Injury Update: Now with more MRIs!

Take heed, boys and girls, here there be some foul language. Turn back if you offend easily.

Well, now it’s settled: I’ve officially fucked myself up good and proper.

As I told my office mate upon finding out the prognosis and degree of my injury, evidently I can’t do anything half-assed, even fucking myself up. So, for those of you who just want the results, here they are: I ruptured/herniated my C6-7 disc, and am scheduled for an Anterior Cervical Discectomy with Fusion on June 27th.

But before I dig further into the results and what they mean, let me step back for a second and explain what happened through the lens of knowing what’s wrong. Hopefully, I can do a better job this time than my previous attempt, which relied on a bunch of incorrect info from the doc in Pensacola.

First, back at the end of January (right after pictures in this post were taken, actually), I decided that I was going to modify my pull-up and chin-up routine and go from weighted pull-ups and chins to unweighted. This meant going from 1-2 work sets of 3-5 reps with weight to 3-5 work sets of 6-12 reps unweighted.

This doesn’t seem like a big deal at first blush (obviously I didn’t think so), but if you work out the numbers, it results in an increase in training load of 11,000 lbs (I weighed 215 at the time). You simply can’t just jump into pushing your body this hard this fast; And you certainly can’t do so on a caloric deficit after pushing yourself relentlessly for two years.

The first week of this increased load, I felt a burning pain in the center of my upper trap. I didn’t think much of it, but it did cause me to decide to take a few days off from pull-ups and chins. The next week, after I was feeling OK again, I jumped right back in. This time, after the first set, I was hurting again, and after the second set, I was in enough pain to realize something was really wrong.

Over the next couple of days, it got progressively worse. I flew out Saturday morning, and by that time, I was coated in Icy hot, downing Ibuprofen and Acetaminophen according to maximum dosage recommendations, and had partial numbness in my left index finger.

In Houston, I had to rush from one gate to the other all the way across the airport carrying my laptop bag, CPAP machine, and a 6 pack of Coke Zero. The farther I went, the worse I hurt, and by the time I got to the gate, I was in excruciating pain. My left arm was shaking uncontrollably, I could not feel half of my left hand, and I had sharp, throbbing pain from my trap through my shoulder and pec all the way down to my forearm. It felt like I had pulled all the muscles on my left side, pretty much.

I gutted it through the flight to Pensacola, managed to make it through the airport, Walmart (to get Ace bandages, a sling, hot/cold packs, and more meds), and back to the hotel room, where I basically spent the night in bed sleeping roughly 15 minutes at a time. On Sunday, after getting 4 hours of fitful sleep according to my Bodymedia data, I hunted down and visited a local urgent care center. The doc there did a few diagnostic tests and poked around a bit and diagnosed my issue as a torn trapezius muscle which was swelling and putting pressure on the nerve root. She advised rest and NSAIDs, prescribed me same (along with a weak-assed painkiller and muscle relaxer), and sent me on my way.

These helped so well that I got less sleep on Sunday, and ended up with 2 hours of sleep by Monday. Luckily, my coworkers were kind enough to cover for me on Monday and let me take the day to try and recover some (thanks Paul and Carole), and I managed to squeeze in 5 hours of sleep Monday for the 16 hours I spent in the bed (again, both from Bodymedia data). Here’s a shot of what that looked like, to give you an idea:

However, this was the worst of it, and the pain calmed down enough over the next few days that I managed to get 5-6 hours of sleep pretty much every night for the next 2-3 weeks. My thumb quit being numb after the first week, and my middle finger started regaining feeling around the third week (full feeling didn’t return until last month). I have progressively gotten better, but it has been very slow, and it seems like it gets slower every day.

Functionally, here’s where I currently stand:

  • Left index finger still partially (~50%) desensitized. Hot/cold sense came back about a week ago.
  • Some loss of coordination with both arms/hands, though I am not positive that this is due to Radiculopathy yet.
  • I can now voluntarily contract my left triceps as of this morning, though I do not know how useful it is yet. Last week, 10 reps with 10 lbs on triceps extensions was all I could do.
  • Good range of motion, though the MRI’s showed that I have a chronic grade two separation of my left AC joint that I literally never even noticed.
  • I have an extensive amount of atrophy on my left upper body. My left pec and arm, in particular, looks like it’s from someone else.
  • Possibly low power output in the left shoulder and pec, though that remains to be seen due to the extent of the weakness of my triceps. Will test further this week.
  • Minimal pain, centered in the neck and trap mainly. Quit taking painkillers regularly about a month ago.

