Greetings again dear reader. When last we left we were discussing the rights of the patient in the hospital and rehashing my "whoa is me" tale. Now we are at day three and the final day before discharge. On this day I got to work with the orthotist. An orthotist is a specialist who hand crafts a specialized supportive or artificial orthopedic device. In my case, I was given a four point restraint which involves a chest plate with shoulder supports and four poles that stick into a chin support in front and an occipital support for the back of the head. In this way you are locked into an immobilized and stable position. I was instructed to wear this device 23 hours per day for the next six weeks. I will remind you dear readers that this was the 1990's and such measures would NEVER be used today. If you are going through a similar experience and are wondering why you only received a soft collar to wear for two weeks, it is because that is the correct application of the support for most neck surgeries.
Being immobilized is sickeningly restrictive and incredibly uncomfortable. The full effect of this comes when you take the brace off after 23 hours and your joints receive the load weight of your head and the nerves spring into action and start telling your brain- all at once- about your orientation in space. It causes immense and immediate nausea and dizziness. Depriving the joints of their normal load does not allow them to sense where they are in space. Reloading the joint after a long period creates a massive cascade of neural information that the brain simply can not process all at once hence this leads to the nausea and dizziness. The muscles too go through a negative transformation. No load on the muscles permits them to adaptively waste away. For anyone who has ever worn a cast; you know what I mean. My head felt like a giant boulder whenever the neck brace was off. This positive feedback cycle was perpetuated for a total of six weeks!
During this entire time I had to use opioids to control the pain but this did nothing for the nausea and dizziness. Blissfully, I was sent home with a cane for the botched donor site in my hip, and a wedge shaped pillow which I was to sleep on for the next two months. What can we learn from my experience and how can we avoid some of the pitfalls?
It is always necessary to have your doctor provide a rational for what he or she is prescribing. If something does not feel right to you, you should question it. If the results are not coming within the time frame anticipated a second opinion may be warranted. In my case, that second opinion would be coming shortly and would be followed another 12 times after that! For now, the release from the hospital to another sort of confinement was at hand.
The first thing I did after struggling up the stairs to my bedroom was to call my chiropractor. Luckily for me that was as easy as yelling; "Honey, could you come on up here please?" Yes, you have it right dear reader. My wife is a chiropractor. Her names is Dr. Maureen M. Hayes and she is my personal physician. Three days of laying in bed had put me in a bad way with my lower and middle back so the first therapy I received was a chiropractic adjustment. OMG what a relief... but then I was remanded to bed in my restrictive immobilizer jacket. I did get a big new TV out of it and I caught up on all my shows watching the likes of Justin Wilson the Cajun Cook and all manner of other mind numbing pabulum.
Alas dear reader the story continues as did the neck pain. When we return we shall begin the long journey of opinions. Until we speak again, I remain yours in optimism and good health.
Sincerely,
Dr. Steven M. Green
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