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Wife's Cervical Stenosis - Alternative to Surgery?

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  • Wife's Cervical Stenosis - Alternative to Surgery?

    My wife Marilyn is in Montefiore Hospital, Bronx NY. Went in on Sunday Oct 11. Has a bad leg infection. She is also getting numbness in hands. They are giving her TWO antibiotics and Lasix to get the water out of leg. She is very obese. Her infection is getting better slowly, but draining as they continue IV antibiotics.
    They did MRI of spine. Neurology MD RESIDENTS said MRI shows spinal narrowing, and will probably need surgery to correct. They scared the hell out of her and me saying that if she doesn't have surgery, she could fall or turn neck and get paralyzed!? Is this correct?
    Can't they treat this more conservatively without surgery? I just spoke to her now 11:45PM and she confirmed that it was the Neurology RESIDENTS that told her this and not regular MD's. They are at Monte because it is the teaching hospital of Albert Einstein College of Medicine. Thank you so much for your help, I am so worried.
    --Alan

  • #2
    Spinal stenosis is a fairly common problem. Is she having symptoms at all? This would include weakness, tingling or numbness, or problems with bowel or bladder control? Generally it is not recommended to do surgery unless the person is having symptoms such as this, as there is also a significant risk of the surgery itself causing paralysis. If she is quite obese, there is also additional risks of any surgery, as you probably know. While there is risk for more easily have significant neurologic deficit as the result of a fall or accident with spinal stenosis, if care is taken to prevent falls and such accidents this is must less of a worry.

    I would definitely NOT consider such a surgery an emergency in the situation you describe, and would strongly encourage her to get at least 2 more opinions from expert neurosurgeons who specialize in such surgery before doing anything.

    By the way, residents are "regular MDs" but they are still in training for a specialty. I think you should at least discuss this with the attending physician, who is the supervisor of the resident.

    Meanwhile, she would be less at risk for falls and serious accidents if she works hard at loosing weight. Is she working on this with her physician?

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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    • #3
      Surgical Resident visit.

      SCI-Nurse-
      Thank you so much for your reply with expert opinion. Marilyn was the Blood Bank Manager at Montefiore, and worked there for 25+ years. She would give out blood for the SEVENTEEN+ operating suites.
      I visited her today. Luckily I was there in the evening when the Surgical Resident came to visit. He painted the spinal operation as routine, with easy recovery-no big deal. She asked who does the surgery. He said regular MD as residents will "open" or do other things under supervision of regular surgeon. He said there are alternative treatments. Still, he really seemed to be a 'salesman" for spinal surgery.
      She has numbness in her hands but had NO trouble grasping and holding a heavy Saline bottle or other items. She is ambulatory, and has no other pain associated with the Cervical stenosis. The extra 120+pounds she is carrying on this spine is not helping the situation. When I told him this, he said they operate on many morbidly obese people.
      Her sister and niece both had stomach bypasses. They both are sick from it. Niece almost dies a few weeks ago from abdominal obstruction.
      I told her to get out of there as soon as infection is under control. Then rest at home, get more med opinions (we live 1/2 mile from hosp) and seek alternative therapies and see how numbness progresses.
      I want to thankt you again for taking the time to reply.
      --Alan
      Last edited by SCI-Nurse; 10-18-2009, 01:12 AM. Reason: Removed personal e-mail address.

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      • #4
        Alan, it is not wise to post your personal e-mail address on a public forum like this as it leaves you very open to spammers and scammers. If anyone here wants to contact you, you can turn on the personal e-mail option, which allows people to e-mail you but not get your address.

        Remember that if you are a hammer, everything looks like a nail. Surgical residents do surgery...that is what they want and need to do. They have to do a certain number of certain surgeries to complete their residency, so of course they are encouraging surgical options only. Again, I would strongly recommend that you and your wife speak to the ATTENDING physician and get at least one other opinion at a different hospital from another attending before making any decision to have surgery.

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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        • #5
          We will get other opinions

          Wife will speak to the ATTENDING physician and get at least one other opinion at a different hospital before making any decision to have surgery. Thanks again for your replies.
          --Alan

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          • #6
            SECOND Surgical Resident visit.

            I visited her again today. I was there in the evening when the SECOND Surgical Resident came to visit. He also painted the spinal operation as routine, with easy recovery. He also seemed to be a 'salesman" for rushing into spinal surgery not taking time to seek other opinions.
            She has still has some numbness in her hands but had NO trouble grasping and squeezing the hand of the MD as he examined her reflexes. She is ambulatory, and has NO other pain in hands or arms associated with the Cervical stenosis. I told him the extra 120+pounds she is carrying on this spine is not helping. He didn't think that was much of an issue.
            They have scared her into thinking that her hands wil get more numb and she will lose use of her hands. This will not happen in a week or a few weeks.


            I told her to get discharged as infection is under control. Then rest at home, get more med opinions and see how numbness progresses. THEN she can make a decision about this dangerous and risky spinal surgery.
            The Neruosurgery team has found a patient to practice on. The risk of spinal surgery is FAR GREATER than going home, resting and recovering from a week+ in hospital-no sleep, IV drugs, etc. and getting more opinions, then making such a decison.

