Thursday, December 15, 2011

Wise words from Mr. Boeree.

Hello everyone. I'm really really enjoying my time pain free! I'm a whole different person. What really makes me comfortable is the fact that my disc is fine, and since i've had it for over a year, I think it's safe to assume that the endplates are permanently fused with my bones. Couple this mentality with no pain, and you have a guy in a great mood! Except this time, i'm conscious of what it means to be pain free and the need to keep it that way (there's nothing worse than feeling pain free and then falling back).

So I got a reply from Mr. Boeree:

Thank you for keeping me posted.  I am delighted to hear that the facet joint injections have been so helpful.

I think it very worth while bearing in mind that there is an important difference between degenerative facets and painful and inflamed facets.  Essentially when we remove a degenerative and damaged disc this motion segment (that is to say one vertebra, its neighbour, together with the discs and the two facet joints and of course all the ligaments that connect them) will not have moved very much.  In addition, as the disc degenerates it tends to place rather more load on the facet joints.  This will almost invariably lead to a little bit of damage to those joints, and this applies essentially to every patient I think who has disc replacement surgery to a varying degree.  Once we remove the damaged disc and replace it with the M6 we tend to restore movement to this level.  Of course it takes time to regain movement in the motion segment but this does come as you build up your activity.  As you do so the facet joints are progressively having to move, where perhaps they have not done so to any great extent before.  This can cause a little bit of inflammation of the facet joints, just as if you were pushing and regaining movement in another stiff joint elsewhere. 

Generally I find, where we need to give facet joint injections, that this will often keep things under good control.  Occasionally you do need to repeat the injections and indeed your interventional radiologist, or whoever did the facet joint injections for you, will probably have said that it is not unusual to give a ‘booster’ set of injections at six weeks. 

Ultimately, if you find you are needing repeat injections every so often the interventional radiologist may want to consider radiofrequency denervations of the facet joints.

I hope all of this is helpful.

I wouldn't mind having these injections every once in a while. If it gets to the point where I have to burn the nerves (radiofrequency denervations) around the facets, so be it. But I think i'll give a shot to the PRP (platelet rich plasma) injections that my doctor in miami recommended as well as continue taking heavy doses of Glucosamine/Chondroitin and Omega 3's.

I'll let you guys know if anything happens. Meanwhile, take care of yourselves and have a happy holiday! I'm heading back home, closing down the restaurant for 1.5 weeks, and enjoying my pain-free back at the beach with my family.

Also, I'd like to publicly thank Mr. Nick Boeree for all the help he's given me personally. He always takes the time to reply to my emails, questions, and concerns without hesitation. His diagnosis of the facets being the problem was spot on, all through merely a phone consultation. He's a great doctor and a great person, and although I hope I never have to see him again, I wouldn't mind sharing a drink with him someday.



  1. That is GREAT news, Mike! Sounds like you have an effective treatment for the residual issues that were left. Hopefully a few of those injections will do the trick. If not, the ablation probably will. :) Thanks for keeping the site up and touching base. I really appreciate it. I am considering the same surgery with Dr. Boeree and your journey is very inspiring. Thanks!


  2. Thanks for the update and I'm so happy for you that it's been identified, treated, and a plan for the future as well. Very helpful for me as I travel down this road rarely traveled.
    Hoping the beach vacation is a great sigh of relief and joy for your family!

  3. Hi Mike- How are you feeling lately? Good, I hope!

  4. Hi Mike - Nice one for writing this blog! It was actually one of the things i read when doing my own research regarding my back. It looks as if you've inspired a few others to blog about Nick and the M6 also. Anyways i just had an M6 put in by Nick Boeree 2 weeks ago at L5S1. After 6 days i was walking 6.1 miles (over a few seperate journeys) 2 weeks on i'm almost apin free and loving it. Nick has done an amazing job with me too. Everything you wrote about your time at Nuffield in Southampton was so similar to mine, those guys are top class.

    Cheers! Hope you're going well still!

  5. Thank you for sharing this knowledgeable post about disc replacement surgery in Houston, TX. Good job.