BobM
12-01-2006, 10:55 PM
I read a lot here and don't post that much, but thought I would share my status, and see what others are experiencing.
I've had two ACDFs (C5/6/7 in Feb 2004, and C4/5 in Mar 2005), both times with donor bone and plate, and 6 weeks off work to recover. After the last time, there was some chronic pain remaining, and I took pain meds so I could get back to work, and give me some time to heal. My pain and shoulder/arm weakness was greatly improved, but the pain did not all go away after the second operation.
I stopped the pain meds a couple weeks ago because I couldn't stand the ever-increasing doses and side affects. Stopping after so long a time was very rough, but I did it. Pain meds are a mixed blessing.
This week I was back in to the Dr to see what is going on. I have an MRI in a couple of weeks to rule out (or in) problems with other discs, or narrow foramina. If they can find a problem we will consider more surgery to correct, and if not they will recommend injections into the joints between the vertebrae to numb those nerves. I will now be reading up on these kind of injections.
I'm just sharing my experience in case it is of use to others, and to see if anyone has comments on their experience with this kind of treatment.
Thanks for any responses
Bob
I've had two ACDFs (C5/6/7 in Feb 2004, and C4/5 in Mar 2005), both times with donor bone and plate, and 6 weeks off work to recover. After the last time, there was some chronic pain remaining, and I took pain meds so I could get back to work, and give me some time to heal. My pain and shoulder/arm weakness was greatly improved, but the pain did not all go away after the second operation.
I stopped the pain meds a couple weeks ago because I couldn't stand the ever-increasing doses and side affects. Stopping after so long a time was very rough, but I did it. Pain meds are a mixed blessing.
This week I was back in to the Dr to see what is going on. I have an MRI in a couple of weeks to rule out (or in) problems with other discs, or narrow foramina. If they can find a problem we will consider more surgery to correct, and if not they will recommend injections into the joints between the vertebrae to numb those nerves. I will now be reading up on these kind of injections.
I'm just sharing my experience in case it is of use to others, and to see if anyone has comments on their experience with this kind of treatment.
Thanks for any responses
Bob
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SpineAZ
12-02-2006, 03:10 AM
Bob:
After you have the testing I'd reccomend perhaps a pain management doctor before any further surgery. I did do Epidural Steroid Injections in my neck prior to my ACDF and also had facet injections. The ESI did work well in relieving my pain and numbness for nearly two years! If they had continued to work I would have done the ESI indefinetly.
I expect to have some future problems with C4-C5 and I'll do the injection route again if I can.
After you have the testing I'd reccomend perhaps a pain management doctor before any further surgery. I did do Epidural Steroid Injections in my neck prior to my ACDF and also had facet injections. The ESI did work well in relieving my pain and numbness for nearly two years! If they had continued to work I would have done the ESI indefinetly.
I expect to have some future problems with C4-C5 and I'll do the injection route again if I can.
SKZ
12-02-2006, 12:02 PM
Bob,
I am queen of the injections, over here. I have alot of arthritis in my facet joints in the neck AND disk issues. I am having ACDF soon. Either Dec. or Jan. You name it, I have had it done to my disks and joints. The thing that helped my facet joints the MOST was something called radio-frequency (RF)denervation. It has a ton of different names. (rhizotomy is another name). They wont just do that procedure without doing several other diagnostic injections in the weeks before the RF procedure. (facet injections to make sure that those help the pain and its IN FACT in the joints). The literally kill the medial nerves, which do grow back. It aggravated my symptoms for about 4-5 weeks afterwards, but then it helped ALOT. Its supposed to give you up to a year and half of relief. (some people get more, some get less). My problem was that it helped my facet joints, but my disks were still hurting so I wasnt pain free the way I wished I could be. It was the difference though, between me being a bigtime basket case, crying everyday and being in pain without crying. To me that was BIG. I think my nerves are growing back because my joints hurt alot again. Its so hard to isolate all this stuff. (joints...disks....) I am finding out from the Drs. that its a very muddy scenario when you have alot of both issues. I had the RF done in April 2006, by the way. I have also had epidural steroids injections, which minimally helped, but the arthritis was still bad. They can never figure out how to help both of my issues at the same time. Hence, SURGERY.
