waderoberts

Today is the 25th anniversary of my taking employment with the Michigan Department of Corrections and my oath to uphold the constitutions of both the State of Michigan and the United States of America.

It is also the 14th month without my SOM LTD benefits since a Grand Rapids based orthopedic surgeon, who incidentally doesn’t do spine surgeries, evaluated me and the available radiological imagery and declared me fit to return to work full duty as a Corrections Officer.

I am sending this same imagery (X-ray series and MRI) on CDROM to you for a more detailed assessment and e-consult, with the hope of making an appointment and a trip to Vail to meet you personally, for a thorough evaluation and a revision surgical plan.

Once again, I would like to thank you for your honesty, sound advice and dedication to the education of spinal anatomy to all who seek it.

Sincerely,
waderoberts

Thank You. I appreciate your positive confirmation of the existing non-union at C7-T1. I didn’t elaborate on the first surgery that was performed in November of 1997.

It was planned to be a single level (C6-C7) diskectomy and (unplated) fusion with auto-graft from my iliac crest that was performed to remove the herniation that was then compromising my spinal column as pictured on the single MRI image previously posted.

The result was a reverse kyphosis and a single level psuedoarthrosis of the C6-C7 vertebra.

A subsequent surgery done 3 years later was planned to be an ACDF with plating of the C5,C6,C7 vertebra, once again using auto-graft from the alternate iliac crest.

The result can be seen on the X-rays provided and linked. I remain interested in having you examine my most recent MRI and X-rays on CDROMs and am trying to make arrangements to be seen as recommended, either by yourself in Vail, or by whomever you might recommend regionally in the Great Lakes/Midwest, but outside the Upper Peninsula.

The fundamental issue and remaining question is for my SOM LTD carrier, regarding my physical inability to work safely as a Corrections Officer, or in a related field that would almost certainly involve at times physically subduing and restraining resisting offenders.

From your previous posts, we have a general idea of the activity restrictions that a competent spine surgeon and physician should place upon a person with a solid 3 level ACDF. The non-union and movement behind the plate of the lowest level of my unsuccessful C5-T1 ACDF would certainly prohibit in my opinion, not only my former employment and related fields, but many others as well and remains a definite liability in my passing any pre-employment physical examination for any employment whatsoever.

My symptoms are severe enough that at present, I am strained to simply care for myself, my simple home and keep up the yard work. I do a considerable amount of research and some writing on computer, but even with ergonomically correct seating and placement of screen, mouse and keyboard, my neck pain limits the time I can spend at a desk. Driving is similarly limited and dependent upon weather, traffic and season as for actual endurance time behind the wheel. Winters here in Michigan’s Upper Peninsula are particularly cold, damp and treacherous with lake effect rain and snow.

I am a full year into this war of attrition with a governmental entity with comparatively unlimited resources and the healthcare providers available to me locally are all associated in one way or another with both the neurosurgeon and/or the facility that performed my last surgery.

My own subjective observations of my cervical spine condition over the past two decades are in agreement with your opinion stated in the previous post, that the C7-T1 non-union, though certainly a pain generator during excessive movement and when stressed to the limitations of the constraints of both the plate and the surrounding ligaments and muscles that support it, is not the only problem that I have with my cervical, or for that matter, upper thoracic spine.

That much is fairly obvious from the CT and MRI images that have been performed subsequent to the second surgery. I admire your reluctance to make a surgical recommendation or diagnosis of any sort without further information and the required diagnostic imaging/testing.

That said, your advice regarding activity restrictions should be within reason. My own rule is restrict my activities to prevent my pain levels from exceeding a 6 or 7 on a scale of 1-10 and rest long enough, even if it involves a few days to recover to return to a baseline pain level of 2 or 3.

As I’ve grown older and don’t seem to recover as quickly, doing so has become increasingly limiting; though strict diet with proper nutritional support, light non-impact aerobic exercise and the judicious use of anti-inflammatory and muscle relaxing medications are of great benefit to maintaining a fairly active lifestyle within reasonable limits.

However, subjective restrictions and recommendations aren’t recognized by insurance carriers, bureaucrats and politicians and that is where my battle for further treatment and medical support is at this point; which is why I am seeking your esteemed opinion regarding activity restrictions with a failed 3 level ACDF with non-union of the C7-T1 vertebra and likely other associated problems of the cervical and upper thoracic spine.

My sincere thanks for your valuable input and insight into hopefully resolving this decades old problem with the best and most reliable advice available to me at this time, yours.

Sincerely,
waderoberts