The deed is done

For better or worse, good, bad or otherwise, the deed is done. Per my doctor’s recommendation, I had cervical/spinal decompression surgery as planned on April 18th.

According to my surgeon, the procedure went off without a hitch…everything looked good. In his words it was “routine”. From that I glean that the procedure was a success and that it went better than expected for someone like me in the “high-risk” category.
That said, I did have significant pain and shortness of breath following the surgery and remained in the Intensive care unit for 6 days before being transferred to the stepdown unit and eventually home. Other than a brief stint on a continuous Albuterol neb, my asthma tolerated the whole surgery thing rather well.

Im now 4 weeks out from my surgery, and what stands out most about this whole experience so far, is the pain. OMG, I’ve never been in so much pain in my entire life. It’s unrelenting. Maybe I’m just not used to it, but when I say pain, Im talking about the kind that makes you actually moan or scream. Yes, I’ve actually screamed more than a few times. You can’t help it. In between those moments when it feels like your being stabbed between the shoulder blades with an ice pick, there’s also a constant dull ache that radiates from the back of my neck downwards to every muscle affected by the surgery. The slightest wrong move in turning my head or moving my arm the wrong way can trigger this. Just typing this post was agony. I had to stop and start, typing only a word or two at a time and then lifting my chin and head up to take the pressure off my neck. Its maddening.

They don’t really prepare you for this. They just hand you a piece of paper when you leave the hospital with a bunch of dos and don’ts and sugarcoat the parts having to do with length of recovery and/or the pain involved. Going into this I figured it would maybe be a week or two and then the pain would gradually ease up. I’m now a month out and Im still experiencing moderate to severe pain 24/7. In addition to that constant deep ache in my shoulder blades, about once an hour now Im getting these strange sensations that feels like individual muscle or nerves fibers are being tugged on and sometimes yanked out. When that happens the pain is brief, maybe 3-4 seconds, but absolutely excruciating. This is when I scream. The sad part is, no one can tell why this is happening or how long it might last. Is it part of the healing process, or is this a long-term consequence of having surgery affects the spinal cord?

I suppose it’s no mystery as to why there’s so much pain involved with this kind of surgery. Unlike cervical spinal surgery where they enter through the front of your neck, (known as Anterior Cervical Discectomy and Fusion or ACDF for short), they had to do my surgery through the back of my neck. When they do cervical decompression surgery from the back, they have to cut through multiple layers of muscles and nerves to get to the area of the spine that needs to be fixed. As you can see in the image above, not only do they have to cut the muscle, but they also have to pull it back a couple inches with retractors and literally peel it off the bone and hold it there while they’re working (yikes). Then when they’re finished, they have to sew the individual layers back up. With all this trauma these muscles are obviously angry and very inflamed. Getting them to settle down and heal is going to take a while.

Then there’s the endless pill swallowing. It seems like every hour Im taking some kind of pill. We’re talking a plethora of narcotic painkillers, nerve and spasm relievers, antibiotics and a ton of Vitamins. Many of the drugs cause constipation, nausea, dizziness, drowsiness, and hypotension. In other words, you feel drugged up, in pain and can’t poop. It’s lovely.

Probably the most frustrating things for me, is that I can’t do anything for myself that involves using my arms or moving my head. For someone who is so physically active, it’s a horrible feeling. Im not used to needing help with getting dressed or taking a bath or cooking. Trying to do even the simplest things on my own, like feeding the cats, sitting down to watch TV or use the phone has been torturous. Things you take for granted like driving to the store or going to a Drs appt, you simply can’t do.

