Sunday, January 22, 2017

Reality hits me hard, with aging parents and uncertainties of life. I learn about OPLL the hard way.

Rarely did I think that a time will come when I will be doing deep research into medical sciences and neurosurgery field. Let alone sharing my parent's medical issues.  But what i have learnt, I must share as this is a rare fourth degree medical condition that others can benefit from knowing , it god forbid, they ever face such a situation.

This is something way outside my comfort zone of IT and Marketing technologies, but a recent mishap accident with my father has made me realize that there are far more difficult and significant things in life that I had yet to confront and I was not prepared to handle it alone. Medical science is truly the next frontier.

Diwali the festival of lights had just gone by and we were all in a cheerful mood. My brother and his family were back home in India and the grand parents were having a good time with grand kids. My dad has just returned back to India after a pleasant three month stay with me here in USA.  

Then came the scary Halloween trick for me. On a fateful day of Oct 30th 2016, just after Diwali in Bhilai, India my dad slipped and fell and the back of his neck hit the swing base. It was not a major accident by external measures, no external bleeding or wound, but it was severe enough to compress the nerves to a point were he could not move or stand up. He was lying on the floor, lifeless and could not move his both legs and one hand.

He was fortunately able to make an audible alarm and was picked up , lifted and transported to hospital.  He was immediately admitted to Bhilai Sec-9 hospital in Chhattisgarh, India. There it was diagnosed that he already had a case of OPLL () and this fall and immobility are symptoms of  a final breakdown.

OPLL is a calcification of the soft tissues that connect the spinal bones which results in a narrowing of the spinal canal and compression of the cervical spinal cord. See below pics. Left pic is BEFORE and right pic is AFTER Neurosurgery. You can clearly see the clear cervical canal in after surgery picture.

                                       BEFORE                                                    AFTER
           

The cause of OPLL is unclear and I could not get a certain answer from anyone, but was told that people of Asian heritage especially Japanese have a higher likelihood of developing OPLL. Also more men seem to be affected than women.

OPLL Symptoms

Most patients with OPLL are asymptomatic with no symptoms at all, but others may experience mild pain and numbness in the arms and/or legs to complete numbness in the extremities. The symptoms are similar to those of cervical cord compression.

Treatment of OPLL

This depends on the stage of OPLL and in my case , my dad is at stage 4 and that is the severest stage. Conservative treatment like activity modification and exercises may help relieve the pain caused by OPLL but I was told that open spine surgery is required. This is what we had to go through at a very short notice and with a high risk that comes with open spine surgeries. Little mistake / mishap and you can have your other nerves not working and you may have more problems than just hands and leg not moving.

If pressure is not relieved on the spinal cord then future damage and loss of neurological function is very much possible. At Sector 1 Bhilai hospital, my brother was told that this may affect respiratory functions as well. So they advised immediate surgery and there is a major risk when you open up the spine.




Since then in last 2 months we have gone through many things and are working on getting this thing taken care of. It is a big help that my brother is back home in India and can execute on many of the on site things.  Simple things like opening zipper or buttons that we take granted for in life start to seem like mammoth tasks. What you can do in person on site, is a significant thing in such circumstances.  Anyway, we are fortunately past all these and my dad is recovering post surgery. Here is a pic.

I would like to thanks and credit the following websites for some of my research. Indian Government portal surprisingly had a good amount of research papers at NCBI.

https://www.emoryhealthcare.org/orthopedics/ossification-posterior-longitudinal-ligament.html
http://www.medscape.com/viewarticle/739292
https://www.ncbi.nlm.nih.gov/pubmed/16306836

We have undergone surgery since then and in future articles I will share more details, but if anyone is in similar situation, I will be glad to share detailed notes, just unicast me.

I was helped by many friends, some friend of friends from my school batch,  known and unknown people so my heartfelt thanks goes out to them and I plan to pay it forward by capturing many of those research and details in my blog so that someone else can be helped.

Thanks

Arvind