The Law of Unintended Consequences (a rant of sorts)

[Bruce K]

So a week ago Friday I did my weight workout and then went to bed.

I woke up Saturday morning with my left arm numb and my ring and pinkie fingers useless.

I called the MD on Monday and starting taking Motrin, thinking I had pinched a nerve sleeping.

MD visit Wednesday and the Practioner decides we need an MRI of my C-sspine just to be sure I haven't done anything else.

The MRI was Monday. In the meantime, things are slowly getting better with the Motrin. Monday night I took the CD to a freind of mine who is a chiropractor just to get a read.

Yup, I pinched the C8 nerve between C7 and T1 vertebrae.

But wait, there's more. Apparently I have a herniated C4 disc, several other bulging discs, and a bone on bone at C6/C7.

I have never had any issues but this is scary. No one can tell my if it was several years of HS football, which of my ski racing accidents, or maybe my 2 major auto racing accidents (one end over end at about 120), or the last 8 years of cycling (and a couple of crashes with that) that caused any or all of these various issues but the general consensus is that the herniation needs a serious looking at by an expert.

I see a spine MD at the Sports Medicine Center tomorrow and am just hoping that the fleet won't be for sale anytime soon.

I think I would have been much happier not knowing.

In fact, I know it.

Keep your fingers crossed.

BK

[1centaur]

I will definitely be keeping my fingers crossed for you Bruce.

Make sure you seek multiple opinions - I think the Boston sports medicine scene is much better than the North Shore's - lots of Bruins/Patriots doctors in the city.

[gman]

Good luck Bruce. I hope it is something that can be fixed and your time off is minimal.

[Blue Jays]

Ouch.
Best wishes for great doctors and a full recovery. :beer:

[rounder]

Good luck Bruce.

[jel]

Sometimes it's just life. I'm 5 months out from cervical surgery, c5, 6 & 7. I'm not riding yet, but my Dr says he sees no reason why I cannot get back on the bike. If he'd only tell me when!!!

[avalonracing]

I don't know you Bruce but I wish you well with this.
You are in a part of the country that has some of the best doctors in the world so you should be able to get some top notch medical advice and treatment.
Even so, I am all about the second, and third opinions.

Back problems are serious, if left untreated the complications and pain can be the worst but I have seen friends do very well with treatment.

Keep us in the loop.

-Robb

[RPS]

Keep your fingers crossed.

BKDefinitely will, and good luck.
Rick

[Louis]

Bummer.

My thoughts: As long as things are improving on their own, avoid surgery - it should be the last option. In my experience many orthopedic-types are way too eager to resort to it.

Caveat: I'm not a doctor.

Best of luck.
Louis

[hansolo758]

Good luck with the appointment. I'll be joining you in a few months...not my neck, but my knee.

[BumbleBeeDave]

Bruce, I join everyone else in hoping fervently that the huge crowd of good doctors in the Boston area will be able to fix you up and make this into the minor problem it should be. Don't give up, buddy! The HED mafia needs you!

BBD

[gemship]

That's not good to hear but I will keep my fingers crossed and wish you well. Thanyou for extending the invite to the ECV riding club's meeting last month. I hope you don't take offense to me not getting back to you. I'm on the fence with riding with groups, it may have something to do with my upbringing.:rolleyes: Then again I haven't been working since Nov. and living on a ever stringent budget for far too long.

Again hope for the best.

[Ozz]

I was just fine until I went to the doc in January...now I have high blood pressure and Bell's Palsy..... ;)

[Gothard]

Monday night I took the CD to a freind of mine who is a chiropractor just to get a read.


When you have a leak in the roof, you call a plumber???
MRIs are made to be read by radiologists. I am generally fedup with having to correct false diagnoses made by people who have no right to read MRIs.


Rant off. I hope you'll get better. Well prescribed physical therapy does wonders.

[Climb01742]

bruce, i second 1centaur's thought. i know i great guy in woburn who treats bruins and celtics -- and coincidently is dealing with his own back issues right now, so he knows exactly -- both professionally and personally -- what you're going through. happy to give you his info if and when you'd like.

good luck and beware the knife! :beer:

[Bruce K]

George;

I went to the chiro to look at the pics because I didn't want to wait an extra day or two to find out what was really going on.

The call from the MD's office said exactly what he showed me and I got it from him in plain english.

It also helped me think about the direction I wanted all this to go.

Surgery is my LOWEST priority as I plan to explore any and all other options first.

