I learned that I was not alone. Surgeons struggle privately in silence, likely trying to avoid stigma and not wanting to create concerns in patients and colleagues. —Julie L. Wei, MD
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June 2022
Many nights I awoke in the dark, consumed by the paresthesia, without the distraction of busy clinics and cases. It took a few weeks to fit MRIs into my already packed schedule. Finally, they were done on a Monday night at 7 p.m. after a busy clinic day. I was busy in the clinic when I received the MRI report by email. I was overwhelmed with disbelief, fear, and distress after reading it:
“Multilevel degenerative disc osteophytes indent the ventral CSF space C3-C4 through C6-C7 without significant spinal stenosis. Uncinate spurring with severe right/mild left C5-6 neural foraminal narrowing—correlate with radiculitis”
The shoulder MRI showed adhesive capsulitis and explained why I still can’t zip up my own dress from the back. Neurotology colleagues facilitated an appointment with a neurosurgeon the next week, and I had a follow-up with my orthopedic surgeon. The neurosurgeon spoke to me ahead of the appointment as a professional courtesy and got me scheduled for a cervical epidural.
During the neurosurgery appointment, the physician assistant saw me and did a full exam, and then finally the neurosurgeon came in. (My issues seemed miniscule when I learned he had been with a patient and their entire family to discuss a newly diagnosed massive brain tumor.)
The great news was, I hadn’t lost my motor function (yet). I was informed that over 90% of adults over age 50 have degenerative disc disease, but most may be asymptomatic. I had two choices: 1) live with it, but the longer I have paresthesia the more likely it’s permanent; or 2) have surgery. He showed me a cervical spine model, and a piece of hardware. “I’ll put a titanium plate with three spacers here to increase space between the discs at C6 and other levels.” When I asked if surgery would make the paresthesia go away, he shared that it could, but many wake up from surgery with persistent paresthesia—it’s unpredictable.
“What’s the worst thing that can happen to me during surgery?” I asked.
“I die,” the neurosurgeon said with a smile. “The worst thing that can happen to any patient during surgery is that the surgeon dies during the case,” he joked. I didn’t laugh.