Saturday, July 23, 2011

13 days...leg pain??

Really not too much has changed in the last two days. I am at that interesting spot where I am beginning to feel more and more "normal" which is great but can also give you a sense of false security. I have only been healing for 13 days but because of the lack of pain I have almost done some things I should not.

When getting into bed I am supposed to do the "log roll". That involves laying on your side...pulling your knees and legs onto the bed and THEN rolling over (like a log). Instead I want to get into bed like I used to (lift the legs up and lay back...like a sit up in reverse). BAD BAD BAD idea...my lower back is not nearly well enough healed to handle that kind of stress. Repeat to self...log roll...log roll....log roll.

I have been trying to get a lot of walking in. Seems great but I seemed to have a bit of leg pain when I did. I asked my surgeon about it and his advice was this. Within 5 minutes of starting to walk take a baseline assessment of how I feel...what hurts and where. If at any time during the walk the pain gets worse...stop.

The leg pain is due to the healing of the ruptured disk that my surgeon repaired between L4 & L5. It is still healing and will eventually scar over...but until then...any undue stress can cause it to re-rupture. NO I do not want a do-over. So I have been paying extra close attention to my pain level when I walk. I found that if I walk slower it seems to respond better. So that turtle walking on the bike path would be me. Used to be when I was young I would fight through injuries...ignore the pain...those days are long gone...I have turned listening to my body's signals into an art form. Call me Leonardo of the lumbar.

Not much else to report....except more of the same. Still cannot believe I am so pain free at about two weeks out. This is truly remarkable...in my way of seeing things. So here's to more pain free walking and continued healing....and oh yea....log roll...log roll....log roll.

Thursday, July 21, 2011

11 days post op

The progress continues to be astounding to me. My back pain as I knew it for the last year is gone. Now for those of you contemplating this surgery....this is good and bad news. Good news is that it just may have worked....but too early for the victory laps and ticker tape parades. But is is VERRRRY promising. The down side is that I still have some pain but that is from the surgery (totally expected). I have some pain at the incision site and internal....but really not that bad....Tylenol keeps it in check.

Sleeping is getting better and better. The first days at home it hurt to roll over and I was using a bed pan to avoid getting up (painful) in the middle of the night. Now I can roll over...arch my back slightly to move my butt around in bed and roll back and forth almost completely pain free. In the morning when I get up it feels "full" and swollen but again that would be expected from my perspective.

I continue my daily walking. I am averaging over an hour a day. The only downside to the walks is a little bit of leg pain. I am not sure if the pain is from walking so much (a type of exercise my body is unfamiliar with) or if it is post surgery leg pain from decompressing the nerves. My hunch is that it is a bit of both. But in general the pain is decreasing daily. I also have been experiencing a bit of restless leg syndrome....but nothing in that regard in the last two days so that may have been a brief isolated incident.

Went to a Colorado Rockies games last night...sat through the whole thing pain free. The Rockies won in the bottom on the 9th. Walked to and from the stadium. Starting to feel like my old life again.

My first follow up visit with Dr Ghiselli (my surgeon) was today. All went VERY well and I got important clearances. One to go back to work and another to drive (Free at last...Free at last). I plan to work from home next week and maybe transition to the office as I feel better. But I am so ready to be back to being productive again and I love my job. Jello brain is starting to set in on the home front (perhaps taping those soap operas for my Mom is having some residual effect).

Finally....I had ordered one of those super duper Human Touch reclining chairs (about $2,100) from a local retailer, The Better Back Store. It was supposed to be delivered the day I returned home from the hospital but the base that I ordered was on back-order (no pun intended). Better Back agreed to give me a loaner (free of charge) until my chair came in. I got home and quickly determined that I was able to find places where I was comfortable sitting and reclining without the chair. I called Better Back and they agreed to give me a full refund. I wanted to mention them because they were sooooo cool about it. No questions asked. Bottom line is that you may of may not benefit from one of these chairs but if you buy from a store like Better Back you may have some options if you find out that it is not needed. Better Back carries a variety of products that you might find beneficial to make your convalescence more comfortable. According the their website...."Healthy Back strives to be the leading brand of high end comfort solutions and ergonomic products for back pain and other physical conditions.". Check them out...they were really nice and I have no connection whatsoever.

