Dr. Ambekar Sudheer
Neurosurgery
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My mother, who is 79 years old has a neurologist appointment in five days. She was recently diagnosed at the emergency room (ER) with spinal stenosis in the neck. However, I am very concerned that me moving her from the bed to the wheelchair is contributing to her daily decline and related symptoms. Her symptoms are muscle spasms in legs and arms, severe cold sensations in her hands and arms, and neck pain. The muscle spasms in legs and arms are increasing, and she also has loss of continuance. In 30 days, she has gone from walking with a walker with full control of her arms legs and bowels to no control at all. Should I continue to move her from the bed to a wheelchair? Or should I leave her in the bed until her appointment? All of her vitals are good, and her blood work was normal since getting intravenous (IV) iron. Please advise.
Hello,
Welcome to icliniq.com. Severe cervical spinal stenosis causing spinal cord compression is known to cause all the symptoms that you have described. However, if the worsening from being able to walk to not at all has happened after your emergency room (ER) visit, I suggest you go to the ER again. This is because neurological worsening is a strong reason to intervene early, so as to prevent permanent disability. You should ideally consult a neurosurgeon as well, as she might require surgery. As regards to mobilizing your mom out of bed, you may do so by applying a hard cervical collar. If the collar is not available, I suggest you do not mobilize her out of bed. But, in a bed bound person, one needs to take care that she does not develop pressure sores in the back and any chest or urinary infection. This can be prevented by frequent positioning.
Patient's Query
Hi doctor,
Thank you for the reply. All of her vitals are good. Will the emergency room (ER) or hospital even admit her? Should I keep her here at home until the appointment with a neurosurgeon in five days? If I keep her home, should I keep her in bed? Or should I use the hard neck collar when getting her out of bed to the wheelchair?
Hi,
Welcome back to icliniq.com. If there has been worsening from the time she was last seen in the emergency room (ER), the ER should admit her. You may mobilize her out of bed only with a hard cervical collar on. Try not to manipulate her neck though. You may keep her home. But, I suggest you talk to your primary care doctor and keep him informed about the worsening status. As said earlier, if there has been neurological worsening to the extent that she is bed bound and cannot get up by herself, the ER should admit her.
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Neurosurgery
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