Re: Neck Surgery Question

[Guest guest]

Hey Rick

I was diagnosed with DDD 20 years ago. And to be truthful My RA seems to just

put this aside. The pain is sometimes unbearable. I have no discs for L1 to

L6. My neck is now giving me problems which leads me to believe that it has

made it there. It is very painful. And He suggest that maybe I take an extra

Celebrex to relieve the pain. He is full of crap. This does not work. I live

in pain every day because of this. Now I have been dx with RA and Lupus. Have

found a new doctor. Hopefully this one will talk to me one on one . We are all

here to help. Any suggestions or info would be greatfully appreciated.

Keep the faith.

Judith Ann

Rick <rhow176@...> wrote:

I know a few of you have talked about having neck surgery. I have a

question if I may. I have had degenerative vertabra at C5 & C6 for

several years. Recently the degeneration has also spread to the C7-T1. I

had told my rheumy about my neck problems several times (every

appointment) and he only acknowledged it once by saying, " the neck might

be related to the rheumatoid " . Today, I had an MRI because the one I had

in January showed a mild compression on the spinal cord. The MRI today

revealed a ruptured disk. My PCP is referring me to an orthopedic and/or

neuro-surgeon for surgery.

My question is have any of you had this surgery and if so, how is the

recovery? Painful? Long recovery time? Etc..?? Any insight on what I

might be looking at would be much appreciated.

Thanks

Rick

www.whosyomama.com

[Guest guest]

In a message dated 18/05/2004 23:53:29 Central Standard Time,

rhow176@... writes:

> My question is have any of you had this surgery and if so, how is the

> recovery? Painful? Long recovery time? Etc..?? Any insight on what I

> might be looking at would be much appreciated.

> Thanks

>

>

Rick

I'm a nurse in a hospital. I work on a neurosurgery unit where we have

patients who have this surgery all the time. If I was having the surgery, I

would

use a neurosurgeon rather than an orthopedic surgeon, because it involves your

spine and spinal nerves. Make sure the surgeon does the surgery all the

time. Lots of experience is what you want. You will be in the hospital

anywhere

from a couple of days to a week. At first it is painful, but less painful

than before surgery from what I'm told. It is very important to get up and

moving as soon as possible after surgery. This has the most impact on how long

your hospital stay is. If I can answer anything else for you, please ask! You

may or may not need physical therapy after your discharge. Cary

[Guest guest]

I have not been on the group in quite a while - but tonight I saw

your message and wanted you to know that I just had sugery 2 months

ago. I am not sure exactly what you are having done - I had cervical

spinal stenosis between C4 and C5. My rheumy referred me to a

neurologist in January for the headaches I was having (I am 31 and

have fibro and Sjogrens). The headaches ahd been pretty much nonstop

for about 3 motnhs - and before that they were sporadic with 2-3 a

day. The MRI showed what the stenosis and I had a frontal diskectomy

in march. The disk was removed (through the front of the neck) and

replaced with a piece of donor bone. A titanium plate was put in so

the vertebrae and bone could fuse together. When they got in there

the disk was actually much worse than the MRI had indicated.

I woke up from surgery and the first thing I said was that the

headaches were gone! I have since had a few tension headaches from

the neck and shoulder muscles when I do too much - but the awful

ones like before are gone - along with the muscle pain, spasms and

EXTREME fatigue. Carrying a cup was heavy and walking down the hall

at school was quite a challenge. The balance problems also

disappeared. It has taken my husband two months to get used to the

fact that I don't need him to rub my legs every night.

I stayed in thehospital only 24 hours!! I wore a soft collar for 3

weeks and I was to be up to walking a mile a day at one month. At

that point I was able to start lifting half gallons of milk - and he

gave me two months to get back to normal activity levels. I have

achieved that quite nicely - I still watch what I lift - but the

only meds I still take are the antidepressant so I can sleep (which

I was on before) and I take a muscle relaxer 1-2 times a day. I do

notice that I have lost some of the range of motion in my neck. But

nothing that keeps me from doing things like driving. Some days it

is more stiff than others and I just turn with my upper body

instead.

