anterior cervical fusion/choking and swallowing issues

Hallelujiah! I am not crazy or faking it!! No one has a clue how much this impacts my daily living and my overall ability to eat ,breathe, speak etc...Did you do speech therapy?

i.m from sudbury, ontario, canada and we do not have a speech pathogist. its been 3 1/2 years and i'm still waiting for the hospital to hire one. i do not even have a family doctor and i'm awaiting my fifth spine operation ( laminectomy of my L1- L3), they will only give me 7 days notice, sucks but thats life

I am 4 weeks post op with a c6/c7 anterior fusion, I started with the swallowing issues this week and as of right now it is just an annoyance.  The nerve pain prior to the surgery that went down my left arm and into my hand was just awful.  NS recommended the surgery over PT and after 7 weeks of agony I had the surgery.  Immediately after the surgery I had relief from the nerve pain but I must admit that the difficulty with swallowing has me a bit shaken.  Glad although saddened that there seems to be many out there with the same issues.  If anyone finds the (answer) to this swallowing/choking issue please share.  Thanks

How does your system of health care work. I am sure that might be a lengthy answer but I have always been curious to how it works and never had the opportunity to ask a Canadian =) How long have you been waiting for your fifth surgery? That nuts only having 7 days to mentally prepare for someting like that!

Hello jackhamm65, I am also a Canadian who has had two cervical surgeries. I have posted on this board a few times now. My surgeries were 15 years ago and back then there was scant information online re: these post-surgical issues.....there sure wasn't a resource as great as this board! I thought i might try to answer your question about our health care system. Our health care system is publicly funded via taxes. Our individual provinces administer health care whereas the funding and oversight comes from the federal government. You could ask ten individuals to describe our health care system and you would likely get ten different answers. The efficacy of our system does tend to differ based on geography. My experience is only with health care in the province of Ontario. But even within provinces one's experience with health care will differ due to geography. For the past decade Ontario has had an issue with access to health care in more remote areas. It has been very difficult to entice doctors to practice in more remote, smaller communities in the province. Because the system is publicly funded doctors who work in major cities are paid the same rates as doctors who practice in smaller communities. Recently there has been some movement towards compensating doctors who practice in remote areas...but these measures are quite new. Another significant problem with our system is the migration of health care practitioners to the United States. Because we are a public system there are set rates for medical procedures, hence there are caps on what a doctor could earn. Of course these rates differ from procedure to procedure and our specialists still earn higher incomes than our G.P's....just as they do in the U.S.A. Probably the most prevalent issue with Canadian health care is wait times. We can only see specialists if we are referred by our family doctor. Depending upon several factors the wait times for these appointments as well as wait times for surgical procedures will vary. One of the factors determining wait times is the nature of the health problem. Cervical surgery is a perfect example of how wait times will differ due to medical issue. Fifteen years ago I only had to wait 5 months for my first surgery and 3 months for my second surgery. If I were to have this surgery now I suspect I might wait a bit longer. Fifteen years ago cervical injuries were quite rare, but with the widespread use of computers these injuries have become much more common.....resulting in longer wait times for treatment. Wait times also depend upon geography. Remote communities will not have as many specialists available as large cities, resulting in those patients in rural communities having to access care outside of their home community....ultimately making the wait times to see the specialists in urban settings longer. Another factor considering wait times is the 'brain drain' mentioned earlier. With medical professionals going to other countries there will be fewer professionals available in Canada....making the wait times longer. There are a ton more factors influencing wait times...to many to go into....so I'll leave it here. Doctors are only compensated financially from the public coffers for services that are listed with the government. Over the past few years the federal and provincial governments have de-listed many, many medical procedures. This means that those procedures are no longer eligible for reimbursement from the government.....the patient has to pay out of pocket if they want these procedures. And this de-listing has been extremely short-sighted on the government's part. For example.....physiotherapy has been de-listed. Physio is a preventative measure.....if physio were available to the general population millions of dollars would be saved in further treatment, surgical expenses, lost wages and workplace productivity. Physio often prevents injuries/illnesses from becoming worse, from becoming surgical. De-listing physio treatment was one of the most idiotic moves by our government re: health care!! With an aging population you don't want to go around de-listing preventative health measures!!!.....but who ever said politicians were smart!! Because our health care system is a public system there is much more government oversight than you would have in the U.S. For example, we have drugs that must be listed with the RCMP (our national police) every time they are prescribed....I actually take one of these drugs. An other example of oversight.....our doctors are monitored quite closely and if Health Canada identifies certain patterns in a doc's practice they are then investigated. One of my pain docs who does injections has been monitored by Health Canada for four years in a row. Health Canada has questioned the number of procedures he does in one day. This doc injects pain patients with an anesthetic, he is very good and very fast....which puts his treatment numbers in a higher bracket. Health Canada investigates in order to assure that this doc is not filing false reimbursement claims. These situations illustrate the responsibility the government has when the health care system is publicly funded......like all government oversight there are advantages and disadvantages. But it is public money and health care practitioners should be held to account. Recently our system here in Ontario has broadened the scope of several health care practitioners. For example....a pharmacist will now be able to prescribe common drugs. Nurses will be given more responsibility re: meds and treatment. We will now employ nurse practitioners....they fall between a doctor and nurse....they have many of the same responsibilities as doctors but are still supervised by the doctor. These measures will make access to health care easier and faster. But of course there is the question of experience and education.....doctors are trained for many, many years.....nurse practitioners are not trained for as long. Re: the entry above from scrnck....I've never heard of anyone being given only 7 days notice for a surgical procedure. Quite the opposite as indicated in my explanation of wait times.....because we have to wait for treatment there is usually a number of weeks, or even months, to prepare prior to treatment. But, everyone's experience can be different. I could go on forever about the positives and negatives of our health care system, but I'll stop boring you now. Hope I gave you an idea of what our system is like!

