It's Been a Week?

I can't believe that it has been a week since I had the surgery. The time really seemed to go quickly.

Teresa commented and asked about the surgery from the perspective of someone who is thinking about having the surgery. In my first post, that was the original intention of the blog, so maybe I should describe some of the experiences in more detail.

Before the surgery, I was very afraid of the surgery itself. It seemed that I was afraid of it all because there were so many unknowns. I was even afraid of getting the IV. Having gone through the surgery, anesthesia and recovery, I am not afraid now. I would be able to do this again with much less concern. The anesthesia was not scary. I don't remember anything at all about the surgery itself. I remember everything up to getting the Versed in the pre-op waiting area. I vaguely remember going down the hall into the elevator. I remember laying on the pre-op bed in the surgery room (they transfer you to the cradle while you are under). I looked around the room. There were about 4 people in there doing different things. I saw the big lights above the table to my right. Someone in dark blue scrubs was looking at my CT/MRI images on a monitor in the corner of the room.

Someone walked up to my gurney and asked how I was feeling. I said that I was nervous and that they gave me Versed in the room, but I didn't think it was working. They said they would give me more. Until writing this, I assumed they had. Now that I carefully look back on it, the next thing I remember is someone asking if I was ready to go to sleep. I said "ok". They said that they were going to start the medicine and that it might burn in my arm a little bit. I didn't feel anything at all.

The next thing I remember was an awareness that I was dreaming. I heard someone say, "Paco? You're in recovery. Your surgery is all done." I began to blink my eyes. Everything was blurry and my eyes felt sticky. I recalled the anesthesiologist saying that they would put an ointment in my eyes since we don't produce tears when under general anesthesia.

I could feel warm blankets covering me. I wiggled my right toes. I wiggled my left toes. They worked. I blinked until I could see better (didn't have my glasses or contacts) and saw a clock. I asked the nurse sitting to my right if it said "9:40". She confirmed and asked if I was in pain. I told her my back hurt where they did the surgery and that my left leg hurt. She said she had given me a powerful NSAID (anti-inflammatory) and asked if I wanted some morphine. I said yes.

By this time, I was fully awake and looking around the room. She injected the morphine and said it might burn a little bit. It didn't, but my arm started itching. I looked down and two of my blood veins in my arm were pinkish red. She said that the morphine triggers histamines and that's what caused the itching and pink veins.

The pain in my back was of two types. The first was a dull, pressure like pain similar to when getting an epidural steriod injection. The second was a more precise pain - very tender, like a cut. I assume the latter was from the incision and the former from swelling and bone removal. My leg did not have the shooting, buring pain like before. It was a moderate, overall ache from the knee down.

My voice was hoarse, my throat hurt and my mouth was really dry. I asked for a drink of water. She wouldn't give me water, but did give me crushed ice. I had at least 3 cups of crushed ice before I left. At some point, they labeled my recovery sufficient and discharged me from the PACU at 11:10. I was wheeled to a private room on the sixth floor. There was another nurse from the floor waiting for me. They lowered my gurney to the height of the bed in the room and asked if I could move myself over to the bed. I wasn't sure if I could, so I asked them if I should just try to crabwalk over there. So I raised my back off the gurney, and used my elbows and feet to scoot over to the other bed. It was uncomfortable and a little painful, but didn't feel damaging.

Before leaving the PACU, someone asked me if I had family waiting. I gave them Jane's full name and they indicated that she would be notified to join me in my room. At 11:30, she hadn't come to the room. I grabbed the room phone that was laying on my bed and called her mobile number. She was patiently waiting in the lobby - no one had contacted her. I gave her the room number and she arrived a few minutes later.

By 12:00, my neck was sore from sitting partially upright and my back and hips were achey. The nurse stopped by to ask how I was doing. I asked if I could try walking. She helped me get out of the bed which entailed rolling onto my side and scooting over until my knees poked over the edge. Then, I dropped my feet over the side and used my arms to 'roll' into a sitting position. At this point, I could scoot to the edge of the bed and get my feet to touch the floor. This technique would be used over and over during my recovery. In fact, I am still using it and will likely continue through my life because there is very little stress placed on the back.