I do pray that you will have the same success I had and that your

surgery provides relief. Even on my " bad " days I can still say that

I am 75% better than I was before the surgery. Take care - most

people were surprised that I was so anxious to have this done - but

with two elementary age children I was excited about the possibility

of returning to some sense of normalcy. These are done all the time

with great success. I would advise that you feel comfortable with

your surgeon ( I went to a neurosurgeon) and make sure your

questions are answered. Mine was very honest at the first visit

about the risks and his success with this surgery (which was

excellent). There was very little I had to ask him and he was very

reassuring without being overconfident in his abilities.

Take care and let us know how it goes!

Janet

[Guest guest]

>> I stayed in thehospital only 24 hours!! I wore a soft collar for

3

> weeks and I was to be up to walking a mile a day at one month. At

> that point I was able to start lifting half gallons of milk - and

he

> gave me two months to get back to normal activity levels. I have

> achieved that quite nicely - I still watch what I lift - but the

> only meds I still take are the antidepressant so I can sleep

(which

> I was on before) and I take a muscle relaxer 1-2 times a day. I do

> notice that I have lost some of the range of motion in my neck.

But

> nothing that keeps me from doing things like driving. Some days it

> is more stiff than others and I just turn with my upper body

> instead.

>

> I do pray that you will have the same success I had and that your

> surgery provides relief. Even on my " bad " days I can still say

that

> I am 75% better than I was before the surgery. Take care - most

> people were surprised that I was so anxious to have this done -

but

> with two elementary age children I was excited about the

possibility

> of returning to some sense of normalcy. These are done all the

time

> with great success. I would advise that you feel comfortable with

> your surgeon ( I went to a neurosurgeon) and make sure your

> questions are answered. Mine was very honest at the first visit

> about the risks and his success with this surgery (which was

> excellent). There was very little I had to ask him and he was very

> reassuring without being overconfident in his abilities.

>

> Take care and let us know how it goes!

>

> Janet

I had my first neck surgery in July of 2002...then I was better for

a time but still had pain in my left arm... the MRI showed that

actually 3 discs were damaged but my Orthopedic surgeon just opted

to take out the one...

I then had surgery on my shoulder for a torn rotator cuff that we

have no idea how I did...

after that I had to have another neck surgery... the one above the

first one. I had several good months but now am having the pains in

my arm again. I am wondering if they shouldn't have gone in and

replace the 3 discs to begin with.

I do know that the truck accident I was in (being rear-ended) caused

the damage to my neck to accelerate but I still wonder. So far, I

have had C6-7 replaced and C5-6 replaced. The CATSCAN showed that

there was a tear at the 6 o'clock position of C4-5 but the ortho doc

didn't think anything of it. Another Doc(the one who did my

discogram) told me he would have removed both and also replace the

fusion at C6-7 and put in one of the cages...

I don't know if the Ortho doc just wants to make more money since he

did triple his bill for the MVA insurance settlement I was recieving

which between the clinic and the lawyer - they split it all.

Now I am looking at another surgery down the road -

I hope you have better luck then I have had.

God bless,

Althea

[Guest guest]

Rick,

My friends know how to bring me out of hiding. I am a caretaker, worse than that

I tend to mother everyone around me and it is difficult to resist when people

are apprehensive about spinal surgery. Any spinal surgery has risks and my

personal feeling is that when problems can be treated without surgery that is

best. However, there are times that surgery is the only logical choice and as a

former surgical nurse, it bothers me when all people hear about are the horror

stories. Unfortunately, there are cases where people have problems but they are

the exception with cervical surgery. Most of us who have had cervical fusions

have had good results.

Cary and Janet both gave you some good advice. I was glad to see that you had

some positive encouragement. My personal feeling it that when they are dealing

with my spine - I want a neurosurgeon. When it is time to have my hips replaced

- I want an orthopedic surgeon. For spinal surgery, I want a neuro with many

years of experience and a very high success rate and low infection rate. There

is NO room for error in spinal surgery.

