This post is all about herniated discs. How many of you or your friends have with neck or back issues? Lots? Yep. We’re going to talk therapy, surgery, and life after neck surgery. How to change some of your bad habits, and maybe stay out of this situation.
BLUF — Bottom Line Up Front
1. Bad posture contributes to blown out discs in the neck
2. If you have neck pain (or back), get an MRI sooner than later
3. Regular xrays DO NOT SHOW what is happening on the spinal cord. Chiropractics have their place but they do not do MRI’s.
4. Loss of function needs surgery. Surgery is the last option but sometimes necessary
Being political is a lot of fun, and there was so much to cover with this very political summer, but I’m going to talk a little about medicine and life. July 5th I had surgery, and that pretty well slowed me down. Notice the Titanium plate in my neck on the xray. I’ll blame it on a cell phone but there’s lots of things in life that contributed to the unstable disc in my neck.
First off, a little anatomy. The head bone’s connected to the neck bones. Inside the spinal column is the spinal cord, the equivalent of a bundle of wires or a fiberoptic cable. Pressure on the cord shuts off the nerve impulses to the muscles like someone standing on a water hose cutting the flow of water. Some water may get through, but not as much as you’d like. Less nerve impulses means less strength in the area where the nerve was going. Leaving the main spinal cord, the nerves that actually go to the muscles have to pass through small openings in the vertebrae. The holes are called foramen. A little pinch on the nerve makes everything ache, but a lot of pinch may be enough to shut off nerve function. “Sciatica” is the term applied to the sciatic nerve down the back of the leg. Enough inflammation around the lower back vertebrae will affect the function of that nerve and the legs. Got the idea? Pressure on the nerves causes pain, and potentially loss of function. The “disc” is a like a shock absorber cushion between each vertebrae. When it “blows”, it puts direct pressure on the spinal cord. In my case, I had a blown disc at C6-C7 and also bony changes around the nerves coming off the spinal cord (at the lower end of my neck). I lost most of the function of my left biceps. I could lift a 12 ounce drink, but I couldn’t pick up a cat… rather important in my line of work.
In Junior High football, we were taught to tackle by putting our helmet and face guard in the chest of the opponent. This results in a “stinger”, where the head is violently thrown back pinching a nerve in the neck and lighting up the nerves going down the arms. Ouch. Stopped playing football in 9th grade and stayed with golf. Had a few more stingers over the years with and mostly recovered okay. I fell off a horse in 2001 with the biggest one of my life and that stinger took about 6 hours to go away including the trip to the ER and lots of drugs. This type of history is so incredibly common in all of us that played a little football when we were younger. It sets up the chronic neck pain from arthritic and bone spur changes in the cervical spinal column. Certainly it could damage a disc.
How technology plays a role. You’ve seen the pictures of crowds of people standing next to each other, or families at dinner tables, all with cell phones out and all of them with their head positioned with their chin on their chest while texting on their smart phone. Then there’s the bad posture of sitting at a computer for hours on end with a similar chin down posture. Even an avid reader of the old fashioned book is not immune to bad neck posture but you don’t see kids pouring over a book for hours on end, just pouring over the computer.
How did I do it? The football and horse accident didn’t help the chronic bone spurring and associated upper back pain, but that darn cell phone did me in. I spent about an hour in the car talking with a cell phone cocked in my left ear, head tilted to the left for the entire time. I went to sleep that night with a distinct sore neck, and woke up the next morning with the same sore neck and a tingly left arm. By noon, I had lost 80% of the function of my biceps. I couldn’t curl a four pound weight. Oddly, I could juggle still and hadn’t loss the coordination necessary for that. That was Thursday. By Monday, I was in the doctor’s office and getting MRI’s on my neck. A long week later, I was in the neurosurgeon’s office and he explained treatment options. There weren’t any easy options left. It was surgery.
Necks and bulging discs fall into about three categories. Long term injuries with chronic pain don’t respond well to surgery. There’s so much going on that it doesn’t even have to involve the main spinal cord. You know these people with years of pain but they’re avoiding surgery. They get by with ibuprofen or Tylenol. Second category are the spinal cases that respond to an occasional steroid shot. Works well for those, lasts about six months, and it certainly avoids the surgery. In my case, and I got the unlucky draw on this one, I had loss of function. Loss of function almost mandates surgery. Do you want to lose function and be paralyzed on an arm, or leg, or from the neck down? I’ll take surgery, please.
My surgery was July 5th, my birthday and was performed by Dr. Lapsiwala of Fort Worth Brain and Spine at Harris Methodist downtown. Great experience. Went in at 10 am, prepped, surgery by 1, out by five, recovered overnight, and home with a collar for support. I had a single plate with six screws bridging across three vertebrae, cadaver bone graft to fuse the discs together, and the surgeon also reamed out all the bone spurs and opened up the foramen (those little holes where the nerves have to come through). Most people get 4-6 weeks off from work while everything is healing. That’s great for everyone that is NOT self employed. Literally, I backed off difficult stuff but I was back at work on the following Monday. (Your results may vary). I’ve got very good bone density and that helps a lot. Older people and probably a lot of women won’t have the bone density and will have slower healing.
How I changed my life. Well it’s still early and I do plan on playing golf again. However, I raised my main computer monitor at my desk up about five inches to eye level. I bought a blue tooth headset for my phone. Now I look really geeky but you won’t see me holding a phone up much anymore. It’s really a blessing. Texting? I’m slowing down — that’s really bad posture. Chronic Facebook addiction? Bad posture if it’s on a smart phone, not as bad on a computer.
Let’s take life a little slower, and limit yourself on the smart phone. Next posts will be back on track. Call me anytime for reassurance on your future surgery.
Okay a little politics. Good insurance, $250 a month premium, $5000 deductible, then 100%. Blue Cross. Hope I get to “keep” my plan.