A DC's Journey to Neck Surgery
5 lessons from the road.
By Tracy Barnes, DC, DICCP, CKTI
It all started in a hotel room – at least that's where the pain became so intense that I had to do something. I felt as if I was being stabbed near my left medial scapular border. Since I was traveling I had none of my usual treatment tools. The TV remote control would have to do. It fit nicely into the space between my scapula and spine, and all was well until the pressure I applied sounded a loud crack in the plastic. Surely this was just a rhomboid trigger point.
Two days pass. Then I get adjusted: full spine with special focus on posterior ribs at T4-6. I receive a deep-tissue massage and cry in pain during most it. I can't find a comfortable position. My self-diagnosis changes from rhomboid trigger point to subluxation to anterior scalene trigger point.
The symptoms progress to deep, aching pain in my left shoulder and down my triceps. I watch multiple videos on alleviating anterior scalene pain and I stumble upon videos of radial, ulnar and median nerve glides. I do all of these because surely it'll go away. Lesson 1: Doctor, Do Not Diagnose Thyself.
I add traction because surely it's just a little cervical compression. I hang upside down up to five times a day and apply ice after. When this doesn't work, I buy an over-the-door cervical traction unit, but it creates a TMJ problem, so I switch to a floor unit. On the advice of a physical therapist, I modify my floor traction to include right lateral flexion with left arm traction enhanced by a stretchy band.
Two weeks after the onset, I'm working and lose feeling in my left thumb and first two fingers. I know I'm in trouble, but continue with my delusion that I can fix it. Lesson 2: Pain Messes With Your Brain.
One night I awaken with pain again and become convinced it must be a shoulder labrum tear. I make imaginary arrangements to see an orthopedic surgeon. By morning, the pain has moved again and I cancel those plans and go get plain neck films taken. They reveal nothing. So, I see another chiropractor and another massage therapist. And I get a session of craniosacral therapy.
When the temporary relief of these treatments wears off quickly, I decide it's time to see my MD, who hasn't seen me in years. He knows it's serious just because I'm sitting in his office.
He does an exam that reveals triceps weakness, decreased reflexes and left arm sensory loss. He suggests an MRI. I leave his office with prescriptions for an oral steroid and muscle relaxer. I fill them. Lesson 3: Careful Saying Never.
At this point, you might be thinking, You're a chiropractor; what are you doing? Please refer to the lessons above. In the midst of pain, the decisions we make are not always the ones we would rationally make. This is good for me to remember, as I soon return to treating people who are in pain. For myself, when faced with increasing pain, loss of function and possible detriment to my livelihood, I sought the help of two chiropractors, three massage therapists, two physical therapists, a craniosacral therapist and two reiki practitioners. I bought three cervical pillows, one cervical traction unit, topical pain patches, therapeutic tape, and multiple nutritional and homeopathic supplements.
About four weeks into the journey, I am taking my boyfriend to the airport when I lose it. The pain in my left arm hurts so bad that I feel like an elephant is crushing it and my forearm is being twisted by the hands of the Hulk. I haven't slept through the night without waking in pain in a month, and I haven't felt my full hand in weeks.
Instead of the airport, we drive to the ER, where I finally receive the MRI I need. (Due to a lengthy insurance precertification, the MRI my MD suggested still had not been scheduled.) The MRI reveals a significant disc protrusion at C6-7 with disc material in my left neural foramen. All my other discs look "pristine."
Rewind to some 23 years ago; to the summer before I started chiropractic school. I was in the middle of a two-day backpacking trip and had just resupplied our food stock. The food bags were hanging high above potential bear explorations. I accidentally walked under the heavy food bags as they fell some 15 feet and smashed into my lower cervical spine, sending me to the ground face first.
There I was, in the middle of Kings Canyon National Forest, with no treatment to be had save for rest and ice. Besides that, I was in my mid 20s; surely this would go away. Lesson 4: Your Body Can Remember Past Injuries.
Back to the present: I get adjusted again, receive another massage and return to my MD, whose usual light tone is now flat serious. He points out my increasing loss of function and warns that time is of the essence.
Grateful for friends who make a phone call, early the next morning I am in the office of one of the best neurosurgeons in town. Lesson 5: Having Resources Matters. I take a friend with me for an extra pair of ears.
The neurosurgeon studies my MRI, does a full neuro exam and lays out my options. He says his normal course of action includes four nonsurgical options: do nothing, see a good chiropractor, get therapy including exercise and traction, or get an injection. He notes that I have thoroughly done all these things except the epidural, which he says would only provide temporary relief.
Then he outlines out my surgical options. The first option involves an anterior approach with fusion and hardware. I turn ashen at hearing this and he quickly moves on to my second option. This includes the use of a Medtronic MetRx posterior approach system that has no fusion and no hardware, and allows him to dilate the surrounding tissues and insert a tool that removes the offending disc material. The biggest drawback to this option is the less than 10 percent possibility that the offending disc could grow back. I decide to take this option and schedule my surgery. Refer to Lesson 3.
It's at this point that I gather every duck I can find and put them in a row. I meet with a compounding pharmacist to understand the medications I am on, and add nutritional supplements to ease the stress of surgery and promote healing. Through friends (Refer to Lesson 5), I connect with the engineer who not only designed the tools to be used in my microdiscectomy surgery, but also had the procedure himself. He talks to me at length and explains every detail. On the recommendation of my PT, I begin triceps and forearm exercises to fire muscle efferents.
Two weeks post-op and I am no longer on pain meds; my muscle weakness is improving and I am on the mend. The lessons I have learned through this journey make me a better and more compassionate doctor. Being a patient is sometimes necessary for learning. Refer to All 5 Lessons Above.
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