I am queen of the injections, over here. I have alot of arthritis in my facet joints in the neck AND disk issues. I am having ACDF soon. Either Dec. or Jan. You name it, I have had it done to my disks and joints. The thing that helped my facet joints the MOST was something called radio-frequency (RF)denervation. It has a ton of different names. (rhizotomy is another name). They wont just do that procedure without doing several other diagnostic injections in the weeks before the RF procedure. (facet injections to make sure that those help the pain and its IN FACT in the joints). The literally kill the medial nerves, which do grow back. It aggravated my symptoms for about 4-5 weeks afterwards, but then it helped ALOT. Its supposed to give you up to a year and half of relief. (some people get more, some get less). My problem was that it helped my facet joints, but my disks were still hurting so I wasnt pain free the way I wished I could be. It was the difference though, between me being a bigtime basket case, crying everyday and being in pain without crying. To me that was BIG. I think my nerves are growing back because my joints hurt alot again. Its so hard to isolate all this stuff. (joints...disks....) I am finding out from the Drs. that its a very muddy scenario when you have alot of both issues. I had the RF done in April 2006, by the way. I have also had epidural steroids injections, which minimally helped, but the arthritis was still bad. They can never figure out how to help both of my issues at the same time. Hence, SURGERY.
BobM
12-02-2006, 02:23 PM
SKZ
Thanks for all this info. Seems my case developed backwards, since I started with the surgery (had the problem, but was not correctly diagnosed for over 10 years).
I am just starting to read up on the different treatment types you mention, so I can make an informed decision if the Dr recommends something. If it's OK, I would like to ask you questions from time to time. First question would be about the injections in the facet joints - is that painful, and are you up and about right after? My Dr explained they do them in a hospital, with x ray images to make sure the needle is in the correct location. Does this sound like what you had?
In return, since I've already had a couple ACDFs, please feel free to ask me any questions about that.
Bob
Thanks for all this info. Seems my case developed backwards, since I started with the surgery (had the problem, but was not correctly diagnosed for over 10 years).
I am just starting to read up on the different treatment types you mention, so I can make an informed decision if the Dr recommends something. If it's OK, I would like to ask you questions from time to time. First question would be about the injections in the facet joints - is that painful, and are you up and about right after? My Dr explained they do them in a hospital, with x ray images to make sure the needle is in the correct location. Does this sound like what you had?
In return, since I've already had a couple ACDFs, please feel free to ask me any questions about that.
Bob
BobM
12-02-2006, 02:26 PM
Kross:
I was under the care of a pain management Dr for the 20 months since the last surgery, but all they ever did was give me pain meds. Took some doing to stop after that long, but I managed. I started this week with a 'physiatrist'. He recommended against PT or a Chiro, and scheduled some tests to see if I have yet another disc problem, or other narrowing around those nerves, and then he wants to start injections (this assumes he doesn't find something that warrants another surgery).
Thanks for your response
Bob
I was under the care of a pain management Dr for the 20 months since the last surgery, but all they ever did was give me pain meds. Took some doing to stop after that long, but I managed. I started this week with a 'physiatrist'. He recommended against PT or a Chiro, and scheduled some tests to see if I have yet another disc problem, or other narrowing around those nerves, and then he wants to start injections (this assumes he doesn't find something that warrants another surgery).
Thanks for your response
Bob
SKZ
12-02-2006, 02:33 PM
Bob,
The facet injections are a piece of cake! I had mine all done in an outpatient surgical center. The IV is worsed than the injections. They give you the "conscious sedation" even though it totally seems like you were 100% asleep during them. You till not feel any pain, whatsoever. All of a sudden you wake up and wonder if you had the injections ALREADY. Never worry too much about the injections because the do not hurt. I personally hate the IVs, though.
My main concern for my ACDF is that I am scared to death that I will be worse after it. I would hate to be worse than I already am. I seriously cannot remember feeling normal in my neck and upperback. It started when i was 45 and I am now 50. Seems like my whole life already.