Standing up was amazing. All of the aches and pains seemed to have been left on the bed. My leg didn't hurt at all. Zero pain. My lower back was fairly sore and my legs were shaky. I carefully and very slowly walked around the room. Jane and the nurse both asked several times if I wanted to sit or lay down. I didn't. Standing felt so good.

I choked down a hospital hamburger, some fries, orange jello, a lemon bar and apple juice for lunch. My mouth was so dry that I could barely eat. I had to take drinks of water to moisten the food just to be able to swallow it. I don't know which medication caused that, but it was very uncomfortable.

The remainder of my time at the hospital rotated between sitting in a chair (uncomfortable due to the pressure on the lower back), pacing around the room and laying in the hospital bed. Like before, the lower back pain was both dull in a broad area and sharp around the incision, but not unbearable in any way.

Although the following topic is a little gross, I am going for completeness in this entry. One thing that I was required to do was urinate by 6:00 PM. It doesn't seem like it would be difficult to do, but after at least a gallon of water and tons of ice, I didn't have the slightest urge to go. It seems that one of the medicines used during or after surgery causes this problem. Morphine? At any rate, it wasn't until around 3:30 that I was able to go. Thank god I was able to because the threat of catheterization was looming. The difficulty with urination lasted until the following morning. Oh, and the pee stinks! It has a nasty smell which I assume comes from the various medicines used.

The ride home was a little uncomfortable. My recommendation would be to choose a vehicle with leather seats or put a trashbag on the cloth seat to make it easier to slide around when getting in. The cloth seats grab your clothes and make it hard to get comfortable. Jane reclined the seat for me. Since then, I have preferred a more upright seat since there is less lumbar pressure from the seat back.

At home, I never felt confined to a bed or chair. It was usually easier to be up walking around even on the evening of the surgery. Jane's parents let me borrow a grabber which I consider essential for recovery since I'm not allowed to bend over. If I did the surgery again, I'd ask for a sleeping pill or determine if I could take a PM version of Tylenol or Advil on the first night. It was very difficult to sleep with the morphine, vicodin, etc combined with the discomfort in my lower back.

This post is getting long, so I will stop here for now. I'll continue next time with the days following the surgery and describe the aches and pains.

At this point, would I do it again? Absolutely. My only regret so far is that I did not do it sooner.

Getting Better

Each day has been better than the last. I haven't needed to take a Vicodin since Friday at 1:00 in the afternoon. There are times when it would have been helpful to relieve some of the discomfort, but I don't like the side effects. I didn't sleep much Tuesday, Wednesday and especially Thursday, so I was ready for a good night of sleep on Friday.

After I talked to the nurse Friday morning, Jane purchased Advil PM. I took two right before bed and actually slept. I still woke up every 2 or 3 hours, but the sleep was deeper and much longer than the 15-30 minute naps from the night before.

Each day, I try to sit in our recliner or otherwise figure out a way to lay on my back to watch TV. The angles established by being partially upright with my back and having my legs extended cause numbness in my left leg and discomfort in my lower back. So far, I have not been able to sit in this more relaxed fashion. Instead, I either lay on my side on the couch or sit upright in a chair with a pillow behind my back. It is tiring and I get sore with either of those positions.

I took my first shower on Saturday morning and it felt really good. I could smell the betadine in the air as it was washed away. Getting rid of the stinky hospital smells was a big relief.

Later in the morning, we went to Dick's Sporting Goods to look for "slip-on" style shoes. There was nothing that worked that provided slip on convenience with any amount of support for solid walking.

My lower back and hips were really tired after walking through the store, so I asked Jane to drive me back home. I spent the rest of the day laying around.

Saturday night was much better than the previous nights. I slept over 4 hours without waking up. I felt quite refreshed on Sunday morning. We went to Wendy's for lunch and then Target to look for more shoes. No luck there either.

When I got back home, I worked on tying some of my own shoes such that they would slip on with some effort, but not slip off when walking. This has worked out well and probably what I would do if I had to go through the surgery again.