When you meet with the doctor you want to find out how long he has been doing

this surgery - their training period is about 10 years so a neurosurgeon has

many years of training behind him. You want to know how often he does this

surgery - my neuro does surgery three days a week and does a variety of neuro

surgeries but he does 4-5 spinal fusions every week. You want to know how many

of his cases have had complications and what type - since my stroke nearly three

years ago (which was not my surgeons fault, I will explain at another time but

he has always blamed himself) my surgeon tells people about my case when he

discusses the risks of lumbar fusions. That is the sign of a very good surgeon -

he is honest and upfront. Hopefully, he will tell you all of these things

without you having to ask. Before my first surgery these are the questions that

he answered before I had a chance to ask them.

Your surgeon should discuss any non surgical options with you and if he feels

that surgery is your only option, he should tell you why the other options are

not good in your case. You also want to be assured that he uses only the most

advanced equipment and the most recent approaches to your particular surgery. If

your surgeon is not off to training very frequently, he is not keeping up with

the rapid improvements in neuro surgery. When he tells you about the surgical

procedure - he should say 'it's no big deal' If he doesn't say that I would be

reluctant to let him do the surgery without getting a second opinion.

It is remarkable what computers have done for spinal surgery. Operations that

were extensive and dangerous with long recovery periods are now done with small

incisions and cameras. This has significantly lowered the risks and made

recovery much easier. If your surgeon is not provided with the latest equipment

find one that is. Don't assume that just because it is a famous hospital that

they have the latest equipment - it all depends on how much hospitals are

willing to invest in their neuro departments. Don't be shy about asking these

questions, you have only one shot at this. It is often times impossible to

correct mistakes made in spinal surgery.

Please Rick, keep in mind that the advances in spinal surgery are incredible. If

you talk to someone who had the same surgery even 5 years ago - it was much

riskier and had a lower success rate. That is why your surgeon should be

constantly updating his procedures and your hospital should be constantly

upgrading the equipment. That is why it is such expensive surgery but it is

worth it.

Before during and after surgery, they will monitor the status and function of

any nerves. Rest assured there are many people in that operating room who have

specific duties. Most neuro surgeons have their own specially trained techs and

nurses who are with them during surgery - they know what he needs before he asks

so he can concentrate on what he is doing.

Don't be afraid to talk to the surgeon about the treatment of pain. You want any

surgeon to assure you that your pain will be treated. Post surgical pain should

always be limited because untreated pain will make it impossible for the patient

to do the things they need to do so post surgical complications are avoided. For

instance, you have to get up and walk as soon as possible to avoid blood clots

in the legs. You have the right to have your pain treated at any time but

especially after surgery.

After my cervical fusion, I had to wear a cervical collar for a few weeks but it

was not uncomfortable. When I was riding in a car or taking a shower, I had to

wear a bigger collar that made it impossible to move the neck but that was only

while doing something that was dangerous. It is tricky to take a shower when you

can't look down but you have RA, you are used to things being tricky. The doctor

will restrict your travel for several weeks but necessary travel is allowed. I

had my surgery on March 2 and flew to Las Vegas (with permission) in May 10 so

these restrictions are not long term. You will also have limits on lifting until

you are completely healed.

The two problems I had after my cervical surgery were that I could not tilt my

head back for several months - I couldn't look at the stars but now I do with no

problem. I had a terrible sore throat for several days after surgery but I drank

warm Jell-O water and that was wonderful at soothing the pain and giving me some

nutrition. After 2-3 days that cleared up.

My incision was across my throat and eventually it disappears into the creases

of the neck. While it is visible, you can wear a turtle neck to cover it up if

it bothers you. You can also have a sense of humor about it - I just told people

that my doctor had enough of me a tried to slit my throat. That incision will

eventually be unnoticed.

After two months, I was back to normal except for some limited flexion of the

neck and that did return.

You have lived with so much with RA ( I do read the list). Cervical problems

with RA are not unusual and you can deal with this just as you have everything

else that you have faced.

If you have any questions and I am not answering on the list, please feel free

to write to me off list at patlinda@.... When my job takes over, I don't

always get to read the list.

