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  • Re: acdf outpatient, No surgery, nerve damage?

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    Old 08-17-2003, 06:52 AM   #1
    j_f_2003
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    Post Re: acdf outpatient, No surgery, nerve damage?

    Most of my post is just an update and me venting so forgive me if I'm out of line. Thanks for the replies on my previous post about acdf oupatient possible. The good news is that I saw a neurosurgeon and he said he didn't think that I needed this surgery. He says my disc is normal. I didn't really talk in depth with him like I did the ortho dr. They got the films before I went in to see the neuro and he came in and asked why I was there. I told him I had neck, shoulder spasms, and pain going down in both arms. Because I didn't fill out a questionaire or get drilled with questions like I did with the ortho, I forgot to mention my headaches and wrist pain but it probably wouldn't make any difference. On the ortho's questionaire one word was hesitency. I didn't know what that was so I left it blank. I don't know why I'm still having a lot of muscle spasms in shoulders, numbness in hands when spasms are at there worst, and pain in the neck. Neuro doesn't think it's related to the herniated disc. I was told that it's a small herniation. He sent me to a nerologist for a neoro exam and possible EMG/NCS. I left feeling happy not to have to need surgery for the disc but wondered what is causing my pain and spasms. Anyway I didn't hear when he said it's possible for me to have nerve damage particularly in a young female. Thank goodness I got dh to go in with me for a second pair of ears. I see the same neorologist I saw a year ago. He told me a year ago that I would be better in a few weeks and since I wasn't, I never went back to him (figured he lied to me and I didn't want anymore to do with him) The neurosurgeon says he's one of the best neourologist.

    I hope something can be done to help me because I really need to get off the pain patch. My pm dr. allowed me to continue on it while I got the second opinion. I've had four epidural injections and the last time the pm said I had some nerve irritation from the epdiural but it would go away. I didn't mention that to the neuro either. So I went from possible surgery to no surgery and now to a neurologist. If it is nerve damage or something else I wonder what they do to cure it. I can't wait to feel good without meds and be able to work and have sex again. I'm to young for all this. I don't know if I'm being punished for waiting for sex till I was with the man I married but it's so depressing that I can't even enjoy that part of my marriage now. I have don't have as much arm strength and I frequently drop things out of my right hand. I'm the biggest clutz.

    I never mentioned this except to my gyn but my bladder is not working right probably with all the pain meds so I hope that once I'm finished with all the pain and meds it will return to normal. Gyn said narcotics can cause retention. It's gotten a lot worse since so I really don't want anymore meds.

    Will a neourological exam and EMG/NCS tell what is causing the problem?

     
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    Old 08-17-2003, 07:29 AM   #2
    j_f_2003
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    Forgot to say that I never asked about it being done as outpatient because it wasn't even an issue once he said I didn't need surgery. Thank God I don't have to worry about general anesthesia now. I'm happy about that. Now if I can get this pain and spasms to stop I'd be really happy. I'm not sure what I will say to the neurologist as I'm still mad at him before when he said I'd be better. He never told me to follow up with him or come back if I wasn't better.

     
    Old 08-17-2003, 08:30 AM   #3
    mel333
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    Hi,
    I am thinking it is important considering your pain that you see another NS or OS. Even a samll herniation can cause nerve pain. The disc can also lead to symptoms like nerve pain if it is torn as material leaking out may affect nerve function. You could do more tests like a discogram to see if the disc is torn or a myleogram that will detect even minor nerve damage. I would further investigate and look into this pain because I think the disc is a likely cause especially if your having headaches also and wrist pain. What level? 5/6? Take care,
    Mel

    ------------------
    23rd July 03, ADR c5/6
    __________________
    23rd July 03, ADR c5/6
    Also disc bulges c3/4 and 6/7. Numerous facet and nerve blocks along with extensive conservative treatment prior to surgery.

     
    Old 08-17-2003, 04:43 PM   #4
    j_f_2003
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    Thanks Mel. I herniated 6/7. I also was diagnosed last year with bulging disc at 4,5,6. I was told there were small tears in cervical discs 2-3 and 3-4. This year in June it showed left foraminal stenosis due to bony spondylosis, and central stenosis. I didn't have stenosis before. This is why I'm confused that dr says the MRI is normal. http://www.healthboards.com/ubb/rolleyes.gif

    How much pain is required before they will do anything to fix the problem? Duragesic has given me pain free days but I still spasm up, arm jumps, and I think I'd want to die if I have to live like this for another year. Enough is enough! I should have been better by three months from the injury. I'll see what the neourologist says tomorrow.

