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Dear Dr. Corenman,
Thank you very much for your feedback. I got the MRA results back. I have right congenital vertebral artery hypoplasia (VAH). All vessels are patent and not sclerotic.
Is there any possible connection to the VAH and cervical bone spurs. The exact impression of the recent C-spine MRI stated stable alignment, multilevel degenerative spondylosis. There is increase in size of left midline disc extrusion at C5-C6 resulting in left ventral cord impingement.
The same day I visited the neurologist….On Tuesday (late) evening, I experienced the same symptoms again. Lip drooping. I had an excruciating headache early in the evening. But I always have a headache, so I didn’t think nothing of it. Then 9:30 came and went, 10:30 came and the right side of my upper and lower right lips were droopy. When I got to the ER, I was feeling pins and needles in my right cheek.
The ER doc wanted to keep me overnight for observation and in order to perform the MRA first thing Wednesday morning. But I didn’t want to stay over. My neurologist agreed to let me go home. The ER felt that it might be an angioedema. But I wonder if it possible to have an angioedema so localized with no other associated symptoms of an allergic reaction.
If there is absolute no correlation between the VAH and spondylosis then great. But despite my cervical and lumbar stenosis and disc herniations, I need to get healthy. Thankfully, my arteries are not atherosclerotic. But if that one vertebral artery gets any build up in the future I’m TOAST! I think, but of course I need to get medical advisement and guidance…cardio I suppose. Because this whole situation is way beyond my scope of knowledge. Or lack thereof.
Thank you, thank you for everything…. reading and most definitely your feedback. I sincerely appreciate this.
in reply to: Left Hand Tremor #5686Thank you very much Dr. Corenman.
in reply to: Left Hand Tremor #5681Dr. Corenman post=1051 wrote: I cannot tell you what the appropriate procedure is for your neck. As I mentioned before, there are three procedures and the best one for you depends upon many factors. Many follow-up visits is not a problem. If the specialist is concerned with your symptoms, frequent follow-up is necessary.
If your neck pain is a 3-4, I assume you have been through a thorough program of therapy and if there is no weakness, a good program of injections. Medications can be helpful and do not have to include narcotics. NSAIDs, membrane stabilizers, SSRIs and a slew of others can be helpful.
Dr. Corenman
I have another follow up in two weeks. His initial PE was more detailed, but at each f/u visit the PE is very brief. This I understand is expected. At each visit my surgeon assesses my reflexes and asks to report my current symptoms. I plan to pose the following question during my next visit: what the surgeon is observing in his reflex assessment (of me) is correlating with my current symptom update? Does my reflex status concern him, which is why he is recommending surgery? Are diminished reflexes a RED FLAG to spine surgeon? In 8 weeks my neurologist plans to perform a repeat EMG. So I’m eager about those results. The initial EMG was performed in August. Is this standard of care? Or does my recent shoulder surgery warrants a repeat EMG? Thank you in advance for your time Dr. Corenman.
in reply to: Can a screw in L4-L5 disc be causing chronic pain? #5653Scott post=1212 wrote: I have a solid fusion at L5-S1. The pain seems slightly higher than at my fusion and it is horrible. Roughly 95% of the pain is in my lumbar area and only minor leg and foot numbness. I have degenerative disc disease at L4-L5 and L5-S1. As stated in my post operative discharge papers, I was noted to have spondylolysis with hypermobility at L4-L5. I have not received all of my most recent films yet but when I do, I will send them to your office.
I find it amazing that you take the time to do this for all these people. I’ve never met a doctor who would chat outside of the office and do it without pay!!! You are a great person truly trying to help people. Thanks again.I agree with you. If it was cost effective for me. I would go to Vail, Colorado to address my neck and back issues.
in reply to: Numbness and motor weakness post-op #5650Thank you very much Dr. Corenman. This makes sense. I understand why my surgeon wants to address my cervical issues.
in reply to: Numbness and motor weakness post-op #5644Thank you very much again for your feedback and advice.
I think I might just consider the surgery, but I need to wait until my daughter is out of school or close to the end of this year. I’m just 4 weeks post op a shoulder surgery.
The Spine Specialist has recommended surgery for the past three months now. And colleagues of mine who are clinicians as well as my PT said I should take care of the problem now then wait.
As you stated above, the risk is bone overgrowth and further impingement on the nerves.
What about scarring?
Dr. Corenman,
Is scarring minimal to address cervical stenosis, what about lumbar stenosis both due to disc herniations.
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