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I jinxed myself..Off to Orthopedic Spine Specialist

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Posted 2/18/2011 12:34 AM (GMT 0)
Well my friends I jinxed myself when I posted about the relief I was getting from the epidural blocks for treating my symptoms relating to the herniated disks in my neck. My December block did not hold past two weeks. For the first time since 2008, the blocks failed. So I have been in a downhill slide since January when my symptoms returned worse than ever leading my pain dr to order another MRI. My left arm is on fire all the way to my fingers which the tips numb and tingly, not only on the left, but now on the right. I have been getting serious headaches 2-3 days a week. I feel very off, unstable like I haven't eaten for days and drank 5 pots of Starbucks Coffee.
Today when I followed up with them for the results the PA reviewed my report and told me she did not think it looked to much different than previous report 2008. Herniation at C5-6 AND a small one at c6-7. A little more reference to stenosis there but she felt it was of no concern. For some reason the facility that did the MRI did not compare it to my last one even though I brought the films. She didn't feel that would have made any difference. anyway I was beside myself, so she transfers me to the reception to make an appt with my PD to review the report in depth. In the short period she apparently grabbed him between patients, took my call back from reception and told me he wants me to follow up with the Spine Specialist at the facility I had my MRI. As scary as that seems, I feel better? My Pain Doc is great and he knows me well enough to know I don't mess around. The spine surgeon he works with is highly rated, so I know I will be in good hands. My appointment is not until March 15th as he is booked until then. He specializes in ADR.
For those of you out there with experience with surgery or symptoms such as mine, what makes you a surgical candidate? I have read a lot and it seems if you have radiating numbness and tingling, weakness in the arms or elsewhere, that seems to be the only correction. I have already gone through PT and it did not help. Anyone have a good experience with Fusion? So I come here because you are all the best.
Posted 2/18/2011 1:16 AM (GMT 0)
Although my fusion was in the lumbar region, I do know quite a bit about them. Fusions in the cervical area have much better outcomes than the ones done in the lumbar area , in part because the vertebre are much smaller and because of that, the area that they need to do the bone graft in , is also much smaller.
Are you giving any thought to adr? Those have better outcomes in the cervical area than the lumbar region as well.
As far as what makes someone a surgical candidate, it depends on the condition but mostly, a surgical candidate has a mechanical issue that can be fixed/repaired with neurological symptoms. The numbness and tingeling would meet the neuro criteria.
Sandi
Posted 2/18/2011 2:24 AM (GMT 0)
Thank you Sandi. I just started reading about ADR because I noticed at the orthopedic group working in partnership to my pain doc they had a spine surgeon on board. When I read his bio I was shocked. I did not realize they did artificial disk replacement as an alternative. But only if you meet the criteria. My mri shows herniated disks at c5-c6 and c6-c7 so I wasn't sure if that means I am not a good candidate. I certainly would prefer to have that based on what I read vs fusion. My pain doc looked at the films himself and said that the disk at c5-c6 was herniated pretty good.
My pain doc now feels it is time to check with the spine surgeon. Regardless of what his PA read into the new mri results, he felt differently and has said I should follow up with the surgeon he recommends. I have to believe that he sees a specific need for me to see a surgeon, right?

I will try to get the written report before I see the surgeon in March. I have the cd of the films, I see big changes when I compare the last one with this one. While I am no doctor, I do know my symptoms are worse and each day is a challenge.
Posted 2/18/2011 3:36 PM (GMT 0)
REDSAM,
I've not had a fusion done yet, but Whitebeard has had this done, look around for old posting about
WhiteBeard, he's a good person here and has had his cervical area fused. I want to wish you well
in what you choose to do, but make sure to get a second opinion, even if the doctor is a 1st class doc...
Hope you can get a low pain day soon.
((((((((((((((((((((((((((((REDSAM)))))))))))))))))))))))))))))))))))
well wishes and healing hugz
Posted 2/18/2011 10:38 PM (GMT 0)
Hi Redsam, sorry to hear that things are not going so well for you. Perhaps after you see your dr in March he can tell you which direction things need to go here.