Today is Monday, and I've been having a little numbness in my left leg. I'm only on the 4th day of recovery, so I'm not too worried about it.

Someone asked how the blog got its name of "Dag A Doo". When Holly was about 2 or 3, she started saying "Shaggily Shaggily". Jane and I never knew what it meant, but it was kind of a funny word. So I would call Holly, "Shaggily", as a cute name. As in "Shaggily, where are you?". Anyway, that name morphed into "Shag" which went well with "Dag" as in "Shag-Dag". Over time, I combined it with the Scooby-Dooby-Doo exclamation to come up with "Shagga Dagga Doo". That has since been shortened to "Dag A Doo" and carried to this blog.

I'm a freak.

Twelve Hours

I have a funny reaction to drugs that normally make people drowsy. For example, when most people take Benadryl, codeine or muscle relaxers, they want to sleep. Not me. I feel tired, but my mind races and I feel a sense of energy. They do take the edge off and relieve the pain, so at least they are worth taking.

Given this weird reaction, I couldn't sleep at the hospital. I felt pretty good so I asked to be discharged from the hospital a little after five o'clock. A physical therapist stopped by and I practiced climbing stairs and getting in and out of my bed. Once that was done, the nurse took out the IV catheter, had me sign discharge papers and I was in a wheelchair on the way to our car.

The ride home was not very fun. Jane's car has a sporty suspension, so it is pretty stiff. Hence, the ride home was bouncy and a little jolting. It took about 15 minutes and I was back home. In total, I was away from home yesterday less than 12 hours.

I was hungry for chicken alfredo, but we couldn't think of anywhere to get something decent "to go". So we decided on Minsky's Pizza (a new post-hospital ritual for me?) and Jane ordered a large sausage pizza.

Most of the evening was spent pacing around, practicing sitting, stairs and getting in and out of bed. I tested the recliner at about 8:00 and was ready for bed by 8:30.

As soon as I stood up, I got hiccups. Really heavy, loud hiccups. We tried spoons of sugar, lemon drops and drinking water. Nothing helped. After about 1/2 hour, Jane told me to close my eyes, take deep breaths and she rubbed my neck and upper back. Like magic, they went away.

I got ready for bed, climbed in and closed my eyes around 9:15. My back was really tender and turning from side to back is a complete ordeal. I could quickly tell that the morphine and other pain killers were still active. My eyes were moving under my closed eyelids and I saw little flashes of light. I knew I was doomed as far as sleeping.

At about midnight, I was frustrated from not sleeping and switched to the guest bed. It is much firmer. By about 1:15, the drugs had subsided enough for me to fall asleep. I awoke about every 2 hours and had to use the bathroom. I got up around 7:00 and washed up (no showers until tomorrow, bleh).

Jane changed the dressing over the incision. The scar is very thin and about 1 1/2 inches long. I have a picture, but decided it was best to only show the dressed incision above.

Jane's parents brought over a grabber so that I can retrieve things from the floor. Much thanks to them as I can now put on my own underwear and pants!

I'd like to thank everyone for their warm wishes. I'm tired and going to lay down for a while.

Out of Surgery

Paco had a hard time sleeping last night--not, he claims, because I was snoring (though I know I was), but because he was anxious and had insomnia. At 1:00 a.m. or so, he went down to the couch for a change of scene (the guest room was inhabited by his mom who had the thankless job of getting Holly up at a less ungodly hour this morning for school). He slept for like an hour, I guess, and awoke at exactly 5:00 a.m. He's one of those freaky people who has an internal alarm clock. His surgery was scheduled for 7:30 a.m.; he was supposed to be at the hospital at 6:00 a.m.; we decided we'd leave the house at 5:40 a.m. and hoped to be late. The hospital doesn't even open its doors until 6:00 a.m. For god's sake.

We STILL got there at 6:00 a.m. Turns out there's no traffic at dawn. Who knew.

