Yesterday was absolutely exhausting. I slept horribly because of nerves, so I was already exhausted when I woke up to get to my 9:50am appointment. Well, and some of that was due to my odd inability to adjust to daylight savings time (for those that don’t know, in spring we move our clocks forward one hour, and in fall we move them back one hour… not every state does it, and it’s an antiquated concept we just haven’t abandoned)… normally, I adjust just fine, which is why I say it’s an “odd inability.” At 9:50am, I had my neurology appointment, then at 3:30pm I had an appointment with my ENT. In between the appointments, Dan and I went to Sam’s Club for some prescriptions and garden stuff. The ENT was really behind, so I actually didn’t leave until 5pm. Needless to say, after that, I was so exhausted I didn’t do anything at all the rest of the day.
On to the neurology stuff, the real reason I know ya’ll are reading this post 😛
First, he listened to all my complaints and asked some basic questions. Then he pulled up the MRIs and showed them to Dan and I. MRIs are SO COOL!!! It was so interesting getting to see what was happening inside of me and what I looked like in so many different layers. He showed us the brain one (from top to bottom and then from side to side). My brain is 100% normal! This is fantastic news. My headaches are also not due to Chiari malformation, which is a condition where part of the brain is protruding from the skull into the spinal canal, thankfully. Then, he moved on to the scan of my neck.
My neck is not normal, not at all. First, lets go over basic spinal anatomy:
Discs are labeled by which vertebra they are located between. There are 7 cervical vertebrae, labeled C1 through C7. There isn’t a traditional disc between C1/2, which means that there are 5 discs between the cervical vertebra. There are 12 thoracic vertebrae (T1 thru T12), between 5 and 6 lumbar vertebrae (usually 5, labeled L1 thru L5), then the sacral vertebrae are fused together to form the sacrum. There are discs between all the vertebrae, including between C7 and T1, and between T12 and L1.
The “spinous process” (as shown in the picture to the left) is the portion you can feel/see on your back. The “body” is in the middle of your body. The “vertebral foramen” is where the spinal cord runs.
There is a tube that runs down the vertebral foramen that contains the spinal cord (bundle of nerves) and spinal fluid. The spinal fluid surrounds the spinal cord and helps keep it protected. Nerves branch out of the spinal cord and into the rest of your body between vertebrae. In the image on the left, you can see the spinal cord running down the vertebral foramen. You can also see the disc, vertebral body, and spinous process. To help orient you, remember the spinous process is towards the back.
Now that you have some basics, I can explain what is happening in my body better.
I have three bulging discs in my neck: C3/4, C4/5, C5/6. All of the discs are bulging in towards my spinal cord. Thankfully, none of them are compressing the spinal cord itself, just narrowing the space where the spinal fluid is. There is still fluid between the discs and the cord. The disc at C4/5 is the worst one, and it is also bulging into the nerve foramina (the space where the nerve is exiting the spinal column to go into the rest of my body). The nerve in the nerve foramina is actually being mildly compressed by the disc. Luckily, none of the bulges are bad enough for surgery!
Also, my neck is almost perfectly straight. In the image that contains the entire spine (the first one), you can see that the cervical vertebra are the beginning of the curvature in the spine and are slightly angled (they are diagonal in relation to the ground). My cervical vertebra are stacked almost perfectly one on top of the other.
None of the bulges should really be causing any pain, except for the one that extends in the nerve foramina. Even the one that is pinching the nerve should not be causing me this much pain, though he wouldn’t have been surprised if it was causing a little pain. The straight neck thing, I imagine, could cause a little pain. However, we have no idea why I’m in so much pain still.
After I explained the pain in the rest of my back, and the pain in my ribs, the doctor decided to order an MRI of my thoracic spine as well. We’ll see if maybe that MRI will yield more results, hopefully my insurance will cover it.
He also put me on a medication to prevent migraines. Apparently, migraines can have the same symptoms as stroke (lovely). He’s hoping that maybe some of my pain and symptoms are related to my headaches and will get better with this treatment. We’ll see.
The good news is, everything with my spine should be fixable with physical therapy. We’re hoping that I can get insurance to cover some work with Joleen, even though she is out of network, so that I can work with someone that knows the whole story. Either way, it’s really nice to have a specific direction for treatment!