Acute cervical spondylosis

[rencei]

I’m a 35 yr. old female who has been on a roller coaster ride seeking a diagnosis and treatment of my symptoms. My symptoms began in Dec. 2004 and diagnosed as paresthesia due to a pinched ulnar nerve. By my first appt. with a neurologist in mid-Jan. my whole left hand became numb on a constant basis. After an EMG and NCV, the results showed early carpal tunnel. By the end of Feb. My left and right hand and arm became numb, weak and painful on a constant basis. My neurologist began to think it might be MS or transverse myelitis. I had a series of MRI’s, a Lumbar puncture, SSEP’s, VEP’s, and BSAEP’s. All of these results came back normal. Since the end of April my feet and legs have become weak, heavy, numb, and at times have sharp pains. My D.T.R.s show hyperreflexia bilaterally quads and bilaterally A.T. and equivocal Babinski signs bilaterally. My ability to walk has become compromised. And at times I am unable to move my legs and arms much at all. I finally had a neurosurgery consult after a visit to the E.R on May 3. I was told that my diagnosis is cervical spondylosis. I have been waiting to have the cervical fusion. My symptoms continue to get worse and I’m told that I have to wait until the end of July to have this surgery scheduled. I notice that when I put stress on my neck when I try to perform daily activities such as driving, cleaning, and computer and yard work, my neck aches, I develop a severe headache, and aggravate my other symptoms. I recently started to fall due to my legs buckling under me. The neurosurgeon has not given me any guidelines on what I should or should not do until the surgery. My fear is that permanent damage might be done. I have stopped all of my regular activities and feel like a prisoner in my home. I have called every neurosurgeon in the city of Jacksonville, Fl and noone is able to help me. Do you have any suggestions and advice to give me? Thank you.

[CCF-Neuro-M.D.-PW]

While your hand symptoms may be contributed to by carpal tunnel, your other symptoms would suggest a myelopathy (or spinal cord lesion), of which one of the most common cause is cervical spondylosis (usually from wear and tear of the cervical vertebrae and discs)

The EMG and NCS will not show a myelopathy other than reduced activation of motor muscle fibers and carpal tunnel is a common incidental but inconnected finding.

Its not clear to me if the spondylosis was diagnosed by MRI, I presume it was. I cannot comment on the severity of the spondylosis and as to how much the spinal cord is pinched  without seeing your MRI, so my advice as far as reccomendations for surgery is limited. Wearing a soft neck collar at night or at other times if it benefits your symptoms can help prevent worsening and be more comfortable for you. There are no specific reccomendation other than avoiding excessive physical activity and neck stretching such as roller coaster rides or painting the ceiling. Physical therapy can be beneficial - it is important to keep conditioned and flexible as possible in your limbs until a surgical procedure can be done. Surgery will prevent the problems getting worse, but it may not reverse what is already there - that is up to the body to heal itself over time

If no abnormal signal within the spinal cord was present, that is a good sign that nerve damage has not occurred too severely.

GOod luck

[ltpainsuf4rrrr]

Hey, I just posted a question right after you on this forum and I to live in Jax. I am not a doctor, but I’m in year 14 of living with pain. Since you obviously are concerned about your situation, why don’t you get a second opinion from a large academic center. We are fortunate to have 2 in this area, the Mayo Clinic here in Jax and just an hour away University of Florida, Shands Hospital in Gainesville. Just Google “Shands Hospital Gainesville” it will take you to their site. I’ve been to both and they are excellent facilities. You mention your neck aches when you put stress on it, have you tried a neck collar? It’s one of those things you see folks wearing around their neck, it is wrapped around and attached with velcro. I’ve had neck problems for years on and off and that collar has given me much relief. I only use when I am experiencing pain, not at other times. It’s not the answer to you medical woes, but it may be a tool that can help. You can buy at WalMart, Walgreens, CVS, etc. costs about $10.

I’ve been to hell and back for 14 years and the one thing I have learned is “never” give up. Keep pushing your docs for answers and if you don’t feel you are getting the right ones, find another doctor. My family doctor of 24 years told me 14 years ago “you are the chairman of the board of your health, you need to be involved in your health decisions and find the right doctors to help you.” How true his words were and are and fortunately I today consider him the CEO of my health. Having a great family doctor in my opinion is one of the best things you can do for you. If he is good, he will help you navigate your way through the medical community which in itself can be overwhelming.

Best of luck to you.

[rencei]

Thank you for your comment and suggestions. I have submitted all of my info for a consultation at Shands Gainesville. Hopefully they will accept me as a patient and can help me soon. I have received 3 different opinions, all of them suggest surgery. The problem I am facing is the lack of surgeon's who accept my insurance. Shands, here in Jax, has given me an appt. in late July and I fear that the longer I wait the chance of permanent damage will be greater. I purchased a collar this morning and plan on wearing it as needed as you suggested. I agree with you about being in control of my health decisions. I wish you the best of luck and pray that your pain goes away.