We'll see where this goes this afternoon.

Thanks to everyone for the support.

BK

[Ray]

Surgery is my LOWEST priority as I plan to explore any and all other options first.

Good luck Bruce. I think the above is a good starting point. Don't be too easily talked into anything. I've had back issues my whole adult life. Mostly minor, but occasionally enough to keep me off my feet for a couple of days. I've done a lot of reading on back issues and have come to the conclusion that nobody really KNOWS what goes on back there. It seems like pretty much EVERYone has problems on a back x-ray or MRI by the time they're middle aged. All sorts of herinated disks, pinched nerves, curvature, you name it. But many if not most of us are never aware of having any problems and just go on about life as if we're fine. Finding out about problems back there seems to be the surest way to start feeling pain. We find out, we start stressing, and all of a sudden it's a real problem.

A few years ago, I had a real problem with my hip and lower back that was so painful it sent me to the ER in screaming agony. I've felt some pretty bad pain in my life (a couple of badly broken bones come to mind), but that one was as bad as anything I ever felt. And my right leg was totally numb from the knee down - no feeling. It took me a couple of months to come back from that. During that time, I talked to a surgeon who assured me that I needed surgery immediately, probably sooner. Because, of course, the MRI of my back showed a veritable chiropractic obstacle course. But enough people cautioned me to give it time. So I did. And I got more serious about my yoga routine and found a few more poses that tend to loosen up the areas of my back that tended to get tight. Never had surgery. Had a few chiropractic treatments and a month or so of PT. But I think time and a few days of painkillers and muscle relaxants got me through the initial trauma. And yoga took it from there. I've been fine since, better than I've been my whole adult life prior to that. And my back is still a disaster area if anyone looks at an x-ray of it.

My brother also had back problems and horrible x-rays. He got talked into surgery as a relatively young man. Didn't help a bit - still had terrible pain for years afterward - arguably made it worse. Later he discovered meditation and it pretty much took care of it. He's pretty tightly wound and he still has times where he works himself into a pretzel, but he's way better than he ever was when being treated aggressively for it. There are a million stories like that.

Not to say any of this will apply to you. You need to explore all options. I'd just say that skepticism is never a bad thing when it comes to back issues. There's science to it and you need to listen to the docs and get their opinions, but there's also a LOT of art to it so it pays to be skeptical.

Good luck,

-Ray

[William]

Hey Bruce,

I hope everything turns out well. I have back issues of my own from time to time and so far no one has been able to pin point it's origins. Go figure?


Wishing you all the best in the outcome.





William

[92degrees]

I blew out C5/6 and C6/7 five years ago. Doesn't take much...I was lifting a fairly light box of books. Get lots of opinions and surgery should be waaaay down the list of options. I never regained all of the feeling in a few fingers but it didn't keep me off the bike for very long.

[Len J]

Better to know and consider your options than find out when you are someplace away from home, in agony....IMO

Good luk Bruce.

len

[Gothard]

Surgery should only be considered when all else fails, or when there is imediate neurologic danger (i.e. irreversible damage due to local compression not improved by any other method).
I got that from a neurosurgeon friend.

[torquer]

"Yup, I pinched the C8 nerve between C7 and T1 vertebrae."

I'm going through the same thing right now. First occurred two years ago, successfully treated with physical therapy. As usual (with me, anyhow), I didn't keep up with the recommended stretches, and (in best Gomer Pyle voice) surprise, surprise, here we are again.

I used to have chronic lower back issues (due to herniated disc as well); the last few years I finally took the wife's advice and tried Pilates, and the resulting strengthening of the core has worked wonders. I plan to ask the PT if there are similar strength-building regimens that may be usefull in controlling problems in this region as well, or if its a question of flexibility (I've always had tight shoulders). I don't do weights (I try to avoid the gym at all costs) but I may need to reconsider.

Hope that you are able to find alternatives to surgery as well.

[1centaur]

Ray, can you give us the names of the yoga poses that worked for your back?

[Smiley]

Bruce, just jumped into this thread and I wish you the very best in the pursuit of the solution and hope surgery is the last resort.

[Dekonick]

Hey Bruce,

I hope everything turns out well. I have back issues of my own from time to time and so far no one has been able to pin point it's origins. Go figure?


Wishing you all the best in the outcome.





William

I can gurantee the origin is in your back :p

Perhaps squirrels are coming into your room at night with little hammers...

