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Upcoming cervical spine surgery

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Upcoming cervical spine surgery

Old 12-03-22, 07:45 PM
  #26  
GhostRider62
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Originally Posted by canklecat View Post
Sounds very familiar. I have cervical spine stenosis, worsening pain for almost 20 years since it started after my car was t-boned when the driver of a full size SUV blasted through a red light at highway speed.

It got worse after I was hit by a car during a bike ride a few years ago. Reinjured the neck. Broke and dislocated my shoulder, with a winged scapula that took a year to sorta-heal.

Constant neck pain. Frequent headaches. The works. And referred pain, or adjunct pain caused by the poor posture and ergonomics resulting from permanent physical changes.

It's pretty rare when the usual perfunctory pain assessment questions at every medical visit are sincere. I tend to brush them off, figuring they're just checking off boxes in a list. I could tell them my pain is "Z-squared" and they'd just write that down, or ask for a number from 1-10 and shrug when I say 6, which is my usual answer.

Once a nurse stopped, looked at me and said "That's actually pretty uncomfortable."

I said, yeah, I know. But I haven't had a day with pain level lower than 4 or 5 in 20 years. After awhile it's background noise.

She seemed interested in details, such as "compared with what?"

So I pointed to my left index fingertip, which was nearly amputated by a machine more than 20 years ago. The entire distal phalanx was crushed into seven pieces and dangling by some connective tissue. Fortunately the blood vessels were intact. The ER just splinted it and sent me home. There wasn't much pain initially because of the nerve damage. It seemed okay the next few days, with some throbbing pain, but nothing bad enough to need more than ibuprofen. It eventually healed without medical intervention, with minor nerve damage (maybe 90% of original sensation) and the fingernail is permanently divided into two overlapping pieces.

In another shop injury a hammer handle split and wedged my little finger, splitting the flesh down to the periosteum. No blood, not much pain. I just cleaned it and wrapped it snugly with a couple of bandaids. It healed fine, just a barely visible and palpable scar.

I was an amateur boxer and, among other idiotic stunts, usually preferred to spar bigger guys. I boxed from lightweight to light middleweight, 132-156, and rarely sparred anyone my size. I usually sparred guys up to heavyweight size. I never learned to pull my punches properly and tended to knock down guys my own size or smaller, which isn't a good thing in sparring. Despite some myths about macho gym wars being as rough as actual competition, it's not a good practice, especially in the amateurs. Fortunately toward my final couple of years I got a better coach who worked with me on technique and restraint.

Anyway, I had plenty of black eyes, cuts around the eyes (actually skin splitting against the eye socket), cracked ribs, and a cracked sternum from sparring a state heavyweight Golden Gloves champ (and he really was taking it easy on me). Never saw a doctor for any of it. Just seemed like part of the process. If people are too sensitive to pain, they usually don't persist in martial arts.

I don't think it's a matter of willpower. Some people just have a different pain threshold. I've always had a delayed pain response, usually hours or days after an injury. And until the car wreck 20 years ago, never had a problem with chronic pain from old injuries. Once they healed that was it, no other problems. But that all changed in 2001.

Same with crashes from bicycle racing or just ordinary bicycle and motorcycle riding. Plenty of injuries. Never saw a doctor for any of them. During my first criterium in 1978, in the final sprint, the guy next to me pulled ahead slightly, swerved into my lane and took my front wheel out from under me. Road rash from ankle to shoulder. I was in the Navy at the time, a Hospital Corpsman working at the National Naval Medical Center in Bethesda. The petty officer in charge of our unit advised me to keep the injury to myself and not go to sick call because I didn't have authorization for off base activities such as bicycle racing and boxing. He said that base CO could very well recommend disciplinary action. So I patched myself up, making sure nothing bled through my white scrubs. And I went back to race again two or three weeks later.

When I was hit by a car in 2018, the ambulance crew saw my busted up shoulder and arm dangling loosely and asked if I wanted fentanyl for the pain. It's a fast acting, very short duration analgesic, and would last long enough to get through the waiting time at the ER. I said, nah, it doesn't hurt that bad so far. At the ER they offered morphine. Again, I said, nah, it doesn't hurt that bad yet. A hydrocodone or Tramadol will be enough (despite media hype, those are very mild opiates and not nearly as addictive for most people as the hysterical news stories would have you believe). Again, they seemed stunned that I wasn't in much pain. I said, "Ask me again tomorrow or this weekend at home. By then it'll be hurting."