This past December a friend of mine underwent the ADR for lumbar surgery and yes, you do have to meet certain criteria to be a candidate for it. I really only know of them being used in the lumbar spine, I don't know of anyone that has had it done for the cervical spine. My friend has really has a lot of pain after having the surgery to the point she is not sure she made the right decision. She seems to think had she gone the traditional surgery route she may have come out better. Her surgeon has all of the top credentials to do the ADR too. I know of one other person that did the same type of lumbar surgery and a lot pain afterwards seems to be a big complaint.

Please let us know what your dr has to say after you see him next month. Take care.
Posted 2/19/2011 1:03 AM (GMT 0)
REDSAM

Hi it sure sounds like those nerves in you cervical spine are being impinged, I have had both a C-6/7 ACDF Anterior Cervical Diskectomy and Fusion in  March of 1985 and then another ACDF done at C-5/6 in Sept. of 2009!  I will tell you both of these surgeries  took away that excruciating arm pain immediately!  The first surgery I had was a tough one for several reasons,  the first being that the ACDF in 1985 was a brand new type of surgery, and was not widely done, and when they did mine they did not use any hardware to hold it together, and they used bone from my pelvis for the graft. The other major reason it was so hard was because of the damage I had the disk at C-6/7 was so badly herniated that it broke apart and there was free floating fragments floating in my spinal canal,  all the doctors were amazed that I was not a quadriplegic, anyway after that surgry I lost my voice for over four months, and had swallowing difficulities. The healing time was very long. Now Fast forward to Sept 2009, I again started having severe arm pain and this time the disk above my previous fusion (at C-5/6) had went bad, and I again needed to have another ACDF done, but this time when they removed the disk they used a cage with ground up cadaver donor bone for the graft and then they put in a bracket across the space being fused and screwed it into the vertebra above and below the graft area to hold it all together. I was in the hospital for 3 days, I was up walking the day after the surgery. I had the surgery on a Monday morning, Monday afternoon when I woke up in my room, my arm pain was completely gone! I was sent home with a soft cervical collar to wear for two or three weeks.  It really was a piece of cake! I might note the first surgery in 1985 I was in the hospital 8 days and I had to were the cervical collar for 5 months. They have come along way in doing this surgery! For me it done everything it was suppose to do and I have no regrets. The only thing I regret is as the Surgeon told me, that I got some very bad genes and my spine is an absolute mess, this past November I had to have more surgery on my neck and I had the articular joints in the back of the neck fused at C-3/4  this is a much different type of surgery as it does not involve the disks, and they go through the back of the neck, and they have to fuse and put brackets on both the joints on both sides of the vertebra.  I have an incision down the center of the back of my neck, the entire length of my neck from the base of my skull to past the begining of my shoulder blades!  Now this surgery was a real bear, and I am still in Physical Therapy three days  a week trying to regain some more mobility in my neck! However with that said , it did take away my upper neck pain and the terrible pounding pain in the lower back of my head!  So again the surgery did what it was suppose to do!

 

I would like to tell you REDSAM  I do not advocate having  surgery if you do not need it, but if it is needed,  well............like my surgeon told me, that the ACDF surgery was  extremely easy compared to doing all the other disk fusions on the spine, and the reason being, is that in the neck, the cervical  spine is more easily accessible than any other area of the spine. Thus making it much much easier for the surgeon to do the surgery! It makes sense to me!  Also he told me the success is much better, but what allot of surgeons don't tell you, and I just found this out in 2009, is that when you have a disk fusion, the disk above or below the fused area will usually go bad within ten years of that fusion. I was lucky I got close to 25 years out of mine!

 

I hope this has helped you, if you have any questions or if I can be of any help feel free to e-mail me.

 

I do wish you all the best and hope everything works out well for you!

