it comes to finding a good fit for any doctor, remember to do a "gut check" with yourself. Please, never ever discount your intuitions when it comes to this stuff - They are your "internal red flag" and will rarely, if ever, fail you! Same goes for your body and how you feel. You know your body the best - you're the one living in it afterall! Always do your best to advocate for yourself, your body, and your needs. And, if you're unable to, ask someone you trust to do so for you.

There are many surgeons out there, just as there are many surgical options available - There's no 'one surgery fits all' operation for Spondylolisthesis!

Resource Links for all things Spondylolisthesis

2012-03-08T09:26:00.002-08:00

This document contains resource links for everything involving Spondylolisthesis.
This document contains a compilation of resource links related to Spondylolisthesis. The main intention of this list is to offer everything from general information, treatments, surgical information, disability-related resources, and everything in-between that relates to Spondylolisthesis. I have begun by creating different "categories" as they come to mind. If you have any additional suggestions, please contact me so that I may add resource links to this list. I hope this selection may be helpful when seeking assistance and treatments for a wide array of matters to do with Spondylolisthesis! I will continue to add resource links as I find them, so please check back in the future if you don't see what you're currently looking for ... Please also feel free to contact me at spondyostories@gmail.com with any questions regarding these and other resources!
Are you interested in joining the closed* Spondylolisthesis & Retrolisthesis Support Group on Facebook? Please click on the link and ask to join! My.Spondyo.Group
GENERAL INFORMATION FOR SPONDYLOLISTHESIS:

Spine Health
- http://www.spine-health.com/

Spine Universe
- http://www.spineuniverse.com/

Spine Universe (Pertaining to high grade Spondylolisthesis slips)
- http://www.spineuniverse.com/professional/pathology/degenerative/high-grade-l5-s1-spondylolisthesis

PubMed Health (U.S. National Library of Medicine - Spondylolisthesis)
- http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002240/

OrthoInfo - AAOS (American Academy of Orthopaedic Surgeons - Spondylolisthesis)
- http://orthoinfo.aaos.org/topic.cfm?topic=a00053

SURGICAL TREATMENTS/INTERVENTIONS:

Laser Spine Institute (Endoscopic Spine Surgery for Spondylolisthesis)
- http://www.laserspineinstitute.com/back_problems/spondylolisthesis/

The Bonati Spine Institute (Laser Spine Surgery)
- http://www.bonati.com/conditions/Spondylolisthesis/

North American Spine (Minimally Invasive Spine Care)
- http://www.northamericanspine.com/

Spine Centers of America
- http://www.spinecentersofamerica.com/spondylolisthesis.html

Mayo Clinic (Back Surgery - When it's a Good Idea & Spinal Fusion - Why it's Done)
- http://www.mayoclinic.com/health/back-surgery/HQ00305

- http://www.mayoclinic.com/health/spinal-fusion/MY01235/DSECTION=why-its-done

MASSAGE & ALTERNATIVE TREATMENT RESOURCE LINKS:

Massage Therapist Locator & Referral for the United States (Assists in locating a large number of different kinds of massage therapists/treatments in your given region)
- http://www.massagetherapy.com/

Soma Massage Integration Therapy (Information regarding Soma Massage & Practitioner Locator)
- http://www.soma-institute.org/

Reiki Energy Work (Definition & General Information about Reiki Energy Work)
- http://www.reiki.nu/reiki/reiki.html

Physical Therapy & Occupational Therapy for Spondylolisthesis (Spine Universe)
- http://www.spineuniverse.com/conditions/spondylolisthesis/physical-therapy-spondylolisthesis

Chiropractic Care for Spondylolisthesis (Spine Universe)
- http://www.spineuniverse.com/conditions/spondylolisthesis/chiropractic-care-spondylolisthesis

DISABILITY, INSURANCE, FINANCIAL & MEDICAL-RELATED ASSISTANCE RESOURCES:

Basic Disability Resources (United States)
- https://disability.gov/

Social Security Administration
- http://www.ssa.gov/

Medicare
- http://www.medicare.gov/default.aspx

Medicaid
- http://www.medicaid.gov/

AARP Health (Supplemental Insurance Coverage for Medicare - 50 plus & Disabled)
- http://www.aarphealthcare.com/home.html

Getting Approved for Social Security Disability Benefits (Post Brenna wrote about obtaining approval for SSDI - Suggestions, Tips & Info., derived from own SSDI case & speedy approval)
- http://spondylolisthesisgrade5.blogspot.com/p/getting-approved-for-social-security.html

Health Insurance Plans (Locate and Compare Health Insurance Plans Online)
- http://www.ehealthinsurance.com/

Health Insurance Plans (Locate and Compare Health Insurance Plans Online)
- https://www.affordable-health-insurance-plans.org/
BLOGS & WEBSITES WHICH PROVIDE ADDITIONAL RESOURCES & SUPPORT FOR ALL THINGS RELATED TO CHRONIC HEALTH CONDITIONS:

