ready, set, cervical fusion!

It's been a few weeks now since Craig and I returned from our second visit to Ft. Myers for my regenerative ligament treatment (a combo of prolotherapy and PRP injections). Round two admittedly took a little more mental energy than the first, as has been the case for any treatment protocol I've started and had to stick with despite a lack of headache progress. But I knew I had to give it a fair shot, which we'd already determined would mean at least 2 treatments. So back we went to Florida.

This time, Dr. Hauser decided he'd add some extra facial nerve blocks (with two analgesics: Serapin and Chloroprocaine) to the normal series of injections. I'm not sure what the final count of injections was because I lost track around 50, but either way, a lot. Here's a not-so-great picture post-procedure, but you can at least get an idea for injection sites (each little dot on my back and neck is from an injection + more up my scalp under my hair).

After my appointment, Craig and I headed straight to the airport to fly home. I've found that most of the soreness from the prolotherapy and PRP takes a day or so to kick in, but it definitely wipes me out. And because the solution he injects is working to tighten the ligaments, that's basically the sensation I feel afterwards...almost like I'm wearing a neck brace from the inside.

Speaking of a neck brace, by this point I'd had the hard collar on for about a month. Aside from dealing with the bizarre shit that people (mostly strangers) would say to me, I'd gotten pretty used to wearing it. Granted, I had the green light to workout with it on (as long as I cut out overhead movements from my lifting and didn't get too crazy with the rest), so that was helping deal with the mental stress. But then two weeks came and went. I spoke to Dr. Hauser on the phone and though I think he would have been open to pursuing a third treatment, I really wasn't feeling optimistic that it was worth continuing. And every day that passed without a change just made me more optimistic that the fusion with Dr. Franck was the right thing to do next.

So, that's what I'm doing. In a few weeks, Craig and I will fly to Tampa for the procedure. We'll fly in on a Sunday, I'll have some pre-op stuff to take care of Monday, including an up-to-date digital motion x-ray (DMX) and an upright MRI (since the one I had a few months ago didn't include all of the views that Dr. Franck wants), I'll have surgery on Tuesday, and then we'll need to stay in the area for about 2 weeks while I recover. We rented a beach condo in Siesta Key (because hey, if you gotta recover from surgery, you may as well do it right). Then I'll have a follow-up appointment before we fly home in early December.

I know I detailed the whole thing in my last post, but here it is again for anyone who cares:

To recap, the goal of this procedure is to get rid of my headache by targeting 2 mechanisms of pain:

1. Compression of my spinal cord (caused by the capsular synovitis is pushing into it) could be interfering with the flow of my cerebral spinal fluid.

2. My vertebral artery is compressed as a result of the instability. The vertebral artery provides huge flow to the brain stem, so when that supply is occluded, it causes poor circulation of cerebral spinal fluid.

During surgery, I'll be placed face down on the operating table. Dr. Franck will use an ultra hi-tech radar guidance system, called the STEALTH, in combination with an intra-operative CT scanner, called the O-Arm, to target C1-C2. A small incision will be made at the top of my cervical spine, below my skull, and two small insertion points at the base of my cervical spine. Using the STEALTH radar system, two 4 mm diameter titanium small screws will be carefully guided from the insertion points, by a minimally invasive technique to connect C1 and C2. Bone fusion material will be directly placed on C1 and C2. Finally, two square centimeters of bone from my occipital skull base at the top of the spine will be removed in order to remove the pressure on the base of the brainstem shown on the upright MRI.




How am I feeling about all of this? In one word: fucking-ready. Maybe that's two words, I'm not sure. Either way, I'm just incredibly anxious and excited to get it done and get the recovery rolling. Most people who've asked me about it hear "fusion surgery" and respond with an "oh no!" or "I'm so sorry!" And I get that...because surgery (especially neurosurgery) never seems ideal, but what most people probably don't appreciate is that after spending the last 3.5-4 years of my life in 24/7 pain, I would do absolutely anything to get rid of my headache. ANYTHING. Two years ago, I quit my job to focus on getting better. I've seen well over 100 medical practitioners along the way. Craig and I have traveled all over the country to see top specialists. We've spent more time, energy, and money than I know how to quantify searching for answers. And even though I've been fighting to maintain a positive, forward-thinking mindset as best I can, there have been a lot of really hard days when I've questioned whether I'll ever be able to live without a headache. So I guess what I'm saying is that it matters less to me what the solution is and more that there is one.

Post-op, I'll be in a hard collar again for 6 weeks and then will transition to a soft collar for another 6 weeks. I won't be able to drive during that time, which might be a little challenging, but we'll figure that out. I'm guessing Charlie and I will just walk 20 miles a day or something, hah! From there, I'm still not totally sure what my recovery is going to look like. Dr. Franck did tell us that by the 6 month mark, I should be back to doing pretty much everything I want to be doing, which is pretty awesome.

I'm sure I'll have more to write (and definitely time to write) when we're in FL in a few weeks. Can't come soon enough!