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    Old 09-20-2006, 05:46 AM   #16
    cpmillerva
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    Re: If I Knew Then What I Know Now

    I had my follow-up appointment with the orthopedist yesterday. Unfortunately the new MRI showed "degenerative spondylosis of predominately the entire cervical spine." I have some degree of failure at every level. The worse are C3-4, C5-6, and C6-7. So the doctor said if I elected to have fusion, it would be a 3-level procedure. He also said that if I elected to try ESI or other treatments, while I might gain temporary relief, the only long term improvement would be the surgery. I have an appointment on October 6th with a neck specialist to let him review the MRI and discuss my options. But it seems if I want any "permanent" relief, surgery is the only option.

     
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    Old 09-20-2006, 06:47 AM   #17
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    Re: If I Knew Then What I Know Now

    I have been watching this thread since it started as I have some of the very same problem. My c6&7 are seriously deteroriating. I have known this since 2002. Recently I developed a very distinct pinpoint pain just to the right of C6. This pain is rather severe at times, immense burning and feels like something is piching the [removed] out of my neck. Causes a differed pain thru out my cervical region. So I go back to my primary who refers me for more Xrays. They show more advanced deteriortion. But obviously not the source of the pain. He refers me for an MRI, which I figured would be the next step. He is looking at a herniated or ruptured disc. Then the ball drops...The ins. company will not approve the MRI. they want me to do "conservative treatments" first. Meaning NSAIDS and physical therapy.
    My question is this....How can physical therapy be done properly on a condition that has yet been fully diagnosed? And an MRI is a diagnostic tool, not a treatment tool. What the [removed] . I was put under the impression sometime ago that physical therapy can do more harm than good without a complete diagnosis. Wether or not thats true I suppose could be debated, but I really am not willing to debate this as it involves my cervical region. I am not a stranger to the problems this area can cause when impeded. I have had surgery on on C1 -3 for another problem, that was 10 years ago, so I am quite familiar with the pain and its meaning.
    Sorry about this length, but can anybody convince me that phys. therapy is ok with out knowing fully where the pain is deriving from? And can someone please explain why the ins. company would deny me an MRI to diagnosis it. Thanks for listening and thank you fo any replies. i am going to go take an NSAID (*big sarcastic roll of the eyes) and lay back down.

    Last edited by HBMod07; 09-20-2006 at 11:23 AM. Reason: Innapropriate language

     
    Old 09-20-2006, 10:46 AM   #18
    edskym
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    Re: If I Knew Then What I Know Now

    Hi wannabewell
    I had the same problem some years ago. The insurance company always want to go the cheap route. The person who make that decession is some clerk with no medical experience. I went back to my doctor and he called ,talk to a supervisor and told them I could damage myself by not having a MRI. I got my MRI. Do not take no for an answer they well give in eventually

    Ed

     
    Old 09-20-2006, 02:41 PM   #19
    wannabewell
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    Re: If I Knew Then What I Know Now

    I am soooo very sorry for the language, usually I check that. My apologies.

     
    Old 09-21-2006, 07:27 AM   #20
    dennisgb
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    Re: If I Knew Then What I Know Now

    Wannabell,

    You are caught in the insurance loop. It's a bad place to be.

    They should call it "Aviodance" rather than "Insurance"...I could write a book...(climbing down from soap box).

    You need to follow the process, but continue to get the information you need, i.e; MRI, tests, consult with surgeon, etc.

    In the mean time, just be careful with the PT. Explain to them what your situation is, and that you won't do anything that causes pain.

    Dennis

     
    Old 09-21-2006, 08:44 PM   #21
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    Re: If I Knew Then What I Know Now

    curt-

    the dr may be correct that surgery is your only permanent option. but remember, he'll make no $$$ if you try the other routes. my own personal opinion is that it's worth your while- if you have a decent insurance plan- to try the epidurals, or TRACTION, or anything short of FUSION- ESPECIALLY at THREE LEVELS.

