I finally talked to the neurosurgeon about my MRI results.

[Ladyhawk]

He suggests removal of two damaged discs at C4-5 and C5-6, bone plugs and a titanium plate. In other words, he recommends fusion of three vertebrae.

The surgery would be done from the front. The surgeon would cut into the left side of my neck, push my trachea and esophagus to one side, remove the offending discs, place bones from a cadaver where the discs used to be and screw the whole thing in place with a titanium plate.

I would have to wear a hard cervical collar for three months.

Problems:

1. He cited a figure of 80% efficacy in alleviating neck pain. I was hoping it would be higher.

2. He cited a figure of 5 - 10% of a chance of vocal cord or vocal cord nerve damage. His assistant said it was lower, to which he replied he'd have to get back to me. As a singer, this is rather scary.

3. It looks like I'd be wearing the cervical collar during the hottest part of the year, which is exactly what I was trying to avoid. Ungh.

4. Also, I don't know if you can swim in those hard cervical collars. I need my nature fix this summer, or I don't know what I'm going to do. I usually hike for awhile around the lake, then plunge in when I'm too hot. I get hot very easily, probably due to medications I'm on. I actually get sick when I get too hot.

What do you think?

[GreenPartyVoter]

1. :^( I dunno what to say. I want you to be comfy, but

all that stuff sounds scary. Better to ask an expert or someone who has been through it. See if there are b boards with folks in the know on them. *hugs*

[OldLeftieLawyer]

2. So, postpone the surgery

If your life's in danger, by all means, go on and have it as quickly as possible.

But, if things are manageable, why have it? At all?

A singer letting someone shove vocal chords? I wouldn't, but that's just me.

Talk to others who've had this procedure. The physicians can put you in touch with patients who've undergone it. Find out if it really works.

I'm always suspicious when MDs quote statistics. It usually means they're lying.

[Ladyhawk]

14. Things aren't manageable. That's the problem.

I'm in such serious pain that I cannot clean my apartment, do my laundry, take out the trash, etc. And I don't have anyone to help me.

[supernova]

3. What kind of collar?

IF the collar is fiberglass; then you could go swimming.

After three months I wore a fiberglass cast after my back surgery. Being able to shower felt like the greatest gift ever.

Hope you feel better.

[mr_hat]

4. Don't do it. I know NO ONE who's ever had back surgery >

that didn't leave them in worse shape than before, including me. (OK, no one amounts to three.)

I had multiple compressions and vertebrae fractures resulting from a lifetime of contact sports (rugby and football) and was persuaded that surgery would be the ticket. I was retired, and hey, I had decent insurance at the time.

The recovery sucked (months of inactivity). it was painful; more so than prior. And then... the pain just stayed, along with limited mobility.

Just my experience.

[Kingshakabobo]

10. I second that!

Therapy and exercise are the way to go. I've known a few people that have gone under the knife and they are worse off.

[Ladyhawk]

12. It's not my back. It's my neck.

Everyone I've known personally has gone through neck fusion surgery without a hitch. I've only heard of one semi-bad experience.

I've done therapy and exercise and I'm still in a lot of pain.

[OldLeftieLawyer]

18. OK, I wasn't gonna say anything..............

but, in my thirty years of law practice, I've yet to see a good result from a back surgery. I've also handled more than a few malpractice cases that did nothing to correct the damage done by surgeons.

You have to remember that surgeons cut. That's what they do, so everything they see - in their evaluation - needs cutting.

When I hurt my back in a plane crash, herniating a disk at L-5, S-1, the neurosurgeon in charge told me that, if I didn't have immediate surgery, I'd spend the rest of my life dragging my left leg.

I was in a private room in the hospital, and, at night, when I was watching TV and enjoying the codeine high, nurses would come in and ask if I was the patient who was refusing surgery. Then they'd tell me the horror stories about what they'd seen in back surgery patients, and assure me that I was doing the right thing.

I also called every personal injury lawyer I knew, and every one told me not to have the surgery.

It's twenty-five years later. I'm in perfect shape, and the neurosurgeon is dead.

There are alternatives, lots of them, and I hope you can explore them before submitting to something irreversible.

