Hi Hiking Spider,
Here are some questions you could ask:
--Given my history, do you think I have a compressed nerve? And what leads you to that conclusion?
--What are the reasons that surgery does not reduce pain?
--Given my history, do you think I’m a good candidate for decompression surgery? And if so or if not, why?
--Closely related to the above: I’ve heard that patients who only have pain on the perineal branch are more likely to benefit from surgery. Has that been your experience? If so, do you see that as an advantage/disadvantage for me? (HS: I don't know where your pain is, so you can tailor the follow-up part of the question to your situation).
You could also ask questions about procedure and the rationale behind the procedure. You'll want to find out what type of surgery the surgeon uses (e.g., transgluteal). And you could use the items that I listed on the last paragraph of this entry (
http://www.pudendalhope.info/forum/view ... =44&t=9349 ) to create questions. For example, you could ask:
--If the surgeon is uses the transgluteal approach: How do you cut the sacrotuberous ligament? I know that some surgeons cut through the ligament (using a z-cut) and others spread it apart. And I've heard that cutting it increases the surgeon's ability to see and access the nerve. How did you decide to use the procedure you use?
--Do you detach the sacrospinous ligament from the ischial spine to give the nerve more room? If not, would you be willing to do that? (I'm not sure if this would be possible with surgeries that are not transgluteal, but you could ask).
--Do you wrap the nerve in anything, such as an amniotic membrane?
--After surgery, will you give me a pain pump that sends a a numbing agent to the nerve for several days (and if not, could you)?
--After surgery, do you put a wound vac on the incision to promote healing and reduce the odds of infection (and if not, could you)?
There are also a host of questions you could ask about recovery time, but those answers may be less important to you than ones about whether or not you should do the surgery and what procedures the surgeon uses and why. Here's a little info on my recovery: I was not supposed to bend over beyond 90 degrees for 3 weeks. After 3 weeks, I can gently go beyond 90 degrees as I'm comfortable. I'm at 24 days and I'm still avoiding bending over just to be safe, but I think I could do it comfortably if I wanted to. The same guidelines were given for sitting: no sitting on the incision side before three weeks (only side sitting). After that, begin to do so gently as tolerated. I haven't yet started sitting that side. I do feel quite mobile, though. I was told it takes four months for the pain to decline below the pre-surgery level, but I am way ahead of that. My pain moved slightly below pre-surgery levels about 10 days ago (and I discontinued extra pain meds 12 days ago). I was also told that it takes a year or, in some cases, even longer for the healing process to be complete, so I think it takes a while for the benefits of the surgery to fully take hold.
April