Hi jackhamm65, there is not much more l can say about our Canadain Health system,...................................................my first operation was in the 1983 and again in 1985,..it was a cervical fusiin of my ondotiod that they overlooked for at least 4 months, iwas playing baseball all summer with a fracture hangman's bone. the fusion took two operation to fuse properly. IN 2009, i had my third operation to remove discs from C2-C6 with a plate and screws to be put in. i couldnt eat for 19 days until i managed to get a the smallest piece of grilled cheese dowm my throat. the operation was to take 4 hours, it took 8, iwas suppose to be off work for 6-8 weeks, i'm still off work 3 1/2 yrs later. due to me first fusion, the surgeon had difficulty tightening the furthest most screw. he later determined he had to reoperate but decided durring the operation the fusion was solid therefroe he removed the plate,. i now wear it around my neck. its easier to explain to people. i have been waiting 3 months for the laminectomy. i cannot walk for any lenght of time, i cannot stand for more than 1 mintue, when my nerves get pinched, its the most extreme pain i've ever felt, butthank god it goes away in short peroid of time, besides al that, i can't sleep more 2 hours before i have to get up to spit, icant speak as well, i can;t eat most meats,.....i sure you know what its like, i hope i answered some of your questions sorry haven't figured out spellcheck take care, good luck yes it is nuts waiting for the phone to ring, very stressful, hard to get your affairs in order, but that's our system

PLEASE get to a reliable ENT Dr to order swallow study/ scoping of your throat. Have you had a follow up MRI? Please let me know. I will keep you in my prayers. This happens to so many of us. Wish we could get. The word out to others as to what to look for and think about following surgery like this. Terri

Hi there...sorry I missed the original post to this reply, but can I ask you to explain what you had done? I had a 3 level cervical fusion in Sept. and although things look good on xray and I just got the clearance to go back to work w/ no restrictions (Praise God!), I am having trouble talking, and my neck feels "choppy" ... it's hard to explain. Not sure what exactly is going on. I am praying for everything to return to normal...and soon. I am thankful for the progress, but the trouble talking concerns me. Any suggestions or advice would greatly help. Plus, I am so tired. Thanks!! My hope is in GOD! :)