Good luck. I wish you the best of luck. If there's anything I can do, feel free to PM me.

[bobbieinok]

22. that's what my brother told me he's heard from all his friends who had

back surgery.....brother's had knee surgery and he says it hasn't improved pain

brother was so adament when it looked like I might have to have some work on my lower back he said 'You make sure you get me back there to talk to him if he's says anything about surgery' ....this was a big surprise from him

[MissMarple]

5. I'd get another opinion...or two.

:shrug:

I'm sorry about your neck.

[SharonAnn]

6. I had major back surgery 10 years ago and for me, it helped a lot

I have hardly any problems now. Of course, mine was quite different from yours. Because of scoliosis which started getting worse when I reached 45 years of age, I had to have quite a few vertebrae fused from about my shoulder blades to down below my waist. Long recovery, fiberglass "brace" (really a clam-shell type body cast) that I could shower in, but when I recovered I found that I did very well.

I went to Mayo Clinic for a second opinion since it was such a major surgery and not often done for people past their teens. My surgeon was one who specialized in this kind of surgery so he had lots of experience.

Don't know if this is any help for you, but I had lots of discs removed, bone grafts, and metal hooks and rods to hold things together while the bone grafts fused the bone. Since I have no residual problems with the metal, it's still there and I have no plans to have them removed.

Fo many of us, the right surgery is an excellent option.

[SharonAnn]

7. I had major back surgery 10 years ago and for me, it helped a lot

I have hardly any problems now. Of course, mine was quite different from yours. Because of scoliosis which started getting worse when I reached 45 years of age, I had to have quite a few vertebrae fused from about my shoulder blades to down below my waist. Long recovery, fiberglass "brace" (really a clam-shell type body cast) that I could shower in, but when I recovered I found that I did very well.

I went to Mayo Clinic for a second opinion since it was such a major surgery and not often done for people past their teens. My surgeon was one who specialized in this kind of surgery so he had lots of experience.

Don't know if this is any help for you, but I had lots of discs removed, bone grafts, and metal hooks and rods to hold things together while the bone grafts fused the bone. Since I have no residual problems with the metal, it's still there and I have no plans to have them removed.

Fo many of us, the right surgery is an excellent option.

[supernova]

8. Scoliosis surgery - I had this in my teens

I'm 42 now and have done very well. In fact, you don't notice it unless I tell you I've had it done.

I didn't have vertebrae fused but I do have Harrington Rods.

Fiberglass casts RAWK!

[rox63]

9. I also had this surgery in my teens

Due to scoliosis, and I'm doing fine. I'm in early 40's now, and the part of my back where the surgery was done doesn't give me any grief. My lower back is another story, but that wasn't touched in the surgery. I have a Harrington rod, and several vertebrae in my upper back were fused. The only side effect is that my upper back is almost totally non-flexible.

[crispini]

11. What other options have you pursued?

If the main problem is pain, I know many people who have had great luck with acupuncture for pain management, especially with soft tissue injuries.

[Ladyhawk]

13. The difficulty is I'm too poor to afford alternative therapies.

I tried acupuncture once (twice?) and didn't think it helped all that much.

What would work for me is massage therapy and a decent bed to sleep in. I think. But I can't afford either. :( I am having a hard time affording enough food to eat.

You have to understand, this has been going on for nearly four years. I've tried PT, exercises, etc. and I'm still in pain. I want something that will FIX the problem.

LH

[crispini]

25. Improvements with acupuncture are seen across multiple sessions.

I had really a really awful repetitive stress injury in my arms and hands. It took about 8 sessions of acupuncture, but it was cured. My acupuncturist charged $40 a session.

And, of course, as you say you want something that will FIX the problem, but it sounds to me that in the opinion of some of the others on this thread, you may go through all that and then it WON'T fix the problem.

Good luck. :hug:

[AngryAmish]

15. I have know a lot of folks who have had cervical fusions

First of all, I am not a doctor. Becuase of my job I meet a lot of folks with orthopedic problems. You are much better off getting advice from your neurosurgeon, or get a second opinion. This is an open internet chat-thingy and I could be a sociopathic 8 year old from Belgium. So please take everything I say with HUGE boxcars full of salt.

