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  • HaloHelp
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    I DIDN’T have the fusion surgery :) !!! I stuck with the Prolotherapy, and it got my neck to be tolerable (pain wise) and MORE STABLE!!!It went from about 9mm to 5.6 of instability where NOW my surgeon isn’t even suggesting fusion now!!!

    It’s now being suggested as a standard among surgeons NOT to do the C1-C2 fusion surgery unless direct weakness is seen, narrowing of the spinal cord area and traumatic injury…even if a person is passing out from it– because the surgery is “so morbid” per my surgeon who did Payton Manning’s surgery. So I personally would suggest to people to rethink and double check ALL options before surrendering to surgery. Because once it’s done…it’s DONE!

    Good luck and God bless!!!

    HaloHelp
    Member
    Post count: 6

    Hi Bill

    I am seeing a Prolotherapist who has had great success in treating people with neck instability. If anyone who has an Os Odontoideum is at high risk of paralysis and death, then doctors should inform their patients that they actually have one. This information was only brought to light by myself, because I looked and asked the right questions. Then after finding out, I’d wondered how many of the doctors knew this and didn’t say anything to me…and it was shocking.

    So, apparently the doctors felt my ligaments held things fine and didn’t need to bother to say anything. If ligaments can be treated to do this assumed job again, where doctors at several institutions over many years didn’t say anything that it existed in me, then part of my confidence is in that thought…unless absolutely ALL of those doctors were unschooled and unknowing about this tremendous risk I had all along.

    I’m going to give myself a little more time to see how I do with the Prolotherapy and then venture to Mayo. I was put on a year waiting list with them, so they didn’t see any urgency in my situation either…though I called to be sure they got the full scope of my walking around with a walker and not having a surgeon who was comfortable in doing this surgery. I still had to wait.

    It’s been a more than nutty situation that has just been fully mind-blowing at the disregard out there. The number one reply I’ve received from any doctor about any problem I’ve ever had including my spinal cord contusion symptoms is: You may have anxiety.

    Being a woman, this is what we hear. Women die from heart attacks because this s what we hear. I am also not the sort who has ever had anxiety and am very relaxed in most situations. So they may as well suggest another female issue, while they were at it.

    But, I’m not fully dismayed. My health is important to me and I want to get my symptoms under control before I am slammed with a surgery I will regret. If I can get to feeling normal again, I won’t do the surgery. If I can’t, I may.

    HaloHelp
    Member
    Post count: 6

    Hello Dr. Corenman,

    I fully aimed to get the best doctor to help with doing my fusion that I know that I need, due to the gross instability. It was difficult, but I surmised that the doctors I was met with, simply had not seen someone like myself often for them to have aimed to make me believe I was fine with all of my odd symptoms going on the way they were. After sitting in a hospital for 2 weeks, it was fully dismaying to be told “you have migraines, so try to ignore it so you can walk without a walker”…after my neck was injured like that.

    It was even more dismaying to try to get therapy done for my issues a few times, but was turned down because, “Your neck is broken and unstable, why’d they send you here? We can’t risk the liability.”

    So, I managed on my own to get better and then headed on a mission to find the real problem and found that contusion. I then headed to Hopkins, fully prepared to get ready for a surgery only to be told about my high VA stroke risk. Shocking, but not initially a deal breaker.

    I had patients with the horrible outcomes of fusions, but none as high up as C1-C2. So, I looked to chat with others online to see how they were doing following their fusions there and it was horrifying. I read of nothing but regrets (literally) and lists of pain medications and the best mixes of them to get any relief and how to breathe through the pain to try and tolerate it somewhat.

    I only heard from one who was only a few months out from surgery who was doing okay, another who after 23 years of fusion did great. But then at the ripe old age of 39, he got debilitating pain and was told his fusion was fine and to “man up” that pain was to be expected at some point from a fusion like his.

