I finally received my MRI results a week later, only because I picked up a DVD of the MRI for my physical therapist. Incidentally, my PA did call me the day after the MRI. She told me that the radiologist had comments on my neck, but that she didn't want to give me results until she had the report in front of her. HOWEVER... the radiologist remarked to her that I had a very serious sinus infection and that he recommended that my sinuses be imaged. Oddly, I didn't feel like I had sinus symptoms, but the MRI showed all of my sinuses being blocked. So... I earned a 2 week course of Augmentin to see if it kicks it. Of course, NOW that I've been on antibiotics for a week, I've started to feel like I have a sinus infection. ENT referral in my future?
(Facebook friends may have already seen my MRI update, but I'm not Facebook friends with everyone that I'm SparkFriends with.)
Right now, I'm winging the diagnosis since I haven't been given a full professional diagnosis yet. From the MRI report, I have:
Hard Disc Osteophyte
Facet Joint Arthropathy
Also, all of the bloodwork for systemic disease came back negative - no rheumatoid arthritis, lupus, or Lyme's Disease.
The MRI report has all the medical-ese, but here's a summary that includes plain-English:
C4-C5: Disc dessication (loss of fluid) with minimal disc signal (the disc barely shows up on MRI), prevertebral osteophyte (bone spur), stenosis, low-grade left side foraminal (channel for nerve) neural compression (pinched nerve).
C5-C6: Near complete loss of disc space, disc dessication with loss of signal (disc basically collapsed), spondylosis (disc is hard), large hard disc osteophyte complex (the disc has been displaced and the displaced area has ossified with a complex of bone spurs), anterior osteophyte (bone spur on the front of the spinal cord, facing the front of the body), uncovertebral osteophytes, marked right side uncovertebral joint arthropathy (joint disease, similar to arthritis), minimal left side uncovertebral joint arthropathy, right & left foraminal stenosis (narrowing of the neural canals), high-grade right foraminal neural compression, mid-grade right ventral nerve root (anterior, or front, root controlling motor skills) compression, low-grade right paracentral (near the center of the vertebrae) canal neural compression.
Cervical Spine: Arthropathy over the entire mid-and-lower cervical spine.
My physical therapist went over the MRI with me and told me that the unfortunate thing is that these results mean that there's little she can do to relieve the joint/bone pain. She can help with my trigger points in my muscles, and she can provide traction to try to open the joints a little, but it's time to see a spinal specialist. She says that it's quite likely that I'll need to have surgery - to remove the bone spurs and possibly to place a bone graft to "jack open" C5-C6 until artificial disc replacement comes out of clinical trials. The surgery to remove the bone spurs will probably become a procedure that is done every few years to clear out the newly formed bone spurs. She also suspects that the arthropathy extends down into the thoracic spine because she's had such trouble with moving those joints, as well. Of course, my t-spine MRI was rejected. A bit more conservative approach would be to have epidural steroid injections into my cervical spine, but that's like putting a band-aid on it. It alleviates the symptoms, but doesn't treat the disease.
My PA called me the next day. Well, not really. The *receptionist* at my PA's office called me the next day saying that "PA's-name wanted me to call you and tell you that the MRI didn't show any herniation, but that you do have arthritis. She wants you to follow up with a pain specialist." I was indignant. First, because the PA was able to call me herself about the sinuses, but not about my spine? And second, my diagnosis goes well beyond "arthritis." I have neural compression, I have narrowing neural canals, I have bone spurs all over the place, I have collapsed and near-collapsed discs.
I don't just want to see a pain specialist - I'd like to see an orthopedic practice with a pain management specialist and a physiatrist on staff. My physical therapist had given me a recommendation for what appeared to be the perfect practice, until I learned that they only see patients on an Out-of-Network basis. They discount the visits by 30% and 50% for the x-rays, and then insurance reimburses 70% and 50% respectively - so it would balance out, but I would have to pay for the visits in full up front. I could expect my first visit to run as much as $525. I'll pass and find an in-network provider.
In the meantime, I'm taking my muscle relaxer, my prescription anti-inflammatory, and Vicodin religiously. Sitting at my desk is bad. After a weekend (long weekends are worse), I spend the first day back in the office in agony as my trigger points all flare up and I have pain running down my arm, occasionally tingling. Driving hurts. Watching anything longer than a tv program hurts.
I'm going to start easing back into exercise. My PT says that a recumbent bike would be best, but I can also gently use the elliptical. I asked about running, and she told me that it's probably not a good idea in the immediate future, but that running is actually better for me than sitting at my desk (which I do 8 hours a day). I will probably wait until we start getting the pain under control before I try that. I found a yoga program for arthritis sufferers on FiOS the other day, so I think I'm going to give that a shot as well. I have to start doing something because it's almost certain that I'm going to be introducing steroids into my body soon and I know that that will result in even more ballooning.