Neck Blog Two: Some Steps Further

of random pictures on the day in question which, although irrelevant to the specific subject, are kinda cool so I'll use them as illustrations and hope you like them.

     As you'll recall, at the time of the previous blog entry I had in my hands (as it were) the x-ray of my neck but not the report. I want to apologize now that I'm not a radiologist and the comparison photo I made for that blog entry is, to put it mildly, wildly stupid: the "good" one is, according to an actual doctor, actually my lower back. That said, the "bad" one really is my neck as of a few weeks ago now, but the situation is less dire than it looked to my uneducated brain. However, it ain't good.

rehabilitation doctor at the hospital. I've been trying to avoid that, one of the reasons I waited so long before going in about this. There's a pandemic on. At the moment, as in so much of the rest of the world, our hospitals are overwhelmed and not only would I feel guilty taking up space during a massive public health crisis, but I would be frightened that my level of care could, through no fault of those trying to provide said care, be compromised by the overstretched, overburdened, overworked state of things right now. As someone who has worked in the background my entire life, it would pain me to contribute to what those poor people are pushing through right now.
     So I did wait as long as I could, but this was getting worse at an increasing, and really sucky, rate so I finally faced up to things and went in with a heavy heart. Now and then, though, life throws a person a bone, and my general practitioner made that happen.
     Several years ago, two doctors who are friends started a medical clinic. Originally, it was a pain management clinic and a transgender surgery clinic, but a couple of years ago they expanded to include, among other things, neurosurgery. Being a small specialist clinic, they have no waiting list! All my doctor had to do was justify to the insurance the propriety of sending me there instead of the hospital, and even if the pandemic alone weren't reason enough, my case is sufficiently "complex". Thus it was that I found myself last week at a state-of-the-art neurosurgery clinic being ushered into an MRI machine on the spot. An MRI machine, I might add, which was absolutely brand-new and shiny, and less than half as loud as the others I've been in (I love technology). This is where it got complicated, though, and why I was going to make that the title of this blog entry – but now we are a couple steps farther after all.

     The reason it's complicated is that the MRI reveals that I do have a trapped nerve – just not one that should be causing the specific symptoms I've been having. The nerve impacted by the arthritis in my neck should be causing problems in my thumb, particularly pain. I do have electric shock sensations in that thumb a lot of the time but that's not my main complaint: my main complaint is tingling and numbness on the outside of my right hand, particularly when I look to the right (which, I mean, is kinda why I thought it might be related to my neck in the first place – screw that rheumatologist from a couple years ago) along with a lot of shoulder and neck pain and stabbing, disabling muscle pains in my upper arm. These latter have been gradually limiting my range of motion for a long time, but it's been accelerating to the point where just holding my arm up to use my phone screen for a few seconds is exhausting. Technically, none of this should be coming from the nerve trapped by the discopathy and arthritis but as we all know, bodies are weird, referred syndromes happen, wiring gets crossed. Furthermore, I have a talent for developing things that don't "quite fit" the standard presentation.

     Luckily, there are diagnostic techniques for this sort of thing and I've just undergone one. It was the advice of the neurosurgeon that before we make any decisions regarding surgery, I should go downstairs to the pain clinic and get that nerve blocked. This way, we can tell whether or not the pain and impairment is coming from there. They were able to schedule it for less than a week later: day before yesterday! Now, my friends, full disclosure: that was not the funnest day I have ever had. In about four hours it will be 48 hours since the procedure and I'm starting to feel better but wow, that was... something. The clinic is amazing, though, absolutely amazing.

     The doctor and specialist nurse who did the procedure were fantastic: everything was explained in detail, my own level of knowledge was accepted instead of seen as Internet-overuse so we could discuss things on a sufficiently clinical level, and although the procedure itself was very painful, extremely weird, and left me feeling the next day like I'd been hit by a high-speed bicycle courier, I could tell that it was being done with extreme care, attention, and professionality, which even while it was happening alleviated any fears I might have had regarding some of the more common side effects (for example, a few days of extreme muscle stiffness and headache because of the delivery of a bolus of medication to the area). Also while it was happening, I became aware that I was not going to become the unlucky one in 3,700 who develops temporary (4 to 10 months) quadriplegia (this statistic being of course world-wide-based and covering all hospitals and all doctors on the planet, good or bad, so I wasn't all that worried because of where I found myself undergoing this). That happens immediately, if it's going to. Overall, 0 out of 10 for having to go through something like this in the first place but a big 10 out of 10 for getting it done there, by these people. 

     Now to prognosis. Technically, I shouldn't be going there yet. It should be too early to say anything, because the steroids need up to a couple of weeks to "settle in", but… I don't think it is. I was initially disappointed that the local, which was supposed to give more definitive results, didn't. Sure, there was less pain in the area, but pretty quickly as the local wore off and the actual reaction to this pretty heavy medical event mounted, all I experienced was extreme local tenderness and exhaustion. I spent the evening with ice on the injection site, in a state of semi-shock, talking too quickly about the procedure, everything I'd been through, and how bad I was feeling. 

from the procedure itself as far as sore muscles and outraged soft tissues goes, but I feel pretty energetic today, an unusual sensation these days, and even though we're not supposed to know anything yet I'm already surprised at how much more range of motion in my arm I have… So I guess, although I'm not willing to lay it down into the stone of a firm opinion yet, I'm probably going to be getting that operation. But wait… There's more!

from which my headaches originate and asked, "Do you get headaches?" So yes, I am in obviously good hands, close to the best feeling in the world. He told me, "I think you have two things."
     Now, I mean I have lots of things – but regarding the neck, which I was there about, he really cleared some stuff up for me. Along with this pinched nerve, I have muscular hypertonia in my shoulder and neck. He pointed out that it could be coming from or exacerbated by the nerve, or it could be a separate issue. It explains why session after session of manual therapy would always help for a while but no matter of keeping up with my exercises and stretches, ergotherapeutic training protocols, and the like would prevent it from coming back. The pain specialist said yes, it's often chronic. If it's coming purely from the neck, the injection I just had will help us learn that and steps can be taken. If it's not, he can still help! And to be fair, based on online research, it probably isn't coming purely from the neck: one of the common listed causes is chronic muscular overuse, and we all know about me and that stuff.

     So, my folks, clearly I'm in for some kind of road, some kind of journey of overcoming, but I'm setting that first foot onto this path with a hell of a lot more confidence and optimism than I had a week ago and with higher hopes – dare I even say, expectations – of getting more of my life back than I had going in. I can't express how thrilled I am to have landed on this particular shore from which to set out.

     I'll keep you posted, hopefully more often than I have been, and in the meantime, be well!