ER or no? 4 week post-OP two level ACDF surgery

Teach, I was thinking your had some other threads here at the forum & found your thread of April 1, stating that you were going nuts being at home & you were just 2 weeks post op. Somehow, someone at school told you some of your students were having mini melt downs so, you planned on seeing the surgeon & telling him you wanted to return to work. I can only assume he took you for your word that you were having a little pain & he allowed you to return to work. Many of us here said you will be doing more harm than good by jumping up & returning to work because you needed to let your body heal from such a traumatic surgery. I believe even your mother tried telling you to slow down & allow yourself time to heal. Its hard to do when you are an over achiever as most of us are. However, I sincerely hope that you have not done any real damage to your neck by not taking care of it. There is no way on this earth that we can force our bodies to heal, its just not going to happen.

Now, the hurdle is trying to convince a dr & an insurance company that you are unable to work. My suggestion is to contact that surgeons office & let them know you gave it your best shot at attempting to work but its just too soon. Maybe you will get lucky & he will take you back off work for awhile longer. Tell them, I made a mistake by trying to go back too soon. Once a person returns to work on a worker's comp claim its very difficult to get taken back off of work.

Are you on any type of muscle relaxer? If not, you should be. Any time a person has spine surgery they should be on one for several months & in some cases they may be needed on & off for life. If you can get the muscle spasms under decent control many times the pain level drops down. If you are on one, then it does not sound like its doing its job. Why do I say this, because the type of pain you are describing sounds very much like the spasms I get from 2 herniated disc in my neck. I thought for sure I was having a heart attack because of all the chest pain. It was not a heart attack or my heart it was muscle spasms coming around from my neck. Try using ice on your neck, it will also help with the swelling. The inside of your neck right now is very angry from the trauma of your surgery. Things need to calm done in there & heal.

I promise you we are not trying to be rude or ugly, but at some point & for your own sake you have got realize just how traumatic your surgery has been on your body. This is why when you first joined HW we all encouraged you to read the posts of the people here that were still recovering from that same surgery & you sort of laughed us off & we were really trying to pass on some good info & help you. Nothing better than getting that type of info than from someone that has been there & done that.

I hope you can get some help somehow.

Your words cannot be any truer. I have overdone it! I think that so many athletes are in the place where I go, getting surgeries, and going back to athletic lives that maybe they give me more credit than I deserve. Maybe it's the norm because of the others there. However, they are not 42 and over 200 pounds so my recovery needs to be much different. WC did allow the dr to take me out two extra weeks and I returned again this Monday. I worked two days, off two days, and will work half day tomorrow before returning to see my surgeon. I had previously lost weight and was 40 pounds less and it is all back. I cannot wait to lose the weight and cannot wait to run but I am out of commission when I even walk two miles. Therefore, I will have to lose it by diet alone for the now. I don't like all the ER trips but I have no choice when I can't see the surgeon. When you have a one month wait to see the surgeon, you have to go to the ER or urgent care.
I am slowing way down, I have no choice. I just felt so awesome at two weeks that this seems extremely weird for me to have fallen back and fallen so hard. I am reading on here and I thought I was the lucky one, I guess it was more like I was the one in denial.

Work on wrapping that ice pack even more so it will not sting. That's what you need to help relieve the swelling, I think.

You mentioned once about needing to get back to your full income. I wanted to tell you to consider how much less Permanent Disability pay will be if you don't slow down and heal.

Yes, you will have to get the weight off by diet mostly for now. Later you will be able to walk/not run! And not 2 miles. You need to be eating good food now to help your body heal which will also help with the weight. Research and find the best things you can do to help yourself heal. It will be a great investment of your time and energy. We're all hoping reality has really set in for you. If so, you should still have a long, productive life AFTER you let yourself heal. You need to let family, friends, neighbors, church know you are not doing as well as you thought you were at 2 weeks and now you need help.

Hoping and praying for the very best for you.