someone mentioned suing a doctor - this the original post, easier to copy n paste =) From personal lawsuit experience,(almost 7 years) everything that we all talk about here falls under the "small print" on the release form you sign prior to surgery. This is my opinion, proceed how you want. I have no feeling on the left side of my tongue, it sticks out to the left permanently, speech therapy for a year, choking fits, coughing fits, those are just some of the issues associated with the dysphagia I developed from them damaging the nerves when they went into my neck. For me it me it was either surgery or paralysis from the neck down. I am 47 now have had spinal surgeries since age 22. Spinal surgery is old hat for me, I don't fear it at all because in the past it had ALWAYS helped me, one of my other surgeries on my low back was a life saver, with out it paralysis from waist down at 32 years old. None of my 4 surgeries has EVER prepared me for the issues I have now. All the things most people don't think twice about, eating & breathing have become my enemies. I read Terri's post earlier and I very much relate to her story. You really have to face the facts of your circumstance and embrace it as tough as it is. I don't talk with my mouth full, which I shouldn't anyways!! lol But I always have to clear my palette completely before speaking, I don't drink fluids fast, meat FORGET IT!! I have half my tongue, it is perfect set up to choke!! If I eat something REALLY sweet that causes excess saliva, not good, it gets thick and mucousy and I can't swallow and clear my airway. Winter, lookout, if I get a cold or something respiratory related I almost suffocate every year, gets scary, almost like asthma, so I have a permanent zPack and steroid prescription for each season…. After my coughing choking fits I have all this trapped air in my stomach I can't release or belch effectively because the muscle tone of my tongue. Not very lady like sounding like a beer drinking chain smoker…. (my voice is very raspy now) Shutting up. I have found it interesting when I focus on my blessings the wickedness fades away. As messed up as I am, it could always be worse and finding this message board and hearing these stories makes me see, it really could be worse.I feel for all the people on this boards and keep you in my prayers for some type of relief or resolution. The more I talk about my issues the more apparent they are to me so I really try not to dwell even though it seems impossible at times. I am on NO medication, I do pain management, careful not to do things, eat things I shouldn't, I am very high energy so this has been difficult for me through the years. I have two daughters that need me, that is what keeps me going.

WOW! I am sorry but thankful for your positivity. I too count my blessings. Before the surgery, I couldn't even hold my head up for long periods of time. I am single parenting 2 teenage boys, so I can relate. I thank God for the grace along the way. Will keep praying!! He IS faithful!! God Bless. :)

i had cervical surgery and fusion at level c4-c5 before 7 months but i still have pain in my shoulders i have new x-ray it shows that there is agood alighment but tthere is pain in my throat like stuck or some thing inside my throat but i can swallow and eat and drink easly i visited germany the doctor in bremen said that the plate was not intalled correctly and throt touch it i dont know what i can do?

I had fusion at C5/C6 with a plate/screws done September 2009.  Initially, didn't have any problems.  In November 2012, I developed a burning sensation in my throat that was constant and it did not feel like the normal reflux.  Saw my primary care doctor, who at first thought it was pill induced esophagitis.  So, off the GI Specialist I went, in which I was placed on several GERD meds which were unsuccessful.  So, an EGD was performed, which was normal.  For 2 weeks now, I have now still have the burning, but also have the feeling as though something is stuck in my throat.  Saw an ENT Friday, in which he did a scope....what was normal.  At this point, I am feeling little CRAZY!  A Barium swallow ordered.  While at the barium swallow, the doctor said my throat spasms directly in front of my plate.  He was not sure if it was caused from the plate, but that he would send the report to my GI Doc.  Went to my GI Doc today, in which he received a report on my Barium swallow showing I am normal?!  So, the doctor who performed the Barium swallow told me one thing, but reported another.  I almost 100% sure the burning/knot in my throat feeling is from this STUPID PLATE!!!  But no one is listening to me!  I left sobbing my eyes out today, not knowing where to turn.  My neck and left arm hurt constantly anyway, but it's not enough to really alter my life.  Since having this surgery, my body has never been the same, but I knew when you messed with your nerve and vertebrae, that would be a risk!

First,I am not a doctor, I just want share my experience with dysphasia, the swallowing ,speaking and spitting problems associated with it, which was a direct result of a Discectomy of my C3- C6 with bony fusion and anterior plate and screws in 2009.


I know i'm not alone or not the worse case but i did find some helpful information from a neighbour that i need to share.