    I read on another site that an with an EMG, "the vast majority of tests will be negative in soft-tissue injury. This is because you can have allot of nerve irritation and have no abnormalities on this test." I was hoping that one of the test would show why I'm still having muscle spasms in my shoulders and arm jumping. Food flies off my fork at dinner and it's very annoying. Someone told me that did cranial sacral massage that the spasms are probably causing the headaches. I hope I'm not wasting money seeing the same neurologist I saw a year ago who told me I would be better in a few weeks.

     
    Old 08-23-2003, 03:35 PM   #5
    j_f_2003
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    Neurologist was surprised to see I was back and not better. He mentioned that the ns I saw is very conservative. I told him what had gone on in the last year and then he just did a simple test to see if the nerves were ok by applying a device that gave me sort of a shock. No needles and no exam. He said I was having a LOT of spasms and had no idea why I am still having them. He put me on a new medication "zonegran" and has no idea if I'd be better or not. It's an antiseizure medication but said that they rarely use the medicine for seizures. He said it works on the neuropathic pain and something else. He said the neck surgery is major. He also said that I am going to continue going up on the narcotic pain med scale if I don't get better. On the way out spouse asked if I should be exercising and he said yes. He said if I don't strengthen the muscles they would get weaker and weaker. He also said it should be supervised with a therapist so I don't hurt myself again and not to go to the gym to work out. I bought a gym membership earlier this year so I could do that. He didn't write me a prescription for more physical therapy and asked me if I was seeing anyone else. I said only pm dr. and he said he would be in contact with him. I go to pm dr. in a month and see neurologist in two weeks for a follow up. spouse wants me to just go to the gym with him so no idea if I will do that or wait to see if I will get a script for more physical therapy. I am hopeful that more p.t. and exercise may help me. I did have a lousy female therapist the second time.

    I have a month's worth of pain patches left and I really need to do some p.t. before I run out rather try to go through p.t. an not get anywhere like I did before the injections. The chiro's office dismissed me because I couldn't increase my exercises to something stronger due to the pain. Then I got the injections and ended up with the lousy p.t. lady. I don't think the pm dr. will have a problem keeping me comfortable while I'm trying to strengthen the muscles. I hope once I exercise again it will reduce the pain and I can stop the patches eventually. Unfortunately the previous p.t. lady just increased my need for pain meds because she was so rough and dug her hands in my neck and pulled manual traction on my neck after her boss told me I would not be getting traction as it would make me worse. She also said I was not having spasms after three dr's including this neuro said I was having lots and said I was "hooked" on vicodin when I was taking only two per day. She needs to be fired! I hope someone else has a problem and complains about her. I wish she could feel my pain. I asked the neuro how long it would be before I got better and he said because it's already been a year, he has no idea if or when I'd get better. I wish I knew what was causing the spasms. I do have a follow up for Mon morning with the spine dr. but spouse wants me to cancel it because I'm not having surgery so I will call first thing on Mon and cancel.


    [This message has been edited by j_f_2003 (edited 08-23-2003).]

    [This message has been edited by j_f_2003 (edited 08-23-2003).]

     
    Old 09-07-2003, 06:52 AM   #6
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    I cancelled the follow up with the spine dr. since surgery wasn't indicated. The spine dr. didn't really know what was causing my opposite sided pain and the neurosurgeon thought the neurologist would be best for diagnosing further on that. I never recieved a call back from neurologist office that I contaced a week later in reference to a possible script for more p.t. like the neurologist said he wanted me to do. By the time I went back to pain mgt dr. a few days ago he said he didn't want me doing anymore p.t. as I've already done it twice and he didn't want me doing any lifting weights, only stretching type exercises, swimming, and I can use my precore elliptical machine I've been wanting to get back on. He asked me if I wanted to consider surgery for the stenosis (to go in and open it up some) but I told him the neurosurgeon said no surgery and the neurologist didn't know when or if I'd be better and wanted me back in p.t. and gave me the zonegran. He asked me if the zonegran was helping and I said I didn't notice any difference. He gave me two injections in the muscle with cortisone. I go back to the neurologist in a week. I'm kind of baffled that with all the technology the neurologist doesn't know what's causing my pain and spasms. I don't even think I had a full neurological exam that was written on the script by the neurosurgeon! I did have an EMG. He talked with me and then connected me to the EMG machine. I was sent to him because the other two dr's said surgery wouldn't help me with my current symptoms as they didn't think that was causing them.