Teach, I hope you will heed what Mrs & the others are saying about the cold packs. It has been proven & is recommended when there is a lot of inflammation going on heat can make the inflammation worse. Right now inside your neck everything is is inflamed & hot as a firecracker so to speak. The tissues & everything inside are extremely irritated & this is your body's way of signaling something is wrong & by putting heat on it is just feeding that internal fire in there. The cold will help calm that down plus help keep the swelling down.

Take care.

Well, maybe he has been a surgeon for 20 years but sorry, I think he is just way too full of himself. He has what we call the God syndrome, one of those that when they do surgery they think you are better after surgery than you have ever been in your life. I absolutely do not believe he has a perfect track record either, after all whether he wants to admit it or not he is only human.

I am thinking this may be a work related situation & if so your hands can be pretty tied when it comes to getting medical help. I would do some checking around & see if I couldn't come up with the names of 2 very good neurosurgeons, then go to the insurance company with those names & ask for a 2nd opinion. This guy is not interested in you, its more about his big ego.

Hi Teach I'm sorry your having all these problems, yes hind site is always 20/20 and it does sound like you have over done it a bit! But with that said some of the problems your having is just natural with this type of surgery! And unfortunately your surgeon sounds like a lot of neurosurgeons that I have seen they are very cocky and arrogant! "They did the surgery and fixed you and anything that happens afterwards is your problem and your fault!" Which of course we all know is BS! After my first ACDF at C6/7 I lost my voice for 3 months or so, and my surgeon swore that he did not damage the nerves going to my vocal cords! Well I did finally get my voice back but 30 years later I still have partially paralyzed vocal cords on my right side from the surgery.(They went in on the right front side) and to this day I still have intermittent swallowing problems and problems with gagging and retching, if I do anything that strains my neck! Also allot of the surgeons don't tell you that when you have a disc fusion that the disc above and or below the fused area will probably go bad with in the next ten years! I was lucky I got 25 years out of mine before I had to get another ACDF at C5/6.

Anyway just know that your not alone in this! We do understand and empathize with you! I would strongly suggest that you take it easy as you can. At this stage you cannot be expected to do all the things that you previously were able to! Teaching children is demanding, so be gentle with yourself and don't over do it! Change your ways of teaching if you have to, or if you can, let your students help you, it might be a good learning experience for them too! Also if your surgeon continues to deny that your problems are related to your surgery, then I would strongly recommend that you seek out another neurosurgeon to check you out and give a second opinion! Everyone heals differently, and at different rates, and it seems your present surgeon is not taking that into account! To be honest I am really surprised that he let you go back to work so soon, and did not give you more restrictions as to what you could and could not do!

If in the future your swallowing difficulties continue, I would suggest that you see a good ENT doctor, and have him check your throat out! I was told by one ENT surgeon that with this type of surgery, that damage to the nerves in the throat is not uncommon, and he was surprised that there wasn't more patients having problems after this type of surgery!

Good Luck to you!

White Beard

WC will deny anything they possibly can and keep the battle up. Don't let them just shrug it off leaving you with the bill. Getting your doc to say that its at least possible helps. Having to deal with WC is enough to cause hypertension related h/a. Lol

Glad you now have a bit of a break and use the summer to work on resting and healing as much as possible and getting your body back to presurgical state. Exercise control and eat healthy, if you have access to a pool swimming or just low impact exercise is a awesome way to spend time.

Thanks for the update and don't bend over for your little people but rather learn to naturally squat down for your one on one's with them or take a seat.

Teach,

I had acdf c4-7 done all at once on 4/21/14, so i am just now 15 months out. i had ALOT of the same problems as you, sadly. I actually changed neurosurgeons, right after surgery, because I no longer mattered. I do have a good one now, but unfortunately, as whiteboard said, they don't tell you you may have to have the discs above and below surgery done down the road. Well,, down the road has come for me. My symptoms are still here, and only half of my bones have fused together, so i get to redo the same surgery again, as well as the discs directly under the first surgery..TOTALLY scared and angry all over again. I ask myself why, and now what am i going to do. i don't know if my body can handle it again. it has been nothing but a hellish 15 months and i still am not better, why in the world would i do it again, for no reason, plus more??? i could really use your' all's suggestions and such please. i am super super worried, and way to young to be doing this again anyway...im only 36 (in 3 weeks) for crying out loud!!
thanks all

Sorry to hear you don't seem to be progressing much as for healing and I really hope that returning to usual activities so soon hasn't caused issues. I personally would find a surgeon for a consult at this point even if I had to pay for it. The other surgeon does not have to know if you ask them for a copy of your medical records and take them to the consult with you. Your surgeon is likely going to blow off all the issues your having since he thought you shouldn't be having them two months ago.