The one thing I should be good at, I suck at right now. They encourage you to walk as much as possible, as it promotes healing. Problem is, its kills my shoulders, especially the left upper trapezius muscle. I can only walk a few hundred yards before the pain in that area becomes unbearable. I have to stop and rest for 10 minutes. By then I lose interest and put off more walking till the next day

Im not totally naive, I knew going into this that it wouldn’t be easy, and that the recovery would probably be long, but I had no idea just how painful and debilitating the process would be. I just want to get to a point where I feel like I’m turning some kind of corner. Where I can see some light at the end of the tunnel, but that hasn’t happened yet. Maybe it will happen tomorrow, may be next week or the week after. I just hope it happens soon because I am seriously over this. Im hoping that once I’m cleared to start Physical Therapy, that things will improve at a faster rate.

Thankfully and knock-on wood, my asthma has been under pretty good control since leaving the hospital and will hopefully stay that way till things improve with my healing. The last thing I need is to use my shoulder muscles to breath. I think I would just shoot myself.

Ill end this post with some photos and at least one piece of good news, my incision looks great. The surgeon did a fantastic job of suturing me back up. After it heals it may not even show a scar. And as always, for the medical nerds out there, you can read my actual surgery notes here.

The day after surgery

Incision 2 days after surgery
2 weeks after surgery
4 weeks after surgery

UPDATE per my Facebook Page Sadly, after showing some moderate improvement in my overall muscle pain, about a week after publishing this post, I started experiencing these weird sensations around my incision site that felt like individual hairs were being plucked out of my neck, proceeded by the most severe pain you could ever imagine. Like a lightning bolt shooting down my neck to my shoulders, then followed by a severe burning sensation. The who thing only lasts about 10 seconds, but it makes you scream or shriek and then takes your breath away. It’s like sticking your finger in an electrical socket for a few seconds, the pain drains you of everything. The scary thing is that I can feel them come on, which causes a lot of anxiety.

After talking with a lot of Ortho surgeon and ruling out surgical adhesions, what I probably have is a irritated or pinched nerve in my trapezius muscle located near the incision in my neck that is firing off at random times, or when I move my head down and to the right or when I move my left arm upwards. The nerve root that serves this area emanates out of the side of cervical vertebrae #5 or C-5). This is one of the areas they repaired during my surgery. According to the MRI I had done yesterday (at 4 am I might add) the hardware they placed there looked fine, though there was some mild edema and inflammation in the area which could affect the nerve mentioned.

Because another surgery is not needed at this point, the next step is to try to relieve these sudden shocks is an epidural injection over C5. I’m scheduled for that the end of next week. They also gave me a bolus of Decadron and some IV Toradol while I was in the ER. Both are anti-inflammatory, neither have helped.

In the meantime, I’m just expected to endure these 10-20 electrocutions every day until they can find a solution: if ever. I’m a very upbeat, Stoic individual with a very high tolerance to physical pain and respiratory discomfort, but I must admit that this is all starting to wear me down emotionally, and I’m not really sure where it’s all going to lead.

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4 thoughts on “The deed is done

  1. Wow, what can I say? I wish you a speedy recovery and I am confident your active lifestyle will be major factor for you.

  2. Wow, reading through this I’m reminded of my mom’s “insulted nerve” from her first hip surgery. It left her mostly unable to use her leg and foot, very well. Her foot was still numb and partially paralyzed when she died about 25 years later. In addition, she also dealt with extreme pain for some time.

    Good luck with the injection. My understanding is when the nerve is insulted, time is unfortunately the best healer. I won’t lie, reading this makes me terrified of this surgery (I have pinched nerve in the cervical spine).

    1. Sorry to hear about your Mom. Dont let my experience stop you from receiving the proper treatment. Depending on the problems people had before surgery, most who have the procedure from the front (ADCF) do very well and recuperate fast. Its when the enter through the back of the neck ( PCDF) that there can be a very long and painful recovery. In my case, It was partially my fault for over-doing it and not wearing the collars long enough. I somehow injured the recovering muscle, essentially tearing it, which caused the nerves in that area to go crazy. The fact is, it take a full year for the muscles and grow back completely. Funny how they never tell you that before the surgery. Anyways, good luck on your surgery, but be prepared for a long recovery and make sure you do everything they tell you. I think youll be fine.

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