Cervical Spondylosis ruminations

Just been reading some postings on DLA appeals on another page, so, rather than interupt those postings, I thought I'd do a political rant here.

I haven't tried to claim DLA myself, so it's interesting to read about the obstructive barriers the system uses to discourage us. I'm still a foreign national, even though I've been here ( in UK ) 30+ years. I always knew, on coming here, that I was voluntarilly reducing my rights, as a citizen of a republic, and accepting my rights as a 'subject' to HM rather than as a free citizen. My choice, but not my preference. As an economic migrant, some issues are easily overlooked. The implications of this were that, as a subject, I would have no right to challenge any of HM Services in HM courts. It's a contradiction, and untenable by law. In theory, all of HM Services are protected from judicial reprimand in this way. Although we like to think we live in a democratic enlightened country, the envy of the world some would say, in actual fact our powers as HM subjects are very limited by comparison with other modern states. We have no written bill of rights and our voting system is antiquated'

Up to a point, I believe the British system is reasonably fair and workable. Until, that is, it becomes necessary to challenge the system itself. A typical example might be parking regulations and how they have been imposed on a law-abiding population without any regard for public opinion, and backed up by a one-sided appeals procedure. It's lop-sided jurisprudence which favours the strong and discriminates against the weak. In a word......Draconian. I'm sure it's not much different with DLA applications and appeals. Any appeals service should be totally independant, and this isn't reaaly possible when they all owe allegiance to HM Services. The interests of the state and the interests of government policy are difficult to challenge in this country. Again, I know a lot of people who like to think differently, but unfortunately, thats a romantic delusion.

I can't remember the last time, if ever, any British government was challenged, in open court, to justify it's actions. A public enquiry seems to be the best they can do, and that process simply isn't free from influence. Speaks volumes, doesn't it ? Recently, I've noticed, various politicians have gone so far as to promise a bill of rights, a written constitution, and a PR voting system. All long overdue, and the changes that should come in their wake are long overdue as well.

The only rights we have, as subjects, are those which have been established, over the centuries, by the process of legal precedence. This method of affirming our rights may have looked progressive in the 16th century, but, in the meantime, the rest of the enligfhtened world has moved forward.

Gerry

Latest news from the bunker!

Well. I've had my consultation with the neurosurgeon. As expected, she showed me where the problem was on the MRI scan, did some hand movement / pressure tests, and recommended surgery to relieve pressure on the nerve at C7. Thankfully, she didn't think it was more extensive than this, and asked if the hand had worsened since it first appeared last October, and how I had managed in the meantime. I told her that it was just the same, except the shoukder / arm pain had abated and that I had adjusted to using the hand as best I could.

So, she offered me an option......to put the op on hold and review the situation again in 6 months. This was music to my ears, as I don't think I was prepared to trade off the possible after - effects of the op with my current discomforts, so might have refused the option for the op anyway. At least now I have the option, as back up, if my situation deteriorates. As long as it's bearable, which it is, I don't mind monitoring it and trying out different home therapies to see how best to manage it. Gotta psyche myself up now for another round of pillow and sleeping position tests. The goal, as always, is to achieve optimum comfort, and win or lose, it's worth a try.

So, a stay of execution, a temporary reprieve from an encounter with the cold steel, and a mild sense of poat consultation euphoria. Unlike me, I'm reasonably content with how I've been pleasantly treated and advised, and now it's back to the nuts and bolts of everyday distractions. One thing though ( ah, this feels more like me ! ) I did ask if there was any advice on self management and, given that she's a surgeon and not a physiotherapist, she could only recommend not lifting heavy items or using a soft collar for sleeping. I have to say that, with the greatest respect, I'm probably a bit ahead of her on that one. That's ok. It's not her area of expertise and, to be honest, you wouldn't want your neurosurgeon to be distracted with anything other than what they do best. I'll have to get back to the physio on that one.

Hows that for a rumination......just the facts, and no hint of obsessive ranting or theorising. I must be slipping !

Gerry

Come on Gerry I need to read one of your long rants to keep me going before my surgery on Friday.

Awaiting a good read Tony

Hi Tony,

Unfortunately, I can't do rants on demand. It might looK like I'm just letting off stream at the slightest whim ! It's got it's own momentum and just happens when it happens. However, I am looking forward to your post op posts. Hope it's a success and you get a good result.

Gerry

Hi Gerry

Hopefully I will only be in 2 or 3 days, so you may have posted a rant by then and I can enjoy once I'm home.

Just to avoid any confusion I'm going to try posting the first 6 pages of the guide here again (maybe I can see what might have happened the first time I tried).