    If you still feel like SURGERY is your only viable option, I further encourage you to look into MINIMALLY INVASIVE surgery. specifically ANTERIOR CERVICAL DISCECTOMY WITHOUT FUSION.

    If you have a decent insurance plan, or if you have the financial capability to travel, there are other options besides fusion available to you. I live in Nashville, TN and I had 5 different neurosurgeons tell me fusion was my only option. Upon further investigation I realized that there are several doctors and facilities around the country that can fix disc herniations, etc WITHOUT FUSION.

    I chose to have my NON FUSION surgery in Lake Worth Fla with Dr. Merrill Reuter. I am 5 weeks post op and so far I feel the surgery has been a success. I still have my own discs, and I have a scar maybe 1/2 the width of my pinky finger to show for it.

    As they explained to me, they are able to help 85-90% of patients without fusion. If nothing else, you keep your options open. Artificial discs are not that far away from being the norm.

    You're going to have a long road to recovery if you choose the fusion route, especially if you're having it done at 3 levels. Maybe it's just me, but I would exhaust all other options first.

    Good luck.

    BW- ex NO VA resident(Vienna)

     
    Old 09-22-2006, 04:32 AM   #22
    cpmillerva
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    Re: If I Knew Then What I Know Now

    BW - thanks for the advice. Do you have the name of the service in Florida? I have contacted a different group (LaserSpine) in Tampa and am awaiting a call from their doctor. But I can tell you that I was not mentally prepared to be told I might need 3-level fusion. And since I have all levels effected, am I just going to see marginal relief until the other levels further deterioriate? Not a pleasant thought. I will certainly be exploring all the alternatives.

    P.S. I live in Warrenton and "pass' Vienna every day on I-66!

     
    Old 09-22-2006, 06:42 AM   #23
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    Re: If I Knew Then What I Know Now

    i had my surgery in florida by Dr. stephane lavoie. he is very good!!

     
    Old 09-22-2006, 07:14 AM   #24
    cpmillerva
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    Re: If I Knew Then What I Know Now

    "I chose to have my NON FUSION surgery in Lake Worth Fla with Dr. Merrill Reuter. I am 5 weeks post op and so far I feel the surgery has been a success. I still have my own discs, and I have a scar maybe 1/2 the width of my pinky finger to show for it. "

    [removed] I have sent an inquiry. And the good news is - he's a preferred provider in my insurer's network.

    P.S Just got a response from Dr. Reuter's service. Unfortunately they want $500 an hour ($200 minimum) just to look at my MRI. I'll have to decide if that's a reasonable approach.

    Last edited by cpmillerva; 09-25-2006 at 12:53 PM.

     
    Old 09-22-2006, 11:52 AM   #25
    bw67
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    Re: If I Knew Then What I Know Now

    Dr. Reuter was in network with my insurance as well. It was also a cheap flight on Southwest, and I have family in the Lake Worth area (10-15 minutes from West Palm Beach), so I had a free place to stay.

    The staff has been great and very accessible...

    Dr. Reuter recommended a DISCOGRAM, that for them pinpointed if my pain was DISC related or SPUR related. The discogram determined in their opinion that my pain was DISC related, so I went ahead and had the surgery. Had it been spur related I don't think they could have done their procedure.

    In my case, they recommended I come down and see Dr. Reuter on a Tuesday, have the discogram on a Wednesday, and then if necessary have the surgery on Friday. They preferred that I stay in town one week for follow up, but they let me leave on the Wednesday following surgery. We had a two year old staying w/Grandma back here in TN.

    I am 5 weeks TODAY post surgery. I had to wear a semi hard neck brace for the first 3 weeks. After that I had to wear a soft cervical collar anytime I was in the car for 3 weeks. BUt I am already allowed to drive.