    So, it is a harsh reality to be faced with me feeling unstable and at risk, but mostly pain free right now. To hopefully getting stability with fusion and potentially losing my career over pain, medications, and not ever having a clear thought again due to taking pain meds. Let alone losing the ability to rotate my head and look like a normal human again.

    The doctor not knowing of the Harms technique name wasn’t a huge deal, I merely wanted to know what types of screws he’d be using (Harms being best), to know if he was using wire, and if he was planning on using BMP—just basic info. I wasn’t aiming to do much but focus on getting better. Getting the shoulder shrug was shocking, but he completely avoided telling me he did indeed use BMP…it took his nurses by surprise too after calling 3 times to find out, “BMP doesn’t sound familiar so I doubt he uses it.” Was the response I got. But he did and refused my request to use my own bone, so I had to find yet another doctor.

    Blocked responses and various almost “blaming” me for feeling as I did, because it was “unheard of”…has been damaging to me—that I’ll admit. Especially being a medical professional myself, which I didn’t always indicate to the doctors, it was sad to see how doctors weren’t very use to a patient who wanted to be informed. One doctor said, “I’m just used to patients coming and saying ‘Fix me doc!”’ Then he stopped giving me much feedback.

    Question: With the proposed C1-3 fusion, “skipping” C2 due to the small pedicle issue…how do you feel that may help reduce VA stroke?

    How are your 25 patients doing after their C1-C2 fusions? Are pain meds and other issues still part of their life?

    HaloHelp
    Member
    Post count: 6

    Hello Again Dr. Corenman,

    It’s not so much the “fear” of surgery for my Os Odontoideum, it’s my being able to live a fulfilling life as normal as possible—that’s what’s most important. I currently am not in a huge amount of pain, except for headaches at times. It took a 3rd whole hospital institution to find, after my outright insistence, that my cord must have been bruised from my accident. But all the rest still contend to this day that there’s nothing wrong, though I saw the contusion on my MRI now and though I had to regain my balance and such after the accident and use a walker.

    Being caught under pain and hooked on pain meds is most daunting: I lived a huge portion of my childhood, strung out on medications for seizures. I was oblivious and actually thought to be mentally “slow” until my parent’s decided to not listen to the doctors anymore and took me off all medications.

    Miraculously, I never had a seizure again after getting rid of the “saving” meds, which I’m now suspicious were partly causing my problems.

    It was discovered immediately that I was a normal kid, but medications drowned out that reality. A friend of mine wasn’t so lucky, he had the same issue as I did but his parents kept him on his medications. His heart stopped at the age of 16, thanks to his being overmedicated. His parent’s never forgave themselves.

    The thought of having to go under the looming pain medications following spinal fusion at C1-C2, for who knows how long, is not inviting Doctors tell my patients they will be out of work for maybe 4 weeks (knowingly and annoyingly underestimating)…3 months later they finally are able to attempt work and often realize they may not be able to handle working ever again or will be able to–but in agony and drugged if they can even afford their pain meds.

    Surgery can cause great pain and enduring pain. Fusion is especially difficult to recover from, and for the C1-C2 it’s such a huge life changer with the mobility quickly taken away. Fusion may be okay for a short while or long while, but when it degrades neighboring structures—it’s all agony and more surgery to fuse more and remove scar tissue. The internet is riddled with story after story of people not doing well after their fusion, or being sent to pain management clinics where they are treated like an addict.

    Here’s a quote from a Bloomberg.com article:
    In a U.S. study in Spine in 2007, surgeons reported fusion was successful in only 41 percent of 75 patients suffering from lower-back disc degeneration. Success measures included pain reduction. Two years earlier in the same journal, surgeons found a 47 percent success rate among 99 patients, 80 percent of which were taking narcotics for pain two years later. Both studies compared fusion to artificial disc replacement in trials submitted to the FDA.

    When pain management isn’t reached, patients turn to abusing other drugs or alcohol. It ruins their life, where they often even end up prematurely in nursing and rehab facilities—essentially wasting away as they become less and less mobile and medications cause them other health problems.

