Herniated Disc

[nicolas18]

Hey guys,

I finally moved to BKK this week. Everything went pretty smoothly, except for a herniated disc condition which deteriorated due to all the furniture I had to move out of my apartment in Belgium.

I had surgery ten years ago, when I was 21, for a herniated lumbar disc. Eight years later, I started having some mild manageable lower back pain again> After an X-ray and MRI, I was diagnosed with another slightly herniated disc. Since it was only slightly herniated, I didn`t get any treatment from the neurosurgeon.

Since I had to get everything out of my apartment during the past month, I had to lift and carry some heavy furniture and boxes around. Obviouslym it didn`t improve my condition and I now experience some burning pain in both my legs and my lower back, as well as some mild numbness in my right leg.

Since I won`t be able to get any health insurance here in Thailand which would cover this preexisting condition, my only option seems to wait and see. Apparently, 90% of patients with herniated discs never actually have to go through surgery because of natural disc resorption.

So, my question is :

In order to go through this six-month period, I`m going to need some serious painkillers and NSAID`s. If possible, it should at least be morphine or codeine-based stuff. I know that this stuff isnt sold OTC in Thailand so what should I do to get it? I`m thinking about going to Bangkok Christian Hospital, which is close to my apartment, but I`m afraid they would ask me to take an MRI (it apparently costs $250 and it would be useless, I already know that my disc is indeed herniated) in order to get some useful stuff.

UPDATE :

Well, this is just getting better and better...

I'm just back from Bumrungrad. I know that I said that I would go to BKK Christian Hospital but I thought : hey! If I pay through the nose for medical opinion at a farang-oriented hospital, maybe I have more chances of getting what I want/need.

Tough luck. Basically, the surgeon told me that I would need an MRI (cost = 20,500Bht, Note to self : Don't forget to call Bumrungrad tomorrow to cancel the appointment) and gave me some nerve drug, whatever that is. I told him that the usual painkillers didn't work and that I would like to know if anything was available to relieve me of my pain. At that moment, he just froze, stopped writing and started staring at me for what seemed like an eternity. Looking for pothead eyes or needle marks, maybe? Anyway, he then told me that yes, there are other drugs available but they can cause addiction so we'll stick with Tylenol. I refrained from telling him that since it seems to require at least a dozen various appointments and exams to get a single tablet of opioid-based painkiller, the risk for long-term addiction shouldn't be too much of a concern.

So, here I am, back at square one. Oh, and it fuc_king hurts like hel_l now. Grr.

[katana]

...After an X-ray and MRI, I was diagnosed with another slightly herniated disc....

I'm just back from Bumrungrad...

Tough luck. Basically, the surgeon told me that I would need an MRI (cost = 20,500Bht, Note to self : Don't forget to call Bumrungrad tomorrow to cancel the appointment)...

Can you not get the hospital that performed the MRI to give you copies of the scan results to give to Bumrungrad?

[nicolas18]

Unfortunately, that hospital is in Belgium. Also, it was done over a year ago. It is therefore useless since my condition has deteriorated... The MRI will be useless anyway : I cant afford surgery even if it was needed (I have insurance but it is clearly a preexisting condition). All I want is some meds to help me cope with the pain....

[Captain Chaos]

Try BNH - they have a specialist spine clinic which I can vouch for having had successful treatment for a herniated disc in 2005 - they did eventually MRI me but it was not their first suggestion - had just an x-ray to start with and physio for 3 months, which didn't work for me, and they only suggested an MRI at that point, which eventually led to surgery which has fixed the problem.

Can't guarantee they won't want to MRI you but BNH usually a bit cheaper than Bumrungrad anyway...

It hurts I know, so good luck dude.

CC

Edited November 11, 2008 by Captain Chaos

[pumpuiman]

Are you nuts? Get an MRI immediately. You could have disc material compressing dangerous nerves (kidney function) Your vertebrae could also be out of whack.

Morphine is the only pain killer you can get for severe pain in Thailand. There are no "mid level" pain killers approved, I know, I went through it.

