Confused about 3rd opinion (sorry so long)

[Pennylane]

Hi all, To make a long story short. In 02 had a ACDF C 5/6 & 6/7 about 10 weeks after surgery the burning pain I had in the shoulder blade area returned NS sent me to PT which did help some when I went back to him. He said ok good I shouldn't have to see you ever again bye.

I continued to have neck pain, Family doc thought I was a drug seeker sent me to another dr who just gave me neurotin which didnt work and excerises to do which didn't help. I went back said send me to someone who is going to find out what is wrong and why I am hurting.

He then sent me to my current pain dr who I love to dealth he is great has done and tried everything on me I think lol. between him and his old partner anyway.

Back in 05 I went to 2 OS's they both said same thing my surgery didn't take and that my top screws was backing out. the 1st OS said he couldn't do the surgery it was beyond his expertise so they sent me to someone that does them. Had everything all set up with work and home 2 weeks before surgery I stopped in Dr's office to drop off paperwork and his assistant noticed I smelled of smoke asked about my smoking said I was down to half a pack and got a call the next day he had cancelled surgery until I got a blood test proving I had quit.

Went back to pain dr told his partner what ha happened and he talked me out of the surgery they ended up splitting ways not long after that and it's just now taking me the nerve to get back up and get it looked at again this time by a NS who instead of looking at X-rays looked at a CT scan and said I think your fused barely and I do mean barely fused in the very front.

Anyway he don't want to redo the fusion but the disk above does need redone he said but wants to wait a year if we can. not sure will post the mri impression at the end.

but he said he thinks I have chronic or muscle damage to go with the nerve damage the EMG shows also I can post that also cause I can not use my right arm for more then ten min's it starts to hurt in the tricep area, gets weak, shoulder blade area burns like a poker sticking in it. still get alot of neck pain right now the back of it, headaches galore, and I'm sure alot more I can't think of right now

but don't know what to think unless in 2 years time I could barely fuse? and can you have chronic muscle spasms? and if so how or what can they do for them? I do have a appointment with the PM but this has been bugging me and wanted to wait till after the holidays.

Mri Impression:

Congenitally small cervical canal in a patient who is status post anterior fusion from C5 through C7. Of note, there is a left central disk protrusion/herniation that results in mild abutment of the cord at the C4-5 level. This results in narrowing of the AP canal dimension to 7mm. Disk bulging is also seen at the aforementioned levels in addion with no significant central or foraminal narrowing.

mild paranasal sinus disease

[gizmogirl]

I was a smoker when I got my fusion (although I had quit up to 6 months several times, I couldn't think straight without nicotime). They don't like to do a fusion if you are a smoker because you often don't build bone through the fusion, making it strong, if you smoke.
My doctor was shocked to find out a year later that I had healed as well as I did. I asked if he meant that I had healed like a non-smoker and he said yes. But at that time I was still somewhat athletic, whici probably counteracted the smoking. I eventually quit for good using the spray (unlike the patch, it's like the gum but stronger nd gives you the peaks and valley's of nocotine levelsmore like a smoker. I also tried hantix. It made me suicidal for the first time in my life and stoped as soon as I stopped taking the Chantix - my SE wasn't documented, but I think this new drug will see more SE's like mine as our population of smokers dwindles to the verry addicted. I was like massive withdrawal. Do any exercise you can, and quit if you can.
Goof luck. I hope you can heal and.or repair it. Make sure you know how to safely move (how much randge of motion you should allow, how many pounds to lifl

[Tbackpain1]

First off, I'm not a cervie, but I do experience chronic shoulder blade spasms/pain, so I can understand where you're coming from with that...its miserable to say the least.

Gizmogirl is correct...many, if not most surgeons will not do fusion surgery on a smoker because smoking inhibits the healing process. But with your screws backing out and the fact that from what you've posted, I would say that you have a "failed fusion", the need is there for you to get it corrected. And in addition to having the failed fusion, you now have an additional herniation at C4-C5 which is probably adding to the pain and spasms you're experiencing. There are surgeons who specialize in fixing "failed" fusions, but I'm not familiar with cervie docs, so I hope others will come along with more info. for you.

Right now, the only thing you can do, until you get another surgical consult or get approved for the surgeon you saw for revision surgery (requiring you to quit smoking and have a nicotine free blood test), is to treat the symptoms. Ice and heat are handy for taking down the spasms...I find that if I rotate between the two, I have better results than using one or the other. Massage also helps, and there are methods of Trigger Point Massage that you can do yourself with a tennis-ball and a wall. The spasms can cause "banding" where it feels like there are "lumps" under your skin. If you can work at those "lumps" with massage, it can sometimes ease the discomfort. I get Trigger Point injections from my PM doc when they get really hopped up.

