For many years, I have advised folks that the secret to a healthy life is simple - choose your parents carefully. I have known for most of my 70 years that our father was a walking time-bomb of future health woes. He was afflicted by rheumatoid arthritis, gout, alcoholism and was a life-long smoker. Up until recently, I thought that I had dodged these bullets. I have not smoked, there is no gout, and other than a few aches and pains in my hands, arthritis "seems" to have skipped over my generation. "Seems", it seems, is a rather ambiguous term.

Over the past 10 years, I have been plagued by lower-back pains, especially when shoveling snow or partaking in the annual leaf-raking effort to move leaves from my backyard to the street. Most of the time, a couple of ibuprofen would do the trick. About 4 years ago, I started experiencing back pain while out for my afternoon walks. Again, some ibuprofen and stretching would do the trick. It was interesting that the only thing that seemed to trigger the pain was walking or standing. I had no problems with riding my bike or driving - only walking was sure to bring on the pains.

After I retired in 2016, I had my semi-annual doctor's visit, and complained about the pain yet again. The doc scheduled me for a physical therapist, and I thought that I might get some relief. Thought is the operative verb here. After the visit, the therapist gave me a series of exercised that she said would help. Well, they did not, and the pain continued.

In late March of 2017, I was helping brother Tom with a project and started experiencing difficulty walking the next day, with extreme pain in my hip that radiated down my right leg. Another visit to the doc and I got an instant shot of confidence when she asked where the pain was - I told her - and she responded with "that's not the answer I wanted". (That is a common problem with asking questions you don't want an answer to. You would think she would know better.) An x-ray determined that I had moderate arthritis in my lower spine - Thanks Dad! Based on the x-ray, the doc scheduled me for an MRI. The results of the MRI necessitated a visit to the local spine doctors. (Contrary to what the TV commercials say, I did not leave the office with a 1-inch incision and no pain.)

The MRI technology is really neat. You lie in a tube-like chamber, you are scooted in and out, there is a lot, and I mean a LOT of noise, and the deed is done. The result is a picture if your inners (see see below) less the option for a set of 8x10 glossies.

My MRI My MRI

As shown above, the area where the arrows converge show a definite constriction of the nerves leaving one of the affected lumbar vertebrae. The area in the right picture show all of the bone spurs (in red) that do not appear in other nearby vertebrae. Specifically, the nerves coming from Lumbar 3, 4, 5 and Sacro 1 were what was causing the problem.

My MRI

As shown above, the nerves exiting from L3, L4, L5 and S1 all converge and go down the legs. These are the nerves associated with Sciatica, a pain in the back and leg. The back surgeon I met with explained what the problem was, and suggested a non-invasive series of steroid shots that would hopefully do the trick. So, a week later, I went in for the shots (which were painless until the doc jabbed one of the nerves), was told to take it easy for a week, and report back. Well, after sitting on my butt for a week, I started moving around, and the shots seemed to be working. Again, "seemed" was a somewhat suspect verb, for after three days of no pain, the pain returned and picked up where it left off.

After another visit to the back doctor, and discussing the options, we decided that surgery was the better option than another round of shots. (I think I detected a smile in the doc's eyes, with visions of loyalty points from his chainsaw dealer coursing through his dreams.)

The Pre-Admission Waltz

The first step in the process of having an operation is to go thru a series of tests and questionnaires to make sure that you are eligible for surgery, and the docs have all the data they need. I went to the location for the tests, and was exposed to what was to become an all-too-familiar routine.

Pre-admission was a visit by 5 different specialists, each of whom walked into the room and uttered the same mantra: "What is your full name and date of birth". No matter that I had a wrist bracelet with my vitals printed on it, the question always came. At one point, I am sure that the same nurse came in twice and asked the same question. After about an hour or so, I was judged to be who I said I was and was kicked out the door with a handful of forms to read.

Into the Belly of the Beast

After the pre-admission tests, the date was for surgery was confirmed. The biggest problem with surgery, other than the fact that some joker was going to be slicing and dicing my back, is not knowing what to expect. The unknown is always a bit of a scare, and the thought of going thru the twilight zone with pain holding my hand was a little unsettling. The day before the event, I got the scheduling call: be at the hospital at 5:30 AM. Needless to say, getting up at 4:30 AM for something fun is hard, but getting up at that hour for a trip into the twilight zone is a bit rough - especially without a cup of coffee.

The wife and I got to the designated location, only to be told that they were not open yet. After about 10 minutes "nurse Rached" walked us down a mile-or-so of corridors and directed us to a cubicle in the pre-op area where another dance started. As with the pre-admissions testing, the first nurse walked in and asked those oh so familiar words: "What is your full name and date of birth" with an additional quiz question, "what are you here for". The first nurse installed an ID bracelet, asked a bunch of questions and left. The nurse number 2 entered and asked the magic questions, did her task and left. This routine was repeated until the only person who did not visit was the parking lot attendant - well I don't think he came in, it was hard to tell.

After all the nurses had come thru, the surgeon and the anesthetist came in, asked the questions, signed my back, grinned and left. All of this took about 45 minutes.

Finally, the OR nurse came in and made sure I knew who I was (yeah, she asked the mantra as well), that all the forms were signed, that I had necessary wrist bracelets, and that I was ready to go - not that I had much choice other than running down the corridor in that backless gown I had to wear. Then a guy in green clothes came in and started wheeling me towards Operating Room number 8.

