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Old 03-05-2007, 11:19 AM   #1
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Surgery now or later?

Hi folks, been a lurker here for a while now, soaking up all I could but now I need some specific help. About a month or so ago I had an MRI of the c-spine and got the diagnosis of severe spinal stenosis at two points, and need to have a 2-level discectomy and fusion (acdf; c5-c7). I went to see an orthopedic surgeon, he looked at me and said I'll need surgery someday and to go away until I have more problems walking. Then I went for a second opinion with a neuro surgeon; he disagreed with the ortho and said that I should do it sooner than later.

Here is my situation: right now I have a surgery date of March 12 in Alaska, but I just got a job in Colorado and will be moving there, we report to work on April 17. We're right in the middle of trying to sell our house. I'm having real second thoughts on getting the surgery done right now as we have two small kids and it will be a huge burden on my wife to deal with the kids, me, selling a house, and organizing a move. Plus, I won't be able to lift a finger to help with the move (but we do have movers coming to do all the packing and loading). The other part is it is really hard to walk here with all the ice around, dangerous to crazy to walk on the sidewalks covered in ice - so how would I walk my 2 miles per day?

I need advice on whether to just go for it and do it now or wait. I'm not in pain at all, I do have some limited numbness and hyper reflexes and some clonus (sp?) in my feet. If I wait until I get to Colorado I can have a more relaxed recovery, but will be in the middle of starting a new job.

Ideas?

 
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Old 03-05-2007, 03:13 PM   #2
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Re: Surgery now or later?

I live in Colorado, by the way (suburb of Denver)). I think it all depends on how urgent the need for surgery is. Some people on this board said they could end up paralyzed if they didnt have the surgery right away. What did the NS say as far as your situation? You definitely wont be able to lift anything after the surgery. I am 8 weeks post op, and I would say it took me minimum, 6 wks. to feel even close to my old self again. (I had C5-C7 like you). I am now feeling alot of muscle spasm, which isnt exactly fun, and in a stressful thing like a move, might even be worse. Stress can really add to the spasms. So are you saying you cannot take off work when you move to Colorado. If that is the case, you may need to get it overwith sooner than later. Its a real tough call.

 
Old 03-05-2007, 03:26 PM   #3
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Re: Surgery now or later?

Welcome! That is a tough call! Do you know if you have any spinal cord compression. I am 7 wks post-op ACDF C5-C6. I had severe cord compression so the surgery for me was something that couldn't wait. My NS explained to me when there is cord involvement it is a much more urgent need. If there isn't cord involvement and you aren't having much pain maybe you could get a 2nd opinion in CO. I also have 2 small children and it has been a rough road post-op. I can't even imagine having to sell and move on top of that so I understand that it is a hard decision. What kind of work do you do? How much time would you be able to take post-op? This is a great place to come to gets lots of info and support. Best of Luck!

 
Old 03-05-2007, 06:30 PM   #4
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Re: Surgery now or later?

Let your symptoms be your guide. I finally chose to do the surgery once my left arm was weak and I had numbness in my fingers and the palm of my hand. If I had fewer or less severe symptoms I would have continued down the conservative route, including epidural injecitons, before I would go for surgery.

A key point here is though many of us have recovered well each person is different. There is no guarnatee you'll be ready for a new job on April 17th. Then what if that occurs? I was in a neck collar (aspen collar) for 6 weeks and couldn't return to work until after the 6 week point.
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Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
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Old 03-05-2007, 06:40 PM   #5
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Re: Surgery now or later?

Anchor,
If you were staying in one place, I'd advise you to go ahead with the surgery. (and I'd shoot the surgeon who told you to wait until you had 'more problems' walking - geesh!) However, in your current situation, unless the surgery is considered an emergency, I'd definitely wait.

I can't even begin to imagine how difficult it would be for you to travel so soon after the surgery. I don't care if you're flying first class with bearers to loft you through each airport - you'd still be one very miserable guy. In my mind, it would not be worth the pain and stress and potential harm the travel and moving could cause you. Really. *shudder*

Not to mention the fact that you are going to want to curl up at home, sweet home, after that surgery. Comfy bed, chairs, pillows, etc., will all seem very important to you during your recovery.

The other thing for you to consider, though, is how soon after you start the new job you can reasonably have the surgery. The average recommendation is six to eight weeks off work. Not everyone necessarily does that, but it's kind of the standard. Will you be able to do that?

If you do decide to wait, do take it as easy as you can between now and whenever you have the surgery. No sense in further aggravating or injuring the parts that are already causing you problems.

I sure hope everything works out to the best possible advantage for you. Good luck!

 
Old 03-06-2007, 09:54 AM   #6
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Re: Surgery now or later?

Anchortown - tough choice, bad timing. In any case if anything changes - more weakness, dropping things, more numbness, gait issues and especially if you develop incontinence (urinary or bowel) you will have an urgent situation. In my own case I started with symptoms in summer of 2004 with gait and arm swing issues. I didn't seek help until June 2005, was diagnosed Aug 05 and surgery was early Sep 05 -- symptoms started getting significantly worse in the last 4-6 weeks before surgery. By the way, I didn't have an accident or anything, docs have no idea why the stenosis developed.

