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amywood20 (@amywood20)

Still having issues 4 months post op ACDF C4-C6

Spine Health | Last Active: May 15, 2020 | Replies (15)

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@amywood20

@jenniferhunter thanks for your insight. My physical therapist started doing manual work on Thursday instead of the ASTYM she was doing on my arm. She is now working the pec area and the arm. I don't know if it's technically MFR though. If I don't get satisfactory answers with the neurosurgeon I am either going to go back to the shoulder doc ("if" the surgeon thinks it's a shoulder issue) or make an appointment with Mayo. I did the bouncing back and forth between these two specialists prior to surgery and don't want to do it again. Both of them, along with two physical therapists, said my issues were cervical spine which is why I had surgery. I tend to think that is what I have going on again. Even the hubby said I might just need to go to Mayo. We'll see how Monday goes. Thanks again for your response!

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@amywood20 When Mayo is open again for appointments, I think that would be a good decision to go there. What you should do is get together copies of all of your imaging before and after your spine surgery. You can contact Mayo with that and they will review the imaging. After that, a decision is made based on if they can offer medical help, and if that is yes, they will contact you about an appointment. You can probably do all of this now. I don't know if anything (other that waiting until COVID-19 urgency has passed) has changed.

When I contacted Mayo 4 years ago, I wrote to a specific surgeon and asked that he review my imaging because I read papers he co-authored and thought his area on interest would be a good match for what I needed. I had been turned down 5 times by local surgeons who didn't understand my symptoms and none would help me, but I knew that this Mayo surgeon would understand because of reading about a similar symptom of leg pain that was caused by cervical stenosis. There was terminology in that paper that I looked up and in doing that, I found medical literature with cases like mine that were described as a rare presentation.

When I came to Mayo for my workup, first I saw a neurologist from the spine center who ordered tests based on his exam and those were blood tests, nerve conduction EMG, MRI so we had complete imaging of the entire spine to rule out any non-cervical problems, testing in the Doppler lab for thoracic outlet syndrome which they confirmed by testing and the neurology exam, and a follow up with a thoracic surgeon about the TOS, and the exam with the neurosurgeon where he discussed my MRI imaging with me and told me his recommendation. The thoracic surgeon had to decide if he thought my biggest symptoms where coming from my cervical spine or the compression of nerves because of TOS which he discussed with me, and he consulted with the neurosurgeon about this, actually in a phone call while I was at the appointment with the neurosurgeon. I had a choice of fusion or artificial disc, but I wasn't a great candidate for the artificial disc because of 2mm of instability at C5/C6. Choosing a fusion let me avoid hardware and I agreed to stay in a neck brace until fused which was at 3 to 4 months. I didn't want possible hardware complications and I knew my body didn't like metals because of reactions I had with pierced earrings. I also knew that my range of motion would be nearly the same with a fusion at C5/C6 because it isn't very involved with head turning. My range of motion is normal except that I cannot touch my chin to my chest when I tuck my head, but it is darn close.

I did a lot of myofascial release before my surgery because I was doing this to treat the TOS, and that helped the neurosurgeon during spine surgery because my muscle was easier to retract. I have continued with MFR since spine surgery which helped me recover from that, and make more progress on TOS. I had to stop seeing my PT because of social distancing now, and I'm doing what I can at home to maintain my progress. I also work and stretch pec minor because that is a compression point for TOS, and have found some tools I can use to press and stretch it as I roll onto it with my body weight. The more I open that up and release the tightness, the better my arm feels and I breathe better too. TOS affects my breathing by making the muscles on one side of my chest too tight, so it doesn't expand well enough, and it pulls up on the first ribs, so they don't relax downward during an exhalation.

Mayo is very thorough in examining all the issues a patient has in a multidisciplinary approach and it is a team effort where the doctors do consult each other and right away, so they are very efficient. My testing and consults were completed in a few days, and I had an answer and an offer of help. I would highly recommend Mayo and my neurosurgeon, Dr. Jeremy Fogelson. I received excellent compassionate care and have great results. Here is my patient story.
https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/