Is There A Doctor in the House?

[edwardofhuncote]

I have news... sort of. There's good, and not so good, but nothing really bad.


I got a letter from my primary care doctor in the mail saying he had recieved the radiologist's report from the MRI scans last Wednesday, and that he was encouraged by them. I appreciate that he thought enough about my peace of mind to send them to me too, so I wouldn't have to wait another week to hear it. Of course it's all in doctor-ese, but luckily, my next-door neighbors are both doctors too. Dr. Dave is a cardio-pulmonary specialist, and his wife, Dr. Sarah is an osteopathic doctor.

So here's what I got:

"Moderate to severe spondylosis throughout the cervical spine, mild eccentric canal and moderate focal right lateral recess narrowing at C5 - C6, with moderate to severe right, and mild left foraminal stenosis. Minor acquired AP canal stenosis at C6 - C7 with mild to moderate bilateral bony foraminal narrowing. Moderate to severe left lateral recess and left foraminal stenosis at C3 - C4."

There's two full pages of medical jargon that goes on like that. Dr. Sarah read through it all and explained it in English... the crux of it is this; I have Spinal Arthritis... varying degrees of it all throughout my neck and upper back. The swelling associated with this arthritis, she tells me, is why part of my hand feels asleep, and unquestionably explains the headaches. She knows the neurosurgeon I'll be seeing personally, and says he's very good. She also stressed I need to take this appointment very seriously. She went on to say it may not necessarily mean surgery immediately, that he may try some local injections first. (gotta' say I don't really love the sound of that...)

So I don't have a ruptured or herniated disc... that's the 'good' part. I'll take it, even if I can't put anything in the 'win' column just yet. 

[David Houck]

That does sound, as your primary care doc said, encouraging.

[pauldo]

Well wishes for you Gregory.  Sounds like your attitude is in the Win column.  That is a score!

[Zut8083]

Just checking, but are you feeling alright after the Prednisone regimen?  It can have some nasty side-effects that creep up on longer regimens, so I thought I'd inquire.  Cheers.

[edwardofhuncote]

Had the consultation visit with the neurosurgeon this morning... looks like a surgery to repair the C5 and C6 joint is the only long-term solution. There is enough deformity to warrant the procedure now but he gave me a choice to try some local injections (called an ESI) first, and see if I get any relief at all. Re-evaluation on June 5th. In the meantime my regular doctor put me on some really strong anti-inflammatory meds. 1500 mg/day of something I can't pronounce correctly.


The surgeon I've been reffered to has personally had this operation himself, and showed me the scar. They go in through the front to do it. (which frankly creeps me out beyond words) While there is a very high success rate, it's a quite complicated operation that takes a while. Then there's the 12 - 20 weeks of recovery and rehab, which for me is potentially devastating.


So I haven't got a lot else to say... just hoping these shots work better than expected. 

[the_home]

I've had the shots... and then I had the surgery (through the front is actually easier and the scar is 'hidden' in a crease/wrinkle in my neck). There's nothing that says you will not find sufficient relief through the shots, so the surgery isn't yet absolutely required.

If you get to surgery, while there is reason for concern, there's at least as much reason (more, I'd witness to) for hope for a complete 'cure' to your current symptoms. The recovery time, which may seem long, passes; but the relief is immediate.

From one who has been there, your report is not necessarily bad news. Be hopeful and strong!

[pauldo]

Gregory the best I can do is offer strength and healing wishes from the midwest...

Tim, thanks for your insight.

[edwardofhuncote]

Haven't updated in a while because there really hasn't been much of anything new... but today is something of a milestone. I get the first epidural steroid injection this afternoon.

With stenosis, the little canals nerves pass through to get out of the spine and out to the limbs are compressed, constricting, or impinging on the nerves, in my case causing numbness. The only true repair is to surgically fix the affected bones, opening up that passage replacing the damaged vertibrae with either artificial or cadaver bone. But to buy a little time, they're going to put a shot between C5 and C6 to try and shrink the nerve that goes out to my left hand, thus relieving the pressure. I'm told there's a 60-70% chance of success, and that I'll know within 48 hours if it will be effective. If so, it should peak in two weeks and last for about eight weeks. I can have two more shots within a year if it works.

Also of note, this was actually supposed to have already happened two weeks ago, but the Pain Management people (that administer the shot) somehow missed that I was a 'new patient', and therefore subject to a fairly comprehensive questionnaire, followed by a consultation visit before scheduling the injection could happen.

Between us, I find the whole thing terrifying. (picture that interface scene from The Matrix...) Seriously, this bass player thing is kinda' important to me, and having 100% use of my left hand is part of that, or I'm not sure if maybe I wouldn't just learn to live with it. I had one and a half cortisone shots in my shoulder a few years ago. (now, go ahead and ask me how somebody gets half of a shot...) The experience was so incredibly miserable that I swore I'd never do it again. And on top of that, they did absolutely nothing. So, here we go again.

Anyway, I brought along my Alembic 'Darkness' t-shirt, for luck, or something.

Some good news - In the meantime, I have been put on an anti-convulsant drug called Topiramate, often prescribed for epileptic seizures. It was kind of a long-shot to try to get some relief from these daily headaches, and somewhat amazingly it seems to be working... 5 days and nights in a row now, I've been headache-free. I honestly can't remember when that happened last. There are some weird side effects, but nothing too crazy.