With or without surgery - I'd be very careful with boxes, etc. as you move. Frankly if I was you I'd avoid lifting anything significant.

Good luck with the personal decisions and with the new job.

 
Old 03-06-2007, 03:43 PM   #7
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Re: Surgery now or later?

My vote would be to wait until you made the move to Colorado. Especially if you're not in any real pain. I would get settled, make a fresh start and GET MORE OPINIONS...

Even if you choose to have the surgery now, you're not going to be fully recovered by the time you make the move and start that new job...

Fusion is such a permanent thing, I would put it off as long as possible, as long as you weren't in pain or risked further injury.

I had herniations at C5/6 and C6/7. My doctors told me I could hold off on surgery until the pain became unbearable. After two years it finally did, but I chose to have a minimally invasive procedure vs. fusion. See my post NON FUSION UPDATE/OPTION.

Regarding some of the other posters comments about becoming PARALYZED- I think some doctors throw that out as a way to scare patients into making a decision sooner than later. My doctors explained that I would be at an increased risk for severe injury if I were in a bad car wreck, fell off a roof etc. I weighed the odds of those things happening and chose to not let the potential risk rush my decision...that's just my take on it, I realize it's not everyone's...

You're in a tough spot with the winter weather, the move and the job change. I wish you the best of luck.

BW

Last edited by bw67; 03-06-2007 at 04:48 PM.

 
Old 03-07-2007, 09:06 AM   #8
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Re: Surgery now or later?

Thanks for all the info folks. I have severe spinal stenosis at those two points, my spinal column is pinched down to 6.5 mm in two spots. That is a pretty tight pinch. But the lucky thing (I guess) is that none of the nervers are affected, so I have no pain. The doctors are a bit baffled that I don't have more severe symptoms becase when you look at the MRI you kinda think how is this guy still walking? I can't explain it except that I have always been a pretty tough guy, maybe I'm just tough all over?

I fell playing hockey this winter, got a concussion, and this exacerbated mild symptoms that I have been having for a few years. So I think I already got my one chance - doctors say if you have this you are at risk during an injury, well I had my injury. I think it just pushed the discs further against my column, they were already damaged from who knows what earlier on.

If it was pain, or something else that I could grit my teeth on I would, but I think I am in a serious situation that needs to be taken care of. I have never broken a bone, barely bruise, and have lived an extremely healthy life, so it is hard for me to go into surgery when I feel pretty darn good. But, I do have lots of weird pains in my eyes, my gait is unsteady, numbness here and there, and tingling... the weired part is that it comes and goes. Some days I have no symptoms, some days I notice them, but no days are they a big factor. But then I look at that MRI and say WOW! Sometimes I wonder if I got the wrong films.

I decided to do the surgery now. Waiting is risky, I'll need it soon, and might as well just dive in. I'll have 4 full weeks at home before we need to move. I don't have to lift a single thing for the move, we have movers doing everything. In Denver we have tons of family that can help us too. I don't stat work until the 5th week mark, and even then it is a half week. So I'm hoping that I can at least start with 1/2 days or something the first week.

My biggest fear is wearing this dang miami J collar - any words of wisdom there? Pillows? How to sleep? Any words of wisdom at flying at the 4 week mark? I can get a direct flight to Denver from Alaska, its an over night flight. Then I would have about an hour drive once I get there.

Thanks for all the help!

 
Old 03-07-2007, 02:34 PM   #9
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Re: Surgery now or later?

Good luck with the surgery. It really sounds like you might be taking a big risk if you wait. Just take good care of yourself for that month, for sure.
I live in Denver and LOVE IT!!!!!!!!!!!!!!!!!!!!!!!! I wouldnt want to live anywhere else. I hope you like it here. Today was 68 degrees and totally blue skies and clear. I wish everyday was like today!

 
Old 03-07-2007, 08:01 PM   #10
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Re: Surgery now or later?

Anchortown - Good luck with the surgery - I too was in no pain just major gait issues and other balance and neurosymptoms. The lack of pain lead to my ignoring the gait issue and possibly why I have some "permanent signal damage" in my cord. I did not have fusion and did not have to wear a collar after surgery - I had a laminectomy which "frees" the spinal cord by opening up the vertebrae - C4-C7.

 
Old 03-11-2007, 06:49 PM   #11
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Re: Surgery now or later?

Quote:
Originally Posted by Anchortown View Post
Thanks for all the info folks. I have severe spinal stenosis at those two points, my spinal column is pinched down to 6.5 mm in two spots... The doctors are a bit baffled that I don't have more severe symptoms becase when you look at the MRI you kinda think how is this guy still walking?
Wow. I was down to 7mm.

The spinal cord is an entirely different animal.

I'm happy to hear that you were offered a surgical solution.
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