My c-spine acting up again... (discography results)

[mmglobal]

Well, I got the answers I needed, but they are not the answers I wanted. Maybe they were.. maybe not. I've been trying to get this discogram done for a couple of years now... but I'm always too busy or Bertagnoli's out of town towards the end of the trip, or I can't consider having a discogram done the day before I have to fly home. It's done now.

C5-6-7 both look severely collapsed w/big osteophytes. C3-4 clearly has a significant bulge, but it's unclear how it it's involved in my symptoms. Remember that this is not about discovering about bad discs as we already know that... it's about discovering if there is a very positive relationship between the discs that seem bad and my symptoms. The symptoms we are not sure about are the neuro symptoms on the side of my face. There is no dermatome from my bad discs and that area. Some doctors pooh-pooh the idea that a symptom pattern that doesn't match a dermatome could be in play. Others have seen too many unexplainable situations to simply write it off as impossible. (Note that before I told Baumbach about C3-4, he told me that my known bad C5-6-7 are mostly not involved in this symptoms... probably higher up.)

Bertagnoli did C3-4 first. As soon as he attempted to pressuize the disc, he noted that he was unable to generate significant pressure as the dye immediately extravasated into the canal area. "Just like on Tuesday" (Some of you will have read my post in another thread about the surgery a few days ago.) With higher volume injection, he generated 7/10 pain in my shoulder. More importantly, it also generated a warm tingly feeling over the entire left side of my face in the same pattern that I usually experience. The rest of the day, that has been more active than usual.

He then moved to C5-6. He was better able to generate pressure, but the disc is pretty severely broken down... there was no question about it needing ADR.... only if it is involved in my symptoms. He clearly generated 8/10 without too much pressure, but the pain was only similar to my pain. I could not really call in concordant.

I suggested that we already knew that C6-7 was completely compromised... No need to test it. Bertagnoli agreed. Upon further consideration, while I did not want another needle in my neck, I was not comfortable with the non-concordant response at C5-6, so I asked him to continue. 9/10 concordant pain at C6-7.

Bertagnoli had to leave, so we did not get to debrief the results. I don't expect any surprises, but I look forward to the lengthy discussion we'll have tomorrow. What I know for sure is that if I'm considering cervical ADR, I'm clearly a 3-level procedure. These three discs have looked like this for some time and will not get undegenerated with time. I'm glad to get confirmation that my neuro symptoms in the L side of my face are related to C3-4. My interscapular pain is likely related to C6-7. However, I am still very high functioning to consider 3-level ADR. I cannot consider surgery before the GPN conference in May, in Miami. So, now I know. I'll let this cook for the next few months and if things don't improve substantially, I'll probably have 3-level Cervical to go with my 2-level Lumbar ADR.

While cervical discography without any sedation was quite painful, I've been functioning pretty well since then. It's 9:30pm and the procedure ended about 3pm. I've been to the hospital to visit my client (she's doing quite well.) I had dinner in my room, but went out later for coffee and dessert with a friend and have been working for the last few hours back in my room. I'm still a little sore and a little nauseous, but I've only had some Tylenol and ibuprofen. (I don't even carry a vicoden any longer.... probably should.)

I hope that the blow by blow report helps someone to understand the process better.

All the best,

Mark

[dshobbies]

Mark,

That which doesn't kill us only makes us stronger and in your case, you only continue to get better at what you do. I'm so sorry that you are experiencing cervical disc degeneration with the subsequent pain and further surgery but your reward, if one there be, will be an empathy for others that has no parallel.

On another note, and I know I've posted this before, is that though a discogram without anesthesia is painful and for me, a huge deterrent in going to Germany, it isn't as bad as it sounds. Yes, you may experience a level 10 pain but the duration of this pain is so short that before you can even say 'ouch' or some other expletive, the pain is over. I realize this post is about Mark but it was posts like his explanation of his discogram that caused such a fear in me over this test, I was willing to compromise my best interests just to avoid it. For any in this situation, it's really not as bad as it sounds. I would not hesitate to go through it again.

Mark, I hope your pain and discomfort continues to allow your usual high functioning. Please take care and take it easy!

Dale

[JeffreyD]

Mark,
Please know that Pauline and I are praying that you receive a spot-on, accurate diagnosis that will lead to catching the correct pain generator(s).

Don't forget to have an Augustiner Green Label for me (just one, now....).

God Bless,
Jeff

[Jim M2]

Mark,
Fascinating how we're all wired a little differently. I'm referring to the facial symptoms from the C3-4 disco. No mention of C4-5, was it negative? Yes, your blow by blow reports helps me understand the process. I'm following in your and Doreen's footsteps with the cervical problems. Whaaaa! Misery loves company!

Jim

[ans]

Definitely not what you wanted to hear. So sorry about this Mark.

Allan

[mmglobal]

Debriefed discogram w/Bertagnoli today. Severe degeneration at all 3 levels... disc in the middle looks ok, but it is getting abused by poor kinematics of surrounding bodies. No question that when I do surgery, all 3 will need to be done. Still a 'quality of life' decision. I can't consider surgery until after my May conference. If things stay as they are now... I'm ready to go.

All the best,

Mark

[ellecincos1]

Mark,

I'm so sorry that there's three discs with problems you must be very disappointed. Luckly you have a docter that could make you as good as new if you decide on surgery. Make sure you tell Dr. B that you want to be the next Bionic Man!!! Seriously, I hope the pain and problems all subside because you deserve it.

Myriam