"The Spoon Theory" document/But You Don't Look Sick (Gives a wonderful sense of what it's like to live with a chronic health condition - A WONDERFUL way to get others in one's life to truly understand what it's like to live with a chronic illness and/or disability! This website, butyoudontlooksick.com, also offers a large array of additional resources.)
- http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory-written-by-christine-miserandino/

Spondylolisthesis Stories (Brenna's website collecting individual's stories regarding Spondylolisthesis)
- http://spondylolisthesisstories.blogspot.com/

Spondylolisthesis Grade 5 (Brenna's personal blog about Spondylolisthesis)
- http://spondylolisthesisgrade5.blogspot.com/

Spondylolisthesis Open Forum on Facebook (Brenna's Spondylolisthesis Facebook Page)
- https://www.facebook.com/pages/Spondylolisthesis-An-Open-Forum-To-Discuss-Spondylolisthesis/255570241154982

My New Spondylolisthesis Group on Facebook

2012-01-17T21:36:00.000-08:00

For all of those with Spondylolisthesis whom are searching for others with the condition, I recently created an online closed support group for Spondylolisthesis on Facebook! I hope that this new group may be a success and helpful for anyone who deals with Spondylolisthesis! After it's fourth day, I'm already learning new things about the condition myself, and connecting with some really wonderful people. Spondylolisthesis is a condition, that while fairly common, both the general public and the medical community seem to know a limited amount about it. It can be a very isolating, and therefore, a lonely condition because of this fact. I was diagnosed with Spondyo in 1996 at the age of 14, following 4 plus years of increasing pain. At the time of my surgeries I had not met anyone with the condition, and had no one to talk to regarding my experiences, pains, and fears. When I began blogging about this condition and a few other chronic health conditions in 2009, I met those with Spondylolisthesis for the first time, and in many ways, it was a tremendous relief, and frankly, rather exciting. No one should have to deal with this amount of pain and struggle, but some of us do, and therefore, knowing that there are others out there who can truly relate is huge! I hope that if you yourself have this condition (or if a family member does), that you may take the time to join this group and see if it's helpful in regards to your questions, frustrations, and so forth. It is a closed group, and therefore, allows for more privacy, as only those whom are apart of the group can see the posts. I hope this fact offers some level of comfort! I look forward to seeing and hearing from you in this group soon! Blessings, Brenna (Cat)

My.Spondyo.Group

Pre & Post Operative X-Rays (From my 1997 surgeries & body traction)

2011-10-05T12:02:00.000-07:00

So, I've been waiting quite some time to take photos of my pre & post operative x-rays from my surgeries & full body traction circa 1997, ... and today I finally did it! Yay! I do plan on creating a more extensive post than this in the very near future, but for now, I will simply post my x-rays from way back when to start things off. I am also in the process of getting copies of my more recent x-rays. Specifically the films which show a better picture of what my spine now looks like as a result of the deterioration, degeneration, and early-onset OsteoArthritis in the L4, L3 & L2 vertebras above my fusion region. In addition, I plan on posting my most recent slip found in my neck, located at the C6 & 7, which thankfully is a grade 1/2, but is certainly still troublesome! If you have any questions or comments, please feel free to type away!

Pre-Operative 1997 - Complete slip called Spondyloptosis

Post-Operative 1997. After full body traction, which increased my height by 3 inches, but L5/S1 still sits at a grade 5 Spondylolisthesis.

What are the best exercises for those with Spondylolisthesis?

2011-10-02T14:58:00.000-07:00

What are the best exercises for those with Spondylolisthesis? Before I share I would like to say once again that I am not a doctor nor a healthcare professional. The suggestions below are based solely on my own experiences, opinions & research. I believe it's important to stay as active as possible when you have a condition like Spondylolisthesis, or any other chronic health condition, although it's often easier said than done and one must exercise caution and truly listen to their bodies, as not to push yourself too hard physically. Just like with so many other things in life, balance is the key. Most of those who have Spondylolisthesis - whatever the grade - know that many traditional activities, sports and workouts are not always feasible. Therefore, finding an exercise that truly works without making your back and body feel less than wonderful, or worse yet, increasing the degree of the slip can be a challenge.

This year marks the twentieth anniversary of my Spondylolisthesis slip and pain. Throughout the years I have tried a number of workouts, some good, some not so much. I was much harder on my body when I was younger. Even pushing myself to do 3 hours a day, 6 days a week, in my teens and early twenties following my surgeries. At that point in time, I felt pretty decent physically. And, as a result of the surgeries and full body traction, my pain had been lessened dramatically. It wasn't until 2006 or so, when I began to experience increasing pain levels and new nerve related issues in my legs. Ultimately, what was going on (besides the fact I have a Spondylolisthesis grade 5 slip which is fused at the L5 S1, nerve damage & pain in my legs & feet, of course!), was new deterioration, degeneration and early onset OsteoArthritis above my fusion region. This is something which was expected, but not so soon after such surgeries. As a result, I had to cut back big time when it came to my workouts.

