Maureen Tate - Neck Deterioration

I first noticed pain in the nape of my neck about January 1997. It my have ached before then but I hadn't particularly noticed. Let me explain how this could happen.

I was diagnosed with rheumatoid arthritis when I was 18 and I am now 53. During this period I have had forty odd operations to correct and restrict the damage caused by arthritis and also, obviously, a lot of aches and pains. This being the case, another pain in my neck wasn't anything to worry me; it was just more deterioration, which I have had to accept.

During the next few months the condition worsened and also my neck gradually stiffened. It became very difficult and painful to turn it sideways in either direction. I had to stop driving and I was obviously very fed up. Driving had enabled me to retain a degree of independence. By April I was getting "clicking" and "clunking" when I tried to turn my head and also, by this time, numbness in my right hand and fingers. On occasions, maybe three or four times a week, I got "electric shock" sensations shooting from my neck, down my right arm and into my fingertips.

During May 1997 I visited the hospital rheumatology department for a regular 3 monthly check. There, I was seen by the new consultant rheumatologist, who expressed concern when I mentioned my neck problems. He arranged X-rays and, as a result of these, an MRI scan on my upper spine. This was done in June 1997. Dr Wright, the consultant, explained that I had serious damage to my top 2 vertebrae and he would arrange an appointment with Mr. Krishna, the consultant orthopaedic surgeon, he gave me a surgical collar and advised me to wear it whenever I had a job to do. Mr. Krishna had replaced my right hip when I had broken it 14 months earlier so I had no fears about surgery, just very fed up that another operation seemed to be looming ahead.

I saw Mr. Krishna on September 1st 1997. By this time my neck was extremely stiff. Just about every time I moved it I experienced the "clunking" sensation. I was also becoming depressed because my activities were seriously curtailed. Although arthritis always prevented strenuous activity, I had enjoyed pottering in my garden, growing plants, tracing family history in libraries and archives and, most importantly, driving. I could no longer visit friends and family without a lift and even holding my head to read, a very enjoyable pastime, was becoming extremely painful. I was concerned at what the future might hold but not greatly worried at that point - after all, arthritis wasn't a killer. I'd coped with the problems it caused before and I would do so again - I was still feeling in my outlook.

As I say, I saw Mr. Krishna on the 1st September. He explained that the problems I had were extremely serious. The top 2 vertebrae were out of alignment and the spurs of bone were catching my spinal cord. This was what was causing the "clunking" sensation. The nerves in the spinal cord, he explained, never re-grew and once damaged, could never be mended. Indeed, if the spinal cord was cut, as it could have been with any "clunk", I would be totally paralysed from the neck down. Also, an accidental fall at any time could cause instant death. This was my understanding of what was said and I was totally shocked. Mr. Krishna explained that he was optimistic that surgery could correct the problems and very strongly recommend this course of action. Having said this, he obliged to point out that surgery of this kind was in itself a danger and death or paralysis could still occur. However, without surgery, either one of these could happen at any time. I agreed to the operation and was still far too shocked to ask any further questions. Mr. Krishna told me to wear the surgical collar at all times and put my name on the waiting list.

The next few months were the worst of my life. The worry and imagination grew in my mind and I became very afraid. It was the thought of total paralysis that bothered me the most. Obviously I didn't want to die, but that would be much better than lying awake unable to move. I started to dread the nights - during the day I could occupy my mind but lying during the night my imagination ran riot. By November I was hardly sleeping and I decided to see my GP and tell her of my worries.

She was marvelous. Although, she admitted, she wasn't familiar with the operation or it's outcome, she immediately wrote to Mr. Krishna and explained my concerns to him. He wrote me a very nice letter and put my mind at rest. He explained that the risk of the op itself being unsuccessful was very low and he had never personally Seen a bad outcome he told me to stop worrying as he was extremely confident, not only of a good result, but also of recovering 90% of normal neck function. With a long history of arthritis, this was good news to any joint and I began to feel optimistic again.

On January 16th 1998 I visited the hospital for a couple of hours and all necessary tests were done - blood, water, ECG etc. The operation itself was explained in detail. The 2 vertebrae were to be aligned, splinted with a sliver of bone from my left hip, held with surgical screws and then wrapped with surgical wire - I like technical explanations to be basic so that I can understand.

I went into hospital on January 20th and the staff were great - very friendly and very helpful, they put me completely at my ease. My op was scheduled for the next morning and I was first on the list. The operation apparently lasted over 6 hours but I knew nothing of this I went down at 8.30am on January 21st but wasn't awake again until approx 6.00am the next morning. I was fitted with a self-injector of morphine for any pain I might feel but used it very little as I woke up feeling pretty good - I think the immediate relief of being able to move my toes (I wasn't paralysed after all!) was enough to ward any thought of pain. I was fitted with a surgical collar to prevent me turning my head and would have to wear this for some months to come. I stayed in hospital for 5 days and during this time felt stronger each day. The operation had been a total success and it was now up to me to be careful and give my neck time to heal.

Since the op, I have visited out-patients on a regular basis and had further x-rays. After 9 weeks, the firm collar was exchanged for a softer one but this is still enough to remind me not to turn my head without turning my shoulders.

Its now 3 months since I had the operation and I'm still very relieved its all over. The "clunking", the pain and the "electric shocks" down my arm all disappeared immediately after the operation. My neck aches a bit from time to time but I think that is just arthritis in general. I still have to wear the collar and I obviously can't drive yet but I can manage light housework and reading and I'm walking a lot more than I was. I have not yet forgotten the fear of possible paralysis and I am not going to rush anything, Having said that, the future certainly looks hopeful again and I'm looking forward to the summer. Personally, I'm very glad I had the surgery.