Paco got called back almost immediately to get prepped and they called me back to sit with him about 15 minutes later. We sat back there and chatted for quite some time, since we were there way too early (did I mention that?). Paco's nurse pissed me off right away by coming in and checking on him while I was sitting on the bed, and then hustling off while throwing, "It would be good if you didn't sit on the bed..." over her shoulder. Yeah, I'm crabby, but god. Why don't you just SAY, "Hey, I need you to move to a chair, thanks," instead of being all passive aggressive. Yeah, I'm starting to talk about me! Excuuuuuse me, but my ego's back hurts too! Fine!

Paco was very nervous and wanted them to give him some tranquilizers as soon as possible, but they wouldn't until his doctor showed up, and His Eminence didn't not walk through the door until 7:29 a.m. On the one hand, Paco was a little put out by the lack of happy drugs. On the other, he didn't want the doctor to have gotten up too early or anything. He might have needed to sleep off a hangover or sumpin.

Actually when the surgeon appeared, he didn't look like he does too much carousing. He looked like a cross between John Belushi and Kevin Pollack. Yeah, I'll wait for you to Google Kevin Pollack.

After his brief remarks, the nurse came in, finally, to give Paco Versed, the anti-anxiety nectar, and wouldn't you know--it doesn't seem to phase him. The man has the most weirdly drug-resistant body I've ever seen. Ibuprofen makes me drowsy, but his heart rate didn't even go down with a Versed bomb in his bloodstream. He was disappointed, but I was like, "Hang in there, they'll give you the ultimate anti-anxiety medication here in a minute," which made his heart rate go back up, heh.

They rolled him off and I went off to the waiting room to look up Lost recaps and conspiracy theories, and OMGOMGOMFG, don't even start with me on that finale, the best thing ever!!!!

A couple of hours later Kevin Belushi came out and told me all was well and it went exactly like they thought and tell him not to shower for two days (ew) and he'll be in recovery for a while and then he'll be in a room blah blah blah gotta go and surgeons are not exactly people persons are they?

So I sat there some more, and then finally I got up and asked the sullen desk worker who really needs to either FIND A NEW JOB or CHEER THE FUCK UP how I would know when Paco was out of recovery and in a room, and she mumbled that "Cortez" would call me and I said, "Cortez?" and she gave me a look like I'd insulted Cortez's mother for naming him that, when IN FACT, I was just wondering who the hell Cortez WAS, for chrissakes not everything a white person says is hate speech, LaVerne-on-Scrubs.

The point was moot, because my cell phone rang just then and it was Paco from his room, sounding perfectly normal. I acted wifely and he was all, "I'm fine," so the extent of my comforting behavior so far has been to giggle at his naked bits when he got up to walk around.

I was worried because when I first got to his room he said his leg felt exactly the same as it had before the surgery and the damn forums he reads say that if the surgery's going to work, you would immediately feel relief from the leg pain after the operation. But when he stood up a few minutes later, his face changed and he said his leg didn't hurt, and in fact, his other leg hurt a little (it didn't before) and I think that you can't make any judgment about the success/failure of this surgery until, oh, more than 1 hour after having it.

I am in his hospital room right now (free wireless!) and he has eaten a big hamburger and walked around the room quite a bit and says if nothing changes he's going to go home this afternoon instead of staying overnight. He feels much better standing and sitting than he does lying down. They gave him some morphine (again, enough to have made me act like a blithering idiot, but he is totally lucid) and so I think he should wait for that to wear off before he makes rash decisions like getting into a car with me.

All in all, he would like everyone who is interested in the back surgery that this was about what he expected it to be, except he tried not to get his hopes up.

He feared having trouble with anesthesia, but he didn't. He says the back pain is different than he thought, more of an ache, and it hurts in his hips, not his back.

That's all. He's bitching at me to hurry up and post this, and also that I need to eat something, and also hurry up and post this. GAH.

One Day Left

Today is my last pre-surgery day. I barely slept last night. I think the last time I looked at the clock was around 1:15 and then I was awake at about 5:40. I imagine that tonight will be even worse.

