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    Old 03-21-2015, 04:38 AM   #1
    gakw3
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    neck issues

    over the past year i have experienced moderate to severe pain on a daily basis. it occurs in my neck, shoulders, mid-back, lumbar region, i have weak aching legs, & weakness in my arms. i have tried all known conservative treatments to no avail.

    unfortunately due to gastrits, any pain medication so far prescribed for me has given me severe stomach pain. i can take muscle relaxers, but they make me sleepy.

    after seeing multiple doctors & having multiple tests, i will soon (hopefully) learn my fate. previously i'd been offered acdf at 2 levels, something i would prefer to avoid. i'm seeing a new doctor now.

    this is the radiologists report of a recent cervical ct scan:

    "there is decrease in the height of the disc space with degenerative spurring at c5-6. central disc osteophyte complex at c5-6 abutting the spinal cord with restriction of the canal. uncovertebral osteophyte to the right narrowing the right neural foramina at c5-6. there is also uncovetebral osteophyte to the right noted c6-7 with foraminal narrowing. bilateral apical scarring noted."

    needless to say, i'm sick & tired of hurting all the time, not to mention, scared of what the future holds. besides the pain, i'm concerned about maintaining the integrity of my cervical spine & nerves.

    any advice, insight or prior experiences you're willing to share would be greatly appreciated.

     
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    Old 04-08-2015, 02:07 AM   #2
    gakw3
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    Re: neck issues

    i am now scheduled for an acdf c5-6 on wednesday, may 6th.

    i had hoped for a disc replacement, but the arthritis is too advanced. there are cysts in the bone & the surgeon believes there is little, if any, disc material left in the space - it's basically "bone on bone."while i understand this may not relieve all of my pain, it will remove the stenosis (both central & foraminal) & strengthen my cervical spine. my only other option is to live with chronic pain & wait for permanent nerve damage, which is really no option at all.

    so i've been reading up on what to expect from recovery. i have a list of supplies to gather before the surgery, i have arranged for someone to be with me afterward for about 5 days. after that, i'm on my own.

    my pre-surgical consult is next monday at which i expect to learn more about my limitations, follow-up care, & which pain management options are available to me.

    needless to say, i'm scared & never having had any surgery of this type i have little to no idea what to expect.

    for anyone who has had this procedure, what advice can you offer in regards to my ability to move around unaided, how long before i can bend at the waist, when & what was the worst part of recovery, & at what point can i resume somewhat normal activities?

     
    Old 04-08-2015, 02:11 AM   #3
    gakw3
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    Re: neck issues

    i am now scheduled for an acdf c5-6 on wednesday, may 6th.

    i had hoped for a disc replacement, but the arthritis is too advanced. there are cysts in the bone & the surgeon believes there is little, if any, disc material left in the space - it's basically "bone on bone."while i understand this may not relieve all of my pain, it will remove the stenosis (both central & foraminal) & strengthen my cervical spine. my only other option is to live with chronic pain & wait for permanent nerve damage, which is really no option at all.

    so i've been reading up on what to expect from recovery. i have a list of supplies to gather before the surgery, i have arranged for someone to be with me afterward for about 5 days. after that, i'm on my own.

    my pre-surgical consult is next monday at which i expect to learn more about my limitations, follow-up care, & which pain management options are available to me.

    needless to say, i'm scared & never having had any surgery of this type i have little to no idea what to expect.

    for anyone who has had this procedure, what advice can you offer in regards to my ability to move around unaided, how long before i can bend at the waist, when & what was the worst part of recovery, & at what point can i resume somewhat normal activities?

     
    Old 04-08-2015, 05:11 AM   #4
    noevr
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    Re: neck issues

    Hi seeing this the first time, with ANY spine surgery the rule of thumb is to get at least 2 opinions! Yes, I know you feel really comfortable with this dr, is it a neurosurgeon?

    You've got to do it for yourself. Really, I hope someone will chime in here. I'm sure you need something done, I don't know what. If it were me I'd make sure the dr. Was highly recommended, at a top hospital, possibly a teaching hospital.

