My appointment with the Neurosurgeon yesterday.

Posted by janagain @janagain, Jun 12 11:29am

I had a much anticipated appointment with my Neurologist yesterday to discuss my surgery that is being scheduled around the first/second week in July. I met my Neurologist when I was admitted to the hospital in March 2024 after being seen in the ER. I was experiencing left arm weakness and to rule out a stroke the doctor ordered a Cat Scan of my brain and a MRI of my neck. I was told I had severe multilevel cervical stenosis from osteoarthritis and needed surgery. At that time we discussed a multi fusion 1-7 from a posterior (back of the neck) approach. I was devasted and had so many questions. This type of surgery has a long recovery period and will restrict my neck movements.
To my surprise at my appointment yesterday revealed better news. He said that after closer look at the CT and MRI images taken at the hospital, he offered me a more conservative surgery. He suggested a anterior approach (front of the neck) insted of posterior and fuse 2-3 4-5 6-7. That's no easy task but I felt, relieved.
I am so skeptical when dealing with doctors, you have to have trust. I found it develops over time after you exhaust all your options and second opinions. The time between the hospital visit and the appointment yesterday had been a very long 3 months. I thought about this daily and wondered how my life would be. I need my hands to play piano, guitar, dulcimer, sewing quilts, gardening and to hold my grand baby due in January. Surgery or not having surgery, you fear your life will be filled with constant dissappointments of not continuing the life you are used to. I know the more conservative surgery will have it's challenges and I feel I've made the right decision. The daunting anticipation as the days grow closer to the surgery are pretty intense. it's how I deal with that anxiety to get through the waiting period. I know that if I sit down at the piano and get immersed in my music, I don't think of anything else! Also sewing that baby quilt for the new baby arriving in January will divert my anxiety. I stay positive and accept that the days prior to surgery may be filled with anxiety but know that I've made the best decision for myself. I'm 66yrs old and I've faced challenges with previous spine surgery. I can do it again.
Thanks! Jan

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@janagain I would love to see your baby quilt when you have it finished. That is such a nice thing to do. I'm glad you will have a bit less of a big surgery, but it will be a challenge. You have to set your sights on being positive about achieving realistic goals after surgery, and also understand that this will stop further damage from deterioration of those levels involved. That's a compromise, and it is better to accept the compromise in movement to prevent a greater disability that is likely to happen (which is what your doctors are saying). The anterior approach is not as painful in recovery as posterior so they say. My experience is only with anterior surgery. It will be significant of course because of how much you need, but in the back, they would be going through muscles you need to hold your head up. Recovery comes in baby steps over a long period of time and everyone has a bit of a different experience with it. I think what will be different is doing things where you are looking down. You may want to limit doing that anyway so you don't stress the top vertebrae above the fusion. Your life will change, but also in good ways with lots to look forward to. Yes, you can do it!

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Hi Jennifer,
We will know the sex of the baby in a few weeks and then....I"M ON IT! I have a vintage baby bassinet that I inherited recently from another family member. It is from around 1970 and it's in perfect condition. I'm going to ask them if they would like it. And I will not only make the baby quilt but decorate the bassinet with the same fabric. The first thing it needs is a good coat of paint. Then the little mattress, sheets, etc. They can wheel the b aby around in their small home for a few months. It's a big one too but you can only use it till the baby can't sit up anymore. It's just so adorable, I can't wait!
I know the recovery is going to be a challenge and I may face the fact that my neck may not move like normal.
I'm just praying it works for me and there won't be anymore surgery needed. The other challenge is my L5-S1. He told me it's a mess and it's going to be very delicate to fix it. The doctor said he can fix it but there is more potential for bleeding in that area. So many factors involved here but he kept telling me, he can fix it. He said it's so unsual and thinks it may even be a birth defect. I've never been told that before. My prior lumbar work stopped at the L5-S1 and I developed segmented disc disease. Before I met my new Neurosurgeon, I visited with the doctor that did the XLIF L4-L5 with laminectomy L3-L4, L4-L5 Lumbar Stenosis , fusion 4-5, posterior decompression Lumbar 3-4 Translateral interbodies . Fusion 4-5. He told me that they were going to have to make an anterior incision and take out the old rod and put in a whole new rod that would support the S-1. My current doctor said that is not necessary. I can't even imagine that kind of surgery and the recovery would be horrible. Anyway, he's not addressing this issue right now because we need to get past the neck fusion surgery.
Basically, I'm a mess and I need to be put back together again. It's going to be months of recovery to get both problems solved. I'm in really bad pain every day from the S-1 nerves. I've been in pain for almost 2 years and it wears on you after awhile. I'm so relieved that I've got a great doctor who can get me through this. But even great doctors can't fix everything.
You're right about looking down, it would pull the muscles that support the head. I'm going to be wearing a cervical collar for a while and not doing very much except for PT. I'm even thinking I may go to a rehab after? I wonder how that works? Would Medicare pay for it? Of course my husband and kids will help me out. But do I really want to depend on them to get me through this in the beginning?
I really appreciate your input Jennifer , you bring up some great points. I am eating healthier, getting more rest,
and lowering stress levels by trying not to make a big deal over the small stuff. This is time for me to do the best I can so that when I go into the opeperating room I'm feeling ready for what comes next.
Jan