Because of my nerve deficit's - and my body's way of compensating to walk & function in general - I am not able to go for walks or runs outside in order to get a good workout. I often fall down, whether it be on a flat surface, downstairs and I've even been known to fall up the stairs. Those type of activities and contact sports only increase my pain and throw off my bodies alignment. So, one machine which has been wonderful in allowing me to get in my cardio without hurting my back, legs, hips, knees or feet, is the Elliptical machine. I highly recommend this piece of equipment to anyone with joint problems or a spine condition.

Building core and back strength is also extremely important when it comes to this condition. I have found Pilates to be an excellent form of strengthening, stretching and even a decent cardio workout. Just like Yoga, you can really tailor this activity around your abilities and opt out of those exercises which cause pain. A bonus for this type of workout is that it helps to naturally realign one's body and spine.

Another terrific form of cardio - which is easy on the body & back - is swimming. While I love swimming, I do have great hesitancy towards doing so, especially in public, as I have foot drop, and therefore, trouble walking without shoes. And, walking with bare feet on a wet slippery surface, is a disaster waiting to happen! While I'm on the subject of taking a dip in the pool, I would like to mention something which was shared with me by my surgeon many years ago. For those with Spondylolisthesis, whom have not had any surgery, specifically fusion, working in a pool with light leg weights over an extended period of time can help to lessen the degree of slip by slowly stretching the spine. I was told of one patient who had a grade 5 and worked in the pool for two years before having a fusion surgery to stabilize the condition. She had her Spondylolisthesis fused at a grade 1 following those 2 years of dedication. Amazing!

Finally, I recently started the newer exercise program designed by the trainer Tracy Anderson, called "The 30 Day Method" and the "Tracy Anderson Method." Like with Pilates and Yoga, there are some exercises which are not conducive to this spine condition, but they can be avoided. Most of the work is done on the ground and it really helps to strengthen your accessory muscles, and in addition, surprisingly gives you a challenging cardio workout as well.

Getting Approved for Social Security Disability Benefits

2011-06-26T21:56:00.000-07:00

The economy of both our own country, as well as countless other nations throughout the world, have been strained to a breaking point in the last few years. With this depressed state of being, and massive stress incurred, we witness a ripple affect within our communities, our government, along with the educational and medical systems, just to name a few. We have all been affected to some degree, whether it's radical and life altering, or on a lesser level, but, if you ask me, our society as a functioning unit has become quite the mess to behold and contend with. I would like to venture to make a simple comparison, and say that our present and recent past state of being, is similar to that of a necklace chain, a chain which was once untangled, shiny, and streamlined, but now is a knotted mess. Long story short, we have a lot of "untangling" to do so that we may once again wear that necklace. When one steps back and takes inventory of our countries' many "knotted necklaces," it's very clear that many of our systems do not work as well as we have long hoped, planned and envisioned. But, even with these many broken systems, we are doing our best to continue hobbling along. Our country has many resources which are unheard of in so many other nations, and while it's most certainly an uphill battle to obtain a larger number of these resources for survival during hard times, it is possible, and many of these resources are part of our rights as a citizen of this country.

We are said to have one of the best judicial systems on the face of the earth, some of the best, most advanced healthcare which is sought out by many persons outside of the United States, and of course, the opportunity to "live the dream." While such subjects can very easily garner conversation and agruement for days upon end, there is one I'd like to focus on today: SOCIAL SECURITY DISABILITY. Just as when an individual goes to battle to obtain their rightful compensation for something like a car accident, getting an award for disability benefits can be equally, if not more challenging. As a general rule we each pay out certain funds throughout our lifetime to ensure our safety, future, and health. A basic example: We carry car insurance in order to protect our own interests. With each monthly payment, we have the expectation, that should we find ourselves in an accident (specifically no fault), that we will then be appropriately and fairly compensated. To me, this means that we should not have to fight tooth and nail to receive the amount of assistance required medically and property wise, to rectify the matter. Unfortunately, this is not always the case. It seems, increasingly so, that "we," as a society in general, have to fight (and fight long and hard) to obtain the resources which we are already entitled to. This matter could not be more true when it comes to the question of gaining Social Security Disability. Most of us have heard the horror stories about applying, and trying to gain approval for, Social Security Disability, at one time or another. But, as a general rule, until it becomes your own reality, or that of someone close to you, you are not aware of the massive feeling of injustice and frustration which accompanies it.

I am so often saddened, disgusted, and completely confused, by the way our government so frequently treats those whom are disabled and/or ill. All too often those who find themselves in need of disability benefits are denied said benefits in the name of "saving money." As citizens of the USA, everyone who works and pays into the social security system relies on the concept that should they one day become ill or disabled, they will, at the very least, have some financial support to fall back on if they find themselves in a position of desperation due to health conditions which are not the result of their own desire, fault or hope. Now, let's not get confused, anyone and everyone should know that benefits alloted from our Social Security Department are not large in quantity by any stretch of the imagination, in fact, the majority of those who collect SSDI don't even receive enough money on an annual basis to push them above the poverty line. But, as we all know, some money is far better than no money. And, just as with unemployment benefits, we the people, pay into this system. Those who collect benefits are receiving money they made during their work history. It's not a free ride, and the total monthly benefits alloted to any given person is determined and based upon the person's former income, ultimately the amount they put into the system. And, that monthly amount is only a fraction of what was once a person's monthly income, not the equivelant. So, for anyone to say that these benefits are a "free ride," money the government and other tax payers are providing, are mistaken.

