I have been debating for a month if I wanted to even bother posting an update. Unlike many, I don’t use my blog specifically to promote anything and so it tends to not get a huge amount of traffic which is ok, but when considering writing a bunch, I often wonder if it’s worth it. In addition, so much has happened since my last post that catching up… going to be difficult.
After my last post, I was finally able to see a physician out of network who indicated he did do the direct repair of the pars fracture. Imagine my surprise and irritation when I got there and he said, “Oh THAT? I don’t do that, I don’t think it works very well”. He did share with me, however, that he felt it would be possible for me to continue running after fusion. Not 100% but it was a definite possibility.
So after I left, I was thinking that it would be this huge battle with the insurance company for him to do the surgery.
The next day things became very clear. I had not driven that much since my back injury and thus the next day I awoke with actual difficulty walking. After a quick discussion with my coach, an appointment was made with a new neurosurgeon at my hospital. (Obviously he is no longer at Mercy Medical Center). I felt pretty negative about the whole thing, but…to my surprise… Dr. H. was affable, pleasant and extremely knowledgable about what was going on. When he walked into the room he had this little yellow pad upon which I saw some pertinent facts about my case scribbled. He had no aura of ego about him.
He asked me a lot of questions. Did a thorough exam and then we sat and looked over the radiological studies. He confirmed my one worry (without me telling him it was a worry) that I was having some muscle degradation (all the other surgeons told me “don’t worry about that” ) with the current situation. All of the other surgeons have said this was elective, and he agreed, but when I asked about what would happen if I didn’t do the surgery, he explained that my situation would only worsen over time. He did say that after one year if I actually fuse that he would allow me to run and lift weights again. 90% of non-smokers fuse, so I am assuming I’ll be in the 90%. He also explained to me why the direct repair would not actually work for me currently, so that I understood why he didn’t want to do it.. (the fracture is really old and now not in the right position). At that initial visit we agreed to get a new MRI and then we would discuss approach. He also laughed a little because he is an unusual combination of neurosurgeon, he does both Spine and Brain and seems to do both equally well. I didn’t know that so of course asked, “Do you really like to do spines?” Yeah… he’s on the 62 spine innovators to know list in Beckers. I guess the patents he holds show some interest in spines.
So I went and had my MRI and very casually called for an appointment. He is a new surgeon here so I didn’t expect that he had absorbed a lot of clients from a retiring MD. It took forever to get a new appointment, and by that time, I was (and am) limping and actually having trouble walking at all. So, yes if there was any doubt I needed the surgery, in any one’s mind, it’s gone now.
He is going to do an approach which spares the back muscles, the ALIF
and place percutaneous screws posteriorly using a muscle splitting technique rather than a muscle cutting technique.
He says I should be in the hospital only one day? Amazing I suspect from reading and his own statements at other meetings, that it will be about 3 days…. We’ll see.
At this point, I have pain 100% of the time in varying amounts, and it limits me – sometimes a lot, and sometimes just a little. So, I am really interested to see how the surgery goes. Some people have great results, others it seems wallow in misery. I do feel confident that the surgeon wants me to get better and improve. I asked him how typical this injury was and loved his reply. He said, yes, I see this all the time, and fix it often, it’s standard. Then he retracted and told me how devastating the injury must have been to me, but that the repair was standard, and of course… I already understood what he meant. So many people want their surgery to be special…. they go on and on about various things:
How long they were on the table….
How many surgeons it took
They list out all the procedures that are on the consent (surprise, there are about 5 procedures involved in every ALIF, you aren’t complex or special).
I know it’s overwhelming, but I am so so glad that my surgeon took a look at my films and said, YEP, seen it, can fix it. When it comes to spines, you should never want to be the complex, tricky one…
My surgeon is of course “One of the best in the country” (ALL NEUROSURGEONS ARE ONE OF THE BEST- you know why? The Residency is SO LONG for neurosurgeons, well… there just aren’t that many of them, and with some running about trying to be president, there are less). He has a low infection rate. He is innovative. He has had success with these procedures, even telling me he could offer me both the names of the infection preventionist at his last hospital and several patients who would tell me of their experience.
But what really sold me on him? The same thing that I think sells all people. We were discussing another patient (remember I do all infection prevention for the Neuro line, so this was work related) and I said something about how her infection situation was not related to the surgery. When told this most surgeons tell me something like, “Gee thanks, I would hate for my rate to increase” His response, “Have you seen how well that lady is doing now? I was worried about her and I am so thrilled at her progress” I loved that.
So coming soon in November to an operating theatre in O town… ALIF level one Spinal Fusion. then 365 days later… maybe a quarter mile run.