Gerry

Cervical Spondylosis Self Management

A guide to managing your day

Cervical Spondylosis ( C/S ) is a confusing and disorientating medical condition. Symptoms will vary from person to person depending on different levels of wear and tear on the neck vertebrae. Because of this, and perhaps because it has been considered best to deal with C/S on an individual basis, it seems it has been difficult for the medical professionals to produce a guide book to general self management for the C/S sufferer, with day to day advice. The purpose of this booklet is to try and fill that gap.

The focus here will be on advice for managing, both practically and psychologically, at home and at work, and not on qualified physiotherapy, medications or surgery. The expertise of the professionals, whilst absolutely necessary at times of crisis, doesn’t always meet the everyday needs of C/S sufferers.

As a long time C/S sufferer myself, I have been only too aware of the typical despondency that lurks behind this condition. “ I get knocked down, I get up again “ should be our anthem. It’s a difficult road to travel and one of the ambitions of this guide would be to try and help develop an overview which puts despondency and creeping negativity into a perspective we can better handle. The guide will be in 4 parts, namely:

1. Activities and movements which might aggravate painful C/S symptoms.

2.Practical tips for managing painful symptoms.

3.Dealing with adverse social reactions.

4.Developing a positive overview of C/S.

Activities and movements which can aggravate painful C/S symptoms.

One of the problems with C/S is that the painful reaction to any aggravation is usually a delayed reaction. It will kick in after 2 or 3 days and may take weeks, even months, to resolve fully. So, it is wise to understand what the possible aggravators are and to avoid any painful consequences by being continually mindful of what activities or movements to avoid.

1. Lifting heavy weights:

This will vary from person to person, but a weight of 10 kgs or under should be ok for those with moderate C/S. For those with a more serious condition, it is best to avoid lifting any weights at all.

Page 2

2Head movements:

Looking overhead, as in watching planes go by or admiring an ornate

ceiling, should be avoided. This movement may compress the neck vertebrae and might cause problems. Turning the head to look behind, or

to the side, as in car driving, can be another aggravator, especially if done quickly. Always be conscious of what seems to be the most comfortable position for the head and settle for that.

3. Working overhead:

Raising the arms above the shoulder horizontal, to do physical work, can

cause problems. Working directly overhead, as in repairing a ceiling

light socket, will definitely cause reactions. Painting or repairing

ceilings should be avoided. A good rule here is to try to be as close to, or

even above, the work you intend doing.

4. Sleeping in a draught:

Because the neck tends to be exposed, when we sleep, it is wise to

check for and eliminate any draughts in your sleeping environment. A

constant draught, playing on the neck, night after night, will exacerbate

any stiffness that already exists.

5.Driving:

Any jerky movements to look to the rear, or to the side can cause

problems. Simply reaching to the back seat, from the drivers seat can

set something off.

6: Gardening:

Any work with spade, shovel or fork seems to relay pressure to the

neck, and is best avoided. Again, any overhead trimming should also

be avoided.

7: Moving

Hi everyone

Looks like Ruminations page has been unlocked, so as you might expect I've got some further thoughts on ongoing C/S issues.

It might seem, to anyone reading some of my postings, especially here in the Ruminations, that I harbour a bit of prejudice towards, or have a lack of faith in, the medical professionals I've encountered over the last 30 years. I've been reflecting on this, as I do, just to try and figure if my attitude is a bit lop-sided and warped when I analyse my experiences. And the good news is this......I'm not prejudiced. I approach each new situation with an open mind, hoping to find someone whose advice I trust. When that does happen, as it does ocassionally, I know exactly how grateful I feel. It's chocolates and champagne all round. I've even approached the surgery thinking...\" If this new doctor can improve the quality of my life, I will decorate his/her surgery for free \". Luckilly, I never actually got to saying it out loud ! Maybe because I always felt a bit disappointed with the advice I was getting. Seems like a common complaint for anyone with C/S.

In order to view this issue from a different perspective, I have to imagine I'm the doctor, and I'm confronting a slightly confused C/S patient, who is obviously a bit upset and seems to distrust most of the treatments and advice they have been recieving. I know that they have C/S from the Xrays, but there are no obvious undeniable symptoms.....so, how do I advise this patient ? I know that their condition will deteriorate gradually over many years and, when the more obvious symptoms do eventually show themselves, that's the time for serious intervention, referral to Neuros etc. In the meantime, it's my job to help this patient to cope with their current C/S related and other problems. I can prescribe some painkillers and hope their condition will calm down gradually. I can refer them to physiotherapy, but I know that their treatments seldom achieve a successful outcome with C/S . I can try and reassure the patient that their symptoms will come and go and it's probably best that they just try and manage around that. This is all I can do until I see symptoms which might warrant neurological testing. I know this won't help the patient much at this moment, but it is standard practice, and it might at least help to lift their spirits.

