Wednesday, September 9, 2009

No Pain in the Neck: Cervical Disc Fusion Surgery

About a month and a half ago, I developed a pain in my shoulder. It felt like I slept funny and was concentrated in the area of my right shoulder blade, radiated to the front of my clavicle and shot down my right arm. The pain was pretty severe but I decided to wait a week and see if it got better.

It didn't; it actually got worse. I went to see my family doctor who diagnosed a "sprain" and prescribed muscle relaxers and Vicodin. Two days later the pain really flared up from my elbow extending to my wrist; it hurt so bad I thought that somehow I must have broken my arm although there was no trauma. There was no specific "event" that I could pinpoint and say "Yes, that's why I'm hurting now". Vicodin wasn't touching this pain. As I lay awake in bed, unable to sleep because I hurt so bad, I began thinking about a friend of mine who had just been released from the hospital after having pain in her arm from a blood clot.

Naturally, my overactive imagination kicked in and I decided to ask Dr. Google what the symptoms are for a blood clot in the arm. Of course, I diagnosed myself with a blood clot, woke my husband up at 5 a.m. and demanded he take me to the emergency room because I was convinced that because I'd waited so long, said blood clot was going to dislodge in the next 10 minutes, travel to my heart and kill me while I slept.

Three hours and a vascular ultrasound later, the emergency room doctor pronounced my veins in decent shape, prescribed some Oxycotin and advised me to make an appointment with an orthopedic doctor for follow-up.

The orthopedic doctor saw me a few days later. By now the pain was centrally located in my right arm between elbow and wrist. Occasionally my shoulder would flare up but I figured it was because of my "Swan Lake" move; the only way I was able to get minimal relief from the pain in my forearm. The Swan Lake move looks similar to this:

I call it the Swan Lake move because it reminds me of a ballerina. I would actually go to bed with my arm over my head like that and frequently performed the move while I was driving the car or sitting at my desk at work. Both the ortho-doc and the neurosurgeon say the move is fairly common in herniated cervical discs although it doesn't officially have a does now: Swan Lake. She took xrays which were negative for any fractures. She prescribed Prednisone and another muscle relaxer and told me to return in a week for follow-up. Again, there was no improvement. She then ordered an MRI on my neck and called me the next day with the results: I had a herniation, specifically C6-C7 which was probably compressing the nerve causing the pain in my arm and shoulder. She referred me to a neurosurgeon.

The neurosurgeon actually saw me pretty quickly because the ortho-doc called him herself to get him to squeeze me in. After reviewing the MRI and performing a few motor-function tests in his exam room, he dubbed me surgery-worthy and I'm now scheduled to go in for surgery next Tuesday. I exist on Vicodin now. While the intensity of the pain has subsided, I'm now experiencing periods of numbness in my hand and fingers. As I'm typing this, my fingertips of my index and middle finger are noticeably numb. It waxes and wanes; sometimes it's numb, sometimes it's fine.

To say I'm scared would be an understatement. According to the doctor, and written here without all the doctor-ese, he'll cut the front of my neck open, move all the vitals like my Carotid artery and voicebox, scrape out the disc "filling" to release the pressure on that poor abused nerve, fuse the two discs together with a permanent plate, refill the area with bone marrow he'll withdraw from my hip, put everything back in it's rightful place and sew my neck back together. Sounds like a good time to me.

The surgery should take two hours and I will be in the hospital for a day before I go home. I'll be wearing a surgical collar for four weeks post-surgery and I can't help but think of the dog after we had her spayed. She wore that stupid funnel around her head for a week after the surgery. I'll probably be looking just as fashionable.

And to top it all off, I have to quit smoking. According to the neurosurgeon my fusion success rate drops to 78% if I smoke; that's down from a 98% success rate. While I know it's something I should do anyway, knowing I HAVE TO is making this whole thing more difficult. I called the Ohio Quit Line last week and they sent me my first two boxes of NicoDerm Patches free of charge; my insurance company participates in the program and I'm able to get a two month's supply of stop-smoking aide free; my choice of patches, gum or lozenges. They also have coaches who call weekly to check on my progress. Right now I'm staring at these two boxes wondering if I can fashion them into a giant tunic since these first few days are going to be rough and I predict I'm going to need the super-sized dose of nicotine.

While I'm not looking forward to another scar, especially one right on the front of my neck (although I'm planning on telling everyone I was in a knife fight), I am hoping for some relief from this constant pain. I am surprised that there actually isn't pain in the area that's herniated; everything has been in my shoulder or my arm. I suppose I'm lucky that I found an orthopedic doctor that knew what she was doing when she ordered the MRI; apparently pain like this is often misdiagnosed as gout, carpal tunnel or rotator cuff problems. I'll also update after the surgery for anyone that may come across this post and find themselves in a similar situation.


Darren said...

I was diagnosed with degenerative disc disease in January (after months of pain). I went for 3 cervical epidurals, RF then 2 more epidurals and am having discography done this week in preparation for a visit to the neural surgeon next week. They want to do the ACDF on me as well so I'll have to quit the smokes as well. I would REALLY love to know how your fusion goes, I'm scared to death as well.

LBD Online said...

I'm so glad I found your post this morning. I've yet again had another sleepness night. I have been bedridden with this pain in my shoulder and down my right arm with some numbness in my left arm. I too was driving, sleeping, doing practically everything in the Swan Lake position. I've finally had my MRI and have two severe herniated discs in c4,5,6. I had my first epidural yesterday. I haven't noticed any relief. I'm on neurontin, soma, norco, and zanaflex. None really help the pain..they only take the edge off - sometimes. I'm waiting for my insurance auth to see the neuro surgeon and have a nerve conduction study scheduled for next week. I've done nothing but cry the last two days. I was babysitting my grandkids daily and have found myself unable to do the girls have had to scramble to find daycare..I feel like a burden to my family and am just in a funk. It's nice to find someone that understands what I'm feeling. Maybe that will give me some peace to finally get to sleep today. Thank you for this post.