There is one option, Fentanyl patches. They had them at Bumrungrad, but really expensive.

Don't let them sell you bullshit neural vitamins, or other crap. Thats just to make money for the doctor.

Insist on adequate pain relief. Don't take no for an answer.

But you will be severely addicted very quickly....so discuss weaning off the medicine with the doctor.

Personally, I think your foolish to just wait and see. My father in law did that for 20 years. 20 years of pain and suffering. To save a buck. Get an MRI, see a qualified neurologist...at least to know the extent of the damage.

Good luck.

[nicolas18]

Well, as I said, the MRI is really not an option right now. I arrived in Thailand just ten days ago and I have yet to find a job here. I have about $4000 left and then, that's it, at least until I find a job. So, spending over $600 for an MRI is really not doable. Also, the numbness in my right leg is quite mild and I apparently didn't lose any strength, so the nerve damage should be minimal.

I'd love those Fentanyl patches but I really doubt that the doctor I talked to yesterday at Bumrungrad would let me anywhere near them...

[huggybear]

I'd love those Fentanyl patches but I really doubt that the doctor I talked to yesterday at Bumrungrad would let me anywhere near them...

Hi Nicolas,

I'm currently dealing with pretty much the same thing. Last doctor told me to cool it for three months to get the nerve aggravation down (I had still been doing some running). The vertebrae that were jammed up in the lowest part of my back (almost in my groin region) are starting to move around although I am still feeling tingles, pins and needles in my right leg when I get up in the morning. Before I was waking up in the middle of the night in agony and slugging 500mg Ibuprofens.

Volteran was prescribed to me. I used it for a while and it definitely takes the pain away. Problem is some weird side effects. Constipation for one.......I didn't take a dump for like three days. Also, I like to drink and the thought of the damage I might be inflicting with the combo on my liver or kidneys, I decided to go with the pain.

Check out Volteran, might be good for you.

[paperwerks]

I have this problem also and have had surgery. It still flares up on me several times per year. I had good results from Samitivej (mainly the exercises he recommened really worked.)

However, I don't go to the doctor any more for this. I am cheap and know what he will recommend. I have my own meathod which always cures the problem for me. Anyone who says that using medications and playing doctor on your own is risky is correct and I won't argue with that. Maybe you have already tried what I do but I will list my personal cure here anyways. my regimine is:

I can always cure the problem doing the exercises (gradually) and using two drugs: 1.) Prednisone 5 mg. This is steroid that shrinks inflammations (makes the bulging disc go back into place) I take 2 per day for 3-4 days and that seems to fix it. Note that this drug is not to be taken long term and can cause liver damage so I don't drink much when I'm on it. If you have not used it before you really should talk to the doctor or phamacist about dosage/risk. Cost 1 bhat per pill. This is what the doctors have given me in the past and it makes sense to shrink the inflammation.

Second, for the pain the doctor prescribed Ultram (pronounced "tramadon in thai) Addicts do not like this drug because the high is very weak but it works for me. I usually take 2 x 50 mg once or twice per day. I don't think you will succeed in getting anything stronger in a pharmacy in thailand w/o prescription. About 50% of thai pharmacies will not sell it -same with predisone. Also, note that if you take too much Ultram (I have read 5 x 50 mg is all it takes) you can have a siezure, so go easy and talk to phramacist/doctor if you want to try this. Cost for strip of 10 ultram generic is 30-60 bhat.

Also, the yoga type exersizes really help me but sometimes I go to fast. If you are really in bad shape just try to lie on your stomach a few times per day helps me.

That is what works for me. The medications are both very cheap and effective but dangerous if taken incorrectly so talk to a profession first if you are not familiar with them. Good luck.

[nicolas18]

Thanks a lot for your advice... I'm considering the traction option by the way. It could be a nice easy way to get rid of that dam_n bulging disc.

I have an appointment in three hours at the BNH Spine Center. I hope the doctor there will be more accommodating than the Bumrungrad one. I'll keep you guys posted.