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            • #7
              Marilyn discharged from Montefiore. Scheduled surgery with Dr. Houten.

              Marilyn was finally discharged from Montefiore today Wed, Oct 21. I wanted her to wait another week or two so she can recover from the severe leg infection that resulted in an 11 day hospitalization. She is very nervous about this and wants to get the surgery done and over with. She scheduled the surgery for next Thursday with surgeon Dr. John Houten, Director of Spinal Neurosurgery Services for Montefiore.
              Thank you for taking the time to help us with your expert opinions on this medical condition. I will post again next week as we near the surgery date. Thanks again.

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              • #8
                Is she planning a laminectomy? How many levels? I don’t mean to shake resolve, but it’s NOT, in my experience, an easy recovery (though I think it really helped me until I got injured, but maybe made me more vulnerable to that). I would thhink getting more opinions would be worth it. If you would go to Philadelphia, may I recommend Dr. Frederick Simeone, a neurosurgeon? I forget what hospital, and googling him gives mixed patient revies, but he was very conservative with me about the surgery, despite coming in ashen white after reading my MRIs and noting my 3mm cord diameter. Dr. Elliot Mancall at Jefferson was more open to, though not advocating, the idea, and also very good—head of neurology maybe, not surgery.

                ...Though I just saw your surgeon is the department head, so maybe I'm being too cautionary. But be prepared for a serious recovery, and sleep on a very flat pillow to avoid developing kyphosis.

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                • #9
                  MARILYN to Montefiore Medical Center ER Admitted to hospital.

                  The spinal surgeon from CA called and said that Marilyn's MRI shows severe stenosis with changes in the spinal cord. Marilyn told him that she feels slightly more tingling in the hands, now up to the wrists. He instructed her to contact our spine surgeon to have her seen right away. He said not to wait until next week. He said that if her symptoms get much worse, and she cannot be seen in the office in a timely manner, then going to the emergency room may be a good idea. Certainly, she cannot travel.
                  After calling her regular doctor, I took her to the Montefiore Medical Center ER. They already have all her records and MRI's. They will admit her to the hospital tonight, and call in the neurosurgeons for a consult. Dr. John Houten, Director of Spinal Neurosurgery Services for Montefiore was supposed to do the surgery on 10/29. He was out sick today, but hopefully he will be in this week to help her.
                  I will post again after the surgery is done to let people know how she is doing later in the week.

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                  • #10
                    Marilyn's surgery for spinal stenosis done

                    Marilyn's surgery for spinal stenosis was done THURSDAY November 12 at Montefiore Medical Center. Dr. John Houten, Director of Spinal Neurosurgery Services did the surgery. She went to OR 11AM. She came up to the PACU at 4:40PM. She is in a room on neurosurgery ward.
                    They had to do C3--C7 and put a plate in there. She has a morphine pump. I gave her some apple juice, water, and fed her some small pieces of pears. It was a nightmare going into the ICU's and the PACU but I went anyway.
                    Friday Nov 13 Update--
                    I visited her today. She is still very sick attached to many lines and drains one day after surgery.
                    I visit her every day, from the late afternoon 5-6PM until they make me leave around 8:30--9:00PM.
                    I brought her some fresh fruit, fed her some orange jello, but she slept most of the time.

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                    • #11
                      it would not say a SIGNIFICANT risk of surgery causing paralysis - more like a rare but possible complication.

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                      • #12
                        Marilyn had the C3-C7 surgery on Nov 12.

                        Have been out of touch since Marilyn had the surgery on Nov 12. They did C3--C7! Four levels, laminectomy, foraminectomy with spinal fusion. Titanium plate with 10 screws! Surgery went well, but recovery is the worst nightmare of our lives.
                        She was in Rehab 79 days. They sent her home with a commode in a diaper unable to walk to bathroom. Long story. After 2 weeks of this she went back in Rehab. Now she is going to the bathroom in Rehab. Walking part way, riding wheelchair part way.
                        They put a raised toilet seat so she can get to the bathroom on her own, even though officially she is on "one person assisted transfer".
                        Just getting out of a diaper is the transition to being a person again. Recovery will take months. She is still weak when standing and needs rest. Taking much less pain med, sometimes none for 12+ hours.
                        I feel such terrible sadness for her. Still, she is upbeat and is committed to making a good recovery and coming home. She says" "Everything will be OK, we'll be retired." Before she can come home, I will have to completely rearrange apartment for her to get around and get to bathroom at night. Sell some furniture, buy some furniture, move some furniture.
                        Sorry for being out of touch so long. Thanks to all for their support.
                        --Alan
                        Last edited by Alanem; 03-03-2010, 02:55 AM. Reason: error

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                        • #13
                          Hang in there!
                          Ugh, I've been kissed by a dog!
                          Get some hot water, get some iodine ...
                          -- Lucy VanPelt

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                          • #14
                            Respectfully..She is blessed. Tell her keep her head up and work hard. Remember some people in this forum have no control of their bowel or bladder it will get better.
                            Appreciate the small gains and the large ones will be ignored!!

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                            • #15
                              Slow, but steady progress

                              Marilyn is making slow, but steady progress in Rehab, practicing standing, walking longer distances, and getting to the bathroom. Thanks again to all for their caring, compassion and support.

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