I received the report of my last MRI from my GP on March 20. It was good news because there are no new lesions and no lesions getting bigger. I asked my neurologist to take a closer look at the brainstem lesions to see how they were doing. When I met with him on March 27, he told me that they were getting smaller. So this was all good news. That led us both to conclude that the recurring shocks in my mouth are from the healing trigeminal nerve (peripheral nerve) outside of my brain. He offered to put in a referral to the neurosurgeon Dr. Kaufmann in Winnipeg for continued management and perhaps another rhizotomy. I had hoped for a full three years pain free. At least with the lesions getting smaller, I may never have as much pain as I did. There will be residual scarring, so things will never be “normal” unless there is a miracle.
(Right now, I’m on drugs at a relatively low dose and I’m managing well. I have had three full days of no shocks at all, so that makes me very happy.)
There is a new problem and that is edema (swelling) around my upper spine that is compressing on my spinal cord. at C5/C6. It was significant enough of a potentially serious problem that my neurologist wanted to refer me to a spinal specialist. There is evidence of osteoarthritis and bone growth that is interfering with my spinal canal. I had thought that the increased tingling in my hands was from the MS but my MS is stable and I have no lesions that would cause that. So, my neurologist spoke to me on Thursday about referring me to the Spinal Centre at VGH. I told him that the only spinal surgeon whose name I remembered (from my time at GF Strong Rehab Centre) was Dr. Dvorak. My neurologist laughed and said it wasn’t likely I’d ever be able to see the #1 spinal surgeon.
I figured it would take some time before I heard anything. But yesterday, less than a week after the referral, I got a phone call from the doctor who is on call this week and it happened to be Dr. Dvorak. They asked me if I could come in the next day for an early appointment. So, this morning at 7:00 I walked over to VGH for my 7:30 appointment with Dr. Dvorak. The new building, the Blusson Spinal Cord Centre, is right next door to VGH Emergency and is a very nice building.
Dr. Dvorak took my history, asked good questions, and then examined me. We viewed my MRI images together and discussed what he saw. I’m doing pretty well. He did mention that some of my reflexes were “brisk” and there was something he noted about my finger flexion. The left arm numbness that I experienced on June 15, 2010, can be explained by the MRI images. He is the first person to examine me who was skilled enough to detect these subtle changes but I think he is used to looking for those subtleties with spinal cord patients.
I have mild
Cervical Spondylotic Myelopathy
(Spinal Cord Compression) with effacement of the subarachnoid space. He described the surgical procedure he would use which would be an anterior discectomy and fusion. He described some of the possible risks affecting voice and swallowing. This is all territory I’m very familiar with because of my work as a speech-language pathologist. It was so nice to talk to him and I felt like I was being treated like a knowledgeable peer.
There is no real urgency to my situation and he encouraged me to think a great deal about proceeding with a surgical intervention. When I need an appointment, I’m to call and he’ll be able to see me within a couple of weeks. Waiting lists for surgery are about 4-6 months.
I am now officially his patient. After having been so mismanaged by the public system with my delayed MS diagnosis, I am now seeing the best of the system. I’m a bit flabbergasted — Dvorak is legendary in the spinal community.
I will do what I can to help the situation. My cousin has the same problem and he told me he had success with physiotherapy. And I’ll discuss with my chiropractor as well.
This
page highlighting Dr. Dvorak’s positions
has a great interview with Fanny Kiefer. He is most impressive and charming. In part two of the interview he describes the osteoarthritic changes in my spine causing me problems.