Cervical Discectomy

gcwebbyuk · May 2009

Beware this post may include a bit of ranting!

I have had issues with my neck for a few years now, usually physio has helped, but my last problem was in december last year, four days after my physio had "fixed" the previous issue, this involved a trip to A&E and course of diazepam to reduce the muscle spasms in order for my neck to be moved.

I then had xrays taken to see what sort of damage there was going on in my neck - xrays showed osteoarthritis - at 30!

I was told to take ibuprofen (3g a day - maximum you should take).

I was then referred to a rheumatologist for an MRI scan and further diagnosis. My first meeting with the rheumatologist was quite poor, he had no notes on my "case" and hadnt seen my xrays etc - luckily I had taken a copy with me.

I was told that I had a disc impinging on one of the nerves in my neck, which was causing the pain around my neck and shoulder and the numbness and pain I occasionally felt in my right arm.

The rhuematologist referred me to a Neuro-Surgeon to discuss surgery. Meanwhile my GP prescribed me amitryptiline to help with the nerve pain.

I had my appointment on Thursday, which turned out to be a neurologist instead of a surgeon. When I arrived - it was a similar experience to the rhuematologist - no notes - no idea what I had been referred for either - they wanted me to have an MRI at which point I mentioned I had already had one... I then had to go back to my GP to get the report from the radiographer and then head back to the Nuerologist (luckily I had taken the day off!)

I have now been referred by the Neurologist and my GP for a meeting with a surgeon to discuss a Cervical Discectomy. I have also been prescribed Omeprozole and Diclofenic to take as well as the amitrityline - in total 6 pills a day - what with the osteo arthritis and all these pills I feel like a pensioner! I have also been referred for physio (on the NHS) and acupuncture.

Right rant over...

So has anyone else out there had a Cervical Discectomy?

Is the NHS usually this bad for referrals? (wish I had have taken out private health insurance before!)

supersonic · May 2009

Glad you are getting to the bottom of it! NHS can be like that, I had a right wrangle with them a few years back with referals, lost notes, delays etc.

Amiltryptiline is a pretty potent sedative, I'd be careful with taht stuff!

Stephen-Hawking · May 2009

Yes mate I've had a Cervical Discectomy, about 11 years ago now. There's good news and bad, bad news is it's a fairly big operation and takes a bit of recovering from. Although in 11 years they've no doubt got better. For me they took bone from my hip to fit into slots cut into th vertibrae either side to get them to fuse - is this what the're doing to you?? I had some complications with the hip bit, but that's rare.

You did need the MRI though - I had the disc collapsing into the spinal cord and nipping it off completely - this means paralysis from that point down- no joke and only the MRI shows if this is happening - sounds like you're 'lucky' Obviously the damage wasn't permanent!

Good news is I've made a virtual full recovery - I occassionally do something daft (like falling off a bike!) and knacker my kneck, but it always clears up after a few days. Bear in mind you'll loose a bit of flexibility in your nexk as two vertibrae will be fused together - which is why I tend to injusr it slightly more often that most.

Bad news is no real visible scars to show off (although my hip's a beauty) but you will make a full recovery. Now you're in the hands of the surgeon you're on his books - so you should get direct treatment from him only - which will be as good as private - apart from the food.

If your op is exactly the same with the hip bones etc feel free to ask any questions- it was an interesting time - I was 36 at the time.

Steve

Si78 · May 2009

how are you feeling after taking all the medication?

Im on Amitriptyline for severe migraines. What dosage are you on?
I have to have 25mg-50mg before bed. Tried taking 50mg, but it was totally monging me out. Take 25mg now. It just about controls the migraines, but im still drowsy a lot of the time.

Regarding the NHS. They treated me really well. Rushed me in after id been to the GP with dizziness, tunnel vision, lack of co-ordination, slurred speech... i thought id had a bloody stroke or something! Kept me in all day, scans, x-rays, hourly checks, consultant saw me etc.
Then got referred to bupa hospital (have bupa cover thru work)

im only 30 too, so you can imagine how worried i was!

sorry i cant help regarding your Cervical Discectomy.
very interested to hear your experience of taking the medication.

hope you are feeling better soon

Si

supersonic · May 2009

I took dothiepin which is a similar type of drug, in 4 doses a day. Did sleep well on it, but it played havoc with my blood pressure.