Based on how slow I was recovering, I went to a chiropractor who also specializes in soft tissue work a few weeks ago, and based on my symptoms, he sent me for an MRI of my neck and shoulder (he suspected a pec tear because of the atrophy). Here are the results of the report:

“C6-7 level shows a broad based disk extrusion resulting in cord compression. Disk extrusion measures 8 x 14 x 5 mm in the craniocaudual, transverse, and AP dimensions respectively. No gross cord edema or myelomalacia is detected. The AP dimension of the canal is 6 mm, consistent with moderate central canal stenosis. There is moderate to severe bilateral foramenal compromise with a probability of impingement to both exiting nerve roots.”

Yea, yea, I know, what the hell does that actually mean? Well, here’s an MRI shot that’s pretty self explanatory:

When I saw this picture, I was worried, but not too bad. Honestly, if you look through a lot of herniation MRIs, this one doesn’t look that bad. But it turns out, this is the good pic. To show you the bad pic, though, I first have to explain it, using a shot of one of my ‘normal’ discs as a reference.

This is a shot of my neck from the top down. My mouth is towards the top of this image. All of the middle-tone gray stuff (the majority of the image) is muscle, which I have a bunch of (hey, silver linings and all that). The thick, dark outer coating is skin. The fluffy looking gray stuff between the skin and muscle is fat, and the really dark, almost black stuff in the middle is my bone and disc. The really white stuff in the image is fluid, and the grayish stuff in the middle is nerves. Here’s a marked on version that better explains it:

So, now that you know what one of my normal disks and spine and such looks like, here’s my herniated one:

And just to point out what may not be immediately obvious:

Basically, the way the doc described it to me (all while I’m pestering him with questions to make sure he has plenty of motive to have me spend the rest of my days rolling around like Christopher Reeve) is that the herniation has forced out most if not all of the protective fluid and is directly squashing both my spinal cord and my exiting nerve roots on both sides. Since your chances of a successful surgery are much higher when you get it done in the first 6 months, and it’s now been a little over 3 months since my injury, I need to do this soon. The soonest I can do it is when I get back from my little brother’s wedding, so that’s when I’ve signed up for it.

Now, that being said, truth be told, I’m hoping to recover enough by then to cancel it. Why? Well, this is permanent, and fusing one level makes it more likely that another level will herniate. If I can heal without surgery, there is a higher likelihood that this level will herniate again, but I’ll cross that bridge when we get there.

The doc does not think it likely that I will improve, and I’m not holding my breath, but I will also not sit idly by and accept my fate. Fuck that. Between now and then, I’m going to do every possible conservative treatment that has any likelihood of success with little to no likelihood of making the situation worse.

And I’m not going to cancel being in my brother’s wedding. Whatever infinitesimal risk I’m taking by putting it off one more week is insignificant in comparison to being able to spend time with my family and be a part of a major event in my brother’s life.

If none of my effort pays dividends, so be it. On the 27th of June, I go under the knife, and I hope that when I wake up, I don’t have to learn how to steer myself with a mouth joystick.

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  1. #1 by GeneStarwind on May 12, 2012 - 2:14 am

    That sucks a huge fucking big one man, I’m sorry.

    • #2 by Brian Hill on May 12, 2012 - 3:07 am

      Thanks man. I’ll get through it though. Just one more thing’s ass that needs kicking.

  2. #3 by Anonymous on May 14, 2012 - 4:39 pm

    Sorry you’ve got to deal with this, Brian. Luckily, you seem to be a tough fucker with a good sense of humor. You’ll make it through OK.

    I don’t understand how you herniated a disc in your c-spine by doing… bodyweight pull-ups? Was it caused by impingement of the swollen muscle? Traumatic event in the airport?

    • #4 by Brian Hill on May 14, 2012 - 4:45 pm

      Yea, I don’t either, though in reading about it and talking to the various docs, it’s much more likely that it’s been bulging and close to rupture but asymptomatic for years, and something just pushed it over the edge. Seems like the vast majority of cervical herniations are caused by poor posture while sitting in front of a computer screen, which would describe about 80% of my waking hours since the age of 17 or so. 🙁

    • #5 by Anonymous on May 14, 2012 - 5:55 pm

      You and me both…I just sat up a little straighter in my chair. Take care.

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