Question: Hi Doctor XXXXXXX some time has past since I originally ask you my previous questions. I have seen an Orthopedic spine surgeon and a local Neurosurgeon and neither one of them suggested surgery. What I want you to know is that my diagnosis of a "congenitally small spinal passage way was a surprise. I played basketball for many years very aggressively and was never injured. Though I am 57, I swim 2 miles per day and am very fit. I idea that I have pressure on my spinal cord bothers me because it makes me wonder what will happen as I age. I look like I am in my late 30's or early 40's, I work hard and I want to be active for the next 20 years. I lost my father when I was 12, so I have always been determined to live a long healthy life, now this diagnosis. My question is this: during the last 4 weeks I have made a number of changes and I am seeing a physical therapist. I am taking large amounts of Vitamin C and sleeping more. I am drink more water and still swimming 2 miles a day, five days per week. Swimming makes my condition feel better than anything else. So the question, is it possible that the herniated disc I have that is pressuring the cord will get smaller if I continue to do the right things? Is it possible that I can get pressure off of my cord without surgery? What are the chances of me living another 20 years without pain, impairment and without surgery? My best friend is a hand surgeon from India by the way, he has been helping me. Please give me you thoughts. My symptoms are much, much better than 4 weeks ago. I am wondering if I can control how this progresses for the next 10, or 20 years? Thanks again, XXXXXXX

Hi Doctor, I am still trying to get a handle on this mentally. Tonight, I swam again, after I was finished my shoulder was very "active ", it ached...various sensations, etc. I did flip turns tonight and was trying to keep my head tucked. My right arm was extended upward too much and I could tell I strained it. I stopped doing flip turns after I learned of my condition 30 days ago, then I started again 3 days ago. The first two nights, I had no pain and the swimming improved everything, tonight the flip turns hurt my right should because I did them improperly. My question is on a separate topic, I just wanted you to have information. This is my question: I had an MRI that shows pressure on the cord and an abnormal cord signal at C-4; yet I have no neurological impairment. I do have pain in my neck and sensations down my right shoulder. The two surgeons I saw did not recommend surgery because their is no neurological symptoms. Both of them think my condition "may have been caused by a very hard collision I had playing basketball in my late 20's. After this collision, for the first time, I felt the same sensations in my shoulder and arm that I feel now. The surgeons believe my spinal cord situation may be stable. My question is this, do you believe the pain in my C7 area and down my right deltoid is related to the compression at C4, or is that pain a separate Radiculopathy? Tonight after swimming, I iced my C7 area after getting frustrated and it immediately got better. I was surprised. This made me wonder about whether the C4 compression on the MRI was possibly unrelated to the pain I have at C7 in the neck and shoulder. When I iced that area he pain and sensations in my shoulder almost went away. Is it possible that I have had spinal compression and an abnormal signal at C4 for 30 years and never knew because of no MRI, or do you think my pain in my neck and shoulder is related to C4 and is a myelopathic symptom instead of a separate Radiculopathy? If it is a separate issue that would explain why icing helped and I am having no neurological symptoms. I do not mind the pain, I am concerned about becoming impaired neurologically when I am older. Finally, as I mentioned before, the pain in the neck and shoulder are much better than 30 days ago, I just need to know if this pain is a myelopathic symptom, or a Radiculopathic symptoms. I am sorry for the length of this. I am trying to understand, so I can monitor symptoms and fight this thing. Thanks, friend.