[cozmik_cowboy]

Hope all goes well!  I'm getting some in my spine for the pain in my hip 6-14-18; that's because the second round in the hip did ZS&N (the first round gave 100% relief for 2 years). 
I'm sure it will, indeed, go well - but just in case, have you considered making yourself a niche market as the only slide bassist? 


Peter

[Zut8083]

Hi, Greg,

Good luck with the Topamax.  That stuff can slow you down in terms of mental processor speed and make you foggy; my conversational abilities regressed to Cecil Turtle from Chuck Jones' "Tortoise Beats Hare" when I tried it.  I was less than a fan as I exemplified why pshrinks call it "Dope-amax".  However, don't worry, it doesn't hit everyone the same way, and I hope it gives you some extra relief and lets you focus on the low-end.  Cheers.

-Zut, the Ever-Under Medicated.

[edwardofhuncote]

Well... let me just say, the only part of that experience that didn't totally suck was when it was finally over. Wow. 

The early signs are good, but the road to there wasn't fun...

I should've seen it coming when they swapped my Darkness shirt for a pullover with a square cutout in the back. Next thing, I'm face down on a gurney, mercifully blind to what's about to happen. After an alcohol wipe, they did a local anesthesia (which I swear did nothing but p!ss me off) the doctor started injecting the stuff, while watching on an xray machine. A few seconds in, my left shoulder suddenly started throbbing. I said so, rather bluntly, through very baited breath. I was told to "just keep breathing". Then it really hurt. I said so again, emphasizing this time, with some colorful language. More instructions to breathe followed. Then the pain went down my arm and suddenly my left hand felt like it was in warm water, getting hotter. Felt like I was being bled out to tell the truth. It occurred to me I might be having a heart attack. Just when I thought there was a chance I might die, they told me it was overwith, and to just lay still for a few minutes.

I found out later, the shoulder throbbing I felt let the doctor know he was close. The pressure from that stuff as it went in, was inflating the nerve. He knew he'd hit exactly the right spot when my hand lit up. He says it'll feel prickly for a day or so, then as that goes away, the feeling will come back. He felt better about it than I did. Let's just say, if there's anything less than 101% improvement, it's very unlikely I'll go through that ordeal again... I just ain't got another one in me.

I did apologize for some of the stuff I said during peak moments of terror. 

[Zut8083]

Dude, that sounds awful.  The MD sounds like he has the warm bedside manner of a Dalek.  I'm sorry to hear that anesthesia didn't work, but I hope the CNS impingement has been relieved.

[David Houck]

Gregory; I'm guessing you've got some time off from work?  And I'm guessing you had someone drive you home.  Do you have enough feeling in your hand to do simple household stuff like feed yourself, or do you have someone helping out?

[edwardofhuncote]

Dude, that sounds awful.  The MD sounds like he has the warm bedside manner of a Dalek.  I'm sorry to hear that anesthesia didn't work, but I hope the CNS impingement has been relieved.

It sucked, out loud. Dr. D. gets a pass though... 6 days without a headache is approaching a record for me, and it might not have happened if he hadn't tried this new med on me. At one point while I was face down getting the injection, he kept asking me to name this tune on a playlist that was running in the background, I guess in some Freudian effort to distract me from what was happening. I finally blurted out; it's John Parr's, "Man in Motion", from the 1985 movie, "St. Elmo's Fire", and I can't talk to you right now ***dammit!!!

Gregory; I'm guessing you've got some time off from work?  And I'm guessing you had someone drive you home.  Do you have enough feeling in your hand to do simple household stuff like feed yourself, or do you have someone helping out?

You know Dave, I left work 30 minutes early for the appointment. Drove myself to the hospital, walked in, did the thing, and walked out when it was over. I had a few (appreciated) volunteer chauffeurs, but it was important to me to go it solo. If for no other reason than to prepare for worse times to come. I was back on the job, making coffee at 6:15 this morning.

I'm actually not encumbered at all. If anything, I just feel sore all over from being so tense during the procedure yesterday. The tingling is going away some now too, but no real big difference yet. I have a practice tonight and a gig tomorrow afternoon, both of which I fully intend to keep. Biggest thing I could use is a nap... I didn't sleep much at all last night. Wasn't really nightmares, but I kept re-living the whole nightmar-ish afternoon over and over.

Here's another not-so-pleasant reality, and it's why I'm not using a minute of leave time I don't have to. After all these years of general good health and not using sick leave time, I have something like 1200 hours of accrued 'extended illness' leave banked. (they don't even offer this as a benefit to new hires anymore I recently learned) However, the conditions of the Family Medical Leave Act only protect my job for 12 weeks. That's not to say they would hasten to put the skates on me at 13 weeks, because frankly, there aren't a lot of liscensed waterworks operators ready to jump in. But the best-case scenario on recovery time for the surgery (which I'll eventually have to have) is 12 weeks, and could easily go to 20, or more. In which case I'll almost certainly be forced into an early retirement with reduced benefit situation. Hiring a trainee at half what I make is cheaper, they simply can't leave shifts not covered indefinitely, and, well... economics is economics. I don't like thinking about my career ending that way just yet.

[cozmik_cowboy]

Look into the FMLA thing further; as I understand it (from being married to management, who had to deal with it), FMLA protects your job if you're out of sick days.  If you have sick days, they can't punish you for taking them - so you can use up your banked hours, and then you have 12 weeks protection (but not pay).


Peter