That said I have met about 20+ persons who have had cervical fusions, and a few with multiple level fusions. 80% had good recoveries, 15% have seen no improvement and 5 % worse. It is generally a pretty good operation and there are many professional athletes who have had the procedure. Cervical disc surgury has a higher rate of sucess than lumbar procedures.

Depending on where your herniation is located (I am assuming you have a herniation) you can cause permanent damage if you do not have it fixed. Rarely it can cause spinal cord damage.

My recommendatin would be to have the surgery, but, again I am not a doctor.

PS, the alternative medicine thing don't work. Sometimes herniations go away on their own, but if you have had this thing for a while you are probably stuck with it.

[Ladyhawk]

16. Hey, for an Amish guy, you know a lot about modern surgery. :)

My impression has been that back surgery is more risky than neck surgery, probably because the back supports a lot more weight than does the neck.

I've also been told the herniations can go away on their own, but it doesn't look like that is going to happen. Also, my neck is so tight and full of knots, I have trouble singing as it is. I can still do it, but I have to double up on the muscle relaxants.

Do you know many sociopathic eight-year-olds from Belgium? :D

The herniations cause numbness and tingling in my extremities, especially the right arm / hand. And the pain is on the edge of driving me mad at times. Probably I will go through with it, but I don't know how a poor person goes about finding a second opinion.

Do you?

[OldLeftieLawyer]

20. You tell the surgeon what your situation is,

and ask if there's a reduced rate and payment plan available. Maybe you can sing for him at a party or something (I barter services all the time). It's a good time to be as creative as you can be.

Is there a university medical school nearby? Take yourself over there and you'll get all kinds of attention from MDs and their students. That's how future doctors learn.

[Ladyhawk]

21. UC Davis is a teaching school. :)

I should be OK monetarily. I'm in the low, low bracket where you get health care, but you get it way late. (It took a year to approve the MRI.) People just above me on the totem pole don't have ANY health care. This thing is just so screwed up, eh?

I might be able to barter something for some decent massage sessions. I can fix computers, sing, do graphics, art, etc. Hmmm.

LH

[AngryAmish]

24. All Belgians are sociopathic - especially the children

I kid.

You have to read your insurance policy. Somewhere in there there should be something about second opinions.

Call up your insurance company also. They can tell you what is covered.

BTW, the Amish invented the MRI. You can look it up.

edited for spulling

[OldLeftieLawyer]

19. Herniated discs

Here's a little secret about herniated discs - as you get older, they wear away, a natural process. That's why people get shorter as they age - the soft places between the vertebrae just get eroded.

And, when that happens, the pain diminished or disappears, as well. That's what happened to me, although yoga and stretching and listening very carefully to a physical therapist helped more than anything.

If you're considering having this surgery because of financial reasons - you can't afford a massage therapist or even a decent mattress - I think you might want to get some rest and re-think how you're approaching this unfortunate situation. If a good bed would be the difference between you having surgery and not having surgery, I'd be willing to contribute to a fund to buy you a great bed.

[Ladyhawk]

28. So, are you going for "The Most Gratuitous Use of the Word Belgium...

...in a Post on Democratic Underground" award?

[Deja Q]

31. I second that. Analyze your doctor and how she/he says things...

Mine was upfront and honest about his career, the procedure, the risks involved. I'd talked to a couple people and they know his record too. (the first surgeon I tried was JUST as competent, but I'd been asked about ever being diagnosed with any emotional/mental disorder and I took it too personally. Wasn't her fault but I felt uncomfortable because of it.)

Both of mine told me the same thing about surgery, though the first one also wanted a CT scan done to get even more clearer details. I dunno if I should have opted for it, but I couldn't afford the co-pay for the CT scan and the 2nd doc saw all he needed to. (but said the 1st one had a valid point and that each doc is different in determining needs...)

If I didn't get the surgery, the disc would have continued to press on my spine. I was already having some severe problems. Many of them are improved, but not yet gone because the spine needs to heal. (that and I've a couple of organic deficiency problems, but those I'm working on too.)

