I'm looking for more information on my diagnosis and prognosis, here is the story:
21 year old, obese, couch potato. 4-6 month history of partial numbness in lower legs (worst in soles of feet) and less severely in upper legs, urinary urgency, at times constant urge to urinate despite empty bladder, sensation of weakness and numbness often worse when standing up, sitting at a desk chair often made numbness worse. Some parathesia in legs. Symptoms fluctated a lot, the only thing that was totally constant was the numbness in soles of the feet.
Family history of severe arthritis and osteo-degenerative diseases - dads spine is severely affected (still walk but on crutches and wheelchair). Mum has degenerative spinal problems but they aren't a main problem. Can't be more speific because they can't remember what's wrong with them
Naturally I go to see a neurologist. After what I imagine was a thorough examination he concludes that its all likely 'just' functional systems but says an MRI is needed to exclude inflamatory diseases. Makes sense to me.
MRI results and consult took place today. In addition the neurologist seems to be under the impression, despite my symptoms having improved a somewhat, recently that my exam clearly indicated something wrong this time (I suspect once I told him I had mental health problems at the first exam, even if he saw me in A&E after being hit by a bus he was determined it should be functional symptoms). I copy the radiologists report in full:
No central canal or foraminal stenosis
normal cervico-medullary junction and cervical cord with no suggestion of any inflammatory process.
T11/T12 prominent broad based disc herniation causing severe central canal stenosis with compression of the cauda equina and focal malacic change.
Mild mid thoracic degenerative change. No further significant central canal or foraminal stenosis.
Normal appearance of the remainder of the thoracic cord.
Constitutionally markedly narrow lumbar canal.
No central canal or foraminal stenosis at any level.
Normal conus and cauda equina
T11-T12 disc herniation compressing the cord with focal malacic change.
I'm happy with my understanding of what a disc herniation is. However my understanding is; when ever a doctor uses the word severe, something should be falling off or you should be dead within the week. I'm well aware that my symptoms are very mild compared to what they might be (and no pain thankfully).
So how to I have a severe disc herniation with minimal symptoms?
I'm 21 years old. Why do I have "Mild mid thoracic degenerative change" or is this related to the herniation.
My understanding of spinal anatomy is limited...to say the least, but I'm reasonably sure the cauda equina further down. Why is this affected?
I also understand that when things presss on the cauda equina it is a medical emergency requiring urgent surgery; I'm very relieved not to be needing any slicing up just yet. Why is this not an issue?
focal malacic change...stuff is getting soft in my spine. I always thought i should be perfering soft to hard in a spine. Anyway what does that mean and why are things going all mushy?
What is a constitutionally markedly narrow lumbar canal when its at home...? (I know where it is) - is this just a red herring - everyone has odd things wrong with them, it just often doesn't cause any problems?
I've been referred to a spinal surgeon for a consult. The neurologist seemed to think that an operation would be little short of insane given risk/benefit ratio (considering my minor symptoms) and I tend to agree, but also thought it important to get confirmation.
He seemed quite hesitant to hand out a prognosis and wanted that left to the surgeon. I'm also having a bladder scan to...something or other... and if so i get shiny new pills with which I am sure, delightful side effects with be included.
Can any of you lovely people shed some light on my prognosis? Will this all go away, will it stay much the same, am I going to wake up tomorrow in mind numbing agony? Not a clue?
Baring in mind I don't move much can light be shed on how I managed to herniate a disc? Is it possible my weight was involved? Would losing weight help?
Any other relevant information you can provide would be well received.
If you want more information, I'm more than happy to provide it. Unless its my pin number, I won't fall for that one, haha.