[Dekonick]

Surgery should only be considered when all else fails, or when there is imediate neurologic danger (i.e. irreversible damage due to local compression not improved by any other method).
I got that from a neurosurgeon friend.

+1000

Personal experience. His advice - no knife until you can't stand the pain anymore. Then we wait 6 more months.

With PT and a really good atlas orthogonal chiropractor (working with my doc's) my herniation has resolved, as have several cervical sublexations I had. I still am not comfortable in low 'racing' bike positions, but a neck wacked by a suburban at 50mph tends to be that way. Good thing I found horse saddles and leather bra wrap (reference to across the hall...)

:)

[cpg]

Bruce,
I wish you a speedy recovery. I can empathize a bit. I had a bulged disc in my neck and had a lot of pain and numbness in left arm all fall. I could hardly work for several months and it was scary! Good news is that I healed and have no lasting physical problems. Be patient and heal. Easier said than done but we're pulling for you.

[Ray]

Ray, can you give us the names of the yoga poses that worked for your back?
There are a lot to choose from and I've tried many before I boiled it down to a routine that takes me anywhere from 20 minutes to a half hour. I do it 2-4 times a week, as time permits and stiffness requires. Although I vary the order, these are the basic poses I use. I might have missed one or two:

Dog and Cat poses.

Childs pose is a good relaxation posture that also stretches the lower back. I often begin and end with this.

Squats.

The basic up-dog, plank, and down-dog sequence is very good, stretches just about everything. This comes out of a whole sun-salutation sequence that's actually a pretty good place to start, includes some good standing bends that work on the hamstrings. I usually do three or four sequences of these early in the routine, interspersed with the next one, warrior pose.

Warrior pose (there are a few of them - I'm not sure what you call the one I do, but it's pretty basic and faces forward, over the knee) gets some lower back loosening and twisting.

Triangle pose and Side Angle pose both stretch out and elongate the lower back and sides - those lower side muscles are a real issue for me.

Bridge pose helps with the back also gives the quads and abs a pretty good stretch.

Boat pose, can be done while moving your arms in more of a Pilates exercise – great for abs.

Locust pose, is kind of the reverse of the boat pose and works and stretches the back.

I can’t find the name of another one that is really good for the back and hips –start in a basic cross-legged seated pose (like you see people meditate from). From there bend forward from the hips and get your face as close to the floor in front of you as you can, keeping your back straight. Then come back up and do this pose toward each side, with your face coming to rest near or on each knee. Hold each of them for a while – if you can relax into this pose, you can feel everything in your back and hips let go and relax and stretch (this advice actually applies to almost all of the poses).

Pigeon Pose is really good at opening up the hips and stretching everything around them.

You should be able to find descriptions of these on the web. Some of these are pretty hard to go very far into at first, but if you take it slow and work into them, I've found them enormously helpful. I still can't get very far into some of them, but they do what I need them to do. This is just the mildest scratching of the surface of what's out there in yoga, but it seems to be a group of poses that works really well for me. I've been adding and subtracting a pose here and there from this basic routine for about six years now, since my back went really bat**** crazy on me in 2003. No more than minor stiffness or pain since.

-Ray

[old_school]

*****, Bruce, I am sincerely sorry to hear this. The good news is that you are are going to be exercising every day for the rest of your life! Don't ever stop. See PJ as soon as your physician gives you the ok.

[rpm]

*****, Bruce, I am sincerely sorry to hear this. The good news is that you are are going to be exercising every day for the rest of your life! Don't ever stop. See PJ as soon as your physician gives you the ok.

+1 Fourteen years ago after my liver transplant severe osteoporosis caused compression fractures up and down my spine, as I lost 2 inches of height. What saved me was seeing a terrific physical therapist, who worked with me for months. I've never stopped doing the exercises he taught me, and I've never stopped riding.

And hey, there's nothing wrong with a 24 cm head tube!

[2LeftCleats]

Can't imagine a neurosurgeon operating this as long as symptoms are improving, unless there is something grossly unstable on the MRI. Spinal MRIs show lots of stuff, much of it irrelevent. I almost never see a totally normal MRI report. There's always degenerative changes and disc bulging, which is just part of life after age 30 or so.

Conservative treatment will generally be the recommendation: heat, ice, cervical traction sometimes, physical therapy, pain relief. Sometimes a short course of steroid helps and sometimes rather than surgery, an anesthesiologist can do wonders. Probably every locality has it's preferred strategy based on local talent, but that's the trend here.

