Yesterday was my second follow up appointment with my neurosurgeon since my accident. It was also the fist time I would be imaged since September 10th. My anxiety had been only increasing as the date grew nearer. Several times I had been told that I would be in the CTO brace consistently for 3 months, and would transition out of it with the help of my Miami J cervical collar for the 4th month. It was what I was expecting, but I worried about how my back was healing. My neck has been feeling really good, and the pain and fatigue I have been experiencing seems mostly muscular at this point. My back, however doesn’t always feel as good. Sneezing, even at almost 10 weeks since my accident, is still very very painful. Thankfully my sneeze count is only at 7. I also have tingling in my back when I am in certain positions which has developed over the past few weeks. I worried that it might not be healing as well as I hoped, and just generally what it looked like after 10 weeks of rest and recovery. I have never had any numbness, tingling, or weakness below my waist which has always been comforting, but I was still anxious nonetheless. The thought of possibly having to spend more time in my CTO brace than what was initially proposed was probably my biggest fear.
I started the day with a cervical and thoracic MRI. It was 35 minutes of very loud, enclosed bliss. I got to lay on my back without my brace on! It was heaven. I’m pretty sure no one has ever enjoyed an MRI more than me. Did I mention that it was 35 minutes!?! Ahhhh… Then I went to x-ray. It was kind of fun to be in my department again for the day. I really miss being at work. Only two of my doctors were there yesterday, and Dr. Ford was in his office when I finished my imaging. I had a little bit of time before my appointment with Dr. Ramsey so I sat down with Dr. Ford as he kindly went through my images with me. Everything looked like it was healing well. My neck fractures looked really good, and T3, which was the worst of my fractures showed good signs of healing. I was glad to see that it was healing, but I do not like the look of it. All of my other vertebrae have a nice block like appearance with space between each one. T3 has more of a wedge shape now with the back of it protruding into my spinal canal. We measured my canal diameter at about 8 mm behind T3. Normal thoracic spinal canal diameter for adults is about 12-14 mm. My canal diameter measured about 12 mm at the remaining vertebral levels. What does this mean? I have some mild stenosis around T3. Which really could mean nothing. Right now in my brace I am pretty much asymptomatic besides a little tingling.
My appointment with Dr. Ramsey went better than even imagined it could have. He was happy with my healing as well. We talked about T3, and the potential for surgery in the future. Because of the wedge shape of the vertebrae I may be more at risk for things slowly sliding out of alignment and associated symptoms developing. This is no surprise. Especially considering Dr. Ramseys’ first words upon meeting me were “You seriously jacked up your spine”. At this point there is no way to know whether or not I will develop problems in the future. We talked about what a potential surgery would entail. He used the term “surgical no man’s land”. That’s not something that elicits reassurance… There was also the mention that it would require a cardiac surgeon because T3 is essentially directly behind the heart and great vessels. And then there’s also the problem of how exactly to get to T3. A posterior approach is not possible because of the spinal cord, and anteriorly you have the sternum, and ribs in the way. Ick. I will choose to not think about these things until surgery becomes an absolute necessity. Which it may very well never become!
After discussing surgery, Dr. Ramsey was full of good news. I can walk on a treadmill, ride a stationary recumbent bike, lift very light weights, and the best news of all… no more brace changers required! I will still be in my CTO brace when I am out of bed for the next month, and my cervical collar to sleep. However, my head does not need to be stabilized while switching the braces so Gary and I can do the changes on our own. Which means I can go to bed and wake up WHENEVER I WANT TO! That makes me so happy. This was a big, unexpected win for the day. I am so very grateful for everyone who has come early in the morning and late at night to put me to bed and get me up in the morning, but this is one step closer to independence and being better. Around Christmastime I will be able to hang out in my cervical collar and in mid January I should be able to be brace free. I also asked about going back to work and he gave me the ok! At this point because my job is procedure based, there’s not much I will be able to do, but I am looking forward to easing back in a few hours at a time.
We stopped by Dr. Simpson’s (Radiologist) office after the neurosurgery appointment and again went over my MRI. He was pleased with my healing also. He was extremely thorough and we discussed everything again, and in further detail. He was interested in seeing how I would look in flexion and extension in relationship of T3 to my spinal cord. All of my images have been in a spine neutral position so canal compromise might be exaggerated in either flexion and extension. It is something I have thought about as well, especially considering my tingling seems to occur when I am slightly flexed. Again, something to worry about when (if) necessary, which is not now. Today I am happily taking my small victories. Very very happily.