Most of those whom apply for disability are doing so out of great need. They are not doing it for fun, because they are lazy, or want to seek some easy way out of working. Individuals applying for disability are usually in a place of financial strain and desperation, and are more importantly, struggling with a serious illness, disability or other medical condition, which severely hampers their life and ability to function and survive. A large percentage of those whom apply for these benefits the first time around are denied. The second attempt may be more fruitful for some, but still, many receive a repeat letter of rejection. And, we can't forget that the process, in and of itself, takes many months, if not years, before that letter of denial is sent to the ill/disabled citizen waiting anxiously for it's arrival. Along the way, most of those in this long, drawn out process are barely scrapping by to make ends meet, all while facing mounting medical bills and a chronic state of illness. In our nation, within our society and it's many communities, we have a general pattern of waiting until things become very desperate before finally helping a person climb out of a deep hole. We build our cities this way and run our healthcare system in the same fashion. Instead of placing a higher value on people, we want to take all the short cuts, throw quality out the window, wait until things are horrible and falling apart, and then we "fix" them. And, ultimately, in these given situations, we have to put much more money into a problem than we would have incurred if we had only taken preventative measures in the first place and spent a little extra doe in doing it right. Is it greed? Is it the lack of patience? Probably. Do we ever learn from this pattern, a broken way of doing things which only seems to leave us in a more desperate place? Seems like the answer is all too often, no. So, while one person cannot change the world, this country, or the various systems we contend with, when the focus is smaller, working only on what we can each do as individuals in our own lives, we learn how to advocate for ourselves and make the system work for us. Learning how to advocate for ones self creates a shift in power and makes life a little easier, and a bit more fair, if you will. I am not claiming that this action and way of being is easy by any stretch of the imagination, but, it does assist in reducing the overall anxiety, feelings of failure, and stagnancy. It also serves to make a person who feels less than powerful, reclaim more control over their lives and their circumstances.

I am certainly not an expert in matters with Social Security and Disability benefits. I don't know all of the laws, loopholes, or answers for why it is so darn hard to get approved for these benefits, but I do know what I've learned along my journey and I would like nothing more than for my experience and understanding to help others who sit in similar struggles. I applied for Social Security Disability benefits in January 2009. I was ready to receive a negative response, a letter of denial, the first time around, and knew that I would likely need to hire an attorney. Just the thought of it made my blood boil. Tell me of one person who is chronically ill, or deals with a serious health condition, who has the energy and resources to fight the system! If you are applying for disability, it is pretty much a given that you are already exhausted, fragile physically, financially, and likely emotionally as well. And that feeling of being "beat down" seems to be pretty universal when it comes to such matters, and well, just as insurance adjusters know this of most of their clients, so do the officials deciding cases for such benefits. I thought to myself right off the bat, "do I have that fight in me? Could I go to war again with something else involving something so important in relation to my health, my future and my life?" I wasn't sure, but I did know that no matter what, I needed to take one step, one day, one problem at a time. Otherwise, I was surely going to crumble from the pressure, feeling of defeat, and sense of both hopelessness and powerlessness. It's hard to go to battle with anyone, especially a big system or corporation. But, if you don't learn to advocate for yourself, no one else will. You may not always get the answers you want, but, laying down and giving up certainly doesn't make the process any easier either.

BELOW I have included some of my findings regarding HELPFUL HINTS in GETTING APPROVED for DISABILITY. They are not a guarantee for being awarded benefits, but most certainly can help, and perhaps make your process a little less stressful and mysterious. When all's said and done, it feels best knowing that you have tried and done everything to the best of your knowledge and ability ... leaving no stone unturned.

As an individual with a very lengthy medical history (one which is very complicated as well), I have found tremendous importance in making sure that I have all my records at my own disposal, even though my doctors, and the medical system itself, has them on file. It's your right as a patient to have all of your medical records, and as a general rule, whether you are ill, disabled, or seemingly healthy, you do yourself a great service to collect all past, present, and future medical records and keep them in your possession. Even while it's the responsibility of a medical system/practitioner to keep your records on file, you never know what could happen to said records, and you are much better off safe than sorry. Medical records have been known to "disappear," both via accident, and some through intentional, but illegal, disposal.

To request and obtain your records you are required to fill out a medical records release form. You may contact your medical office's Medical Records Department by phone and fax, but you are better off actually visiting this department in person. If you have more than one medical provider, including specialists and other healthcare practitioners, you may need to fill out multiple release forms, especially if you have been seen at different hospitals and within more than one medical system. Make sure that you collect every piece of your medical record; including any scans, x-rays and test results. There is a section on the form where you check which records you are requesting, make sure to check all of the boxes, and if something is not listed/specified, make sure you check the "other" box and explain the record(s) you are seeking. Yes, you may be required to pay a small fee for some of your records (more specifically your actual physical scans like MRI's, CT's and x-rays), but, trust me, if you find yourself in a less than lovely situation in the future where you need those records and they have magically disappeared, it could mean the difference between a proper diagnosis, denial of benefits, or even a smaller settlement for a medical malpractice lawsuit.

