FU with NS

[joeworkflow]

UGH... not exactly what I wanted to hear, but I figured as much. What it boils down to is one or the other:
1). Neck pain is due herniation at c5/6 or c3/4 if it turns out to be 5/6 I'm going to be in a world of hurt as there is DDD at c4/5 as well. The NS said, if we have to go in and fuse 5/6 we will really need to do 4/5 & 3/4 at the same time. :( not good. If the neck pain is due entirely to 3/4 we can just open up the channel the verve comes through to see if that will help.

Something tells me, it's not going to be that simple. When I saw the images on the screen with her she was (very compassionately and honestly) quick to point out the state of the discs at 5/6, 4/5, & 3/4 and if we were going to do one we'd might as well do all the others.

I don't know...I want to play the ostrich game and hide my head in the sand and just call out for pain management...:confused: I hate this part of all this. She was very cear to point out that "did your former NS inform you that once you started the process of fusion on cervical discs, the others would take up the slace and tend to fail?..." I just didn't think it would be that fast. I'm just stunned....we got home from the 7:30am appointment that lasted until 9:15am and I told my wife, "I'm going to put my pj's back on and just crawl into bed..." Please, please, please don't burn me for this. I am so discouraged. I was hoping she would say, "at this point, there's really nothing we can do for you surgically, based on your neurological assessment..." Leave well enough alone and let me just go off for a little while not having to worry about anything...NOT!

We've got the standard tests lined up, EMG, bone scan, ect...but to get me to a level where she can operate on me she's requesting that we taper my meds to a level that will allow for postop comfort. UGH...realistically, how do we do that when I'm already hurting. I know I CAN do it. And based on the results of the EMG WILL do it, but OMG, I wasn't at the place emotionally today.

Ahhh....I could ramble on and on, but there you have my NS follow up in a nutshell.

Let me know what you think

Joe

[Mark N]

joe, if you think about it she did tell you that you can do nothing and just wait, at least that is an option even if she didn't spell it out. Now to what she did say, be an ostrich until you get the report back and find out it is something more than the C3-4. Maybe fortune will look down on you and limit the surgery to just that work and you will find great relief [hey you have to have some dreams:) ]. I hope this is what is indicated by the test and you don't have to go the fusion route with so many levels involved.

Stay in bed if you need to for a couple of days and then come out with positive thoughts until you find out for sure what needs to be done.

[joeworkflow]

joe, if you think about it she did tell you that you can do nothing and just wait, at least that is an option even if she didn't spell it out. Now to what she did say, be an ostrich until you get the report back and find out it is something more than the C3-4. Maybe fortune will look down on you and limit the surgery to just that work and you will find great relief [hey you have to have some dreams:) ]. I hope this is what is indicated by the test and you don't have to go the fusion route with so many levels involved.

Stay in bed if you need to for a couple of days and then come out with positive thoughts until you find out for sure what needs to be done.

Who know's what will happen, but as she stat three pointing out the levels that wrere affected, I could almost feel the destiny placed on me. C5/6, c 4/5, c3/4. fixing these will no boubt give me the greater lever of stability and if you wil comfort. I can an WILL discouss comfort with my PM Dr after the proceedure to optimise the GREATEST level of comfort...

shoot...shoot...shoot...I didn't want it to turn out this way and in fact was hoping for a real WIDE back door that allowed me sneak out the backdoor which allowed me to have installed a pain pump and just coast for a while. but such is not the case. I need to lesson the meds I'm on to be able to conduct a surgery and then from there POUND EM, POUND EM POUND EM!!!:) nOT REALLY, BUT THAT;S REALLY GOING TO BE PART OF IT....
Please pray for me friends, 'm really discouraged. the option left open to me is a multi-levil fusion...God help me...:(

[Kathi49]

Joe,

I feel for you, I really do. :(

But I am a little confused. In your earlier post to me you said that the C5/C6 was already fused. Am I missing something? Also, can you specifically state what the NS said about the other levels? I know you probably don't feel up to it emotionally; I can sympathize. But I am just wondering. I have had two levels done and yes I may need more. It is a hateful thought. But as Mark said and as your NS said, if it is just the C3/C4 then things might not turn out as bad as you think. :)

Post again when you feel up to it. And again, I feel for you.

