PamC

Thank you so much, Dr. Corenman!

Initially, back in June, they (the hospitalist team) seemed most concerned with vascular issues. I had occlusive blood clot in several veins (with much axillary and supraclavicular swelling) post pacemaker placement.

I could not get a therapeutic INR on warfarin so was switched from heparin drip in the hospital to Xarelto. Voila. The blood clot dissolved fairly quickly (as least the visible/palpable cords, jugular and axillary seemed to melt away). I did, however, have ongoing issues with shoulder/arm pain and weakness and some issues with my left leg (e.g., spasticity, weakness). The neurologist who consulted during my hospital stay said my symptoms made no sense to him and pretty much sent me on my way, even suggested a possible psychogenic basis to my symptoms (which is totally hilarious if you knew me; I’m more often accused of being too laid back and stoic for my own good).

In any event, when my symptoms persisted, I sought second opinion(s). I’m told I have a small diameter spinal canal with compression on the cord at multiple levels. If I understand the brief feedback from the spine surgeon, the compression of my cord is increased by certain movements (in certain ranges of motion). As a patient, I’m trying not to ask stupid questions, but am trying to understand how one neurologist would shrug his shoulders and a second one would send me ASAP to a spine surgeon, the latter of whom is basically recommending extensive surgery (almost sounds like cervical reconstruction with combined anterior/posterior approach and intervention at multiple levels…lots of decompression and fusion).

In the hospital in June, I had several days of abnormal neuro exam (upgoing toe on the left, significant ankle clonus and knee clonus, hyperreflexia). When I saw the spine surgeon last week, I had diminished/absent DTRs at the knees. So, I get the impression that my situation is fluid. I’m happy now that I’m followed by a neurologist and orthopedic spine surgeon who I like a lot and trust. Maybe I should just ask for a copy of my clinic note. My diagnosis had been “active C5 radiculopathy” and “left ulnar neuropathy” and I think the spine surgeon takced on “cervical myelopathy.”

What constitutes cervical instability? When you use that term, what do you mean? Abnormal motion of the vertebral segments?

Again, thank you so much. There *is* a lot of information to decipher. In March of this year, I’d have claimed to be an amazingly healthy adult. Events of the past few months are a lot of “take in” and make sense of.