Most things are taken care of around the house. There is a little laundry left and we want to vacuum and straighten up. I got my hair cut last night and then swapped out a sprinkler head because the hostas grew too tall and blocked the short one that was there before. I figured I'd better do that before the surgery since bending and digging will likely be banned for some period of time. We have the mowers on schedule, food in the freezer and sandwich stuff for when I get back home. I still need to pack an overnight bag and generally fret about things

In other news, we finally got the right laptop from Dell. I ordered one at the end of April under a Mother's Day discount (plus a supplier discount...woo!). Dell shipped it within a week. I turned it on for the first time and immediately noticed that the text on the screen was tiny. I mean like cell phone tiny. Jane looked at it later that evening and her first comment was about the text size too. We both said "At least it is clear. We'll get used to it." That never happened. It was just way too small. I adjusted all sorts of settings and spent time with Dell tech support. Nothing worked without messing up something else.

It seems that I had fallen prey to the advertising about "Upgrade your monitor to WSXGA+. 72% more viewing area!" What this really translates to is a lot of pixels (dots) on your screen and therefore smaller text. After several hours convincing tech support that my mistake was ordering this screen, they approved a return and sent me to customer care.

I returned the whole laptop and reordered a few days later. The new laptop has the standard widescreen and looks normal. I'll admit that the other screen was clearer, but at least I can read the text with this one!

Jane, Holly and I went to On the Border last night for dinner. Jane has honed in on a couple of items that are palatable to her and consistent in quality, so she is not so reluctant to go there. I think she might be liking the cilantro too because I didn't hear a single mention of it! Perhaps Mexico has changed her.

I probably won't be able to post here again until Friday. Not even sure if I will be able to do it then depending on how I feel. In the meantime, thank you for your comments and support.

Maybe Jane will take dictation and create an entry for me? Send her email and comments...surely you can convince her!

Two Days to Go

The recovery from the myelogram was pretty simple. I just had to lay on my back until the next morning and then take it easy. Jane ordered Minsky's pizza and served it to me while I relaxed in the living room recliner. She overreacted to every movement I made.

"WHAT ARE YOU DOING?!? DON'T MOVE!"

"Uh...I'm scratching my head."

"Oh, ok."

I know she was just caring for me, but it was entertaining to see her so hyper-reactive! After a weekend of recovery, I was back at work. On Wednesday May 2nd, I met with the neurosurgeon. The results didn't provide much new information, but did show some previously undetected scoliosis in my lower back. The herniated disc was still present at L4/L5. The doctor said that a three-level fusion would be necessary to correct all of the problems, but he could not recommend this to me due to my age. "Maybe in 8-10 years..." he said.

I was disappointed that there was no apparent correction available and asked what could be done about the leg pain. He went back into his office and reviewed the films more carefully and returned a few minutes later and suggested a laminotomy/discectomy at L4/L5. He gave an 80% chance of success, reduced from the normal 90-95% due to the problems at my other lumbar levels. He also gave me the option of neurontin, but indicated that I should not take it if I planned on doing the surgery.

After leaving his office, I immediately called Jane. I wanted to do the surgery. I wanted a chance to have the pain gone. We talked more that evening and discussed when to do the surgery. The next morning, I was on the phone to schedule the surgery. The date was set for May 24th.

I worked out arrangements with my mom to take care of our daughter, Holly, since I had to be at the hospital at 6:00 a.m. Since then I have mainly fretted, assessed, researched and organized.

I'm the type of person who can never really be ready for something like surgery. My mind races with options, paths, doubts and consequences. I can never shut it down. This problem even happens with simple things like a tooth filling, epidural steroid injection (ESI) and blood samples. For some of my ESI appointments, I took xanax. In fact, in one of the ESIs I had a few years ago, I requested sedation. I just can't calm myself down. I think this was probably the panic I experienced during the myelogram.

So today I went to the hospital for my pre-surgery appointment. They verified my information and gladly accepted the $250 copay for the surgery. I met with a nurse who took my temperature, blood pressure, pulse and medical history. She discussed the day of the surgery and how it would likely proceed.

6:00 AM - Arrive at hospital and check in

6:?? AM - I will be taken to a bed and prepped for surgery including an IV. An anesthesiologist will meet with me and gain consent. At this point I will be eligible for medicine to calm me down. After this is done, Jane can come back and sit with me until the surgery starts.