[joeworkflow]

Joe,

I feel for you, I really do. :(

But I am a little confused. In your earlier post to me you said that the C5/C6 was already fused. Am I missing something? Also, can you specifically state what the NS said about the other levels? I know you probably don't feel up to it emotionally; I can sympathize. But I am just wondering. I have had two levels done and yes I may need more. It is a hateful thought. But as Mark said and as your NS said, if it is just the C3/C4 then things might not turn out as bad as you think. :)

Post again when you feel up to it. And again, I feel for you.

Thanks for your post, Kathi...

My previous fusion was at c6/7. What she found at the other levels were as follows:

c5/6: severely DDD and is most likey the cause of my neck pain at this point
c4/5: Also severly DDD and if they find out that c5/6 is the culprit in causing the pain my my neck & shoulder she would like to fuse that level as well
c3/4: Again Severely DDD and it "MIGHT" be (with a LOT of wishful thinking) that the nerve root coming out of the left side and which runs down the neck is the one causing all the problems I'm experiencing. She will open up the channel and hope that it helps with the pain.

I'm going in for an EMG, Bone Scan, Flexing and extending X-rays, we're also going to scope my vocal coards to see if they are fine. I've noticed that since my first fusion I've always had trouble with my voice going hoarce. If she needs to do a 3-level fusion she would rather do it from the same side so as to not cause problems with the Right which just might leave me without a voice...

Bottome line it's one of two things:

c5/6 - if that's the case we will end up fusing most of my neck: c/5/6 - c3/4.
c3/4 - if we can determine that the pain is coming primarily from a nerve root at c3/4 she will simply open up that nerve root and see if that corrects the problem.

What's odd is that is antrior and one is posterior. The 3-level fusion is going to have to be from the front, so we want to make sure that the issues with my vocal cords are not from the 1st surgery I had so she doesn't duplicate them and leave me without a VOICE!

Obviously if we're only talking about opening up the c3/4 verve root space that is FAR less DIFFICULT but till involve the muscles of the (back) neck. i.e. posterial. That does take longer to heal.

Hope this helps...I've taken another, "I'm too depressed to go into the office today" day off so I hope you guys can come up with something to help me smile about...:)

Obviously, the 3rd option is not do anything since i do have my pain well managed and it doesn't stop me from doing things with my kids I would like to do at this point. I actually wanted to just get a pain pump installed that would be focused more on the direct source of pain and provide me with extrra mobility....I feel like I'm screwed....:(

[Kathi49]

Joe,

I don't blame you for wanting to take a day off. :(

I just wanted to ask since I see a lot of "ifs" in your post have you undergone any diagnostic injections and/or are any of these discs enroaching on your spinal cord? Oops, I just re-read your other post. Are all of them herniated? And do you have a copy of your MRI report? I would be interested in what it says. Also, do you have weakness or nerve pain in your shoulders or arms?

It is odd that one is anterior and one is posterior. But she must have her reasons for wanting to do it that way. I have been told pretty much the same thing. The next fusion MIGHT have to be done from the back.

And, I too, have had hoarseness off and on...just can't hit those high notes. :)

In any case, you sound like me, just DDD everywhere!

I almost hate to say this. But the one thing that Kim (Slipnside) and I say all of the time is that our fusions weren't so much about pain, even though it was horrible. It was more about stability. I suppose a pain pump could help with the pain. But in reality and as my NS and PM always told me...it will only get worse (meaning the pain and DDD and deficits). I am just trying to say that conservative measures last for awhile and then you have to do something or risk neurological deficits that are not reversible. And again, I am quoting my NS. If it were just the facets causing pain, I wouldn't have said what I just did. But since the discs are pretty bad, I tend to lean more towards what your NS is telling you. I am just really curious as to what the actual MRI report says.