Monday, July 18, 2011

8 days post op

**This somehow was inadvertantly deleted so I am reposting it and adding two more days to it**

Home for two days...I have to admit it is a huge relief to be out of the hospital. The care was great and nurses and staff at Rose Medical Center were wonderful but there was just this something that I could not put my finger on. If I wanted to feel better I needed to get out of there...resume my "normal" life.

The first night at home my son went to Subway to get sandwiches for my Mom (my short term caretaker) and me. So I just hung around the house that night and was trying to find out where the hell could I sit comfortably, and for how long. What things did I need in the bedroom at night? Like medications, thermometer (of course I could not find it), something to drink, phone, bedpan (easier than getting up if I was in pain), computer, etc.

Then there are all these things that I just took for granted in my life...that I now needed help with in some way. There was the 10 pound lifting restriction (feeding the cats, cleaning the litter, taking out the trash) and the bending and twisting restriction (things that were down below my waist where I could reach them like pots and pans, shaving cream, shoes, etc). Trust me there is a lot to figure out and it is really nice to have someone to help you out...thanks Mom!. On the other hand I don't want to turn into "that guy" that does nothing for himself and asks to have it done for him even if he can do it himself. Yes I can walk to the refrigerator and get myself a cold drink if I want one....but the temptation is there. Bottom line...do what you can do for yourself...but make sure you are following your doctors orders with weight restrictions and such. But you will be blown away by how many things in your house are at a place where you would have to bend at the waist to get at them....to reach those items you now need to put them on higher shelves or do a "deep knee bend" to the floor to pick them up. You gain a brand new perspective for your "normal" life.

Speaking of "normal" my bowels also got in on the action today....where was all that food going? I had not had a bowel movement since Monday (day of surgery). I will not belabor this but I was doing everything in my power (bran flakes, bran muffins, prunes, carrots, roughage, etc). Game over...back to "normal".

Sleeping in my bed again was wonderful. It was soooooo comfy compared to the hospital....and no tubes in my arms, or my penis, or nurses walking in at 3:00 for meds....wonderful!! I had to wake myself up for meds...which I did for a couple of nights but by that time (Sunday) I was no longer taking narcotic pain killers. I am still using a bedpan at night (easier than getting up) but I think today that ends....time to make the short walk to the bathroom. I have had a little bit of restless leg type of thing going on...not sure why....maybe coming off of narcotics...and that has disrupted sleep a bit but for the most part I have slept great. When you get up in the morning your back can feel kind of "full" or swollen...but walking around for a few minutes alleviates that. But the best suggestion I can make is get all your "night" stuff to your night stand...that way it is there when you need it and you can just roll over to get it rather than wandering around the house for it in the middle of the night.

The back brace....a rapidly developing love/hate relationship. I love the way it supports me....and that is about it. I hate the way it looks. I hate the way it can cut off my breathing when I sit a certain way. I hate the way it makes me all hot and gross (yes it is 95 outside lately so this may have more to do with temperature than the brace). I hate the way it looks (oh I already said that...well I really do). It makes me feel like an old man and I don't like that. I was no Adonis but I took care of myself and this feels like I didn't. Get over it Craig...because it is not going anywhere. I wear it over my clothing. Maybe I can figure out a way to wear it under clothes with a loose fitting shirt over top of it...who knows...work in progress...love/hate!!

I am not able to exercise (with the exception of walking) for three months....something needs to change and that something is my diet. I used to work out everyday aerobically. I knew going out to eat was not an option...nor was eating a bunch of crap...so I needed to do some shopping. I also wanted to be a bit more cognizant about what I was eating. All my life I have had a propensity to put on weight and for 3 months I am not going to be working out regularly...that means eating better, lower calorie meals. Not that I ate bad before but I would do "take out" a lot so this was a good time to get things like salads, vegetables, etc back into the diet in a more consistent way. That meant a trip to the grocery store on Friday (one day after I returned home).

