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Jennifer

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Hunter

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9 hours ago · Spondylolisthesis and DDD in Spine Health

@red3 Hey Ruthann, your body is probably telling you there's a problem, and your brain is saying, hey not so fast! I've been through something before and I don't know what to do about this. May I give you a few suggestions to start a conversation with yourself?

I did a lot of things that were my way of talking to that scared child inside me. I started by making a list of the adverse events in my life that made me feel afraid, and they were things with similar feelings of medical or dental procedures and why I felt the way I did. I looked at that list and saw a pattern, so I knew why my need of spine surgery was triggering anxiety. What was common to all of my fears through childhood is that I didn't have emotional support, and at a young age, I didn't know how to understand it all, so I was alone with the burden of my fear and anxious about the next time I would be afraid.

I also realized that children are not born with fears. Fear was driving up my blood pressure and I asked myself why I was doing this to myself. Fear is learned somewhere along the way, and I decided that I could deprogram my fears if I understood them. My childish way of looking at this was my attempt to protect myself when I was vulnerable, but it wasn't serving me well now as an adult with an important decision to make. I also reached out to people I knew who had overcome a lot of medical issues that were more serious than what I faced. I knew them because our paths had crossed through my participation and experience with music and connecting with other performers. Both had written books about their survival experiences, and I re-read those books looking for words that could build my courage. Because of my spine problem, I was facing the loss of my ability to do my art work, and I sent a message to one of the authors, my friend Wayne Messmer, whom I had performed with in a community band. At first, I didn't know that I'd been part of his recovery. I had met him at a time in his life after he had survived a gun shot wound to his throat, and he had just regained the ability to sing. The invitation to sing with our band was the first since his recovery and his voice is his gift that he uses to sing the national anthem for a few of the Chicago sports teams. I had the most wonderful response from him telling me that even though I was facing an unknown, it was worth the chance to save my talent.

I also asked for permission to be afraid. Through my early years, I had been expected to just endure, and was teased about my fears, so I knew better than to talk about it, but as an adult, I needed to do that, and to find a way to tell that little girl that it will be OK, and I'd be with her through everything. I also asked one of my doctors who had heart surgery, and he told me that he was afraid too. If a doctor can have fear of a medical intervention, then it must be OK for me as a patient. It helped me to know that, and to realize that they are human like the rest of us. They also have to cope with the tragedies that they see in their profession. Doctors and patients are a lot alike.

I used all the life experience I had to address this and my knowledge of biology, and I needed to understand in detail exactly how surgery would help me. It all made perfect sense, and I was making a choice to go forward. I had already lost the ability to control my arms and the strength to hold them up. I knew that my spine would get worse, and that I was lucky because I had a choice to avoid a disability if I chose to have spine surgery, and with that, I chose the very best surgeon I could find.

I also used music, art, and humor as my therapy to distract me from thinking about surgery. I learned to lower my blood pressure by using deep relaxed breathing while I listened to music I loved, and that became a skill that I could call up in my mind when ever I needed it. I had been measuring my blood pressure before and after my music therapy and could drop my numbers by at least 15 points. I drew pictures of my doctors because I wanted to like them. I didn't want to see them like those who had provoked my fears when I was young. I built on that by looking at pictures of my surgeon while I was listening to music to associate him with all that good stuff. I also watched TED talks about fear and funny videos.

Gratitude also helps combat fear. Being thankful for all the goodness in your life, and making sure that you surgeon knows you are grateful for their help also goes a long way toward helping you feel better and more in control of your situation. Surgeons do have stressful jobs, and I felt as a patient, that I could reduce that stress with gratitude and that it would help my surgeon help me. I made a point to meet him right before my surgery so I could thank him for helping me, and also to reconfirm that I didn't want hardware used in the procedure as we had agreed upon. By this time, I was calm and interested in what was going on around me.