    I know the p.t. lady was terrible and if she hadn't been so rough, I may have considered it again but even the pm was not happy with the way she treated me so he didn't want me going through that possibility again. What else could it be????? My hands have always been cold. I still have pain in both shoulders, neck, spasms, tightness in muscles in chest, back, and my R arm jumps. Not related to herniated disc, stenosis, or spondylosis. Should I demand that the neurologist do more testing? His saying to me "I have no idea if or when you will ever get better" doesn't give me any hope and it makes me want to die although I didn't tell him that. He also mentioned that unless I get off these pain killers sometime I'll just keep going up the ladder. I guess he tought that p.t. would help me get off the meds. It never did before and made me worse.

    Forgot to say that initial diagnosis were small tears through C 2-4 bulging disc 4,5,6 and herniated disc C6-7 and new MRI showed no disc pathology but showed left foraminal stenosis due to bony spondylosis and central stensosis. Both orthosurgeon and neurosurgeon said MRI's were normal and the herniation was very minor! Stenosis was just a small narrowing and nothing to be concerned about.

    If anyone has any ideas about what I should say to neurologist at my next appointment or about what other test I should ask about please let me know. I'm sick of being given more pills and told he doens't know what's causing this or has no idea what's wrong. I want him to find out!

    [This message has been edited by j_f_2003 (edited 09-07-2003).]

    [This message has been edited by j_f_2003 (edited 09-07-2003).]

     
    Old 09-07-2003, 07:24 AM   #7
    schragie
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    Ugh! I hear your frustration!

    First, please don't forget to tell the doctor about problems with urination. In some cases, it could be a result of disc problems.

    Second, I know you don't want to take more pills, but I have had bad problems with spasms in my eck/shoulder and a muscle relaxant called Flexiril helped a lot (though it did make me sleepy). If I took it at night, spasms would not wake me up and also I slept well. I also had the "jumping arm" which scared the heck out of me.

    Since your docs are not recommending surgery and yet are baffled by your pain, maybe it's time to try something unconventional like acupuncture or biofeedback? I haven't done them myself, but they could help.

    Again, sorry your doctors visits have been so difficult in terms of getting answers. Ever consider seeing a physiatrist? They deal with spinal problems/sports injuries/etc.

    You may also want to get another opinion--from another neurosurgeon. I went to several. A different physical therapist might also help. There are ways to stregthen your muscles without lifting weights and I found relief in strengthening my stomach muscles, which improved my posture. Losing a little weight if you are overweight could help too.

    Lastly, do you have a desk job? If you do, consider ergonomics, get a good chair. Use a headset instead of keeping the phone in crook of your shoulder.

    This probably sounds preachy, so forgive me if it does. I hope you find some relief soon!

    Lisa




    ------------------
    1999 fusion C5-6 & C6-7
    2002 herniation of C4-5
    __________________
    4/2006:TLIF L5/S1
    2002: C4-5 herniation
    1/1999: ACDF C5-C7

     
    Old 09-07-2003, 07:30 AM   #8
    j_f_2003
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    I forgot to mention that when I went to p.t. the second time with the b*$%cg lady, She didn't do initial therapy on my neck. She said my shoulder was impinged and my clavicle was not even with the other. They were uneven. I never told this to any of the other dr's because I forgot all about it but I do remember she mentioned the shoulder being impinged. So they got the ortho dr. who I never went back to to write another script for shoulder therapy for one month and then neck therapy for one month. Maybe the pain has someting to do with my shoulder or clavicle? The ortho I saw originally before my neck MRI was a shoulder dr. so he never even figured that one out! Geeze I saw the right people but no one can figure out how to treat and cure me for good. Wish I could get better. It's been 1 year now. My shoulder bones seem fine except for the spasms in the muscles. My clavicles are still uneven. I'm lost!

     
    Old 09-07-2003, 07:44 AM   #9
    j_f_2003
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    Lisa,
    Thanks so much for responding.