Be careful of how you move your neck around and how much weight you carry with your arms. Remember, a gallon of milk weighs appox. 5 lbs, so be careful with grocery bags, doing laundry, etc. I find that activities around the house (cleaning, laundry, dishwasher) exacerbate my shoulder issues, so I try to minimize how long I do any task, breaking it into smaller chunks, even though it means it takes me 45 mins to fold laundry or do the dishes. You may find that wearing a soft collar during activity relieves some of your symptoms...check with your treating doc before trying that out though.

Good luck to you.

Theresa

[Mark N]

PennyLane, gizmogirl and Theresa have given you excellent advice and there isn't much I can add to what they have said. I do want to reinforce that your barely fused after two years is typical of people that smoke as it slows down bone growth. That is why the surgeon was unwilling to go ahead with the surgery until you stop smoking.

Yes muscle spams can become chronic if you have an underlying problem triggering the spasms. A muscle relaxer may be something you need to have your doctor prescribe. Other than that ice, heat, and massage, that Theresa suggested, is able to help some people.

[BrokenBladder]

PennyLane,

I get these lumps in my back and the only thing that helps is ice/heat and my son knows how to gently massage them out without hurting me.

I'm a smoker too and I've been able to quit twice in my life and both times I did it using the AD Wellbrutin. It really worked like a charm. I took it for two weeks and then one day, in the middle of the day, I would get ready to have a smoke and think to myself "these things taste horrible." I've heard so many good things about Chantix. I have a friend who had NO desire to quit smoking, but some girls at her work actually made a bet with her that if she took this she would quit. It wasn't a small bet either as everyone pitched in some money and the winnings got up to $225.00!! The deal was that she take the Chantix everyday for a month and if she was still smoking they would use the money for a girls night out BUT if she quit the entire pot of money would go to her to do whatever she wanted with it. I didn't think she would quit because I knew she didn't have any desire to give up smoking. In fact she told me one time that she would go to her grave smoking because she enjoyed it. Here's how the story went. She went to the doctor and got the Chantix and started taking it. Everything seemed to be fine but she continued to smoke. To my amazement about 3 weeks into this ordeal she called me one night and said, "Lisa I don't know what's happening to me but I can't smoke!" At first I was kinda scared cause I thought maybe she was having trouble breathing or something, but she told me that she suddenly feels like she never smoked and didn't want one at all.

[Pennylane]

Hi Thanks so much for your fast replies, I did quit for a brief time right after my 1st surgery after I woke up and went home I slept almost the whole week afterwards. I also had that horrible bedpan experience I've seen a few of you mention also. I was so glad to see I wasn't the only one they made use it right after neck surgery that made me so mad I did let them know about it.

but I did start back up about a month later smoking that is. if not a little longer. the most recent surgeon I just seen the NS didn't say if my screws were backing out so not sure if they are or not??? but I know the OS 2 yrs ago said they was actually 2 of them said that. I've been thinking of trying Chantix but because of the many SE's I've read about not sure if I want to or not.

I've learned the hard way about breaking the household chores up but thank you for the tips. and very careful about lifting anything. I still try to do alot of the ROM excercises and use some of the tricks like the ball on the wall to work out trigger points yes it does work good too doesn't it. lol

I am currently on flexerill 10mg twice a day but it don't seem to be helping alot with the shoulder issue esp. when I aggravate it. just had a cervical RF on C 5,6 & 7 two weeks ago still not sure if its helped alot hard to tell sometimes if its muscle or nerve that is bothering my arm.

but thank you all very much for you advice and help and may you all have a painfree weekend

[gizmogirl]

try the chantix - it works great or it doesn't. If it doesn't, you just stop taking it. And you're hearing this from someone who had the worst recorded reaction!
Also, try the gum. You'll be a mess in the AM because it's so slow to kick in. (line your stomach with oatmeal so you can stand the acid of a cup or two of coffee!). But after a few hours, the gum eases the withdrawal. If you don't believe me, take two cross country plane trips, one with the gum and one without. The trip WITH is much better!
It IS possible to quit with no withdrawal, but you need to use Nicotrol spray (ridiculously expensive - like $100 or more a week in nicotine replacement therapy EACH week until you can taper off it. And even that is 2 minutes before you get a little nicotine to ward off the withdrawal (while a cig delivers 200 nanograms in 2 seconds)
Good luck and don't let something fixable go for 18 months or something where you'll get nerve damage.
Jane