And I've had severe headaches since I was a kid. Neurologists can't decide whether it's migraine, cluster headache or trigeminal neuralgia. Those are pretty well acknowledged as pain level 8-10, sometimes reaching an excruciating level that few people can tolerate for long. Now I just say "migraine" because otherwise they assume I'm self-diagnosing and mooching for opiates. But analgesics don't help with migraines or cluster headaches. They can help with trigeminal neuralgia, but in my experience a local injection of Xylocaine or something similar works great for trigeminal neuralgia. No need for opiates. Now I take a beta blocker as a preventive and it usually works pretty well.

So when I tell nurses or doctors now my pain level is usually around 6, but I'm not crying and begging for prescription pain meds, I can tell they don't believe me. But you really do learn to push it into background noise. You can't cope otherwise. Once the pain hits a 7 or 8, yeah, I want something stronger than Tylenol.

Anyway, I got tired of medical professionals who either disregard patients with genuine pain. Or, almost as bad, refer us to "pain mismanagement clinics" that turn out to be Medicare/insurance milking scams. Typically they'll set up as many appointments as possible, each six weeks apart, before actually doing any treatment. I watched my mom go through that mess years ago for her arthritis, scoliosis and deteriorating joints. They made an appointment, which accomplished absolutely nothing other than to give her another appointment for a nerve block. But when the next appointment came up six weeks later, it was just a consultation to *explain* the nerve block. Then another six week wait for the actual nerve block. Before her health care system switched to this Medicare milking scam, her regular ortho doc would do the nerve blocks at the same time, no delays or redundant appointments.

Unfortunately I was referred to just such a pain mismanagement clinic to be evaluated for cervical spine ablation. I was sent to them in 2018 and their soonest appointment was six months away. When I asked why the guy said "Take it or leave it" and hung up on me. This time my ortho doc, who's a good guy, said he could get me in within two weeks. But when I was contacted by the clinic, they pushed it back to nearly two months. So after this upcoming appointment I'll be looking for another ortho clinic.

There's a good reason many of us have switched to finding our own solutions for coping with chronic pain. For me, CBD was somewhat helpful but expensive for what it does. Kratom has been much more effective and I can continue to function and stay physically active. Some folks suggested alpha lipoic acid, which I've been taking for a month or so. It might help a little but not enough to justify the cost of yet another supplement. I can't take NSAIDs daily, especially ibuprofen -- it aggravates my psoriasis and psoriatic arthritis symptoms, which has recently been confirmed by studies. Tylenol does almost nothing for me. I get as much good from hot soaks in Epsom salts, a percussion massager and TENS unit.

So, yup, what you've described is too familiar. There's got to be some medical professionals out there who get it. But I haven't found one yet.
I can sort of relate but spine pain just wears me out.

AND I hate being asked my pain level. I had a Neuro Surgeon tell me is usually only sees patients if their pain is at least an 11 and my pain of 7 would not normally get an appointment but he is doing it as a favor to my referring Doc (they are buddies from Med school). I say to him, there is no 11. 10 is basically death.

Broken ankle = 3
Broken ribs = 4
Broken humerus = 5 (compound fracture with an osteotomy post urgery)
Ruptured appendix = 6
Toenail completely cut off without any anesthesia = 7
Occipital Neuralgia = 8
Trigeminal Neuralgia = 10

Basically, I just need a 9 to complete it.

When I tell a nurse my pain is a 4 or 5, they seem very disappointed. I might just use your answer and just always say "6"

I never boxed except playing hockey, I played in college and then for years as an adult. Getting hit with a slapshot can sting or knock you out. Took a slapshot to the head once, knocked me right out. Skate cut my ear right off, it was dangling by a thread. There was some action in front of the goal and then I was taking the faceoff, the ref says, you need to go to the bench and I like, "what penalty, what did I do" and he takes me by the arm to the bench and our trainer nearly passed out seeing my ear hanging. It only took 35 stitches after the game, the coach taped me up. Honestly, that didn't hurt. Mostly just lots of black and blue marks and lots and lots of stitches. I got mugged in Davis Square (Boston Area). Three young thugs wanted my money. I wouldn't give it to them. One slugs me. I get a real good shot on the middle big mouth and pathetic a weak left on the other one. The middle guy was the mouth. Once he went down, the others backed down. I go back to school and my Southie buddy says, "I did know you had a game today" and I said that we did not play today. My buddy goes, ok where did you get that new shiner. I told him they tried to mug me and he goes, "Billy, get theF'n bat". If you saw the movie, "A beautiful mind"......that was Billy although not from Charlestown but very close. Something for sure is wrong with me, several times thugs have tried to take my money with a knife. I worked to hard for my money. Never gave it and they never got it. Pretty damned stupid.

