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  • Andrew Brengle

How am I doing now?

Updated: Jun 9, 2020

In early June 2020 (1 year and 2 months post-op), my neck feels stiff, but the periodic discomfort and pain earlier experienced occurs less frequently. That discomfort mainly presented itself as a weird pressure running vertically up and down my spine from neck to mid back region. It's kind of amorphous, without having a definite location I could pin point. But if I sat on a solid surface like a wooden chair or even on a chair with a slim pillow for any period longer than 20 minutes to half an hour, I would feel this pressure. Kind of a dull, hollow, cold ache.

I still can't lie on a bed or couch with a pillow behind my head reading in that manner where your head is propped up with your chin closer to the chest than when standing. Nor can I sit in a chair with a laptop on my lap and type for any amount of time beyond 5 or 10 minutes. The neck gets a forced, irritated feeling and starts sending prickly sensations out. The head has to be more or less "thrown back" to maintain lordosis. I often read lying flat on my back holding the book or iPad aloft above my head. A workout for the arms, and the book/tablet ends up smacking you in the face or chest if you're nodding off. It's also better if I break up laptop typing with a standing desk--which is a high bureau in our hallway.

Exercises with rubber bands and free weights continue to help. I am up to 12 lbs on each dumbbell. (started with 5 lbs summer of 2019, then 8 lbs fall into early winter, 10 lbs late winter into spring of 2020) I don't like to go too many days without doing these exercises since I always feel better after. If I let 3 or 4 days go by without doing a series of back building and stretching exercises, and core-building routines (abs workouts), the stiffness in my neck asserts itself and my spine feels pinched and my left arm extra sensitive to buzzing, prickly sensations. Moving and flexing the muscles warms them up and lubricates them, and takes pressure off the underlying bone structure, while seemingly soothing any nerve irritation. Maybe endorphins come into play, but it always feels better to move.

I still don't have the strength or stamina I would like, as I notice when doing yard work or heavier manual labor such as stacking wood or moving things around a garage or basement.

I did wean myself completely from gabapentin (Neurontin) by mid May 2020. Since gabapentin helped with nerve pain and sensitivity, I was nervous about pulling back. After a few initial tries, I got down to one 100mg dose a day and eventually stopped that, without any significant resurgence of pain or sensitivity. Gabapentin can reduce coordination and leave one feeling less motivated to get out and do things. It may also impair memory, so hoping I feel a little sharper in body and mind without it. Still taking 5000 units of vitamin D and vitamin B-complex supplement.

Have been for a couple of bike rides on road, without incident. It's a bit of a strain on the back and neck to keep one's head up and looking forward (vs. down at road), but you can get used to it. It is going to take a bit of work to feel normal on a bike again. I also do Pelaton workouts indoors. I did go skiing back in late February (or was it March?) before I technically was supposed to. Sticking to slow, well-controlled, cruiser runs on easier terrain, I played it conservatively and it felt very natural and good to be back on skis. That may be the routine from here on out. Skiing for pure, laid-back enjoyment, with no need to prove anything.

As of late March 2020, a few days short of my surgery's one-year anniversary (March 29), I am functioning quite well. It has been a long haul, but the results are worthwhile, considering what I escaped - full paralysis - and what awaited me had I done nothing. Allowed to run its course, the myelopathy in my neck would have slowly choked my spine to death. I can't even imagine that end game.

Residual symptoms and ongoing weakness: I still have sensitivity in my left hand, especially the thumb, left over from the damage the ski accident fracture did to my nerve root at the C6-C7 foramen. My right arm is symptom-free. My neck is generally stiff, or feels stiff, although my range of motion side to side has improved greatly after 12-months. The ability to move my head up and down in a vertical, nodding motion remains limited, and I don't push it. Most limited is my ability to tilt my head side to side, again something I don't try to force. Gabapentin, a drug that helps buffer nerve pain, is a constant companion. I take about 400 mg a day (200 mg in the morning and 200 mg in the afternoon or evening). This is down from 600-800 mg taken leading up to and in the weeks after surgery.

I also take 5,000 units of vitamin D supplement daily to boost naturally low iron levels in my blood and to support bone graft growth. I take a vitamin B-complex supplement to promote spinal cord healing and general nervous system health; research suggests a link, although the connection has not been clinically proven.

I sleep on my back or on my right side. Sleeping on my left side is uncomfortable after a prolonged period - 30 minutes is about my limit. I purchased a cervical pillow that is concave in the middle with a slight ridge on the outside to support the lordotic curve in the neck. Sitting on a hard chair for more than 10 or 15 minutes stiffens my neck and shoulders. Or at least I sense a compression of the cervical area after too long, even if I put a pillow on the chair. I have exercises for building shoulder and trapezius muscles that support and protect the cervical area. If I don't do these for a few days, my neck cinches up and becomes a focus of discomfort. Since the trapezius muscles on your upper back are among the biggest on your body, the incision cutting through them and then the spreading of them during surgery inflicts the most trauma. This is also the most painful part of the recovery, as these muscles repair. And longer-term, they also seem to be the weakest link.

Generally, I feel weaker as a whole compared to life before my accident and surgery. Weight and rubber band stretching exercises have done a lot to restore strength to my back, shoulders, and neck. Over all, my strength and stamina remain below what I am used to. I am sure some of that may be due to aging, as I am on the cusp of 60. I don't remember growing tired a half hour into yard work or outfitting a boat. And in the morning, when I awake I rarely feel fully rested and ready to seize the day. It is an effort to rise. Perhaps the gabapentin plays a role here.

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