I woke Friday morning a bit bleary after my trip in the MRI cigar tube and staggered around trying to remember what happened yesterday. Then I realised I had a Christmas present. An envelope
with 20 CAT scan, x-ray and MRI images sitting on my dining room table. I’ll have a quick look before I go to work. I can’t resist this stuff. The images are like looking deep inside yourself. I often wonder if I will see my soul in an MRI image. I tore the envelope open and began to sort through the negatives. The x-rays were no surprise. They showed a lot of deterioration caused by wear and tear over the years and advancing osteoarthritis. The 1998 fusion I had at C7/T1 was clear but, to my surprise, two other vertebrae at C4/5 had also fused of their own accord. I had been warned this might happen. Now I had five vertebrae in my neck instead of seven like other people. I gradually sifted through the CAT scan and MRI images holding each one to the light. On three levels of my cervical spine there was narrowing of the intervertebral discs as well as ossification of the posterior longitudinal ligament. The nerves running out of my spine were being crimped at numerous levels by degenerating discs and narrowing of the the neural foramen through which the nerves pass out of the spine. That explains why my arm and hand hurt. All of this I had expected and it is a pretty simple job with modern microsurgery to expand the foramen and relieve the pressure.
I got to the second last negative and held it to the light. A a chill went through me.
“I’m fucked,” I thought. I stared at the ghostly black and white image of my spinal cord running up through the vertebrae of the spinal canal into the base of my skull. I have looked at heaps of scans of the cervical spin and I can read them as well as any radiologist. You didn’t need any expertise to see what was going wrong with my spine, particularly the spinal canal. I felt numb. It was quiet in my apartment. Only the rush of the surf on Queenscliff beach rippled the silence. The timeless ocean, fragile humanity. I felt alone staring at those images. It was a lonely confrontation with mortality. I placed the scans in the envelope and tried to compose myself to face the working day.
I tried to put it out of my head and treat it just like any other day, but as I walked to the ferry I knew it would be a long one.
At 4 o’clock, with my envelope of images tucked under my arm, I was once again in Chatswood on a busy Friday afternoon. Dr Farey didn’t keep me waiting long which I appreciated. I walked with him to his room, knowing this was not going to end well and I wasn’t going to enjoy it.
I handed him the large envelope and, as I had done this morning, he began to hold each of the images up to the light. He looked intently at each one, without commenting before laying each one down on his desk. I had been through this many times before. I knew if he took one of those images and clipped it up on the lightbox I was done. Slowly, methodically he worked through the pile. No images went up onto the lightboox. With three images to go, a ripple of hope arrived and I thought I might get out of there with no bad news.
Then he looked at the second last scan. He spent quite a while holding it up to the light and looking at each of the images thereon without commenting.
“Ummm,” he said finally. I saw that it was the same scan that I had looked at this morning. It was the scan of my cervical spine canal. He sat there looking at it for some time without further comment. We had both landed on the same scan. “Here it comes,” I thought.
Finally he turned to me and very methodically piled all the scans into the envelope. “Well you have multilevel, degenerative disc disease and compression of the neural foramen on the left side of your spine at several levels. This is giving you the pain. This is fairly easy to fix, but you’ve got a much bigger problem,” he said.
“No surprises. Here it comes,” I thought. He then described the problem in the canal of my cervical spine. The next bit was a shock – the solution.
He described the process for surgical intervention. At first I just didn’t believe it.
“Can someone survive after you do that to them,” I asked.
“Sure, I do this operation all the time. It’s a well-established procedure but it’s major, major surgery.”.
He drew on a plastic model of the cervical spine sitting on his desk, a detailed picture of the removal of the entire back half of the spine, from the base of my skull to the level of my shoulders. “What do you do with it, after you take it out, do you put it back?” The answer was no. This was not a finger or toe he was talking about. This was a spine. They don’t grow back.
“This exposes the spinal cord but releases the pressure being applied by the spinal canal.”
I still struggled to believe what I just heard.
“What happens if you drop the scalpel and puncture the spinal cord and the cerebrospinal fluid leaks out?”
“You’ll be a quadriplegic,” Farey said matter-of-factly.
We spent quite some time discussing all the options.
“You can do the small operation and relieve the pain but if you have the big operation I can do both at once. At some point in the next ten years you will have to have it done, or you’ll end up in a wheelchair. It may be wise to have it done now before symptoms develop. You’ve got some decisions to make.” We agreed to meet in three weeks.
I was once more in the lift trying to digest bad news. This hasn’t been a happy place for me I. I emerged into the teeming hoard of Friday afternoon commuters thinking that by some strange time warp I had reappeared in Hong Kong.
“Since when is it okay to spit in the street in Sydney?” I thought watching some of the passers-by. I hailed a cab and told the driver to head had to Manly as I wrestled with my emotions.
“I hate Chatswood. It’s like a Chinese Beirut,” was my conclusion.
“I guess this is another setback in my broken leg rehab,” I concluded. Gutbugs come home. All is forgiven. I need a challenge I can deal with.