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Old 09-17-2010, 05:39 PM   #1
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Red face Swallowing issues after ACDF/another fusion?

Hi all. I had 2 level fusion 2 years ago and have had problems with swallowing and choking since. I cannot swallow my Lortab 10 mg pill as it gets stuck every single time!!! I am no switched to Percocet 10 mg and that is much easier to swallow. But any pill that large I can't do. I also choke/have a hard time catching my breath with swallowing liquids, feel like I can't breathe at all and have to pound on my chest. Foods are mostly fine.

Today, I saw my ENT for this issue. He ran one of those microscopic tubes with a camera on it down nose and throat and looked at top of throat and to the voice box. He of course numbed all this. He had me say "eeeeeeee" and swallow. He then poked it in a few spots that really bothered me, which he said was good. But basically, he thinks that its a stretch injury of the superior laryngeal nerve leading to diminished sensation on issue of swallowing liquids. I am getting a modified barium swallow study done as soon as I get it scheduled. Then possibly therapy for swallowing after that. He cautioned me about having another fusion surgery right now until we find out what is going on and if we can improve what is going on. Because the surgeon wanted to go on the other side of my throat and not have to go through scar tissue, so this means another stretch injury to the other side! Which he says is not good at all. So, I am very scared. I told him that I knew this disk was not going to wait long, that it would only get worse. I am going to have one more epidrual done, I have had 2. See if the 3rd one helps at all. If not then I am in the situation of having another fusion, suffering, or risking this other nerve. Its a bad sitaution right now. I would like to know if ANYONE else is going through this exact thing??? If so, what have you been told? What are you going to do, and what are your options??????

Its rough right now, because if I can't have the surgery I am stuck with this pain. Please, if you have had this or anything close, please give me advice? Thanks so much to everyone!!!!
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Old 09-21-2010, 01:09 AM   #2
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Re: Swallowing issues after ACDF/another fusion?

I had the same surgery for levels c5/c6 & c6/c7. I am 6 weeks post op and am having the same problem. I go to see my surgeon on Monday and was going to talk to him about it. I can't swallow anything large and have to take tiny bites of food (not necessarily a bad thing) or else I end up throwing up. I have been cutting my Soma pills in half because they just won't go down right.... if it doesn't get stuck and come back up, I can feel it going down my throat. Even a tiny Sudafed feels like it's rubbing on my esophagus as it goes down and typically takes a while until it passes farther down. (make sense?)

 
Old 09-21-2010, 07:56 AM   #3
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Re: Swallowing issues after ACDF/another fusion?

Queenie, Did he say what this stretch injury was caused from? Is is related to your fusion surgery or scar tissue? Did he mention what the Barium swallow study may reveal? Sorry about all the questions but I'm wondering why he told you to hold off on the sugery. I realize they can't be messing with that area after fusion but I'm really curious to see your prior fusion or disc problems contributed to this problem.
By now you know others are experiancing problems with swallowing or in the throat area. Did you happen to mention that you came across others who had fusions done with problems such as yours?

What area are you getting the injections on?
I'm sorry I can't answer your questions as Ive yet to schedule an appointment with a surgeon. Although I will be asking once I get in. My PM stated he does not think its related but I am not convinced of that. Its strange to me that many times its worse when my over all pain is up. Not to mention the stories Ive read here.

You must be frustrated with one holding the other up & no answers. I hope something comes from this next test & you can move forward with the surgery if this is what is needed. There has to be a reason why & hopefully someone gets some kind of clue or answer soon.
I hope someone comes along & can help you out here. God bless. Sammy

 
Old 09-21-2010, 04:06 PM   #4
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Re: Swallowing issues after ACDF/another fusion?

