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Surgery – Car Accident Update

August 15th, 2008 by Madeleine

I got my MRI results on Tuesday. They show damage to two discs, both are compressed. One is more compressed than the other, the other is protruding and pushing on a nerve, hence all the pain.

I have two choices. Do nothing and see if it fixes itself (its been almost 5 months). Have surgery to remove the damaged discs and replace them with artificial ones.

There is no choice really. I cannot stay on the drugs I am on for much longer. My quality of life is awful, everything I do is limited by “I can’ts” because of the injury. If it was going to fix itself surely it would have at least improved by now. On the other hand, surgery means I will be out of pain and will be able to do anything pretty much (including equestrian eventing eventually – though apparently I can’t consider being a front-row forward).

Surgery on my neck is frightening. It will leave a scar on the front of my neck and as good as the results will be I will never quite be as good as I was before.

I have three weeks to ‘decide.’ I have already decided but I am going to seek a second opinion just to be sure.

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14 responses so far ↓

  • I was told years ago by a neurologists that I needed to have surgery for the painful sciatica
    (Pinched nerve in my back /slipped disk) I asked him if I should see a chiropractor
    He said no and brushed them all off as Witchdoctors, I opened up the the phonebook to the chiropracter with the biggest add , who specialized in accidents and hard cases, and
    with just one adjustment I went from 10 years of excruciating pain
    to Zero pain, All Im saying is find
    a chiropractor who specializes in hard cases and give him a chance before the surgery. I am so Glad I did that the neurologist told me i may have even more pain after the surgery. Now im still in perfect health years later with no surgery.

  • It is interesting you suggest this. I was at a friend’s chambers for drinks the other night and met the building’s cleaners who recommended I see the chiropractor’s downstairs and said similar things to what you are saying.

    I figure there is no harm in asking someone who does not have a bias towards surgery for an opinion on my MRI scan results. If they tell me that surgery is my best option then well and good.

    That said I am a tad uncomfortable at the thought of trusting a chiropractor to do any adjusting. One wrong move and I could be in a worse situation and not covered by ACC.

    I definately will seek out some info though and I will give the rest some more thought so thanks.

  • Chiropractors deal with spines so it makes sense that when they manipulate the spine it’s going to have an effect of some kind. Where I believe chiro goes wrong is when it extends the claims of the extent of the effect of manipulating the spine to other areas of the body without studies that verify that.

    It seems to be a temptation for anyone who finds a remedy for something to try to turn it into an all-singing, holistic cure-all that will save humanity.

    If I were looking for someone to work on my spine I might resort to a chiropractor but would first look to proper medically-qualified physical therapists.

  • Do not let any practitioner manipulate your neck.
    Unless there is evidence of severely prolapsed discs do not have surgery.
    Do find an osteopath and work on posture, range of movement and deep tissue exercises to strengthen muscles.
    Do find a gym and a trainer and start on a weights and exercise programme.
    Do not take NSAIDs, use asprin.
    DHC rather than Tramadol.
    Elevate the head of your bed by 50mm or so and use the thinest pillow you can and do not use foam or feather.
    Use wheat bags, a heat pad or hot water bottles for pain relief.
    Posture, strength, range of movement and pain free rest are the keys to a recovery which may or may not be as good as new but IMNSHO surgery is a guarantee that you’ll never be as good as new.
    Goodluck.

  • Apparently there is evidence of a severely prolapsed disc. My MRI shows one disc is like a pointy triangle on one side instead of a nicely rounded elipse like the other ones.

    Further after 5 months of physio (we did not go to osteo because without the MRI we were not sure what was there) which included as much stretching and strengthening and exercise as I could tolerate I am still in awful pain and experiencing numbness at times – my sitting tolerance today before numbness kicks in is about 10 minutes.