From reading the past posts, i was lucky to have my plate removed a year later because a screw was loose ( no pun intended) although some of the people who know might think differently, anyways, after my surgery l found l could not speak properly, my tongue hangs to the right and is useless, l could not eat the same and had to WAKE UP EVERY 1 to 1 1/2 HOURS TO SPIT. I found this to be the most aggravating symptom as a good night sleep helps the body recover quicker. SINCE JUNE 2009, I have not slept 5 continuous hours more then 5 times in the last 3 1/2 years.

A short list of relevant medication was sleeping pills and oxycontin 40mg 3x daily. Even with that I could not sleep without waking to spit every 1 to 3 hours if l was lucky and really tired which l am. I'm not going to get into this, but my family physician has decided to wean me off my oxycontin prior to my next surgery ( Laminectonmy of my L1- L3) to remove burns spurs from putting pressure on my nerve which causes extreme pain, so the point is i'm still in pain and getting worse so i was willing to try anything.

My neighbour said for his bad back he uses over the counter Robaxacet extra strength. Just for comparison, prior to trying this i would take my sleeping pills and go to bed and wake up no more than 3 hours later in so mush pain that i had to get up and go the couch and try to distract myself by watching late night tv before l was so tired that i could go back to sleep around 5am.

So l gave Robaxacet extra strength a try and for the last two nights, i have been able to sleep continuously for 5 hours without waking up to spit. Then pain is there when i do wake up but i feel a lot better sleeping for those lovely 5 hours. like l said its only been 2 out of 7 nights in the last 3 1/2 years that i have been able to sleep that long.

I think the action of medication against muscles spasms lets me sleeps without having to wake and spit . Remember i'm not a doctor so seek their advice before starting any new medication. I'm without a family physician, fired my last one for failure to provide adequate care.

I have not yet made a determination if it works against my pain. The jury is still out


I hope this helps someone,,



scrnck

I know this post is from 6 years ago (started anyway) but a wealth of information. Thank you to all that have contributed. I just had surgery 9 days ago for C-4/5 and C-5/6 replaced and plates added. Thankfully, my Doctor is seeing me tomorrow to remove the staples since all of the sudden I am having a serious skin reaction where the incision took place. I have pain where the plates are so I am not sure if I am reacting to the metal in my body. For the most part, I do not have the pain I had before surgery and am glad I went through with it. I had severe, daily, chronic pain in my left and right arm. Now, my right arm is perfectly fine but I have a numbing sensation in my left index finger and weakness in my left arm, off and on mild pain in my left shoulder, elbow, and wrist but I believe this will go away with some more healing time. Aleve has helped me significantly. I hope to be off all the pain medications and nerve meds I have been on over a year now. Overall, I think the surgery was a success. Mentally alone, I feel so much better and looking forward to resuming a normal life. My best to all of you.

Ask your doctor for a referral to a Speech-Language Pathologist (SLP) for evaluation of your swallowing if you are experiencing difficulty swallowing (dysphagia -- dys-fay-juh) post Anterior Cervical Spinal surgeries.  While doctors may state that tissue appears normal and is not "pressing" as someone stated in one of their posts, this does not account for damage to nerves which would affect swallowing.  Any resulting edema can also affect range of motion of pharyngeal musculature and result in dysphagia.  Also, it is important that your pharyngeal (throat) muscles are evaluated while you are eating - not simply viewed at rest with a scope.  Damage is possible to glossopharyngeal and hypoglossal nerves above C3, superior laryngeal nerve at C3-4, and recurrent laryngeal nerve and vagus trunk at lower cervical areas. Prevalance of dysphagia (swallowing difficulties) following Anterior Cervical Spinal surgeries ranges from less than 2% to greater than 50%!  (Lee, et al.)  Do not overlook the importance of receiving an evaluation for swallowing by an SLP.  You may be at risk for aspiration which is when material (food, liquid, oral bacteria, saliva) enters your airway (trachea and lungs) instead of going to your esophagus (food tube that leads to your stomach).  This can cause pneumonia and possibly respiratory failure if left untreated or if a significant amount of material is aspirated.  Following evaluation by a SLP, techniques/recommendations will be provided to improve your swallow function and decrease your difficulty with swallowing and decrease risk for aspiration.  Your surgeon may have done an excellent job and was very diligent during your surgery; however, risk for dysphagia after these surgeries is always there - sometimes it is unavoidable.