Prolasped Discs: Meds versus Surgery?

[zingawinga5]

I have prolasped L5,4 and Siactic involvement, leading to neurological deficits in my L) foot. I am just reaching the stage of ocassional urinary incontinence.
Injuiry was 6 yrs ago but have had a "nurses back" for many years.
Currently I take Oxycontin and Oxyynorm for pain relief, along with paracetamol. I am now unable to tolerate anti-inflammatories.
Recently I started on Amitripylline,after initally refusing it two yrs ago, because I also take Fluoxetine and Venafluxine, and worried about interactions.
Well it was wonderful-for 2 wks,and then i had an interaction. I stopped the Amitrip, and saw my Ortho surgeon today-to start the booking process for a spinal fusion with graft, cage and screws; he says a discectomy isnt applicable in my case.
However today he suggested I take nortripylline-after saying I need stabilisation.
I feel that it is just being prolonged and am scared of further possible negative side effects.
My mobility was as such: 3 weeks ago I walked with a frame and managed only basic self cares. Cooking was out of the question.
I am a 47 year old woman and am well aware of the severity of this particular operation. I am in New Zealand.

[zingawinga5]

Thanking you for you advice, which as a nurse and having researched it quite a bit over the last few years, I agree with.
My ortho surgeon is of the opinion that sucess is often linked to emotional/physcological state, and of course I have had a couple of sessions with a pyschologist to discuss the entire procedure.
I just feel that prolonging it, is just dragging on when i would like to be able to return to nursing - albeit in a non-acute setting.
Again, I appreciate your response.

[S. Kaul, MD]

Hi there!

With your symptoms of neurological deficits I would certainly suggest a surgery (excluding possibilities where it would be too high a risk or unlikely to improve your condition). Meanwhile it is advised to use medications for a symptomatic relief. However being on amitripyline; the dose of fluoxetine and/ or venlafaxine would need to be adjusted and this would need to be done in consultation with your prescribing doctor. It would be best to discuss this in detail with your doctor so that you can have a well tolerated balanced drug prescription, to avoid side effects.
Hope this helps.

Take care!