Erin and I first became acquainted, professionally, when she contacted me to purchase stock images from my company PhotoAbility.net for her medical outreach project for woman with disabilities. We later became friends via a private woman’s group for those with Spinal cord injuries.
She posted about nerve pain in her neck and the at-home traction device she was prescribed to help with the disk herniation she had that was meant to take the pressure off the disk space involved.
Seeing the image of her lying flat on her back with the traction device around her head brought back poignant memories of my own traction from my C 6-7 subluxation at age eighteen.
It would seem her neck had sustained a great deal of strain and damage over time, since her accident 13 years ago. As a result, her quality of life as a mother of 2 boys, a wife and working woman as Program Specialist @Partners for Inclusive Communities at the University of Arkansas College of Education and Health Professions was suffering. She needed a solution.
Then, one day, after I attended a business conference and was required to push over two miles in a broken wheelchair with little back support (another story to come), I started experiencing what felt like whiplash starting the next day. My head felt heavy, and I was tense and guarding (a term used to describe how your body subconsciously tightens up the muscles around the nerve damage to protect and defend them from more pain). I started getting regular massages. They would help temporarily, but the pain was so bad that I was taking Ketorolac, and couldn’t work at desk for long. I finally made an appointment with an Orthopedic Doctor, who ordered a MRI and follow up with a Neurosurgeon.
Two weeks later, the handsome, and quite renowned Neurosurgeon (I was fortunate to have this doctor in my area), walked in and opened my MRI on his screen. There was no denying the shock factor of the significant disk herniation and central cord compression visible at C-4-5. I was diagnosed with a moderate canal stenosis from a large central disc protrusion, which narrowed the spinal canal and compressed the spinal cord, resulting in pain, numbness, and loss of function, a condition called Spinal Stenosis. Surgery would be required either now or in the future, but I was told that “You are at risk of cutting off the blood supply,” and one wrong move could lead to paralysis at the C-4-5 level, meaning a high level quadriplegia with no use of my arms or hands. He recommended I get this done as soon as possible.
I was in shock, unprepared for questions, and was scheduled for surgery for their earliest opening, which was in four weeks’ time. December the fifteenth. When I started reading about this surgery, ACDF: Anterior Cervical Discectomy and Fusion , I realized that it was much more complicated for someone who was already not walking and used their arms for all of their mobility. In order to heal from this operation, the neck must be protected with a brace, and there was to be no lifting of more than six pounds of weight for six to eight weeks while it healed. Patients were encouraged to “begin moving legs while still in bed, and walk several times a day within days of surgery”.
If my only form of exercise, strength and cardio, comes from using my upper body, and my personal care requires I lift myself with my arms from bed to wheelchair, from wheelchair to shower chair and toilet, to relieve pressure, and to dress, how was I to manage not lifting for these six to eight weeks? Would this would render me a completely dependent on someone else for all my care? Who would care for me? Could I work with the potential pain after the surgery and meds? Reading the forum posts of others who’d had this surgery left me in a depressed panic.
Some considerations I had begun to have:
How do I renovate my shower to be a roll in, and what would it cost? ($4000) Do I need to buy a roll in shower, or does my insurance cover it? (It doesn’t.) Do they have a shower chair that can roll from the bed and then slide over into a bathtub? (Yes, but none that are self-propelling, so even when I can push my chair, I would be unable to use this without assistance.) Is home Health Care nursing covered? (Yes, up to eight hours, but when do I learn how much will be covered? After I am already immobile and unable to advocate myself?)
I wanted and needed to find others, anyone who’d had this procedure and who also had an existing paralysis. I posted to many forums and SCI groups, though to no avail. But Erin did respond that they were also now recommending she get the same surgery. Same level!
So, we began taking notes and questions from others in our group. How did this happen, and how can it be prevented? Erin Stated she “Was not as active, and gained a little weight. Well, quite a bit, actually. I’ve been injured for thirteen and a half years, and have loaded and unloaded my chair four to five times a day from a car in an unnatural way, causing major stress. Many body systems age prematurely with SCI, one being the musculoskeletal system. So, what I believe is that the stress, weight, and inactivity, coupled with the chair unloading and loading, just took its toll. I have degenerative disc disease and bone spurs all over the affected discs.”
Nutrition, smoking (neither Erin nor I smoke), age, and posture are all factors in disk herniation.
