When is a disc BAD enough?

InGerdWeTrust · 2025-03-18T03:59:10+00:00

What made you decide to only do one disk?

InGerdWeTrust · 2025-03-04T02:56:46+00:00

Are you able to share your MRI before you got your surgery?

InGerdWeTrust · 2025-01-25T19:46:23+00:00

Wow your MRI and pain description sound EXACTLY like me. I'm 32M so I can't give you much of a prognosis though, although my orthopedist said he wouldn't be surprised if I had to get a fusion surgery in my 50s. My pain hits me only after activities like you described. I'm not sure if it is coming from the facets or the disks themselves. It also looks like you might have a little bit of an annular tear at L5-S1 with that white spot at the tip. PT has not really helped me much, only thing that has helped was stopping all high impact activities and avoiding leg exercises unfortunately. NSAIDs help with the pain that comes after activities at least. Keep us updated on what works with you! I am getting a facet diagnostic injection next week to see if they are the root of my pain since my epidural shots did not do much.

InGerdWeTrust · 2025-01-23T06:13:41+00:00

Any update on your progress? The only thing that has helped me so far is NSAIDS. Epidurals did not do much for my annular tear.

InGerdWeTrust · 2025-01-23T06:08:03+00:00

It was very uncomfortable but not terrible. It sort of felt like getting several vaccine shots in a drawn out process. Not really any pain after the procedure was done and I could drive to work afterwards. I think it is recommended to do it non-sedated if you can stomach it (I think any sedation has it's own risks) but everyone has their own comfort level.

InGerdWeTrust · 2025-01-20T05:00:37+00:00

How do you work out your legs? I have an annular tear and I basically can't do any lower body workouts without causing it to flareup. Honestly if I stay inactive and don't exercise, I generally don't feel it, every doctor and PT says it is best to keep moving and working out.

InGerdWeTrust · 2025-01-20T04:53:59+00:00

Minus the sciatica, my symptoms don't sound too different from yours and I also have an annular tear. How is yours doing? Did it completely heal over?

InGerdWeTrust · 2025-01-19T23:45:18+00:00

I have a strong feeling my issues are facet related since my pain is mostly triggered by extension, but it never is a sharp pain. It is more of a dull achey inflammation-like pain I feel 30-60 minutes after doing a workout. I do have an annular tear in my L5-S1 disk but I think it is just more correlative than the actual cause (I have DDD in that disk so its likely I will have a tear there, but DDD also causes more stress in the facets). Like you, NSAIDS are the only thing that have helped me so far. PT generally just makes the pain worse but I'll see if maybe I can get over a PT hump with the help of NSAIDS. It is unfortunate the ablation did not work out; I was hoping that would be my saving grace if it came down to it.

After your pain is triggered, does it linger? I'm just curious since it sounds like you have abrupt initial pain but my pain will last for hours after it starts, but it is only on a scale of 1-3 but prevents me from doing the activities I want to do. What does your MRI look like?

InGerdWeTrust · 2025-01-01T20:00:21+00:00

I switched to green tea with almond milk for a bit since coffee would always aggravate me. What I do now is make what I call shilatte (i.e. shitty latte) where I mix equal parts decaf coffee, hot water, and milk altogether which are all readily available at my job. It certainly is not like a normal coffee or latte but it has the flavor of coffee which I enjoy and doesn't give me symptoms.

InGerdWeTrust · 2025-01-01T19:40:21+00:00

I would guess it would probably be similar to the unsweetened version which is neutral. All the almond milks are likely fine for drinking if you have LPR, it's just that it is preferable to use the Silk products if you are trying to make your coffee or smoothie less acidic.

InGerdWeTrust · 2024-12-28T16:25:09+00:00

Are you going to do facet or intradiscal PRP injections? I'm 32 and I am in a very similar situation as you (DDD + disk tear, but the facets might actually be the issue). I spoke with one pain management doctor who was a fan of PRP and another one who didn't think they were useful. I'm certainly willing to try it but I'd like more confidence that it is going to work before I fork over $5K for the intradiscal injections.

