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Iwan Sadler- Diagnosis

Reaching a Diagnosis - A Patient's Story Part 2

I went to see my doctor the following day and explained the situation.  He made an appointment for a MRI and gave me some tramadol and  naproxen pain killers.  Whilst waiting for the MRI I returned to work on light duties, having been advised to avoid anything too ‘physical.’  

 Not being able to work properly was frustrating.  As my symptoms had improved a little I went back into the warehouse.   Everything was fine initially, but then one day as I picked up a 20kg feed bag and twisted to place it on a shelf at shoulder height, all of a sudden I had the feeling I was going to pass out.  
 
Iwan Sadler

My work colleague walked towards me asking if i was ok.  I lifted my head to reply but all I could see was his silhouette.  My vision was all blurry.  I started to panic.  I finally got to my feet but I felt sick and my balance was really affected.  I had to go off work, again.  

The following day I went back to see my doctor and explained the symptoms were getting worse especially after physiotherapy and I was very concerned. He referred me to a surgeon and also increased my amitryptaline.  After a month I had still heard nothing, so I contacted the hospital directly, only to be told I had been referred to the wrong type of surgeon and I needed a ‘neurosurgeon.’  My referral had therefore been passed onwards.  

It was now August 2014 and I was still waiting, so I decided to ring the neurosurgeon’s secretary directly. She advised me my appointment was not until June 2015!   I explained my situation and said I was only 20 minutes away, so if anyone cancelled their appointment I would be there.    On December 5th I got a call, they would see me that afternoon – it was like Christmas had come early.    

My MRI was finally performed. I spoke to my doctor about the results, explaining about the muscle spasms in my left arm, the dizziness and imbalance. The doctor explained it might be ‘trapped nerves.’ He prescribed me Amitriptyline at night time and referred me to the Musculoskeletal Team. It didn’t really make sense to me – how could a few trapped nerves give me all these symptoms?

MRI showed showed a C4/5 disc protrusion touching the spinal cord.  This was causing some ‘signal change’ within the spinal cord.  There was also a bony spur on my C5 vertebra compressing my left C6 nerve root.  

I went to see the Musculoskeletal team. I was seen by a physiotherapist and he asked my about my symptoms. I explained when I hyperextended my neck it would make me feel dizzy and nauseous, like I was about to pass out. He began to examine me, manipulating my neck. As he started to hyperextend my neck, the symptoms started; I could feel myself passing out and I had to ask him to stop. He apologised that he had to put my neck in painful positions. He asked me if I would like surgery or prefer further physiotherapy.
I was shocked that I needed surgery. I couldn’t just say yes without talking it through with my wife and family, so I went for the physiotherapy option, I had nothing to loose by giving it a go and it also it gave me time to gather more information. 

He had explained that I had problems with my disks pressing on nerve roots but the answer wasn’t informative enough for me. I walked out of there pretty stunned and confused. I wanted in depth answers so I went home and started doing my own research. I rang the radiography department of my hospital and asked if it was possible to have copies of my last x-ray and MRI they said that they could put it on a cd rom for me for a small fee I agreed and within a few days I was able to pick up my results. ​

My first physiotherapy session was with  the same person who saw me before.  He told me to lie down face first on the physiotherapy table and he started putting downward  pressure on the back of my neck.  I could instantly feel the pain and as he worked himself up and down my cervical spine.  In the end i asked him to stop, I got up and again my balance had gone.  I was feeling dizzy again and my eye sight was blurred he asked if i was ok and I explained to him the symptoms.  I got to my feet but had to sit back down.  He told me to  sit there for a few minutes until the symptoms passed.  A few minutes later I was able to stand.   He asked me if I wanted another appointment but it was clear in my head this wasn’t working, I needed to see a surgeon. 

I walked out of the physiotherapy department feeling nauseous and dizzy.  I got into my car and slowly made my way home but when I got home I had to lie down as I now had a really bad headache.  As I lay there I noticed my vision was blurring and I couldn’t move my legs.  This was getting really scary.  I started to panic.  I got out my mobile and rang my wife, who called my parents to come round.  By the time they arrived, things were improving a little.  They rang the physiotherapist who advised me to lie down and if the symptoms returned to go to A&E.

Within a week I had my physiotherapy appointment.  I had tried acupuncture before with some benefit, however this time round, despite 6 sessions, I found it of little benefit.  The best outcome from the therapy sessions was a chance to better understand my condition. The physiotherapist explained that my muscle spasms was due to my body sending messages to my neck muscles to protect my cervical spine and it would to this by contracting around the area which was causing me more pain by putting more pressure on my spinal cord.  She advised if i could get my neck muscles to relax,  it would really help with my pain and my symptoms.  This seemed to be useful when my symptoms flared. 

My wife drove me to my appointment; I was too scared to drive.  As we made our way to the hospital I was thinking of all the questions I wanted to ask, but when I walked in to see him, I just sat and listened.  He pulled my MRI on the screen and the first thing he said was” this hasn’t happened overnight.”  He explained that I had reversal of  the cervical lordosis (forward curve in the cervical spine instead of a backward curve) and my intervertebral discs were degenerate, particularly at C4/C5 C5/C6 and C6/C7.  This was associated with stenosis and  a significant radiological abnormality on the left at C5/C6 where an osteophyte was encroaching on the intervertebral foramen.  He did mention even with surgery I would still have the symptoms and therefore he advised me to try and manage the situation conservatively with physiotherapy.  He suggested acupuncture.  He also said that I wouldn’t be able to do any physical work and that he would review me in a few months.

Despite these therapy sessions my symptoms were generally progressing. I started to loose my grip strength, I developed pain in my left leg and my walking started to deteriorate.   I saw my GP on a regular basis.  He continued to increase my Amitryptaline.  I suggested seeing a pain specialist but he said to wait until I had seen the Neurosurgeon again. 

I was becoming frustrated with the lack of information.  I joined forums online and did loads of research about cervical stenosis,  degenerative disc disease, spondylosis and then I came across the term Myelopathy…. It comes from the Greek ‘disease of the spinal cord’ and all of the symptoms seemed to fit with mine.  It was then I realised it wasn’t nerve pain that I was having, this was pain due to pressure and damage to my spinal cord!  I just knew then that the longer I have pressure on my Spinal Cord the worse my symptoms would become and I could develop new ones.