    I went to Johns Hopkins, and this is where I was told I was at risk for the vertebral stroke due to my small pedicles. Many surgeons usually are not so forth coming with even basic questions I’ve asked in the past like, “What’s the procedure called you’ll do–‘Harms’?” I literally got a shoulder shrug as the answer from that top doc. So, for this doctor to tell me this, it had to be important. He said, “It’s rare that someone is at such a high risk for vertebral artery stroke. But you are, so I’m recommending we skip C2 and fuse C3!” I didn’t know how a skip could be done or how that’d even help make it any better (do you?), but that was his word choice not mine.

    I think sometimes extending life at all cost isn’t always the best cause. To be honest, if I injure my C1/C2 good enough where I don’t have immediate help, I’ll die since I won’t be able to breathe on my own. I’m not afraid of dying, I’ve already been there and it’s not a bad place to be.

    Weighing my options is still on the table, and so far Prolotherapy is my choice for now. The doctor I go to only uses natural substances, and I haven’t had any issues with it. My ligaments wore out over the years and then fully gave way due to the accident causing this instability. Things held together fine for so long, and I was super active where my neck should have snapped a thousand times over.

    So, this is why I’m confident in the Prolotherapy to try and get my ligaments back to how they worked so well before. Doctors wouldn’t EVEN tell me for years that I had this Os Odontoideum, so they seemed to think my ligaments were doing the job for me, too. Like it was the job of my ligaments and not my vertebra, to hold my head on…so they said nothing…4 doctors! After reading my MRI reports and seeing it as the second dx right in front of them, and they skipped over it…really stunned and ticked me off to be honest that I HAD TO ask about it!

    So, yes…unfortunately I’ve got an Os Odontoideum and it’s causing me twitches all over, makes my head feel like it’s going to fall off as itl iterally wobbles…and yet I had to leave my hospital of choice in a major city at the #1 hospital because they said though my neck is measurably unstable—I don’t have any muscle weakness yet and I would surely not want that type of fusion surgery. They even said my head wobble might be from stress—right after I got injured and they continue to think that. Though my arm went numb, top of head went numb, I stuttered, blurred vision and horrible balance to boot!

    A few doctor searches and I finally got one to pull up my MRI and showed me that I had a spinal contusion…it was clearly visible! So, you could say that I more than have a bad taste in my mouth about quite a few things, but I am overall very practical and calm in most cases…even this. So, racing to a surgeon isn’t my choice, but I understand your advice.

    How would you say your patients did after their C1-C2 fusion? Did they all get completely off pain meds—never to complain again? How would you know if it ever turned sour for them if they moved or went to another doctor later or even went to one with a different specialty to help with their ongoing issues? If they came back due to pain and their fusion was holding and it looked good, would you just refer them to the pain clinic?

    Thanks for your time in reading this lengthy letter Dr. Corenman.

    Here’s in reference and in warning in the use of BMP:

    BMP usage is causing harm:
    The US. Committee is now after Medtronic for paying physicians who authored the BMP research and left out the cancer causing facts ($210 million dollars was paid to them—public knowledge). Full article that the government has outright evidence of them hiding their direct knowledge of MANY scary side effects with cancer being ONLY one of them.

    You mentioned that BMP is safe to use, because there was only one report saying it was dangerous. If a company like Medtronic has to falsify information about their product that should make everyone nervous. It was more than proven that the results of the use of BMP was corrupted and biased as shown in thE New York Times article.

    And this quote would convince me to never use it:
    “The researchers had information showing that at two and three years after being implanted with the genetically engineered protein, significantly higher numbers of Amplify patients were being diagnosed with cancer, but they did not report it on their paper.
    The authors mentioned the cancer link only in a table accompanying the paper. The text itself never addressed the concern of whether BMP-2 might fuel cancer.
    “As a physician, you go by what your colleagues publish,” said Charles Rosen, an orthopedic surgeon and president of the Association for Medical Ethics. “It’s an abuse of trust.”

