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Re: L5-S1 replacement and Ironman [resqd1] [ In reply to ]
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I'll throw in my experience, though I haven't had disc replacement, nor am I any kind of medical professional.

February of 2019 I slipped on some ice getting out of my truck. What started out feeling like a pulled hamstring got slowly worse over 6 months (still bike riding though), and had a traumatic event in late August 2019 when I sprinted in an unrelated workout. Basically I have shooting pains down the back of my leg whenever I bend over or pick something up. Chiro was ineffective. MRI confirmed L5-S1 herniation. Cortisone was ineffective. Scheduled surgery for June 29th. Just a few weeks before that a sneeze triggered another herniation at L3-L4 (confirmed by second MRI). Convinced the surgeon and insurance to cover both at the same time.

June 29th microdiscectomy at L5-S1 and microdiscectomy/laminectomy at L3-L4. The latter was completely sorted, but the L5-S1 is pretty much exactly where it was before surgery. Well, that's not quite true -- there's now a constant component to the pain, but the peak pain is *slightly* less. Just had another MRI last week and will see the surgeon again next week to discuss options going forward.

So I'll be keeping tabs on this thread.

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Re: L5-S1 replacement and Ironman [TriBri00] [ In reply to ]
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TriBri00 wrote:
so I am a doc, actually an interventional pain guy and I treat this problem daily. Most of my folks were not IM ready anytime recently or ever.

A couple of items stand out from your story. I gather you are a firefighter in California. Firstly, thank you. Secondly 38 days out there is a tremendous stress. Before moving to a permanent option like surgery consider PT, injections, and rest/time. All of us here understand your need to return to competition, but a few months off of your usual routine may be better than surgery. That said, lumbar surgery is sometimes needed. Best outcomes are seen when the surgical indications are clearest. That means an anatomic abnormality like spondylolisthesis (bones out of alignment), disc herniation, or foraminal stenosis.

Lumbar disc replacement has fallen out of favor. The rationale behind it makes sense but the long term outcomes were not better than fusion. I'm not saying that your surgeon is wrong, but I'd recommend a second opinion. I have a buddy here who is 60 and running after L5-1 fusion and a Boston qualifier at that. Hope that helps, PM me if you want.

b

FYI... I connected with Grant today... and saw his images. I told him the same thing, injections first... then surgery as a last resort. The good news is that he doesn't need a disc replacement or fusion. A simple microdiscectomy is the right move (assuming he doesn't respond to non-operative stuff).
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Re: L5-S1 replacement and Ironman [resqd1] [ In reply to ]
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Do everything to avoid Surgey and if you still can't get it better then Surgey is last resort.

I could hardly work or walk 3 months ago. I ran 2 miles on Sunday, not pain free but its a start.

2024: Bevoman, Galveston, Alcatraz, Marble Falls, Santa Cruz
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Re: L5-S1 replacement and Ironman [Toothengineer] [ In reply to ]
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Copy. Thanks. Kona huh. I’m
Jealous
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Re: L5-S1 replacement and Ironman [Toothengineer] [ In reply to ]
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Brendon, how did you end up with the messed up disc. Was it tri workloads combined with dentist work bent over?
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Re: L5-S1 replacement and Ironman [devashish_paul] [ In reply to ]
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Pretty simple Paul.....

Not enough swimming not enough core and weights past few years combo that with long rides during COVID and a couple 4-5 hour dental procedures once returning to work full time = herniated disk. Crappy injury.

2024: Bevoman, Galveston, Alcatraz, Marble Falls, Santa Cruz
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Re: L5-S1 replacement and Ironman [Toothengineer] [ In reply to ]
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Well that sucks

Covid19 = no pools
Covid19 = getting detrained for your professional job (leaning over fixing teeth all day)
Covid19 = more time to do long rides
Covid19 = Gyms closed if you were using them for core work

Hey, I don't know if you have a rowing machine (or access to one), But if the pools shut, then you get the core work done right there....but if the pools are open, lots of dolphin kicking on stomach no breathing, on each side, on back. The nice thing for both rowing machine and dolphin kicking is you can do it to the intensity that your spinal limitations can handle other land based core work because these are non weight bearing scenarios so you can modulate the workload. Best of luck. Are you already qualified for Kona 2021?
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Re: L5-S1 replacement and Ironman [devashish_paul] [ In reply to ]
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devashish_paul wrote:
Well that sucks

Covid19 = no pools
Covid19 = getting detrained for your professional job (leaning over fixing teeth all day)
Covid19 = more time to do long rides
Covid19 = Gyms closed if you were using them for core work

Hey, I don't know if you have a rowing machine (or access to one), But if the pools shut, then you get the core work done right there....but if the pools are open, lots of dolphin kicking on stomach no breathing, on each side, on back. The nice thing for both rowing machine and dolphin kicking is you can do it to the intensity that your spinal limitations can handle other land based core work because these are non weight bearing scenarios so you can modulate the workload. Best of luck. Are you already qualified for Kona 2021?



I blame Jack Cartwright; he started waiting to do all these 6+ hour weekend rides to cool areas of texas we never ride to! lol

Good idea on the rowing machine; I am not sure how it works once the back is hurt but yes I should have done more of that.

Yep one year ago I put together a solid race at Florida to get back to Kona.


To the OP I went back and reviewed my notes from my chats with other with back injuries friends and my friends that are surgeons..... a replacement is one of the more aggressive procedures you can have done. I would really look at all options, disc issues are not quick things to heal. Your looking at 12 months for the connective tissue to scar over due to lack of blood supply to the area. I would try to stay moving as much as possible even if its just walking. In Aug I was able to walk 1 mile in about 22min it was such a success!

2024: Bevoman, Galveston, Alcatraz, Marble Falls, Santa Cruz
Last edited by: Toothengineer: Nov 4, 20 10:42
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Re: L5-S1 replacement and Ironman [Toothengineer] [ In reply to ]
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With the rowing machine (or dolphin kicking in the pool) you can go really light on resistance because there is no gravity connecting your sole of feet to your sternum...so you can work with a subset of your full body weight in terms of application of force which is golden when you have to rehab...eventually you can apply as much force as you want and your back can take, but that's where we have to check that our brains don't write cheques that our bodies can't cash.

I 1000% agree with my experience of getting as mobile as possible as early as possible. Once I was able to return to jogging at 7-8kph it was like magic happened and pretty soon I was running at a fast enough pace to win local age group (OK was 54 at the time, so no one is running super fast). But it took forever to get back to both walking and running. I could swim and use the rowing machine long before that, but my scenario was pretty bad. I was semi paralysed and could not get across the kitchen to get a coffee and needed my wife to do that given you can't carry a coffee and use crutches at the same time. For several years my daily trip to the pool was the single time that I was pain free...until I got back on land.
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