paul wheaton wrote:Really horrible night. In severe pain. I think I should be in the hospital.
Jocelyn Campbell wrote:
... there is a definite bulge/rupture between C6 and C7. It seems that resolving that bulge sooner rather than later helps the nerves that are being impinged return to normal function more quickly and possibly more completely. Some times there is permanent nerve damage from disc impingement.
The surgeon said Paul's bulge is one of the easiest to resolve surgically. He half-heartedly (?) agreed that physical therapy and other methods, including time, are worth trying to see if the body will resorb the bulge, though he didn't think that was very likely. I would like to think this is a professional bias on the surgeon's part, and that Paul could resolve and resorb (is that the word the doctor kept using?) the bulge with less invasive methods than surgery. Though I do think the doc honestly felt he could rid Paul of pain much more quickly with surgery than other methods. The important thing is that Paul is interested in trying non-surgical methods first.
Penny Dumelie wrote:A thought I wanted to share...
When you are not used to using pain meds (or prescribed meds, in general), the train of thought can be to use them only as necessary and only when the pain is unbearable.
Don't follow this train of thought.
Pain meds should be used so that there is no pain. Fiddle and figure out the balance so that he is taking the meds before the pain really kicks in (assuming Paul can get to that mostly painless point). It's much harder to get pain under control when it fluctuates. I imagine you were told this by the professionals, but wanted to share just in case no one said anything.
Marilyn de Queiroz wrote:
Resorbing the disk (if it isn't ruptured) would be great! The idea is that it is kinda like trying to get the toothpaste back into the tube after it's been squished out. You have to do the correct movements (or have them done to you) to accomplish that goal. For example, just pulling on both ends of the tube of toothpaste doesn't usually work very well, and just letting the tube of toothpaste sit on the shelf doesn't do a lot either.
Did the surgeon say why he thought that it was unlikely? Is the disk is actually ruptured rather than bulging? That is a huge distinction.
On the plus side, permanent nerve damage doesn't happen instantly in this scenario.
Mike Wong wrote:Hey Jocelyn.
Thanks for keeping us all updated with Paul's condition. Vertebral disc prolapses are very common, and in the neck it is usually the lower ones that experience this, which is unsurprising considering how most people are head forward in front of screens these days. Fortunately, they are usually self-limiting (resolve themselves) if not too severe, but often reoccur because the root causes are not dealt with. However awful it seems at the moment, it is still early days and this is when it is at its worst.
By the way, the disc does not need to resorb for symptoms to resolve - conservative treatment can produce significant reduction in symptoms without any changes in MRI. There are also many people out there who have a serious looking bulge (on MRI) who have never had any symptoms at all, while some with excruciating pain may have a very minor bulge or even none at all! Severe loss of sensation or arm weakness are better indicators of severity, and is usually what surgeons will use to decide whether to perform surgery or not. As Marilyn said, surgery often leads to further surgery down the road, but obviously it is sometimes necessary (but not as often as the surgeons make out!)
You've already had plenty of advice from the lovely folks here, so the only thing I would add is to keep Paul's head and neck well supported and as comfortable as possible. What I said previously about a reduction in arm symptoms being a good indicator of improvement still stands, so any position that achieves this is good. This position will change over time though, so be aware of this.
Hope things start to get better ASAP. Stress is one of those things that seem to amplify the problem, so have a relaxing recovery
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