Whiplash after cervical fusion

[jgaby]

I had severely herniated cervical discs (C5-C7) so I had an anterior discectomy with fusion with a titanium plate screwed into the vertebrae at the end of June 2011.

The surgery went so well that the pain radiating down my arm was almost completely gone right afterward. I was on strong narcotic IV pain medication. I was instructed that when I had to use the bathroom, I needed to call a nurse or aide because my IV pole had to be disconnected and I wasn't very steady on my feet yet. Whenever I got up to use the bathroom, I always pressed the button to raise the head of my bed, as I wasn't strong enough at that point to get up from a flat bed. Then, I would hold onto the IV pole, take it into the bathroom with me, and the nurse/aide would be outside the door to guide me back to bed. I always got back into bed with the head of the bed raised

The day after the surgery, a woman from housekeeping came in to change my sheets, and I had to go to the bathroom anyway, so I got out of bed and the nurse aide again disconnected the IV and helped me to the bathroom. When I got out of bed, the head was raised, so naturally I assumed it was still raised when I returned to bed. I couldn't see it because I was backing onto the bed rear end first, then was going to roll slowly backward down on the bed. In addition, I was tethered to the IV pole and I had to hold onto it while I walked to bed, so I was concentrating on the pole and I was also spacey due to the pain meds. Expecting the head to be raised, I reclined assuming that the head and pillow would be right underneath me. Since the bed was flat, I fell back and my head was flung violently all the way backwards, as far as it could go. It was much worse than whiplash in a car accident because having had no sleep, being on pain meds, and just having surgery the day before, I was too weak to resist the backward motion of my head. It was actually more like shaken baby syndrome than whiplash. It was a worse pain than I could have every imagined. In addition, I had this bizarre deafening pounding in my ears (as if my heart was beating inside my head). This especially panicked me, as I thought I might be having a stroke.

An X-ray was taken the following day and it showed that the bone grafts and metal plate were intact and in the correct place.

I started experiencing nausea/queasiness/dizziness (no vomiting, diarrhea, or fever) eight days after the whiplash. I was trying to take a nap, but I felt my heart start to race and I had a little trouble breathing. I measured my BP (I have well-controlled high blood pressure) and heart rate; my BP was fairly normal, but my heart rate was 101 when I got up out of bed. The pain in the back of my neck and head was suddenly much worse than the pain I had from the surgery itself and the whiplash. I went to the hospital. By the time I got to the triage nurse, I could barely speak because I was having so much trouble breathing and my legs felt so weak and I thought I'd fall down at any time. She had me lay down on a bed and told me I was "just having a panic attack." I had the strangest sensation that I could pass out at any moment, so I wanted to convey information to her in case that happened. I told her about the surgery and the whiplash and that they shouldn't give me any anti-inflammatories as they inhibit the growth of the bone grafts. I was taken back into the ER and was given Zofran and Ativan. By then, the pain in the back of my neck was even worse, so much so that my body was twisted and I was screaming, and I still felt that I could lose consciousness at any moment. In addition, my right arm felt really weak and "floppy" when I tried to raise it, and I felt tingling in my leg. I told them all of this and I also told them that I was scared that this had something to do with the whiplash. I thought maybe something came loose from the surgical site and was pressing into my spine or that the whiplash had resulted in a blood clot or something. They didn't seem to have any sense of urgency. During my whole stay in the ER (a few hours), I felt a strange sensation that I was going to lose consciousness at any moment. They recommended that I get a cervical MRI on my own and then discharged me with a prescription for Zofran for the queasiness/dizziness.

The MRI of the cervical vertebrae was normal. The constant severe nausea/dizziness and pain in the back of my neck and the top/front of my head were still there. In addition, I had an odd feeling that my body was moving very slowly, that my brain was "swimming" inside my skull or in a fog, and that I was not able to speak as fast as I used to. Since being in the ER, I have developed mild tremors in my hands.

I went to a neurologist, and the MRA/MRI of my brain and neck (of the tissue as well as the blood vessels) were normal. The neurologist also ordered a 24-hour Holter monitor, and that just showed the same PVCs I've had for many years.

It's now over a month since the whiplash, and the queasiness/dizziness are worse (note: when I'm lying down I feel a little better). The ENT said there's nothing wrong with my inner ears. The anti-dizziness medication (Antivert) doesn't really help. I have trouble reading now—I confuse words and can't stay focused on one line of text, and I feel I'm desperately searching for words when I speak. I can't remember anything for more than a few seconds now. Also, I now have a total lack of emotion, as if I'm a blank slate. I'm not even really depressed; I don't laugh, I don't get upset or impatient, no emotional reactions to anything whatsoever—it's as if I'm completely dead or numb inside. My balance is not good either—I sometimes veer a little to one side when I walk. I'm completely fatigued, even when I don't take the Antivert, and I'm off all pain medications, so that is not the reason I'm so exhausted. I dread getting out of bed in the mornings because I know the dizziness and nausea are going to start and be there all day. I've read about Chiari and orthostatic or tachycardic intolerance, and I'm wondering if they would apply. I read that head/neck trauma can cause both of those conditions. Wouldn't the Holter monitor results have revealed those conditions if I had them? When I stand up after laying down in bed for a long time, my BP is 133/65 and heart rate of 115. After walking or sitting for a while, my BP is 116/67 with heart rate of 49. I just always feel so lightheaded, as if my legs are going to buckle underneath me.

If I had a TIA in the ER, it wouldn't have left these long-lasting effects. Could the whiplash have caused brain damage that wouldn't appear on the MRI/MRA? Is it possible for a stroke or brain damage to not show up on an MRI several days afterward? There is something seriously wrong with me and I am not getting better. I will see the neurologist this week, but I wanted to see if anyone else had any opinions on this.

[MG (Admin)]

ok...I understand that the MRI's etc were normal.
Was your neurological exam also normal?
How is your mood etc?
Sometimes PTSD (or related issues) can cause many of these symptoms...do you feel that there were psychological affects of the whiplash?

[jgaby]

I saw my cardiologist yesterday and she thinks it may be postural orthostatic tachycardia syndrome (POTS). I will be undergoing a tilt table test soon.

[MG (Admin)]

ok..let us know how it goes