7:30 AM - Surgery is scheduled to start. Jane will be taken back to the waiting area. I will be taken to the operating room and transfer to an operating table. (I think I will be eventually placed on a special frame for lower back surgery. I hope that I am not wearing the tights and leotard.) Once everything is ready, the anesthesiologist will ask me to count backwards...

8:30 AM to 9:00 AM - The surgery should be done around this time. I am told that I will wake up in a recovery room, not the operating room. I might have an oxygen mask on to provide additional help while waking up. I should expect to spend a couple of hours in recovery until most of the effects have worn off and I am stable.

11:30 AM - I will be moved to a hospital room for the remainder of my stay. Here I will be able to eat, drink and get out of bed for the first time. Jane will be able to meet up with me again. I am not sure if the doctor will have talked with her yet. I hope so because I don't want her worrying too much.

After this, I will work on pain management, stabilization and preparing to go home. The nurse has set up the surgery so that I can stay overnight. I understand that someone will visit with me before I go home to discuss restrictions and provide methods for getting out of bed, walking, climbing stairs and other things we take for granted.

I'm getting anxious about the surgery. I woke up early this morning and couldn't go back to sleep. I'm looking for things to distract me, but the mind is a powerful thing and always seems to win.

Myelograms Suck

Nerves are not highly visible on x-rays, CT scans and MRIs. Radio-opaque dye, however, is...well...opaque on x-rays, CT scans and MRIs. If one was to surround nerves with this dye, you may or may not see the nerve outlines depending on the location of the dye. That is the gist of a myelogram. Oh yeah - they inject the dye into your cerebral spinal fluid (CSF) and you have to lay on your back for about 24 hours.

The value of the myelogram is that the doctor can see the nerve outlines and determine if the nerves are receiving pressure from another object such as a disc, bone or scar tissue. This gives the doctor a map which can be used to evaluate surgical and non-surgical options.

I did not enjoy this procedure. The internet has a lot of descriptions of what is actually done. In all cases, your back is cleansed and numbed with a local anesthetic. Then, with fluoroscopic (x-ray) guidance, a needle is passed through the skin, fat, muscle, etc and into the fluid around your spinal cord. Once the needle location is verified by withdrawing a small amount of CSF, the dye is injected.

This is where the descriptions of the test on the internet vary. Some explain that the needle remains in your back for the remainder of the test. Others state that the needle is removed after injection of the dye. I was lucky in that mine was removed immediately after the dye injection. At this point, the x-rays begin. I was laying on a table with the ability to tilt. And it did, indeed, tilt. First, they rotated the table so that my feet were in the air and my head was down. This allows the dye to move towards the brain. Then, the table was tilted the opposite direction and I was practically standing up.

When the table first began to move, I started to feel hot. I felt the sweat building on my forehead, then on my back and legs. I told the nurse that the room felt really hot. She got a cool, wet towel and placed it on my neck and head. Suddenly my ears started to ring and I began to feel faint. I told them that I was going to pass out. They seemed unmoved by my complaint and continued the test for another minute or so. I complained that I was feeling faint again and was sure that I was going to be out. The neuroradiologist quickly leveled the table and told me to roll onto my back and pull my knees up. I did so and was no longer faint. I still am not sure if the dizziness was caused by the tilting of the table or panic and anxiety. I lean towards the anxiety theory, but don't know that I have a way to prove it.

After the x-ray portion of the test was completed, I was wheeled on my gurney into the hallway to wait for the CT scan. There was a line of several patients ahead of me, so the nurse brought my wife back to wait with me. We joked around a little. I was so glad the test was over. It was nice to have her with me again.

The CT scan couldn't have taken more than 2 minutes. The procedure was uneventful except for trying to move yourself, laying flat on your back, from the gurney to the CT table. When it was over, I slowly transferred myself from the CT table back to the gurney. I felt this horrible pinch/pain on the left lower side of my back. I gave a good loud grunt in an attempt to disperse the pain. I later learned that my gown had been taped to my back to keep it out of the lumbar puncture area. When moving from the CT table, my gown got hooked on the table and tore the tape away. I was presented the lovely gift of a bruise from this activity.