If this attempted description of the doctor's perspective is anywhere near the truth, then you can see the lack of options available to them, and even less so to the patient. It's a bit of a recipe for further confusing the patient, but the doctor has limited choices. If the doctor is more familiar with C/S they might suggest using a more suitable pillow ( ? ) or advise being careful with neck movements. That's it basically.

Even if the patient gets a referral to physiotherapy or to a pain clinic, that's going to take a month or two to materialise. For me, the thing to be concerned about here is that, for good reason, the doctors and physios won't advise any unrecommended therapies that might help the patient deal with the 99.9% of their time which is spent in between appointments. They can't, it's not accepted practice.

Wouldn't it be nice to be given a leaflet of advice, so that at least we have the option of following some programme of guidance, which we feel might be beneficial. It's not even necessary that the guidance is proven to work, it need only be a template to work off. As long as the guidance is not detrimental, it can only be beneficial or useless, and any self respecting C/S sufferer should be able to spot any useless advice from a mile off.

I fully understand that the people who would normally compile such an advice leaflet would encounter problems advising for different grades of C/S , varying symptoms and different rates of degeneration, but I don't think that should be to the exclusion of any advice at all. In over 30 years, since first diagnosed with C/S, I have

Hiya Gerry.... :cheers:

I just decided to pop in here to see where you were at. Boy did i have a lot to read to catch up!!! :lol:

I have to admit that i have avoided coming into the CS forum lately....The reason being is that I am still in a lot of pain...10 months Post Op!!!!! :cry: I was worried about putting you and any others considering the surgery off going through with it. I know its not the same for everyone and i dont think you the type of person to be put off by others surgery, but i guess I almost didn't want to admit to myself that I feel that maybe my surgery was not as successful as I had hoped it would be.... :wah: I am now on new stronger meds again and waiting for an appointment with a Pain management specialist....He is very reputable around here, so I hope its worth waiting the 3 months for my appointment!!!

You seem to have a really great positive attitude to CS...I admire that a lot!!! I am working on that myself....keeping my stress levels at a minimum, looking into relaxation, trying to take 1 day at a time and not think of my future with doom and gloom...Who knows whats around the corner, hey...???? :D

Take gentle care of you, my friend...Love Jassy..xx.. :fairy:

Hiya Gerry.... :D

I just wanted to let you know i was thinking of you and wondering how you are doing.....Take care.....Jassy..xx.. :fairy:

This is the first time I have visited this site. My husband has just been told that he has probably got CS.

I have had a tendency to osteoporosis for many years now and looking at this and some other CS sites the following points immediately sprang to mind:

Most of you have been told that your problems are caused by 'wear and tear' - of the bones in the neck.

Some of you may have bony prominances as well.

Cs tends to be treated along with arthritis although it is clearly not the same.

.....So I would ask the following questions:

Why should some people have excessive wear and tear whilst other people doing the same jobs/work etc have no problems?

Why has nobody noticed the similarity to osteoporosis?

.....Perhaps the answer to the second question is that it has been noticed, but that the medical profession as a whole has just a big a problem with osteoporosis as CS. However, a great deal of research has been done on osteoporosis and it can be dealt with. The big stumbling block is that the medical profession as a whole is at least thirty years behind the research.

When I was diagnosed I did a literature search into research papers and found the answers I needed.

.....The big issue is how diet affects the structure and maintenance of bone. Calcium can only be absorbed correctly into the bone in the presence of the correct balance of vitamins and minerals. Too much calcium is as bad as too little - causing bony prominances. I was able to correct my problem through diet and weight-bearing exercise. Perhaps a similar change of diet would also help to deal with CS, at least slowing further deterioration.

.....I suggest investigating osteoporosis web-sites which do n o t advocate drinking milk - osteoporosis is greatest in the countries where most milk is drunk. There is a description of bone metabolism and how to change things on (the usual prefix) health-reports.com/Osteoporosis - but try to ignore the sales pitch!

.....My husband will be changing his diet immediately!

Hope this helps.