Here is some good advice on How to Save your Spine and prevent being in our position:
Get your Vitamin D: A study in the 2013 Global Spine Journal indicated that adults that underwent spine surgery were deficient in vitamin D, showing a relationship between low levels of vitamin D and a herniated disc in the neck. Vitamin D is obtained mostly by exposure to sunlight, which accounts for 80 to 90%, and 10 to 20% from nutritional intake. Therefore, getting more exposure to sunlight and supplementation of vitamin D may be a therapeutic measure in preventing a neck herniated disc – See more at :http://www.necksolutions.com/neck-herniated-disc.html…
Reduce Sugar Intake: “Eating carbohydrates like sugar, honey, whole grains, starches, and fruit causes osteoporosis.”
See more on The Rollin RN feature: FIT, FABULOUS, and SUGAR? Aren’t we sweet enough?
Drink Adequate Water: A normal disc is 80% water held within the cells. A reduction in the amount of water results in a thinning of the disc.
Exercise: Get proper exercise that does not further strain, or damage the spine, such as stretching, yoga, and developing muscles to support posture and are opposite of those used for pushing/propelling and transferring.
Watch your Posture: Poor posture and age is another factor. Those with higher levels will automatically protrude in the neck and will be at risk. Pretend to the best of your ability that a string is pulling you up from the top of your head, and be aware of how you are seated while at the computer and while exercising. Most importantly, how are you seated in your chair?
Proper Seating: A proper seating evaluation can help determine how you can be best supported for optimum body alignment. Get this ordered from your doctor and have a qualified PT evaluate your current seating and recommend changes, and new wheelchair and back support if necessary. Your chair is an extension of your body. Don’t neglect it.
Nutrition: “Eating for a herniated disc often centers on providing the body with the nutrients it needs to maintain healthy cartilage, since that’s what the annulus fibrosus is made up of. Foods that support cartilage health include those rich in Vitamin C, E and D, as well as supplements including glucosamine and chondroitin. A herniated disc diet should also include plenty of calcium to support the health of vertebrae. In general, the diet should include plenty of vegetables, fruit and lean protein such as fish, chicken and beans.” https://www.laserspineinstitute.com/articles/herniated_disc/eating/482/
“The tensile strength of vertebrae depends on the collagen matrix that is made of protein, not the calcium and magnesium mineral deposits in the bone. The ligaments, tendons, and muscles are all made entirely from protein and fat. Eating a diet high in protein from red meat, fish, fowl, seafood, and hard cheese will produce strong bones, ligaments, tendons, and muscles and will prevent and reverse degenerative spine disease.
One of the major reasons for degenerative back and neck disease is a diet high in carbohydrates and sugar. The high-carbohydrate diet can causes an increase in the blood insulin level, which triggers an increase in the catabolic hormones, causing the body to literally eat itself. Unfortunately, the spine is the first to suffer when the catabolic hormones scavenge protein from the spine for redirection to the legs and arms as needed for the “fight or flight” emergency response.
Eating protein and healthy fats while limiting carbohydrates induces the production of the hormone glucagon which is the best way to protect bones.”
Eat like your life depends on it…because it does!
Supplements to consider Talk with your doctor about
- Glucosamine and Chondroitin supplements
- Vitamin D
- Calcium
Avoid Overuse Injuries: According to Erin “twisting and loading and unloading chair into car “definitely increases our risks of herniation and neck and back pain. We are definitely at greater risk since many of our body systems age faster than Abs”. She is planning on getting a transfer seat and lift system put into my van that will help me out-and I don’t have to do a full van conversion.
Avoid More Trauma from Falls Erin and I both have fallen many times from wheelchairs and have hit head which could have contributed to the trauma on spine according to doctors. Our initial injures could have weakened the disks as well causing early degeneration. RX: “Don’t Fall!”
Erin is scheduled exactly six days prior to me on December the eighth. We both want to go to Acute Rehab after surgery to get the best possible care, but pending insurance, we may be required to go to a less skilled nursing facility (i.e. nursing home) which would be a regretful and depressing fate that so many of those who are not fully independent either temporarily or permanently must experience as their only available option.
Home Health is a possibility, but not full time, and depending on how we both fair, (there is a risk of spinal stroke, paralysis, or other complications related with the surgery) that may be another option.
Please heed our warning, learn from our shared experience, monitor, and do not create undue strain and disk degeneration or herniation on your cervical or lumbar spine. Take the best care of the body you have been given post injury, and preserve your quality of life for as long as possible.
Erin and I will update our readers on our outcomes, and hopefully help others who may require this surgical repair to feel less anxious and get the best outcomes.
As Erin says, it is now our goal to get through these surgeries and “Get back to the busy and full lives we used to live”.
If you, or anyone you know has had this type of surgery and is a SCI, please reach out at contactus@pushliving.com or comment below on your experience. Thank you
You can reach Erin at United Spinal Arkansas ARSPINALCORD.org or at egildner@arspinalcord.org