[Gothard]

Can't imagine a neurosurgeon operating this as long as symptoms are improving, unless there is something grossly unstable on the MRI. Spinal MRIs show lots of stuff, much of it irrelevent. I almost never see a totally normal MRI report. There's always degenerative changes and disc bulging, which is just part of life after age 30 or so.

Conservative treatment will generally be the recommendation: heat, ice, cervical traction sometimes, physical therapy, pain relief. Sometimes a short course of steroid helps and sometimes rather than surgery, an anesthesiologist can do wonders. Probably every locality has it's preferred strategy based on local talent, but that's the trend here.

A ton of wisdom in the above lines.

[Bruce K]

I saw the spine MD today and most of this will sound familiar after reading all the good stuff here.

Because things seem to be improving in both grip strength and dexterity, we are not going to do much now.

I am stopping the Naprosin for 5 days and replacing it with Prednisone, then back on the Naprosin for 10 more days.

Follow up visit in 3 weeks.

As long as things keep improving, that's it.

If things deteriorate or do not improve an further or if there is a significant increase in pain, then (and only then) will we talk about any surgery.

Apparently, if there is no significant improvement, then the window to correct the problem and have a decent chance of regaining full strength and dexterity begins to close after about 90 days (from the original date of "injury" - 2/27).

At around the 30 to 45 day mark I would have to make a decision in order to get everything scheduled within that window.

So for now, those 8th graders better not p++s me off. Mr. K on 'roids isn't gonna be a happy camper. :D

BK

[Hardlyrob]

Yikes Bruce!

Sorry to hear that, but it sounds like you are on the right course.

Let me know if there is ANYTHING AT ALL I can do to help. Us North Shore folks need to stick together.

Rob

[Polyglot]

I just opened this thread for the first time today, which i somewhat coincidental, as tomorrow will be 10 years to the day that I had my last bad bicycle accident. I messed myself up pretty bad in the accident, as I fractured both elbows and dislocated one of them, fractured a lower thoracic vertebra plus other lesser things. The emergency doctors were reasonably incompetent as they missed almost everything, as notwithstanding close to 20 x-rays they only caught the dislocated elbow with corresponding fracture (even I could have told them that one as the bone was dangling there on its own.) In their defence, I must say that I was in such pain that I was not much help to them and they ended up putting me out, so they concentrated on the areas of impact: the head, arms, neck and upper spine. (I had been riding an antique penny farthing when the front wheel blocked, throwing me over the handlebars, reaching perhaps 7-8 feet in height before coming crashing down.) The second fractured elbow was caught the next day when I complained to the night nurse in the orthopedic ward. The fracture to the vertebra was diagnosed two days later after an MRI. For the elbows the doctors offered me two solutions: either simple casts and accept a slight decrease in mobility or operations on both with the likelihood of recovery of full mobility to both. I chose having both arms in full casts for 7 weeks and must say that apart from not being able to fully straighten out my elbows (with consequent minor difficulties in my golf and racquet sport swings) have no difficulties. For the vertebra which may be important to Bruce, I was given a Jewett brace which I was to use for 4 months. I was very diligent in using the brace and after the 4 months, I must say that my back and fractured vertebra were fully healed. However, that is not all. Prior to fracturing the vertebra, I had long had recurring back pains. In the last 10 years, I have had no back pain whatsoever. It is almost as if the 4 months of wearing the brace "cured" my propensity to back pain. The doctors said that it is quite common for athletes, especially cyclists (this all occurred in Italy and I was being looked after by the same sports clinic doctors that looked after many of the top athletes in Italy) to have long-standing minor traumas that negatively impact your life and that sometimes it takes little to allow you to overcome them. I am convinced that the 4 months of forced rest from cycling and other sports allowed my body to finally heal. In fact, beyond the one clearly fractured vertebra, they showed me three other vertebrae that were not "healthy". After the 4 months, each of these less than ideal vertebrae were all looking better than before too.

[Tom]

I just got word I have a herniated disc in my neck, I believe I gave it to myself last September dodging a bug on a descent. (An insect - not the car...) It hurts like a bastard when I ride, so I'm going to tell the specialist we have one goal - get me back on the bike as soon as possible with as little pain as possible.

I'm curious how your treatment is going and whether conservative methods are working for you. Your case sounds a lot worse than mine, I have one big one but that's it, so if conservative treatment is working for you then I am hopeful I can avoid a major downtime.