 

White Beard

Posted 2/19/2011 1:22 AM (GMT 0)
All very good advice. I have read that the ADR doesn't work real well in the lumbar area as it tends to put more stress on the vertebrae above and below the disk replaced. I have read some that have had it done in the neck and they have good results, but again those that were allowed to trial a multi-level did worse.
I want to do my research so I go armed with good questions. I agree that I will be getting a second opinion for something this important.
When I started down this path, I trusted a chiropractor who kept hammering my neck with some computer driven hammer thingy (no manual adjustment). The more he hammered the worse I got, until I broke down during a treatment because I was worse not better. Thus the MRI revealing the herniated disks. He wanted me to pay 5000.00(not covered by insurance) to lay in a decompression chamber and he guaranteed it would cure me. Otherwise my only alternative was SURGERY. I fired him. Then went to my GP. He sent me to their in house physical therapy group, where they sold me a bill of goods there as well, after all the pt and heat treatments, massage, I still had pain, spasm and tingling and numbness, but now had 2500.00 of useless gadgets. I went to my trusted pain doc, who treated me with the blocks from 2008 till December. So I figured that would go so far.

I will check out Whitebeards posts and more reading so if anyone suggest good questions to ask. I would greatly appreciate it.
Pain Free Hugs.... sue
Posted 2/19/2011 4:41 AM (GMT 0)
I just had my 2nd cervial fusion 2 weeks ago. n One thing I can honestly say is if you have it done, even tho in a few weeks you feel better that you have in a long time, DO NOT do more than advised by your surgon.  My first fusion collapsed, and they were going to do a corpectomy, but they had do use c7 and when during surgery the surgeon "penetrated" c7 with his thumb, and the fusion at c6 took, he decidid to re-fuse 6&7 s and a half weks into it I am feeling much better...FORCING myself to remain planted and doing nothing...not going to chance it this time. yeah
Posted 2/19/2011 5:13 AM (GMT 0)
REDSAM

 

Before I had that ACDF in Sept. 2009 I had had several epidural spinal injections by my spinal pain management Doctor, each time I got relief from the injections but it only lasted 3 or 4 weeks, and then the pain and discomfort and numbness and tingling would come back. My surgeon told me that by having those injections and getting that relief, that helps confirm that the disk there is the problem and it is impinging on the nerve and thus causing inflamation. making the situation worse, the steroid was reducing the inflamation and in turn relieving the pain and other symptoms, but it was not fixing the cause.  So the injections at best was only temporary.

 

 I might add, I will not go to a chirpractor to have my neck worked on, in 1985 I was in the Air Force stationed out side of Fairbanks in Alaska, my doctor on base was an osteopath  and he done numerous manipulations on  me, and darn neat killed me doing it. He did not know at the time that I had the massive herniated disk at C-6/7 and it was only by the grace of God that I am still here., as I had been suffering with extreme pain in my arms just like when you hit your crazy bone in your elbow really hard, but the searing pain and numbness would not go away, Any way he had me on the table and put his one arm around my neck and the other arm around my legs and snapped his arms together, I thought I was going to die, then he had me lay flat out on the table and he put one hand on each side of my head and then quickly snapped my head from side to side. when he did that, I honestly saw a bright white flash of light and I heard something like thunder in my ears, and my whole body lifted off the table.  The doctor jumped back,  he said he had never seen a persons body go rigid and stiff and then lift completely off the table like, to me it felt like I had been struck by lighting, or something.  He start profusely apologizing, to me and told me he would never manipulate my spine ever again. it was shortly after that, that they sent me down to the Air Force base in  Anchorage and did a myleogram on me and then  in the middle of the Myloegram they wrapped me up in blankets and took me by ambulance to the civilian hospital in Anchorage tp have an MRI done and then they had the civilian neurosurgeon look at me and they admitted me to their hospital and  did the emergency ACDF surgery on me.  Anyway I was told then by the neurosurgeon never to let anybody manipulate my neck and any other part of my spine if I had a herniated disk. and I haven't!!!. What you have described in your post sends chills down my spine, I honestly consider you very very lucky that that chiropractor did not do more serious damage to you!

 

Please! Please! Please!  be careful!

