Surgery

I had tried at all costs to avoid having surgery, but after nearly a year, and still having constant pain, and the inability to even sit for very long, I finally was ready for it.  I did a lot of research into ADR (artificial disc replacement) and micro-discectomy surgeries.  Micro-discectomies are the most common surgery for herniated discs in the US and are covered by insurance.  The surgeon basically goes in through a 2 inch incision in the back, cuts a hole in the disc and removes the disc material that has bulged out and is pressing on the nerves.  This usually immediately relives the pain substantially for many patients as the nerves are instantly decompressed.  It is a relatively simple surgery that takes around an hour or so.  The downside to this surgery is that it takes a long time for the hole in the disc to scar over (4-6 months) and the disc will never be normal and will always have a weak spot.

With disc replacement, the surgery is a little more involved as they have to go through the front of the stomach to get to the spine.  This is because the spinal cord runs behind the disc and there is not enough room to get the disc replacement in through the back.  They remove the entire disc and replace it with an artificial one.  There are a few more risks as this is a more invasive surgery than the micro-discectomy, and it is not covered at all by most insurance companies.  In addition, the latest generation of artificial discs are not available in the US due to the delays in FDA approval.

I went in to see the surgeon, explained my history and he said I needed to get another MRI since my other one was about a year old.  So I went and got my second MRI and it revealed that after my year of injections, physical therapy, avoiding everything physical that I loved, and my mission to heal my disc, it had all resulted in no improvement to my disc:

And the following image is looking up into my body (so left and right are reversed).  You can see the herniation circled in red, still pressing into my sciatic nerve an spinal cord.

He recommended getting a micro-discectomy as it is less risky, easier to get, and 85% of people do very well after having them.  He assured me that I would still have a very good chance of being active with few problems after I recovered.  He usually reserved disc replacement surgeries as an alternative to fusion surgeries, which from all the research I've done and what the surgeon told me, should only be considered as a last resort.  I had also heard several personal stories of people who had micro-discectomies and were back to their old lives with no problems being athletic.

I was pretty sure I would go with the micro-discectomy, but decided to get a second opinion from another surgeon just to be safe.  So I sought out a well respected spine surgeon at Abbott who came highly recommended by some friends who worked at the hospital and had asked the doctors they knew there.  I saw the second surgeon and he also recommended getting the micro-discectomy and said that my surgeon was very good and he would have no hesitation getting surgery from him as his technique was very excellent, and he had nearly 30 years of experience.

So I made arrangements to get my pre-op tests, got 2 weeks off of work after the surgery all set up, and had the surgery in early Feb. 2011.  I was a little nervous as I had never had surgery before, but hopeful that this would be the start of the road to my actual recovery.  With my awesome parents by my side, I arrived at the hospital, was checked in and put through all the pre-op stuff, and was eventually rolled into surgery, given anesthesia and it was lights out.  I woke up about 2 hours later in recovery, not feeling too bad, although a little groggy.  It took a few hours until my room was ready, so I laid in recovery watching the other patients being wheeled in and out.  My surgeon came out and I was interested to know if he was able to stitch up the hole in my disc.  Not every surgeon even tries to do this, but it has shown to help provide more support to the disc.  Unfortunately, the surgeon said I had a very large tear in my disc, much larger than he expected, and the disc material would not support the stitches and they just pulled out when he tried to put them in.  I was a little bummed to hear this, but it was out of my control and not a guarantee that things wouldn't heal anyway.

A few hours after a got to my room, a occupational therapist and physical therapist stopped by.  The OT, gave me some papers and some information about moving etc.  to be honest I can't remember a whole lot of what she said as I was still a little foggy.  The PT came in and had me up and walking, at first with a walker and then without.  After my operation, I ended up having a little trouble recovering from the anesthesia.  At first I felt fine, but after I tried to eat some toast and vegetable soup (nearly 20 hours after having eaten anything), I became very nauseous and light headed.  They gave me an IV since I was having difficulty getting anything down and I stayed overnight.  Here you can see the covered incision in my back along with the yellowish stuff they use to clean your back, which kind of stains your skin for a few days.

The next morning, I felt much better and my Mom drove me home, which was a little painful due to the horrid conditions of the Minneapolis streets that had really taken a beating over the rough winter.  The potholes were big, plentiful, and unwelcome.  I made it home and laid down on my pull out couch, and just took it easy.  More on my recovery to come.