[sdegraff]

If you are worried about the delay in time Mayo clinics have a walk in policy. You can call and see what the average wait time is at the present time. The first day they triage you and get your details and then you show up everyday until they call your name. Usually any where between 3 to 10 days depending on the current number showing up. Call ahead and see what the average wait time is.

[ltpainsuf4rrrr]

Shands Hospital Gainesville is a teaching hospital and is tax supported. I believe they will see anyone wanting to come there, it is a very busy place. Since they are a teaching hospital, they tend to be up to date on the latest medical technologies. Before you go there, gather up all your medical records pertaining to this incident, including the films and results of all your tests. Their radiology dept will review your films and give their opinion of them on the first visit. I also believe if Shands Jax is accepting your insurance, Shands Gainesville will also as they are the same ownership. It is sad as patients we must continually have to deal with these insurance issues.... You don’t even want to get me going down that road. I firmly believe insurance should cover you anywhere you want to get medical help. There was a time that is was that way and it wasn’t too long ago. I think you are going to make a good “chairman.”  :-) Good luck

[eflow1027]

Hi, I to have been having problems again with my neck. I now live in Jacksonville, Fl. My first neuro doctor in Spring Hill Fl. told me to go to Shands in Gainesville. He said that they would take my insurance and they were the best(Dr. Jacob) is one of the best for the neck? Maybe your local Dr. can fax all the info. to Shands and get you in faster? back in 1998 I had surgery on c6&7(herniation)all was well only alittle tingling down my right arm from time to time no real pain, until about 1 month ago. this time the pain is all on my left shoulder,arm & my 2nd two fingers are numb on my left hand,I had an MRI no dye done very quick this time, report states broad based centeral herniation at 6-7 again with impinging spinal cord.? I have my 1st appt. with Shands G-Ville on June 10... I'm very fearful this second time around, the 1st surgery was done in the back and healed very fast. I am told that if done again it might have to be done through the front and alot different type of surgery.. I am only 39 yrs. old ...I sure hope that it is just scar tissue in the same area.?                                                          Thanks for letting me vent any info. would be great...       Good Luck to all of you, Please keep trying to get into Shands or Mayo? My Dr. said that Mayo was good but alot of young Dr.'s bye for now...

[rencei]

I found out today that Shands Gainesville will not accept me as a patient because they do not accept my insurance. I have called all of my doctors and my insurance company and everyone has told me the same thing...I have to wait until Shands here in Jax can perform the surgery. I cannot understand why my need for care is being treated as a well care check-up. I'm not excited about a 6 hour surgery nor the risks involved. What happened to helping people? As far as Mayo, I'll give them a call but I feel more confident in Shands. Maybe it's the gator in me...LOL

I do plan on seeing if there is any legal recourse and determined to make some noise and to be heard. Good luck to all of you.

[ltpainsuf4rrrr]

Sure sorry to hear about the insurance situation at Gainesville, frustration comes to mind. One would think if Jax accepted A, B and C insurance, so would Gainesville. I went to Gainesville during the years of 1992 through 1996 and the biggest complaint by most - the system was bogged down because they would accept everyone, including the uninsured, but you still could get to see a doctor within a reasonable amount of time. So now, you have insurance they don't accept, yet they will accept certain insurance and all of the uninsured, Hmmmmmm. I guess it is just a sign of the times, but to me it is hard to really understand that those with no insurance get treatment and those with certain insurance don’t get treatment. I am a true believer everyone is entitled to quality health insurance. In this case, no insurance is better than some kinds of insurance.....  In 2002, I was seen by a surgeon on June 3rd here in Jax. He wanted me to have additional tests and planned surgery for the last of June or early July. However the next day (June 4th), I was in extreme pain and rushed to the hospital. The ER doctor contacted my surgeon, they admitted me, did the tests on June 5th and the surgery on June 6th. The nurses at the hospital explained my original surgery was considered “elective” surgery. Since I was admitted through the ER it is considered emergency surgery and things happen much quicker because of this. The very same surgery, different guidelines. Go figure, this wasn’t a face lift, but rather abdominal surgery and I certainly didn’t consider it “elective.” So, if your situation progresses and you find yourself in the ER one day soon, you may very well find your surgery will happen in days, not months. Keep in mind, it doesn’t just happen if you make it to the ER, the docs have to really see it in your face, hear it in your voice and know at that very moment you are suffering or are in unbearable pain. So, if your condition finds you in the ER, don’t hold back, just let it all out!  Back then I didn’t know there was a difference between elective and emergency, today I do and to someone in pain and or suffering, it can be a lifesaver.

Yes, I understand your concern about the surgery and the risks, but also try to think about the positive.... A successful surgery will give you back your life and the pain and suffering will be just a memory. Again, sorry for your suffering and believe me it is coming from a guy who realizes the true meaning of the word. -Good luck