Tim, 60 “Do the Work”

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ContributorTim, 60Read Full Bio

Biography

Tim, 60, is a very active married man with three grown up children as well as two grandchildren with another on the way. Tim’s back problems started after a mountain biking accident years ago, which ultimately lead to him having a microdiscectomy. He got a number of years of relieve from that only to have recurring pain almost twenty years later that crippled him to the point where lumbar fusion was his only choice. He talks how the changes in technology have made these surgeries so much different after he spent over a week in the hospital with his first surgery and then less than three days for his more complicated lumbar fusion operation.

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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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Tim, 60, is a very active married man with three grown up children as well as two grandchildren with another on the way. Tim’s back problems started after a mountain biking accident years ago, which ultimately lead to him having a microdiscectomy. He got a number of years of relieve from that only to have recurring pain almost twenty years later that crippled him to the point where lumbar fusion was his only choice. He talks how the changes in technology have made these surgeries so much different after he spent over a week in the hospital with his first surgery and then less than three days for his more complicated lumbar fusion operation.

My name is Tim, and I'm a few months short of my 60th birthday. I've been married for almost 35 years. I have three sons, two daughters-in-law, and three and a half grandchildren. I've worked most of my life in a desk job in the financial industry.

So, my back pain journey really started with a bicycle accident that I had in the early '90s. I was up in the San Gabriel Mountains with a couple of friends riding on mountain bikes, and I unfortunately sort of hit a part of the trail wrong and sort of fell the wrong direction, then started falling down the cliff. Fortunately, I had a helmet on. At one point in time, kind of went airborne, and finally sort of landed at the bottom. And I was fortunate at that point in time that I didn't really have any really bad injuries. I didn't have a broken bone or anything like that, and I remember sort of lying there at the bottom sort of feeling, especially around my legs, just sort of making sure that there wasn't something going on that I couldn't feel yet, and the other two guys were kind of looking down from up above, I think sort of wondering what they were gonna tell my wife because they thought they just killed me.

I was all right and I kind of was able to sit up a little bit and get going, and one of the guys hiked down and we hiked back up. I sort of sat down on a park bench while they moved the car and were putting the bikes on the car. It was more difficult to walk the 10 feet from the bench to the car than it had the probably two or three miles of that hike back out.

It was several months later that I had an episode where I was doing something very simple and I was watering some plants and I was holding a pot, and I sneezed. And suddenly just this incredible pain down from my lower back right down into my leg happened. That sort of classic sciatica. Intense, debilitating pain. Kinda did the typical male thing, "Come on. This can't be that bad," sort of deal, and went and saw a doctor.
They did tests and took pictures and all that kinda stuff, and basically I remember him showing me the bulge in my disc. The L5-S1. And it was just basically rubbing against that nerve. So, at the time, he tried treatments - steroids, that sort of thing. It helped but it really wasn't doing the trick, and they finally said, "You know, well, there's a surgery that we can do."

I think going into that first back surgery is the first time I had ever had surgery. It was really almost the first time I'd really even been in a hospital, and so, it was a little bit scary from that standpoint. This was, I think, around '92 or '93, and I ended up being in the hospital for about a week, which, in the hindsight, seemed like a really long time.

Having surgery like that was scary, but at the same time, I was being told that this pain was gonna go away, and I was at a point where I was sorta saying to myself, "Anything to have this pain go away." I had the laminectomy surgery, and that was a successful surgery. It took the pain away, and for a period of time every once in a while it would kinda creep back into my life, and we were able to address the pain mostly with steroid treatments, and were able to kind of get it back under control.

Flash-forward to about 2007, and I specifically remember what I was doing primarily because my wife will remind me every time I talk about it that it was a stupid thing I was doing. There was a tree stump that had died and we needed to get it out of the ground, and rather than hire somebody I said, "Well, we can just do this. Come on, let's go down and do it." And so, I'm down there in a funny position pulling at this tree stump while someone else is digging trying to get this thing out of the ground, and suddenly I just sorta felt something happen, and it was that same shooting pain down my leg and I said, "Okay. I gotta stop for a little bit."