    I'll be honest and say I'm not 100% absolutely completely better yet. I do still have some stiffness and soreness in my neck. But I think that is from the physical therapy and the fact that I am no longer relying on the brace to support my head.

    I also still have mild arm pain, but nowhere near what I felt pre surgery. Dr Reuter's staff have told me that the arm pain should continue to subside- that when the nerves have been compressed for as long as mine have that it's going to take some time before the pain is completely gone.

    I wish I was a couple months post op and completely pain free so that I could more emphatically recommend Dr. Reuter. What I can recommend- especially if he's in network and you have the $$$ to travel- is that you explore the option before you cave into fusion.

    I also contacted Laser Spine, as well as Micro Spine, Dr. Jho in PA, Dr. Schiffer in San Fran, Dr. Theofilos in West Palm Beach and Carolina Neurosurgical Assoc in Charlotte. In most cases the facility didn't take insurance AT ALL. So you'd be out of pocket your out of network benefits PLUS any amount over reasonable and customary. Plus travel expenses.

    Laser Spine does have some financing options, but even at that they were way out of my price range. Dr. Jho had a 2-3 month waiting period. Micro Spine, Dr. Schiffer and Dr. Theofilos didn't take insurance. Carolina Neuro took my insurance but didn't feel they could help my specific case...

    Again, best of luck.

    BW (I grew up 5 minutes from the last metro stop on the orange line off of 66 in Vienna)

     
    Old 09-23-2006, 11:56 AM   #26
    puparoo
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    Re: If I Knew Then What I Know Now

    cpmillerva,

    Please do keep us posted on your final decision, docs, etc. I too have a three to four level herniation with compression, stenosis, bone spurs, etc. that would require laminectomy, etc. I'm only 30 so I'm trying conservative measures first. In fact surgery hasn't even been seriously considered because my pain levels are fairly low 2-3 or 3-4 and I have no nerve damage or weakness (at least that isn't measured on an EMG/NCV or in a neuro exam). I have some symptoms that I think they are writing off to craziness. I personally believe that they are related to the compression, etc.

    But, like some others said, PT, ESI's etc. may or may not help the bone spurs, etc. that you have, but are worth a shot and may decrease your pain levels. Unless you are experiencing serious neuro side effects, the shots may help you and put off surgery, even indefinitely?

    Who knows. Just a thought. I hope everything goes well for you.

    Cheryl

     
    Old 09-23-2006, 06:38 PM   #27
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    Re: If I Knew Then What I Know Now

    TO HAVE OR NOT HAVE NECK SURGERY?
    I think one of the things I see here on the board is there are MANY diagnosis that REQUIRE immediate surgery,,,,,,,,and some which are great for conservative care............some you MUST have a fusion..but if the only thing is anterior herniated disc then not having a fusion is agreat option......but when you have spondylosis, which is the bony rough seaweed, that soon is a bone spurs...these bony growths infringe into the spinal canal and compress the cord then a fusion is pretty much a MUST ...you can't opt out of a fusion when bone from the vertabrae is removed, like with correction of endplates or removal of a large spur. The spine would be unstable. A disc is a sac filled with jelly......and when they herniate they cause acute or chronic pain as the surrounding tisssue is inflammed due to pressure. The epidural or facet blocks work well for this diagnosis..........If you have an acute posterior herniated cervical disc along with shifting of the vertabrae, causing pressure on the cord this surgery is better done sooner rather than later.Aiming not to leave permanent damage to the cord..... A simple discectony with or without fusion is almost a rountine 30-45 minute surgery and fast recovery/............the worse your diagnosis the more likely you are to not have those perfect easy results..................Epidural Blocks won' do anything to correct spinal stenosis caused by bone spurs or spondylosis growing into the cord....Even so many elderly people with spinal stenosis have ESI's because the pain is alleviated a short while since surrounding inflammed tissue is calmed and , but not cured. ...............When you have surgery for stenosis or foraminal exit stenosis, your recovery will generally be longer and the return to normal activities a little slower than someone who had a simple disc herniation.
    So it's important to know the diagnosis..since the pre-op diagnosis lets you know what to expect during the the recovery,..........I think many of the people who post here are the unlucky ones who have had injury on multiple levels and have permanent cord or nerve damage at the foraminal opening( like me!)...........If you have foraminal exit syndrome and have the foramin opened that is a pretty big amount of bone grinding to open up the hole........just like with spinal stenosis when the vertabrae are reamed out..........ouch!-- the having a fusion is a must.
    Lot of different surgery done through the same type of incision.