Birdfeeder

Hi Birdfeeder,

It's interesting what you say. I've never come across a comparison of the two conditions, and similarly no suggestions of milk / dairy diets with vitamins. With Osteoporosis there is a need to deal with calcium related issues because of the nature iof the degeneration. But, with C/S , the degeneration tends to be injury based or arthritic based and the calcium issue isn't usually considered. The bony spurs, osteophytes, in C/S, are generally regarded as corrective growths to help stabilise the neck. However , they do interfere with the nerve roots and thus cause all the symptoms associated with C/S. Even removing the spurs surgically can create greater vulnerability. Osteoporosis tends to be a whole body issue, whereas C/S is contained in the neck, although with radiated symptoms, and that raises the question of why other joints don't have the same kind of degeneration as would happen with diet deficiency or osteoporosis.

There's nothing to say that improving your diet, with an eye on keeping the bone structure healthy, wouldn't help with C/S, but such advice never appears in recommended therapies, unless, of course, a condition, such as osteoporosis is suspected as the cause of the C/S. It seems that, where no other condition is apparent, then C/S is considered a mechanical problem and therapies tend to address movement issues.

With my case, I don't have other joint issues and therefore would need some convincing to change my diet. But, I don't discount it , simply because it looks like a healthy option anyway. And who knows, over the years, it might offer improvements. I feel a little research coming on here, but for the moment I'll stick with memoryfoam, cervical pillows and altering sleeping arrangements to keep the worst symptoms at bay.

Gerry

Hi Everyone,

Had my 6 monthly review with the neurologist this week. All went well, a pleasant visit, and she agreed that, as I was managing ok and not experiencing pain in arm, that there was no need for surgery as yet. She gave me an 'open appointment' as an outpatient, for the future, in case the pain returns. This means that I won't have to go through GPs and Physios again just to access the neurologist. I've also got another review in 12 months time.

Obviously, compared to other people's experiences, I'm very happy with this outcome...i.e avoiding surgery. I've still got numb / clumsy hand, but with no pain as such, and I've adjusted to using it at home and at work. A year ago I couldn't write my own name, or turn a screw, or hammer a nail. Now most of the co-ordination for these tasks has returned. I think it's more a case of learning how to manage it and if I can, hopefully, keep any arm pain at bay, then I don't think it will evolve into a big problem.. So far, so good.

Gerry

Off again !

Just been thinking about how I define my day, the decisions and choices I make, and perhaps most importantly, what are the critical factors which influence my decisions. I don't particularly like doing this because it means I must confront and question the 'easy' options I take and thereby risk undermining my comfort zone. If I unsettle my routines, then I've only got myself to blame for any ensuing discomforts. Today I feel pretty good, a bit of neck stiffness and numb hand, but otherwise ok, so I can afford to be a little philosophical and experimental about my decision making processes on days when the outlook is a bit more gloomy.. On those days, I really only want to tackle how I feel, rather than how I think.

My first thought is the word 'experimental'. What does that mean. I think it's from the Latin and means something like 'out of normal thinking'. I like that...a bit like todays phrase 'thinking outside the box'. DEfinitely suits my ramblings.

Now, Iknow that, on a rough day, I'm not going to be thinking 'choices about decisions'. I just want to take the meds, wait for the relief, and leave the thinking to others. All agreed ? I've made a decision without thinking, which excludes all else, and I don't even want to think about any complicated analysis of what I'm doing. Perhaps I know, subconciously, that thetre are problems with my decision making but there's nothing wrong with a bit of blunt denial if I know the actions I've taken might bring some relief. It's a subconcious trade-off. I'm just as inclined towards it as anyone else. The thought of turning a bad day into a moderate day has it's appeal and how I do that should be nobody else's business.

However, as I'm already having a good day, I can look at this process more closely and I can see that I don't have to be a 'rocket surgeon' to realise that this is the same thinking that accompanies alcohol or drug addiction....an irrational denial of the pros and cons of my actions in order to achieve one outcome.....temporary comfortable oblivion. It raises multiple questions \"How long will it last ?\" , \"Are there side effects ?\" , \"Will the dosage need increasing ?\" , \"Am I treating one problem with another problem ?\" , \"Should I be trying something else ?\" etc. etc. These are all questions just begging to be denied, simply because we all know the answers. If only there was one medication which ticked all the boxes positively, then I'd have no need to unsettle my thinking like this. But there isn't. And there never will be. So, no need to waste our time holding out for miracles.

