Question
QUESTION: Hello Dr.
I am waiting for a three level discectomy and fusion in my neck. It has been diagnosed very late and my symptoms are getting worse by the day. I have wasted shoulder muscles, weak arms, bladder and leg problems. I also have a herniated L5/S1 disc.
My question is what should I do whilst waiting for surgery? Should I continue normal life or rest all the time? The speed of deterioration is quite scary.
Also I don't know how I will cope with the neck surgery while I have so much pain in my lower back, is it possible to do the lower disc at the same time as the neck?
I live in England so things tend to be rather slow to get done.
Thank you
Linda

ANSWER: Linda,
 I am sorry that you are in so much pain and discomfort.  I would say if you can, try and live a normal life within the parameters of not creating increased pain.  If you rest all the time, more of your muscle groups will atrophy and become weak.  In regards to your neck, what are the millimeters of herniation in the three levels that are going to be fused.  You say you have weakness and wasted shoulder muscles, what are you doing to help that right now?  Are you stretching at all?  What position do you sleep in, because this can be one of the major irritants to both the upper and lower back.
 In regards to the lower back, the bladder issue is a little more serious because that means that the S1 nerve root is being impinged upon causing possibly your bladder issues.  Is most of your pain in the lower back or down your legs?  I know I am asking a lot of questions, but to give you the best feedback I need a little more information.

Thanks,

Martin

---------- FOLLOW-UP ----------

QUESTION: Thank you for your reply. Things have changed considerably since I sent my first message. The diagnosis was made by a neurosurgeon that I paid to see privately because for the past three years the NHS doctors I've seen have been telling me there's nothing wrong.
As I don't have the money to pay for the surgery to be done privately he notified my GP and I saw an orthopedic surgeon, I still had to pay to see him privately because there is about a four month wait to see anyone on the NHS. I don't know if he was having a bad day or his ego was hurt that I went to someone else first, or he didn't like it that I said the NHS had failed to see it, but he started by saying he could do it 'but' then he gave me a terrifying list of risks, starting with 'you could be paralysed' and ending with 'it might not work anyway'.
When I asked what would happen if I didn't get it done he said he didn't think it would do much harm, so I was left feeling that I was asking for a really dangerous procedure for something that was trivial.
I was stunned so I said could we leave it for now, he said good idea, come back in three months.
He also said nothing could be done for the lower disc because I had the one above removed about 7 years ago.
I have no intention of going back to see him even if he was the only surgeon in England!
I'm very confused and very scared, don't know which scares me more - having the operation or not having it.
We are not able to find out the success/failure rates of a surgeon, we take what we're given but if I have the surgery I will find the money to have the neuro do it.
So I don't think you can help me much, sorry I can't answer all your questions, I don't know what millimeters of herniation. I haven't been told to do anything about the wasted shoulder, I thought nothing would help until after the surgery. As for sleeping it is difficult to find a neck position that doesn't start off head pain, my lower back pain has lessened a bit, it's not terribly painful all the time now, just if I stand/walk or turn onto my front when I'm asleep.
Thanks for the advice not to rest, I was worried that by keeping going I would make it worse. If you have any input on what might happen if I don't have surgery, that would be good.
Thanks anyway
Linda

Answer
Linda,
 From the sounds of the surgeon, it sounds like he doesn't care much and would not be a great choice for you.  Since you don't have spondylothesis or any other major issue pressing on the spinal cord I would work on postural exercises, like strengthening your scapular muscles along with stretching your pec/chest muscles.  Even those these things may not completely alleviate the shoulder wasting away issue, they will definitely  help you recover from your potential surgery.  Have you tried icing the neck before going to bed to help you find a position that might be more comfortable?  I really wish you the best luck.


Martin