After all this was done, I was taken back to a recovery area where I was to rest for 2 hours before I could go home. This process is to give the spinal sac hole time to heal over and prevent CSF leakage. If too much fluid is lost, the patient can get a terrible headache lasting a couple of days.

I was starving since it was now 3:30 in the afternoon. Jane sat with me and helped me eat. The bed was supposed to be up to 30 degrees from horizontal. The nurses did not have a good ability to estimate 30 degrees so I was basically laying flat. If you've never tried it, you should try eating and drinking while flat on your back. Coke makes you choke with every drink and applesauce is almost impossible.

Procrastination

Getting scheduled for physical therapy took a while. My pain management doctor had suggested a specific person who was heavily booked. I finally got in around the first part of December. The first physical therapy appointment always begins with an assessment of the symptoms and tests to determine movement profiles, mobility, strength, etc. The therapist asks me the general questions first and takes a lot of notes. She then tells me that she will leave the room while I strip down to my underwear. She leaves and I remove my clothes and pile them neatly in a chair.

I get back up on the table and sit with my legs hanging over the side. It's always an embarassment to be mostly nude in front of doctors. This time, however, another woman enters the room and I am notified that she is a student in training. GREAT. So the usual movement tests begin and embarassment rises as my love handles hang over the top of my boxers. The crowning moment of the exam was when she asks me to sit on the side of the table, legs hanging down.

"Now slouch."

Ok...I slouch.

"No...I mean really slouch. Yeah, like that. Now bury your chin into your chest."

I am now curled up with my fat belly squished down onto my thighs. Neat rolls of fat formed up to my man boobs. At this point, all dignity is lost.

Thankfully, the assessment was soon over and I am able to put my clothes back on. I am taught a couple of beginning exercises and the electrical stimulation machine is attached to my lower back and activated. It felt pretty good, but I was actually more sore by that evening.

On December 7th, I returned to the pain doctor for my third and final epidural. I was actually feeling good. I had almost no pain in the left leg - I reported that I was 85% of normal. Given this information, the pain doctor decided not to give the epidural and instead return in 2 weeks for a checkup.

Within a few days, the pain was back. My legs and feet were cramping all the time. The red-hot-poker pain was back in my calf. I got my final epidural a week before Christmas. It didn't help at all this time. There was no pain recovery.

I continued the physical therapy 2-3 times a week into early January. Since my symptoms weren't improving, my therapist recommended scheduling the myelogram and taking the next steps towards surgery.

I talked this over with my wife. I knew the likely outcome was a discectomy. We had booked and paid for a trip to Mexico in March. Since the trip was only 2 1/2 months away, I decided to wait on the myelogram.

Over the next few months, I took tons of Ibuprofen. On bad days, I'd take Vicodin and a muscle relaxer. I used many of the techniques I learned in the physical therapy. I slept with a body pillow between my knees. I tensed my pelvic/abdominal muscles when getting out of bed, getting out of a car and similar activities. The pain level was unchanged.

We got back from Mexico in late March. I decided that I should probably schedule the myelogram.

I procrastinated until late April.

Crummy Back

My first back problems started in 1993. I was 18 at the time which makes me 31 now. I worked on the loading dock at a distribution center for a very large company. One morning, I was loading a huge TV in a box into a trailer. I turned to grab the next box to stack and I saw the TV box starting to fall. I twisted around to catch the box and ended up bending backwards and felt an intense pain in my lower back.

I had trouble straightening up when I tried to stand. My manager sent me home for the day. I still had pain the next day, so they sent me to a doctor under worker's compenstion. I started physical therapy but within a few days I started feeling pain in my left leg. I was sent for an MRI and they noted some degenerative disc disease and a bulge in the L4/L5 disc. I went off to college and continued to experience the pain. I was sent for epidural steroid injections. I had 3 injections and the pain went away. At the end of this incident, I recovered well but suffered a loss of reflexes in my left leg.