And it was at that point I had said, "I think I've really done something wrong this time." Because it was much worse than any time before. For a couple of days, I was able to work from home. Went and saw a doctor, and the doctor said, "Well, let's try this," and we tried a steroid treatment and some painkillers and things like that. The painkillers, I didn't like the way they made me feel, and they didn't seem to really do much for the pain.

For that period in time, it impacted everything in my life. You feel very helpless to it. You realize that there's just nothing that you can do about it. I am, for the most part, a relatively optimistic person, but right now it's really pissing me off because I can't do the things I wanna do, and I'm relying on somebody else to do everything else for me. I was worried about my job, but I was thinking, "My life can't continue this way. There's just no way." Something was gonna have to change. Talked to one doctor that suggested that a drug regimen was the right way to go, and the other doctor was more along the lines of, "If you really wanna get rid of this, we're talking surgery. There's a way to fix this surgically."

He knew exactly how to fix it, but that it was a serious surgery, and if you looked at the MRIs, the pictures you could see what was going on with the vertebrae. You'd see vertebrae above there that were all perfectly aligned, and then you'd get down to the one. You could see that it was compromised. My wife Kate and I discussed the possible different options that we had. The pain was not going away. The impact on my life was not going away. I'd been lying on my back for almost two months trying to work from home.

So, after, you know, talking a lot about it between the two of us, I think even talking to a couple of people that had had a similar surgery, talking to the doctor as well as my other doctors about it, I really came to the conclusion that the surgery was the best option for me at that point in time. Two days before the surgery, you go in for the pre-surgery meeting, and that may have been the most difficult part of it because they read you that list of all the things that can go wrong. Um, and that's a pretty daunting list.

You're moving around a lot of critical stuff, and there was all sorts of discussion about the things that might not work ranging from gastric issues to sexual issues, and while that was a daunting list and a scary list, I still was overwhelmed with this idea that the pain was gonna go away, and I really kinda felt as though something really went wrong on that front. It'd be worth it if the pain went away.


So, we drive to the hospital to be there at 5:00 in the morning, and you're in a waiting room with five or six other people that are having the exact same surgery that morning. There wasn't a whole lot of talk between us, but you could see people in various states of the same sort of pain you were. Some were. Some, not as bad.

That part of it was relatively easy, because they kind of take you in and they lay you down and they give you the first drugs that knock you out, and you're out pretty darn quick, and then the next thing you know they're asking me a lot of questions. Just how I feel. I wasn't in a whole lot of pain at that point in time just because I was still waking up. I was still under the influence. But I did know that at that point in time, the pain in my leg was gone, and then you wake up a little bit more and you start to feel the surgical pain, and you're kinda going, "Oh, God, this is bad, this is tough."

And that was on a Wednesday, and the second surgery wasn't until Friday morning. So, you really gotta kind of take it easy. And they had you on some pretty serious drugs. All I remember is having a lot of really crazy dreams, and sort of being half awake through most of the night. I do remember kinda continuing to come back to the idea that my leg didn't hurt anymore. Next day, they do the surgery where they go in my back, and that's where they go in the back and all they're really doing the next day is putting in the two posts and screws that hold it all in place so that the two vertebrae can now grow together over a period of time.

That was on a Friday and I think went home from the hospital on Sunday. And when you're in the hospital, you have a lot of people there helping you and you can ring the buzzer whenever you need something, and if you feel that the drug's not right, there's someone right there that can deal with that immediately. Going home and realizing that's gonna be a different game altogether. And we made a decision before we even went to the hospital the first time was to look into getting a hospital bed into our house, which I think was critical. That did two things. It gave me a bed that I could kinda move around in. It sort of leans up and you could get yourself more comfortable in the bed. It also allowed my wife to get back into her bed [LAUGH] which she appreciated.

Getting up and going to the bathroom is a huge deal, and you need to have somebody else there. Every one of those little things that we all take for granted, you're relying on somebody else, and that part of the recovery was difficult. The other part of the recovery that was difficult, at least in my situation, was that being told that it was going to be several months before I could even start physical therapy.

All I could do was walk around the block. It was several days before I could really kind of do the walk around the block. That part of it was difficult because while I keep coming back to the fact that that pain was gone. I still didn't have any confirmation that all the other things that mighta gone wrong weren't going wrong, because I wasn't able to, you know, sort of test everything out. One of the things that's really awful about surgery like that is the first time you have a bowel movement, and they're kinda telling you that they're not gonna let you do certain things until you have a bowel movement, and it was several days, and that was not a pleasant experience. And that's kind of a scary thing because you don't know whether it was sort of a regular part of the surgery or whether something was wrong, and so you're kind of wrestling with the feelings that come across from that.

