I am very new to all of this. I was rear ended in Oct 05 and after 6 weeks of pain and limited arm function and little progress in recovery,
discovered that I had a C5/6 herniation with impingement and discplacement of the cord. I also have forminal narrowing from the herniation. I have upper back and neck pain, numbness in my entire right side, nerve pain in my hands, arms and feet, my neck does not move in
most directions, but worst of all is the shaking and lack of strength and coordination in my arms (primarily right).

I have had alot of physical therapy and massage therapy. Pain meds, muscle relaxers, anti-inflammatories, neurontin, and even tried IV
colchicine therapy. Lots of time spent on ice packs and in traction. I had my first steroid epidural on Feb 15th, it helped with the nerve
pain in my hands, arms and feet. It did not seem to improve my function. I am planning to try a few more epidurals and see if they will help with more of the symptoms. I am finally up to about 3 days, 6hrs per day at work. I have had to learn to pace myself and work every other day. I spend most of my time off lying down to take the weight off my neck. No social life,
no housework, no yard work, no christmas shopping, no wrapping, etc. I have really tried to rest it out, as was recommended by all of the
doctors and therapists. I truly do not feel any more functional and take several pain pills on the days that I work.

I have sent via email zip files full of .jpg files created by my MRI which was given to me on CD with a viewing program. I have also sent the entire disc by US Mail to Germany for about $5.00

I have been evaluated (by symptoms and MRI) by:
Stenum
AlphaKlinik
Pro-spine
They all said that it looked like I should be a candidate for ADR. Some requested more xrays, suggests discography the day before surgery, etc.
Most doctors think that, barring spinal cord distress symptoms, I should wait a minimum of 6 months to allow natural healing process and hope
for surgery not to be required. It looks like Germany would cost about $28k with travel expenses for one. I have gotten an estimate from Australia at about $24,000 with travel expenses for one.

I am planning to find the doctor with the most experience/best outcomes in cervical ADR's. Price will not be my deciding factor. I have not
decided to have surgery, but I truly believe that it will probably be the best option for me. Only time will tell. Until then I am looking into
Bowen therapy and disc traction that is done by a few chiropractors in the area.

Has anyone else had the entire right side of their body go numb? Did you find a cause? Has anyone else had the weakness in their arm? What was the best treatment? How long should I try to go on like this before deciding to have surgery? Will the rest of my neck be damaged if I do not correct the narrowing?

Hi Jessica!!

Welcome, fellow cervie--- http://adrsupport.org/groupee_common...icon_smile.gif

Looks like you've already grabbed the bull by the horns and sent your case to some of the best experts available. That's a really good start.

It also sounds like life is pretty miserable, so I guess I'm wondering A)who recommended/ why the 6 month-wait; and B)what is the definition of spinal cord distress symptoms?

Your last two questions are very, very difficult to answer, and the former depends largely on you and what you can deal with--and then what you and a competent, trusted doctor figure out together.

Prior to my 2003 fusion of C6-C7, I experienced loss of fine motor function and weakness in my left arm, and was on high doses of morphine for the pain. The entire side of my body didn't go numb, but I often experienced a 'slithering' sensation and lots of muscle twitches and spasms.

My fusion was perfect; I didn't ever notice a restriction of movement or 'stiffness', and I was back to my sports very quickly. Completely pain-free.

Unfortunately, the fusion did worsen existing problems in C5-C6, and here I am now facing ADR in C5-C6--but with far fewer symptoms than yours. I've been advised not to wait by ProSpine and my own NS, and to have it done before it got any worse.

Then again, my problem is no longer a hernia; it's nerve compression due to osteophytosis and foraminal stenosis.

Do the doctors who have seen your case feel that 6 months more will bring a real chance of spontaneous healing of the impingement/displacement due to the hernia? Or do they feel it's a long shot?

I'm not a doctor and so it's hard to compare our cases, but the symptoms you describe really have me amazed and sorry they can ask you to remain this way for so long unless there's really a good chance of a good recovery without ADR.

If you 'truly believe ADR will probably be the best option for you', maybe it might be worth trying to see about having it sooner??