    Did someone else refer you?good luck,
    Cathy

     
    Old 04-08-2015, 07:02 AM   #5
    frenchfri1003
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    Re: neck issues

    I had a 2 level ACDF in 2010. I found a few sites online prior to my surgery and copied and pasted the questions. I did ask many of these questions. I had a spiral notebook where I dated each visit, with the questions and answers so that I could refer to them. You may also want to bring someone with you so that they can ask, questions and recall the information that you many not write down or recall yourself. It is a very emotional time when you decide to have surgery. I know that I was bone on bone for 5 years prior to accepting the fact that I needed surgery. Mine was going to be either a 2 or 3 level fusion. Luckily they only needed to fuse 2 levels. I also hoped for an artificial disk but it didn't happen. Good luck. You should have a second opinion. I asked my surgeon who I loved who he would have do the surgery if it was for himself or a family member from a list of names I brought with me. He told me no to a few and 3 he said that he would use. I then made a consult with 2 of them. They all came up with the same surgery but different recuperation plans. I presented them to my surgeon who did the surgery and he explained his reasoning. Good luck with your surgery.

    Here are some of the questions that I asked.

    Questions before choosing surgery:
    What is the specific anatomic lesion being addressed?
    What is the natural course of the condition if left untreated?
    Why does the surgeon recommend this specific procedure?
    What are the alternatives to surgery?
    Article continues below
    What is the risk/benefit ratio (the chance of a bad outcome as weighed against the chance of a good outcome)?
    Can I talk to other patients who have had a similar procedure?
    What are the long-term consequences of the proposed procedure (if a fusion is being contemplated, will it lead to additional problems at the level above)?
    Questions about the spine surgeon:
    How many of the recommended procedures does the surgeon do a year?
    Is the surgeon fellowship trained? (Note that this is especially important for a fusion)
    Who will be assisting the surgeon?
    Questions after electing surgery:
    What will the procedure entail?
    What are the risks and possible complications and how are they treated?
    How will I feel after the surgery?
    How many days will I spend in the hospital?
    What is the expected postoperative course (such as physical therapy, time to return to work, return to full activity)?
    At the first consultation, your spine surgeon should recommend a second visit, giving you time to think about your options and write down additional questions.
    In general, your spinesurgeon should be educational, describe the risks/benefits and possible implications of the surgery he/she is recommending, and state the reason for the specific type of surgery. If the spine surgeon is not open to your questions, you should consider choosing another surgeon.

    Here is a different list of questions.

    Questions before you decide to have the surgery
    What type of surgery are you recommending? Why?
    What is the source of the pain that is being addressed? How do you know this? (Exploratory back surgery is not done).
    Please explain the procedure - at a very high level/with some detail/in great detail. The amount of information depends on your personal preference – some want to know everything, some not so much! To actually see the surgery (animated – no gore) – view our Spine surgery animated videos.
    What are my non-surgical options?
    What is the natural course of my condition if it is not surgically addressed?
    What would you recommend if this were your friend/wife/sister/daughter etc…?
    How long will the surgery take?
    What are side effects, potential risks and complications?
    Article continues below
    Please explain the risks and how they relate to me personally. For example, chances of having a non fusion if you are overweight, a smoker, risks if have a grade 3 spondy, etc.
    What if you get in there and see something different than you expected?
    Do I need to donate my own blood? If yes, why? For most types of back surgery, blood does not need to be donated ahead of time.
    Do you perform the whole procedure? Will any students/other surgeons be doing any parts of the operation? If yes, who are they and what are their qualifications? Some surgeons only do a small part of the operation, others do the whole thing. If another surgeon is required, e.g. a vascular surgeon, their role is important and it would be good to know their qualifications..
    Who else will assist you in the operation? What is their background and qualifications?
    What are the long-term consequences of the proposed procedure? E.g. will the operation ever need to be re-done? If it is a fusion, will it lead to degeneration at other levels of the spine?)
    Questions about the surgeon