All of this was a process, and I learned a lot along the way. Am I immune from fear now? Of course not, but I can recognize it earlier when it sneaks up on me, and get on top of it sooner. I also compare a new situation to what I have already faced and how I can now handle it, and I realize that I can do this by taking apart the problem and examining the parts. If you can control fear, pain will be a lot less, and my fear had been the fear of pain all of those years. I thought spine surgery would be really painful, but it wasn't. It was tolerable to me even without painkillers. The pre surgical pain was gone immediately, and I did have surgical pain, but none of that compared in intensity to a pain that I had because of a spinal injection which was the worse pain I ever felt in my life before I came to Mayo. I had sucessfuly managed to get through that and stop myself from passing out by using my breathing, visualization and music techniques in my mind, and other things by comparison were not as bad as that was. After surgery, the pain medicines made me nauseous, so I didn't take them at all after I left the hospital and I did just fine. I rested and slept and gave my body time and peace to heal…. and when I was ready, I picked up my brushes and painted my surgeon with his blessings. When I was nervous before my surgery, I drew pictures of him so I could be comfortable and think about him as a person instead of a doctor, and that naturally led to my desire to put into a painting what my words could not say. It was done in gratitude for him, but also for me because I needed to regain that ability by setting the goal, and now he has a painting he loves, and he learned something from me, his patient. I know I've already shared my Mayo patient story with you, but for anyone else who is now joining the conversation, here it is.

https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

2 days ago · C5-C6 issue affecting my shoulder? in Spine Health

@amywood20 I would encourage you to get several opinions about your C spine. Surgeons use different spaces, cages,etc, and plates on the front of the spine. If it is only one level to be fixed, it can be done with a bone graft and no hardware, and not all surgeons would offer that, but mine did at Mayo which is what I wanted. Hardware brings the possibility of complications if something is dislodged or a screw backs out. Patients can feel the plate in their neck. With my asthma, I didn't want anything extra in my neck taking up space, so I had only a bone graft. I stayed in a neck brace until fused at 3 months, and it as worth it to not have hardware. My neck also used to be straight, but since surgery, and my therapy, I have my normal curve back without a surgeon rebuilding it for me. I don't get pain with weather changes like a lot of C spine surgery patients with hardware do. It's better without rods because my range of motion is normal except that I cannot touch my chin to my chest, but it is darn close. My head turning is normal. If you have hardware placed on your spine to put a curve in, you probably will not have normal ranges of motion, and the longer the fused portion is, the greater the stress it will put on the adjacent segments that can move which raises the risk of spine surgeries in the future. Plates also do this and the fusion shrinks as it heals, so the plate gets longer in relation. If the plate rubs on the adjacent disc, it can cause injury and wear a lot sooner. There are immune reactions to foreign materials too, but none with a bone graft and my surgeon said it heals best with just bone. You can always elect to do the curve rebuild later if you think it is necessary after your recovery. My physical therapist advised against surgical intervention for the lordotic curve, and my curve is normal as long as I don't trigger muscle spasms in my chest and neck with over exertion. I also now how to fix it if it happens, and most of the time I feel normal without being aware that I did have surgery.

I think you are right that bearing weight on your hands will cause pain because it's compressing everything and you already have tightness between your chest and neck. Just the muscle spasms from a spine issue will do that. It would bother me too to do that because of TOS, and I am not as strong as I was before my spine injury and the muscle atrophy that came with it.

I still think you could have TOS issues, and your doctors are not even thinking about that possibility, as they are mentioning other diseases as a cause without you having a test to confirm that. That is just guessing. Also the the snapping in your feet and ankles happens to me too. I've had plantar fasciitis, and that starts with tightness in the hips, thighs or pelvis that translates down to the feet. I get snapping in a knuckle on my thumb, and my therapist has me pull on the joint and twist first in the direction is goes easily, and then in the opposite direction. I hold that with a gentle pull, and it reseats the joint . That is the same thing that happens in lower limbs, so myofascial release will probably help as it loosens everything. It's the tightness and twisting in the body that causes alignment issues, and over time, wear and tear on joints. When you subconsciously brace against something it gets worse too. I still guard my left shoulder and raise it, and I have to learn to stop doing it.

Your neck might feel better with a microwaved heat wrap to relax the muscles and it can act like a neck brace. I did that a lot before my surgery. Topical Arnica gel helps too calm nerves and inflammation. I have a list of questions I can find for the spine surgeon if you want it. Take it easy and don't push too hard for a faster recover. You body needs to take the time that it needs.