 

White Beard

Posted 2/20/2011 5:19 PM (GMT 0)
What a treat. I took the advice of Chartruex and spent several hours last night getting to know Whitebeard by reading his posts and advice. WOW... What a story. Thank you for taking the time to post to me and share your story. I hope you are having a pain free day today.

I seem to have the worst luck in the world. My pain doctor has been my life source for the past several years. So I believe he knows it is time to forward me to the next level. You are right, the fact I have received relief by his blocks from 2008 through December says something. I was devastated when the December block did not hold longer than a few weeks. He knows that surgery for me is the LAST resort, so I must now explore that possibility. I am in a better situation now than in 2008. My husband wants his wife back and the kids their mommy. I struggle to keep working so we can have insurance. Where once I felt secure, I now see that no matter who you are there is no job stability. We just changed insurance carriers so maybe these are all signs it is time. Last year drained me at work, which I am sure escalated things. Those of us with CP know that long term stress is a burnout waiting to happen. It did. I did get associate of the year award, but where I am now is in a bad place.

I was told to expect the appointment with the spine specialist to be 2 hours minimum. What typically happens in these appointments?
Posted 2/21/2011 4:22 AM (GMT 0)
REDSAM

When I had my first appointments with the surgeon the last two times, they  first sat down and asked me what my symptoms were, and they wanted a full description of what problems I was having. They went over all my medications I was on and asked about them,  then went over the reports and the X-rays and the MRI after going over them thoroughly I was examined, the typical neuro exam, testing my reflexes and strength,  and of course asking me numerous questions through  it all.  I was then  told  that they thought they could help me. Andboth times they  brought the MRI pictures up on the computer, and had me sit next to them, and they went through the pictures on the MRI, frame by frame explaining what was wrong with my spine and what they could do to correct it. The thing that I thought was kind of funny  is that . I had two different surgeons, the one I had in Sept of 2009 with the C-5/6 ACDF did this routine, and that surgeon left, and this past November when I had the Posterior Articular joint fusion done, this other surgeon also did this same routine. My neurosurgeon that did my last surgery pointed out that my pain doctor was right about the problem being at C-3/4 but was wrong about needing a ACDF to fix the problem. He showed me on the MRI that the Disk was intact and it was not causing my symptoms but that the left posterior articular joint was completely deteriorated away and thus causing my vertebra to slip. He then like the previous surgeon proceeded to explain how he could fix the problem. They both told me to think about it and let them know, when I had the ACDF I had already made up my mind as I knew from my previous adventure with a herniated cervical disk what needed to be done. So I told him go ahead, and he agreed and then started the process to get the surgery scheduled. This last surgery the posterior fusion I spent some time researching it so I took a week or two before getting back with him to schedule the surgery. 

REDSAM your PM Doctor sounds allot like mine, and I have the up most trust in him. Before sending me to a surgeon he had given me several epidural injections and a battery of test MRI, X-rays, and EMG studies to name a few. But there have been times that I have been sent to a surgeon and for what ever reason the surgeon did not want to do surgery and my PM thought that I definitely needed it, he would then send me on to a different surgeon for a second oppinion.  In fact he is now doing that on my right Hip but this is the third surgeon, and he is also doing another MRI. Like he said he would not do that and order more test if he was not convinced that there was some more going on an he wanted to get to the bottom of it.

Anyway I wish you well with your appointment with your surgeon.  Good Luck to YOU!!

White Beard

Posted 2/22/2011 10:25 PM (GMT 0)
Thank you Whitebeard for your response. I believe I have a pretty good idea of what to expect.

I got a copy of my MRI and it says:
C3/4: Mild left uncovertable spurring with mild left foraminal narrowing.

C5/6 Central disk herniation more towards the left with left uncovertable spurring, moderate central spinal stenosis and left foraminal stenosis. (THIS IS THE LEVEL MY PM WOULD BLOCK)

C6/7 Left posterolateral disc herniation and spur with left foraminal stenosis.

There does not appear to be any mention of spinal compression specifically, does that mean there is none then and this radiating pain and numbness is in my head? The references to the stenosis level seems to have changed from mild (last report) to moderate this report.