Well the ENT said it is VERY common when patients have the fusion surgeries as they have to push things aside to get to the spine. He said that they push the veins one way and the throat the other way and when doing this the posterior laryngeal nerve gets stretched in order to move everything over, so they can have a stretch injury. He didn't say that everyone will get this, just that it can happen and it is common during these surgeries. My ENT wants me to get the barium swallow done first before I go thru with the other fusion as if it is a strecth injury then if my surgeon goes through the other side of my neck and I get another stretch injury then I could end up in trouble with swallowing and eating for life. So, he just wants to be safe and do this test to find out why I am haivng the problem. It can be the stretch injury OR it can also be the rings that are around our airways, they can narrow due to swelling and so there can be an area where my airway is narrowed. Which is what I think I have is the narrowing because that is what it feels like to me when I swallow. I can pinpoint exactly where things don't go down good. I am also snoring really badly, which I never have done before and my husband says that since the surgery I have snored. So I do think that these fusion surgeries can cause a lot of problems with our throats and airways. Which is not a good thing. So, I am just being cautious with my decisions first before I go through another fusion. I know that I need this fusion, as I am in pain, but I want to be careful and know everything I can before I go with it. Just be careful in what you do and ask as many questions as you can. I will let him know that I have spoken to others with swalloing issues as well. I hope that it gets better for those of you that just had the surgery and are experiencing this problem. It is no fun and I get very scared when i choke with liquids. It is bad. Good luck!!! I will keep everyone posted as I get news!
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Old 09-21-2010, 06:10 PM   #5
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Re: Swallowing issues after ACDF/another fusion?

Has anyone suggested having the second fusion from the back? Both of my neck surgeries have been posterior and I have no trouble with swallowing. We had one person here who is a professional singer who was offered either way so as to protect his voice. So they can do it. Longer recovery but the instrumentation is all in the back....might be able to remove the front stuff but I don't know...I'm all posterior. Too many stories of swallowing and voice problems for me to ever consider an anterior.

hugs..........Jenny

 
Old 09-21-2010, 07:35 PM   #6
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Re: Swallowing issues after ACDF/another fusion?

Quote:
Originally Posted by jennybyc View Post
Has anyone suggested having the second fusion from the back? Both of my neck surgeries have been posterior and I have no trouble with swallowing. We had one person here who is a professional singer who was offered either way so as to protect his voice. So they can do it. Longer recovery but the instrumentation is all in the back....might be able to remove the front stuff but I don't know...I'm all posterior. Too many stories of swallowing and voice problems for me to ever consider an anterior.

hugs..........Jenny
I was thinking the same thing!

 
Old 09-22-2010, 06:27 AM   #7
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Re: Swallowing issues after ACDF/another fusion?

Well sounds to me like you may have an answer after this next test.

I know exaclty what you mean about not being able to pinpoint exactly what it is. At times it feels like something is lodged or stuck & others I just start choking after I take a drink of something. No warnings, like it goes down the wrong way yet that is not what happens. I was choking yesturday while drinking water. This morning it feels like something is stuck in my throat. Can also feel the meds getting stuck so I feel like I have to keep drinking & hope I don't choke. Another thing is I can actually feel the meds when I swallow. I don't recall that being an issue before surgery. Its really strange.

Needless to say we have a lot of the same problems but sounds like yours is worse. I have pain right in the center where you feel it move when you swallow & it can get bad. Thats the worse part for me.
Snoring is another new post op problem for me also.

I'm really curious to see what comes from your test & thanks to you I know its important to make the next surgeon aware that these problems exist.
No way would I want it to get worse with another anterior surgery.
Good luck with your test & of course keep us posted. Sammy

 
Old 09-23-2010, 06:35 AM   #8
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Re: Swallowing issues after ACDF/another fusion?

Queenie, I wanted to come back today & add I had a heck of a day yesturday with the coughing choking fits. Of all places in the store.
I was hoping noone would attempt to slap me on the back. That would have done wonders for me pain level. It really was bad for some reason. All day I'd choke & then have the coughing fit that can follow. It started when I was drinking water. My daughter asked if I was ok & what I was choking on.