Do yourself a big favor and create your own medical history file in your home or place of business. This is YOUR RIGHT as a patient. Your medical provider and/or insurance company cannot deny you access and copies to your medical records, and you do not have to disclose your purpose for requesting them, period. If you feel hesitant for any reason, simply mark your reason for request as "continuing medical care." This reason is never a lie, because as long as you are alive, you will always be receiving some form of ongoing medical care. Once you have copies of your medical records, review them and make sure that they contain your entire history. Never give these records away. If someone needs to view/copy any records, make sure you tell them that these records are your own personal copies and must be returned/not kept for use in any new files. Be careful with this matter, as with some medical offices, once you allow transfer of possession, even if you tell your doctor that these are your own personal copies, they can then be kept in their files and they will not release them back to you. I learned this the hard way. So, please ensure that any records you carry with you, are copied and returned to your file/possession that same day. No files left over night!

When it comes to applying for disability and submitting your case, you want to provide as many medical records as possible. Once you've applied for disability your case worker will request your medical records from various medical practitioners and departments. Do your best to follow up and ensure that they have access and information needed to obtain all of your medical records, as you don't want or need any records, doctors, diagnoses, treatments, and so forth, to be overlooked or not considered. Obviously, the larger degree of records you have, the more serious your condition(s) appears, which therefore, shows an overall greater need. Following along these lines, also remember to include all of your medical diagnoses when you first create your application. Including even those medical conditions/diagnoses you may feel are minor, non-important, or unrelated to your main concern and disability. Again, the more you have, the greater your need appears to those deciding your case. Yes, some of these conditions may very well not affect your life, disability, illness or overall functioning, but, you still have the diagnosis, and so, if you have them, use them to your advantage!

When it comes to applying for SSDI, speak with all of your medical providers beforehand, or at the start of the application process. Visit with, or contact any and all of the doctors, medical professionals and specialists who may be involved with your past, present and future care. Even if the medical professional only played a small part in your diagnosis and treatment, they may have additional and helpful information for your case. Just as with your number of medical records, the longer your list of healthcare providers (and more diverse), the greater the need and severity of any given illness/disability is presented. Request letters of explanation and referral from as many of these healthcare professionals as possible. Any letters on your behalf (more specifically letters which carry more compassion and factual information which detail how these conditions have negativity affected you and your life), even if they are short and simple, go a long way in developing a better case for obtaining approval. Letters from medical professionals are essential (do try to think out of the box too, as primary care doctors are important, but specialists and other healthcare professionals like therapists paint a more diverse picture of your struggle and general need), as they have the medical expertise required to punctuate your medical diagnosis outlined in records, and such explanations better put a face and life to the various black and white documentation. Also, letters on your behalf from individuals in your life outside of the medical arena are also helpful. Seek out as many people in your day to day life, both those within your family and extended friends, in addition to your co-workers, and request letters directed to the SSDI department as well. You can create a general outline of a letter and have each person either add to it, or simply sign it, or rather, they can start from scratch with their own. While such letters will speak to your illness and/or disability, they need not be as medically focused/centered as those provided from your doctors and other healthcare providers. Rather, these more personal letters are better suited in sharing actual observations and feelings. Have these selected friends and family write something on your behalf which explains what they've observed in relation to how you have affected by your health problems; what has changed in your life and how you may benefit from assistance with disability income. When I applied for SSDI I had a number of people write letters on my behalf and I strongly believe that it positively affected the decision of my case.

I realize that the process of applying for disability is a long, stressful, frustrating, and all too often, a daunting task. I know that the points I have mentioned above may not be a guarantee for an easy case, but I do hope that by using these tips a few people may find their own application process a little less difficult, and perhaps even a bit shorter from start to finish. Just as with advocating for your own health and learning how to navigate the medical system, when it comes to seeking disability benefits, one of the best things a person can do for themselves is to research and acquire as much knowledge on the subject as possible. It most definitely can be a lot of work, and I understand all too well how much of a struggle this can be. When you are dealing with a chronic illness you have a limited amount of energy and it's a challenge to determine where to best use that energy at times. But, for myself, I have found that matters to do with disability benefits and medical related issues are areas which are to my benefit to spend my limited energy. I hope that if you are wading through the process of a disability application, that you do not give up, continue to fight, and always advocate for yourself. You deserve help and respect. These benefits are your right as a US citizen who has worked hard for x amount of years, and it's simply not acceptable for anyone to say otherwise. You are not alone, even though it may very well feel this way.

Chronic Pain Anyone?