    Yes I do use a headset, no desk job, am not overweight 5'7 138 lbs . I am willing to try a different therapist provided they don't give me a hassle with my pain meds. The first p.t. sessions I had I wasn't able to get through the exercises because I didn't take enough pain meds and dr's pleaded with me to take pain meds before therapy and the first thing the new p.t. lady said was not to take a pain pill! I told her my dr. told me to take pain meds and she yelled at me. I took pain pill anyway after she left but still got a hard time from her about it and she drilled me about my use of narcotics.
    What is a physiatrist? It's not a chiropractor is it? if so I already did that. I take zanaflex for muscle spasms and it knocks me out. Glad to hear I'm not the only one with an arm jumping. I thought I was the only one. Never heard of that with anyone else before. Thanks so much :-) to know i'm not alone. It drives me crazy. Food flies off my fork or spoon. I did mention the urinary retention and neurologist said it was from the pain meds which by the way I need to taper off eventually of he says.
    I also like to use the Thermacare heat pads on my shoulders. I'm not saying I want surgery I just want an accurate diagnosis and treatment or cure so I don't have to stay on meds forever. I was very happy to hear I wouldn't need any fusing of my neck. But now what?

     
    Old 09-07-2003, 11:07 AM   #10
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    j f,

    A physiatrist is an md---physical medicine and rehabilitation. I just asked for a referral to one. I think anyone with more than one issue needs a physiatrist to pull everything together. In my experience physical therapists have tunnel vision and they all contradict each other.

    Are you getting copies of the reports from all the neuros? I have all mine so I can remember accurately what they said.

    fly

     
    Old 09-07-2003, 12:54 PM   #11
    j_f_2003
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    Oh yes I did. It was the same ortho dr. that they called for the script to do shoulder therapy for me. I went back to him for a follow up and we only addressed the neck issue not the shoulder. I still had spasms but they were not as bad, (probaby because of the epidural injections I had) but the spasms are now back. Maybe I should go back to him? I don't know he's not a surgeon and all he did was prescribe more p.t. for me to which by the way it turned out to be to a therapist from h$*l. He couldn't do anything else for me other than prescribe p.t. in my opinion. My pm dr. doesn't want me doing any more p.t. I did finally get the reports sent from the neurologist to the pm dr. office about one day before my appointment. I kept calling and calling and the neuro's office girl said they would send them and they didn't but she said she would get back to me about the p.t. issue that the neurologist wanted me doing and she didn't. Not very reliable office staff. I will make sure I tell the neurologist what I need to when I go in because I can't get messages or reports across to other dr's without a big hassle or long wait. He will probably be suprised I haven't started therapy yet because the girl I spoke to told me on the phone he wanted to see me back in a month after I had about 5-6 therapy sessions so I alerted her that I never got a script for therapy.

    [This message has been edited by j_f_2003 (edited 09-07-2003).]

     
    Old 09-07-2003, 12:58 PM   #12
    luvwindnhair
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    testing
    __________________
    L5/S1 herniation 7mm 01/18/00
    Microdiscectomy/Laminectomy 10/12/00
    Thoratic pain began Dx buldge @ T-8 08/02
    Had MRI on Lumbar because pain was returning, also scaned T spine 8/02, Dx recurrent L5/S1 herniation and new herniation @ level L4/5
    Cervical pain began 2/03
    Had MRI~Dx herination @ level C 6/7
    Had anterior decompresion with hardware and use of my own hip bone graft to C 6/7 8/14/03
    Accepted in Clinical trials/getting my 2 level Prodisc ADR in Feb!

     
    Old 09-07-2003, 01:39 PM   #13
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    I still think you need to ask for a referral to a physiatrist. A physical therapist can only deal with one problem at a time. I also want my physiatrist to give me a program that I can do at the Y. They have rooms full of machines there.

     
    Old 09-07-2003, 04:38 PM   #14
    PainInTheNeckJackie
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    JF... try getting the EMG to check for nerve damage. That seems to be my problem too. I got the EMG/NCV on Friday and am awaiting the results. The bladder problems are the worst, and they are not from medication in my case, because I avoid the meds and deal with the pain constantly, because I cannot stand the way meds make me feel

    ------------------
    Jackie
    ***************
    Left paramedian subligamentous herniation C5-C6 causing left foraminal stenosis and cord compression;
    ------------------------
    Right paramedian subligamentous herniation at C6-C7, abutted against the vetral aspect of the spinal cord

     
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