Monday, July 02, 2007

Surgery

In March of 2003, for no particular reason, I woke up one morning with a crick in my neck, which then worsened to the point that I had several emergency room visits before being diagnosed with a herniated disc.

Basically, your spine is made up of vertebrae separated by these slightly springy (like a hockey puck) discs. The discs have some kind of jelly-like interior. A herniated or ruptured disc is what they call it when the disc tears and the inside of it pushes out. This can be harmless - some people have ruptured discs and no symptoms - but if the material impinges on a nerve then it can cause numbness, tingling, pain, or weakness. When this happens in your lower back, the result is called "sciatica," and a lot of people suffer from this, but there's no common name for having it in your neck.

It basically sucks. The original thing in 2003 was horrendous, and since that kind of faded I've just been careful all the time, to the point that I feel like people think I am some kind of weird hypochrondriac about it. (I feel like some weird old person who has a trick knee or a hip that aches when it's going to rain or whatever.) It sucks to continually tell people that you can't do some very commonplace thing (turn your head a certain way, sit in some particular chair, etc.) because of your neck.

And it's not black or white. I can do lots of things, it's just that they aggravate my neck, and if the aggravation is bad enough, I get a flare-up.

But this has been pretty manageable until this January, where on the heels of irritating my neck slightly in various ways, I committed the unthinkable crime of sleeping one night on my couch. That started a really heinous flare-up that is still ongoing.

Stupid neck. Bah!

Anyway, last Friday I talked to a surgeon. I already emailed my mom about this, so I'm going to just paste that email into here.

I think I'm going to go ahead and schedule the surgery. They say they are about 6 weeks out in the schedule, but I think I'll aim for mid-September because Barbara is having her hip replacement in early August and it's hard if we're both out at the same time.

The nurse practitioner and the surgeon showed me my MRI and the x-ray they took while I was there on the computer and it's really easy to see how the disc is making my spinal column veer around it.

The surgeon said that I basically have three options:

1. Wait and let it heal on its own. I did this in 2003 and it did basically heal but I've needed to be careful ever since because I always have little flare-ups and now I've got a full-blown breach again.

2. Try a steroid injection. Some people get no pain relief from this, some people get a few hours, and some people get six months.

3. Have surgery.

The reason I don't really feel like trying #2 (the injection) is that it's not pain that's my primary concern. If I just knew I'd have this pain forever, I probably wouldn't have the surgery. What I'm tired of is having to constantly be careful about my neck Every Fucking Day because if I'm not it's going to flare up and be really bad. I'm tired of only have two positions I can lie down in. I'm tired of not being able to snuggle with my boyfriend (and I really do mean "snuggle") because I just can't lie with him in any nice positions.

For the surgery, they go in through the front of the neck. They remove the disc completely, and they take bone from somewhere else in your body (not sure where, but probably the hip or
something) to put between the vertebrae in place of the disc. Then they put a metal plate in the front and screw it on to help hold the vertebrae together. (It's called "spinal fusion.")

It is pretty safe and works for most people. I'd probably go home the day after the surgery and need to take about two weeks off work. I'd wear a neck brace for six weeks to help while the bones fuse together. In 2-6 months the nerves themselves (the ones previously impinged by the disc) would start to heal and that can go on for up to 2 years.

The danger of spinal fusion is that, when that one joint in your spine can't flex, it puts more stress on the adjoining joints. But in follow-ups over 20 years, there isn't an increased risk of needing further neck surgeries for that reason, if you compare people who had this problem and did or didn't have surgery.

Anyway, I'll keep you guys posted, but for now, those are my plans.

3 comments:

Jason Galbraith said...

Good luck with your surgery! You'll probably hate reading this, but I will pray for your speedy recovery.

cartaufalous said...

OK, so I'll say it again. You are completely insane to let a "doctor" touch your spine.

This is the sort of thing that chiropractors do best. I have a 3-0 record with chiropractors fixing my spine problems, and a deep distrust of doctors who like to use drugs and intervention to "fix" problems that would be better served by straightening and adjustment. I know you think chiropractors are witch doctors. I'm just lining up here, so that when you're disabled, and can only lie on your operating bed and mutter indistinguishable things, I can say something like "I told you so".

-robin

Tam said...

While I appreciate your expert opinion, I'm too empirically minded for your experience to outweigh what I think the science suggests.

I did visit a chiropractor early this year, but then I did some reading.

In short: don't get me started.