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Old 01-02-2008, 07:08 AM   #1
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Question Hi new here, need help please, kinda nervous and desperate

Hi All, I am new here and desperatly looking for help. Sorry for the length. Here is a bit of my history if it helps. In 2002 I had a 2 level ACDF on C4 through C6. While it was deemed a success after a few years, I was left with alot of pain and put on meds, for DDD and arthritis as well.

In 2004, I developed Lumbar problems at the L4/5 and L5/S1 level, bulging discs, facet arthropathy, DDD, and other mumbo jumbo. I've had facet injections, trigger point, ESI's nothing helped. I am holding off on a lumbar fusion that might be needed. So far I was doing okay.

Well, on 12/21, I fell in a hospital parking lot that was not plowed, it was solid snow and ice, nor was it sanded or rock salt thrown down, nothing. I got out of our SUV and I stepped out of the truck and I slipped and fell on the chunks of snow and ice(even though I was holding onto the door) and landed on my lower back with the back of my head and neck hitting the running board of the SUV very hard. I blacked out briefly(just saw a major flash of white), and was helped up by Hubby and Son.

I made a report of it to the hosp, because I didn't want an elderly person or anyone for that matter slipping and falling like I did, especially if they were alone, they might not be seen in between vehicles or be able to get up. The nursing sprv had me go outside w/her and show her where I fell. She saw all the snow and ice(where it had broken from my fall) and was stunned and asked if I wanted to be seen. At the time, I said no, I would ice it, take my meds and see my own doc if I felt something wrong. I figured after a fall like that, I would be sore anyway. She took my info and said she would log it.

Well needless to say, I tried to make it through the holidays in agony and after X-mas, could not move my head or neck at all. The pain was burning and unbearable, I was dizzy, falling forward and had headaches w/nausea. I was told by my Ortho docs nurse to go to the ER immediately. I had an X-ray done and they ordered an MRI stat with results Stat. It came back that I had herniated C3-C4.

This is what it said about C3/C4: Marked left posterior focal disc protrusion partially effacing the left anterior thecal sac is seen. I'm not sure what "Marked and focal" mean in this instance. I know the doc said that "protrusion" is herniation.

They immediately put a hard philly collar on me, telling me not to move at all, nor was I to take it off, and to see one of my docs within 24 hours, NO LATER! I was leaving the ER at 11:30pm and they wanted me to call and talk to one of the docs on call or leave them a msg. Also, any numbing and tingling to not drive to the hospital, but to call 911 immediatly!

Friday, I called my Ortho, he's out of town until mid Jan and I can't get into see him until Jan 14th and no other doc was available(odd). My primary docs office, she is away until today, but the Nurse who knows me well told me, "You are not an alarmist, you don't complain, I am in agreement with the ER doc, you MUST be seen and to call my spine surgeon ASAP, and that my PCP won't touch me or fool around with this".

Well, I called my Spine surgeon and He is away until Friday 1/4 and so are all the other docs in his group!!! The nurse there had the hospital send my MRI report so she could review it and she called back and said, "Keep the hard collar on, try not to move too much and if you take it off, ice the area and take motrin for swelling". :-/ I guess a fellow is being called in today to review it and tell me what to do. I was also instructed that any numbness or tingling, even in my legs or feet to call 911.

So, here I am left, being told I needed to be seen within 24 hours ASAP. All my docs are on vacation(my luck) and no one to see me yet. I am in agony, dizzy and nauseaus(sp). I've been falling forward while walking, with collar on and off, losing my balance as well.

I didn't have my lower back MRI'd though, I was so worried about my neck. Not sure if that has to do with my falling forward, or if its due to my cervical?

Again, sorry for this long post. Can anyone tell me what the MRI results mean? Basically the "Marked and Focal", I mean, it doesn't say, "small or large", so I have no idea how big this is. I know protrusion is herniation. Does C3/C4 cause headaches, dizziness and nausea? I've looked everywhere on the net. Thats how I found this forum.

I am not an alarmist as the my PCP's nurse said, but....in all honesty, I'm getting kinda nervous, because although there is no nerve impingement, I am having major pain in my neck(back and side of neck), radiating down to my shoulder(left), also up in my ear(left), and very very dizzy. This all started after the fall. One nurse said that headaches and dizziness could be expected with C3/C4. I just can't find anything that shows the symptoms of a protrusion there. Maybe everyone is just being overly cautious or I am just being under cautious? I don't know.