[Sheryl]

You need a course of physical therapy (PT), probably 10 days to 2 weeks of intensive PT. But before a PT program can be worked out, they will have to see an MRI. PT will include traction among other things.

You can get one done at Phayathai 2 for substantially less than at BNH or Bumrungrad and then take the film with you to see the doctor at BNH,. If you do this, be sure to tell them that you need only the film and do not need a radiologist interpreastation since the doctor you will consult will read the film himself. (it's an extra 2-3,000 for the radiology report).

There are other places that offer inexpensive MRIs too but qaulity may vary. I have done the Phyathai MRI/BNH consultation route so I know that the quality of the films from Phyathai are adequate.

Assuming the doctor agrees that PT is a viable option (i.e. that you aren't in imminent danger of permanent nerve damage) your problem then becomes where to get it done as it won't be cheap at BNH. Look into St. Louis or Bangkok Christian Hosp, I'm not sure if the latter has a PT dept but you can ask, St Louis I'm pretty sure does, both are non-profit hospitals and substantially cheaper than the for profits. (It's still worth getting your consultation at BNH, though. Have the doc write down his findings and recommendations re PT for you to then take with you. Theer will be language barrier at the cheaper places but with PT a lot can be communicated through gesturer and you'll soon get the hang of it). )

As for the meds, doctors in Thailand are very reluctant to prescribe narcotics, especially in a situation like this where the pain isn't for just a few days. And indeed, the addiction potential when narcotics are used fort his type of problem is pretty high, and it has happened to plenty of peopkle who were sure it never could happen to them. Anti-inflammatory drugs plus either paracetemol or tramadol (if it agrees with you) and a heating pad are a better option. Besides, it will be important to be able to tell if the pain is improving in the course of PT.

Good luck

[nicolas18]

OK, so I just thought I would you guys some kind of an update...

Basically, the situation has gone horribly wrong.

Back in November, when I was supposed to start my TEFL courses with the Text-n-Talk folks, I had a panic attack at MBK. At first, I thought it was a heart attack since the symptoms are basically the same, but after a long check-up at BNH Hospital, they found out that it was just a panic attack. After that, I was so afraid to go out and have another one that I stayed in my room the whole time, didn't go to the TEFL course and didnt'do anything basically.

I think the back problem that I had was in part responsible for this stress overdose.

Anyway, in December, the back and leg pain increased dramatically. The doctor at BNH gave me some Tylenol with Codeine which obviously didn't help much and he finally decided tthat I should have surgery : a laminectomy with metallic implants.

This surgery was performed last week. Everything went smoothly except that during the surgery, the doc realized that the herniated disc was in part "glued" to the nerves. He therefore had to move and manipulate the nerves a lot in order to remove the prolapsed disc.

Because of this, there is now a very strong inflammation of the nerve roots from the nerves of my right leg. Basically, my right leg and especially my right angle hurt like hel_l. At the hospital, I received some morphine injections which totally removed the pain. It was perfect. I was discharged last Monday and, once again, even though I was in agonizing pain, the doc only gave me Tylenol with Codeine along with the highest dosage of Lyrica and Neurontin.

Since Monday, the pain has increased dramatically so I went back to BNH where I saw a pain specialist. I asked for some stronger painkillers and the reply I got was "We have morphine tablets but I dont think they would be right for you". I asked why but didnt get an answer.

I tried to go today to Bumrungrad to see if I could get Fentanyl or Morphine but they told me that they cant give it because they dont know my case.

So, here I am, with a limp, in agonizing pain and with some serious side effects from the high dosage of Neurontin and Lyrica.

When I came to Thailand, I had enough money to live for four months without a job. This is now the third month and I am in no shape to find one. Any recruiter who would see me limping to his office and wincing with the pain during the interview would throw my CV in the dustbin.

Sorry for this long wall of text, but I am quite desperate right now, even contemplating suicide, and I had to share this story with some people.

[huggybear]

OK, so I just thought I would you guys some kind of an update...

even contemplating suicide, and I had to share this story with some people.