Does this seem in line with my symptoms.
Posted 2/23/2011 4:50 AM (GMT 0)
REDSAM

 

No the radiating pain and numbness and tingling in your arm is not in your head! What you wrote is inline with the symptoms you are describing. You have bone spurs and stenosis and the narrowing of the foramin and that is where the nerve roots are that come off the spinal cord, and if they are being impinged, by those bone spurs or the narrowing of the foramin, ( the opening in the vertebra where the nerve from the spinal cord passes out from the spinal through.) that impingement is what is causing all the pain in your arm. Allot of times the disk herniates and presses on the nerves in this area. If the disk herniates and is pressed directly into the spinal cord, that can cause a life threatening situation, that is what I had happen to me in 1985 my spinal cord looked like a horizontal U because my disk was pressed so deep into my spinal cord. That is why the doctors and surgeons could not understand why I wasn't a quadriplegic, and when they found it, they had to do emergency surgery.  And I had allot of complications from it. It does sound like since  your impingement  went from mild to moderate that your condition is getting worse. I do hope you get this taken care of soon, but in the mean time please be careful on what you do!

Good Luck to YOU REDSAM

White Beard 

Posted 2/24/2011 12:45 AM (GMT 0)
White Beard. You have given me (i know this will sound funny) the best birthday present this year! Today is my birthday! You are really a wealth of knowledge & SUPPORT a true asset to those of us in need. I actually now understand where my problems stem from and what this means in terms I understand. When I looked at the CD of my MRI I thought for sure there was spinal compression as it looked like the herniated disc was pushing into the dark center of the spinal cord & kinda pushing it over, maybe now what I am seeing is the spurs? Not that it matters because what you talked about above makes perfect sense and the progression seems to be in line with why the last block did not hold. I hope they can fix me!

My appointment with the spine specialist is March 15th. That was the soonest they could get me in. I am being very careful because I am very un-steady, sometimes when I move my neck it gets stuck. I'm 45 with the body of an 80 year old. I will keep you in my thoughts, i hope you are feeling better.

Thank you again!
Posted 2/24/2011 4:29 AM (GMT 0)
HAPPY BIRTHDAY REDSAM!

I am glad I could be of at least a little help to you. When ever I read a post about someone having problems with their cervical spine I start Cringe! It just brings back some really frightening memories, and I know what I felt and what I went through, the base chaplian acturally talked to my sqadron commander, and they were all concerned that I was going to die before they found out what was wrong with me.  And since that time I have taken human anatomy, and all those nursing clases to become an RN,  and I really understand how lucky I really was. And now when I see posts, and the  posts are like yours, I just don't want anything to happen to you or anybody, and I don't want you to  have  to go through what I did!  So take care of yourself and be extremely carefull untill you see your surgeon. I just want you to have many many more  HAPPY BIRTHDAY's !

 

Good Luck to YOU!

 

White Beard

Posted 2/25/2011 1:17 AM (GMT 0)
Thank you White Beard. The same with me with regard to helping others avoid some of the pain I have had in my travels through life. In an earlier life I found a website much like this one to help me through my hysterectomy. I learned so much and was lucky enough to be asked to be a chat/board moderator. Ever since then no matter how miserable I feel, I always feel better if I can help someone, or offer a hug. It helps me cope. I have met many friends on different boards, so I learned what I know by engaging people like you and the members here.
I too want many more birthdays, pain free, cancer free. I have a huge opportunity to grow in my career, watch my beautiful kids spread their wings, and summer is coming. I want to do what it takes to enjoy 2011 and beyond.
Posted 2/25/2011 9:53 AM (GMT 0)

Redsam, I too have had fusion at C-5/7 in 2006.  You talked about your neck locking at times.  Mine was doing the same thing.  It would lock up and I would have to move it a certain way and it would unlock until finally I tried to unlock it and it really popped.  That was the end of that.  Everything went downhill from there.  My left arm would buzz, shoulder tenderness, my thumb and 1/2 of my index finger would go numb.  I literally lost the use of my left arm.  Couldn't lift my arm more than a couple inches from my side. 