I did go to see the PA. I told her about my symptoms of choking, shoulder and neck excessive pain. I told her that I hurt a lot! She looked at my large neck and I told her about the painful lump on the base if my neck. She mentioned my weight gain was not normal, gave me some eating suggestions, informed me it was fat, and told me to see my endocrinologist. She said it is a fat pad on my neck and maybe stress can gather there. She wrote me another script for pain relief but told me I will need to begin pain management afterwards because after three months, it is chronic. I contemplated going to the ER a few times because of the pain but I would have to drive myself as my children are too young and I felt they would give me a shot, so I didn't. Also, there are four ER trips WC are denying that are associated with my surgeries. I went to the volleyball court once with my kids for five minutes....bad decision. I cannot believe I am so limited. Even after swimming in the pool, I am in pain. Once I could lift my arm, I was put at MMI and no one cares about the residual pain. Very frustrated.

Those symptoms sound like Cushing's (which I have do to decade of steroids). Basically it's an overabundance of cortisol, which can be caused by extreme stress, or Cushing's Syndrome.
The hump, is often called a buffalo hump (nice, right?). Weight game is super common, and can be very hard to lose, until you have the cortisol levels under control.

Definitely see the endocrinologist.

Didn't the surgeon see to it that you were given a paper on Autonomic Dysreflexia? It explains a lot of the symptoms you have with blood pressure, chest pain, headache ... It's potentially lethal if not treated correctly. When you feel your blood pressure going up and pulse rate going down you have to sit up - opposite of what you feel like doing. I carry a card in my wallet. There is a lot of good reliable information online and cards you can print, from respectable websites, not just forums.

Swallowing problems are the norm with ACDF. Nerves are damaged when the surgeon uses metal retractors that pull the neck apart and the esophagus and trachea aside so he can see. I was on tube feeding for weeks after my surgery and couldn't swallow anything but soft stuff for months. My swallowing still isn't normal after 2 years, but it wasn't good before either.

I have the neck and shoulder area plus shoulder blade area and bicep pain. I haven't been able to find out definitively what causes it, but it seems like a neck/nerve issue. It doesn't ease up.

Do you have the freezing and burning feeling in your feet and legs? I'm super sensitive to stepping on anything cool, like a tile floor barefoot. Legs hurt, but on EMG testing there's nothing wrong with the nerves there. Pain issues like this are commonly from central pain syndrome see www.centralpainsyndromefoundation.com A lot of doctors will mention central cord syndrome, but completely ignore central pain syndrome. Sorry, but there's no cure for this.

Migraine headaches, possibly part of the autonomic dysreflexia, seems to start at joining of neck and skull and radiate over to front.

I have a pain doc, so at least I'm not wasting money in the ER all the time, looking like a drug-seeker. I've had multiple injections and ablations, but they are not working anymore. Even this doc doesn't want me coming but every 3 months. I wouldn't dream of letting an NP try to treat me. Surgeons, even my family friend, give up after they have done their thing. Rehabilitation doctors, physiatrists, are woefully ignorant of what to do for us too.

I've found helpful information from others with the same problems at www.aaparelyzed.com.

I live on hydrocodone, tramadol and Zofran and sometimes Klonopin or Valium for leg spasms. It's no cure, but helps with my "real" pain from bone spurs and arthritis in my spine pinching nerves. I call my leg pain, which is caused by damaged nerves in my neck sending mixed up messages to my brain, my head pain or not-real pain. Nothing touches it. See comments from others in the central pain forum.