No I am not going to blog about going to the grocery store...it was the same as usual....with the exception my son drove me. What was interesting is that I walked around for about 2 - 3 hours that day. Then got home and went for a walk after a couple of hours. I felt good enough be out and about for extended periods of time immediately. Yesterday (Sunday) I went for three different walks of 0:30, 1:30, and 0:30. I felt great! My legs feel a bit tired but I feel great....truly! Iheard from someone else that walking was key and I am taking that to heart. My mom keeps saying "Oh Craig...please don't overdo it"...but it feels natural to get out there and DO something. I have always needed the ability to blow off steam....this is not the same as riding bike but I have to go with it...because it is all I've got.

Finally narcotic pain killers (percocet, vicodin, diluadid...to name a few). This is one subject that had concerned me forever. I have an addiction type personality. If you can do it to excess...I can do it to excess. I felt like I needed the pain killers to manage my pain but also felt like I needed to be very wary of them. I started taking narcotic pain killers last fall and here is it almost 12 months later. I generally took them in the evenings because that was when ibuprofen or acetaminophen were totally ineffective. Well Sunday was the first day I did NOT take at least one in probably 10 months. If you want one single reason why this surgery was a success you can point to that. In one week I am sitting here telling you that I did not take pain killers yesterday and I likely will not take them today. It was the pain that was killing me and right now it feels manageable and I am a mere one week post op.

BIG HUGE GIGANTIC WIN....more in two days!

Thursday, July 14, 2011

Check out day....yeah!!!!

Time to go home....REALLY time to go home....there is this overall feeling that hospitals are for the sick so if you want to be well you need to leave the hospital ASAP. Could I stay here another day....yes....is my back fine....yes again....it is these damn flu like symptoms that is like the only thing that would keep me...but today I have a caretaker on the home front (my Mom).

One thing I would truly recommend on this whole thing is that you have someone to "help you out" when you get home. Could you do it yourself....sure. Is having someone to go to the grocery store, pick up around the house, help you put on your socks, make dinner, etc helpful? Incredibly!

Today was more of the same....feverish, achy, flu-like. The back was tolerable...the flu like stuff sucked. FINALLY got to take a shower today....damn near orgasmic.....3 days of grime and bed head.....made me feel human again. So all in all I feel pretty good....wish I had a better baseline for those that read this in the future but I think the flu-like stuff is an aberration.

The back hurts but is manageable. Have a little bit of leg pain when I lift my right leg but nothing too bad and Ghiselli seemed not too concerned. Said that was pretty typical.

This morning the IV came out...that always feels good after 3 days....looks pretty "tired" around then. Three days of rolling around in bed, bumping things, snagging on things....good riddance. I am tubeless. In exchange I have hardware. Can't wait to see the first X-rays....that should be cool.

Well it is time....the hospital staff has been great. Nurses there when you need them but not bopping in at 3:00 am for no reason. Food was decent. And then there was the morphine pump....fond memories of that bad boy.

From now through the end of two weeks I will do every other day updates....then every other week for the rest of the first three months....then monthly for the rest of the first year.

I still need to figure out how to get this to show up better on a Google search....probably need to go to some spinal forums and post my link. Also I would like to do some patient outreach with my surgeon and some of his future fusion patients. Again I am doing this because there just did not seem to be this type of information like this on the internet...if I can reduce one person's anxiety before their surgery it will have been worth it....actually I think I reduced my own anxiety by talking it out....so I already accomplished my goal.

Is this finally what it is going to feel like???

I think I got to day three and my hunch is the worst is behind me. Basically I have two different things going on....one I expected and one I did not.

Like every day before I had milestones....today's was having the wound drain removed....the biggest issue I had with that is that everytime you roll over onto your back...the tubing gets pinned across your back incision....ouch! So I had to stand up to have it taken out....and good thing I could not see what they were doing...probably was not pretty. The drainage tubing came out in two different levels and there was this really strange negative pressure....and I mean DEEP inside of me....it hurt (actually ached) but in a place I have never had pain before....not unbearable....VERY uncomfortable.

Spent a lot of today still fighting off the fever and such...in the morning Dr. Ghiselli came by and asked me if I wanted to go home and I really did not. I felt like hell....like I had the flu....I mentioned this to the nurse and she said "maybe you do". Hmmmmm. Anyway just felt like I did not want to be home without someone like my Mom to help out. Love my boys....they are not very nurse-like. I proceeded to sleep like maybe 18 of the next 24 hours....wiped out....again....not wiped out from the surgery but wiped out like I was fighting flu symptoms....probably will never know.