    It has been like this since Thursday so right now I cannot work my 6 hours because I have to sit in a car for 20 minutes (in good traffic) to get to work and I cannot sit more than 10 minutes right now. (Usually I can sit for 40 minutes without a break but it plays up sometimes)

    I want to avoid surgery as I am very aware that it is a guarantee of never improving past a certain point. That point keeps changing too as the first time it was 95% recovery then three weeks later its now 80% recovery which is really peeving me for a whole heap of other reasons.

    I am interested in what you say about the drugs. I prefer Aspirin to pretty much anything else as it works so much better than most things but I have not been using it with this injury.

    I have a sensitive tummy so I have been told by a specialist to never take anything harsher than Paracetamol ever again, that said… my drug cocktail at the moment is:

    – 1 Synflex twice a day (though I often forget to take it before bed)

    – 2 Paracetamol and 2 Codeine 4 hourly

    – 2 Tramadol 6 hourly when the above is not enough (sometimes the Tramadol hits me fine, other times it hits me like I am stoned and I cannot walk straight, think or drive – it is unpredictable so I never take it if I have to drive or sit an exam if I can help it)

    – Alcahol when all of the above is not enough (this bit is not prescribed and against the advice on the labels but when desperately climbing the walls with pain … what can I say, it bumps the drugs up really effectively)

    – I was also prescribed Amitrip to bump the drugs up but I HATE it, I am a permanent zombie on it and I do not find that it bumps the drugs up anyway)

    What is DHC?

    I have the pillow thing sussed but I will try elevating the bed.

    The other problem is that without surgery happening really soon, ie within the next 3 week (which it will) I can kiss my job goodbye.

    After reading all of the above, do you still think I should see an osteo? I am open to the concept despite the above headaches.

  • DHC

    http://www.medsafe.govt.nz/profs/Datasheet/d/DHCContinustab.htm

    http://www.erowid.org/pharms/dihydrocodeine/

    DHC works for me because of the slow release and the slight mood elevation. The only down side with DHC is constipation but a high fluid intake and if necessary a daily dose of metamucil will solve the problem. The next step up from DHC is Oxynorm for a quick release analgesic and Oxycodone for a continuous release but both are similar to Tramadol with sleep problems, odd dreams etc, and a slightly disconnected feeling. I agree with your thoughts about Amitrip and other neural analgesics, gabapentin and the likes. These medications leave me in a zombie like state with the possibility of nodding off at almost any time of the day or night and with an insatiable appetite Although they don’t appear affect the libido they leave you with a marked decrease in sensations.
    Neural analgesics can also cause memory problems, ie, give way signs where despite seeing a car coming when you look the other way you’ll forget about it and pull out into traffic and after a few near misses I flagged gabapentin.

    Osteopathy is bordering on “wingnut” alternative medicine with their talk of essential fluids flowing and the like but to me it’s been a very gentle alternative to physiotherapy. Cranial osteopathy is another therapy that I can suggest but unfortunately these practitioners are rare and hard to find.

    You say you and your bloke are Christians of the born again variety so I don’t know how you would regard yoga but I do think you should find an instructor to work with you on your posture, core strength, and range of movement.

    I would suggest that you wear a soft collar when driving but other than that the collars, IMNSHO, do nothing for the core strength that you need to work on.

    As for surgery, scary stuff if you ask me, it certainly wouldn’t be my first choice but has the surgeon suggested a partial discectomy, removal of the portion of prolapsed disc that’s pressing on nerves, rather than a full disc removal and replacement.

    And finally Madeleine I’ll bang on again about posture, range of movement, core strength and pain free rest. These are the things that are crucial, with or without surgery, to any recovery.

    Good luck,
    Cha.
    ps, with regard to the drink, I agree it’s a great supplement to the medication but unfortunately alcohol is a depressant and the blues are last thing you need.

    pps, a little high quality weed to take with the drink can do wonders for the mood.
    Cha.

  • Blogger seems to dock the url, trying again
    http://www.medsafe.govt.nz/profs/Datasheet
    /d/DHCContinustab.htm

    Cha

  • Thanks for all that. I have taken a look at the pages – I will definately discuss this with my GP. I have coped extremely well on codeine over the past 5 months with zero of the side effects that are typical but it is at times not enough, hence the Tramadol.