2 days ago · Spondylolisthesis and DDD in Spine Health

@peggyn Thank you for your kind words. I hope what I've shared will help with education about spine issues and help you with your decisions. I needed to know every detail I could, and I was dealing with surgeons who didn't recognize what I knew about the stenosis until I got to Mayo. I had stenosis in my C spine in the central canal, but not at the nerve roots, so my pain pattern did not follow the dermatome maps. It was causing loss of muscles and coordination, and I am so glad to be past the recovery from that. I think my muscle mass is still improving now at 3 years post op. Did you get a detailed explanation from your surgeon as to how surgery can help you?

We just got home a week ago from the Colorado Rockies and Rocky Mountain National Park. Usually altitude doesn't affect me as much, but I had some chest congestion when I got there, so my first couple days didn't feel so good because of breathing problems and incorrect dosages of my thyroid medicine, but I drank a lot of water. By the end of the week, I felt much better, and even though walking around in the cold temps at the altitude made my heart race at the time, we took it slow and I was better by the time we left a week later. I think it really takes about 2 weeks to acclimate and that is probably easier in summer when it isn't so dry inside. We were boiling water for humidity which helped a lot.

2 days ago · C5-C6 issue affecting my shoulder? in Spine Health

@amywood20 I'm sorry I missed your response. I've been traveling and not online.

I know from my own experience with TOS, that overdoing any strength training resistance or weight lifting can kick up the symptoms. I have had the unbalanced chest tightness on one side be enough to cause a functional scoliosis and rotate my chest out of shape. It has caused me to loose complete feeling in my left arm below the elbow on one side of the forearm, and that was only relieved when therapeutic stretching rotated the thoracic vertebrae back in line, and my therapist stretched the tight areas on the front of my chest and neck with myofascial release. I get ribs that twist out of position. I was worried about loosing complete feeling because at the time, I still had spinal cord compression and was still looking for a surgeon willing to help me, so it made that seem like it was spine related, but it wasn't; it was the TOS doing that.

When you describe TOS symptoms laying on your back, that says to me that the front of your chest might be to tight, and that might be what you are feeling. If you stand sideways and look in a mirror, do your shoulders line up under the center of your neck or are they forward? When I first started laying on a foam roller, and stretching my arms out perpendicular to my body, they were so tight, they could not stretch to touch the floor. Doing this over time got them to the floor, and they are even better now because slowly I work at all the tight areas that are resisting that movement.

The ankle pain you mentioned can be caused by nerve compression anywhere along the path to the ankle. It can even be from overly tight muscles in your hips and pelvis. For me, I had a similar pain in my ankle that felt like a dog was biting me that was caused by bone spurs contacting my spinal cord in my neck. I could turn that pain on and off just by rotating my head. That was my first symptom of cervical stenosis before anyone diagnosed the spine problem, and that connection was missed by all the doctors I saw before I came to Mayo as being related to the cervical stenosis. I found medical literature with a case similar to mine, and I wrote to a surgeon at Mayo with that and he took me as a patient.

Here's a link about lots of pelvis alignment issues
Lumbar plexus Compression https://trainingandrehabilitation.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/

I see from the calendar, that you have probably had your knee scoped by now and met a spine surgeon. You do have a lot on your plate right now with possible shoulder surgery too. Any surgery will create scar tissue that will tighten your fascia and can make symptoms worse, and recovery is better when you can stretch this out with MFR therapy. It seems like you may need to choose your priorities of what should be addressed first. If you have TOS, most often MFR therapy is best over a long term because surgery for TOS can create more scar tissue that just adds to the problem. I was advised against surgery for TOS. I know a lot of this can be overwhelming, and the tricky part is when the pain originates somewhere else, and you had all this testing on your ankle. With knee problems, you can have issues with your pelvis and it's alignment which can cause sciatic pain and it seems like a spine problem. That is very treatable with physical therapy and MFR, and I've had pelvis alignment issues too and it all connects through my body as tightness from my neck and chest to my hips and pelvis. You'll need an expert level MFR therapist to figure all that out when you are able to work on it with your doctor's blessings. It takes a lot of patience when you are recovering from surgery and can't do therapy, but it's all part of a good recovery and following post op instructions. I went through that too when I was waiting for my spine to fuse and everything tightened up from surgical scar tissue. Work out your plan and in what order you need to do things to recover. Set your goals, and then you will take baby steps for awhile until you can get there, but you will get there. Believe that, and you can do it. Pay attention and get sensitive to the nuances of your symptoms and your progress. It helps to write it all down so you can chart your progress. You might not be able to continue with weight lifting as a regular routine. You'll need to listen to your body on that after you have recovered from any procedures. Work with a physical therapist and discuss that when the time comes.

