PCP wants me to have back surgery b4 wls

I posted this in my OH blog, but felt I needed to share it.

I have had back issues for 15 years. I had surgery to remove scar tissue in 2001. The pain started up again almost immediately, but I haven't had insurance (other then a short, short blip with Medicaid) since then. Now that I have, I went to my doc and we did the physical therapy route until my PT told me she couldn't help me anymore. I ended PT worse then I started it. Then we tried steroids (while I'm on the doc supervised pre-wls diet) which brought a minimum of relief. Then she finally had me get an MRI. The results were in and it wasn't pretty and the bad news is that I need another back surgery.

My PCP is encouraging me to go for that surgery first. I am going to fight it tooth and nail. They say that the damage is so bad that weight loss will not help it. Only surgery. You know what... I think they are wrong. I think it will help. How can it NOT help to lose weight. I carry most of my weight in my stomach. What is that pulling on? My back. I have a huge butt.. what is that weighing on? My back. So I am going forward with wls and lose weight for at least a year, THEN I will consider back surgery. So there.

Opinions? Advice? Support?

I agree with you that taking that weight off will help, but it sounds like it will maybe only help with pressure/pain relief. It sounds like you do need another back surgery, but I would be inclined to agree with you to get the wls first so that when you are recovering from back surgery, you aren't gaining even MORE weight to put pressure on it as it heals. That's my thought process, though. Best of luck, this isn't an easy situation. *hug*! 

Abby

EDIT: I just noticed you are having RNY! This may be why they want you to have the back surgery first as RNY, from what I understand, really limits the types of pain meds you can take. So this is a toughie. I can see why the PCP wants you to do the back surgery first now. :( 

I agree with you too. Get the weight off before you get back surgery. I had back surgery before I gained weight and I can not imagine trying to heal from back surgery at a higher weight. When I did get heavy the pain in my back started to return a little and when I lost the weight it subsided. Give yourself 6 months or so and lose all the weight you can as fast as you can and then have back surgery. We can help you stay healthy with vitamins and protein in the mean time if that is your PCP's worry. The PCP may be thinking you're going to be all sickly and anemic post-WLS but you don't have to be. We LWs have ways to keep you healthy!

--gina

ETA: I just read Abby's edit and she makes a good point. You might want to check out the sleeve (VSG) or the duodenal switch (DS) if you're going to need to take NSAIDS for your back. For DS surgeons on the west coast see www.dsfacts.com .

Kelly,
Sorry you are having more back problems.  I bet losing weight would help it feel better but maybe not cure what is wrong.  I would check the kinds of medicine you are taking since you are having RNY like the others suggested.  You really can't take NSAID's.

Good luck and be sure to keep us posted on what you decide.

Linda

Even if you eventually consent to the back surgery...recovery and physical therapy will be SO much better if you were at a lower weight.  Your PCP is looking at this backwards!

What a tough call! I want to share a different but perhaps similar experience. I had an undiagnosed stress fracture in my knee at the time of my RNY. It caused problems because I had trouble walking, which is needed to get the bowels moving and the gas from the anesthesia out. I also found myself taking the hydrocodone for the knee pain instead of the surgery since I could not take NSAIDs.

I am sure that my weight loss has helped my knee to heal but the initial recovery was made tougher. Our situations are different but please think twice about delaying the back surgery. This is a situation where there is not a perfect solution but rather trade offs. I am sure you will come to the right decision for you. Good luck, Kelly!

Amy

Thanks for the support, folks, I needed it. I have no intention of having the back surgery until at least a year after my wls. I honestly would rather live with the back pain for the rest of my life, then deal with my weight the rest of my life. I've adjusted to life with back pain and I just can't give up my chance for the wls at this time.

I will, however, discuss the best surgery option with my doctor, but I really am content with my choice of the RNY.

I truly appreciate the folks who brought up the NSAID issue. I knew about that, but I didn't connect that issue with the need for pain meds after back surgery. It was something I needed to be aware of.

I love this board. You guys rock.

Kelly, I had back surgery in 2006 and I HAVE to take NSAIDS. I have arthritis in my spine as well as other issues. The alternatives they suggested for pain at the surgeon's office for pain, I was already on so it was necessary for me to have a surgery that allowed me to take NSAIDS. Since the sleeve alone was not an option with my insurance, the DS was it.

PLEASE do not discount your need for pain relief after surgery. The RNY is so limiting, it allows for only a few alternatives, none can really touch the pain. I know, btdt.

Please reconsider at least the sleeve.

But, yes, have the back surgery AFTER your wls. Otherwise is backwards. You will be 6 months or more recovering from back surgery, depending on what they do...I know I was out of commission for 12 weeks in a cast relearning just to sit and stand.

Liz

Ok... I got confused and I'm all good now.

When you all said no NSAIDS after surgery, I thought that meant no pain meds, like post surgery pain meds like Percocet or Vicodin. I knew about no ibuprofen for everyday pain. I was sitting here thinking if I couldn't have Percocet after back surgery I'd really have to think about it. lol Not true, however, as the narcotic pain meds are not NSAIDS.

As far as ibuprofen for daily back pain goes, it doesn't matter as it has never worked. Ibuprofen has never even touched my back pain, so I'm not worried about it.

Feeling so much better, as my confusion clears.

 Hi Kelly

I am a back surgery vet too. I had all my back surgeries prior to WLS and probably will have to have at least one more in the future. I had two discs that had torn all the way through at L4-L5, L5-S1. The first surgery they removed scar tissue and did lamenectomies on both levels, 2nd surgery they removed scar tissue and repaired a dural tear and 3rd surgery did a cicumfrential fusion on both levels. I still had pain after the fusion and was hoping the weight loss would make the pain go away. I am sorry to tell you in my case it didn't and my weight loss surgeon had told me not to get my hopes up too high that it would make the pain significantly better.  I do have much better stamina and the pain is better but not gone. I am still on chronic pain meds and flexeril. As the other posters said I would definitely look in to the VSG or DS so you could continue to take NSAIDS. I miss them a lot even though I really shouldn't have been taking them prior to surgery due to kidney issues. I did take ibuprofen when the narcotics were not effective. The NSAIDS work so much better for the back/leg pain. I wish I could tell you differently but like someone else said the back surgery recovery would probably be easier with less weight. I got up to my highest weight when recovering from the fusion because of the exercise limits waiting for the fusion to take. I wish you the best in your journey and your decisions.