So really not much else to say about Day 3 other than I tried to get up and walk as much as possible...but I was so tired I would walk and crawl back in bed and sleep. With the fever and sweating....I had a quite a 3 day funk going on...could have taken a shower but I was too tired. I think it was about this time (about 9:00 in the evening) I started thinking...I need to get out of here. A change of scenery would be good for me....get away from all the "unhealthiness" of a hospital and back into the "normalcy" of day to day living....yes by the end of the day I truly felt like I wanted to go home.

Tuesday, July 12, 2011

Day two...ups and downs....

You know my ex pisses me off sometimes....why does she have to be right so often? Good thing I like her. As a matter of fact she brought me to the hospital for surgery...a good egg I say. But she kept saying..."wait until day two...it might take a turn for the worse then". Well damn if she was not right.

The day started quite auspiciously...5:30 AM and the phlebotomist was searching for a vein....excellent timing. The day was mostly uphill from there. Met with Ghiselli around 7:00...he was optimistic but guarded...he sad it can go up and down for the first few days. (must have been talking to my ex).

Today was the day I met the Physical Therapist and the Occupational Therapist. They helped me with getting out of bed, putting on back brace (which my doc wants me to wear for 3 months), how to bend over, pick things up off of the floor, what I can and cannot do, going back to work....etc.

Then about 1:00 a HUGE win...out came the catheter...not that it was that bad....just annoying. I just kept worrying that I was going to snag it on something...anyways...it is gone now...yea...the downside...I have to get up to go to the bathroom....no biggie unless the pain is up.

Speaking of pain...it was on the downward slide all day...I went off the morphine drip around noon and went on "regular" solid painkillers (percoset) and seemed to be doing great. The therapists got me up and walking around the hall and doing "laps". I felt great....until right before dinner....the pain started getting worse but again I assumed that was all "normal" in making a transition from liquid pain killers to solids.

I had dinner and right afterwards felt like I was running a fever. I pulled out the thermometer and took my own temperature (99.8 F)....sure enough. I notified the nurse and waited for her to show up. In the meantime I looked up "post surgery fever" on the web. Turns out it is pretty common. Can it be serious stuff? Yea. Does it occur in over 50% of all recoveries...yes again. Nurse gave me Tylenol for fever and had me work on spirometer (a device that checks lung capacity and helps guard against pneumonia). Basically you take a wait and see approach...the Tylenol should knock it out. They just monitor it and watch to make sure it does not go above 101.5 F. That is almost two degrees higher than where I am now...not likely...knocking on wood.

So I feel kind of crappy right now...going just try to sleep it off....on the plus side pain is down. Just need to shake the fever. See....I told you my ex was right...damn her. ;-)

Another update tomorrow...

The day/night of....so what happened????

Woke up at 9:30 AM the day of surgery...I have been a "professional" sleeper  since I was a kid and at times like this it serves me well. I ran some errands and got to the hospital at 12:30 & proceeded to wait.

At 2:00 I was taken back for surgery prep....and it was a whirlwind. Questions...IVs...meeting nurses, anesthesiologists, surgeons, assistants....the list goes on. When I was finally wheeled into the operating room (OR) there was 10 people in the room and Dr Ghiselli and his assistant Renee were not even in the room yet. That freaked me out just a little...it was kind of like....oh wow....they are really taking this seriously. And if you have not been in an OR lately...the temperature is kept at a breezy 60 - 65 degrees Fahrenheit...a bit cool....and I like it cool....especially if you are wearing one of those stylish hospital gowns ;-)

In addition to the the surgeon, I had an anesthesiologist,  a neuro tech that "wired me for sound", two nurses, X-ray technicians, and several others. The neuro tech was interesting...he placed electric probes up and down my right side to monitor nerve activity....he was present in the OR the whole time....he first took a baseline...then as Ghiselli worked...he watched for any abnormal activity with my nerves and neural system...it was very cool...and to top it off there was an MD neurology specialist monitoring the whole thing remotely (or at least I like to think he was doing that instead of posting to Facebook)....it was VERY reassuring.

