Re: Doctor question - please help
you have gotten some really really great advice and some i was going to mention too. the one thing here that seriously bothers me is that after four years of what you had going on, it states NO changes? do you have BOTH of your MRI reports just to compare findings at particular levels? some of what you just already had was/is degenerative in nature and would also be more ongoing/deteriorating whether it is OA or DDD, i have very heavy DDD esp in c spine, and it shows. just that alone in and of itself would continue, so really am wondering here how MUCH change, or advancement has taken place overall over four more years of moving that neck(even just basic flexion and extension that we all do ALLL day long), lifting, twiting and tourque and just the normal 'daily' activities you do that does also add to this too.
have they actually definitively confirmed this IS OA or DDD? do you know for sure? how did they actually tell you they confirmed the OA Dx? OA is a deteriorating joint condition to my understanding(my dad had this horribly bad in both knees then ankles) while DDD is more within the discs themselves deteriorationg, and can also weaken vertebrae too. i just do not see even ONE of what are many many actual facet joints (two at each level) even being deteriorated or holding fluid as in facet edema? nothing appears to be impacting joints yet you have a joint deteriorating condition/disease process, ya know what i mean? just wondering since the humera did not appear to work well? (tell me if i am wrong here, but isn't humera SUPPOSED to help STOP the actual deterioration/progression in joints, and help the pain? did THAT do that for you) but that too could be becasue your pain just can be more radiculopathic in nature too which it realistically would NOT help so much in THAT area, esp if your pain is not within joints. while the many different types of anti siezure meds usually have the best track record with calming the firing signals from inflammed spinal areas that create radiculopathic types of pain/symptoms. lyrica is a good one to try for pain if you do not get side effects. but you most definitely DO need a GOOD pain clinic here that is not afraid to simply treat pain 'appropriately". there IS a huge difference betweeen PMs that do NOT use any levels of narcotics to ease suffering and the ones who will 'only' give injections, big difference. and that IS the type you just need desperately esp since alot of the OTCs taken for way too long in way too high amts will damage not only ones liver, but also the kidneys too. this does unfortuently happen to way too many people out there who usually have a pretty good high level of pain, but have opiate phobic docs, or they are too flippin lazy to do the documentation for need to even Rx them to any given patient. and that partient not only suffers with pain, but organ function loss ONLY becasue OF their own doc who is 'supposed to be' actually helping them and also advocating for them too. that one just makes me ill. too many people are simply suffering and feel soo flippin helpless. its finding that GOOD solid pain clinic carsch that will really help YOU to deal with the pain aspect while you seeking consults/evals from other neurosurgeons, or a good accredited spinal surgeon whos been trained specifically in c spines and has the higher level of training to even enter that spinal canal. some do, same with some neurosurgeons too, and some do not. and of course it goes without saying to stay the heck away from the OTHER ones you have seen who sound like total idiots considering what you just have going on there that DOES need some attention soon.
was that cord contact finding present on your four years ago MRI at all? that question i really need answered, just knowing if this HAS been recently found or was there four years ago too. that one finding is what would really concern me moreso than others since it states CORD contact caused by herniation and not simply "thecal sac or dura effacement" or compression(its way beyond THAT at this point)? those are the outter 'cushion' surrounding and protecting your actual spinal cord as kind of the 'shock absorber" between the backs of the vertebrae/discs area and the cord itself. anytime you just have direct contact(even with only 'mild' it is simply NOT supposed to even BE that far into the canal, ever) with the spinal cord in the c spine esp, it CAN turn into a serious issue with even one lil fender bender type accident with an airbag deploying into your face or into the neck, among many other things we just can 'do" moving our own necks too? this is MY bigger fear with the mess i also have again in my c spine(initial round for me stared in 02). i too have an area at C 3-4 that has very direct cord contact at this point and this automatically also impairs the overall ability of your CSF fluid to do what IT just does all day long too, going back and forth from the brain(where it gets replenished every so many seconds) then flows down one side of our spinal cords to sacral just keeping it fully bathed and hydrated, then right back up into the brain again and once again gets replenished. any changes in that CSF pressure or impairment of that CSF will create a flow issue and congestion within that specific area as well. you can actually see that impairment upon my last MRI done in aug, that shows the contact, but is still allowing at least 'some' CSF to flow thru that area too, which is what you simply NEED to have or that contacted area if this goes further into the cord, will eventually dessicate/dry out then the spinal cord tissue will die off too with no good reptitive recyling hydration present. then that part of the cord is no longer just 'good healthy neual tissue and any functions it once performed are also not there anymore either.
if i were you, i would really seek out a good surgeon, neurosurgeons personally i have had the best luck with in these types of situations(c spine and spinal cord surgery) since they are usually better trained going into or relieving pressure off of the c spinal cord levels(make darn certain that the NS you choose ALSO uses whats called 'intraoperative monitoring" that monitors your motor and sensory functions when there just is any possibility of collateral neural damage BY the surgeon.esp when relieving cord compression too. it really IS more of an early warning/safety precaution for the surgeon and for you). but it will ALWAYS, with no matter what 'type' of actual surgeon you are seeking out, experiece, knowledge and years of hands on experience too just really matter. word of mouth from someone who you probably do already know who has had an ACDF done(this just sounds like what would have to be done at your c 5-6 at the very least) is one of the best ways to find the 'good ones' out there. but you do need to tackle this more important c spine issue before doing anything with that lumbar based upon what i have seen here.
if there is ANY way that you could actually first, type out word for word how that interpretting rad first initially saw your c spine four years ago in THAT report, then type out the same word for word way he is seeing it now, it seriously would help to answer some other questions too(i personally just do not understand having an actual deteriorating joint condition and yet not one single of the many facet joints within the spinal appear to even be impacted at all). its all in how a particular finding gets worded and the specific wording/language used to describe too that helps to really get the best underlying idea of how the finding is actually showing at least to him or her upon seeing it on hardfilm. it could be very helpful, esp the two together.
but DO start trying to find a really ghood PM while also nailing d0own a 'good' neurosurgeon to try and tackle that c 5-6 issue. for anything below the c spine, an ortho really would not be a problem for me, but up in that very highly vascular and innervated and with junctions area of the c spine, i would personally not settle for anything less than a very highly experienced NS. good luck with this, and please DO keep us posted, marcia
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.