Monday, March 31, 2008

Surgery or no?

I'm fine, just stressed out about whether to have surgery or not. I thought this was settled. The neurologist cleared me for surgery, and I would have called to schedule it this afternoon except...she stressed me out about having surgery and urged second opinions, as my primary care physician did, even though he said he was really concerned about the neck issues last fall, when I was still saying, "so what?"

I spent most of the afternoon feeling waffly and neurotic and finally emailed family and close friends the news. One friend brought me back closer to center by responding with anger to the neurologist: "Who referred you to this surgeon? You didn't just pick him out of a hat, did you? For someone who has seen so many doctors and who has such clear and imperative symptoms, I don't quite understand shopping around for other opinions. I do think yes, ask this doctor why the fusion rather than the other [the Prestige disc] and how about with osteoporosis; those are significant questions." A nurse who knows me well (from another practice) also emailed back and said that the people in her practice think of Dr. Wunderkind very highly, which alleviated the concern that maybe something has gone terribly wrong with recent surgeries. My mother gave a nice contradictory opinion, that I should still go with my gut instinct (surgery by Wunderkind), immediately followed by a sentence about getting a second opinion since other doctors suggested that.

The neurologist said she couldn't see having surgery done, but she didn't put up the right MRI film, the one that shows the spinal cord compression on the left side, not where it looks not so bad in the middle. And she couldn't determine whether one cross section was cervical or lumbar. I had to go grab the other films and said, "How 'bout look at the times stamped on the film" (all the lumbar was done first). She didn't look at all the brain films either. Then she read the radiology report and noted that the radiologist noticed spinal compression and stenosis, but didn't revise her opinion. It's a little scary to think this may be what goes on behind closed doors in medicine. She said it was nice to have a patient who has a medical background. I think it would be nice to have doctors with medical background. Or who can at least read an MRI film. We'll revisit some of the other issues in a few months and maybe do extensive testing for the word and memory issues, which would mean visiting specialist number I-don't-know-what. But as far as the spine issues, let's see how she'd do with this pain level for months on end. She asked what I hoped surgery would do. Umm, help with the pain. Restore function. I wasn't showing Hoffman's sign this morning and didn't have much weakness this morning. Tonight's a different story, trouble with hand again.

Maybe there was just a disconnect since she suggested PT. Umm, I've done that. Maybe she thinks this is recent and I'm jumping to surgery rather than realizing I drag my feet about doing anything interventionist.

The neurologist thinks most of the neurology problems may be due to the extensive job stress and other major life stresses I won't write about here (the spine doctor didn't ask about specifics, though I said stress probably caused it). I told her I was thinking about quitting my job. She said don't quit, that she was in the third year of medical school when she was my age and I'm young and working is good for me. But if I fold up and die inside because of part-time work, it's really not worth it. And the anti-disability environment is terrible.

My friend who had successful spine surgery a few years ago called this afternoon and I jumped her for information and support, both of which she gave. I remembered the herniations above and below C5-C6 are new; she said this is a normal progression and happened to her and others. Waiting for surgery may turn it into a 3-level fusion. Not nearly so much fun. We discussed the anti-disability environment and specific problems she has had that are very similar. Strength in numbers, or at least misery loves company.

I still feel weird I haven't seen the radiology reports for the brain. I've noticed almost all imaging reports carry some odd anomaly that is minor but that would worry a lot of people. I've learned to stop worrying about that so much after several scares where the radiologist was convinced I had ovarian cancer or whatever. If you have imaging done, random anomalies will be found and investigated.

What if I'm allergic to titanium?

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