Rick, I have had four back surgeries and after each one - the pain was so much

less than before the surgery that it was a relief. I hope the same will prove

true for you. After three lumbar surgeries, I have no restrictions on lifting

and I use a waist leash for walking with my assistance dog. My back is in good

shape today and I do not have an ounce of back pain.

Best of luck to you.

Pat

[Guest guest]

Thanks, Janet, for sharing your neck surgery experience. I'm very happy

that yours was such a success!

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Re: Neck Surgery Question

> I have not been on the group in quite a while - but tonight I saw

> your message and wanted you to know that I just had sugery 2 months

> ago. I am not sure exactly what you are having done - I had cervical

> spinal stenosis between C4 and C5. My rheumy referred me to a

> neurologist in January for the headaches I was having (I am 31 and

> have fibro and Sjogrens). The headaches ahd been pretty much nonstop

> for about 3 motnhs - and before that they were sporadic with 2-3 a

> day. The MRI showed what the stenosis and I had a frontal diskectomy

> in march. The disk was removed (through the front of the neck) and

> replaced with a piece of donor bone. A titanium plate was put in so

> the vertebrae and bone could fuse together. When they got in there

> the disk was actually much worse than the MRI had indicated.

>

> I woke up from surgery and the first thing I said was that the

> headaches were gone! I have since had a few tension headaches from

> the neck and shoulder muscles when I do too much - but the awful

> ones like before are gone - along with the muscle pain, spasms and

> EXTREME fatigue. Carrying a cup was heavy and walking down the hall

> at school was quite a challenge. The balance problems also

> disappeared. It has taken my husband two months to get used to the

> fact that I don't need him to rub my legs every night.

>

> I stayed in thehospital only 24 hours!! I wore a soft collar for 3

> weeks and I was to be up to walking a mile a day at one month. At

> that point I was able to start lifting half gallons of milk - and he

> gave me two months to get back to normal activity levels. I have

> achieved that quite nicely - I still watch what I lift - but the

> only meds I still take are the antidepressant so I can sleep (which

> I was on before) and I take a muscle relaxer 1-2 times a day. I do

> notice that I have lost some of the range of motion in my neck. But

> nothing that keeps me from doing things like driving. Some days it

> is more stiff than others and I just turn with my upper body

> instead.

>

> I do pray that you will have the same success I had and that your

> surgery provides relief. Even on my " bad " days I can still say that

> I am 75% better than I was before the surgery. Take care - most

> people were surprised that I was so anxious to have this done - but

> with two elementary age children I was excited about the possibility

> of returning to some sense of normalcy. These are done all the time

> with great success. I would advise that you feel comfortable with

> your surgeon ( I went to a neurosurgeon) and make sure your

> questions are answered. Mine was very honest at the first visit

> about the risks and his success with this surgery (which was

> excellent). There was very little I had to ask him and he was very

> reassuring without being overconfident in his abilities.

>

> Take care and let us know how it goes!

>

> Janet

[Guest guest]

In a message dated 20/05/2004 01:52:17 Central Standard Time,

bluerose11@... writes:

> The CATSCAN showed that

> there was a tear at the 6 o'clock position of C4-5 but the ortho doc

> didn't think anything of it. Another Doc(the one who did my

> discogram)

This is one of the reasons you want a very good, very experienced

neurosurgeon. They see the CT and MRI results very differently than the orthos

and

radiologists. Things those docs think are no big deal, our good neurosurgeons

look

at and say " Oh yeah, that's always a problem when that happens, even tho it

doesn't look like much " . Cary

[Guest guest]

That's a very good point!!! Thank you

Rick

www.whosyomama.com

Re: [ ] Re: Neck Surgery Question

In a message dated 20/05/2004 01:52:17 Central Standard Time,

bluerose11@... writes:

> The CATSCAN showed that

> there was a tear at the 6 o'clock position of C4-5 but the ortho doc

> didn't think anything of it. Another Doc(the one who did my

> discogram)

This is one of the reasons you want a very good, very experienced

neurosurgeon. They see the CT and MRI results very differently than the

orthos and

radiologists. Things those docs think are no big deal, our good

neurosurgeons look

at and say " Oh yeah, that's always a problem when that happens, even tho

it

doesn't look like much " . Cary