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My "superfund sites" (myelopathy, bad feet, knees & hip)
Spine Health | Last Active: Dec 22, 2021 | Replies (4)Comment receiving replies
Hi, Jennifer (@jenniferhunter),
How nice to be in touch again!
I've been working with an excellent physical therapist since my neurosurgeon advised us not to jump right into surgery but take a more conservative approach: try physical therapy for six months, then let's talk again. I'll be going back to see him next March. Our meeting then will be to decide if surgery is called for, further physical therapy, or just what might seem the best route. At the moment, I'm on a physical therapy hiatus: after two six-session approvals by my insurance, I reached the last of my approved sessions. My therapist plans to reapply for more sessions after the first of the year; as that's only two weeks away, I can be patient. In the meantime, I'm doing here at home all the stretching exercises she taught me.
It is difficult to say when you're working with a new doctor, whether his advice is sound or it's time to insist on a more assertive approach to treatment. In March when I see my neurosurgeon again, and if I feel I've gotten nowhere with physical therapy, certainly I'll speak up and say I'm ready to give surgery a go. If that should happen, what he'll say I've no way of knowing just now. When he and I met last fall, and I explained that my chief (almost only) complaint was gait difficulty, he responded by saying (and I believe wisely) that we could do surgery for what he regards as "borderline" myelopathy, and I'd find that that issue by itself wasn't the cause of my gait troubles.
That's why I thought in the meantime I'd look for a practitioner who could pull together my various trouble-spots (borderline myelopathy, bad feet, bad knee, bad hip) and suggest some sort of whole person (holistic) diagnosis: perhaps my wobbly walking is not caused by only THIS or only THAT, but by ALL of my weaknesses working in tandem, resulting in my poor balance. (When I get back to physical therapy, I intend to inquiry about "walking coaching." I'm sure I could gain by being taught how to relearn proper walking.)
My primary has asked if I'd like to see a psychiatrist. That's a medical specialty I'd not heard of before! Have you?
I've taken up enough of your good time, Jennifer. As always, I love getting your insights. And as I said at the top, it's great to be in touch again!
Ray (@ray666)
Replies to "Hi, Jennifer (@jenniferhunter), How nice to be in touch again! I've been working with an excellent..."
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Ray, @ray666
While it is possible that you have several issues contributing to your gait and how well and balanced you can walk, if you have myelopathy or spinal instability as I did, that alone can cause your gait to be unbalanced and make you walk with a sort of limp. I know this because during the time before my spine surgery I was working with a physical therapist and having a lot of spine related muscle spasms in my neck. The spasms would twist or tilt my vertebrae independently and because I had no space left around my spinal cord because of cervical stenosis, it put more pressure on my spinal cord when the vertebrae were moved. I also has 2mm of movement in slipping of vertebrae past each other (retrolisthesis). Effectively, it just made my spinal canal smaller around an already compressed spinal cord.
I experienced intermittent issues where the spasms caused me to limp and there was nothing I could do to stop the limp, and I had trouble emptying my bladder. Both of those symptoms were from spinal cord compression. As soon as my physical therapist corrected my neck vertebrae alignment, I stopped limping and my bladder functioned correctly again. That is why I would question your surgeon's comments about the cause of your wobbly walking. He may be missing the myelopathy component that is a signal that spinal decompression is needed because you also have other issues that affect walking. If he is waiting for permanent damage like a white area showing up inside the spinal cord, that is waiting too long.
I also had dizziness and vertigo when my vertebrae were shifted along with bad occipital headaches. The vertigo was bad enough one time that I actually fell backward when I looked upward at bird flying overhead. Since my spine surgery, I have had no more vertigo. I still can get just a slight rotating of vertebrae if I do something causing a muscle spasm, but it is very minor and I know how to correct it right away.
You can always get a second opinion from someone else and should if your symptoms are increasing and your doctor isn't concerned. It also sounds like your insurance isn't very generous with physical therapy visits. Hang in there.