Hang in there I know it is a bummer. And I, myself, am waiting for next shoe to fall!

[joeworkflow]

Joe,

I don't blame you for wanting to take a day off. :(

I just wanted to ask since I see a lot of "ifs" in your post have you undergone any diagnostic injections and/or are any of these discs enroaching on your spinal cord? Oops, I just re-read your other post. Are all of them herniated? And do you have a copy of your MRI report? I would be interested in what it says. Also, do you have weakness or nerve pain in your shoulders or arms?

It is odd that one is anterior and one is posterior. But she must have her reasons for wanting to do it that way. I have been told pretty much the same thing. The next fusion MIGHT have to be done from the back.

And, I too, have had hoarseness off and on...just can't hit those high notes. :)

In any case, you sound like me, just DDD everywhere!

I almost hate to say this. But the one thing that Kim (Slipnside) and I say all of the time is that our fusions weren't so much about pain, even though it was horrible. It was more about stability. I suppose a pain pump could help with the pain. But in reality and as my NS and PM always told me...it will only get worse (meaning the pain and DDD and deficits). I am just trying to say that conservative measures last for awhile and then you have to do something or risk neurological deficits that are not reversible. And again, I am quoting my NS. If it were just the facets causing pain, I wouldn't have said what I just did. But since the discs are pretty bad, I tend to lean more towards what your NS is telling you. I am just really curious as to what the actual MRI report says.

Hang in there I know it is a bummer. And I, myself, am waiting for next shoe to fall!

I just really have to deal with things as they are and how difcult they are to ge through on a daiy basis. I double giong thruoth a tripple level fusion will be answore at this point and TO be honest, I am going to talk with my pain mamagemet dr is a pain pump willl help over the next year or so. I know there are other problems do deal with with, but at this point I;m really looking for the LEAST INVASIVE means possible I do know that I will ahve to undergo several operations in the next couple of years, but I'm not at all ready for them. If I can controll the pain and at the same time minimize the stuff I'm having to deal with, then I would rather go down that path for nowl Time will tell and We will adjust accordingnly, but if if I an hold off for six months or so that would be perfect...

Blessings and I hope all goes well

Joe

[Kathi49]

Joe,

I understand and I do empathize, believe me. I know what you mean by trying to hold off for 6 more months. I held off on the C5/C6 fusion for two years. My NS told me right at the time of C3/C4 fusion that the C5/C6 was pretty bad as well. I know I have said it before but he did NOT want to do the lower level until he saw how well the first one healed. So, I did get two years worth out of that wait until it was "time". That is why I asked you if you were beginning to have any deficits. That seemed to be my problem. Sure, I had pain and plenty of it, but by last August I could not hold a pen nor write.

I also understand how you feel about facing multiple surgeries. In a way, I kind of wish my NS would have done C3/C4 to C6/C7. But his words were, "We don't fix what ain't broke." That is what I meant by waiting for the other shoe to drop. And maybe I am way off for wishing that. But the day they tell me they have to do another one is a bridge I will have to cross then. And, well, I may be looking at surgery for an issue totally not spine related which would be major surgery. Yet, my doctor for that one says to try PT first. And that I will do!

In the meantime, yes, talk with your PM and get his/her opinion. Like anyone will tell you here, no one can force surgery on you. That is your choice. Hang in there and blessings to you as well. :)

[Mark N]

Joe, I know what you mean about holding off for a while. I did the same thing with my thoracic fusion, waiting until paralysis was developing. It gave me a couple of decent years before going through another fusion again. I hope it works out for you and you can delay the needed surgery on the other hand it may be better to get it done and over with. Good luck with whichever path you have to take.

[BrokenBladder]

Joe I don't have the problems that you do, but I can understand why you would like to bury your head in the sand. I'm so sorry to hear all of the pain you're going through both physically and emotionally. Give yourself some time to think about things and I know you will make the right decision.