I am also concerned that the neck, trapezius, and upper back spasms will never go away. That freaks me out because they really affect my lifestyle alot.
While I am at it about the surgery.... (oy) I dont know whether to use my hip bone or donor bone. I am sure my surgeon will have a large opinion on this on Dec. 19th. I am definitely needing C5-6 and C6-7 fused. I also have issues at C4-5 which is now freaking me out that I might end up with a triple. If there already alot of arthritis and bulging disk (plus anterolisthesis, which is a small imbalance in the way the vertrabra sit on top of one another) at C4-5....after fusion I cannot imagine the adjacent level wear and tear issue not happening if I dont take care of it now. My discogram only showed C5- C7 being a disk issue, even though my MRIs showed bulges at C4-5.
SOrry to interrupt your thread. But since you said it was OK, I took the liberty. hehe.
The facet injections are a piece of cake! I had mine all done in an outpatient surgical center. The IV is worsed than the injections. They give you the "conscious sedation" even though it totally seems like you were 100% asleep during them. You till not feel any pain, whatsoever. All of a sudden you wake up and wonder if you had the injections ALREADY. Never worry too much about the injections because the do not hurt. I personally hate the IVs, though.
My main concern for my ACDF is that I am scared to death that I will be worse after it. I would hate to be worse than I already am. I seriously cannot remember feeling normal in my neck and upperback. It started when i was 45 and I am now 50. Seems like my whole life already.
I am also concerned that the neck, trapezius, and upper back spasms will never go away. That freaks me out because they really affect my lifestyle alot.
While I am at it about the surgery.... (oy) I dont know whether to use my hip bone or donor bone. I am sure my surgeon will have a large opinion on this on Dec. 19th. I am definitely needing C5-6 and C6-7 fused. I also have issues at C4-5 which is now freaking me out that I might end up with a triple. If there already alot of arthritis and bulging disk (plus anterolisthesis, which is a small imbalance in the way the vertrabra sit on top of one another) at C4-5....after fusion I cannot imagine the adjacent level wear and tear issue not happening if I dont take care of it now. My discogram only showed C5- C7 being a disk issue, even though my MRIs showed bulges at C4-5.
SOrry to interrupt your thread. But since you said it was OK, I took the liberty. hehe.
SKZ
12-02-2006, 02:42 PM
Bob,
The best Dr. I have had so far is my physiatrist. This guy has a heart of gold. And that is saying alot because I have gone thru Drs. like toilet paper! hahaha. There are alot of loser Drs. out there and I got tired of putting up with them, being in pain , and wasting my time. The best ones for me have been physiatrists. A good one will refer you to a pain guy if the physiatrist doesnt do certain injections (e.g. the radio-frequency procedure...facet injections....medial branch blocks...etc)
I hope yours is worth their weight in gold like the one i FINALLY found.
The best Dr. I have had so far is my physiatrist. This guy has a heart of gold. And that is saying alot because I have gone thru Drs. like toilet paper! hahaha. There are alot of loser Drs. out there and I got tired of putting up with them, being in pain , and wasting my time. The best ones for me have been physiatrists. A good one will refer you to a pain guy if the physiatrist doesnt do certain injections (e.g. the radio-frequency procedure...facet injections....medial branch blocks...etc)
I hope yours is worth their weight in gold like the one i FINALLY found.
BobM
12-02-2006, 04:21 PM
SKZ
You are providing lots of info for me, thank you. Just the concept of them working the needle into the right place....but as you describe it, I can do that!
If you have C4 to C7 you will be like me, except mine was done in two operations - the first when I was 52. Even though I still have some issues, there is no doubt in my mind that I am much better off now, then if I had not had the surgeries. Each case can be different, the key is to learn as much as possible and connect with good Drs.
Lots of discussion about using your own bone, vs donor bone. Both of mine were donor bone and plate, and no collar afterwards. My Dr recommends against using your own bone, unless a person has issues which would hamper the healing (like being a smoker, or diabetes, etc). He said there is no significant difference in fusion rates, and harvesting the hip bone makes the operation longer, and the recovery more painful (since two incisions), and risk of complications in the hip area. Others here are told differently.
