When I closed my last blog post of September 12th (Click HERE), I promised that my next post of In My Humble Opinion would focus on an update of my journey with my back issues… and the planned surgery to “fix” things. Understand that I am not afraid of much (including death), as I have lived a full and satisfying life that could end tomorrow with zero regrets. My greatest fear however, is to be an invalid, being “stuck” in a life of inactivity and chronic pain. Everything I do is geared towards staying healthy. I eat well, work out regularly, and “avoid like the plague” toxic people and stressful situations.
As the back story, I was an active and healthy 67 year old man in May of 2021, when I began to experience symptoms (weakness and pain) in my legs and feet. An MRI showed spinal stenosis at L4/L5 with possible Spondylolisthesis (a condition similar to a herniated disc.) Suggested treatment included physical therapy, epidural steroid shots, and then surgery if neither of the first 2 “worked”… which they didn’t. But what type of surgery and by whom? I’m generally not a “second opinion guy". I’ve accumulated a group of doctors (and lawyers, accountants, auto mechanics, etc.) that I trust implicitly, or I wouldn’t work with them. But back surgery is a little different, and I didn’t have the same trusted relationship with my orthopedist. I got a few recommendations for a spinal surgeon… and made an appointment with a surgeon who was recommended to me by my urologist. Carol and I were very impressed with him, and while he was looking at my MRI during the initial consultation, I asked him if he wanted to see the written report. He emphatically replied that he preferred NOT to be influenced by someone’s else’s interpretation of the film study - which surprised (and impressed) me. Understand that I had been walking around (albeit painfully) and worrying for 12 weeks about the Spondylolisthesis… which requires a spinal fusion to correct.
After speaking with Dr. Murray for about 10 minutes I said to him: “Doc (I always refer to my doctors as “Doc”) - you’ve been discussing my condition for 10 minutes now and you haven’t used the word “Spondylolisthesis” once”, to which he replied: “Mr. Grass, I just don’t see it in the MRI. I do see some spinal stenosis at L4/L5 which is consistent with your symptoms.” We then agreed that I should get the definitive film study specifically designed to identify (or rule out) the more serious condition, which I scheduled for the next day. His suggested plan was for a bi-lateral L4/L5 laminectomy (clean out) if it was “only” the spinal stenosis, and a further discussion about a spinal fusion, should the X-ray show something he didn’t expect. To say that I was relieved when the X-ray came back negative is an understatement, and I finished up my due diligence with a “third” opinion at Penn that confirmed Dr. Murray’s diagnosis… and his “plan of attack” of the laminectomy.
I’ve had to commit to several surgeons in my day, including a much more invasive partial nephrectomy in 2014 for kidney cancer. I know a decent amount about a lot of things, but spinal surgery is NOT one of them. Trust and comfort level (as well as the surgeon’s credentials and recommendations from my doctors) are the determining factors for me in these types of decisions, and Carol and I just “knew” that Dr. Murray was the right choice. After learning as much as I could about the actual surgery and the planned recovery, I scheduled the procedure with Dr. Murray for October 5th… as the surgeon at Penn did not impress me nearly as much. The prognosis was very good for a full recovery and a return to the normal, active person that I’ve been for all these years… but these things are far from a slam dunk.
But what is a “full recovery” and how could this be measured?
The first step was for the surgery to be successful… which it was. I knew immediately (I was home from the hospital by 2PM the same day of the surgery) that it had worked. By the time I hobbled out of the car and up the steps to get into bed, I told Carol that the symptoms were COMPLETELY gone… and my legs and feet felt fine. The problem was that my back was killing me from the incision, which I was totally prepared for but still…
I may sound like a wuss (and some people reading this may agree) but I am actually a pretty good patient. Once I make a decision I commit to it… and all that it entails. That included prepping during the 3 weeks before surgery, as well as a detailed plan for rehab, which included walking every day (and I don’t love walking…especially when it is cold out), and a full regimen of physical therapy. The ultimate goal for me was to get back into the "hot room." As I mentioned, I don’t care for walking (nor biking), and I don’t like lifting weights or any of the machines available at gyms and workout facilities. But I did refer to myself as an “active… 67 year old man” - so how do I define active? For me, it is Bikram Yoga (or “hot yoga” as some people refer to it as). While it IS a form of “hot” yoga, it is a very specific genre. I have been doing it for almost 10 years now and it changed my life (and “saved” it), when I was “forced” to try Bikram in a last ditch effort to find something to help with the male chronic pelvic pain syndrome I suffered with back in 2011. I have been going 3-4 times a week for about 10 years now; it is a full body workout (including cardio)… and it is MY exercise regimen. If you are curious you can google “Bikram Yoga”, or check out the BYX December 2017 newsletter HERE... that featured an interview I gave about my yoga practice a while back. To summarize it is 90 minutes in 105 degree heat and 40% humidity; 26 poses (each done twice) - always the same 26 and always in the same order. It is extremely challenging, and controlling your heart rate with your breathing is essential. A guest teacher once told us a story about when he taught a class of Dallas Cowboys in an August training camp a few years earlier, and several of these pro athletes “ran out of the room” halfway through the class. Everyone from Philadelphia knows that the Cowgirls are wusses anyway, but these are still elite athletes ;-)
When I told my surgeon that my goal was to resume my yoga he loved the plan, and I informed my physical therapist during the first day evaluation on October 25th (20 days after the surgery) that I wanted to gear everything towards my yoga practice, and she was “all in” as well. Because of this, the PT sessions “incorporated” many of the 26 poses into the rehab, but still followed the basic road map of physical therapy for back surgery.
My last PT session was December 1st and I was released from her care… along with her blessing that I was ready. I nervously scheduled my first class for Thursday 12/3 at 9:30AM, mostly because the owner of the studio (and my yogi) teaches that class. I am happy to report that I had a great class, and made it through with no back pain (nor leg pain) at all. I was afraid I would forget the poses (which I didn’t), that I would be super tight (which I was), and that my strength would be significantly diminished (which it wasn’t). The thing that surprised me the most was that I forgot how “cardio challenging” the series was, and I can now better relate to the occasional first time student who is intrigued enough by the yoga to give it a try. It’s been 6 weeks now and I am back to my regular schedule of 3 times a week… and am still completely pain free.
I used the word “Miracle” in the title of this post and I truly believe it is the right word. The miracle of the latest medical technology that has transformed back surgery from my parents’ time of “avoid at all costs”, to a safe and effective procedure that was worth the risk. The miracle of finding Dr. Murray, whose 2nd opinion was spot on, and whose skill and expertise has given me my life back. At this time of the year when people have recently celebrated the religious miracles of the past, I will aways remember the holiday season as a time when I too can be thankful of my own kind of miracle. Happy Holidays to all. Peace and Love, H
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