My Spinal Fusion Saga (with a happy ending).

After viewing an MRI of my lower back, I prayed New York neurosurgeon Dr. Ezriel Kornel wouldn’t utter the dreaded word “surgery.” He said, “You have a cyst in the ligaments around your L4 that has to come out.” I visualized a laparoscopic number with a tiny scar and I’d be back home the same day. Then he said, “I recommend fusing the L4 with spondylolosthesis (slipped vertebra) with the L5 to stabilize the area, remove the disc, replace it with OptiMesh that turns into bone and insert permanent titanium hardware of two screws, a rod and a clamp.”

When I could speak again, I asked, “What about going through airport security?”

“Not a problem,” he answered with a smile.

“Wow.” It took a moment to get my head around what he was saying. “Back bling.”

I’ve now learned that more people have back issues than I ever imagined; they’re all terrified of surgery; it can be the best thing you can do for your body and mind; and everyone asks the airport security question.

Ten months before, I thought I was fine. I had a few aches and some stiffness that, as a baby boomer, I attributed to (cringe) aging and arthritis. Then one morning I tried to get out of bed. My entire lower right side felt like burning concrete and someone, somewhere, was driving a pickaxe into it. With my luck, I thought, I’d thrown something out in my Pilates class. You know, while doing something that was supposed to be good for me. I’d been doing Pilates for over two decades. It was doubtful.

Once I walked around I was fine. My hope that I’d slept in some funny way lasted until the next morning. Instant burning-concrete-and-pickaxe replay.

Friends told me, “I had that. It’s sciatica. It’ll go away. Are you stressed out about something?”

Please. Who isn’t stressed out about something.

It didn’t go away. What was really strange was it was most comfortable to sleep on my left side but when I tried to get up the pain on my right was so excruciating I had to scream to get through it. I couldn’t sleep on my right for long without it hurting. That left my back only, which I don’t like. I wasn’t exactly a man-magnet at this time, nor did I want to be.

An x-ray showed a vertebra right above my sacrum had slipped slightly, causing the disc to bulge and press against the nerves that go down my right leg. No one knew what caused this. Based on older x-rays, it was a new condition and I’d had no trauma. But I’d been hearing popping sounds in my lower back for years. Not one-time pops, like a chiropractic adjustment. It would pop and crunch every time I repeated a certain movement.

Each professional I saw commented, “If it doesn’t hurt don’t worry about it.” A Pilates instructor warned me, “That’s not right. You need to really strengthen those abdominal muscles. Even though you’re in good shape you can still have weak muscles around your spine.”

Apparently I was born with loose ligaments and fascia (connective tissues). Sitting/slumping at a computer for hours on end, often with my legs crossed, didn’t help. Something had to give.

To alleviate the pain I tried massage, acupuncture, and chiropractic adjustments. The relief was temporary. I switched to a kneeling chair at my desk (Office Star™ Ergonomic Fabric Knee Chair that I found at Staples). It was more comfortable and I sat up straighter, but if I sat for more than 15 minutes and tried to get up I was sorry. I started using a timer to alert me to move.

I went to a physical therapist. The pain was still there. Through an orthopedic practice I had a steroid shot (Kenalog), another. The pain was still there. Not as bad, and I could get out of bed (carefully), exercise, walk, even cautiously enjoy my African dance classes. But daily discomfort, the constant worry that this would get worse, should I or should’t I do this or that, and not sleeping well made me very cranky. I had a new understanding of people in chronic pain as well as painkiller addicts.

Through all this I was taking Tylenol and Aleve. I stayed under the daily max of each, usually under half the max. When I had my annual physical, eight months after this began, the ALT number for my liver was above normal. Not crazy above, but enough for my doctor to say: no alcohol or Tylenol for a month. The alcohol was easy to stop. The Tylenol? What I wouldn’t give for a hit of that.

I knew acetaminophen can screw up your liver (especially when mixed with alcohol, which I had cut way back on), and NSAIDs like Aleve can tear up your stomach. I knew it’s easy to O.D. on acetaminophen because it lurks in everything from certain types of Alka-Seltzer and Midol to Vicodin. Click here and scroll down for the National Institute of Health’s list of products that contain acetaminophen. You’ll be surprised.  http://www.nlm.nih.gov/medlineplus/druginfo/meds/a681004.html I was often tired but I was sure that was from not sleeping well and being in my ancient fifties. What did I expect? Here’s the danger of acetaminophen: the liver is insensate. You have no idea if something’s wrong with it. With NSAIDs you know if your stomach hurts.