Dunno, just throwing thoughts out there...in any case, pleased to meet you here and looking forward to 'cervie talk' with another sis http://adrsupport.org/groupee_common...icon_smile.gif

Hang in there,

Trace

dont go here Stenum
lots of bad storys.
chuck

Jessica,
I had the weakness and nerve damage in my left arm and side prior to two new ProDisc ADR's at C5/6 and C6/7 in January 2005 in Bogen, Germany by Dr. Bertagnoli. Who is your doctor here in the States who has evaluated you and is it he/she that has suggested waiting the 6 months? If not, I would get another opinion from one of the better spine surgeons here in the States that has a lot of experience with cervical disk replacement. There are a number of really good ones. If there is nerve damage going on, waiting for 6 months seems like a long time unless they have a really good reason to think it could heal naturally. That obviously would be preferable to surgery. But I have ADRs at 4 levels and that can be a great thing too. Dr. B. is great, but I only went to Germany because I could not get 2 levels done here at the time. There are some really good docs here in the States, also.

Wishing you a speedy resolution,
Linda

I heartily echo the above responses. I would also suggest asking your doc to define "healing"--as I understand it (and what seems to have happened with me), the herniated material may resorb but disks don't heal in the sense of getting back to "normal," pre-injury status. Therefore, is your doc predicting that with resorption your symptoms will abate? be resolved? --And have other problems been ruled out? From my own post-MVA experience, my doctors got so focused on my extruded disk, it took my insistence for them to finally diagnose and surgically correct injuries to my wrist and shoulders.
Please keep us posted.
Barbara

Jess

Welcome! http://adrsupport.org/groupee_common...icon_smile.gif

You're what I call a self-starter. You've obviously monitored this forum for a while before posting, done a lot of research into your condition, determined how to transmit your information abroad (on your own) to the surgeons who can do you the most good (if you decide to go overseas) and are asking the right questions. You've already leapt right over the single biggest hurdle - figuring out what questions to ask and where to ask them. Good job!

Not being a cervie my help is most probably only general, but I can comment on a couple of things. Physicians tend to want to let the body heal itself rather than perform invasive surgery, working up to surgery starting with the most conservative treatments first. In general, this is certainly a wise policy. How long to wait and what steps to take along the way are subject to debate, however, and unless you can confirm that the individual suggesting your 6-month wait has more specialized information on your condition than you, I'd question their strategy (at the very least). I've learned to never assume that a physician has more or less knowledge about a particular condition than I. I've come across several professionals with far less knowledge about ADR. This is not to say they aren't competent, only that no one professional is capable of reading everything out there about every condition, and a motivated patient is far more likely to ferret out *all* the knowledge available than a general practitioner or one in another field.

Ditto on Chuck's comment about Stenum. Do a thorough search here to locate more information about that facility before contemplating going there.

Jessica, welcome to our community! I hope we can help. In the meantime, I created a FAQ on Stenum, where some patients have had surgery. Some have done OK, but others have had disastrous complications. See the topic here.

ive counted more bad outcomes then good.
http://adrsupport.org/groupee_common...icon_smile.gif
if going overseas see dr b or dr z
chuck

Thank you all for your great advice. I, of course, was concerned that I was being hasty. On the one hand, my HMO says that I will be "fine". "It may take a few years, but most people get better in a few years without surgery." On the other hand, every PT and the doctors outside of my HMO say "you have a serious problem" and "I wouldn't wait too long".

I was doing a bit better for a short while. I was hopeful that trend would continue, but no such luck. The last month has been a downhill trend. I failed the strength tests in physical therapy last week, with my right arm showing significant weakness in many areas. That was the proverbial straw for me. I am trying to schedule my surgery for July 2006. What a relief to have finally made my decision. My depression has became much less since having a light showing at the end of the tunnel. My first choice is Dr. B, though I am consulting with Dr. Z and Dr. Jan Goffin in Belgium, just for backup.
You have all been terrific and I hope soon to be telling my tale of recovery...