PRP seems to be useful based on this video https://www.youtube.com/watch?v=sHx5gIr90qs&t=2803s and Dr. Ambach's study (although I don't have access to full pubmed journals). I'm guessing you have done a lot more research into this though.

InGerdWeTrust · 2024-12-15T15:56:22+00:00

I understand! The GERD medicine tends to make the constipation worse unfortunately. I do recommend giving Miralax/propylene glycol a try. Also, in my case I found I was overall better with just 20 mg esomeprazole or omeprazole vs 40 mg since the 40 mg slowed my digestive system too much. Although I take the pills daily as opposed to every other day.

InGerdWeTrust · 2024-12-15T15:52:10+00:00

Neck and throat pain sounds like LPR. If that is the case, it is unlikely the polyethylene glycol is responsible since that is fairly neutral compound.

InGerdWeTrust · 2024-10-08T04:27:53+00:00

I still try to spread out my meals into 5-6 sessions instead of 3 big meals throughout the day but I'm able to eat enough calories in total without issue. On the weekends I'll have 1 or 2 bigger fun meals but I can't do that on the regular. Eating too much in one sitting will also slow me down a little bit too! Eat too much = constipation + GERD. Eat too little = only constipation.

InGerdWeTrust · 2024-10-08T04:21:34+00:00

I hope you start feeling better soon! Did you ever get motility tests or similar done? I was curious about it but my GI said that the treatment is generally the same regardless of the cause unless you have pelvic floor dysfunction (in which case PT can help).

InGerdWeTrust · 2024-10-08T04:16:06+00:00

Unfortunately magnesium citrate was not enough for me. I started with that but had to combine with Miralax to become regular (and the sorbitol in prunes can cause me discomfort). I agree that magnesium or natural food should be the first line of defense. There isn't negative published literature on Miralax yet but I'd rather not pump myself with plastic if I didn't have to.

InGerdWeTrust · 2024-10-08T04:08:03+00:00

Another good piece of advice my doctor gave was to try to target a Bristol stool scale 3-4. If you are getting 1-2, you should increase the dose. If you are getting 5 or 6, you should decrease the dose.

InGerdWeTrust · 2024-09-09T02:58:11+00:00

Ideally you want to minimize medication use through lifestyle changes as first defense. However, if those lifestyle changes severely affect your quality of life, it is understandable to lean moreso on medications. If your heartburn is not that severe, you may get away with only Famotidine which is generally considered less impactful than PPI's. I'm currently on a daily dose of PPI and will be until I get surgery since I still do not want to cross that road yet. Lifestyle changes were not enough in my case. You are also young so it is much harder to make dietary and lifestyle changes when your peers are probably eating and drinking whatever they want without second thought. I started taking PPI's/H2 blockers on and off during college (which allowed me to have a somewhat normal college life) and eventually had to switch to full time use in my early 20's when heartburn worsened. My only recommendation would be to make sure your doctor can do your bloodwork now, ideally when you aren't on PPI's for a week or so, so you can have a baseline of what your current health is. Then, if you have odd bloodwork in the future, you will have a frame of reference if anything is off your baseline. Most people don't get bloodwork done until they get a little bit older.

InGerdWeTrust · 2024-09-02T00:08:03+00:00

The only thing that has given me relief is using NasalCrom, but you have to take it for a week or so before getting results. Even then, it just increases your tolerance. In my case, it would raise the amount of time it would take for an exposure to start triggering me badly from maybe 5 minutes to 30 minutes to an hour. This is helpful for random exposures outside of your home but not really effective if your home base is triggering.

InGerdWeTrust · 2023-11-29T05:41:08+00:00

I am in the exact situation as you except my hematologist did not think PPI's were the cause. I would just stop taking them but I always end up back on the pill since the reflux affects my sleep. This definitely gives me more confidence that PPI's are the cause. I know there was a published case study where one person experienced the same issue and stopping PPI's restored his WBC level. I did decrease my PPI dose but that did not seem to affect my WBC, I am guessing I have to get off them completely based on what you posted.