2011-06-03T00:36:00.001-07:00

Chronic pain. The phrase, or rather, state of being, makes many of us cringe with great discomfort and resistance from the get go ... but unfortunately, so many of us deal with it every single day of our lives. It makes daily functioning - everyday activities - extremely challenging, and affects many, if not all areas of our lives. Those who battle chronic pain know just how much it can affect energy levels, attitudes, mental and emotional states, along with our general interactions and behaviors in the world. It is always on our minds, sometimes so much so that we cannot sleep, participate in activities, even eat. Chronic pain literally drains us; depleting our energy levels so much so that it is a struggle to get out of bed some days. And, once we open our eyes and make that first movement to get out of bed, we are faced with the challenge of "getting going," so to speak. We quickly and easily become exhausted from dealing with the pain which emanates throughout our bodies, and for some (myself included), the pain is so great that it feels as though one's body has been hit by a mack truck during those hours of sleep. Depending upon the cause and source of the pain - which may be experienced in a variety of ways - one thing seems to remain consistent: It is a daily struggle which is always present, creeping into every aspect of our lives.

Pain is our body's way of telling us that something is not right within one of our many body systems. It is meant to alert us to a problem, and in turn, we are suppose to either "fix it," or stop the action/behavior which is causing the pain. But, when we are faced with a permanent health problem/condition/illness that results in continuous pain (and therefore, the problem is not fully corrected), we have to seek out different ways of "solving" our pain problem. So many of the "solutions" for chronic pain, provided by the medical community, are more or less "band-aide" fixes. Of course, there is the popular "medication fix," which does not truly address the problem, although for those that have too much pain to deal with life, it is often a necessary evil. On the positive side, medication may assist in decreasing pain levels, resulting in the body conserving and directing more energy towards healing the core problem(s).

Surgeries, and other medical procedures, are common place for western medicine providers as a means to solving pain related conditions. But, I must say, that in my experience many of these "solutions" only lead to more problems, rather than fixing the underlying issues. And, I fear that there are a few too many doctors out there whom are a bit too excited to jump to the surgery route, but, that is just my humble opinion, not a fact. Of course there are situations that require surgical interventions in order to save a person's life, and I understand this as well, as I faced a similar dilemma. In my personal situation, while my operations and procedures promised not only to save my life (which they did), and reduce the pain (to a good degree for several years), the outcome was far from what was suggested or anticipated, and to be frank, my pain remains a life long struggle. When an individual does require surgery, more often than not there remains a mix of ongoing and unpredictable problems as both a direct and indirect result. It's typical, at least in my experience, that many doctors and healthcare providers often bill a given procedure or surgery as a complete fix; a fix that promises a solution to the given condition, end of story. All of us dealing with chronic pain - whether it arose from a spine condition, injury, illness, or any other countless health condition - know the truth. And the truth being: That there is no true "fix." No matter how grand, no matter how praised the procedure, or skilled a physician, there is no simple, quick or perfect answer to the pain problem. So many people want to believe in that fairy tale. And it is understandable, as we hate to see our loved one's in pain and suffering firsthand is not a joy either, especially if it is a long term and daily experience. It seems unending, and honestly, much of the time, it is.

Medical science has come a long way in a short period of time. That much is true. But, for all of you fellow chronic pain sufferers - those whom battle chronic ailments and diseases like cancer, auto immune diseases, spinal conditions, transplants, severe infections, and so much more - know that no matter how spectacular the presented solution appears, there is no band-aide which truly sticks. This is why I have believe it is so important for those who suffer with chronic pain to share our stories and provide each other support, empathy and compassion. While there are many causes for our pain, we all deal with similar struggles, face the same challenges, battle the same attitudes, navigative the same painfully broken medical system, and fight for a sense of normalcy with everyday that passes.

I hope that anyone and everyone who deals with chronic pain may feel that they can share their stories, their tears, their anger, and their accumulated knowledge & experience on this page. I hope that we can provide each other some support, resources, and the "do's and don't's," all in the name of decreasing the pain. Chronic pain sufferers are the only ones who can truly empathize and hear other chronic pain sufferers. The same sort of rule is witnessed with both chronic illness and other serious long term health conditions. It is a struggle to get others in your life to really "get it." I find that while they try to understand, try to sympathize and be compassionate, it is nearly impossible for them to understand the full magnitude of chronic pain when they are not in it everyday, every minute, like we are.

I know that many of us try to remain quiet about our pain, not to bother our significant others or family and friends. And that as a general rule, we try to avoid sounding like we are "complaining." And we are not complainers. We are usually survivors ... courageous survivors at that, and all of whom endure far more than anyone should ever have to deal with in a lifetime. It becomes beyond frustrating to get others to truly understand that we do not enjoy being in pain, nor do we enjoy having the same answer to the question, "how are you feeling?" This struggle often interferes with, and strains relationships and friendships. It can make us doubt ourselves, our bodies, our minds, and can result in an internal, and seemingly hopeless battle of anger, frustration, and sadness.