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@janagain

Hi Jennifer,
We will know the sex of the baby in a few weeks and then....I"M ON IT! I have a vintage baby bassinet that I inherited recently from another family member. It is from around 1970 and it's in perfect condition. I'm going to ask them if they would like it. And I will not only make the baby quilt but decorate the bassinet with the same fabric. The first thing it needs is a good coat of paint. Then the little mattress, sheets, etc. They can wheel the b aby around in their small home for a few months. It's a big one too but you can only use it till the baby can't sit up anymore. It's just so adorable, I can't wait!
I know the recovery is going to be a challenge and I may face the fact that my neck may not move like normal.
I'm just praying it works for me and there won't be anymore surgery needed. The other challenge is my L5-S1. He told me it's a mess and it's going to be very delicate to fix it. The doctor said he can fix it but there is more potential for bleeding in that area. So many factors involved here but he kept telling me, he can fix it. He said it's so unsual and thinks it may even be a birth defect. I've never been told that before. My prior lumbar work stopped at the L5-S1 and I developed segmented disc disease. Before I met my new Neurosurgeon, I visited with the doctor that did the XLIF L4-L5 with laminectomy L3-L4, L4-L5 Lumbar Stenosis , fusion 4-5, posterior decompression Lumbar 3-4 Translateral interbodies . Fusion 4-5. He told me that they were going to have to make an anterior incision and take out the old rod and put in a whole new rod that would support the S-1. My current doctor said that is not necessary. I can't even imagine that kind of surgery and the recovery would be horrible. Anyway, he's not addressing this issue right now because we need to get past the neck fusion surgery.
Basically, I'm a mess and I need to be put back together again. It's going to be months of recovery to get both problems solved. I'm in really bad pain every day from the S-1 nerves. I've been in pain for almost 2 years and it wears on you after awhile. I'm so relieved that I've got a great doctor who can get me through this. But even great doctors can't fix everything.
You're right about looking down, it would pull the muscles that support the head. I'm going to be wearing a cervical collar for a while and not doing very much except for PT. I'm even thinking I may go to a rehab after? I wonder how that works? Would Medicare pay for it? Of course my husband and kids will help me out. But do I really want to depend on them to get me through this in the beginning?
I really appreciate your input Jennifer , you bring up some great points. I am eating healthier, getting more rest,
and lowering stress levels by trying not to make a big deal over the small stuff. This is time for me to do the best I can so that when I go into the opeperating room I'm feeling ready for what comes next.
Jan

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@janagain Jan, I think Medicare will send you to rehab after your spine surgery, so don't worry about that. It is a complex surgery. You may want to look for and talk to physical therapists now, so you will know who you want to see when you are cleared for PT. They can give you information about what recovery would be like. You will need help in the early days, and it's perfectly OK. That's how your family shows you their love, and you would do that in a heartbeat for any of them if they needed you. You've probably always been the one to take care of everyone else, and now it's your turn. I know that takes some getting used to.

Good for you for eating healthy. You'll need some good protein during your recovery. That's a good question for your surgeon to ask to work with a nutritionist to aid in healing after surgery. I do get some tight muscles in my neck sometimes that I massage out. My vertebrae can rotate from muscle spasms and I need to get them straightened out.

Jennifer

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@janagain
Congratulations on the new grand baby on the way! Very exciting!

I also have cervical stenosis and myelopathy and had ACDF surgery on C-5/C-6. I was having weakness in arms and hands, bladder control issues, headaches and neck/shoulder pain and muscle tension, and difficulty walking (balance issues and felt like I was wearing cement boots). The surgery was only one level so recovery was not too bad. Do you know if your spinal cord is being compressed or flattened? Did they tell you that you had cervical spondylitic myelopathy? My stenosis is due to congenital narrowing. Do you have that or were you in an accident? Were you told why you have so much degeneration? I had worked over 30 years at a desk job which didn’t help my cervical spine.

Like you, I also have lumbar spinal stenosis/DDD and especially severe at L4-L5. I have been getting injections to help manage pain but they are starting to not work much and may need to get surgery L3-S1 soon. Were you in an accident that caused your need for lumbar surgery or was it from degeneration?

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Aren't you glad they took that "second look"? I often wonder thinking about past MRIs, what if the radiologist was overworked that day and just gave my MRI a cursory inspection? Think about how much could be missed. Scary.

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dlydailyhope- Thank you for responding to my post. Thanks for the congrats , I'm very excited about this little one coming into the world that I get to call my grand baby! I have one grand son who is now 9yrs old. He is growing fast and he's an amazing kid. (Grandma's brag, ya know!) When you said in your post that it feels like you are walking in "cement boots," I identified with that immediately. I lose my balance too easily. I cannot keep my balance while standing on one foort nor walk heel to toe. If I'm out in my yard and walk along an area that I have to navigate a little closer, you would think that I live on a live volcanic erupting shaking mountain. I lose my sense of balance! Yes, there is compression of my spinal cord, many compressions. This all started when I was in my early 50's and now I'm 66. My doctor told me that I may have a congenital birth defect of the S-1. No other doctor has told me that, that was a new one. 2yrs ago I had injections in the S-1 that had very little effect. My cervical spondylosis with myelopathy is from age-related degenerative changes in my spine. I was not in an accident, they are chalking this all up to osteoarthritis. Have you been aware of congenital narrowing all your life or just found that out recently? When I look at my MRI results of my L4-S1 all I see is the word , severe. It was suggested that I have surgery on the neck first and deal with the L4-S1 after that. I'll be recooperating all summer. I've lost 60% use in my left arm.
heisenberg34- I sure am glad they took a "second look." You're not kidding.

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