We met with the doctor on a couple of occasions after that, post-operative meetings, and he was taking pictures and sort of seeing how I was moving and all that, and the good news was that I was progressing well. It all seemed to have gone well. My recovery thus far had gone as planned and probably was maybe a little bit ahead of schedule, and I remember seeing him in early December, which was four months later, giving me the go-ahead to start the physical therapy. And this doctor had developed his own physical therapy regimen that he had trained a handful of physical therapists to do, and fortunately one of them was near where we lived.

The first thing we learned about back problems is that your back problem is not in your back. It's in your core. So, it's all exercises that have to do with strengthening your core, strengthening your legs, and things like that. It's amazing how tired you are for almost a couple of months after the surgery and how quickly you get tired, but I would go through the physical therapy sessions and as I'm doing them, I'm sort of thinking, "Well, I could do this." And you're about halfway through it and you realize that you are drenched in sweat and you are, you know, dead tired. But then, as you kind of go through it, you realize that he's helping to build you up and helping your ability to do the exercises more easily, take it to kind of that next level if you're on a scale of 1 to 10.

TIM: If you're doing an exercise at kind of the 2 or 3 level, he's kind of working you up into the 7, 8, 9, maybe 10 level, and you realize you're making progress, which makes you feel good, and one of my targets was to be able to go out and play tennis again. I remember it being in March of that year, so really kinda four months after I started physical therapy that the physical therapist said, "You can go out and play tennis." But he was only gonna allow me to hit off of a machine, because that way I knew where the ball was coming and I wasn't making any herky-jerky movements.

I was eventually able to kind of work my way back to playing tennis and doing other things. The doctor tells you all these things you're not supposed to do, and there's some really good ones on the list. Like, you're not supposed to sweep. It's kind of a weird motion that's not good for your back. So, that's a nice thing not to have to do. [LAUGH] Um, you're not supposed to lift things. But eventually, after I found myself confident enough and felt strong enough that I can do those sorts of things.

I've got three grandchildren now and I feel no problem whatsoever in lifting any of those grandkids. One of 'ems two and a half years old, and he spends a lot of time on my shoulders carrying him around. I was and remain very fortunate to have my wife Kate in my life, and she was my primary caregiver, and she took that on very seriously. She went to all the appointments that I had with all the various doctors, so she was very knowledgeable of what I'd been through and what I was going through and what needed to happen going forward.

I'm very fortunate in that the success of that surgery has stuck, and it has stuck, I think, in large part because the surgery was successful, but also in large part that I've taken pretty good care of myself in the meantime. I play tennis two or three times a week, and when I do that, I have to be kind of smart about making sure that I stretch well before that and make sure that I just don't walk out on the court and expect it all to work.

Again, part of that is because of the back issue. It's also because I'm about to be 60 years old. But it is important that I continue to take care of these things because I do realize that one of the negatives to this surgery is that by doing the fusion at the one level that I did, it actually puts a little bit more stress on everything else on the other side. The work that I do that follows up on that therapy doesn't just work on that particular back situation. It helps keep everything else working relatively well.

The thing that I tell people that are in that same situation is that it's important, I think, to exhaust all your possibilities and know all your options before you just go straight to surgery. If you try a medical regimen and it isn't working for you, you can still do the surgery. If you try the surgery, it's kinda hard to go back to the medical regimen. So, make sure you understand all of your options and consider everything - all the other options. Make sure you are prepared not only for the surgery but for the physical therapy, and really the lifetime change that has to come along with that.

And if you're not ready to do that, or if you really can't commit to that, surgery may not be the right thing for you, because I've talked to people who have done the surgery angle and have ended up almost in a worse place. Now, I'm not gonna lay any blame anywhere, but the possibility is is that they didn't take the post-surgery instructions and physical therapy as seriously. Sometimes it's easy to say, "Yeah, I'll do it." And then you get back in your life and you've never been active or you just aren't in a place to be able to take on that part of the challenge, which becomes really kind of a lifelong challenge.

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