Anyway each time it brought you to mind. I was speaking to my sister also & she said her MIL will do the same & can't figure out why. Guess what?
She had fusion years ago.
She found what your ENT said very interesting & is passing the info along to her MIL. She said it happens out of the blue & her MIL is as bothered & confused as we are.
Thanks again, Sammy

 
Old 09-23-2010, 05:50 PM   #9
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Re: Swallowing issues after ACDF/another fusion?

Hello all, I had my surgery just 7 weeks ago, July 28th. C5,6,7 with plating. I have had swallowing issues since the surgery, and I still have vocal problems. My voice is very hoarse, I cannot project at all and am constantly being asked if I am sick, or "did you go to a concert last night?"

The swallowing is especially frustrating. I feel like it was bad at first, OK for a few weeks, and then more recently has gotten bad again. In the past week especially I noticed it feeling very tight, almost as if I was choking a bit even if I am not eating. Swallowing is affected, I cannot swallow liquid unless I am at eye level. If I tip my head back, I cannot swallow.

I know I am early in the game, but the continued voice problems and this swallowing thing are driving me crazy. I also had a lot of numbness pre-surgery, and none of it is gone. I am a father of two young girls, 4 and 2, and it's very hard to deal with their youthful ignorance; but it's also a great blessing that has helped me get my mind off things.

I am interested to read about the swallowing problems. I hope we all attain a level of normalcy, or comfort.

 
Old 09-24-2010, 05:36 AM   #10
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Re: Swallowing issues after ACDF/another fusion?

Mike did your surgeon use a drain tube & leave it in for the first 24hrs?
My surgeon used one to prevent problems. I was not bad following my surgery compared to others Ive read about.
Yes its still early on for you & I'm sure you'll see some improvement. Try to relax & even if your feeling better follow your surgeon orders & restrictions. I can't express o you how important that is. I'm sure everything is swollen in there & as Quennie explained (bless her) everything it moved & disturbed. I wish you the best of luck & enjoy your little ones. Sammy

 
Old 09-24-2010, 06:00 AM   #11
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Re: Swallowing issues after ACDF/another fusion?

Quote:
Originally Posted by sammyo1 View Post
Mike did your surgeon use a drain tube & leave it in for the first 24hrs?
My surgeon used one to prevent problems. I was not bad following my surgery compared to others Ive read about.
Yes its still early on for you & I'm sure you'll see some improvement. Try to relax & even if your feeling better follow your surgeon orders & restrictions. I can't express o you how important that is. I'm sure everything is swollen in there & as Quennie explained (bless her) everything it moved & disturbed. I wish you the best of luck & enjoy your little ones. Sammy

Thanks Sammy. To the best of my knowledge, they did not use a drain tube (I'm guessing I would have remembered). I keep telling myself it'll get better, I guess in general I shouldn't complain. I meant to ask, if anybody who had numbness prior to the surgery could detail the recovery of sensation, that would be most appreciated. Did feeling come back in days, weeks, months? I know it takes a while. Also, anybody with pain behind the shoulders both prior to and following surgery? My surgeon told me this is probably an area of great inflammation, and could take awhile to recover. Final question, anybody experience any facial symptoms after surgery? I have had some numbness and tingling on the right side (incision side), it seems to be in the area around the sinuses. Primarily under and over the right eye, and along the right cheek. Also, my right eye feels very "dry", and gets blurry easily.

The surgeon told me that the vocal nerves "innervate" the sinus nerves, which I took to mean it's all connected. He didn't seem concerned. This has been consistent since the surgery, so again, I'm assuming that since it involves nerves it could take awhile.

Thanks Sammy for answering, and thanks in advance to anybody that can shed some light on any of my questions. I have never gone through anything like this and feel very "alone" in my search for information. Any feedback is really, really helpful.

 
Old 09-27-2010, 06:43 AM   #12
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Re: Swallowing issues after ACDF/another fusion?

I'll give it a shot if its ok with Quennie, although you have a better chance at getting more replies with your own post.

