Wednesday, June 14, 2017

I Need to Have Surgery to Relieve the Pressure on my Spinal Cord.

When it comes to healthcare, it’s important to be your own advocate.  Doctors can give you answers, but sometimes you have to know which questions to ask.

When I went to the clinic two weeks ago, their focus was my heart.  I had chest pain on the left side, which is a red flag.  It took nine days before they could completely rule out heart problems.  Then they gave me a clean bill of health and said, “Good luck on your trail run.”  At that point, they were assuming I had a muscle strain that would heal with rest.  So was I, but I wanted to know for sure.  I scheduled a consultation with an orthopedist.  Had I not done that, I wouldn’t have known I had a spinal injury.

After an exam, the orthopedist knew it was a nerve, rather than a muscle injury.  She was on the fence about ordering an MRI.  MRIs are expensive.  I have insurance, but I would still have a significant out-of-pocket cost.  I wanted to know for sure, so I encouraged doing the MRI.  Had I not done that, I wouldn’t have learned how serious my condition was.

Had I not aggressively pursued more information, I probably would have started the Bighorn Trail 100, not knowing that I had nerve damage that would make me more apt to trip and fall, and also not knowing that a fall could easily result in permanent disability.

After seeing the MRI and doing a more thorough exam, the orthopedist referred me to a neurosurgeon for a consultation.  I had that appointment on Tuesday.  It was only then that I understood.  The doctor told me I needed surgery.  Not, “I recommend surgery” or “Surgery is your best option.”  It was more like, “You need surgery as soon as possible.  We can get you in on Friday.”  Surgical procedures aren’t normally scheduled that quickly.

I was a little shell-shocked.  I thought there was a good chance that the disk extrusion would heal eventually with non-intrusive treatments.  It probably would, but there's a more immediate concern.  The disk is exerting so much pressure on my spinal cord that it's already causing nerve damage.  It's imperative that they relieve the pressure as soon as possible.

So far, I had been lucky.  I was having intermittent discomfort in my chest.  I wasn’t having pain anywhere else.  I wasn’t having weakness or numbness in my legs.  I wasn’t losing motor control.  I wasn’t losing control of my bowel or bladder.  All of those things were possible.  If I move in a way that causes further compression of the disk between my T8 and T9 vertebrae, it could put more pressure on my spinal cord, resulting in nerve damage that would likely be permanent.

To impress upon me how certain he was that I needed this surgery, the doctor used the phrase “slam dunk.”  Then he started talking about Superman.  Actually, he asked me if I knew who Christopher Reeve was.  If you don’t know, he was the star of four Superman movies.  Then he injured his spinal cord in a horse riding accident.  After that, he was paralyzed from the neck down.  He eventually died at the age of 52.  That’s four years younger than I am.

His point was that unlike most tissue, nerves don’t heal.  If you injure your spinal cord, the damage is permanent.  I was already showing symptoms of nerve damage in my right leg.

I’ve never had surgery before, and I never thought I would have spinal surgery without getting a second opinion first.  As he showed me my MRI images for the second time, he explained why my T8/T9 extrusion was so serious.  I quickly came to understand that the risk of not having surgery was significantly greater than the risks of the surgery itself.  I was nervous about the surgery, but I was much more nervous about what could happen at any time before the surgery.  Suddenly three days seemed like a long time to wait.

The procedure is basically to make an incision in my back, cut a hole through the bone, and then remove enough disk material to relieve the pressure on my spinal cord.

This morning, I went back to the hospital with Deb, so she could see the MRI images herself and ask questions.  Then I had a preparatory procedure that involved having a CT scan so they could insert a marker into my back.  That will show the surgeon precisely where my vertebrae are.  The surgery requires pinpoint precision.  In the afternoon, I had another doctor appointment to go over pre-op procedures.

Tomorrow, I don’t have any doctor appointments, so I’ll have a full day to freak out.  I’ll read through all my instructions for the surgery, and I’ll do one last workout on the stationary bike.  I’m not allowed to run, because the impact could cause further damage to my spine.  After the surgery, I’ll still have strict restrictions on my activity while I recover.  For the first two weeks, I won’t even be able to ride the bike.  I probably won’t be able to run for the next three months.  I’ve already cancelled the Bighorn 100, but I need to start cancelling reservations for my other summer races.

My surgery is scheduled for Friday.  Believe it or not, neuro-surgery is now an outpatient procedure.  The procedure itself should only take one to two hours, but it will be done under a general anesthetic, so I’ll have to stay in the hospital until that wears off.  I should be able to go home the same day.

Wish me luck.


  1. David - I hope your surgery goes well. I'll be sending healing thoughts your way. Best wishes for an uneventful recovery.