    If there is even the slightest chance of causing harm, after so much good is aimed for, it should be at least considered. I know people who go into these fields, go into for all the right reasons. But I do also know how the system is corrupted with kickbacks for useage of say, Medtronic devices.

    This is taken from additional research: “This risk of adverse events associated with rhBMP-2 is 10 to 50 times the original estimates reported in the industry-sponsored peer-reviewed publications.”

    There’s an article where BMP has been found to injure the nervous system:

    There’s research showing how “BMP enthusiast” overstate the morbidity of harvesting bone to ensure patients on the use of BMP instead:

    The increased fusion rate isn’t by that much to want to risk a patient, I personally feel. What does it help to fix their back, only for them to get a killer cancer later or other serious complications that hinders their living a complete life?

    I HAD TO REMOVE THE LINKS TO THE ARTICLES SINCE THEY WEREN’T BEING ALLOWED OTHERWISE I’D HAVE THEM HERE.

    HaloHelp
    Member
    Post count: 6

    Hello Dr. Corenman,

    I have an Os Odontoideum, then had an accident that rendered me unable to walk straight due to poor balance, dizziness, blurred/double vision, trouble concentrating, numb right arm, tingling sensations on top of my head and then some. My measurement of instability is beyond what it should be, I cannot recall it immediately…but it is bad (if I had to guess it’s 8mm). So it was verified by several doctors in regard to the instability.

    I choose not to do surgery for a variety of reasons, one being quality of life. It was suggested that I have C1-3 fused, since I have small pedicles and am more likely to have a vertebral stroke. Skipping one extra vertebra I just don’t see how that will lessen my chances of having that predicted stroke.

    I also work in the medical field and listen while my patients pray for death or something that will finally work against their pain following a “successful fusion.” The fusions are successful, and may last for a good amount of time…but then the wear and tear on nearby vertebrae, which starts to give way and the pain simply mounts where no amount of pain patches or pain meds work…and misery, substance abuse, depression and other worse case scenarios arise.

    The scary part is, none of my patients have even had fusions as high up as mine is being proposed to be. So I cannot even measure the pain that I know is surely to come at some point to me. It’s a sad reality to know the state of risk I’m at for death or paralysis, versus having a life full of misery post-fusion surely to come right away or a little ways down the road.

    Surgeons, I know, do their best at creating successful fusions and are often indeed able to achieve what they set out for. But I lost faith in quite a few of them as I discovered blocked responses and unfulfilled questions…like hiding the fact that BMP (bone morphogenetic protein) was to be used in their proposed surgery for me, though I asked directly what’s used for fusion, even the nursing staff and assistants never had heard of that being used with THEIR doctor they worked with. But, they did and they wouldn’t allow me to use donor bone (it wasn’t something they did-2 surgeons told me that).

    So, with the certainty of increased cancer risk due to this secret use of BMP, would that surgeon ever know what additional agony they had put me through worrying for cancer to creep more likely my way? Would they care, since they now know that BMP studies reflect off-label use as being detrimental to the health of patients? Yet, they still use it.

    Say I did get fusion done, when I’d show up to my surgeon sometime later after the surgery, complaining of absolutely agonizing pain now in my head and neck–and they run tests to see that my fusion is holding so ALL is well–would they say I’m just having anxiety (a common dx for women given by docs) or just give me an easy supply of drugs that will eventually cause my organs to fail and/or have me to fall into a lazy depression where I’m unmotivated to even get out of bed?

    Quality of life is so very important, especially for those like myself who haven’t even reached middle age.

    My neck instability doesn’t require me to sedate myself with pain meds, so my pain is manageable at this stage unlike the time of the initial injury with my pre-existing Os Odontoideum (that I personally found on my MRI reports-4 of my doctors didn’t find it important to tell me that my neck was broken from birth).

