Jan, 73 “A Fighter’s Instinct”

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ContributorJan, 73Read Full Bio


Jan, 73, is a widow with two children and three grandchildren. Jan had walking partners whom she hiked with every day. Around 2001 she started to feel pain walking her usual route. Her back began to hurt all the time and she felt “miserable.” She tried Pilates and physical therapy; the only thing that worked was icing her back. After having many epidurals, she had an MRI and found out she had a slipped disc. The only way to fix it was surgery. Jan was so scared at the prospect; she put off surgery until it was “unbearable,” and she decided it was the best thing for her.

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ContributorDr. Robert G. Watkins IV, MD, Orthopedic SurgeonRead Full Bio


Robert Watkins IV, M.D., is co-director of Marina Spine Center and Chairman of the Surgery Department at Marina Del Rey Hospital. Dr. Watkins is a board-certified orthopedic spine surgeon, specializing in minimally invasive spine surgery, computer-assisted surgery, spinal-deformity treatment, and disc replacement. Dr. Watkins earned his medical degree at the University of Southern California’s Keck School of Medicine and completed his residency in orthopedic surgery at the L.A. County/USC General Hospital. He then worked as a traveling fellow in Europe, specializing in artificial-disc replacement and scoliosis surgery. Over the past decade, he has lectured on spine issues to doctors, patient groups, athletic trainers, and physical therapists; led research teams that have published studies; and taught surgeons on specialized techniques. He is the spine consultant to many Los Angeles sports teams, and has treated professional, college, and high school athletes from all over the country.

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Jan, 73, is a widow with two children and three grandchildren. Jan had walking partners whom she hiked with every day. Around 2001 she started to feel pain walking her usual route. Her back began to hurt all the time and she felt “miserable.” She tried Pilates and physical therapy; the only thing that worked was icing her back. After having many epidurals, she had an MRI and found out she had a slipped disc. The only way to fix it was surgery. Jan was so scared at the prospect; she put off surgery until it was “unbearable,” and she decided it was the best thing for her.

I'm Jan, I'm 73 years old, I'm a widow with two grown children, three grandchildren. I have been in real estate for about 35 years. I recently have cut back on it, trying to get my life together so I can travel. I used to have two walking partners that I hiked with almost every day if possible, certainly every weekend. And there was a steep hill up a canyon near my house that we always went up. Eventually you get to a flatter surface. It was challenging, and somewhere around 2000, I started getting these pains that wrapped around my hips and I had no idea what it was but I just told them I needed to go slower, and then somewhere in 2001 or two, I got a terrible pain down my leg.

I had heard about people with back issues, but it was nothing I'd ever thought I'd have and I knew nothing about what they did about it. I carpooled a lot from my house in the Studio City to Santa Monica and the drive started to just be unbearable. My back hurt all the time. I went to physical therapy and did Pilates. I had a business partner at the time and he got really aggravated with me because I slowed down, I couldn’t do what I used to do. And I would spend a lot of time bending over, touching my toes, stretching, kneading my back. That was just miserable, I said the best thing I could use in all of life is if I had a bathtub filled with ice it would be great.

It was explained that I had degenerative disc disease and they can't explain why some people have more problems than others. Often people have one level fusion, they get better, and never have any problems again. Where my discs continue to slip, so it was bone on bone rubbing and the only solution for that was to continue to have fusions.

And they kept giving me epidurals and finally they did an MRI and they said oh, you've got a slipped disc, and the only thing you can do about that is surgery. It's a big surgery and you’re out of commission for a really long time. I was scared to death. I didn't wanna do it. I was a full time working mom. So I limped around for a really long time. And then finally it was just unbearable, all of a sudden what seemed like something I was never gonna do, I said I gotta do this right away. How quickly can you get me in to do this?

The first disc fusion was L3/4 and since then in the last 16 years, I've had fusions through L1/2 through L4/5. My first fusion in 2003 was not only very painful, but it was a long and depressing recovery. The technology at the time and the beliefs at the time were that after your fusion you should do nothing in the way of exercise. Somewhere around the three month period, I got really depressed. I couldn't sleep, I was antsy, what do you do with yourself when you're home for three months? I started watching a lot of television which I'd never done before in my life. I was taking drugs. You get very withdrawn emotionally and you're not connected to your social universe the way you normally are, the technology with fusions has changed enormously. The first fusion they went in through the back and my second fusion they went in through my front and back. The pain with these surgeries is really significant. They give you a lot of pain meds. I've always been given a button press thing where you could give yourself Deluded or Morphine every eight minutes. Usually they wean you off of that in the hospital, three or four days and you go home on some type of medication, pain medication.

And you're pretty helpless at the beginning. You have to learn to let other people help you which I found challenging to say the least. I'm very independent and didn't like having to ask people to drive me places, bring me food, take care of me, help me bathe. And I had to do all of that.

