100% pain-free 3 months after successful surgery

David

Posted 2011-06-19

In December of 2007, right after Christmas, I slipped on my icy front porch and landed on edge of the only step. The way I fell, I landed with the edge of the only step right down the middle of my buttock – my tailbone striking it and catching all my weight. I was in terrible pain and could barely set for more than 15 minutes the first few days. When I went to an orthopedist, they x-ray'd my tailbone area and my wrist (which by then was a bit sore from catching a bit of my upper body weight). Nothing was broken. They said it was bruised and the bedside manner of the doctor made me feel belittled for even coming in to see him. Fast forward to this spring, 2011. My tailbone was still not right from the previous injury, with it often aching after airline flights. I work in a job that requires 70% travel. Then, in late Feb early March I fell on my basement stairs. Fortunately, I was holding the hand rail or I would have broken my neck and landed the bottom of the stairs. Unfortunately, I smacked my tailbone again, and this time could not sit for 5-10 minutes. OTC meds did nothing to cut the pain, neither did the opiate based drugs my family physician – who flat out told me he was not comfortable doing manipulations, etc. (though I was in too much pain to even ask about it). He said this time X-RAYS showed I had broken it and there was nothing that could be done except pain killers. After several months and continued research I dreaded having to drive to Duluth, MN where the only Dr. listed on coccyx.org's recommended doctors list, near me, could be found. I was about to have to take a short term disability due to the continued aggravation. My customers thought it odd when I visited their office with the professional looking Sciata Seating System by Inspri that I purchased, after reviewing all the donut options and the like from coccyx.org. One of my colleagues, when I brought this black executive pillow to nice dinner, thought I brought my laptop because of the clean look, shape, and size.

To make a long story short, I did some digging and found that Dr. Louis Saeger, M.D., F.A.C.P.M. (see Doctors and specialists in the USA, Minnesota) wrote a paper about coccyx injury treatment. Fortunately, my insurance does not require referrals (though my family Doctor would have given me one if asked). I scheduled and got in to see Dr. Saeger within one week in his Blaine, MN office on the north east end of the Twin Cities of Minneapolis and St. Paul, Minnesota. The first injection was done just a few days later, using fluoroscopic technique and resulted in a 60-70 percent pain reduction for me. Now, I can make it through most of the work day at a desk without sitting down – and tomorrow will be 2 weeks. He warned me that it may get worse before it got better – but in my case it did not. My next shot is scheduled for Monday morning.

My insurance is some of the best in the country and will likely cover 100% of the treatment, which was in network. However, the insurance did trigger their subrogation claims process making me document the incident that caused the injury so they could see if some other insurance, like auto accident, business, workman's compensation, etc. – should pay instead. The price billed to my insurance was around 300-400 for the initial screening visit and about 1800 for the fluoroscopic injection. The pain relief I have received seems lasting but the there is still some pain left. This is as Dr. Saeger said it may be, he did not pull any punches and says some people get no relief, some get complete relief – in the first shot. Still others, receive partial relief and subsequent shots help. If I see the same pain reduction again, I think I will only need one or two more to be completely pain free.

I can highly recommend Dr. Louis C. Saeger, M.D., FACPM, Midwest Spine Institute. Their website needs some work, but do not let that scare you off. The whole staff was professional and I am very glad for Dr. Saeger and his staff of professionals.

Update, 2011-09-18

While my first injection gave me significant and lasting reduction in pain, the 2nd seemed to make things worse. I estimate I got back 5% of the additional pain I had lost. Of course, it did not help that I took a cross country flight the day after the flight. In fact, I suspect I my flight caused further injury. Fortunately, a week later, I resigned the position I was in that required 70% travel. That was about July 1st. I went in for a 3rd injection on August 29th, and took it easy for a few days afterwards. Again, I have significant reduction in pain. Probably back to 95% or more pain free with at least a 20% reduction over last night. Clearly the steroids are doing good at helping my tailbone and/or soft tissues in the area heal. I definitely have zero regrets on the fluoroscopic injections done by Dr. Saeger. If the trend continues, I either will not need another treatment OR I’ll need one more at most.

