to fuse, or not to fuse...that is the question! long

[Guest guest]

My whole world just got flipped upside down yesterday. It took me until now

to process everything and try to get grounded.

Since my rear-end fender-bender on 7/12/07, I have seen multiple doctors

ranging from chiros to neurosurgeons. I've had 14 sets of x-rays, CTs and MRIs

of my cervical and lumbar regions, and 1 surgery in each area (the neck ACDF

C5/C6 was successful; the L5/S1 discectomy was not). I've been on narcotics and

muscle relaxers for 17 months, which have essentially become ill effective.

I am scheduled for an L5/S1 TLIF on 12/15/08.

Just yesterday I met a neurologist that I'd been referred to from another

neurologist (who couldn't diagnose me); having been referred to the 1st

neurologist by my neurosurgeon because he couldn't diagnose me either! For the

last

17 months I have been going out of my mind with extensive numbing and

tingling of my hands/arms and feet/legs. I felt good after my neck fusion but

the

symptoms came back 4 months post-op.

It just so happened that I smacked my head on the headrest REALLY HARD upon

crash impact. The whole nine...birds chirping, dancing stars around my head,

and instant nausea. In fact, if I hadn't have vomited an hour later, I

probably would have skipped driving myself to the ER. But I took that as a sign

to

not ignore the potential bodily damage I may have suffered. Wow. Good call.

Anyway, the ER did their usual thing - x-rays and CT w/out contrast of head

& neck and lumbar. Told me to see my PCP within 3 days. I had a migraine for

about 2 weeks but just figured it to be whiplash/concussion related and it

would go away. About 3-4 weeks post-wreck I noticed trouble finding vocabulary

and forming sentences or enunciating properly, unable to concentrate or pay

attention, irritability, etc etc. The vocabulary speech impediment thing lasted

the better part of 6 months.

All this time, every doctor I've seen has zeroed in on either my neck and

shoulders or my lumbar, but never the head/brain. I got better with the above

symptoms after my neck surgery in Feb 2008, but after about 4 mos, I noticed a

bunch of symptoms returned - sciatica, lumbar pain, numbing/tingling in all 4

extremities and brain fog.

I started asking EVERY dr that's treated me so far to tell me what's causing

the numbing and tingling and how can we fix it. I've been bounced to over 14

doctors with no resolution until I met the neurologist yesterday.

He is the only one who, within 10 mins, said, " I can't understand why all

these doctors have treated you for everything but the obvious. Your brain has

suffered a minor injury. Minor defined as not comatose or vegetative " . He went

on to explain about white and gray matter in the brain and how it's attached

to the skull by " strings " , which during impact were stretched like rubber

bands and potentially broken - which constitutes soft tissue injury and

wouldn't

show up on x-rays, CTs or MRIs. He spent 3 HOURS with me explaining about

pain and receptors, how the spinal canal is designed and functions, how

surgeons are too eager to cut because that's what they learn in school and how

people like me with unexplained additional injuries fall through the cracks and

are never treated properly, being left to suffer on their own with drugs or

life-long pain.

He is also dead set against me having the L5/S1 fusion until he has enough

time to gather everyone's notes and images to determine that it is my absolute

last resort. (Guess I didn't realize that there is an apparent ego thing

going on between neurologists and neurosurgeons)! In any event, he asked me to

at

least consider postponing the surgery until he has seen the notes.

So I'm trying to figure out why, after 17 months - but 10 days before a

major surgery, God decided to send me a doctor who absolutely nailed my theory

of

brain damage (because that's what I've been thinking all along and he just

came out with it on his own); and now I have to make a decision on what to do!

The average person would probably just advise me to postpone it, but my

neurosurgeon is adamant about going through with it on schedule because I've

been

b*tching at him about horrendous pain for over a year - and because I've

been treating my L5/S1 for nearly 10 yrs with every other option available, to

the point where nothing else is working any more.

I'll spare the report details, but in summary, the ER's report of 7/12/07

said:

" There is marked degenerative change at the L5-S1 interspace noted....marked

degenerative change L5-S1 with near complete obliteration of the joint

space. MRI may be helpful to exclude disc pathology " .

An independent MRI was performed on 7/27/07, which said: " L5-S1: Moderate

right lateral recess stenosis from right parasagittal disc osteophyte

formation. Correlate for potential right S1 radiculopathy. There is mild left

lateral

recess stenosis as well. There is moderate to severe bilateral foraminal

stenosis from combined facet arthropathy and marginal osteophytes, right greater

than left. Correlate for potential L% radiculopathies. "

Then I had 2 double epidurals that lasted roughly 9 months. My failed MetRx

discectomy was 9/29/08. The latest MRI of 10/26/08 stated:

" L5-S1: Interval laminotomy on the right. There is a right paracentral

protrusion with enhancing marginal fibrosis. Mild mass effect evident on the

thecal sac. Small nonenhancing fluid collection evident at the laminotomy site,

exerting no mass effect on the thecal sac. Facet arthropathy and right foraminal

disc bulging stable moderate right foraminal narrowing. "

OKAY, so the question is, to whomever can interpret these findings: is it

evident that a fusion is, in fact, necessary at this time?

The problem with postponing the surgery is 1) new year = new insurance

deductable, 2) hubby is able to take 2 wks off to help me recover in Dec and is

prohibited per his company to take any time off until March 2009, 3) I HURT

24/7!

Any opinions and comments, board posted or private (_NCGorgeous1963@..._

(mailto:NCGorgeous1963@...) ) are WELCOME!

Hope everyone's feeling better today.

Best regards,

Patty A

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