The back fusions I've had with my current doctor have been much easier to recover from. He believes in getting you up and out as soon as it's reasonable and possible to do it. And that's helped psychologically. On the other hand, you think you're ready to go out and do something, go to a party, somebody drives you there, you think I'll just stay for a few hours and you get there and you're beside yourself in pain. This last surgery I went to a party, I thought I'd drop in and drop out. I dropped out really fast. I couldn’t do it. And those things, when you know you're gonna go through that, you kind of manage better emotionally, but you still go through it. You still go through feeling alienated and disconnected from the normal pace of life.

The last surgery was in August and I'm just now able to really put in a full day, gone back to work which I didn't expect to do. I had had an L1/2 fusion that had been done in a modified way, which unfortunately didn't hold and I had to go back and have screws put in that L1/2 area this past June and it was just a typical fusion. It was supposedly a little easier than some of the others because they only went in through the back and not from the side.

It still takes a good six months to just get up and out into your normal life. You're bedridden a lot at the beginning, but what I found, and they've now learned about me cause I've had so many surgeries is that I wanted to be left completely alone, just kind of zone out. Until the pain becomes more manageable. People who haven't had these surgeries I don't think fully understand what it is that one goes through. And when you've had many of them, it becomes increasingly difficult to recover quickly. Your body needs a certain amount of time to heal and you have to honor that in order to get better, I think.

I had a wonderful physical therapist who I trusted enormously, I got on to her for many years. When you go into physical therapy you start hurting again more than you did because you have to use muscles that you haven't used. Especially your abdominal muscles. She moved away and I was very upset about it. I tried another person who hurt me so badly in three sessions that I had to leave and get an epidural.

Right now I'm with somebody who was recommended to me by my doctor, and she's been incredibly thoughtful about what I've been through and hasn't hurt me at all. She has worked very slowly at helping me regain my strength. When you have back surgeries, it's hard to get up from the toilet. Your whole body really just kind of falls apart and has to be put back together. And it is demoralizing. Or it can be while you're in the process of doing that. I have friends who've never had anything who are my age and you know they're like little energizer bunnies, they put in a full day running around, working, going out at night. I can be very discouraged by that.

When I found out that I needed another fusion, it's a little bit like a body blow. It's like somebody punched me in the stomach. I go home, I don't talk to anybody about it. It takes a while to absorb it and to get used to the idea of it and to start dealing with it in a way that you can. This year, I found out I needed two different fusions, and what I did to motivate myself to get well was I went out to lunch with my ex-business partner who is a dear friend of mine and said I'm going on Safari with you next year. And I told my doctor that he better get me better because it was on my bucket list and I was going. I find that planning things that you can look forward to is really an important part of getting better.

I have a lot of terrific doctors. Doctors I've come to know very well and trust, who are easy to communicate with, I feel very fortunate about that. My back doctor is somebody I can email night or day. I've driven him crazy with questions, asking why this why that, why can't I do this. He's been unbelievably patient with me. It has helped this process enormously to know I have somebody there for all the time I can reach. I'd really had a bad experience with my previous doctors and I was guarded about trusting another one. I spent an hour and a half just talking to my new doctor about my situation and why my discs kept slipping and the fact that he spent an hour and a half with me just talking about it honestly, was fantastic. Just so encouraging that he was willing to take the time to explain what he thought was going on and what I could expect in the future.

Which nobody else had done with me. I have rheumatoid arthritis and I don't make hemoglobin the way I should, and so I have all these doctors who are connected to each other, who I can reach almost all the time and I feel very protected by them and safe. It's not easy to build that community of doctors, but it's so important when you have chronic health issues. You have people you know and who encourage you and who you trust.

My kids have gone through this with me now and they're my big support system. I try not to ask too much of my kids, they both have careers that are very demanding and you don't want to call them up and say hey can you bring me food. It turns out now you don't even need people to bring you food, there's something called Instacart that you can call up and they bring you whatever you need. You find different ways to navigate the whole thing. I think you've gotta anticipate there are times you're gonna be blue, and in pain and frustrated with your recovery.

You've just got to expect that during the course of this recovery you're going to feel better some days than others, some days you'll feel very frustrated about your recovery. One of the things I've struggled with because I've had so many surgeries, nine and 10 years, having people say oh you poor thing, oh you've been through so much. And I can't stand to hear that, I-it's not-it’s not how I want to see myself and it's not how I want people to see me. And, I'm not quite sure exactly what you do with how people see you, but it-you can manage to see yourself in a certain way.

And part of that is not feeling sorry for yourself or feeling like a victim or wondering why this has happened to you. There are so many other people who have had other things that are worse and that's how I try to see it. I believe that most people have a fighter instinct and a desire to live life to the fullest and I feel fortunate that somehow that is what I wanna do. I've never wanted to put aside things that I've wanted to do because of what's happened to me.

I've had to delay some of the things I'd like to do, but having them as goals has always been a motivation to get through whatever it is and keep going until you get to do what you want. I am going on this Safari next June no matter what. I've told my doctor, he's well aware of it. He said it may hurt, you may bounce around and you will bounce around in trucks and it will hurt, but you're screwed together in a way where it's safe to do it and so, that is what I'm doing. I think that's how you have to live your life. Um, there's always joy to be gotten out of life and I feel fortunate that I've got the means and the wherewithal to do some nice things. It's just a matter of recovering enough to do them. I look forward to that.

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