You seem very knowledgable, I suspect you will make the right decision for you!
Thanks
Bob
You are providing lots of info for me, thank you. Just the concept of them working the needle into the right place....but as you describe it, I can do that!
If you have C4 to C7 you will be like me, except mine was done in two operations - the first when I was 52. Even though I still have some issues, there is no doubt in my mind that I am much better off now, then if I had not had the surgeries. Each case can be different, the key is to learn as much as possible and connect with good Drs.
Lots of discussion about using your own bone, vs donor bone. Both of mine were donor bone and plate, and no collar afterwards. My Dr recommends against using your own bone, unless a person has issues which would hamper the healing (like being a smoker, or diabetes, etc). He said there is no significant difference in fusion rates, and harvesting the hip bone makes the operation longer, and the recovery more painful (since two incisions), and risk of complications in the hip area. Others here are told differently.
You seem very knowledgable, I suspect you will make the right decision for you!
Thanks
Bob
SKZ
12-02-2006, 04:42 PM
The hip thing does not appeal! I hope my Dr.is one of those donor advocates. I am about to turn 51, so we are not far off in age. What a bunch of geezers we are! haha. My husband is 56 and he has neck and lower back issues. I think watching me is enough to make him be more careful when he lifts so he doesnt end up with a fusion.
Seriously, do not sweat the injection thing. These things have never been painful for me, just EXPENSIVE.
Seriously, do not sweat the injection thing. These things have never been painful for me, just EXPENSIVE.
sunshine221
12-03-2006, 02:27 PM
I'll second the cheer for physiatrists!! They are the perfect mix of neurologist/physical specialist that many of us need. Next month I see a neuromuscular specialist, not quite sure what to expect. I just developed some sciatic nerve pain probably from my "off gate" - hopefully it will go away soon.
ThoreauFan
12-05-2006, 07:46 PM
Kudos to you, Bob!
You have overcome some very difficult obstacles.
I'm hope you gain some relief during your current course of treatment.:wave:
You have overcome some very difficult obstacles.
I'm hope you gain some relief during your current course of treatment.:wave:
BobM
12-06-2006, 12:53 AM
Thanks everyone, for the ideas and words of support.
My present pain meets the definition of chronic pain - it's been long enough for the injury and surgery to heal, but there is some neck and shoulder pain that stays just above the level where my mind feels like something has to be done for relief. The pain meds bought me time to feel confident that I've waited enough for things to heal, and now I'm hoping for further help that avoids the narcotics. We're never satisfied, are we? :)
I almost hope the upcoming MRI finds something that another surgery would fix - like maybe an osteophyte that was missed, in a place easy to get to. The radiologist from the most recent MRI (1 month after my C4/5 surgery) said there was still some narrowing evident, and wanted to do a CT Myelogram since the MRI images were blurred by the plate and screws.
Injections are also being discussed, but I wonder if those treat the symptoms and not the cause? I'm not ruling out any treatment options at this point.
I'll let you know what I find out, in the hope that it's useful for those having surgery now - maybe it helps to see where some people are, a couple of years out from surgery. I've had lots of improvement, and still looking to get back to pain-free if I can.
Thanks
Bob
My present pain meets the definition of chronic pain - it's been long enough for the injury and surgery to heal, but there is some neck and shoulder pain that stays just above the level where my mind feels like something has to be done for relief. The pain meds bought me time to feel confident that I've waited enough for things to heal, and now I'm hoping for further help that avoids the narcotics. We're never satisfied, are we? :)
I almost hope the upcoming MRI finds something that another surgery would fix - like maybe an osteophyte that was missed, in a place easy to get to. The radiologist from the most recent MRI (1 month after my C4/5 surgery) said there was still some narrowing evident, and wanted to do a CT Myelogram since the MRI images were blurred by the plate and screws.
Injections are also being discussed, but I wonder if those treat the symptoms and not the cause? I'm not ruling out any treatment options at this point.
I'll let you know what I find out, in the hope that it's useful for those having surgery now - maybe it helps to see where some people are, a couple of years out from surgery. I've had lots of improvement, and still looking to get back to pain-free if I can.
Thanks
Bob