    Now with Prolotherapy, I have since had 3 treatments and after the first treatment 40% of my symptoms went away! I had finally felt normal for the first time in many months! I think the injections were a lot less toxic and scary than BMP, I looked over the risks involved–other doctors only told me they wouldn’t suggest it because of the risk of infection. After me personally having had several patients lose function and sensation in their hands due to an infection or misplaced IV line…this was a risk everyone takes with any procedure so I couldn’t understand why they’d try to scare me with only that thought.

    After my 2nd Prolotherapy treatment, I was asked to wear a hard collar to potentially help even more in my recovery…that didn’t work for me personally though it has and does for others. My neck got weak and my posture seemed to push my head more forward and cause more strain against the collar. So, I’m not using the collar now and only recently had my 3rd round of treatments…it’s recommended I have 6.

    In knowing how scar tissue is more fibrous, and tendons and ligaments don’t have a direct blood supply…poking holes to get my body to add more attention to the area is what I hope gets things to go back where they belong.

    I’d lived many years not knowing (though my doctors did and hid the fact from me) that my neck wasn’t attached because my ligaments held all things in place. If the ligaments could do it once, I am confident they will do it again. I want to at least be given a fighting chance instead of an almost certain future of chemical dependency on pain meds where I’ll never have a clear thought again outside of my fighting a narcotic.

    This is important, people are important and even the former Surgeon General C. Everett Koop risked it all to get this scary Prolotherapy done and he is a success story! I’ll place his story below.

    So truly, if there’s any light you can shed on anything I mention here I’m fully for hearing about it because at this point…I think I’d rather leave it in God’s hands than in the hands of surgeons who don’t inform or answer direct question and refuse to lay out all options. For the record, I’ve spoken to some top neurosurgeons totaling 5 who have all been less than straight forward and it really shocked and horrified me. More importantly, it saddened me, because I felt bad in knowing now what my patients must go through in finding good answers when in dire need…and I had an advantage having the medical background that I do!

    Surgeon General talking about Prolotherapy:

    Please read this letter from C. Everett Koop:
    Although I have not been practicing surgery for about 15 years, I continue to see many people who have benefited from Prolotherapy as a treatment for ligament laxity.
    In my own case, I had been diagnosed by two separate neurological clinics as having intractable pain. My symptoms and the lack of sleep were affecting my work. I obtained complete relief from prolotherapy. After that, I began using it on the parents of my pediatric patients.
    I saw remarkable benefits when the method was used with proper indications. Certainly, if used properly, prolotherapy does no harm but can be of extraordinary benefit. I have changed many lives.
    Watching some of my colleagues fight the system for the payment for Prolotherapy in their practices has led me to believe that those who make the decisions about what will and will not be covered by insurance plans are those surgical specialists who benefit most by operative procedures which are frequently not indicated, expensive, and ineffective.
    Sincerely yours,
    C. Everett Koop, MD

    HaloHelp
    Member
    Post count: 6

    Hi,

    I am about to try something called Prolotherapy for my loose ligaments in my C1-C2 area. I have similar problems as you do and it can only help and it’s been known to work.

    I don’t want the surgery either, and the prognosis is honestly horrific from what I’ve read. So check it out and look for Prolotherapy, the doctor in Oak Park, IL is one of the top in the country and you can put a search in Youtube to find more specifically on Prolotherapy for c1-c2 instability :) Be sure that if you get it done that it’s done with “comprehensive treatment” meaning, not just a handful of injections…but a slew of them where the whole area is covered well enough to treat everything–some fail because not enough was covered.

    I am hopeful it works for me and I just found out about it myself…I can’t wait to try it :) It’s all about getting the ligaments to repair themselves and create stability, causing them to get tight again!!! A dream come true for me.

    Even where I read negative articles about prolotherapy, the people who had it done attacked the article writer…so I would say there is something to this…I wish you luck and I know your pain…you are not alone :)

    And I’ve had doctors say the craziest things to me too that they should be ashamed to even dare to say to another human being…I read where a doctor said you were seeking attention…I swear…I don’t know where their heads are at sometimes!

    ~Halo

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