    I have been to see an Osteopath that my ACC Occupational Therapist recommended. Both Osteos at the practice reviewed my MRI scan and they are confident that they can sort out the residue whiplash and there is a good chance that the prolapsed disc may come back in however they have pessimistic views at the severity of the compression. They both agree with my surgeon that even if all of the above is fixed the really badly compressed disc is likely to need replacing at some point in my future as these cannot re-expand.

    This leaves me in the predicament of do I have the surgery to replace that compressed disc now given I am at the top of the waiting list (not sure where in the world you are but that is a big deal in New Zealand as when you have an accident your health insurance leaves it to the govt scheme to deal with your medical care) or do I wait and see how long I last, then go through months of mucking around with specialists and pain management – more pills going into my body – and stuffing over my employer and my family to get back into the position I am in now where they will do the surgery in less than 3 weeks? It feels like a big gamble but given everyone who has seen the MRI seems to think that the badly compressed disc is stuffed and will pack up on me and I will in all probability need surgery I am kind of wondering whether I should see another specialist or whether I should face the music.

    In the mean time I am continuing with Osteo and trying frantically to gather information.

    I have no issue with yoga as a form of exercise, I just wouldn’t participate in the spiritual side of it so I will definately give that a go. I am trying very hard and have been for some time now to improve my strength and range of movement and my posture and core – the horse riding I did prior to the accident was very good for my core, though of course I have not been doing it post-accident.

    My ACC OT said maybe I should do Osteo to sort out the prolapsed disc and the muscle and spine stuff, have the surgery to sort the compressed disc given its kinda pointing that way if not now then not too far off, then continue with Osteo.

    I am still in a head spin about it though. If I officially delay the surgery my job is toast as they will not hold it any longer – there has to be a time limit on how long they put up with temp after temp doing my role which is fair enough, it is a business not a charity. That said money and career are not worth more than health and wellbeing. But if I am going to end up needing surgery anyway… argh! I don’t know!

  • Madeleine, first off, ACC is your insurance company and NOT your friend, a suitable outcome for ACC is you off their books and back at work. And years down the track when you present with Spondylitis you’ll have the devils own job succeeding with any claim to ACC so proceed with caution. Short version, don’t be bullied!.
    ACC fund the surgery so any talk of a public waiting list is way off the mark.

    Your job, a job is a job, plenty more where they come from.
    Your neck, you’ve only got one set of cervical vertebra, no more in your size.

    My thoughts on how to proceed, assuming you have an entitlement to earnings related compensation and with the knowledge that radical surgery is a final option, draw a road map from here to a best possible outcome. Resist the urge to take what may appear to be the easiest route. Organise the right people, therapists, trainers, instructors, and places, gym, walking routes etc and most importantly, a way to measure progress.

    Quit the present job, take up another as a full time get weller, funded by earnings related compensation entitlement, cue conflict with your insurer ACC, and take a punt that over time measurable progress will be made.
    And perhaps surgery will be a last resort but three weeks looks to be a rather hasty “last resort”.

    Cha.

  • After heaps of chats with my Osteopath who is very pro-alternatives to surgery and lots of thought, I have decided I will have surgery.

    My Osteo says that his treatment will be able to settle the pain but he cannot guarantee to what level. He also says that I will need disc replacement surgery within 2 years anyway, such is the severity of the irreparable damage, and as I am at the top of the waiting list and the next two years could have uncertain pain levels and that recovery is always better the younger you are then I should go ahead with surgery.

    I will still have Osteo before and after and will still work on the other things I can do to help myself get stronger and more pain free.

    Thanks heaps for you thoughts though anonymous, you really helped me to think it through and find the peace I needed to make this decision.

  • My niece has a scar on her neck and it looks pretty cool. Sometimes “war” wounds cause character.

  • Hmmm. Not so sure that “cool” is the look I am going for.

    There is always makeup!