I cannot stress enough, how important it has been to ensure I do not further injure my tailbone as I heal. I use an electric sit-stand desk at home and at work. I also use a Inspiri Sciatica executive gel cushion as a kneed pad to allow me to kneel at my desk when I get tired of standing. I can probably get a good hour swapping between two knees, left knee, right- knee. I sit for no more than about 15 minutes a day except when driving 15 miles each way to/from work.

Update, 2012-08-26

After the job change, my next job afforded me the opportunity to stand, but had a 1.5 hours of commute time each day. My tailbone reached the point where it was barely sore at all if standing still, a little when shifting my weight from foot to foot, and some pain on my commute. Sharp pain when getting out of my VAN and my car as well. Then, I changed jobs in April of 2012 again, and the new one I sat more and it got sore more. With the new job, I decided to see if I could get the employer to buy a sit/stand solution for me at work, by contacting the occupational health office. It took a while, and they did, but not without a doctor's note saying I needed it for pain management. Since I had not been to the doctor in over a year, I figured I would visit Midwest Spine again and get the note, as well as see what my options were. Got the note, but did not like the options: live with the pain, chiropractic, or trial of electrodes for pain management.

I opted for Chiropractic treatment, and picked one near my home. The place was very unprofessional, not respecting my privacy, and so I llook online and found the listing on www.coccyx.org for Dr. Laura Posl, (see Doctors and specialists in the USA, Minnesota). I have had several treatments by Dr. Posl, they seem to have reduce pain again to the level that I do not always feel pain when I get up from seated… but if I sit for too long, or on the wrong surface (like my Van's soft seats) I have pain. I can ride in my car with its less comfy seats and be more comfortable when I get up (almost no pain usually). The manual manipulations treatments from Dr. Posl's office were done VERY professionally – and this is greatly appreciated considering how embarrassing it can be to be treated this way in front of a female doctor and female helper/nurse/aid… Since it seems my first treatment gave the most relief but I still have too much pain to too often, I guess I will have to ask Dr. Posl my options on my next visit. Interesting note: when I sit in my car, I have found that if I shift my weight by rotating my hips forward and back, just right, I can feel the sensation of the tailbone pulling apart like a joint dislocation – but with no significant additional pain.

I am starting to think surgery will be the only chance for lasting and complete relief.

Update, 2013-07-28

After about the 4th round of manual manipulation with no additional lasting relief, I opted to contact Dr. David Polly at the University of MN (see Doctors and specialists in the USA, Minnesota) and also a different David's story with the same doctor.

Dr. Polly's staff was professional, light-hearted, and very honest about the prospects for success/failure. I did the sitting tests that were needed to show my coccyx was bending the wrong direction when I sat down and made the decision for surgery.

On October 16th, 2012 Dr. Polly removed my coccyx entirely and built up the bone that would no receive direct pressure with appropriate surgical grade material. Healing was very slow, but exactly as he explained. At first healing was good but then the wound started to separate a bit. Ultimately, twice a day, my wife had to clean the area with hydrogen peroxide to keep the normal skin bacteria at down enough to allow the surgical wound to heal. I had to go on short term disability but was ready to return to work by January. During my last follow up appointment Feb 27, 2013 – I had virtually no pain and the wound was fully healed. At this point, July 26 I have been 100% pain since shortly after that last visit (or was it before, I cannot remember) -- long enough that I catch myself slouching in the chair and reclining like it never happened.

Of side note: Because I have IBS and do not like how hard most post-surgical opiates are, I recovered with only Advil and Tylenol. Dr. Polly insisted on me filling the scripts for the opiates (and the powerful anti-constipation drugs I did take some of) just in case – since he did not want me to be without if I changed my mind while he was going to be away from the office. The pain level was tolerable to me without the opiates but your mileage may vary and I would definitely have filled the scripts again first, just in case.

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