    How many times have you done this procedure? In general, when it comes to surgery "practice makes perfect", so more is better. (However, if the doctor is recommending something that is not often done, such as multi-level fusions, more would not necessarily be better.)
    Are you board eligible or board certified? You can usually look on the wall and see a certificate.
    Are you fellowship trained in spine surgery? This is more important if the surgery is a fusion, artificial disc replacement, or other more extensive procedure.
    If I want to get a second opinion, who would you recommend? (Someone not in the same practice)
    Statistically the success rate for this type of surgery is _%. What is your personal success rate, and how many of this type of surgery have you done?
    Can I talk to other patients who have had a similar procedure?
    Any defensiveness on the part of the surgeon when you ask these types of questions may be a red flag. A surgeon with good results and appropriate qualifications will not be threatened by these types of questions and will respect your attention to these matters.
    Questions about what to expect after the surgery
    What kind of pain should I expect after the surgery and for how long?
    How long is the hospital stay?
    May a family member spend the night with me in the hospital?
    How do you manage the pain in the hospital?
    Which pain medications will I be sent home with? What are possible side effects of these prescriptions? E.g. Constipation, drowsiness, etc.
    Will you know before the surgery if I will need a backbrace afterwards? If so, will I be fitted for one before the surgery?
    Who can I call if I have questions after the surgery? What is the process for communication?
    How often will I see you after my surgery?
    What symptoms would warrant a call to your office?
    What symptoms would warrant immediate medical attention?
    What limitations will I have after surgery and for how long?
    How long will I be out of work? School? Whatever...
    What kind of help will I need when I return home?
    When can I drive again?
    When can I resume normal (light) household chores?
    What expectations do you have for my recovery?
    When is it safe for my spouse and I to have sexual relations again?
    How soon after the surgery can I start physical therapy?

    What does the new MRI show?

    How is it different from the last one?

    Does it change the plan for the surgery?

    Do you perform entire procedure, if not who else and what portion?

    Who will be administering the anesthesia (general anesthesia?)

    Concerns with throwing up after or being nauseous?



    What is the plan for fusing?

    What does the cage look like?

    What does the plate look like?

    Is it possible to see both?



    What time will the surgery be?

    How long will the surgery be?

    Pain, swelling, bruising

    Who will be in the operating room when I am having the surgery done?

    What should I expect as far as my recovery?

    How long should I have someone at home with me and when can I just recuperate by myself?

    Swallowing / food / medication

    Type of pillow / sleeping

    Stairs / being in car / driving / lifting

    Limitations

    Hard collar

    Soft collar

    Bone stimulator

    Physical therapy

    When

    How often

    What type (The McKenzie Method or certified)

    Stretching or rotation to get range of motion?

    When would I be able to shower?

    Changing of the bandage?

    Removal of stitches?

    Vitamin E to reduce the scar or something else?

    Do’s and don’ts?

    When do I need to stop the anti inflammatory?

    When would I be able to start again?

    When would I go back to see you as a follow up?

    When would I be able to go back to work?



    Good luck with your decision and your recovery!

     
    Old 04-08-2015, 07:57 AM   #6
    gakw3
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    Re: neck issues

    so far i've had three surgical opinions. the first doctor wanted to do a 2 level fusion. the second said he wouldn't touch it. the third, who i'm seeing now, ordered more tests to get a clearer picture. this doctor does indeed come highly recommended & i feel comfortable in his care.

    over the course of the last year i've been misdiagnosed several times, had symptoms ignored or, at the very least, overlooked, & even had a pain specialist (who did not wait for the radiologist's report) tell me that if i wanted medication to mask the pain he'd help me.

    i'm tired & frustrated by all of this, but i've done my research & realize something needs to be done.

     
    Old 04-08-2015, 08:11 AM   #7
    frenchfri1003
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    Re: neck issues

    I totally understand how you feel. I waited 5 years from the first time I decided to deal with the pain at which point I was bone on bone in 2 levels. It's great that you have done the research and feel comfortable with your current doctor. Since my surgery I have been rear ended twice once 8 months after surgery and a month ago. I'm tired of the pain and cycle cervical and lumber issues have caused me. Good luck with the new tests.

     
    Old 04-08-2015, 08:39 AM   #8
    noevr
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    Re: neck issues

    I must say that is the best list of questions I've seen. That needs to be in the sticky.

     
    Old 04-08-2015, 06:45 PM   #9
    frenchfri1003
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    Re: neck issues

    Feel free to copy and paste and put it in the sticky notes. Not sure how to do that.

     
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    central stenosis, ddd, foraminal stenosis, osteoarthritis



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