As for anxiety, I've been there too. I was terrified of spine surgery, but I worked through that, and facing all my fears and learning from them changed my life. There is always a lesson in the adversity we face if we are open to learning from it. Fear can sneak up on you and be there in the background distracting you in your decision making. I've learned how to manage fear, but I'm not immune to it; I just recognize it sooner now and can take steps toward overcoming it. Just prior to my travels, about the time of your response, I was dealing with a dental issue that sent my anxiety upward again. We all are affected by our fears early in life and the patterns we learn, and I still have work to do. Work out whatever you need to do to ease your stress. For me that was using music and art as therapy.

Hopefully by now you have some more answers, and a better path toward your decisions. Let me know if I can help any further.

2 days ago · Chiropractor question and advice in Spine Health

@jadillow Welcome to Connect and thanks for asking the questions. I hope my experience can help.

If you have a possible spine issue, it could get worse if a chiropractor manipulates it. A spine problem can cause instability where one vertebrae slips past another because the disc isn't holding it together, and an abrupt push could move it and weaken it. As discs age, they dry out a bit and get weaker. If there was a prior injury from something like a car accident or a whiplash, there can be damage like small cracks in the outer fibrous bands of the spinal disc, and these cracks can open up more with aging as discs dry out, making a rupture or herniation more likely. I speak from experience. This happened to me, but not from a chiropractor.

All I had to do to rupture the C5/C6 disc in my neck was turn my head when I was stretching, and my disc ruptured with a pop sound, and my head suddenly turned past it's range of motion. I had a whiplash 20 years earlier, and this disc was bulging on the MRIs for years before this happened. When the jelly like nucleus inside the disc is expelled, it causes inflammation, and the body reacts to that and the uneven pressure on the end plates of the vertebrae by remodeling the bone and growing bone spurs. In my case, the disc ruptured into the central spinal canal, and the bone spurs grew there with it and all of it grew into and compressed my spinal cord which over time caused neural and muscular deficits. My disc lost 50% of its height. I had spine surgery at Mayo 3 years ago.

I did have scapular pain to the shoulder blades, and spine surgeons told me that it was related to the spine problem. The scapula are connected to the spine by muscles and function to allow arm movement by rotating. Every muscle has an opposite muscle that acts to control movement like a tug of war against each other. Spine injuries cause muscle spasms, and that tight muscle beats up on it's opponent and it all gets tight. It's the body's way of protecting itself when there is an an injury.

Other problems with similar symptoms can be posture related, and I have that too with thoracic outlet syndrome. If you are working a desk job with poor posture and have a forward head and arm position, you could be creating that type of issue that puts pressure on the nerve bundle that pass through some small spaces in the shoulder between the collar bone and rib cage. TOS causes arm pain and weakness as well as decreased circulation by compressing nerves and blood vessels and pressure in the chest. Doctors familiar with this are hard to find because it isn't covered well in medical school, but a teaching medical center like Mayo is a good place for an evaluation. Look for a place that treats TOS if you are looking for a specialist for diagnosis. My treatment is long term physical therapy. TOS causes the front of my neck and chest muscles to be too tight, and my physical therapist strengthens the muscles of the shoulder blades in back while stretching the opposing muscles in front.