Nicolas, don't go getting all crazy and sh*t. Keep in mind the drugs you are taking for pain are probably not helping with the suicidal thoughts. That is not the way out, there will be sunnier days in your life for sure. Don't miss them.

There is an outfit in BKK called the "Disc Rehabilitation Center". Have you seen them?

Go back to those doctors that worked on you and tell them things aren't right. Then get another opinion. Then go tell the people at

"Disc Rehabilitation Center" and have them get you on a rehab exercise regimen.

BTW-I've been fighting the same problem for about a year now, so I'm in this with you brother. Buck up man! Positive thoughts will help too.

[nicolas18]

OK, so I just thought I would you guys some kind of an update...

even contemplating suicide, and I had to share this story with some people.

Nicolas, don't go getting all crazy and sh*t. Keep in mind the drugs you are taking for pain are probably not helping with the suicidal thoughts. That is not the way out, there will be sunnier days in your life for sure. Don't miss them.

There is an outfit in BKK called the "Disc Rehabilitation Center". Have you seen them?

Go back to those doctors that worked on you and tell them things aren't right. Then get another opinion. Then go tell the people at

"Disc Rehabilitation Center" and have them get you on a rehab exercise regimen.

BTW-I've been fighting the same problem for about a year now, so I'm in this with you brother. Buck up man! Positive thoughts will help too.

Thank you. But, as I said, I only have one month worth of money, so I cant really afford any kind of expensive program.

Before leaving Belgium for Thailand, I took a travel insurance for three months. So, until February 4th, all my expenses at BNH are paid by my insurance. After that, I wont be able to afford anything.

Thanks for your kind words, though...

[chakatee]

In order to go through this six-month period

Since I won`t be able to get any health insurance here in Thailand which would cover this preexisting condition, my only option seems to wait and see.

So, spending over $600 for an MRI is really not doable.

Before leaving Belgium for Thailand, I took a travel insurance for three months. So, until February 4th, all my expenses at BNH are paid by my insurance. After that, I wont be able to afford anything.

The 3 above statements seem a little contradictory

But anyway, if the third one is the fact, your insurance will (should) continue covering you for the problem that started before you reached the 3 month limit.

Fly back to Belgium (your 1st MRI was done there so I suppose that is your home country). Your social security will take care of you for your physical problem. If you have no money for the flight, your embassy might help you getting back.

And you come back with a healthy back after either first finding a job (before coming here) or with some more than 4000$. Trying to live here with no job in sight and that amount of money is silly.

[nicolas18]

The 3 above statements seem a little contradictory

But anyway, if the third one is the fact, your insurance will (should) continue covering you for the problem that started before you reached the 3 month limit.

Fly back to Belgium (your 1st MRI was done there so I suppose that is your home country). Your social security will take care of you for your physical problem. If you have no money for the flight, your embassy might help you getting back.

And you come back with a healthy back after either first finding a job (before coming here) or with some more than 4000$. Trying to live here with no job in sight and that amount of money is silly.

After a few phone calls, they indeed agreed to cover me and they paid for my surgery last week. Unfortunately, it is a travel insurance and I seriously doubt they would cover me after the end of my contract.

Anyway, going back to Belgium is not an option for me. I don't have money for the flight, and even if the embassy would agree to pay for it, I don't have social security anymore in Belgium since I don't work or live there. And on top of that, I would have nowhere to live there, being an orphan.

So, yes, I guess I'm screwed.

Oh, and I'm back at BNH Hospital now... The medication they gave me on Tuesday made me faint three times, the third time was inside BNH when I was going for an appointment. So they decided to admit me.

I'm quite a tough guy but yesterday, I spent all evening crying in my room. I see no way out of my problem at the moment.

[Sheryl]

Glad you've been admitted

While you are there (and still on insurance) be sure to get a repeat MRI to see if there is a reason why the pain is not diminishing

[pongosnodgrass]

You've had two back operations already and you're 31years old?