Si78 · May 2009

supersonic wrote:

I took dothiepin which is a similar type of drug, in 4 doses a day. Did sleep well on it, but it played havoc with my blood pressure.

did it lower ur blood pressure?

Before the Amitriptyline they had me on beta-blockers (for the same migraine problem). They made my blood pressure drop. And when I was exercising my heartrate wouldnt go up, so i would be exhausted after doing very little....

scary things these tiny little tablets!

Si

supersonic · May 2009

Both! I was on beta blockers too (at the time they thought I had an adrenalin producing tumour of the adrenal glands) and the dothiepin worsened the effect of it. I would go from massive spikes in BP to really low drops! My heartrate was low too because of it.

Si78 · May 2009

bloody hell, that must have been awful. erratic bp well dangerous.

You all sorted out and ok now mate?

supersonic · May 2009

Sort of! Had the big wrangle with the NHS about the testing, which included two cancelled ops and a third opinion (had two specialists with conflicting and opposite opinions), and was eventually told I had M.E. and glandular fever while they would continue to monitor the other situation. B.P. is much better now though!

I know where GC is coming from, can be a nightmare!

gcwebbyuk · May 2009

Hi guys - sorry havent been on here much since last week.

Went back to docs on Friday as the pain in my arm (now both strangely) was getting worse.

The doc prescribed me some more codeine to take when the pain gets bad - so was stoned most of the weekend on it - took some in the day yesterday while at work (no driving) and have been at work today - not taken any so far today.

The amitriptyline seems to work well - i am taking 20mg in the evening (usually about 10pm).

It does make me drowsy which helps with sleeping, although nowhere near as drowsy as I feel when I take codeiene!

The biggest side effect I have noticed from it is that I am constantly needing a pee!

supersonic · May 2009

Codeine can do the opposite to the solid matter disposal though!

gcwebbyuk · May 2009

Stephen-Hawking wrote:

If your op is exactly the same with the hip bones etc feel free to ask any questions- it was an interesting time - I was 36 at the time.

Steve

Yeah thats the same op - awaiting my letter for the appointment to discuss it further....

the wait continues....

gcwebbyuk · May 2009

I managed to get a copy of the MRI report from my GP - not sure if this makes sense to anyone - or if anyone can translate this into English :shock:

"There is normal vertebral alignment and preservation of the vertebral body heights and disc heights. There is degnerative dehydration of the upper five cervical discs. The atlanto axial joint and cervical vertebral junction appear normal. The cervical spinal cord is of normal dimensions and emits normal signal.

At the C5/C6 level, there is a large right posterolateral osteophytic disc protusion which is narrowing the right neural foramen and is impinging on the ventral root of the exiting right nerve root. There is also effacement of the right anterolateral thecal sac without any cervical cord compression or myelopathy.

At the C5/C7 level, there is a broad based posterior disc bulge without any cord compression or myelopathy. Ther nueral foramens are patent without any impingement of the exiting nerve roots."

Make sense to anyone???

I have a physio appointment at the hospital tomorrow - so will see if I can have a look at the MRI images themselves. :roll:

Stephen-Hawking · May 2009

Well from what I know, from my own experience it looks like there's no impact on your spinal cord - That was my biggest issue and is a worry - a simple bump in the car for example could do permamnent damage to the spinal cord - so you'd need the op sooner rather than later as a precaution. You're ok you don't have that.

What I was told is that your disks are like crab meat wrapped in cling film !! and are obviously roughly circular sitting between the vertibrae. Sometimes a bit of the 'crabmeat' can leak. there's a nerve runs out from each side between each pair of vertibrae. When the 'crabmeat' leaks it can jangle the nerve (which is the pain) this can cause he muscle to contract which causes the nerve to be jangled more - viciouse circle ends in complete spasm - often the pain killers and anti inflamitary drugs are to releive this spasm - if they can get to a non jangling position then happy days. This whole effect is what's often known as a slipped disk. One solution is a minor op to snip off the leaky bit of crab meat.

Unfortunately my freind you've got more than a crab meat leak, your 'cling film' has collapsed altogether (luckilly outover) - and is probably squashing the poor nerve so the whole package has to be removed and the vertibrae welded together, as I described in my frst post - but you'll be fine.