I also took note of the surgical table....an interesting contraption that supposedly simulates you "standing up"...the surgeon wants to set spacing between the vertebra (prior to fusing) at the same distance that would be found if you were standing. It supports you at your hips, knees, and chest (and maybe somewhere else) but you get the general gist. I was moved to that table (and catheterized...yea) AFTER I was put under. Also the lighting was intense..turn those babies on and you could probably see things inside my stomach.

So I was laying there waiting for Dr Ghiselli to show up for the "opening ceremonies"...and all of a sudden I am in the recovery room...what the hell?? The anesthesiologists are sneaky little bastards aren't they? I did not even get to hear what music Ghiselli was rocking out to (supposedly the surgeon gets to pick). I was talking to the nurse (cute and flirty...but married) when I was "beamed up to the recovery room"....not a "Star Trek" theme song to be heard.

Monday, July 11, 2011

The day/night of...shouldn't it hurt more???

July 11, 2011...11:57 PM....first of all....I am amazed....I was ready for pain that was unbearable and it just did not happen!!

I am posting this now so it shows up the day of surgery..."it" is behind me....and I feel pretty damn good....can't wait to aee the X-rays....I know I now have some hardware just like the background in my blog....how cool is that??

Back with all the details in a half hour!!

Craig

Sunday, July 10, 2011

The night before...can you say anxious???

Yes as a matter of fact I am a bundle of nerves. Tried to stay distracted today. I had brunch with a friend, paid bills, took my bicycle in the shop for repairs (won't be needing that for a while), and talked to my mom...who is coming out to Denver to play nurse for a couple of weeks beginning 3 days after the surgery.

I have had what many might consider to be a rough past year. In that time period I have 1) suffered a major breakup after a 6 year relationship, 2) was laid off, 3) started a new job, 4) moved out of a neighborhood I loved, and now 5) have a significant health issue. Now those five probably are 5 of the top 10 causes of stress in one's life and I have had them all in one year. Woe is me huh? Well the year sucked and I somehow continue to enjoy life. Not sure if that is because I am naive, brain dead, emotionally void, or what....but I just would not characterize myself as depressed...even though maybe I should be. Am I down a little...yea...but I am ready to get on with this...and put this behind me.

I have a friend that is battling pancreatic cancer and there is this little saying my ex-wife is fond of saying and which I have adopted too...."well...it's not pancreatic cancer". So anytime I feel down...I just try to tell myself "well...it's not pancreatic cancer"...and it helps...because really my life is pretty good.

I have a job I love, two really cool kids, a bunch of people pulling for me, and even an ex wife that likes me (and I like her too). Yea I wish I had a "special someone" in my life and yea I wish I did not have to have surgery tomorrow...but I am financially stable/successful, doing some really fun things in my life, and in general my life is good. I have a structural problem in my back, a good diagnosis...a highly qualified, skilled, & experienced surgeon...and physical fitness and good "overall" health on my side. "It's not pancreatic cancer".

I am not a religious man...but I DO believe in positive human energy and spirit....and I thank all of those who have said they are thinking of me, are praying for me, and are sending positive energy my way. I have turned into such a sap over the last 5 years....the emotional human things in life...mean so much more to me...than all the material possessions in the world. I am sitting here writing this...and tears are welling up...because of how kind people have been to me regarding this. Yea...this is not a big deal....but there is something that has touched me very profoundly through all of this...and I am riding that wave of good energy.

I am ready for it to be 24 hours from now...yes I will likely be in a lot of pain...but the recovery begins at about 5:30 MDT tomorrow when they roll me out of the recovery room. This had been a long trying year for me...it is time for things to start going right...lets get this done!

p.s....I would LOVE visitors in the hospital so if you feel inspired please stop by...or call...or whatever...I would love to hear from you (in person, text messages, email, Facebook, whatever)...just touch base with me somehow...contact/hospital information below.

Craig
craig.goudy@gmail.com
Rose Medical Center
4567 E. 9th Ave.
Denver, CO 80220
Main Switchboard: 303-320-2121

Thursday, July 7, 2011

How do you treat my symptoms in the best and least invasive manner???

