Dr. Michael Joseph Olek, DO

Very sorry to hear about your walking difficulties, but if your symptoms are due to physical pressure on a nerve root or the spinal cord, surgery is the only cure. 
Take care.

Unfortunately, there is no way to increase the healing of nerves, however, you should be seeing an occupational therapist to help you with hand exercises to increase flexibility and strength.

Michael J. Olek, DO

Generally speaking, surgery to the cervical cord does not cause ataxia. Without knowledge of your full medical history, it is hard to reason why you are ataxic. I would call the surgeon's office and get a reply from him/her.

The first thing is to try to determine the cause of the nerve pain. If it is from a pinched nerve, then there are procedures to decrease or remove the blockage. If the pain is from diabetes, then diabetic control is the best way. If the cause of the pain is unknown, I would start with an over-the-counter medication such as aspirin or tylenol or an NSAID (Non-Steroidal Anti-Inflammatory Drug) if medically indicated with your medical history and current medication list. Please check with your primary care doctor before taking any of these medications. Physical therapy and acupuncture can also help. There is also several over the counter creams that help including zostrix, but please use gloves when applying. I would also keep pursuing the reason for your symptoms with a pain specialist who can offer various test and various solutions to pain without narcotics, such as a spinal cord stimulator, depending on the location.

One of the best tests to distinguish between these conditions is a spinal tap. The cerebro-spinal fluid (CSF) is abnormal in over 90% of patients with MS, so I always recommend that this test be done.

I am going to assume that you had ulnar surgery at the elbow and not at the wrist. You should take the advice of your surgeon. You do not want to bend at the elbow early after surgery which may tear stitches or inflame tissue. Physical therapy usually starts 6 weeks after surgery. For optimum results, I would wait at least 6 weeks before driving.

Michael J. Olek, DO

If you have an acquired mononeuropathy, such as from diabetes or alcohol, and the offending agent is controlled or removed, healing of peripheral sensory nerves occurs about 1mm per day. Hereditary neuropathies cannot be reversed, but entrapment neuropathies, like carpal tunnel syndrome, can be partially reversed.

If you have no other neurological signs then it is probably due to your ear. If you also have neurological problems, please see a neurologist. Also, have your primary care physician check out your ears.

Michael J. Olek, DO

Please see your primary care first then talk to your psychiatrist if you are on any psychiatric medication since that is a common cause of your symptoms. If everything is OK as far as primary care and psychiatry, then the next step is to see a neurologist to rule out seizures or headaches or other similar neurological conditions.

Elevating your feet will decrease the swelling in your feet, which might decrease some of your pain, but it does not help with the root problem for the neuropathy. I would suggest seeing a primary care physician or a neurologist to try to determine the cause of the neuropathy.

Yes, please have your chest pain evaluated as soon as possible.

No.

Not alone. Any virus can cause flu-like symptoms of fever, fatigue and headache. I have not heard of covid-19 in a person that young, but if the only symptom is headache and irritability, I would take him to the pediatrician.

As soon as 18 months or older.

Michael J. Olek, DO

Usually 2-6 weeks.

Michael J. Olek, DO

1 millimeter per day if they can, and they may not heal at all or heal partially.

Michael J. Olek, DO

Child psychiatrist.

Please consult an oral maxillofacial surgeon.

I do not know if I can give you an accurate number in an individual patient. I do not know how long the patient was diagnosed with multiple sclerosis, nor do I know what treatment modalities have been tried in the past. If she is an EDSS 9 patient then she is more prone to infections and that is what causes mortality in MS patients. She also may have other medical problems which would factor in to the equation. Below is some general information on the progression of MS.

MS is not a terminal condition, and long-term studies suggest that multiple sclerosis only has a small impact on life expectancy. A study in Canada examined this area in terms of level of disability and found that life expectancy for those people whose experience of MS ranged from no symptoms to full time use of a manual wheelchair (less than or equal to 7.0 on the Expanded Disability Status Scale (EDSS)) was only slightly reduced.

The research found that people with more complex disability (EDSS greater than or equal to 7.5) were more at risk of potentially life threatening complications - such as respiratory or cardiovascular problems which tend to result from reduced mobility. Co-morbidities like stroke and vascular issues affected the overall life expectancy figures. Even with this group included, overall life expectancy for people with MS was only about six to seven years less than that for the general population.