    Last edited by Administrator; 11-14-2011 at 11:13 PM.

     
    Old 09-23-2006, 07:01 PM   #28
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    Re: If I Knew Then What I Know Now

    I did not review my post and I sure had a lot of mispelled words...........and in one place wrote can instead of can't..........I met to say if there is drilling work done on bone then a fusion is generally a must because to not have a fusion would leave the vertabrae unstable..........you don't have that problem if all you have is a herniated disc.......the jelly in the disc can be drained if it is herniates and is pressing on a nerve or you can have conservative care and hopefully the thing will dry up if it is already ruptured...........I was interested to know that ALL people have bulging and herniated disc as the age....that is the norm. And as long as they don't press on anything important(nerve roots or cord) then there is no pain. These shock absorbers are pretty well dried up when we get into our 70s-80s

     
    Old 09-24-2006, 08:12 AM   #29
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    Re: If I Knew Then What I Know Now

    The more I read on these posts the more I wonder-what are these doctors thinking?? I was diagnosed with a bone spur which is almost completely blocking the spinal canal, among a few other minor issues. I have been going to a pain clinic and have had 2 ESI's which did not work at all. My primary care just keeps giving me perscriptions for pain killers-vicaden, percoset etc. which I hate taking. Last night the tramadol kept me up till 3 in the morning. So why are they doing the ESI's if it's not going to work? I am miserable and can not stand the pain any more. After doing my research a friend gave me the name of a specialist at a spine clinic. I called and got an appointment in Oct. but recently called back because the pain is unbearable and asked for closer appointment. Sure enough I'm going this Friday. If I hadn't taken matters into my own hands I'ld still be playing around at the pain clinic. I am scheduled for one more shot there and then I don't know what they have planned but it would be dragged out for another few months. You have to be your own advocate and do your own research!

     
    Old 09-24-2006, 08:31 AM   #30
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    Re: If I Knew Then What I Know Now

    SuzQ- You are so right. YOu must be your own advocate and do your own research and we are lucky to have a board like this to share experiences and what not. I am a health educator and part of my job is to help people become self advocates. Never had a clue how truly important this was until my neck started having problems involving the cspine. Now I know how important it is to self advocate and really self inform. I think 99% of the folks on the board echo this and are truly self advocators and are very much in control. We just cannot depend on the docs.

    In terms of your ESIs, I too have stenosis and spurs. From what I"ve learned from the docs: While the esi's and pt won't ever fix the spurs and stenosis, it may make the tissue surrounding the cord, discs, etc. (and discs themselves shrink) therefore relieving pain. So the ESI's are mostly for pain management but sometimes slightly diagnostic too.... if they don't work, they know that the bone spurs are most definitely causing the compression, etc.

    And I think good doctors will definitely try a more conservative route before sending you directly to surgery. Surgery should be the last option unless you are in danger of permanent nerve loss or other severe problems like that. Pain seems to be secondary to them. I understand that the surgery, in some cases, may not fix the problem. In some, it actually might make it worse and for some, it remains the same.

    I'm sure you'll hear from people who are wayyy more experienced than me and with different opinions. But this is what I've learned along my own journey. There are days I wake up and am like, "Just cut me open and fix this!!" and then I realize, "Well, that just might not fix me at all and might make things worse"... so I just deal with it.

    Seems so glum sometimes...

    Puparoo

     
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