Saturday, September 3, 2011

Fixing My Pain in the Neck --

Hiya.

I usually post here on my preppy lifestyle blog, May December, but spinal surgery doesn't sync with posts on monogramming and Nantucket travel photos....

So, I've created this site for my neck-related content.

On July 26, 2011 I underwent a posterior cervical microdiscectomy to repair a herniated disc and compressed nerve root.

Before my surgery I did some googling to try to find out what to expect with this operation. There wasn't much helpful information written by patients with this condition, so I've decided to write about my experience here.

I'm a layperson, so forgive me if my healthcare jargon isn't perfect, and please feel free to skip this entirely if you're not into the nitty gritty of medical stuff.

My injury -

I had a herniated disc, level C5-C6, with compression of the C6 nerve root. I got the injury doing a headstand in yoga in May '10 (...and yes, I know doing that headstand was a really, really bad idea).

It took a tick for me to be properly diagnosed, but eventually I got an MRI and there it was:Boo! Hiss!

My surgery -

After 13 months of unsuccessful conservative treatment and worsening neurological symptoms, it was time for surgery.

There are various surgical options for this problem, but I opted for a neurosurgeon (NS) and a posterior microdiscectomy. My disc herniation was lateral and my symptoms were mostly in my hand and down my arm, so this particular procedure was a good match for me.

The morning of surgery I checked in at Cornell early, met up with my NS, walked into his OR, was given some Versed, and went off to la-la land...

The procedure itself took about two hours. Here's a totally non graphic/not gross animated youtube of the operation.

When I woke up in the recovery room my neck hurt. I mean H-U-R-T!!! -- like an 11/10 on that smiley face pain scale. IV Dilaudid helped, multiple bags of ice helped, but this thing was no joke. My NS had told me how painful the procedure was, and I was glad I had some advance warning so that I didn't think anything was wrong.

I stayed in the hospital for one night to get IV pain meds and prophylactic antibiotics, and was discharged late the next morning.

We're fortunate to have an apartment close to this hospital, but if you have to travel any extended distance to get home I'd recommend getting a hotel room/finding a place to stay for a night or two if possible. Being in a car for more than 10-15 minutes the day after surgery would have been unbearable for me.

Later in the week I was able to sit/recline in the car for the hour long drive up to our CT house. By then my pain was well controlled with Percocet and soon after that I began to feel like a human being again.

In terms of pain/recovery, I'd break it down like this:

operation day - post-op day 3: Excruciating and awful. These were hard, rough days.
post-op day 4 - post-op day 5: Sensitive and painful. I felt like someone whacked me across the back of the neck and shoulders with a 2 x 4, but it wasn't unbearable.
post-op day 6 - post-op day 10: Achy, but tolerable.
post-op day 11 - on: Sore, but off pain meds.

The bad:

This surgery made everything uncomfortable - lying down in the same position for too long was uncomfortable, moving around too much was uncomfortable, coughing or sneezing was dreadful, and going from a supine to a seated position was pretty much torturous.

Thankfully all of these things got better and easier each day.

The good:

I was sleeping through the night by post-op day 8 and off all medication (pain, muscle relaxant, and NSAIDs) by post-op day 13. I'm six weeks post-op today and now have zero pain. Yay!!!

My doc -

I chose Robert B. Snow MD, a Cornell neurosurgeon, for my surgery. In short, Dr. Snow rocks; the man walks on water as far as I'm concerned.

It's a strange thing to meet someone once before agreeing to have them cut open your spine, but I felt comfortable doing this with Dr. Snow.

He took his time during our consultation and was firm, but not cavalier, about suggesting the surgery to me -- I had been hemming and hawing and needed a little kick in the pants to finally sign that surgical consent form. He has a nice mix of confidence and patience, a rare but attractive combination for a surgeon.

Technically Dr. Snow did a perfect job with my operation. When I woke up in recovery I no longer had any tingling, pins and needles, or pain in my hand. Poof - gone! It was dramatic to have symptoms that were almost constant for 6+ months just vanish.