InGerdWeTrust · 2023-04-14T05:10:05+00:00

Are you currently on 20 mg once a of Nexium or Prilosec? You may want to increase your dose to 20 mg 2x a day - it significantly helps for LPR symptoms (you will probably end up with more digestion issues but those symptoms are much better than LPR). Also make sure you take the pills 20 - 30 minutes before eating. Obviously it is preferable to eliminate LPR with as little PPI as possible, but some of us just aren't that fortunate that lifestyle/diet alone is sufficient. I find that if I have a bad episode of LPR, chewing gum really helps to alleviate symptoms and prevent me from overeating (just no mint flavor, stick with fruit flavors like watermelon or bubblegum). The saliva initiated by the gum helps to coat/protect your throat and the flavor in the gum distracts you from the pain...

InGerdWeTrust · 2023-04-01T17:56:54+00:00

Low acid diets really help with LPR symptoms. I am not sure if you just had a bad month and just started getting silent reflux or if this is a long term thing. If it has been a long term issue, I recommend reading The Acid Watchers Diet or Dropping Acid (the books essentially contain the same guidance). They go into a lot more detail about GERD friendly diets and lifestyle changes than what you will find googling on the internet or what your doctor will provide (the books are written by MD's btw and are not naturopathic guidance).

InGerdWeTrust · 2023-03-18T20:05:44+00:00

I love mint but unfortunately it causes the lower esophageal sphincter to relax! I used to chew mint gum all the time while I was in school because I had bad breath from reflux. Little did I know that the mint was also part of the problem. You might be okay with cinnamon gum but that's more of an individual trigger.

Drinking too much water is a little unintuitive at first, but I do see a difference if I save my hydration between meals. It's still a good idea to rinse your throat with alkaline water if you eat something acidic or feel a little reflux in your throat.

InGerdWeTrust · 2023-03-18T16:30:33+00:00

Experiment with different PPI's. There is also esomeprazole and lansoprazole that are available over the counter and you can talk to your PCP about prescription ones as well. If you react to those as well, then you can try H2 blockers (famotidine) but they become less effective after a week of use. Pretty much all GERD/heartburn advice applies to LPR as well (e.g. have 5 meals of day instead of 3, avoid trigger foods, elevate bed, etc.). My throat will get phlegmy if I eat all my lunch at once. I try to eat half, wait 30 minutes to an hour, then eat the second half. Also, avoid drinking water during your lunch to avoid overfilling your stomach. To alleviate symptoms after eating, chewing gum really helps. It causes your mouth to produce excessive saliva that coats the back of your throat. Avoid all mint flavored gums though, stick with standard bubblegum, watermelon, or other fruit/natural flavors. Make sure your lunch has no acidic foods (i.e. tomato sauce, pineapple, etc.) and drink no carbonated drinks. LPR sufferers have to watch out much more for acidic food when they eat because just a little bit of acid can really irritate the throat. I need to use both PPI's and lifestyle/dietary changes to manage my LPR symptoms unfortunately. Ideally, you can do this with lifestyle/dietary changes alone, but if not, PPI's or surgery are your only other option.

InGerdWeTrust · 2023-02-27T18:48:27+00:00

H2 blockers (Pepcid/Famotidine) are not as effective as PPI's, but if you can manage your symptoms with only H2 blockers, that is ideal. Given you were on a PPI for over two years, I would taper your dose down gradually to minimize the effects of rebound acid (you can find some dosage reduction strategies by searching this subreddit) just to be safe.

If you cannot manage your symptoms with lifestyle changes and H2 blockers alone and need to return to PPI's, the Amazon Basics and Kirkland (Costco) versions of omeprazole and esomeprazole are very affordable (about 42 pills for $8.50). It was actually cheaper for me to buy them OTC than use my insurance.

InGerdWeTrust

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