The good news is, I won't be having surgery on my neck any time soon. But that's about all there is. (This is the first half of the write up, and went on for far longer than I expected. If you want to skip ahead, I highlighted the diagnosis and prognosis.)
We left yesterday morning at 8 a.m.; grabbed some noms at McDonald's, took a quick tech support call from the hotel, and hit the road. What I thought would take us 4 hours took 2.5. I'm bad at judging those things, apparently.
We're not hungry yet, so we go to Wal-Mart, where I pick up a few things (Like a frame for my new poster
for pointing me its way!), look at the games, and then drive across the highway to Staples to get some drafting vellum. Yeah, they don't got that. They do have a lot of other fun looking things, but I resisted buying anything. Sadly, I realized that already in my life I have built up a collection of art supplies and tools worth hundreds of dollars and then given it all away not once, but twice. This time around, I only try to buy the things I need
, instead of want
Which is why today when I went to the local mom & pop office supply store to buy some drafting vellum off the shelf, I ended up spending $50 on pens and ink and neato erasers ... :D
Back to my story.
We left Staples and went to the mall, across from Wal-Mart ... so, back across the highway once again. The place was practically empty, a few patrons milling around the bored attendants at the remaining stores that were'nt boarded up. We got some frozen lemonade, and still had some time to kill, so we drove back across the highway to Target. Pick up a few things there that I thought about after leaving Wal-Mart, and then decided to hit the road and find the doctor's office.
My appointment was scheduled at 1 p.m.; they had asked that I arrive 30 minutes early, and it was now noon. I figured that gave us time to get lost a few times, even though I had printed out directions from Google Maps.
We nearly missed the exit, but Andy spotted it while I was thinking it was still some miles off. We then followed the numerous quick turns Google maps had us take, reched the end of the directions ... which was also the end of the road; no doctor's office in sight. And no street numbers matching what we needed.
We circled the block, and I dug out the map that I remembered was included with the packet of preliminary paper work I had been sent to fill out. Google had failed to take into consideration that a major hospital and medical school existed between where we needed to be and where Google left us. Our destination was on the other side; we navigated around the boundry of the hospital campus, found a parking space where the new directions told us we should be, parked and started looking around. Found the building, found the suite, and checked in at 12:20.
And then found out that because I had already done all my paperwork, I didn't really need to be there early. We sat in waiting room for 45 minutes, left with a choice of reading material that was either American Hunter or Martha Stewert Living- but at least there was plenty of the magazines. At 1:05, I was finally called back, and the fun began.
I got my vitals taken; every thing was fine. The woman doing them was having some trouble with the blood pressure cuff, so I told her the story of how one overinflated and exploded off my arm once. I'm sure it made her feel better, even though she became more clumsy than before.
The physician's assistant came in, and began reviewing my notes, asking my symptoms, looked at me knwoingly, nodded his head, and told me it was most likely carpal tunnel syndrome.
I did take some satisfaction in telling him that this is what was thought a year ago, but that the surgery on both my hands didn't help any. He frowned, looked puzzled, and began reading through more of my paperwork. He jumped up and loaded up my MRIs on the computer, looked through them quickly, grumbled a lot when he found that the one he really wanted to look at had noise distortion, and then started asking me a lot of questions, did some strength tests on my hands, some basic nerve response tests, and then sat back and looked at me for a moment before he started to talk.
He talked fast, and gave me a lot of info, and to be honest I didn't have any more questions at the time, but I also can't remember word-for-word everything he said to me. I've seen meth addicts sit still longer than this man did. I liked him; he seemed brilliant; but somebody gave him more sugar than he should have had.So, basically it turns out that I have the neck of someone 20 years older than me. He gave it a name, which included the word Degenerative. The disks between my vertebrae are breaking down and slowly collapsing, squeezing out and compressing nerves. He said that I was an oddly complex case, because I was asymptomatic; none of my symptoms matched up correctly to what he was seeing in the MRIs and from the tests; the pain in my arms should be starting in my neck and working down, instead of starting in my fingers years ago and working UP. And he was totally bewildered at my complete lack of neck pain. He showed me a cross-section of my neck, length wise, and pointed out where the worst problem was occuring, but also showed where every other area in my neck was also being affected. He pointed out my spinal cord; in a normal neck, it would be perfectly smooth. Mine was dented at each intersection of vertebrae, with one disturbingly deep dent in the most problematic area- which leads, finally, to the explanation of why I won't be having surgery soon.
When vertebrae are fused together and can no longer move as they should, this places additional stress on the other vertebrae as they try to compensate. Because of the overall condition of my neck, he feels strongly that fusing one set of vertebrae would cause a cascade of failures throughout the rest in as little as three months, leading eventually to my entire neck needing to be fused together.
Not really something I want to deal with in my early 40s. He explained to me that this was not the result of anything in my lifestyle; I wasn't sleeping wrong or sitting with bad posture, it was just genetics. While neither of my parents have this, they could easily both carry a recessive gene that I happened to luckily inherit.
So with surgery not an option, he explained what was possible. Primarily, he feels the goal is to keep me going for another 10 years, in hopes that technology will catch up and I can get bionics. Or something. What can be done is treating the symptoms. Unfortunately, it seems that nothing can stop the progressing damage, and it's very likely that what has been done is irreversible. However, as he pointed out, surgery can NOT be undone, and considering the probable eventual outcome ... anyway, he suggested two immediate treatments. He gave me a prescription for Neruotin, a drug used primarily to treat seizures by helping nerves to work better; even though I don't have seizures, he hopes it will help the nerves. I'll start at 300 mgs nightly, and then work up over a few days until I reach 1200 mgs a day or I start seeing some improvement, whichever comes first.
He also wanted to try injecting steroids and a numbing agent directly into the area where the bundle of nerves beig most affected left the spine, as a diagnostic measure to make sure that the right area and condition was being treated, as well as hopefully providing some relief if this turned out to be so. Unfortunately, that was something that had to be done as an outpatient at the campus hospital, because it was done using a live x-ray, which my local hospital is not capable of doing. While I was mulling over the prospect of yet another 150 mile drive, he got a pensive look on his face, and stepped out to have a word with his secretary.
When he came back in, he hesitantly mentioned another possibility, surgical in nature. While the fusion surgery involved entry through the front of the neck by the throat, there was another surgery that would go through the back of the neck, expose the tunnel through the spinal column where the nerve bundles left the spinal cord, and then grind away the surrounding bone to give the nerve bundle more space to expand and breathe, so to speak. As I was processing that, his secretary stepped in and said that the steroid injection could be done but I needed to go NOW
This led to a blur of activity as I was processed through the remainder of my visit, my payment processed, my surgical orders prepared and faxed, and roughly 3 minutes later seemingly, I ws being escorted out the door and given walking directions to the hospital admissions.
For now, it's way past my bedtime, and this is taking longer than I expected. Tomorrow I'll write about nurses and graham crackers; kindly, wizened old ladies in pink vests; not having my uterus removed; needles to the neck and what results they brought.