Ineterestingly (honest!!) depending on which pair of vertibrae the nerve is coming from determines where you get the pain and tingles - the nerves from the cervical spine (neck) run down the arms - so your c5/c6 (ie fifth and sixth vertibrae from the top) run down your shoulders through the inner parts of your arm - so you'll be getting pain and tingling fingers in your forefinger and middle finger (c6/c7 would affect your little finger and ring finger) Mine was C5/C6 too. Lower down your back they run down your legs - sciatica is just hte same as all this but lower - which is why people limp with it!

btw you have 7 cervical vertibrae - so c5/c6 is lower down in your neck. Did I say that they'll operate from the front - so you'll be a bit horse after!!

Enjoy.

Steve

kellog · May 2009

hi just browsing the net regardsing cervical disectomy and came across this forum

i have discovered that i have two discs gone in my neck and a third is threatening so am currently awaiting surgery to have two removed and replaced with a cage of some sort

i have been off work for four weeks now and may not get op for another four weeks and that is with private health care from work! mind you a hospital relocation and a surgeon going on holiday takes up 3 weeks of this

medication wise i take 25mg of amitryptaline 3 times a day, garpapentin 300mg twice a day for nerve releaf and can top this up with 5-10mml of oramorph to ease pain and it still hurts

all of this does make you pee a lot and i also take senacot and lactose to ease the solids issue

all in all a horrible way to be and hopefully the op will cure it

once i have had my op i will update you with how it went but it is reassuring to see that someone else has had a successful op as when they tell you the potetial problems that could occur it is a very daunting situation to be in

Stephen-Hawking · May 2009

Yeah good luck with the op Kellog, mine was private too in a Nuffield hospital, work paid - probably the same treatment, but the food's better

The good news is the op is less painfull than the state you're in waiting. I had a couple of steroid injections into my neck while I was waiting to help control the pain, not sure how effective they were.

I'm sure I said before don't rush your recovery, it's frustratingly slow but worth getting it right. I'm doing aan extended coast to coast cycle ride in a fortnight and my neck is the least of my worries - my lungs, legs, brain now they might not cope

Oh and a word of advice - because I was in a Nuffield I could have visitors whenever I wanted - not good, you need some time to recover and you;re knackered after any op. The constant stream was too much for me, well meaning, but knackering. I now know why most hospitals have visiting hours - might be worth having a word with your loved ones beforehand and create some times when you can sleep during the day, you'll need it.

Keep us posted, be inteested to know how your recovery goes.

gcwebbyuk · May 2009

Finally found out when I will see a surgeon...

...august 24th - 3 bleedin months yet! :evil:

i wish i had have taken private medical insurance before all of this

I have booked a 2 week holiday to Egypt for next month so I can have two weeks doing bugger all to see if resting has any improvement.

Good luck with your op Kellog - be interested to see how it all goes.

supersonic · May 2009

3 months just to see a surgeon?! Christ. Then will be the waiting list for the surgery.

I can sympathise, hope it is quicker.

gcwebbyuk · May 2009

I have a review appointment with the neurologist on the 18th June - so will see then if there is any way of moving it forward.

Biggest problem is taking the odd day off to see these people - its a complete joke.

Bottom line is - take out private health insurance

kellog · June 2009

blimey 3 months is riddiculous

i have waited 5/6 weeks from original consultation and finally get my op next weds 17th - as long as no more urgent cases land in front of me

i have private health and whilst the consultation and mri scan were quick you really fall into a postcode lottery in terms of how long it will take to get your op as this type of operation has to be done with full icu and crash team back up so your back into the NHS hospitals anyway

dont panic on the icu issue as its just so they can monitor you after the op for 24 hrs incase you have swelling to your neck after the op that may restrct your breathing

they described the op to me as inserting a bit of tupperware into your neck

in terms of pain relief try 25mg amytryptyline 3 times a day and 300mg gabapentin twice a day

i still have pain if i sit vertically or stand for too long but other than that they work really well for me - they are addictive though if taken for too long but at least they dont make you vomit like codene can

anyway i week to op so will post up again when its all been repaired

gcwebbyuk · June 2009

Had a follow up appointment with the Neurologist today, she was shocked that my appointment with the surgeon was such a long way away, seeing as she wrote the referral letter on the 30th april - her assistant phoned the surgeon's secretary and left a message saying it was important I was seen earlier - which is a bonus I suppose.