The diagnosis is in...so now what? After several consultations with my surgeon there were two different issues that needed to be addressed:
  • The spondylolisthesis that is present in the L5 - S1 vertebra (which is causing my back pain...my primary symptom)
  • The degenerative disk disease (or ruptured disk) that is present between L4 - L5 vertebra (which is causing the sporadic numbness and pain in my right leg...but much less prevalent than the back pain)
Originally the surgical plan was to do a fusion at both levels. But at my final pre-operative visit it was determined that Dr Ghiselli could do a Transforaminal Lumbar Interbody Fusion (TLIF) at L5 - S1 and a Microdiscectomy at L4 - L5. Because of the location of the rupture of my disc (towards the back of my vertebra) they would be able to "trim" the part of the ruptured disc without removing the back of the vertebra to gain access (which is normal in a microdiscectomy).

The latter was a HUGE win because removing the back of the vertebra (the lamina) can, in and of itself, cause structural instability of the vertebra that might require future surgeries (up to and including a second fusion). But after reviewing my case for what seemed like the 10th time...my surgeon felt that he would be able to remove the source of the leg pain...without doing a second fusion AND without causing structural instability of an otherwise healthy vertebra.

I know this is a small nuance...but these changes came as a result of me constantly questioning the surgical techniques and seeking out the least invasive solution possible. At this last visit (which was mainly to sign the surgical consent forms) I asked the surgical team..."Why are two fusions needed...are there any other less invasive alternatives?".  Bottom line...educate yourself thoroughly about the surgical techniques being suggested and ALWAYS question them. No one else will be your advocate and seeking out the least invasive technique is always advised! This is not rocket science (well actually it is) but this is your only body...you get precious few chances to get this right. There are no dumb questions...only regret for not having asked them.

As a result of the changes to my surgical plan I will get the following benefits:
  • The total time for surgery was reduced from 6 - 8 hours (for two fusions) to less than 3 hours (for one fusion and a microdiscectomy). I am sure my insurance company will be mailing me a check for the money saved on operating room rental!
  • The success rate for a successful single fusion is significantly statistically higher...than for a double fusion.
  • The recovery time is less.
  • There is less pain.
  • There is less reduction in spinal flexibility.
  • The back retains more of its natural shock absorption (the fewer levels that are fused).
  • There is less stress placed on the spinal segments (and discs) above and below the targeted fusion area because I will be removing one less "shock absorber".
A true case of less is more....I think you get the gist...and I am satisfied with the final MUTUALLY agreed upon surgical approach.

Four days and counting...and amazingly I feel less stressed than I did a month ago. I am, in some regards, looking forward to putting this in the proverbial "rear view mirror" so I can get on with the rest of my life. I have done my homework and I am ready to be healed and to start the rehabilitation.

Next....The day before and morning of...how will I feel then??

Wednesday, July 6, 2011

What is my situation???

To borrow a phrase from another blog I read recently...back pain sucks! You don't realize how important your back is to your daily activities until it hurts... and when it hurts it mentally takes you out of the game. Your limitations and frustrations affect not only you but those around you as well.

Background

I consider myself an athlete and have always been in decent, but not great shape. In high school I played football, baseball, and track and field. For some reason I caught the running bug in HS and began running and did so for 30+ years.

The first I noticed any issues was about 10 years ago when I had some tingling on the top of my right thigh right above the knee. It resolved itself in about 3 months and I really did not think much about it after that. Like most people I would “tweak” my back every so often and honestly just assumed it was soft tissue damage...it would tend to go away in a day or two and all was well.

In June of 2010 it came on with a vengeance. By this time I had quit running 2 years ago...ironically it was not my back that caused me to stop running but instead chronic achilles tendonitis. But 30 years of damage had been inflicted. I was in Jackson WY...after a couple days of relatively strenuous hikes I noticed that it was too painful to stand upright. I could relieve the pain by bending over. And now I had something new...the tingling in the thigh came back. My pain was just slightly to the right in my lower back...at the top of butt. I could make the pain subside with riding my stationary or road bike but when I stood up it would come back as if I had done nothing. Walking was the worst. I would have to shower hunched over to make the pain subside...albeit temporarily.

Diagnosis

After about a week of this...I decided it was time to see my primary care physician. He referred me to a Osteopath in their practice. His first step was to order an MRI which is able to detect soft tissue problems. The initial report came back with problems at several different levels of my back. His assumption was that the years of running were to blame...and to quote him...”you can run for 30 years and see me...or not run (or exercise) and see the cardiologist down the hall..pick one”.