I went for several years after that incident with various back pain, but not much leg pain. I would occasionally get muscle spasms which responded well to muscle relaxants. In early 2002, I had a fairly nasty cold and cough. I was getting ready for work and bent down to get something from under the sink. At the same time, I began a fit of coughing. Almost instantly, my lower back went into a severe spasm. I was hunched over and in significant pain.

My wife urged me to see my family doctor. I was prescribed muscle relaxants and responded fairly quickly. As my muscles relaxed, the leg pain arrived again. I was scheduled for an MRI and diagnosed with further bulging at the L4/L5 level and spinal stenosis. I was scheduled for physical therapy and 3 epidurals over the next few months and finally responded to the last one.

Between 2002 and September 2006, I was doing well. I had the occasional spasms that required muscle relaxants, but the spasms always subsided. I had been working on remodeling a bathroom since Labor Day weekend and I felt the spasms come back. Around September 15th, the spasms were fairly intense and I was starting to feel leg pain again. I had muscle relaxants left over and took those like I was supposed to. I went on an ATV trip on October 8th and noticed that the leg pain was getting much more intense. I had a lot of trouble sitting and standing. The muscles were not relaxing this time. Something was different.

When I returned from the trip, I went to my family doctor to get a stronger relaxant and some pain medication. He prescribed those, but also scheduled an MRI. I had the MRI on October 30th. The pain was excruciating. I didn't know if I could continue to lay on the MRI table for the whole 15 minutes. My leg and back hurt terribly. I got the results on November 6th. The stenosis and degenerative disc disease had worsened. I had broad disc bulges at L3/L4 and L5/S1. The L4/L5 disc had herniated.

I was sent to a pain management doctor for pain control and given a referral to a neurosurgeon. I had an epidural steriod injection on November 9th. I had immediate pain relief as usual and was optomistic about the results. The pain relief lasted about 4 days. Both of my legs were cramping badly at night. I'd get out of bed and work out the cramps several times each night. I had a second injection on November 21st and was requested to start physical therapy.

On November 22nd, I met with the neurosurgeon. He looked at the MRI results and told me that I have a "crummy back". I agreed, and asked about my options. He said that it was complex since there were so many factors involved - the 3 levels of disc problems as well as the stenosis. He requested that I get a myelogram so that he could determine the nerve interaction. I mentioned that I was being scheduled for physical therapy and that I still had one epidural injection remaining. We agreed that I would see how those activities went before pursuing the myelogram.

More on this later...

First Entry

I am having back surgery one week from today. Specifically, the procedures are called laminotomy and discectomy. In the former, a small amount of bone will be removed to provide access to the disc. In the latter, small fragments of the herniated L4-L5 disc will be removed. It'll probably hurt.

I decided to write a blog around this surgery as I've scoured the internet to find what I should expect before, during and after the surgery. My research has been somewhat futile. There are sites that say I will be able to do things in one week or six weeks or 3 months. Some patients are riding bikes, swimming and flying on airplanes in their first two weeks; others are told not to even climb stairs for 4 weeks. Some patients go home the same day. Some patients are in the hospital for 4-5 days. Some patients have extraordinary restrictions - there are many studies that say that these restrictions do no good and that recovery is faster and just as successful/unsuccessful without the restrictions.

As I am not a doctor, or trained in any such way, I make no claims as to the accuracy of what I'll discuss. I will allow, however, that I'll be truthful in how I feel and how I am recovering. Perhaps someone will stumble across this someday and it will provide them with a real account, from a patient's point of view, of a single level discectomy.

So how do I feel right now? Well, my back is a little achey - but that pain isn't the reason I am having the surgery. The reason is the pain in my left leg. It's been there, almost constantly, for 8 months. As I sit at the computer, my left calf feels sore like I overused it. My foot is hot, buzzing and numb on the sole. My ankle feels weak. I'd put my current pain at a 4.5 out of 10. That's about average for me...sometimes it swings up to 8, but thankfully that is usually brief.

Tomorrow I'll provide a view into my back problems and how I ended up with the decision to have surgery.