On the other hand though, she advised me that it would be better not to have the surgery as I am so young (30) and to hope that more conservative measures will help sort me.

Been having physio now for a long time (private or nhs) - so not really feeling that conservative measures are going to fix it.

Am fed up with taking pain killers all the time, and how they make me tired - especially when working.

I have a 2 week break at the end of the month, so hoping some good relaxation will help in someway :roll:

gcwebbyuk · June 2009

If anyone is any good at reading MRI scans, mine are uploaded here:

http://s284.photobucket.com/albums/ll9/ ... RI%20Scan/

gcwebbyuk · June 2009

Think this is the one that shows it best:

Tom Barton · June 2009

Hi there - sorry to hear about you predicament.

Firstly - Stephen-Hawking - beautifully explained - I may have to use the crabmeat explaination in my practice!

Secondly - Amytriptyline is not primarily a sedative. It is actually an anti-depressant originally and is still used to treat depression frequently. It is also an old anti-depressant which means it has a list of side effects as long as your arm so it has in recent years found itself being used in neurological pain disorders/problems. It is a particulary useful drug for treating neuropathic pains and usually only needs a low dose to acheive its effects (thus avoiding other more unpleasant side effects) - one of the main ones of which is a sedating effect - so most professionals will instruct patients to take at night. (I would note that when you stop taking it - you will not become depressed).

Thirdly - Having been both on the receiving end of the NHS and also working for it clinically. Getting 'in the system' can be a nightmare, particularly when your an outpatient largely capable of your day to day tasks and with a primary symptom of pain. Pain is the MOST underserviced area of the NHS and alot of figures get thrown around - for example a proper nationwide pain clinic service with advanced forms of pain management could potentially save the NHS billions in drugs but obviously taking similiar numbers to set up.

My best advice is to nag the crap out of secretaries and GP's and out patients departments (the neuro-surgical secretaries are good people to nag) and don't let them forget you - sure it may make you unpopular on the phone but they still have to treat you none the less. Go along quietly when nothing is happening and they'll probably forget... Also if you REALLY are not happy with what a dorctor/surgoen tells you - you are always entitled to a second opinion from another surgeon on the NHS (you don't HAVE to go privately - and besides private consultations may often end up with advice to go for procedures because they want to make the money from doing said procedure).

Ask if there are any CHRONIC PAIN management centres/clinics around and see if you can get on one - it may seem twee but they can teach excellent pain management stratagies to help you control your pain and many people find they need less analgesia afterwards. Do some research on the web and see if you can find anywhere near you that might help and see if you can get your neurologist or GP to refer you.

In regards to surgery, you are young for surgery - but speak to your consultants and explain the impact this is having on your life and see what they say. Nag if they are being slow getting appointments out to you and unfortunately neuro surgery is an imfamously busy field (in as much as there are alot of people with problems and not all that many teams).

gcwebbyuk · June 2009

Thanks for replying

I have a GP appointment on Weds, as the pain is starting in my left calf too - feels like a strong cramping feeling which lasts for hours - not pleasent.

Will call the Neurosurgeon's secretary again on Monday and nag too!

Am concerned I will need another MRI before the surgeon makes any decisions as the ones above were done in feb, so will have been 6 months ago when I finally see him.

Dirtydog11 · June 2009

Whats with the Omeprozole? I 'm prescribed that for Gastrisis.

Tom Barton · June 2009

Taking regular anti inflamatory drugs like ibrofen and diclofenac and aspirin can massively increase a patients risk of stomach upset and gastric ulcers - the omeprazole is there to counter the effects of taking these drugs all the time :-)

kellog · June 2009

Well i am back and still alive and kicking after the op

i have had my c5/c6 and c6/c7 discs replaced last Weds 17th June at Derby City Hospital.

The op took three hrs and by the time i came out of recovery my wife had been having kittens for 5 hrs and was told she could not wait on a ward for me but to go home and call back in the afternoon

After a short discussion with the ward sister this was all resolved and my wife was told she could wait and the sister would let her know what was happening - she kept her word but this is a big op with big risks and those closest to you should be treated better

Anyway other than that the treatment i received was first class

After the op i was transferred to what is classed as a step down unit - not quite intensive care

Basically there is one nurse to 3 patients and you are checked for blood pressure, temperature, oxygen levels, pain relief, and body movement to arms and legs every hour on the hour.