The real issue I'm trying to get to here is the point of choosing what action to take when confronted with the prospect of a tough day ahead. Easy Option A seems to have evolved with inclusive denial of any real benefits except temporary pain relief. It also includes a denial of any counter effects. Option B might be to try and weather the storm and hope it's not so bad tomorrow. A brave choice, but perhaps over-reliant on unknown hopefulness. A second bad day can easily undermine this option. Option C might be to take meds today to calm the storm and use the relief time gained to try and figure why it was a bad day to begin with. Option D might be to only take meds if the pain is intolerable and use the time etc. etc. There are many options, but the ones which offer the possibility of any improvements, especially long term, should stand out above the others. Any option which offers minimal reliance on meds and the possibility of lessening any discomforts to a manageable degree is probably the all round best option available.. As they say, it's as good as it gets.

With C/S, a lot of the uncomfortable painful symptoms such as headaches, neck stiffness, shoulder aches, are actually caused by neck muscle adjustments as the neck tries to protect th

This is great. All this empty space to explore ideas. Feels like there's a whole vacant vitual universe out there just waiting to be filled with new ideas. I might even invent a few new dodgy theories just to keep it ticking over. Seize the moment and all that. Sometimes when we're communicating about such serious and sensitive matters, as C/S, we have to avoid saying things which might offend, or even distract from how we percieve others might be feeling. It's a bit of a minefield, which seems to me to not be the best environment to explore new ideas, simply because we don't desire to tread on any toes. And yet, it is the most appropriate place because any ideas are shared by others whose interests should be similar.

If anyone had the idea to conduct a survey of new therapies for C/S, this would be a good place to start, to check for any feedback, before entering the lenghty process of clinic based trials. Those trials take years, and if the outcome is faulty, they can also take years to undo. The only problem with sharing new ideas on the internet is that it is not accredited and therefore cannot be trusted. Fair enough. However, if, like me, you have been subjected to dubious accredited advice in the past, it seems just as valid to explore any ideas encountered with an open mind and trust in our own ability to assess their usefulness. Just because our trust in professional advice may have been bruised and dented shouldn't mean that we also lose trust in our innate ability to assess with reason.

Apologies for the lecture. I just saw an empty space and went for it!

Gerry

Right. You've had long enough to digest and comment on my previous postings. Time's up. Gotta move on. Here's the next installment !

This is how I see the whole C/S scenario and all it's many varied symptoms,.

A person with no neck problems will be unaware of the work the neck does in protecting and ensuring proper functioning of the organs which pass through it i.e. throat, windpipe, nerve cords, spinal column. An occassional sore throat, crick in the neck, or choking sensation may create some sensitivity, but generally the neck does a great job of going about it's business unnoticed. The dynamics of the protective muscular reactions of the neck ensure this is so.

With C/S, and other similar spinal conditions, the reative processes which the neck employs must be increased to ensure continued protection and functionality. These increased on / off reactions, because they exceed the the limits of what the neck is designed to do under circumstances, can cause their own problems, or even exacerbate existing problems. Stiff neck, headaches, shoulder and chest aches and pains, all result from increased neck adjustments rather than from the original spinal problem.

Direct symptoms of the spinal problem, and any resulting nerve compression, usually manifests as numbness, tingling, pins and needles, loss of sensation and lack of coordinated movement in hand, arm, leg, bowel or bladder.

A distinction should be made between these two sets of symptoms because they both need to be dealt with differently. The reactive on/off symptoms can be treated by better understanding of and application of techniques to accommodate the level of protection which the neck is trying to achieve. If we know certain conditions under which nerve compression is less likely to happen, or is less severe, then it follows that reactive symptoms will lessen also, because the neck no longer needs to apply such extreme protective adjustments.

At present, the only way to assess the best conditions for this to happen is through trial and error ( or trial and success ), adjusting our behavioural patterns, most particularly our sleeping routines. These assessments have never been carried out on a clinical basis, as far as I know, because they would take too long and cost too much. AS such there is no real advice out there to guide us through such a process and therefore it remains trial and error (success). If we are honest with ourselves, then we know that there are no real alternative treatments on offer, which guarantee the possibility of improvement, except to completely numb all our senses with prescription painkillers, and such a course of action merely guarantees long term dissatisfaction, for reasons we are all aware of.

Where direct nerve compression symptoms are concerned...numbness etc., a different course of action is required. These symptoms generally require surgical intervention, but only where it is considered advantageous to do so. Sometimes it is considered too risky and so the patient is left with no option but to learn how to self manage the problem. Back to square one ! It's not always wise to put your faith in questionable options which might never materialise. And whose to say that, by learning and applying self management techniques, any general improvements achieved might not also affect the nerve compression issues long term, thus perhaps lessening the need for intervention.

We shouldn't lose our trust in the body's ability to try it's best to heal itself.