After my bike accident last year, I still had some pretty good pain in the shoulder about 3 weeks post surgery although the compound clavicle was already healed. I thought my shoulder needed some work or adjustment from my longtime chiropractor who is also a cyclist and has worked at the Olympics. Guy knows his stuff. So, I go to him telling him the pain and can he do anything. He says, "You have the highest pain threshold of any patient I have ever worked on". "If you are telling me you are in pain, you have a real problem. Go back to the Surgeon." Turns out my scapula was also broken and they missed it in the trauma center (also missed a fractured trochanter).

What is different about cervical pain, it never goes away. Broken bones heal and they don't hurt too much. The chronic pain in the neck just chips away. It sucks.

Edit: Since this was post 3000, I had to make it extra strength.

Last edited by GhostRider62; 12-03-22 at 08:14 PM.
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Old 12-04-22, 10:38 AM
  #27  
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Originally Posted by GhostRider62 View Post
...After my bike accident last year, I still had some pretty good pain in the shoulder about 3 weeks post surgery although the compound clavicle was already healed. I thought my shoulder needed some work or adjustment from my longtime chiropractor who is also a cyclist and has worked at the Olympics. Guy knows his stuff. So, I go to him telling him the pain and can he do anything. He says, "You have the highest pain threshold of any patient I have ever worked on". "If you are telling me you are in pain, you have a real problem. Go back to the Surgeon." Turns out my scapula was also broken and they missed it in the trauma center (also missed a fractured trochanter).

What is different about cervical pain, it never goes away. Broken bones heal and they don't hurt too much. The chronic pain in the neck just chips away. It sucks...
Yup, I got the impression from the ambulance crew and ER staff, and chiropractic clinic, that my pain threshold is higher than usual. The chiropractic clinic had an industrial strength sort of TENS machine, maybe an EMS or NEMS? Anyway, they'd turn it to 2 and ask if I was okay. I'd say "I don't feel anything. Turn it up." Usually I'd settle for 7 or 8 on the dial. They said most patients complained if it was set higher than 4 or so.

Might be a difference in skin and nerve response as well. I found a really good little inexpensive TENS device on Amazon a couple of years ago, much better than the earlier home TENS doodads I used to have. This thing really has some kick. The only time it bothers me is when the electrode pad isn't making full contact and I get some stinging sensation on the skin, which is more annoying than painful. But if I make sure to clean the pad so it makes full contact and find the sweet spot on the skin, it just contracts the muscles and feels great. I usually set it for around 6-8 and let the muscles dance. It's still less painful than those occasional midnight Charlie horses many of us get while sleeping after a good hard bike ride, run or workout. I've literally fallen out of bed rolling on the floor from those wee-hour muscle spasms, while my cats are looking at me like I'm crazy. But it's over with after a few seconds.

I haven't found a good chiropractor since my first serious injuries about 20 years ago. Back then my lawyer sent me to one of those accident and injury pain clinics, all paid by the eventual insurance settlement. Since then not many lawyers have those kinds of sweetheart deals with doctors and chiropractors because some judges and courts consider it unethical. But TBH, I had no complaints. I got great treatment from that clinic and the settlement took less than a year.

After my 2018 injury, I tried an attorney who was himself a cyclist and serious runner, recommended by fellow cyclists. But I can't say the experience was any better, or even as good as my first incident. It took more than three years to settle, and during the mediation phase there was an implication that there was something unethical about the attorney's office sending me to a specific ortho doc for evaluation and proposed surgery for the busted up shoulder. The ortho doc and clinic were great, but they couldn't do the surgery because it turned out I also had thyroid cancer with the goiter distorting and compressing my trachea so badly I couldn't be intubated. So I never got shoulder surgery. Anyway, I thought the ortho doc and clinic were fine, but the court mediator and opposing attorney seemed to imply there was something unethical about the whole thing. The settlement didn't even cover half of my actual medical expenses, despite the fact that a cop witnessed the collision. The cop wrote it up as "equal fault" because I failed to dodge the car that ran the light and hit me. But that's Texas. Drivers reign supreme and pedestrians and cyclists are dismissed as mere road bumps.

Fortunately the VA got me into their health care system immediately and took care of most of my health issues from 2018-2019, including full body scans to evaluate my neck and spine issues. Unfortunately the VA health care system failed badly during the pandemic as they were overwhelmed by elderly veterans, so the planned treatment for my cervical spine was postponed indefinitely. But I turned 65 in November and switched to Medicare. Between the two options I'm better off than many Americans, so I don't really have any serious complaints.

