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Hi all - I'm scheduled for an anterior cervical discectomy at C5/C6 a week today; I turn 44 in 2 days. My NS (one of the best in the South of England - found after a disappointing experience with a first neurosurgeon) is not going to do a fusion because of the strain this could put on the discs either side. He's going to use a Medicrea artificial ceramic disc, a relatively new introduction in the UK, which technically should allow a pretty much full range of movement. Really, I'm looking for some realistic expectations of recovery and any tips people have found helpful.

The only surgery I've had before is a hysterectomy. My situation is a little complicated in that I have Graves' Disease, and I'm concerned about the physical manipulation of the various things in my neck in order to get at the disc; my thyroid tends to go supernova if manipulated (or if the wind changes, or if there's an R in the month). I'm also doing a test this Sunday/Monday to rule out a pheochromocytoma (adrenal gland tumour). I have 2 herniated discs in my lower back L3/L4 and L4/L5, which have grumbled along for 22 years, but are not great right now; I guess I'm compensating on posture and movement in order to protect my more chronically-painful neck. I'll have to srike a balance between sitting/lying to help my neck but not being too immobile in case it sets off the lumbar discs. Falling apart, I am :-)

I don't get much sleep anyway thanks to the Graves' - 4 interrupted hours a night if I'm really lucky, and that's the way it's been for a year. So I'm really not looking forward to the neck brace etc. as I already have a feeling of blockage in my throat from my thyroid, and I'm guessing I'll end up sleeping once every 48 hours from sheer exhaustion. My NS has advised not delaying the surgery because my spinal cord is so compromised. I have severe weakness and really subdued reflexes on the right side, and asterixis/liver flap (I wake up with my right hand literally flapping in the air from the wrist and have to lie on it to get it to quieten down). Can't carry a cup of coffee without throwing it across the room, can't lift much of anything. Horrible pain in the base of the skull around the occipital bun, and down my neck occasionally on both sides, nothing in my shoulder - the severe bicep pain has eased off a bit, but it was so bad a few weeks ago, it was screamingly unbearable. Numbness across the thumb edge of my hand and across my palm. About 25% strength in my right arm compared to my left. So my questions are:

1. Does everyone wear a neck brace? Hard or soft? For how long? Do you sleep in it as well? Does your neck feel unstable without it? What kind of pillow is recommended?
2. How severe is the pain immediately after surgery? Morphine doesn't work on me unfortunately.
3. How soon do people move from soft food to normal food, with the swallowing issue?
4. I'm guessing I'll be encouraged to do a lot of walking in the days and weeks of recovery; how far is far enough to start with?
5. Are there any creams or lotions recommended to use on the incision? How soon does it fade? Is it okay to shower?
6. Was anyone completely bedbound after surgery? Our bathroom is at the opposite end of the house from the bedroom.
7. Is returning to a desk job after 6 weeks feasible for most people? I don't have much option there because I won't get sick pay beyond that, and the bills still have to be paid. Are there any recommendations to make life easier when at a desk?
8. How soon have people managed to go back to weight-training and other exercise, if at all?
9. What kind of follow-up appointments and checks have people had?

Many thanks for any answers - it's always really helpful to read other people's personal experiences :-)

Beth

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I'll put my experience here just in case it helps someone in future. I had my operation on Friday night and am home Sunday morning. It took about 3 hours; they cut one muscle (sternocleidomastoid) on the right and moved my trachea, larynx etc to one side, removed my damaged disc and put in a ceramic one between the two vertebrae. No fusion, no fixing the new disc to anything. It's increased my height by 2mm and my neck muscles are adjusting so twingeing a wee bit, which should die down when they're used to it. I'm swallowing and eating normally apart from very dry biscuits; I was eating buttered toast in the recovery room as I came round from the anaesthetic, and have been eating full English breakfasts and normal food ever since. Overnight in ICU, then transferred to my own room. I can sleep flat on both sides with no problems. On a pain level of 1-10, it was 6-7 in the recovery room (so manageable even though it made me a bit grumpy), and about 2 now.

Morphine, gabapentin and tramadol don't work on me, so I had a sleepless uncomfortable 8 hours until they finally listened to me and gave me codeine and diazepam, as I originally requested. Then I just twiddled my thumbs and waited to be let out; walking within 2 hours of the surgery with no problems, and just kept walking up and down in ICU until they got fed-up with me. I saw the physiotherapist the morning after the surgery and was given some stretching exercises to do every 30 minutes, which I've been doing religiously, and I have really really good range of movement. Showering and washing my hair normally.

The muscle is stitched with dissolvable stitches, and the incision is held together by metal round clips - incision about 5 inches long in total, running from below my ear to the centre of my neck. I had a drain put in which collected about 100mls of blood and gunk overnight. No infection - I had 3 doses of antibiotics through the IV. Speaking and even singing normally.

Have a slight feeling of fullness in my lower throat/upper chest and back like trapped wind, and coughing isn't terribly comfortable. Apart from that I feel wonderful - the arm and hand pain and numbess has gone, and my strength is back. No neck brace at all; my thyroid levels are normal, and there was no adrenal tumour. I apparently have a slight heart murmur which is probably down to the Graves' Disease and no-one is stressing about it. Sent me home with codeine in case I need it; got to go back in 8 days to have the metal clips removed, and chill at home for a total of 6 weeks. I can return to weight-training after 3 months but will probably leave it longer and go very very gently. So my experience of anterior cervical fusion is really very positive, possibly because I opted for it fairly quickly before too much nerve regeneration was needed. Good luck to anyone else needing the same thing.
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10 weeks after still have shoulder pain after c5/6 acdf surgery ido walking everyday and hope the pain in shoulder goes iIhad trouble swallowing and still have trouble with hoarseness JEAN
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