Before you start any treatment, you need to define the problem. You might start with a neurologist who can determine where your pain is coming from and if it is being caused by nerve compression. They can order imaging of the spine, neck and shoulder that can find a structural problem or injury. If there is a spine issue, an evaluation with a spine surgeon would be a next step, but choose carefully as spine surgery is a big step and you want the best surgeon available. It's normal to get multiple opinions before surgery, and I had 6 opinions from different spine surgeons beore I found the right surgeon who would help me. 5 refused because they didn't fully understand the problem and didn't look further. I wasn't able to find a surgeon willing to help me near my home, and came to Mayo. It may not be a bad problem if you are catching it early, and physical therapy may help. My physical therapist also does myofascial release which stretches the tight fascia that is holding the body out out alignment, and it allows the body to return to more normal movement. That is a long process for me because of the issues that developed over years, and I have to work through the layers of tight tissue. Even if you do not get a diagnosis of a spine issue or TOS, you can still benefit from MFR therapy. The therapist can feel the tight network within the body and stretch accordingly. It's like kneading bread dough except that they push and hold it against the barrier until it releases.

Here are some links to more information and our Connect discussion about MFR therapy. Let me know if I can answer more questions, and if you do see specialists for evaluation, I hope you will share your journey.

My patient story https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

Myofascial Release https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Thoracic Outlet Syndrome

https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988

https://trainingandrehabilitation.com/how-truly-treat-thoracic-outlet-syndrome/

2 days ago · pain in lower back near my spine in Spine Health

@happyat76 I have had pain similar to yours where on one side of my lower back, it hurts and it causes fatigue when walking. I work with a physical therapist, and what happens to me that causes this is a misalignment in my pelvis and/or sacrum, and realigning it cures that pain. The pelvis is made of 3 bones and can twist and shift. When it is out of alignment, one leg may seem shorter, or may be pointing differently if you lay on your back. There can be an upslip, where one side is moved upward or an inflair where the illium (our "hip bone) could be rotated inward. Muscles that connect the lower spine to the pelvis can become too tight and pull the pelvis out of position.

Physical therapy helps me maintain normal pelvic alignment as does building core strength. Waking and hiking with some hills helps and also riding my horse at a walk as long as I do that with good posture because it exercises all the muscles up and down my spine and strengthens them. This problem causes sciatic pain and can mimic a spine problem, but physical therapy can cure it. If there is also a spine problem in the lower back, having a pelvic misalignment will just add to the pressure on the spine. It's important to retrain any postural bad habits that are contributing to the problem. My physical therapist also doe myofascial release which stretches the fascia that is too tight that pulls the body out of alignment. There is a lot of information about MFR therapy in our Connect discussion here at https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Here is a technical link that explains the issues written by a physical therapist for physical therapists.

Lumbar plexus Compression https://trainingandrehabilitation.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/

2 days ago · pain in my breastbone, ribs and chest in Bones, Joints & Muscles

@jmb73 You're welcome. I hope you find some relief. Some doctors don't understand MFR therapy and sometimes the last thing they would consider is a physical problem. Did you have more information about what that means when you said the arthritis is wrapped around your nerve that causes a headache? Is that an arthritis issue in your spine? It does help to ask your doctors for specifics when they say something like that.

3 days ago · pain in my breastbone, ribs and chest in Bones, Joints & Muscles

@jmb73 You might want to see a physical therapist for an evaluation. I've had similar symptoms and I have thoracic outlet syndrome which is enough to cause muscle spasms in my neck and chest, twisted ribs, and headaches that are muscular in mature. Finding a doctor who understands TOS is difficult as it is not covered well in medical schools. My physical therapist does myofascial release which helps a lot by releasing tight fascia that is restricting movement and normal function. You can do MFR work without having a diagnosis of TOS, but if you have TOS, you may be able to have physical therapy long term. TOS does cause breathing problems for me and Mayo is a good place to go for an evaluation of this. You can also try teaching medical centers that treat TOS to look for a specialist.

Here are some links with information and the link to our Connect discussion on MFR that has a lot of information.

https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988

https://www.painscience.com/articles/respiration-connection.php

https://trainingandrehabilitation.com/how-truly-treat-thoracic-outlet-syndrome/

https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/