10/7/2009 - Starting out

I'm starting this blog in the hopes that someone else might benefit from my experience. As I've searched for information on degenerative disc disease all I have found are dr.'s and other stuff, nothing from people.

First, a little background. In early spring 2008 I started having neck pain, I've been told that I've complained about it for longer than that, but spring 2008 is when I really remember it starting. I went that summer taking constant Ibuprofin, around 800mg at a time and it helped somewhat. By August 2008 it hit the point where it was starting to impact everything. So, I went to my "primary care" physican. He said it was probably me sleeping wrong, perhaps a new pillow would help. So, I went home, tried various things and nothing helped. My wife was lathering Tiger Balm on my neck every day and I was still taking Ibuprofin all the time.

In either September or October 2008 the pain was so bad my heart rate was elevated and I couldn't sleep so I took myself to the ER one night. They thought I had Meningitis and wanted to take a spinal tap, other than that option, they had no idea what was wrong. I refused the spinal tap since I had ONLY ONE of the symptoms of Meningitis (the neck pain) and left.

I went back to my doctor again and explained that it can't be "something from sleeping" as it's been going on for months. He prescribed a muscle relaxer, Norflex, and a steroid, Medrol Dose Pack, and sent me on my way. That helped a little, although the script was for a week's worth. After I stopped taking those the pain immediately returned. So, I called the doctor office and was told "he's not going to prescribe any more, it's strong medication". So, I went back to the Ibuprofin and suffered.

Now, at this same time I had a sinus infection which I didn't know if that was causing the neck pain. I was sent to an ENT who said the infection wasn't that bad and they don't cause neck pain. She said perhaps I have a problem with one of the disc's and should have it looked at. I called the night time number for the doctor and got someone *other* than mine. He said the sinus infection couldn't cause the neck pain and after me explaining what was gong on, he said I probably have something else going on.

The next day I made an appointment with that doctor since he seems more helpful. This was around Christmas 2008 and he prescribed the same muscle relaxer and some Vicodin. I have relief finally over Christmas but after I stopped taking those, the pain came back.

In January 2009 I went to see this second doctor again who I asked to write an order for an X-Ray. He agreed that it was warranted since the pain had been around for a while. I made the X-Ray appointment and had that done. When I followed up with the doctor about the results, he said there were signs of degenerative disc disease and ordered an MRI. By that time is was February and I had the MRI done. Same results, degenerative disc disease at which point he referred my to a neural surgeon. Dr Salehi. Finally, some progress!

So, my wife and I go off to the neural surgeon. He says it's bad enough that what he would do is a cervical disc fusion but to try non surgical options first. He referred me to the Midwest Academy of Pain and Spine, Dr. Elborno. I made an appointment with him and that's where those treatments started.

Dr. Elborno immediately started me on Norco, Elevil and Neurontin and I started getting some relief. I had 3 cervical epidurals done from February 2009 to early May 2009, none of which helped more than a few days. Oh, I forgot to mention that for the past several years I have suffered from "pins and needles" in my left hand, I had always assumed it's because I work on computers all day for a living and it was the start of carpal tunnel. What I didn't know what it's called "neuropathy" and is common with disc problems where the nerves in the neck are getting pinched.

In late May 2009 Dr. Elborno performed a cervical "Radio Frequency" (RF) procedure on my neck and after a week I was off the pain killers. I got maybe 4-6 weeks of relief from this, at least enough to take the pain down to a sort of manageable level. But by July the pain had returned. So, I went back to Dr. Elborno, he put me back on medication and performed 2 more cervical epidurals in July and August, neither of which helped. Dr. Elborno wrote an order for another MRI in August, which was 6 months after the first one, to see if anything had changed. I should note that I had a follow-up visit with my primary care physician after the second MRI and he basically said nothing has changed. My visit with Dr. Elborno regarding the second MRI had different results. He said it's slightly worse and that "he doesn't like my disc"... Funny doc, neither do I.

In August or September 2009 he put me on 10mg of Opana ER twice a day, Norco for the "break through" pain and Elavil and Flexeril later in the day and at night. By that point the Norco by itself was really just touching the pain and it only lasted a couple hours. The Opana was supposed to give more extended relief. So, I tried that up until late September when the pain increased exponentially. I went to see him and was changed from the Opana to Oxycontin and Norco, again for the "break through" pain. I'm still taking the Flexeril and Elavil at night which helps me sleep, well, most of the time.

So, now we're up to today. I have a cervical discography scheduled for tomorrow, October 8th 2009, and from what I understand this is going to "map out" where the source of the pain is. MRI's aren't detailed in what they can see but give a good general idea. The discography is performed under "waking sedation" and essentially he's going to stick a needle in the spine and see where I yell OUCH. When he finds those spots he will inject a dye into the area and use the fluoroscope to take detailed images of that area. I can then take the results of this to the neural surgeon, Dr. Salehi, who I have an appointment with next week (Tuesday, October 13th, 2009).

I've read mixed opinions on the discography, people that have had it done say it's painful, other doctors say it isn't. I'll post my experience here after it's done.

From my previous visit with the neural surgeon, and my conversations with Dr. Elborno, the only real option left is the cervical disc fusion (ACDF). The previous MRI's show one disc with "moderate to severe" protrusion, another one shows "moderate". So, one of the goals this week is to determine which one is causing the pain and if it's worth a multiple disc fusion while they have me opened up.

I have also read and been told differing information as to recovery time for the disc fusion. I'll have to go on short term disability (STD) at work for this, my question is how long we have to go with 80% of my paycheck. Of course, work also wants to know how long I'll be out, I guess I'll know more after the discography and follow-up with the neural surgeon.

More to come tomorrow after the procedure....