I believe that this issue is similar to the struggle so many of us face with doctors, and convincing them how we feel in our own bodies. We know ourselves better than anyone else. Yes, even better than the "god like," "know it all" doctors, whom often try to tell us we are crazy or depressed when they can't find an answer to our pain and constellation of symptoms. It is an easy train to jump on, not to mention a frequently travelled train ... It allows the doctor to appear competent when they doubt themselves (which they rarely admit to), and with their authority and status, we begin to doubt ourselves, believing that our pain is not real, or that we are crazy, selfish, and/or attention seekers. It happens so often that we begin to ignore our best advocate; our intuition. When we are ill, dealing with so much pain, facing daily fatigue, and literally struggling to get through the day, we have little energy left to battle doctors, question their authority and push for help. I have experienced this first hand more than once, and it nearly resulted in my death, and ultimately changed my life forever. I would like to note that I do not dislike all doctors, and do promote visiting a provider(s) whenever your health requires. But, I want to emphasize how important it is to listen to your own voice, trust your gut, and not buy into the idea that the doctors know all and should not be questioned. From both my own personal experience, and from observing and listening to other's, I have seen a pattern that seems to occur far too often, one which I find frightening.

I will post blogs to this page that describe various personal experiences in the "field of pain"... situations, stories, experiences, and interactions, that others that would likely not fully or truly understand, unless they too have been in the throws of chronic pain. I will also add my findings when it comes to what has worked for my pain, and what hasn't cut it. Two treatments/practices already mentioned in the blog include Soma Body Massage Work and Reiki Energy Work. You may read more about the practices themselves, as well as how they have helped relieve my pain. There are additional website links provided which are related to sites which further detail the practices and where you may find providers in your area. If you have any questions about said practices, please don't hesitate to contact me! Also, please add your own suggestions, as we can never have too many ideas and suggestions for the relief of pain!!!

My desire for this blog subject is simple: I hope that it may allow a dialogue to open between all of those whom experience chronic pain, so that we can share, support one another, listen and truly hear each others pain and struggles (because sometimes that's all we need; no judgement, no comments, or even suggestions, just someone that really knows how you feel and can therefore provide validation in your experiences). There are obviously a lot of different ailments, and with all these various conditions comes a variety of surgical procedures/options ... Some are more successful than others, some are "newer" and/or "experimental," and many can only be found at certain medical hospitals, universities, communities. If you have information regarding any procedure, providers, hospitals, etc., please provide any details that you may deem important and ultimately helpful to someone dealing with the same or similar situations. From my experience, given the level of patient privacy rules these days, it is often hard to get all the information you need, the nitty gritty of the details, what to expect, how a doctor performs (even personality), and all can help a fellow chronic pain patient find a good fit for their health care choices....hopefully, making their future a bit better through knowledge that may allow them to avoid certain things, and ask certain questions.

Spondylolisthesis: My Story ... Round One

2010-09-07T18:51:00.000-07:00

Between the ages of 13 and 14 years old I began to experience pain beyond comprehension. I spent a great majority of my time pretending that my back didn't pulsate in pain, that strange shooting dagger like sensations didn't throw down my legs, and that my body hadn't come to look deformed in the trunk region, with the actual Sacrum protruding out approximately an inch from my low back. I was entering my teenage years and everyone else was fine, so why shouldn't I be? Besides, I had been to a number of doctors starting around the age of 10 or 11, all of whom said I didn't have a problem ... no cause for pain. So, it must be in my imagination, I thought ... Or rather, everyone must feel this way, right? Wrong. After playing many sports throughout my childhood, all of which I loved and enjoyed dearly, I had come to a point at the age of 12 where I could no longer take it, I simply could not run, move and interact in the same fashion that I had always known. Mind you, at this point I complained rarely, as once again, the doctors, the authority figures of my health and body, said that I was just fine. Not one made mention of a spinal deformity becoming so severe that it may ultimately take away my ability to walk, even to function and survive in the future, should there be no intervention or treatment. I didn't want to create problems ... I didn't want to be so different that my world would be flipped upside down for the rest of my life. But, I knew that there was something terribly wrong and that I had to voice my fears and concerns once more to both my parents and doctors.

On a weekday after one of my first days in high school, I was sitting in my father's living room, I gulped and sweated in silence, trying to figure out a good way to show him the ever increasing lump on my back and share the pain that I was in. I had already sporadically displayed minor amounts of discomfort in my parents' presence, especially after quitting all sports, but nothing that would truly display and outline the extreme fear, pain and uphill battle we were all about to face. I cannot recall the details, just the look on my dad's face when I lifted my shirt to show him the painful protrusion. Just like my skin appeared for that last year before my surgeries, his face went a pale grayish green and I knew the severity of the situation. I began to cry, tears flowing from my face faster then I could stop them, and I finally let go. He held me in his arms and began calling people for immediate appointments. Finally, my parents knew what I knew, and that this was no figment of my imagination, not a ploy to gain attention or get out of playing sports, as the doctors had once suggested. This was real ... extremely real. And it had to be addressed with emergency speed.

