Dr. Peter Rosen, 68 “A Whole New Perspective”

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ContributorPeter, 68Read Full Bio

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Peter, 68, is an obstetrical anesthesiologist which keeps him extremely busy and has him running around the hospital to monitor his many patients. He is on his feet most of the day. Peter is extremely active and participates in activities such as marathons, triathlons, and cycling. When he first felt symptoms in his back it “stole his life away.” He had reticular pain, which went down the back of his legs into his feet. After three rounds of nerve blocks, Peter had to see a surgeon. The surgeon said Peter had degenerative disc disease at L4/5 & L5/S1 and fusion surgery was the best way to solve the problem

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ContributorStephanie, 55Read Full Bio

Biography

Stephanie, 55, has been married to our patient contributor Andy for 19 years. She has three children from a previous marriage and two stepchildren from Andy’s first marriage. Her biggest concern has always been making sure Andy does not become too dependent on pain medication. She had trouble understanding his pain and his avoidance of social situations. He had had surgeries and other procedures before she and Andy started their relationship, but he was not pain free. She wanted to motivate Andy to be proactive about his chronic back issues. She found a neurosurgeon that ended up bringing Andy the pain relief he didn’t think was possible.

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Peter, 68, is an obstetrical anesthesiologist which keeps him extremely busy and has him running around the hospital to monitor his many patients. He is on his feet most of the day. Peter is extremely active and participates in activities such as marathons, triathlons, and cycling. When he first felt symptoms in his back it “stole his life away.” He had reticular pain, which went down the back of his legs into his feet. After three rounds of nerve blocks, Peter had to see a surgeon. The surgeon said Peter had degenerative disc disease at L4/5 & L5/S1 and fusion surgery was the best way to solve the problem.

My name is Peter. I'm 68 years old. I'm an anesthesiologist. At any one time, we could have anywhere from five to 30 women in labor. Running around constantly, placing epidurals. Running into the operating room for emergency C-sections. Getting a stat call to a room because a baby has been born that's not breathing and having to run in and resuscitate the baby. I am on my feet constantly. Running back and forth, putting out... one fire after another. It's a very physical job.

And in addition to that, I've run over 30 marathons. Done a whole bunch of triathlons. And I ended up with a hip replacement. But I've remained very physically active. I'm an avid cyclist and I ride my bike three to four times a week for, it's maybe 25 miles at a pop. And so, when I started having my symptoms relative to the back, it affected my whole life. It stole my life.

And that's when I went and started the process of diagnosis, evaluation, and eventually treatment. I think that a lot of us take our health... for the most part, for granted. You know, pain is a factor which influences the whole aspect of your life. It affects your work, it affects, in my case, your exercise. It affects your mood, it affects your personality. I never had back pain. What I had was... this is a medical term, but radicular pain, which went down the back of my legs into my feet.

I noticed that, when I was working, that I would have to... sit. And I mean, obviously, if it was an emergency, I overcame the pain and ran as quickly as I could. But when I had the luxury of sitting down, I would walk for 20 or 30 minutes and then sit down for 15 minutes, because I just couldn't get through the extreme pain. I would go out for a bike ride, and then I would get off the bicycle, and all of a sudden I would have this... sharp pain going down the back of my leg. It almost felt like somebody was sticking a knife into it.

And after about three weeks of not being able to ride or do anything physical and struggling at work, and that's when I basically called my internist and told him what was goin' on. He wrote an order for an MRI, came back with the results, and I already knew what was going on. I knew that I had either a herniated disc or spinal stenosis, but I had to confirm that. Initially I had some selective nerve blocks. There's a anesthesiologist near where I live who does those, and I had a series of three.

And I got pretty good relief. I actually know people who've had selective nerve blocks, and it-it worked. They put some steroids in there and they put some local anesthetic in. And two, three years later, they're still walking around, and they did not need to have the surgery, and I was hopeful that that might potentially be me, but it wasn't. I would get three weeks of relief and then the symptoms would come back. So after the three nerve blocks, she referred me to an orthopedic surgeon. So the orthopedic surgeon and-and I both looked at the, the results of the MRI together, basically, on the computer.