Thanks,
Carly

 
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Old 01-02-2008, 04:15 PM   #2
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Re: Hi new here, need help please, kinda nervous and desperate

Hi Carly928, I hope you can read this entire post.

Welcome here. Sorry about your fall. Before I reply, I will remind you that I am not a doctor so I am just giving my personal, experienced opinion from what you have written here. I am fused C4-7 after multiple surgeries.

You had a bad fall and you need care, but I am thinking that they are being over cautious because they have a potential law suit on their hands. Nothing you wrote tells me that you are in a "dire" situation. Serious yes. I am guessing your fusion put some extra stress on the levels above and below when you fell.

I would recommend that you get a MRI of your full spine because you had a fall. With your pre-existing condition in your lumbar and your fusion above, you need a full MRI. Since you are not having other symptoms I think this can wait until you see your surgeon. Your symtpoms do seem to correlate to the C3/4 level, but you should be fully checked out.

The terms marked and focal when used medically mean --
Marked: Identified by
Focal: A localized area of disease finding.


The good news is the part of the MRI you posted says effacement and not the word "impingement". Effacement means that it is in the space -- not as bad as compressed or impingement. This tells us that you have probably a small to medium protrusion. Actually protrusion and herniation are not exactly the same thing. A bulging disc is a smaller protrusion of the central nuclear material still contained by some of the outer annular fibers. A herniation is a disc that has developed a hole and material inside leaks out.

With C3/4 you could expect some general neck and shoulder and arm symtpoms and headaches. Any time you have a fall or whiplash type incident your spinal cord could have touched the sides of the spinal canal and will cause severe irritation and inflammation. This could cause dizziness, weakness, and severe pain.

Wear the collar, rest, and get into the spine surgeon as soon as you can be seen. Good luck and we are here is you have more questions.

 
Old 01-03-2008, 07:19 AM   #3
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Re: Hi new here, need help please, kinda nervous and desperate

Neckpatient, THANK YOU so very much for answering my post! It is greatly appreciated. I was afraid to check on here again and see it slipping further down with no replies.

The info you have given me is very helpful and has put my mind at ease, very much so. Whats bothering me is that I am very very dizzy, nauseous. and losing my balance, to the point of walking and almost falling forward, I'm basically off balance now. The pain is intense, along with bad headaches now, despite the regimen of my meds for my other spine issues, especially in my shoulder and going up the left side of my neck and into my left ear.

I also am starting to feel tingling in my pinky fingers, off and on though. I just didn't need to deal with all these new problems. I was trying to decide whether to have my lumbar fusion when this happened. Hoping I can get into see my Surgeon tomorrow and I also want to see my Ortho spine rehab doc, he'll be back the 10th. So for now, I'm taking it very easy. The collar though, owww, very very uncomfortable, I actually think its too big for me. Its a medium, but they didn't measure me, just had someone come in and put it on immediatly after the MRI results and was told "Do not remove it at all".

I am going to request a full body MRI, although my neck pain was through the roof when I went to the ER, its the first time I've ever rated my pain at a "7", my lower back is hurting more than usual too. I just feel really really *off*.

As far as the ER being overly cautious, I think the doc may have been due to what the MRI showed and my prior MRI had no problems at C3/C4, but not everyone there cared. I won't get into specifics, but I was told if they don't bill my insurance, then I don't get seen! Thats not right at all! I have to see what happens next.

Thank you so very very much for your help. Someone else mentioned that the thecal sac was a bundle of nerves that the spinal fluid flows through and thats why its so painful. Ohh, I can vouch for that.

Again, you kindness and thoughtfulness in answering my post and helping me is greatly appreciated.

Blessings,
Carly

 
Old 01-04-2008, 09:09 AM   #4
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Re: Hi new here, need help please, kinda nervous and desperate

Carly,
It sounds like you may have also had a concussion, since you hit your head so hard. This would make you nauseous and dizzy. Did they test your pupils or do any other type of test for a head injury?

Holly

 
Old 01-06-2008, 04:50 PM   #5
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chablis3 HB User
Re: Hi new here, need help please, kinda nervous and desperate

Carly, sorry to hear about your bad fall. Hope you get to see your surgeon asap. Sounds like something is very out of whack, and the sooner you get some answers the better. Holly mentioned a concussion, and that is what came to my mind right away when you mentioned dizziness and nausea. Good luck to you and hope you get some answers quickly.

Wishing you the best,
Judy

 
Old 01-07-2008, 06:11 PM   #6
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Re: Hi new here, need help please, kinda nervous and desperate

Did you see your dr?????????????

 
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