Yeah, the pain management farce is a pain in the neck. But that's an issue caused by government and media hysteria over the "opioid crisis" that has very little to do with legitimate medical care for chronic pain patients. They've conflated recreational drug users and addicts with legit chronic pain cases to inflate the statistics. So doctors, clinics and hospitals are terrified of being gigged by the government and being accused of being "pill mills." And now instead of being sympathetic and responsive, doctors and nurses tend to regard all of us as potential junkies by default, even when we specify that we don't want prescription pain meds, but some alternative treatment.

And I see in recent medical journals some new studies that indicate corticosteroid injections may actually worsen joints and osteoarthritis over the long haul. So now I'm expecting ortho docs and rheumatologists to tell us they can no longer use local injections of anti-inflammatories because of a preliminary study that hasn't even been finalized.
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Old 12-05-22, 06:57 AM
  #28  
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canklecat A 70-year-old non-cycling (but active) buddy of mine had similar surgery for similar reasons. The recovery took a few months but yielded excellent results and he ended up much better than before the surgery. Wishing you the same.
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Old 12-07-22, 05:20 PM
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Alrighty....all done with surgery and been home for a few hours.

Surprisingly, I have no pain yet.....I do have a hoarse voice though.

Thanks for all the well wishes.

Last edited by Desert Ryder; 12-07-22 at 05:24 PM.
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Old 12-07-22, 05:52 PM
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When I did audio at the hospital patient seminars, a doctor showed photos of a back surgery patient bear hunting a week after surgery.
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Old 12-07-22, 05:53 PM
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Originally Posted by Desert Ryder View Post
Alrighty....all done with surgery and been home for a few hours.

Surprisingly, I have no pain yet.....I do have a hoarse voice though.

Thanks for all the well wishes.
I hope the surgery is successful.

I understand swallowing normally can take time, they cut you open thru the back of your throat and pried you open to get to the vertebra. The plate is just anterior to the spine and just posterior to your throat. Might time a little while for that to normalize. GL!!!
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Old 12-08-22, 09:50 AM
  #32  
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Originally Posted by Desert Ryder View Post
Alrighty....all done with surgery and been home for a few hours.

Surprisingly, I have no pain yet.....I do have a hoarse voice though.

Thanks for all the well wishes.
Great to hear.

The hoarse voice is likely just from the endotracheal tube. However, it may also have resulted from manipulation of the recurrent laryngeal nerve, a common complication of ACDF. That gets better a lot more slowly and can be permanent.
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Old 12-08-22, 10:43 PM
  #33  
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No riding for a while..

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Old 12-11-22, 04:18 AM
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Had surgery on the 7th. It is 214AM 12/11 and I am bored out of my skull. My sleep pattern is all jacked up.
Another week off before I have to return to work. Probably a few more weeks with the cervical collar.
The worse part about all this is the hacking from being intubated. going on short walks to help get it out.
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Old 12-11-22, 03:29 PM
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Walking is great for maintaining base aerobic and leg strength fitness while recovering when we can't ride. Especially if you can develop a gliding, low-impact speed-walking form.

Back in 2018 after I was hit by a car, I was unable to ride outdoors for several months. And coincidentally I developed thyroid cancer the same year, so my energy level was in the dumpster.

A friend gave me his old Cyclops trainer, so a month after the injury I'd set up my old school steel road bike with a more padded saddle, wore thicker padded shorts, raised the stem, and was able to sit more upright without discomfort to keep the legs spinning.

But I got bored with that and began walking around the neighborhood. It was a bit awkward with one arm in a sling. And I was surprised to discovered my hips ached after only a couple of miles. Full body imaging scans showed no skeletal or joint problems below my back so I figured it was just unused muscles rebelling at new exercise. I kept at it and now I often walk, jog and run 3-8 miles several times a week.

At first I studied some YouTube videos on speed walking and easy jogging to ensure my form was good with minimal impact. And I got a couple of pairs of Under Armour Hovr Sonic shoes with a Bluetooth sensor in one shoe that synced with Map My Walk and Map My Run apps for realtime feedback on my walking/jogging form: cadence, stride length, etc. Really helped keep my form in shape to avoid injury. Not all UA shoes include that Bluetooth sensor, but the inclusion is less expensive than buying a separate tie-on sensor used by some serious runners. The Hovr Sonic and other UA Hovr shoes are still available online, usually heavily discounted for the outdated models that still work perfectly well.

