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I posted this in war on opioids because I think it's the most appropriate location, although it touches on a few topics.
I was doing some thinking about everything that happened from the first time, in Jan 2017, that I began to experience symptoms from a severely degenerated C5-6 disc (and a more moderate annular bulge at c6-7). In January and February, I felt like I had a severe crick in the neck, nothing terribly unusual for me but worse than cases I've had before. In February I finally went to the doctor and got a steroid injection / medrol dose pack. This seemed to do some good and I hoped I had turned the corner. In March, the disc herniated and created a significant nerve impingement. The pain spiked to about a 7 and I had the kind of typical scapular pain and shoulder pain that often occurs with nerve impingement along with severe neck pain and stiffness. My doctor prescribed flexeril and another Medrol dose pack. A week later he added Celebrex and prescribed PT.
By early April, some of the intense paraspinal muscle spasms started to calm down, and I felt like maybe I had turned the corner. On Palm Sunday, I went for a run before mass. Felt amazing and went about 3 miles. About 15 minutes later, the right side of my neck started to burn, and within an hour the burning sensation covered the entire side of my face. I did not understand until later that this was because the mechanically deficient disc, along with the end of the intense muscle spasms, allowed for significant abnormal motion and facet joint overload with the impact of running. PT finally started 10 days later, and I found I would have intense bilateral burning on the sides of the neck with any kind of exercise. The pain settled into a routine of intense pain at the base of the neck from muscle spasm, followed by intense burning pain down the sides when the spasms let up.
In May, I finally had an MRI... it showed the DDD and bulges, but no nerve impingement. My doctor sent me next door to the neurologist who performed an EMG two days later that showed C6 (bicep) denervation (believe it was a historical artifact at that point from the initial herniation, which was probably large and significantly dropped the pressure inside the disc). He prescribed Lyrica (which never helped) and sent me back to PT. At the next PT session, my therapist tried manual traction, which caused a horrible relapse of the muscle spasms. I'm certain the damaged disc tore some more with the traction force... not his fault as this is a standard modality but it worked badly in my case. At this point, I insisted on a referral to pain management. They set me up for an injection, which I had at the end of May... just in time for a family trip to DisneyWorld. I felt ok on the trip, as the injection seemed to help a bit. By the time we got back, it had worn off. I had another mid June, but unfortunately a few days later symptoms flared again - likely another episode of the disc degenerating some more... At this point I made appointments with surgeons to discuss options.
Essentially, the rest is history. I decided on an ADR, both myself and my surgeon not understanding that some of the pain was facet joint generated. The intense muscle spasms ended right away, but the part that was facet pain got significantly worse. It was truly agonizing, and three months later I essentially had to beg the surgeon to order facet blocks, which led to an RFA. This helped but only eliminated the worst of the pain.. At this point, the PM folks put me on 2X Norco per day, the first true pain medication I had been given. Two months after that, I had a revision to fusion.
Where am I going with all of this? Lot's of people participated in my care, and all of them really wanted to help. All could see that I was in agony throughout the process, as it was pretty obvious. But no one prescribed any serious pain medications, and the current climate is to blame in my opinion, along with my generally low key personality. I certainly have to take responsibility for not demanding better - although in this climate it's unclear if it would have helped. If you look at the articles on DDD, it can take 1-2 years for discs to fully degenerate when they are in this kind of degenerative cascade, and often symptoms get much better at that point. The one aspect of my care that I will always believe was wildly inappropriate was the lack of pain medication. If I had been given this from the start, I think there is every likelihood I would not have been so desperate at 6 months to have surgery to get some kind of relief. Perhaps I could have managed through, and perhaps not. But in my view, the climate around opioids robbed me of that opportunity, because medical professionals are simply too scared to properly treat this kind of serious pain.
I know that was very long winded... if you made it all the way through, thanks for listening to my rant!