This effect has been seen in other studies of health insurance records - for instance an American study of data collected between 1996 and 2009 and a Canadian study with records from 1984 to 2012 both found that life expectancy was on average six years less for people with multiple sclerosis.

A Norwegian study in 2017 found that life expectancy in people with MS is increasing at the same rate as that seen in the general population. Overall, life expectancy was seven years less than people who didn't have MS (74.7 years vs 81.8 years). The life expectancy for people with relapsing remitting MS was longer than for those with primary progressive MS (77.8 years vs 71.5 years).

Michael J. Olek, DO

Recovery:
When you wake up after your surgery, your back may feel sore and you will probably be attached to one or more tubes, including:

-an intravenous drip to make sure you do not get dehydrated
-a drain to take away any fluid from your wound
-a catheter, if you are having difficulty urinating
-a pump to deliver painkillers directly into your veins every few hours

The tubes are usually attached for only a short while after your operation.

Discomfort:
Immediately after surgery, you will have some pain in and around the area of your operation. You will be given pain relief to make sure you are comfortable and to help you move. The original pain in the leg usually improves immediately, but if it doesn't, tell the nurses and your doctor. A very small number of people have difficulty passing urine after the operation. This is usually temporary, but in rare cases, complications such as nerve damage may cause the legs or bladder to stop working properly. It is important to tell your doctor and nurses immediately if you have problems. It can take up to six weeks to get over the general pain and tiredness after your operation.

Stitches:
You will have stitches to repair any cuts or incisions made during your operation. Deep stitches beneath the skin will dissolve and do not need removing. Stitches or clips used on your skin will be removed 5–10 days after your operation. You will be given an appointment to have your stitches removed before you leave hospital. Your stitches may be covered by a simple adhesive dressing, like a large plaster. When you wash, be careful not to get your dressing wet. After having your stitches out, you will not need a dressing and will be able to bath and shower as normal.

Rehabilitation:
Your medical team will want you to get up and move about as soon as possible. This is because not moving can increase your risk of deep vein thrombosis and movement helps to speed up the recovery process. After your operation, a physiotherapist will monitor your specific needs and help you safely regain strength and movement. Exercising the spine as instructed will help you recover quicker than if you stay inactive.

Getting home:
You will be able to go home one to four days after your operation. How long you have to spend in hospital depends on the type of surgery you had (recovery is quicker after a microdiscectomy) and your state of health. It is important to take things easy at first. Some help at home is usually needed for at least the first week after surgery. Avoid heavy lifting, awkward twisting and leaning when you do everyday tasks.

When to seek medical advice:
Lumbar decompression surgery is generally safe with a low risk of complications, but they can sometimes occur. Contact your surgeon or doctor as soon as possible if:

-there is leaking fluid or redness at the site of your wound
-your stitches come out
-your dressing becomes soaked with blood
-you have a high temperature (fever) of 38C (100.4F) or above
-you have increasing pain or numbness in your legs, back or buttocks
-you cannot move your legs
-you cannot urinate or have lost control of your bladder
-you have a severe headache
-you have a sudden shortness of breath – this could be a sign of a blood clot inside your lung (pulmonary embolism), a lung infection (pneumonia) or other heart and lung problems.

Work:
When you can go back to work depends on how you heal after surgery and the type of job you do. Most people return after four to six weeks if their job is not too strenuous. If your job involves a lot of driving, lifting items that weigh over 5kg or potentially violent situations, you may be off work for up to 12 weeks.

Driving:
Before starting to drive again, you should be free from the effects of any painkillers that may make you drowsy. You should be comfortable in the driving position and able to fully control your car, including being able to do an emergency stop without it causing you any pain. Most people feel ready to drive after two to six weeks, depending on the size of the operation. Some insurance companies do not insure drivers for a number of weeks after surgery, so check what your policy says before you start to drive.

Repeat surgery:
After back surgery, 20%–30% of people experience recurring symptoms. These can be caused by a weakened spine or another slipped disc, formation of new bone or thickened ligament. Other treatments, such as physiotherapy, will be tried in the first instance, but further surgery may be needed in some cases.

Michael J. Olek, DO