What the Neurosurgeon Had to Say

I went to Santa Barbara to meet with a neurosurgeon who was highly recommended by my father. He had minor back surgery years ago, and it helped tremendously with his pain. In fact, rarely does my father ever complain of pain. That occupation is held by my mother and myself. One of us is always in physical pain. Mother suffers in the mornings and afternoons, and I suffer in the evenings.

The Neurosurgeon told me directly that surgery would not help my pain. He said he didn't know for sure if the herniated disc was causing pain, but it probably wasn't the major contributor. I have pain in other places that are unexplainable (if you just look at a MRI), and also I have peripheral neuropathy, which is not helped by anything other than CBT (cognitive-behavorial theory) and drugs like gabapentin and Cymbalta and sometimes opiates. He ordered an MRI for my cervical and thoracic spine, although the Neurosurgeon mentioned that it was likely to come back relatively normal. However, he wanted to rule some things out.

The vast majority of his argument had to do with what's called "central sensitization," which is basically how the brain processes and reacts to the pain signal. Initially, pain is sent to the medulla, and from there it goes to the high functions of the brain because pain is one part stimulus, but it is also an emotional phenomenon. And it's that emotional component that is probably the most difficult to treat. People with depression and/or anxiety interpret and experience pain differently than the normal population. The Neuorsurgeon spoke to all of this, and I eagerly sounded back with bits of learning I've gathered over the past month (I had a very rudimentary understanding of the nervous system). The Neurosurgeon said that while he was concerned about the psychosomatic aspect of the pain (how my disorder interacts with pain), he knows that it's no less real--it's just that surgery at this point won't help at all. He mentioned a man in LA who he sends patients to when he can't help them, and he also mentioned going to the Stanford Pain Clinic and potentially seeing Dr. Sean Mackey (I've listened to a couple of his lectures), who is constantly doing research on chronic, noncancer pain.

The Neurosurgeon didn't see any problem in taking a couple of Norco's a day. He said he would call me when the results of the other MRI's come in.

He's probably one of the best doctors I've ever met. 

The Neurologist is concerned that I have some type of demyelinating disease, and in a couple of weeks, she's doing a nerve conduction test on me with hopes of finding what neurons are affected.