I was sent to several doctors in my city, all of whom, thankfully, referred me on to the bigger and better specialists in the Orthopedic field. I had Spondylolisthesis at a degree that was so severe it made the doctors both excited and fearful. In all actuality, due to the degree of slip, my spine was labeled with the condition Spondyloptosis, as it was beyond that of a grade 5, the most severe slip on the Spondylolisthesis grading range. My spine at the L5 had not only slipped from the vertebra below, but it had collapsed, fallen to a degree of more than 3 inches, so that the L5 was actually sitting parallel with my S1 or my Sacrum. The severity of the situation was such that a surgery, or rather, series of surgeries and procedures, must be scheduled within the next year, but preferably, the next six months.

Spondylolisthesis

2010-09-02T18:08:00.000-07:00

Spondylolisthesis is a spinal condition in which one of the vertebra (usually the lower Lumbar region & Sacrum) slips forward from the vertebra below. Spondylo means spine, and the word listhesis, literally means to slip. While this condition is actually fairly common in general the population, it is rare for the condition to slip to a degree which is great enough to create problems. Physicians and the medical community label the varying degrees of slippage, from least to most severe, as grades 1 through 5. A complete slip, beyond that of a "grade 5," where the vertebra no longer sits on the respective vertebra below, is called Spondyloptosis. This condition can occur at any vertebra level, but is more commonly seen in the lumbar region of the spine. This is the area in which I experienced my Spondyloptosis. I am now considered a grade 5 Spondylolisthesis following a series of surgeries, procedures, a full body cast and extended therapies. My spine is fused from the S1 (Sacrum) through the L5 & L4 (Lumbar).

There are a number of debated "fixes" (surgeries/procedures) for Spondylolisthesis, but due to the infrequency of the condition becoming severe enough to require surgery, they are more experimental than common practice, in my opinion. I am not a doctor, nor am I an expert on this condition, that is, if you consider an "expert" as someone who has specialty credentials in the medical field. Rather, I am simply an individual whom has dealt with this condition first hand for my entire adult life, not to mention the majority of my juvenile years as well. My hope for this page on Spondylolisthesis is to utilize the power of the internet in order to reach as many individuals, in all age groups, who may be dealing with this condition in their life. Whether the condition is labeled at a grade 1, or a case more severe, I hope that my personal experience, insight, and research with regard to the spinal abnormality, may help as many individuals as possible. This condition tends to be less well known than other conditions and diseases, and due to this fact I found it difficult to connect with any fellow sufferer's during my painful, tough, and life altering struggle with this extremely painful condition since my initial diagnosis, I hope to create new dialog and connections within the orthopedic community.

As I mentioned previously, there are several treatments for this condition, which are ultimately determined by the grade level found in any given patient. I believe that it is highly important for anyone whom faces decisions regarding this type of serious medical intervention be able to obtain as much information as possible prior to moving forward with any treatment plan. My recommendation is to thoroughly researching the condition itself, the various surgical and non-surgical options, statistical outcomes, possible side affects, and even the prospective physicians whom specialize in this very unique condition, as all of these components are essential when it comes to advocating for yourself as a patient with Spondylolisthesis. Not only are there several more commonly practiced surgical and medical procedures offered as treatment, but there are also a few alternative options that may work well from both an intervention standpoint in addition to that of preventative measures. The better bet is seeking a combination of treatments, which may result in a more rounded and promising future for a patient.

Treatment is often determined by the severity, but even in the most severe cases, there are a few options that may not be presented or addressed by a provider, therefore limiting options, and resulting in a rush for the operating table. Now don't get me wrong, I am not opposed to surgical intervention, as my condition was very severe, and without immediate intervention, my overall quality of life would have been bleak, even fatal. I would also like to note, that like many surgeries, whether it be on your spine or your heart, surgical intervention may assist in increasing the overall quality of life, but it rarely, if ever, makes one "normal" again, nor "fixes" the health issues completely. This is a myth. There will always be a sort of "life long up-keep," which is required to assist in allowing your body to function in the best way possible, in a less than normal state. Again, this is my opinion, which is based simply upon my personal experiences, observations, and research.

I hope that anyone who may be just learning of this condition (parents who are educating themselves with regards to their child's recently diagnosed condition, any adult that has just been diagnosed, and is seeking information, resources, options and help, along with those veteran Spondylolisthesis sufferers), may take time to research the condition to the best of their ability, ask many questions, thoroughly investigate all options that may be available (both western medicine and alternative health care), and feel free to contact me with any questions, advice, stories, or anything else that may be prevalent to the goal of assisting each other in making the pain, along with our general quality of life, a little better.

This condition is a life long presence and battle. It can be very scary, painful, and all around difficult. I will share my timeline from my earliest pain and symptoms, to my surgeries, and ultimately, my current struggles. I pray that this page may help both those facing a Spondylolisthesis diagnosis, along with anyone whom finds themselves seeking support for a family member or friend. Even if I only manage to reach just one person struggling to stay afloat in this overwhelming process, I will be grateful that my painful experience was able to make another's less frightening and isolating. I know that there are others out there, and I cannot allow those whom are facing the same daunting unknown, struggle through the darkness, when I have already walked the journey.