Now, almost a year from the onset of my back problems, the pain had skyrocketed due to the cyst. I had to have surgery. I was freaking out. Taking out the cyst, an out-patient procedure, didn’t concern me. It was the several-days-in-the-hospital and 6-8 week recovery time of the spinal fusion that I wasn’t sure I should have done. Hearing friends solemnly say “I know someone who went through that and they’re still in pain” then brightly adding “but who knows what they can do today!” didn’t help. Normally, I’d consult five doctors before having anyone cut into me. I was in too much agony to do that.

Luckily, among all the fear mongers, I found two people who’d had spinal fusions and were delighted with the results. Ian Lesser said, “Best thing I ever did, though I had it done right after 9/11 and had to wear a bone stimulator with wires hanging down in back for about a month. People thought I had a bomb.” He also told me what his doctor said when he asked before the surgery how much it would hurt. “More painful than stubbing your toe. Less painful than getting shot.”

Shelley White had her back fused from her shoulder blades to her tailbone! After hearing what she went through and that she was an inch and half taller and exceedingly happy that she did it — “I feel like God reached down from heaven and gave me a beautiful gift” — I christened my operation The End of Suffering Tour. All would soon be better in every aspect of my life.

It’s now over two months since I went under the knife. I’m so giddy with energy and a body that feels twenty years younger, my girlfriend Nicki Tal proclaimed, “You’re like a frustrated stripper now!”

Bring on the pole dancing.

I’m pain-free and half an inch taller. The body must burn more calories to combat pain and to heal, or those painkillers deaden the appetite (or both). I easily lost ten pounds and have kept it off. I find it easier to make decisions. Business dealings that had stalled are suddenly falling into place. There’s even romance in the air. Woo-hoo! Maybe all that oxycodone and restful post-op sleep recalibrated something. Or (here’s the airy-fairy in me coming out) I literally needed more backbone.

People keep telling me how young I look. What’s a little short-term pain for that! Unlike a facelift, my insurance covered almost all of it. In fact, they shelled out more for this operation than I’ll probably pay in premiums for the rest of my life, causing me – for the moment – to stop complaining about their exorbitant rates.

As for whether you should go to a neurosurgeon or orthopedic surgeon when back problems persist, I first went to an ortho in Greensboro, NC, and consulted neurosurgeon Dr. Kornel, who was a NY friend, at the same time. They said basically the same things. I happened to be in New York and near Dr. Kornel when all this came to a head. But the orthopedic practice I went to for the Kenalog shots were now telling me they send all their back patients to neurosurgeons and couldn’t advise me on whether to have the fusion. The doctor who gave me the two injections wouldn’t get on the phone to talk to me. From the suddenly defensive and not-so-nice way his assistant spoke to me, I have a feeling those shots may have been what caused the cyst. If that was the case, thank you! It forced me to have the surgery.

What’s most important is that you have to go to physical therapy and you have to do the exercises. You also have to be careful about the way you move your body for the rest of your life. Twisting, for example, can increase the odds the vertebrae above or below the fusion can slip. Twisting and lifting something, even if it’s light, is the worse thing you can do even if your back is fine. As Dr. Kornel said, “Fixing it is the easy part. Making it stay that way is up to you.” There’s just one thing I forgot to ask Dr. Kornel. How much does that back bling weigh? I have to factor it in when I get on a scale.

UPDATE: I’ve  now passed the one year anniversary of the surgery and still feel pain-free most of the time. I did get a “warm and form” back brace through a doctor that’s fitted to my body. It helps a lot if I drive a long distance (I’m talking hours), sit at my computer all day, or am on my feet moving things around for long periods. The downside to the brace is that it can weaken your back muscles if you depend on it too much. And it’s just sooo sexy. I do resort to Aleve or Tylenol once in awhile. I get regular massages because the muscles around the surgery site can get very tight. I’m still happy I had the surgery. I will never forget the pain I was in before. Now, does everyone who has had back surgery have the great results I’ve had so far? No. I’m just reporting good news that I hope will help others.

For more on Dr. Kornel and his practice Brain and Spine Surgeons of New York in White Plains (and Dr. de Lotbinière who assisted) http://www.bssny.com/meet-our-physicians/Ezriel-Kornel/

He recommends this site for anything back related.  http://www.spineuniverse.com/