[LeftyMom]

17. My mother's had it done twice

(the first time the bone slipped out and made the problem worse, the second time they did the same thing but with a steel rod as well) and now her doctor is recommending a third surgery.

Her voice was not effected, but my mother sounds like Janis Joplin with laryngitis anyhow, so this wasn't our major concern. The scar is fine and hard to see, Mom has matching scars on both sides of her neck from the two surgeries but they barely show. However, she hasn't really had any significant improvement in terms of the pain in her neck or the weakness in her hands.

I suspect that your doctor may be overstating the effectiveness rate, just because I know a few people who have had similar surgeries and none of them seem to be in less pain than before the surgery.

Do you have any other options? Have you got a second opinion yet? My mother's 2nd opinion neuro is trying to treat her without surgery, so we'll see how that goes.

[Sgent]

23. Make an appointment

with a Physiatrist -- which is a physician who specializes in Physical & Rehabilitation Medicine. They will give you a good indication of whether surgery is a good way to go, or if there are other methods (physical rehab, etc) to try first. You may have to have a primary care doc refer you as there aren't a lot of these guys around -- although it is a medical specialty (like dermatology, orthopedic surgery, neurology, etc). Make sure to bring a copy of the MRI (not just the report, but the actual films) so they can read it.

I have to say that I've seen many, many good outcomes from back surgery, and a few bad ones. It is not an absolute. Often, many problems however can be aleviated without surgery.

[Ladyhawk]

27. OK. One of my physical therapists told me that the disc may be leaking.

I've gone the PT route about five times, I'd say? Because I'm poor, I can only have a certain number of sessions within a given period.

The reason I posted is because I'm pretty much out of alternative options.

LH

[Sgent]

29. Physical therapists

are not psyiatrists, and they are not interchangable. The have significantly less training, are not physicians, and and have no training in such areas as reading an MRI or looking a neurological damage on a medical basis.

I stand by my original comments. You wanted a second opinion, and a psyiatrist (or a neurologist who is interested in this type of thing) is the person to see. You could also see another neurosurgeon to determine if their maybe an alternative technique.

[Ladyhawk]

26. I've already done the alternative therapies...the ones that are covered.

I can't afford alternative therapies if I have to pay for them. :( I will see about getting a visco-elastic bed topper, but I have to approach a friend about the money. God, I hate to do that, but :shrug: what else can I do?

[Deja Q]

30. I recently had similar surgery myself. So take this advice from a Toad:

1. 80% is still very good. My surgery helped me recover arm strength considerably.

2. Mine were affected, albeit temporarily. After 2 weeks I was fully healed of that issue. This is inevitable as C4-C5 are right there in just the right spot. Don't worry, it will go away - especially if your surgeon takes her/his time.

3. My surgery isn't as invasive as yours, though not by much and less was done. 3 months is not abnormal. (some web sites say 6 weeks, but that's the internet - many sites claim to be official but only are like TV infomercials.)

4. DO NOT TRY SWIMMING DURING RECOVERY. PERIOD. You might make things worse. Once everything is confirmed healed, you'll be able to SLOWLY get back into your routine. And I get hot and sweat easy too. If you have the surgery now, it'll be off by mid-June. July and August are typically worse in terms of heat.

Addendum: DO NOT DRIVE while wearing the collar. And wait until the first after-surgery checkup (~3 weeks) to inquire about driving. If they say the collar needs to be on, then do not attempt to drive. Response time and vision range are reduced; nor is it fun to risk ruining what they've done in your neck.

Addendum, additional: There are other potential complications - such as blood clots forming in the legs. They put me in this fancy set of knickers that plugged into a gizmo that kept my legs warm and in continual, slight motion.

Addendum, additional, additional: Get an autograft - have them remove your own bit of bone from your hip (same side as the incision they make, if possible). The only major risk is an extra site for infection or temporary loss of sex drive. I did the autograft and I'm good as ever (FWIW). Plus, your own bone is more likely to fuse than someone else's (Allograft) Besides, with the meds you'll be on, you won't be able to do the loosie-goosie or anything else during the initial convalescence period.

Best wishes! And I bet you'll get through it! :hug: