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Somewhat disappointing neurosurgeon visit

I went to see the neurosurgeon today and was both terrified and excited about whatever the outcome may be.

He was a very nice guy and quite thorough with his exam and questioning in my opinion. I was happy with that.

But when he came in at the end of it all after reviewing my cervical spine MRI from back in August he said he agreed with the orthopedic spine surgeon I'd previously seen that he wouldn't operate on it.

He is referring me to a new pain management doctor, and having me see a neurologist, and having an MRI done of my brachial plexus. So he's not just ignoring the problem. But I'm just so frustrated. I'm getting to a pretty darn disabled point now. I can't live like this forever, and if they all won't operate on it what the hell am I supposed to do? I know surgery isn't necessarily going to be a magical fix, but I'm completely losing my life and I guess I'm just going insane at this point and this appointment was thoroughly depressing.
Microlaminectomy and discectomy at C7-T1 on April 26th.
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Comments

  • FrancineSFFFrancineSF Posts: 318
    edited 01/16/2013 - 9:34 AM
    ...Hi there, Eaduby...

    I am curious - what would the operation be? And, more importantly, why are two surgeons not willing to operate? Is it the level of risk or is it that they are holding out with surgery as the absolute last resort? Surgeons seem to like to perform surgery, so it makes me wonder if they are seeing something where the risk is so great that it offsets the benefits to you.

    Also, do you know if it has anything to do with your insurance? I don't know where you reside, but if out of the U.S., is it a limitation of the NHS preventing them from moving forward with surgery?

    Have you asked those questions?
    10/26/2012 ACDF C3/4 C4/5 surgery
    No pain; no pain meds - thank goodness!
    04/01/2013 - 5 months + 1 week - FUSED
    Doing some physical therapy for even better range of motion
  • eadubyeeaduby Posts: 100
    edited 01/16/2013 - 9:51 AM
    FrancineSF said:
    ...Hi there, Eaduby...

    I am curious - what would the operation be? And, more importantly, why are two surgeons not willing to operate? Is it the level of risk or is it that they are holding out with surgery as the absolute last resort? Surgeons seem to like to perform surgery, so it makes me wonder if they are seeing something where the risk is so great that it offsets the benefits to you.

    Also, do you know if it has anything to do with your insurance? I don't know where you reside, but if out of the U.S., is it a limitation of the NHS preventing them from moving forward with surgery?

    Have you asked those questions?
    ACDF of the C6-7 disc.

    They don't want to because the MRI only shows minimal narrowing of the neuroforamen so they don't believe there is reason to do surgery. I on the other hand believe that if all conservative treatments have failed and I am becoming disabled and constantly in pain then wouldn't that be a reason to do surgery? Also when you consider the fact that foraminal stenosis is often not well viewed on MRI so the stenosis may be much worse than what can actually be seen in my images, yet no one wants to order any other type of images.... I am 24 and besides being a smoker do not have any risk factors. I am young and pretty darn healthy.
    Microlaminectomy and discectomy at C7-T1 on April 26th.
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  • My surgeons (neuro and osteo) will not even think of doing surgery on a smoker. Being a smoker brings your chance of sucess way down. Most surgeons will not operate on smokers anymore because it brings down there sucess rate considerably. That might not be it because they didn't come right out and tell you, but it might be a part of there reason.
    Gary
  • gaj399 said:
    My surgeons (neuro and osteo) will not even think of doing surgery on a smoker. Being a smoker brings your chance of sucess way down. Most surgeons will not operate on smokers anymore because it brings down there sucess rate considerably. That might not be it because they didn't come right out and tell you, but it might be a part of there reason.
    A good friend of mine is a pack a day smoker and had ACDF done in July, so I didn't think that it would be a reason not to do it. Also if it were the reason why not say if you quit you can have the surgery? If that's all it would take I'd do it in a second even though I really don't want to. I think that they aren't convinced enough that the foraminal narrowing is the reason for the pain which would be understandable, but at the same time doubtful since my symptoms are so spot on, or worse they think I can't possibly be in so much pain from what looks like such a minor problem on the imaging. Am I going to have to inhabit the ER every other day begging for pain relief before someone takes me seriously?
    Microlaminectomy and discectomy at C7-T1 on April 26th.
  • I went to many orthopaedists, neurosurgeon, etc. ....and only 1 orthopaedist showed me on the MRI that I showed all these other doctors, that I have a medium herniated disk in C3 that is pressing on my spinal cord! He was the only honest spinal surgeon who told me the truth. He did said that if I did surgery it would only last for 7 years as the pressure from that surgery would affect the disks above and below what he fixes and I would have to do more surgery! He told me this is something you need to do when the pain is unbearable and as a last resort. He told me when I can't stand the pain anymore....he told me you'll know where to find me! I wish all doctors were honest with their patients and not give them false hopes! I wish they would be direct and honest and tell you the truth instead of holding back what is really on their minds!
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  • Hi Eaduby,

    I just want you to know I prayed for you. I'm not as young as you but am not that much older. Hang in there.
  • Same as Gary. Neither of my surgeons will perform non emergency spine surgery on a smoker. My Pain Mgmt Doctor will not Rx opioids to a smoker. He considers the inability to quit smoking makes one a high risk for opioid abuse.
    C3-C7
    Severe DDD, Severe neural foraminal stenosis at 2 levels, moderate canal stenosis at 2 levels, significantly impaired left shoulder & arm function. Chronic moderate compression fracture at C6.
  • Thanks for the comments and thanks for the prayers spine blues. Like I said previously I don't think Smoking is the issue at this point since it wasnt said that quitting would change the answer. The way it was said to me was more that based on my images they wouldn't operate. I'm really scared because financially my family is in a very bad spot because of this. I can barely work, and I'm the breadwinner of the family. Theres just way too much of my life ahead of me for it all to have to
    Microlaminectomy and discectomy at C7-T1 on April 26th.
  • "not a surgical candidate" when my spine journey began. It would upset me as there didn't seem to be anywhere to turn. Eventually I did have a laminectomy but it wasn't the pain that led the decision it was a significant weakening in my left arm and the results of a myelogram. I went in knowing that they operating to prevent a further loss of function and if any pain relief came that was a bonus. I didn't get the bonus.
    I am now sitting here 4 years after the laminectomy and facing fusions top and bottom. I have a good surgeon who is very blunt and says he only wants to fuse my cervical spine once and if I can hold on 5 to 10 years that may be possible. Nightly traction is helping along with heat, tens etc...
    The lumbar fusion depends on when the ESI stop working, had one Tuesday and hoping it continues to lower the pain down.
    Funny that when I wasn't a surgical candidate I was frustrated thinking if they would just operate I'd be okay and get back to my life. Now that I am a surgical candidate it's "what can I do to postpone the inevitable as long as possible"...
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • davrunner said:
    "not a surgical candidate" when my spine journey began. It would upset me as there didn't seem to be anywhere to turn. Eventually I did have a laminectomy but it wasn't the pain that led the decision it was a significant weakening in my left arm and the results of a myelogram. I went in knowing that they operating to prevent a further loss of function and if any pain relief came that was a bonus. I didn't get the bonus.
    I am now sitting here 4 years after the laminectomy and facing fusions top and bottom. I have a good surgeon who is very blunt and says he only wants to fuse my cervical spine once and if I can hold on 5 to 10 years that may be possible. Nightly traction is helping along with heat, tens etc...
    The lumbar fusion depends on when the ESI stop working, had one Tuesday and hoping it continues to lower the pain down.
    Funny that when I wasn't a surgical candidate I was frustrated thinking if they would just operate I'd be okay and get back to my life. Now that I am a surgical candidate it's "what can I do to postpone the inevitable as long as possible"...
    I already have weakening in my right arm and hand, and being right handed it's terrifying. Having a career where I use my right hand all day makes it even more terrifying. I'm two and a half years into my career, I'm only 24. I love it and have been doing an amazing job with it, but now I can see it fading away. My company has been very supportive, but at the same time I didn't get a responsibility that I have *really* been wanting and it was looking like I was going to get before the problems started simply because my attendance at this time is unreliable. Understandable, but disappointing all the same. With pain, weakness, and doctor appointments and procedures I'm lucky to get in 20 hours a week as opposed to the 50+ I would work before.

    I use heat at night, I use tens on occasion but it only is good for relief while I am actually using it. Once I turn it off the pain is back to what it was before within 5-10 minutes.

    A good friend of mine is about the same age (just two years older) and she had an ACDF back in June of her C5-6 due to a severely herniated disc that was compressing her spinal cord. She still gets pain. She still has some problems. I know it's not a cure-all as much as I'd like it to be. It has helped her to be able to work again though, and to be more active again as a mom. The things that I am desperately missing.
    Microlaminectomy and discectomy at C7-T1 on April 26th.
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