I still have chronic neck pain from being hit by cars twice in 20 years, with a cervical spine ablation procedure coming up soon. The pain limits my time on the bike, so I've been doing a lot more walking and running the past couple of years. In many ways I still prefer cycling, but the great thing about walking and running is the less elaborate gear and prep, compared with "serious" road cycling. Some days I just go out wearing the same shorts and t-shirt I wore to sleep. My prep time for a road bike ride can take 30 minutes to check everything. For walking and running, maybe 5 minutes at most.
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Old 12-11-22, 03:44 PM
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Originally Posted by Desert Ryder;[url=tel:22735782
22735782]Had surgery on the 7th. It is 214AM 12/11 and I am bored out of my skull. My sleep pattern is all jacked up.
Another week off before I have to return to work. Probably a few more weeks with the cervical collar.
The worse part about all this is the hacking from being intubated. going on short walks to help get it out.
My clavicle was plated on the seventh. I think I am still detoxing some of the drugs used in surgery (no pharmas since).
I hope you manage recovery well. Take it slow, each move
dedicated and thought out. Slow your walk (from normal) and stay warm. All the best!

You might practice some slow/deep breathing, with a longer exhale. I believe my regular practice of this aided me greatly, through covid.

Last edited by streetsurfer; 12-11-22 at 03:54 PM.
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Old 12-16-22, 01:21 PM
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A week after and all the bandages have come off. I finally got to shave my face after 8-9 days
Looks like about a 3"-ish long cut along the skin fold on the left side of my neck. Have internal stitches also. Still numb around it.
I don't think there will be much of a visible scar. Still another week till my follow up appointment.

Not so nasty pic...

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Old 12-22-22, 01:01 AM
  #38  
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Well, I had to postpone my cervical procedure this week. The day surgery clinic wouldn't budge on its requirement to have the person who drove me also stay in the waiting room throughout the procedure and take me home afterward. So, no Uber or Lyft. The one person I know who could have done that (she do so for me for a previous day surgery two or three years ago), was committed months in advance to another client that day.

Last week my insurance provider told me, no problem, we can arrange transportation with a "minder" for you. But when the time came, they couldn't.

I have a friend who's a sometime rideshare driver. I planned to pay him out of pocket for the day, on his day off, but he was gone for this holiday week.

Literally and figuratively a pain in the neck.

But after reading about some (albeit rare) complications from the procedure for subdural cervical spine injections, I suppose I can see why they're concerned. But if it's really that critical, seems like it would make better sense to make it an in-patient procedure and keep me overnight.

Probably be another two months before I get another crack at it, as slow as this clinic is. I'll probably start looking for another ortho doc.
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Old 12-22-22, 04:56 PM
  #39  
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Ok..finally. Some hardware pics....plate, 8 screws, and the little dots are in the disc spacers (3)



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Old 01-16-23, 04:29 PM
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Hey Desert Ryder,

I'd love to know how your recovery is going. I have a near identical diagnosis as yours. Surgery is being scheduled. I hope you're doing well.
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Old 01-19-23, 07:00 PM
  #41  
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Originally Posted by CampDaley View Post
Hey Desert Ryder,

I'd love to know how your recovery is going. I have a near identical diagnosis as yours. Surgery is being scheduled. I hope you're doing well.
Thanks for the concern.
Recovery is going well. I never had any pain from the surgery. The incision has healed up well with some numbness in my throat and jawline area still remaining.
I have a follow up appointment tomorrow. I'm sure I will have new x-ray pictures.
I seem to have a full range of motion while turning my head to look from side to side, and up and down.

I did get a prescription for physical therapy but haven't looked into it yet because of a change in insurance carrier on the 1st of 2023.
I have been slowly trying to rebuild muscle strength and mass in both biceps.

I hope your surgery goes well and best wishes for a speedy recovery.
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Old 01-21-23, 02:00 PM
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I had fusion at C5/C6 in 2011. I have done pretty well with it, now almost 12 years. However, the last year and a half, I have been having quite a bit more pain and a loss of range of motion. I have just about given up on drop bars, I still have one bike with compact bars, 65mm reach and 120mm drop. I have that set up with more of a riser stem than I prefer, just aesthetics. I still get sore if I am in the drops for more than a little time. My other bikes have been switched to either V-O Porteur bars, or Ritchey Beacon bars. The Beacon has 65mm reach and only 80mm drop, and flared 36 degrees. I was pleasantly surprised how much I like them. Both types have given me a lot of relief.

CampDaley, I wish you will with your surgery and recovery. Try to stay in as good of shape as you can pre-op. Post surgery, don't try to push it too much, do what the medical and therapeutic professionals suggest. Sticking with the therapy, and doing it properly, is highly important for both short, and long term, recovery. I have had 4 spinal surgeries, including disc replacement at L5-S1, 2004. I am still averaging 5000 miles per year.
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