I too did physical therapy and injections but eventually there was nothing but surgery left.  My hospital stay was only 1 night and I remember only using vicoden for pain for a couple of weeks.  The surgery and recovery time aren't bad but definately follow your doctors orders afterwards.

Hope everything goes well with the doctors appt. and Happy Birthday!   

Posted 3/4/2011 3:54 AM (GMT 0)
Well this is turning out to be a real MESS. I found out last Friday that my GP left the practice and moved down state and the only other doctor is 70 years old and is only there to diagnose colds and flu. OMG I now have to start over with a new doctor at a time when I am at my worst. I am so stressed out to the max now. I did some research over the weekend and found a doctor and went to see her on Tuesday. She spent alot of time going over my history but when she got to the part of my pain doc sending me for a surgical consult she FREAKED. She made it clear that she does NOT like my pain doc, and feels he is sending me to a sub par surgeon who she does not know personally (They are after all on staff at the same hospitals). So she indicated that she may force me to go to one of her cronies before she will do a surgical release on me.
Well, I found out today it IS the only option. I have the pleasure of knowing a VP at a big college in our state that trains chiro's, physical therapists, radiologists and doctors too for Bone and Muscles etc. He wanted to have one of his staff doctors review my films and give me some insight from an un-biased source. The verdict is just as predicted White Beard, my only option will be surgery and most likely with Fusion. My Pain Doc also confirmed at my appt this week that he feels surgery is warranted. Not that any of this is a surprise, I am going down hill day by day and finding strength to work is becoming a challenge. Depending on how things play out our family vacation in July may be at risk. I told my hubby that I hope that I will be at the end of recovery or far enough where I can take a car ride to the lake resort, and would be more than happy to relax in the cabin with the view of the lake. I can skip the boat rides and fishing. Oh well...Only time will tell.
Posted 3/4/2011 5:06 AM (GMT 0)
Well REDSAM if the surgery is not put off to long there should be no reason to have to postpone your vacation in July, if everything goes well and you follow all your Doctors orders to the T you should be in tip top shape by that time. And hopefully you will get the instant results that I got when it come to the relief of your arm pain.  I know that even this last surgery that I had in November, my surgeon told me this past Monday that he is extremely pleased that it worked so well and relieve the pain in the back of my head and upper neck, he told me that after getting in there while doing the surgery that he really had his doubts that this surgery would even help me that much. He said he felt that way because of the condition my neck is in, he said that the  arthritis is really really bad in there, so he wasn't expecting that good of results. He did say that my pain doctor was right, as he was convinced that this surgery would help me! I do know this last surgery I had, was totally different and extremely rough compared to having the Anterior Cervical Diskectomy and Fusion. And this recovery was so much longer and harder, but in the end it did what it was suppose to do, and I am extremely pleaseed about that!!! But nothing is free, and especially with this last surgery I have lost allot of mobility in my neck and that was the trade off, over all I guess,.....at least for me,..... I think it was was well worth it!

 

REDSAM you have allot to ponder and some tough decisions to make, I wish you well and know that we are all here to help you in any way we can. You are not alone! Good Luck to YOU!

 

White Beard

Posted 3/5/2011 10:29 PM (GMT 0)
Thank you White Beard. Yesterday was such a bad day for me. I was in so much pain I could not sleep. I was walking the floor until 3am. Even resorting to infomercials. The positive side of things is my husband got the chance to talk to the unbiased doc and has a deeper understanding of things now. I think he sympathized with me, but in the same vain thought I was kind of milking it. Not any more. He wants this fixed as soon as possible, especially because he has now made some connections with my symptoms. Falling, dropping things, headaches from hell, restless nights. So he believes if I like the surgeon I see on the 15th, that I should get it scheduled and if my new GP doesn't like it, then move on to a different one perhaps with a recommendation from the surgeon or hospital. I don't think I am being unrealistic.
I will be following the directions of my surgeon to the T. I tried the rush back to work thing other times, and there is NO reason for it. No rewards for it and the fact I did is forgotten when it really counts.
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