Saturday, September 5, 2009

The Unkindest cut of all

Went to the doctor yesterday to review the "options" for my neck. Ginny went with me as usual to provide adult supervision. It started out poorly when the doctor said "I have the results of your electrical conduction tests and I've highlighted in yellow the abnormal or poor results". Two thirds of the page was highlighted in yellow. I immediately suspected that this wasn't going to be a cheerful conversation. I was right. So after reviewing the results, I said, I assume this is a buildup to telling me that I can't have minimally invasive surgery and he said "that is not an option". Well it turns out there were no options except to have fusion of the vertebrae.

I told the doctor that I would like to discuss some of the risks of the operation and Ginny volunteered that I was afraid of paralysis (which is true but I'm not sure I would have lead with that question). The doc said that if I was concerned with paralysis, then I should have the operation because there is a greater chance of being paralyzed from not doing anything and letting the spinal cord continue to be damaged. He took us through the MRI photos again and pointed out how there were compromised nerve roots going to the arms (hence the arm numbness and burning sensation in the hands), a few vertebrae out of alignment and pressing in on the spinal cord causing the nerve signals to be delayed (hence the high pain threshold that I have suffered/benefited from), and peripheral nerve damage which causes a lack of feeling altogether in some instances (maybe that is how I gave myself a third degree burn a few years back).

So I asked the important question "doc, will I be taller and more handsome, when the operation is over?" he responded that I was a pretty handsome guy already.....I took that as a "no" on being taller.

So the operation for those of you keeping score at home involves taking out the disc material between the c4-c5, c5-c6, and c6-c7 vertebrae, putting in bone shims between those four vertebrae, putting in a plate (not fine china) and attaching the plate to the c4, c5, c6, and c7 vertebrae making it effectively one bone. At the same time he would fix the backward angle of my neck which is part of what is impinging on the spinal cord.

I asked if I had to be totally anesthetized for this and he just rolled his eyes and said three or four different ways, yes you have to be totally out. Why would you even want to be awake. I tried to explain that I would like to make sure they don't screw up and remove a leg or something but I could tell that wasn't going to make points with the guy who would have a knife at my neck in the very near future. I dropped that line of discussion.

The doctor said it would be a 4+ hour operation and that I would be out of commission for "a minimum of three weeks" which was a mild surprise because I was afraid it would be much longer. He said he was back at work 2 weeks after having a similar operation and I said "I'm a pretty tough guy, I will try to come back in less than 2 weeks". He said he would be keeping a close eye on me to make sure I don't screw something up.

He asked when I wanted to go under the knife and I said what do you have open? I was appalled when he said the 25th.....of this month. I reacted poorly saying that I had to check on my disability insurance and all that. How about January I replied, he said in an ominous tone " you should have this done sooner rather than later if you don't want to do further permanent damage. You have to hand it to him, he doesn't sugar coat things.

I left the office with a little tear in my eye, I'm tough but mostly in the abstract. You can take off my leg, remove my foot, or even replace my knee while I am awake, but put me to sleep and mess with my spine????? I'm not that tough.

I will finalize the operation date on Tuesday or Wednesday next week, I'll keep you updated.

the John

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