I know i'll probably get flamed but I think many of the symptoms you've suffered could be addressed by non-conventional medicine. I have cervical kyphosis and mild scoliosis which also affects my discs and I would never go to a conventional doctor for treatment for the referred pain I experience. I know most of the advice will be pain management or eventually surgery, when nothing else works. Surgery should always be the very last course of action and not a reason for the doctors to make money. A long time ago, when I was living in London and unable to move for several weeks because of the pain, the thing that finally got me moving was a chiropractic adjustment. I was really lucky.

I really think it's worth you consulting a good chiropractor to see if he can help you before you go further and further into the surgery and post-surgery spiral. The best I know in Bangkok is Dr Don at Bioenergy Asia. He won't muck you around. Tel 02-2580350. I've just made another recommendation for him in a post requesting a good chiro, so some smart alec might accuse me of having a connection to Dr Don but apart from being a very satisfied patient of his, I have no connection to him.

If you're suffering pain from inflammation, an ice pack will help to keep the pain down.

Good luck and don't despair. Being in pain is the pits but your condition is not terminal and there is, I'm sure, a solution out there that will work for you. Hope you get your strength back soon.

[Nignoy]

I'd love those Fentanyl patches but I really doubt that the doctor I talked to yesterday at Bumrungrad would let me anywhere near them...

Hi Nicolas,

I'm currently dealing with pretty much the same thing. Last doctor told me to cool it for three months to get the nerve aggravation down (I had still been doing some running). The vertebrae that were jammed up in the lowest part of my back (almost in my groin region) are starting to move around although I am still feeling tingles, pins and needles in my right leg when I get up in the morning. Before I was waking up in the middle of the night in agony and slugging 500mg Ibuprofens.

Volteran was prescribed to me. I used it for a while and it definitely takes the pain away. Problem is some weird side effects. Constipation for one.......I didn't take a dump for like three days. Also, I like to drink and the thought of the damage I might be inflicting with the combo on my liver or kidneys, I decided to go with the pain.

Check out Volteran, might be good for you.

Having an operation on a herniated disc is no guarantee either, I had problems with discs in my cerebral spine, they were removed along with 4 damaged vertabrae and a titanium cage inserted, I was put on a pain management capsel called Zydol , it took 6 months to take effect , but now after 10 years I am painfree as long as I take my meds

[nicolas18]

I didnt have a choice, pongos...

There was a degenerative neurological loss in my right leg. In other words, I was experiencing growing numbness and weakness in my right which could ultimately lead to paralysis.

I am now still at BNH, they are trying everything they can not to give me opioids (electrical stimulation, balms, NSAIDs, acupuncture, etc...). To be honest, I'm getting shots of morphine as long as I'm staying at BNH. But once I'm out, I will be back on the weak Tylenol with Codeine. My pain is getting worse too. It clearly is nerve pain but I've never experience such painful nerve inflammation in my life.

So, I'm really in deep deep deep trouble. With me staying for a few more days at BNH, I can't find a job. Which means no money at the end of February. Which means no money for the rent in March. Which ultimately means I'm f****ed.

To be honest with you guys, suicide really does seem like the best solution for me these days. I cant go on enduring this physical and psychological pain anymore.

[pongosnodgrass]

Hope you get well enough to try to follow up some of the suggestions here. There are obviously people,strangers, who sympathise enough to post for you and talking about suicide just kind of freaks people out. You have to know that there is always a way out, however desperate things might seem at times.

Thailand is a place where you can survive on very little so not enough rent money may not be as big a problem as you think. Have you any friends who can help you out for a short while or did you come out her not knowing anybody? Can you speak to someone (they should have an International Guest Relations manager or similar) at the hospital to see if they can contact anyone at the Embassy for you? And the hospital should have a responsinbility for your post-operative well-being if they performed surgery on you. Tell them you're not happy with it.

You might be an orphan but there must be someone, a friend, relative, or colleague back home in Belgium who can help you out.

Good luck and I really hope that things work out for you.

Edited January 20, 2009 by pongosnodgrass