Cervical Issues

Thanks stray dog!

I also had been taking naproxen as needed which has been fine but with these flare ups, naproxen can't touch it!!

So sorry to hear about your pain, bebbles! I think I missed something...what is an ESI?

@Darla; ESI is an epidural steroid injection.

The appointment I just had was with the second opinion. They offered injections but I will decline because I am already scheduled with the VA for injections but I will use the civilian provider for surgery.

Bebbles,
I have limited experience with the VA but I can't say anything bad about them ... pleasantly surprised would be more accurate. I have recently seen a new rheum at the VA. My old rheum was aware and said she only rarely saw patients at the VA. Anyway, they know each other so that was good.

I may have a future need for surgery on my lumbar spine. I will face the choice between the VA and the University if and when the time comes. It is often the case that patients have surgery at the University and almost immediately request transfer to the VA for post-op care and follow-up. Frequently, the same surgeon will do the follow-up care at the VA. So that would be something to consider.

I haven't seen (Seashell) posting much lately. I get somewhat worried about her.

Hello,
Another update. I looked back at the neurosurgeon's notes from the VA in sept which are in front of me. It clearly states I opted for injections and he agrees injections at the C3/4 & C-5/6 level. Well this pain doctor decided on C7 T-1 level, so for that reason the VA is absolutely out!! St. Elizabeth's hospital said if they do them it would be in fact at the C-3/4 and C-5/6 levels. Wonder why the VA pain doc decided on those levels that day? That wasn't the plan! I will go therapy for a while and surgery in April is the next date. Hopefully someone reads this tonight but forgot to mention I am doing school bus driving which I enjoy but it seems to be added to stress and pressure on the back of the neck. I like the company so I will ask to change jobs tomorrow to just be a monitor on a small bus which has a lot less stress or drive a small bus or van. I drive the big bus now and it definitely beats me down. If not, I will be resigning tomorrow in two weeks. Only been with them 3 months, they need monitors, and I have my supporting documents in order. Thanks all!

Bebbles, it's been a bit since we have heard from you. Hopefully if you see this you will give us an update.

Take care.

Hi bebbles, sorry to hear that! I know having been through a LOT I pushed for an MRI sooner rather than later for my latest issues. I am not in the VA and I am sure it is very different. I agree with you... take the MRI since we know there are problems and let that guide things. There are therapy and injections, medication etc. But let's see what we have. I hope you get some answers and more importantly some relief soon.

The outside neurosurgeon is saying 2 more injections so he can narrow down what level triggers the tingling and pain in the bicep and tricep area. He is hoping this may eliminate the need for a 2 level fusion. Yes the VA paid for the first MRI and the 2nd viewed the disk and report but you're saying it would be too soon for another. Tricare covers the second which I exclusively use at this point.

Bebbles, I went back to your original post & read about the results of the MRI. I now remember both surgeons had the same opinion about C4. From C4 on you have issues that are listed. When a person has narrowing/stenosis, it is not uncommon for a nerve to be compromised & not be seen on an MRI. This is where the physical symptoms play a role.

I understand the surgeons thoughts on wanting to make sure which level is causing the issue. I have seen surgeons do this with patients that have multiple levels involved, meaning more than 2. You have a good surgeon in your corner. There is no point in operating on a level that may not be the problem level. I am not a dr, so here it is in layman's terms, lol. Back when I worked I could tell you what level produced issues if there was a problem, such as arm pain, tingling, numbness in certain fingers, shoulder pain & that sort of thing.

All you can do is ask the private neuro if he feels the MRI should be updated. Do not be surprised if he says no. Again, yours isn't a year old & no where did I see it state the film was poor quality. Both surgeons would have told you if the films were not good. If one is poor quality, the radiologist will comment at the bottom & if it's bad enough the radiologist will recommend repeating it for better quality. MRI's are not cheap & this is another factor.

I know Seashell mentioned a test called an EMG study that is done to check nerves. My first exposure to EMG's was late 70's. They were a big thing back then. However, in the early 90's neurosurgeons were not ordering an EMG like before. I asked a well known neurosurgeon here why the spine surgeons had moved away from them. His answer was, they are not a reliable test for spine problems. I live in a very large city. For over 20 years one of the things I did was read our client's medical records. In that span of time I can count on both hands how many EMG studies came up positive when it involved the spine. Those that were positive had horrible nerve damage with severe symptoms. An EMG is excellent diagnostic test for carpal tunnel syndrome, someone with ulnar nerve problems & such, but pretty much useless for spine issues.

I know you are pretty upset & frustrated. Have you discussed with the surgeon how long it takes to get ESI's scheduled through the VA? Do you have the option of having them done outside of the VA with a better time frame? The surgeon would know who to refer you to, just a thought. Maybe consider compromising with the surgeon, have the 2nd injection & see what happens. If nothing favorable happens see if he will agree to go ahead with surgery.

Seashell thank you for that text book analysis! And to the last 2 replies, I greatly thank you as well. The neurosurgeon does want me to do 2 more injections here shortly which I am willing to do. What bothers me the most as far as pain is the neck itself and the bicep pain as I mentioned previously is laying dormant and could be triggered any moment by the wrong or extreme movement to the right it seems. Seems like I am picking up more tingling to the right index and thumb more now days but is not painful. I was wondering and like I asked him directly, what does the surgery do for the pain in the neck? He said that would be something we would work on afterwards, I guess as in therapy which I doing now. The surgery he said would address the pinching syndrome and the stenosis. By the way, I did have an EMG back in Sep I believe but they said it was inconclusive as it related to my issue.