I woke up to oxygen up my nose, a neck drain, antibiotics fed via drip to left hand and also a drip into my right hand which was also a feed for morphine that you self administer by pressing a button and the staff monitor your usage.

I found these staff brilliant and stayed with them from 3pm "ish" on weds till 11am on Thursday

I was then transferred to a ward where i was monitored for all the same things as above but only 3 to 4 times each day and other than having to go back on to oxygen overnight on Thursday i was allowed home on Friday evening

Now back home i feel a bit jitterry on my feet, extremely tired, a bit sore around the neck wound and also a bit across my shoulder blades but all in all not too bad for what the surgeon described to me and i quote "you do not realize the size and complexity of the operation you have just had now go home and relax and i will see you in a couple of weeks"

I have been given paracetomol, diazapan for a 5 day dose, amityptyline reduced to 2 x 25mg and my garbapentin to 300mg

I have a wound check tomorow, an xray on thursday and my stitches out on 29th June - four big sterisrtips on a wound about 3 inches long

gcwebbyuk - i dont know how you are coping with the pain - i have been lucky as my boss has been brilliant too me - i have been off work now for 8 weeks and they say 6 to 8 minimum to recover and he is aware of this and has actually told me not to rush it.

Surgeon wise i have had reports from friends who used the same guy as me in the past so he came with glowing references and he treated me as a person and not a patient which made me feel comfortable - especially when he cracks a joke to you when you in the anesthisia room and he is going into theatre and your next!!!!!!!

Thats the op in a nutshell really and i shall post up more of my recovery as i go along

gcwebbyuk · June 2009

Great to hear your op went well - and hope the recovery goes well for you.

My neck took a turn for the worse this morning, couldnt straighten my head without severe pain - phoned NHS direct and have been prescribed more diazepam (2x2mg 3 times a day for 4 days).

Am about to go to bed now - but concerned it won't be a very good nights sleep as every time I move it 'kin hurts!

Will be interested to see how you recover - timescales etc.

kellog · June 2009

gcwebbyuk take Tom Bartons advice and moan like hell to get you through the system

I know exactly how you felt when you couldn't move your neck due to the pain as that is how i woke up and my problems began.

You must be in agony so try camping on the hospital doorstep to get through - if you cant camp have you tried A and E to see if they will give you an emergency MRI

good luck mate

Jim (aka kellog)

andytheflyer · June 2009

Hi Kellog,

Glad to hear you seem to be on the way back up. Found the posts interesting as I have exactly the same problem, buit the surgeon gave me such a fright about 5 years ago (when I was 50) in telling me the risks that when my turn came for the op I declined. Surgeon advised that it might go away as I got older and the discs naturally shrank, but that it might come back. Shoulder pains, right arm feeble, numb fingers etc..

That's exactly what's happened, so tomorrow it's off to a local private hospital where I work in Turkey - I can get an MRI scan at 36 hrs notice for £100. Take the MRI scan back to the UK and get back in the queue.....I was told if the problem came back they would get me back in the system pronto.

But, to hopefully reassure you, I also had the same problem at the other end of my spine, and a couple of years ago got a private MRI scan when I could no longer stand the pain in legs, groin etc, went home, into A&E, saw surgeon and 3 months later had 3 level lumbar decompression. 2 days later walked 2 miles, and soon after was right as rain. Now biking about 150k a week, no leg pains at all and never felt better in my life. I suspect you will soon be the same. If you recover like I did, you'll be back on a bike in a week or two.

To anyone else going through this nightmare, the trick is to get the MRI scan - that takes months on the NHS, but if you can afford it a bit of health tourism can get you that scan at reasonable cost, and then you have the evidence in your hand. Your MRI scan looked just like mine. The source of the problem is very obvious, even to a GP.

Other posts have made the point that you need to get the NHS to take you seriously - I had to kick up a fuss, produce the MRI scans (and mention that my wife is a doctor - she told me how to to make the system work for you, rather than the other war around). With some peristence and a bit of waiting I was fixed 6 months after no longer being able to walk.

So Kellog, well done, you've done the first hard bit, the next one is geting fit again on that bike! But I suspect you'll enjoy that!

All the best. Andy[/b]

Cervical Discectomy

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