I saw Mr Sepahi this morning. His initial view was that things were not too bad, but he was surprised and confused as to why the problem was reoccurring. He said he was pleased at how well the release of the herniation had gone last year, with a better outcome shown on the early images than he had expected. However the fact my cord had then deviated again was unusual, and more so the fact it had adhered to the dural patch because he had specifically used a synthetic patch to try to avoid any fusing with other tissue. He also thought the release of the adhesions had gone well in April and could not explain why I have, if anything, worsening symptoms.
He is reluctant to operate again as he does not feel there is any benefit to be gained. Contrary to what he had planned, he said he had closed the dura again in n the second op because he was concerned that, as well as the risk of CSF leaking, there was too much risk of blood or other things getting into the thecal sac and causing arachnoid cysts. We talked about alternative medication to try to ease the nerve problems in my foot particularly. He also feels I should cut down on the amount of ibuprofen I take due to risks of stomach ulcers. I pointed out that I had discussed this with the GP a couple of months ago, and her view was that ibuprofen was preferable to taking more tramadol. He is going to write to the GP to suggest the medication changes.
I talked about the impact it is having on the quality of life and don’t want to give up, although I don’t want more surgery unless there’s some more solid justification. He is going to write to a neurosurgeon in London to get a second opinion, and in the meantime I should carry on doing my exercises and see how the change of meds goes. If I get any worse, particularly things like loss of bladder or bowel control, then I am to call his secretary or go to ED.
In all honesty, given what I know about the relatively rarity of the condition, this was pretty much what I expected to be told. However it was still gutting to actually be told he doesn’t know why it happens, and that he doesn’t know what else to do. As I went to leave, I struggled to get up from the chair in his office, and then bumped into the doorframe on the way out – a bit of a regular occurance with my drunk walk effects of the balance problem.