And he said, You know, you've got this problem at L2, L3. L3, L4 doesn't look really good, but I don't think your symptoms are coming from there, and you have a a major problem at L5, S1. He said, I-I can do it from the back. But the only way to-to deal with this permanently, and to give you the kind of relief that you're looking for is a fusion. When I heard the word fusion, I freaked out. Totally freaked out, because I understood, intuitively and immediately, that it meant both an anterior and a posterior approach.

That's a big operation. I thought I was gonna have maybe a microdiscectomy, maybe a little decompression. Fusion just-just blew me away. And I panicked. Well, I think most people don't appreciate what that means. It just-it scared the hell out of me. I walked out of the office, basically in a state of shock. And came home, sat my girlfriend down and... said, I think I bit off more than I can chew. And by the way, I have done anesthetic for these operations, so I really knew what it entailed.

And I just sat with it. I knew that the diagnosis was correct, I knew that the... proposed surgery was correct. I mean, I was having anxiety, and I was having a really, really hard time accepting what I was gonna have to go through. And after about two weeks, I said, This is enough. You've got a good surgeon. You have a competent anesthesiologist. The surgeon that I picked does three, four of these a week. And I let it go. I just said, I'm gonna go through this. I've got the best... of everyone available, and it's gonna be okay.

It's really interesting when an anesthesiologist has surgery. Because all of a sudden, you're on the other side. And... I think you in fact learn something from that experience. You don't really appreciate how frightened how people are going in to that operating room. They don't really know what to expect. They wheel you into the operating room, and that's-that's it. That's the last thing you remember. The next thing you remember is waking up in recovery. I woke up in recovery and I took a deep breath and I said, I made it.

And I immediately noticed that the pain on the right side of my leg was gone. I was in the hospital for five days. Doctors are not very patient people. [LAUGH] Well, I mean, the catheter is not a comfortable thing, but... to some degree, I was relieved that I had it, because I didn't have to, you know, get up or go to the bathroom. I had a PCA. Which stands for Patient Controlled Analgesia.

Which is a machine where you can push a button and it delivers a measured amount of narcotic to you. Had a lot of pain. And it was incisional pain. I mean, I had two major incisions, so I had a long incision in my back. I had a short incision in my abdomen. I was in pain. And the narcotics make you constipated, so I... I was bloated. I was extended. Wasn't really all that... interested in eating. I was not interested in... visitors, very much.

I just wanted to just kind of like lay there and get through it. I was tired. I was uncomfortable. I was bloated. I was distended. I was in a lot of pain. I was miserable. They left me alone for the first two days. Third day I got up. [LAUGH] Just that little bit of movement was excruciating, you know. Took me a long time to... to get up, just to that I would be sitting on the edge of the bed. And walking was difficult. My legs were weak. I was still a little bit woozy. The anesthetic was probably still in me a little bit.
And they walked me. Uh, that was the first time I walked, and I did fairly well, and then the next day... uh, I went through the same thing, except they gave me a walker. And I started walking around the corridors of the hospital. By the fifth day, I was walking around the corridors of the hospital without the walker. The nurse was standing next to me, was holding my arm to make sure that I didn't lose my balance. And I started feeling more like Peter. And I was discharged. The... first month of being home was the worst month of my life.

My orthopedic surgeon warned me, You're gonna be tired. I said, yeah, that's for the other guy. I'm a jock. You know, I ride 35 miles, I run up and down hills and dales. I'm in great shape. My resting heart rate is, like, 35. Th-that's not gonna happen to me, I'm gonna be f-I'm gonna be fine in a week. Sure. I was just... t-totally drained. One of my cousins actually came out and stayed with me for a month.

I was able to get up for my meals. I was able to get up, uh, when I had to go to the bathroom. Took me a while before I could have a bowel movement, because the narcotics were so... constipating. I had pain when I moved. I had pain when I tried to sit up. I had pain when I tried to stand up from the couch, or-or the bed. At that point, the most uncomfortable aspect of my recovery was my ab-abdominal distension. I was so constipated, I just-I would've given anything to be able to go to the bathroom.