The initial diagnosis was “spinal stenosis”. My doctor tried several “adjustments”...like a chiropractor...but those provided little or no relief. He then referred me to a orthopedic specialist who tried a series of epidural steroid injections (ESIs). They have been used for low back problems since the 1950s and are still an integral part of the non-surgical management of sciatica and low back pain.

The goal of the ESIs is pain relief...at times the ESI alone is sufficient to provide relief. Most practitioners will agree that, while the effects of the injection tend to be temporary - providing relief from pain for one week up to one year - an ESI can be very beneficial for a patient during an acute episode of back and/or leg pain. Importantly, an ESI can provide sufficient pain relief to allow a patient to progress with a rehabilitative stretching and exercise program. If the initial ESI is effective for a patient, he or she may have up to three in a one-year period. Unfortunately for me...no such luck. My pain level had increased and I was experiencing a combination of increasing lower back pain (my most prevalent symptom) and leg pain and numbness (also intense at times but sporadic).

By now I was starting to get worried and felt it was prudent to see a medical practice that specialized in spinal maladies. I did some research and settled on Denver Spine. My initial visits were with a generalist who evaluated my case and tried two more ESIs...more from a diagnostic perspective than a pain management standpoint. After a couple of months I was referred to discuss my case with a surgeon in the practice...Dr. Gary Ghiselli.

Dr. Ghiselli ordered a new MRI and a CT scan. To cut to the chase he very quickly determined that my symptoms were the result of two conditions:
  • Spondylolisthesis...the facet joint between my L5 & S1 vertebra was broken and my disc was completely shot resulting in my spine slipping forward. After much speculation Dr. Ghiselli agreed that it was most likely the result of increased degeneration from a childhood injury. I'm sure with all the sports I played...over time it really took its toll. I don't recall what stage it was identified as but I'll tell you it was the "hurts like hell" stage whatever that is. Spondylolisthesis was the source of my back pain...which in my case was the main symptom.
  • Degenerative disc disease...the sciatic nerve travels out between L4 & L5 vertebrae and that level had a ruptured disc as a result of DDD. This is likely brought on by the structural problems caused by the spondylolisthesis. The disc ruptures and the soft spongy material from the inside of the disc presses against the nerve causing all kinds of fun symptoms as leg pain, numbness, etc. In lay terms...it made my leg hurt in addition to my back hurting.

Tomorrow....How do you treat this??? Can you treat this???

Why am I doing this blog??

It is funny...in general I have not been a huge blog reader per se...and I likely am not going to start now. But I felt that there was an incredible lack of information about the "success" stories about the type of surgery I am going to have next Monday...July 11, 2011 and I am bound and determined to be one of those success stories. You can find horror stories by the dozens and they break my heart to read them...but I have to think that this surgery would not be so widely recommended if it did not have positive outcomes for many people.

I will post a variety of stories about
  • My history
  • My diagnosis
  • My surgical treatment plan
  • My surgery
  • My stay in the hospital (day by day...hopefully I am up to it)
  • My rehabilitation
  • My outcome after 1, 2, 3, 6, & 12 months
    I know this blog is not for everyone but I know there are a lot of people out there that are just as scared and anxious about this as I am...I am writing this for you because I wish someone had written it for me. I found one great blog out there...and I have been in contact with him and wanted to give him a nod from a distance...his blog can be found at http://insanum.com/blog/spinal-fusion.html. He is 38 years old and 6'4" 230lbs...so a bit younger than me...but suffice it to say his story was an inspiration to me. He is the guy I want to be....I want to be writing six months from now that this was one of the best health decisions I have ever made in my life....who knows.

    Bottom line...this is ELECTIVE surgery. No one is holding a gun to my head...least of all my surgeon. But at 54 years old (55 in October) I have been active all my life and plan to continue to do so for a loooong time. My kids are almost both in college and I am about to become an empty nester. I will miss my kids horribly on a day to day basis...but I am also looking forward to the opportunities it presents.

    My quality of life has deteriorated over the last year...constant back pain, daily pain killers, and things I have eliminated from my list of activities...hiking, skiing, sex (yes you read that right...sex hurts...there is a song in there somewhere).

    So the journey begins...more to follow later today.

    Craig