My neck pain completely faded away by post-op week 3, and now I'm just left with some numbness in my index finger and thumb. The feeling may or may not come back, but either way I'm thrilled with the results. Being out of pain is such a gift.

My small, neat incision on the back of my neck:
Not bad, right?

It's been a challenging month and a half of post-op recovery, and I know there's still more physical therapy and healing time needed to get back to my old fighting form, but I'm so glad I finally had this operation. I hope to be good as new in another 3-4 months.

The bottom line -

I am six weeks post-op and my surgery was definitely successful. I am completely, 100% pain-free now. I have some lingering numbness in my hand, but all other symptoms and pain are gone. I am so, so happy I had this operation.

Upward and onward (...but not upside down any more).

And for those of you out there considering posterior cervical discectomy, I hope sharing my experiences has been helpful to you. For more, there's a long, complete version of my history below.

Please feel free to email me directly - MelissaCMorris4 at gmail - if you want more info or have any further questions.

Pain in the Neck, background information --

Here's a bunch of background information on my pain in the neck situation....

My injury -

On Memorial Day Weekend of '10 I did a headstand in yoga. I'm a lifelong athlete, and I have a regular, solid yoga practice. However, I don't normally do headstands and my neck didn't take kindly to that pose. The day after the ill-fated headstand I woke up and couldn't turn my head to the right.

My symptoms -

I had moderate, diffuse pain in my neck and scapula right after my injury.

A couple months later I developed symptoms that traveled down my arm and into my hand. I had pain, numbness, tingling, buzzing sensations, and weakness along this C6 path:

My treatment before surgery -

Stuff that helped:
-oral steroids
-epidural steroid injections
-traction
-opioid medication
-anti-seizure medication*

*Neurontin was tremendously helpful with my nerve pain, but I gained a whopping 13lbs while taking it, so that part of the med was awful.

Stuff that made it worse:
-physical therapy (everything but the manual traction)
-acupuncture

Stuff that made no difference at all:
-non-steroidal anti-inflammatory medication
-muscle relaxant medication
-wearing a soft cervical collar
-heat
-ice
-massage

Physicians, Surgeons, and Physical Therapists --

I've seen a gaggle of healthcare providers in the year+ that I've been dealing with my herniated cervical disc nonsense. Some of these neck-related practitioners were terrible, some were so-so, and some were fantastic.

Here's who I'd recommend in NYC...

My neurosurgeon, Robert B. Snow MD at Cornell.

This man is the bee's knees -- kind and experienced (but not too old) with expert hands and sharp judgment. He's always on time, returns phone calls, answers any/all questions (...and I had MANY), talks you reassuringly through the procedures he's recommending, and follows up thoroughly. My spine hearts Dr. Snow.


My physiatrist, Alex Simotas MD at HSS.

Dr. Simotas was terrific at finding the right balance/combination of meds to help with my pain. He also gave me some much welcome temporary relief with 2 epidural steroid injections. Chronic pain can be a frustrating condition to deal with, but Dr. Simotas was always patient, thoughtful, and helpful. I trusted him completely, so when he said it was time for me to have surgery, I knew I had to take that next step.


My physical therapy clinic, KIMA Center for Physiotherapy & Wellness in downtown Manhattan is awesome.

In the past 15 years I've had 8 shoulder surgeries and now this spinal surgery. All of those operations have meant a lot of rehab and a lot of contact with physical therapists -- in my experience, no one does P.T. better than KIMA. They are actively involved, out of the box thinkers. Many of them are also athletes so they can relate to a patient like me that just wants to get back to a healthy, sporty, pain-free life after surgery.

Hey There, Hi There, Ho There --

...you're as welcome as can be.

Many thanks for reading my entire pain the neck story.

I normally blog over at www.MelissaCMorris.com, my preppy lifestyle blog. Follow me over there, or if you have further questions/comments about posterior cervical microdiscectomy surgery, please feel free to ping me at MelissaCMorris4 at gmail dot com.
Cheers.