So I stopped the narcotics. I just stopped 'em. And I-I went extra strength Tylenol, I took one in the morning and one at night. I just kept... thinking that I'm gonna get up the next morning and I'm gonna start to recover. Kind of like... when you have a-a really bad flu. All you can do is lay in bed. That's all you can do. And weeks went on, and I wasn't getting my energy back. I got a little worried. And by six weeks, I was starting to feel like myself again. And I was able to take care of myself.

I had actually told the people at the hospital that I planned on being out for five weeks. Which is-now, is like, laughable. And it turned out to be 10 and a half weeks before I was able to go back to work, and I only returned to work on a part time basis for quite a while. I'm now four months out. And I feel good. I have not yet started physical therapy, because, the one thing about a fusion is that you need to make that the bone graft is actually starting to fuse.

And too much bending or lifting or whatever could delay that. I have, probably, another six weeks before I will start my physical therapy. And I have a walk that I've laid out. It's a 45 minute walk, from my house around the neighborhood. I do that every day. I look forward to that, that's, like, the best part of my day, practically. My first walk was, for lack of a better term, brutal. When I first started walking, I walked like three blocks and came back. And every day, I've walked another block, and another block, until I got to, you know, where I eventually wanted to go.

22 minutes out and 22 minutes back. And I do that, now, effortlessly. And I don't get tired. I'm very conscious and careful about what I do. I don't bend over. I kinda like bend at my knees to pick things up. I don't lift anything at all. I'm careful going up and down the steps. As an anesthesiologist, I see people during their surgical... procedure. I see them in the recovery room, and then they go home.

I also knew someone who had the same surgery, and he said to me, this is what I experienced. Don't think that there's anything wrong. It's gonna be six weeks before you even start to begin to feel like yourself. That was very helpful for me.

I called the office. And I said, I have one question for you. I said, I have all these physical limitations. I said, What about sex? And they said, As long as, you know, you're not gonna be hangin' from the chandeliers or doin' somethin' crazy, it's okay. I spoke to my friend. He said, After mine, I stayed on the bottom. [LAUGH] And the biggest help that I had was my friend who had the same surgery. That was... immeasurable in terms of how much it helped me... realize that what I was going through was normal, and that there wasn't something... wrong. And I would call him often and complain. I would say, Were you still feeling this at three weeks? And he was very patient with me, 'cause I kept asking him the same questions over and over and over again, but he said, Pete... you're gonna be out of it for six to eight weeks. This is perfectly normal. This is exactly what I experienced. That was the greatest help for me. So to have someone who's been through it before, who you can bounce your frustrations and your fears and your doubts against, it's immeasurable.

I have been at the hospital that I work at for 40 years. Have a good reputation. I have a very good relationship with the chairman of the department. And when I initially went in to speak with them, to tell them that I was gonna have the surgery, their response, without even... without hesitation, was, Peter, take as much time off as you need. And whenever you're ready to come back, your job is here for you. And not too many people get that kind of flexibility. And then when I came back to work, it was understood that there were certain things that I could do, and there were certain things that I couldn't do. Like lifting a patient from the gurney.

Your body tells you what you can do and what you can't do. And if I couldn't do it, I just simply said, I need help. And everybody understood that I had just had major back surgery, and everybody was very accommodating and very understanding and very sympathetic. I just eased back in. If I were a couch potato, I would say that I had gotten back to my regular life. The pain that I experienced, pre surgery, was so... uh, debilitating. I remember going to a cocktail party, and standing and talking to people, and I had this, I felt like there was a knife sticking in my leg.

And I was trying to take the weight off of my foot while I was, uh, talking to that person, and it was terrible. That's gone. And at four months, I am conscious... uh, of being careful. I'm much more conscious of where I'm walking, 'cause I don't wanna trip over something. When I walk down the steps, I'm holding onto the railing. You know... it's really hard to tell people what to expect. I don't think they hear it. There's a certain form of denial. It's not gonna be that bad for me.

I've never experienced anything like it in terms of the debilitation that I felt for the first four to six weeks after the operation. But once your energy starts to come back, you slowly start to put the pieces of your life together again, and eventually it becomes normal. But that's hard to convey. It really is. There really are not problems at this point. I'm just waiting for him to give me the green light to, probably, start out on a stationary bike, and then I'll ultimately be able to get back on my bicycle and, you know, ride into the sunset. Ride into the sunset. Ride into the sunset. Ride into the sunset.

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