[Pennylane]

thank you Jane I will try it just as soon as I go back to my pm I will see if they will write me a script for it. but my pm wants me to try a SCS now but I'm not sure I am going to go ahead with the trial just to see how that works but with the herniated disk at C 4/5 not sure if that is a good ideal or not. I might post something about that later when I feel more up to it. but once again thank you all for your suggestions and help.
Penny

[gizmogirl]

Do NOT even think about getting an SCS (search ntimes.com and this site) yet. You still need to know if you are risking losing the use of your arm without surgery. Even if the report says the pressure on the cord or nerves doesn't look too big, it might be enough (my mri didn't show that my spinal cord was folded over and kinked upon itself for 4 years - only in surgery did they have the right angle to see it).
You need to quit longer than a month for bone to heal. You know how they say smoking gives you wrinkles becuz it reduces capillary flow thus oxygenation? Well, the kind of "flow" you get in bone is a million times more subtle, so you can see how smoking could tilt the scales till you just don't have enough to grow new bone. A fusion with bone still requires that you grow a fair amount of bone. Mine, with metal, which causes me no pain and was a complete success is still mostly bone - they just put in the scaffolding and hope that your bone with grow through and around it until it's totally dense with your bone.
If you can't quit, use the drugs to cut down drastically and do whatever aerobic that won't hurt healing.
Good luck

[gizmogirl]

thought I'd just check in and remind you that you want to get a neurosurgeon to look at your MRI and see if you have to fix both the failed fusion and the compression of the spinal cord. I would hate to see you lose the use of your arms, permanently, only because you did not get it checked soon enough. You might even want to check with a lawter who does malpractice to ask him how to get them to take your need for surgery seriously - maybe you just need to have the lwyer sed them a note reminding them that you are waiting for them to respond to your request for a prognosis. Try reading c. Woolfe in some of his less technical articles like for Webmd.
Good luck,
Jane

[Pennylane]

Jane, The last surgeon I just seen in Dec was a neurosurgeon he is the one that wants to wait a year. He is the one that said my 1st surgery fused but barely. 3 years ago now It was 2 different Orthopedic surgeons who said it didn't fuse. and those 2 also said that screws were backing out, but the NS didn't say anything about that.

The NS wants to wait a year he said because it's such a big surgery but the more I think about it the more I think maybe he wants to see if the disk bulge at C3/4 will be worse that way he will be able to take care of both C3/4 and C4/5 so then I'll be fused from C3 to C7 He didn't say that but the more I look at my MRI I bet that is what he was thinking.

I am trying to cut back on my smoking still can't afford to get the Chantix yet and still waiting to learn more about it. I have seen so many different people react so many different ways to it.

It has been a bad couple of days, I've noticed that when I do certain ROM excercises and other stretches it seems to bring this horrible headache on one that gets so bad it even hurts to lay my head down on a pillow. So I've had to even stop doing those. The right side of my neck and the whole shoulder blade section just seems to hurt so bad and it goes all the way down to my finger tips and it seems to have my arm swelled up. And nothing I take has helped the pain and then it seemed like I was getting these electric type of shooting pains going across from the spinal cord to right under the arm pit area every now.

I am concerned about the SCS I know it is supposed to help with the shoulder and arm pain.....but on my MRI it says I have congenitally small cervical canal so it don't take much for a disk bulge to go into the spinal cord I guess. and I'm concerned that the SCS will or might mask the symptoms if the bulges get worse or it won't take care of the pain I have in the neck. and so far I have mainly found alot of infor on it for the lower back and legs and most of the feedback I've seen is most people won't have it done again. I go to see the shrink the 1st of Feb and then back to the Pain Doc the 5th but thats a normal check up.

Thank you so much Jane
Penny

[Tbackpain1]

Penny,

I just wanted to offer the info for you, if you're interested. Ohio, like many other states, has programs through the Dept of Health that offers assistance for quitting smoking, including nicotine replacement therapies, counseling, phone support, groups, etc. to help you quit. In NY here, its a pretty simple process, and I'd imagine its much the same for Ohio. Here's the link: http://www.ohioquits.com/?gclid=COT6ybmekJECFQ2nGgodoAECOw

Also, Oprah.com has all kinds of links up for smoking cessation, since she just did a show on it. I'm not a huge Oprah fan, but the links she has on her website are useful.

I tried the Wellbutrin quitting method back when it was first coming out a few years back, but I had very limited success and the medication SEs were not pleasant. I haven't investigated Chantix, but for me, it would probably be cost-prohibitive because its a new drug. Good luck.

Theresa