Bull-caca. http://adrsupport.org/groupee_common...n_rolleyes.gif

Bull-caca. http://adrsupport.org/groupee_common...n_rolleyes.gif </div></BLOCKQUOTE>

Herniations can be re-absorbed over time with the risk of future DDD. Jessica, however, is talking about narrowing, which isn't going to go away if it's due to bone growth.

Thanks for elaborating, Jim/Laura http://adrsupport.org/groupee_common...on_biggrin.gif

I've heard that line before: 'most people' + 'get better' without even specifying the pathology = financial brush-off + relative cluelessness of spine disorders. http://adrsupport.org/groupee_common...icon_frown.gif

HMOs like to quote those several year standards. Maybe in several years you will have another insurance plan as well~ surely if you're employed with that pathology/symptoms and off work in bed for that amount of time, you'll not be employed and likely on Cobra insurance if you can keep it at all...

HMO babble/cost containment...

Wonder what doctor needing to work for a living would want to follow that advice of the "several year standard" with clinical findings and symptoms that keep one resting in bed all day for relief...

A nastier twist to the insurance game is a question of how they generate their statistics. If "most people get better in a year or two" and most people in severe pain have to go out on disability from their work, after a year or two do most people get put on long-term disability and are now covered under a different insurance system? If you look at the numbers without thinking, it looks like most people no longer need insurance coverage for back/neck pain after a couple of years. I wonder if it is really a numbers game.

Trace, Annapurna, Mariaa -
Thank you for sharing my frustration with the HMO's. I really don't need them on board to get the surgery, but it would be nice to have support so that when I come back I would have after care. I feel like making them approve a fusion, and then NOT actually have it, just to cause them some grief in return.
I feel lucky that my injury will be covered by auto insurance and that I will probably be reimbursed at some point for the surgery. Those of you who have to/had to get approval before hand must be even more frustrated than I. http://adrsupport.org/groupee_common...n_confused.gif

Perhaps what these professionals are referring to is the population as a whole.

Every spine site I have read, has said that MOST people DO get better within a couple of years with therapy.

Then, there is the rest of us, who despite various non surgical treatments DON'T get better.

My own NS (who is highly respected here in Oz) said to hold off for as long as possible having an ADR or fusion. He said there was a remote chance that I would heal on my own. He also said to wait, until I couldn't put up with the pain any more as either op is very intrusive.

Believe it or not, not all surgeons are gung ho to operate.

Unless you are experiencing serious neurological symptoms that are getting worse, it is wise to wait and see.

Remember, these operations CAN and DO create problems of their own. There are lots and lots of people on this board to attest to this. There are also lots of people on this board to attest to the success of their surgery.

I think when it comes to any type of surgery, unless it is an emergency, CAUTION is the way to go.

For me personally, I will probably have an ADR after August. My condition hasn't deteriorated, and my pain levels are definately related to what I do, which isn't much. I'm just sick of not being able to do normal stuff.

Just my two cents worth.

Hucky

I have to voice one modifier. I've said before that this is a rather cold statement but pain is a quality of life issue. In addition to deciding if your pain and/or neurological symptoms warrant immediate actions, you also need to understand the trend of your ongoing damage. Most people according to website I've seen go through period of lessing pain, almost a remission, as their damage increases. It's almost as if the spine goes through regions of increasing and decreasing stability as the damage increases. If you simply react to pain and other symptoms, your damage level may increase to the point where there is little that can be done once the pain returns.

DON'T rush off and get surgery. DO understand what is going on with your body and react to both what you are feeling today and what you will be feeling tomorrow. For more specific advice general to everyone, find a surgeon you like. Establish a relationship with him/her. Agree on tests necessary to monitor your condition. Live your life and occasionally do the tests you've agreed upon. At some point, your pain, symptoms, or condition will pass a point where you decide that it is time to act. Don't rush into it but don't close your eyes to your total condition.

I don't mean to contradict Hucky, but American surgeons are used to thinking of fusion, where holding off until the last minute is advisable. ADR means that you can intervene before damage to other structures gets too bad, which occasionally means intervening before the person's pain become intolerable but it is clear that the disk is quickly losing height.

I think that is very good advice Annapurna.

I agree, monitoring your condition is vital. As you say, more damage can be going on when you THINK your in remission.

Hucky