It did take awhile for some of my pre-op symptoms to settle down. I can't remember exactly how long but longer then 3 months. If I'm recalling correctly it was very gradual & at first I did not think I'd get any relief in some areas. I had a huge amount of scapula involvment, the entire shoulder area along with the arm, chest & so on.... It really is a long recovery for most I believe.
The fascial problems I'm not so sure about but it makes sense. I get tingling on the side of my head at times. I did have almost immediate relief from a headache that started pre-op, thank god.
Try putting a post up.


I want to thank you again Quennie, sharing your doctors visit has really helped me to understand a lot more. Its so much better not to have to wonder. I have to believe we are experiancing much of the same here, to much in common. I had one heck of a time getting a cupcake down yesturday. Thats not the norm for me but does happen.
Hope this next test goes well. God bless, Sammy

 
Old 09-27-2010, 02:28 PM   #13
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Re: Swallowing issues after ACDF/another fusion?

I was at physical therapy and mentioned that there had been discussion on the boards about swallowing issues after surgery. I had my c5/6 fusion in Oct. of 2007 acdf and have never gotten past swallowing problems. My therapist said 100% of the therapy practice patients that have had acdf have swallowing issues and have not "outgrown" them over time. Not very encouraging! I am discussing this with my neurosurgeon as soon as I get in to see him for a repair surgery at the area I had my fusion. Something has happened and that area is compressing the spine again. I am really concerned of losing the ability to swallow if he goes through my neck again...sigh. I had heard there was as high as a 50/50 chance of swallowing issues, but I think it so much higher! Hang in there!
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Old 11-18-2010, 02:13 PM   #14
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Re: Swallowing issues after ACDF/another fusion?

I feel for you! I too am s/p acdf c5-c6. Its been 5 weeks.. I feel like I swallowed a golf ball, feels like someone is pressing their thumb on my esophagus and holding it there... I am so distraught about it! Not only is my right arm still numb and painful down the shoulder to the forearm to the fingers, but I ended up with this lovely bonus of a "chicken bone" stuck in my throat!
Has anyone had any relief? If so, how long did it take?

 
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Old 11-19-2010, 12:01 PM   #15
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Re: Swallowing issues after ACDF/another fusion?

WLS

I had c5-6 decompression surgery (no fusion) in June of this year and I also developed swallowing problems. The rate of this complication is very high for women. I have read that they are actually doing a study into the issue. From what I understand it occurs when the surgeon places the clamp to hold the area open and the breathing tube that they use for you during the surgery. It is being studied that once the breathing tube is inserted and the cuff around the tube is inflated, when the surgeon places the clamp, the pressure on the cuff for some reason increases and puts pressure onto the esophageal nerve. The thought is that when the surgeon is ready to place the clamp, if he/she asks the aneastiologist (so bad at spelling) to lower the cuff pressure until the clamp is placed and then slowly increase the pressure to insure that the pressure does not go to high as to put pressure on that esophageal nerve. (I know, probably too much information.)
I am now seeing a gastroenterolgist and he is trying different medications to see if he can what he calls "jump start those darn esophageal muscles").
I have just learned to change my eating habits. I cut my food into smaller pieces and I do not eat three large meals aday, I instead eat smaller and more freguent meals and I drink a lot of water. I have found that dougher food (muffin, cupcakes, cake...) are a little harder to get down, I will drink lots of fluids to help make sure the food goes down.
I am told that eventually the nerves do regenerate and your swallowing does improve and eventually does return to normal.
I guess it is just one of the many things that takes time to heal after this surgery. I will say that before the surgery I was in really bad shape and after, my issues of swallowing (which is getting much better) and nerve pain in one of my arms is beginning to heal with physical therapy. Traction at physical therapy was added to my physical therapy treatment along with message and heat. Since the traction was added, I am beginning to notice a litte improvement in the arm pain. I find that when I am not using my arm alot, than I will not have a lot of pain, however, if I use it alot (like everyday at work) or if I forget that I have a weight restriction on carrying bundles, than I also notice the increase in pain.
I was told it would take about 1 to 1.5 years for me to completely recover and I am now believing that it really does take that long to completely heal.
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Last edited by shisslak; 11-19-2010 at 12:06 PM.

 
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