Once inside, the OR nurse came in and introduced me to the other nurses in the OR. That is the LAST thing I remember until I woke up in my room. Other than a drug induced hangover, and a pain in my backside, the experience wasn't bad - I ain't gonna do it again anytime soon - but I guess it could have been a lot worst.

The Whizzer of Ahs

After waking up to a cabal of nurses and nurse assistants, all making sure I was who I said I was, the fun began. First, I was told to empty my bladder. Never mind that I did not feel any pressure (after all, I KNOW when I have to whiz) I HAD to do the deed, or else.

It was the "or else" that lead to an experience that I would call - PAINFUL! After whipping out her portable ultrasound device, rubbing it over the area usually associated with a bladder, I was told that my bladder was almost full, and I had to pee or get a catheter. Well, I tried to pee, which was not easy with a room full of women all gawking and waiting for the stream and the lingering effects of what I later found out had been an epidural (numb from the middle of the back down). So, after an unsuccessful attempt, I was told that I was going to get the catheter.

Being somewhat naive, I just thought that they would insert a needle into the bladder from outside the body and let it drain. Oh no, not even close! It was then that I learned that the internal plumbing of the male urinary track is about three feet long, with twists and turns and HURTS LIKE HELL when the nurse shoves that telephone pole sized tube up the tubing meant for outward flow of liquid. I swear that I left fingernail marks on the bedrail. But there was no great feeling of satisfaction when everyone in the room reassured me with "oh, you're peeing now". After this, I could only imagine what would come next.

Good Morning!

After getting my new plumbing set up, life settled down to a predictable routine - somewhat. I did have a TV in the room, but there was nothing on it. It got to the point where I was watching programs that were flat boring. I guess having 400+ channels at home spoiled me somewhat, but the 20 channels on the hospital TV were borderline cruel and unusual punishment. I ended up watching CNN, which had a running commentary on something or the other - I think it was about George Washington's cherry tree scandal.

spirometer

I also had a device called a Voldyne 2500 (shown above) which had a tube leading to a set of chambers. I was told that I had to inhale from the mouthpiece while keeping a small valve on the left at the "best" setting, and raising a second column on the right to the "2500ml" setting. I was also told that I had to do this 10 times an hour to prevent pneumonia. I hate to admit it, but this device became boring very quickly. At one point, I think I was inhaling to big band classics to break up the monotony.

Meals were a high point, although high is a relative term. The first day was eat because you had to stop your stomach from growling. The second day was search the menu for something that sounded palatable. Fortunately, there was no third day! The only bad aspect was that I had to use a phone to call the mess sergeant with my order, and guess where the phone was - just out of reach! Fortunately, I learned that if I punched the call button on the side of my bed, I could get someone to hand me the phone.

I learned to have all sorts of fun with that button! On the night before I was going to be evicted, and the catheter had been removed (much less pain, but still not a process to be re-experienced) I had to pee, so I just got out of bed and went to the bathroom. That got all the nurses running into the room to see what was going on. I found out than that my bed was wired, and it set off alarms if I got too frisky. I guess that the "Fall Risk" bracelet also had something to do with it. I figured the bracelet was wrong, after all, it was still spring, and should have said "Spring Risk".

There was one aspect to my stay that was… um… a pain in the neck. Every couple of hours, a nurse would come into the room, turn on the lights, intone the mantra, and take my blood pressure and temperature. This was ok during the day - it distracted me from the TV. Where it got really bothersome was when "Nurse Sunshine" wandered in at 2 and 4 AM, went thru the mantra and performed the tests. I got pretty good at just groaning and sticking out my arm. I was amazed that after just two days of laying on my butt, I was able to get my BP numbers into double digits. My normal 120/80 was 94/60 at one point.

The night before I left there was a new nurse/supervisor who decided to come into the room at 2 AM, turn on the lights and introduce himself. I am not sure, but I think he backed out of the room in fear after I verbally unloaded on him.

There was also the opportunity to have a bit of fun with the process. One night, "Nurse Sunshine" came in and intoned the mantra. I responded with "Spangler Arlington Brugh, January 2, 1905". I got a look that was one of total confusion. She said that she was glad that she knew who I was and did her thing. I asked if she was not just the least bit curious - no she wasn't - and after explaining that "Spangler Arlington Brugh" was the real name of Robert Taylor, I got a "Who?" Another case of youth wasted on the young.

Homeward Bound

Two days after surgery, I was ready to go home. So after proving I would walk, pee and act surly, I was cleared to go home. I got one last wheelchair ride out the door, and after the ride home I was able to crawl into the condo with the aid of a walker. The first day was not too bad: lay in bed, watch TV, wander out to the dining room for an occasional meal, take my meds every four hours. Day two was another story. I got up, wandered out for my morning coffee and almost did not make it. I had a pain in my leg that was enough to make a grown man cry - I didn't, but it still hurt like hell. I have been shocked with electricity a few times in my life, and I would prefer 110 volts anytime over the pain I experienced. I got hold of the surgeon's assistant who prescribed me yet another prescription. (CVS profits will be up this quarter.) I got another appointment with the doc the next day, and he told me that the pain was caused by swelling where the jackhammer had removed material around the nerves, and that it would get better. He was right, after a day or so, I would walk without scaring the hell out of the neighbors with my screams of pain.

It has been four weeks since the operation, and I actually feel pretty good. I can walk around the local parks, drive short distances and have stopped taking meds, other than the occasional glass of medicinal wine. I look forward to improvement in the coming weeks. The proof of the pudding will be taking an hour long walk with no pain. I can't wait.

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