Need opinion - neck pain & what it means for teacher's job - Spinal Cord Disorders Message Board

boxer_dog_luv · 05-20-2004, 07:08 AM

May 2003 ref. to neurosurgeon for left neck pain & MRI done. NS on exam found carpal tunnel, worse on left, confirmed by EMGs w/ successful release 7/11/03. Seemingly symptom free until 3/1/04 then progressively worsened symptoms of left neck pain. Again ref. to NS who ordered 2nd MRI. I posted last week after 2nd MRI about the agony of laying on table for study. Well returned for F/U and 2nd MRI results 5/13/04 show:

1. Circumferential disc bulg. w/ uncostoverebral joint hypertrophy at C5-C6 level bilaterally causing bilateral neural foraminal narrowing.
2. Asymmetrical disc bulg. at C6-C7 to the right w/ acc. hypertrophy of the uncostovertebral jiont also causing right neuroforaminal narrowing.
3. Cervical spine remains unchanged since study of 5/31/03.

Anybody that has had an MRI: Do you think this explains my left arm/thumb off and on numbness all the time. My MD says yes b/c I can reproduce numbness by turning/flexing neck to either side & wants surgical intervention. The NS says he is puzzled, doesn't think it is bad enough for surgery. From the recent posts, I am more terrified b/c I read of the long term pain after surgery and multiple procedures.

I am taking Orthoflex, Soma at night and Darvocet for extreme pain with a disability statement (limited duty <20 lbs.) Meanwhile, I am HS teacher who must float out of my classroom and must carry in my arms all books, papers, etc. needed for a planning period. I am never sick or absent for 7.5 yrs here, teacher of year last year (so I have a good reputation on my job). My director said he didn't know what to do w/ the MD typed form with limitations, gave it to school secy. who filed it. In other words, these people do not intend to respect this. I am so frightened. If I am still having symptoms, which I am, feel like the brutish work conditions make it worse--then a surgery date will sched. at 6/10 appt. What happens if I am not able to teach come August 1? I am bitter b/c I feel like I have had "help" to get to these neck probs--must carrry cases of copy paper back to classroom, move computers, have been tripped purposefully as an assault by a student (school chose not to take action against student--as always and swept it under the carpet). I am getting really depressed b/c I feel like my employer doesn't care (at least 7 more days of school left). How can I protect my job w/ whatever happens? I have tenure but we are a nonunion state. I just have no experience as I have never had an injury or general anesthesia surgery before. Appreciate anybody's input.

X-man · 05-20-2004, 08:20 AM

A couple of observations...

Based on your previous posts and current status, you certainly provide enough of the same pain profiles, symptoms and test results that many other posters like myself experienced prior to undergoing surgery. I'm sure you'd agree that it isn't realistic to get by each day for the forseeable future by taking a series of prescription drug "cocktails." Having said that, you also need to be comfortable moving toward surgery by getting a second or third opinion if necessary to confirm your diagnosis. Did they suggest any PT first? If you want to exhaust all other possibilities, this is one route to go. But I've noted striking similarities in your case and mine through your posts and to me surgery seems highly probable. And if PT doesn't work, you're only delaying the inevitable and then you'll really be bumping up against your school schedule.

If you do have surgery, you'll be on weight and activity restrictions based on your particular case. I'd be very doubtful that you'll be able to lift more than 10-20# by the time August rolls around, even if you had surgery the day after school was done (which won't happen). Your employer needs to accommodate this situation. I would check with an attorney. If you feel this injury is traceable to something that happened on the job, there should be workers' compensation rules that govern what has to happen in this case. I don't know the situation in your particular state, but I'd assume that if it is a work comp claim, then your school will HAVE to comply (or risk some serious consequences) with whatever the doctor's orders are regarding your physical limitations and ensure that you are accommodated properly for your return-to-work.

Finally, I sense a great deal of anxiety over having surgery and can certainly understand this. I tried to avoid it at all cost myself. It doesn't help that many who post on this board are unfortunately experiencing less than perfect results after surgery. You can't ignore the fact that this is a possible outcome you'll face too. We all go into surgery with that in the back of our minds. So do your homework (no pun intended) and get a comfort level with the surgeon's experience and success rate in this area. Also understand that people who post here will likely be those with ongoing problems. Those "success stories" are most likely off enjoying themselves and a pain-free (or much improved) life and are not posting because they no longer feel lousy. So I believe intuitively that this board tends to be somewhat biased toward those with negative outcomes. In my case, I'm still recovering but if it helps, I'm feeling like surgery was absolutely the right thing to do and I only wish I'd done it sooner.

Just like the rest of us, you'll eventually come to terms with the risk versus the possible benefit. This will only happen when you decide your life/lifestyle and the pain you deal with daily isn't a viable option for the rest of your life. Then surgery becomes the goal, not an obstacle.

Sharon1957 · 05-20-2004, 07:22 PM

I have had quite a few neck surgeries so I offer the following advice to you. I had to get to the point that my life was totally affected with continuous non-stop headaches. I had no choice whatsoever to take the risk. You need to prolong the surgery as long as you can. I have been through five of them. It is just that once you fuse a disc, it is unable to move and then it places stress on the next level to compensate for the nonmovement. Each year that goes by more of us have agreed to partake in trials, such as myself, to help spinal surgery. I had the very best of surgeons at John Hopkins, and I am not finished yet. I am fused from C1 to T1. I have no mobility in my neck at all, and even though my pain, is less I still have one level which has not fused on three separate occasions. I do not smoke or drink and walked to make my fusions take. My orthopaedic surgeon has advised me that a new substance has been developed that makes a "for sure" fusion. However, Hopkins, which is the #1 medical facility is not using it because of "cost." Perhaps in one year, it will be available. You have not explored pain management. I at one point had to be placed on a duragesic patch to hold onto my job until my last surgery. Now, I take an antidepressant at night (which helps pain tremendously) an antiinflammatory every day and anticonvulsant (which helps nerve pain). Once you begin those neck surgeries, and you already have two bad disks, you will still be able to move, but I am sorry, you will never be pain free. Sorry, but usually if you have degenerative disc disease and bone spurs in the neck, you can count on your lumbar spine having it too. I met a teacher and made a friend when I had one of my spine surgeries and she also has the same problem we have. She is a small woman who also does not smoke, exercised, and was a hard worker and her fusion never took also. She pushes herself as we all do to hold onto our job because a lot of our self-worth has been through the attainment and pride in our professions. Hang in there, explore medication. I am going to try nerve route blocks here soon and if that does not help, a med-tronic system. There are options out there to keep going. You will know when the time is ready for surgery, you just won't be able to take it anymore. Just make sure you have the very best--a hospital with the latest equipment before you do it.