Surgery, finally!

by Tom Shafer

February 23, 2019

So I suppose I should provide an update about my health, and in particular my back surgery. Of course, if you have been reading my blog, you know that this procedure should have occurred back in the middle of November 2018. Unfortunately, my insurance company intervened less than twelve hours from first cut, and I was forced to endure six weeks of unnecessary and needless physical therapy. All of that drama is laid out in another posting (“To Every Stupidity There is a Surgery”).

Technically, my neurosurgeon performed two procedures on February 12th, a bilateral posterior lumbar decompression and posterolateral fusion L5-S1 with instrumentation (computer guidance). The nearly five-hour surgery went well until I developed a cerebrospinal fluid leak during the decompression. Because the damage to my L5 and buildup of “stuff” (my surgeon’s words) — likely scar tissue and calcification — were extraordinarily close to the spinal cord, he nicked it while trying remove the debris. After a successful blood patch, he was able to complete the decompression — though he admitted that because of proximity to the spinal cord, he could not remove all of the debris he wanted. However, he was able to create a clean opening for the nerve – the most important outcome for both procedures. The fusion part of the surgery went exactly as planned: four laser-guided screws and lots of bone cement. My lower lumbar is going nowhere! A six-inch scar will be the singular tattoo marking my ill-fated tumble from a Colorado waterfall in 2016.

• 

Of course, the fluid leak required twenty-four hours of non-movement with my head in an almost flat position on a flat bed. (FYI, a spinal leak creates a debilitating headache that cannot be treated – unless the head is placed in a level position with the spine itself.) Unfortunately, I slept only four of those twenty-four — so that coupled with bad TV made for a very long day. I was able to read some, though frankly the awkwardness of my physical position limited the ability to do that.

Interestingly, though I was only able to sleep four hours, they were probably the most remarkable sleeping hours I have experienced in quite some time. Because I am notoriously bad at the whole slumbering process, I rarely if ever dream. Now, I’m sure that I do, but because I procure only twenty of the necessary forty winks per night (four+ hours for those of you who do not speak winks), I just don’t spend enough time in the REM cycle to sustain dreams worthy of remembrance. So when it happens, it’s sort of big deal to me. However, I do recognize this was not a pure event by any stretch, due to my powerful pain killers, a nearly five hour surgical procedure, and one strong sleep aid.

Anyway, my dream was directly connected to the book I am currently reading, The Two Towers, book two of The Lord of the Rings series written by J.R.R. Tolkien. Now, some of you may be wondering why a retired, middle-fifties school teacher would be reading a high fantasy trilogy for fun. Frankly, I should have re-read these back when the movies were released (2001 by Peter Jackson), but I didn’t — I’ll blame work and other related responsibilities. I had read the series of books while in junior high (including The Hobbit and then The Silmarillion later in high school), but I thought it was time to put a pair of older, more experienced eyes on the world of Middle Earth.

Now, perhaps I have built this up more than I should have because nothing truly dramatic happened in my dream — but to me it was so fun! Some of the main characters of the series, Gandalf (benevolent leader from the powerful wizard realm), Legolas (an archer and son of the King of the Elves), Gimli (an axe savant and royalty in the Dwarf dominion), Aragorn (a ranger and heir to throne of Gondor), and Theoden (king of Rohan and the Horse-lords) were riding from Edoras, capital of Rohan, to join the coming battle for Helm’s Deep, a valley that protects Rohan’s defensive fortress, The Hornburg — and I was riding with them! I was mounted on a powerful black steed and was listening intently as the five of them were discussing strategy and wondering about the fate of their four hobbit friends, Merry, Pippin, Frodo, and Samwise. Of course, the landscape was beautiful (the wilds of New Zealand, where the movies were filmed) — and we rode and rode and rode. I’m not aware that I ever spoke, nor does that even matter. At some point, Gandalf peeled off to fulfill an important errand, and we felt apprehension and sadness because of it. Then, dramatically, I woke up.

Once again aware of my situation, I patiently awaited the end of my twenty-four hours of torture. Two o’clock finally arrived, and fortunately, I suffered no headache whatsoever as I was raised incrementally (ten percent an hour) over the following six hours — and I suffered no setback from all of that. Occupational therapy took me through my paces early Thursday morning (February 14), and I was able to complete all their tasks easily. Physical therapy arrived late morning, and I was able to walk the floor, climb stairs, and step over things carefully — completing their protocols (though I had cheated earlier by practicing with my nurse at about 5:30 in the morning).

My surgical team stopped by during lunch and asked if I thought I was ready to go home. I told them I was, as long as they felt I was ready. So a couple of hours later, my wife picked me up to take me to our homestead — a late afternoon Valentine’s surprise (I think!).

As I word-process this today (eleven days post), I still feel pain at the surgical site, and I am told that the achiness I am experiencing through my lower body is normal and might take several weeks to clear. I sure hope so. But, the shooting nerve pain in my legs is gone, and I am no longer suffering saddle anesthesia — both good signs. I saw the surgeon on February 22 for a checkup and stitches removal – and for discussion about my future. He and his team thought I was doing extraordinarily well, so he released me to resume driving and to perform light chores around the house – and ordered script for more physical therapy which will begin next week. Outside of continued sleep loss, I do think I’m progressing. Just the fact that I can sit at my keyboard like this without being in constant pain is a very good sign.

Long-term prognosis is still sketchy at this early date, but I did receive some hopeful news. My surgeon asked if I had any goals that I would like to reach before the end of the year. I told him that I would love to return to golf – though I knew there was a chance that I may never be able to. I told him that my boys and I have a fall golf trip, one that I have participated in for twenty-five+ years. He thought that attending the outing was a good goal to have, that it would be up to me to work for it. Since this was the first time he had signified that the surgery may permit me to return to golf, I was more than excited. This meant that the other activities (hiking, biking, kayaking) were definitely in play now.

Of the numerous surgeries I have had (except for the near-fatal perforated colon), this was the first one that presented truly life-altering possibilities – like life-long pain and non-participation in all of the aforementioned sports. Even the total knee replacement offered lots of hope for return to most – if not all – of my previous activities. But with the neurosurgeon’s blessing and my hard work, I know that successful return is within my reach. If my nerve pain is reduced (or dare I say eliminated), that will be icing on the cake.

Tiger doesn’t have to fear my comeback, but the rest of my boys should!

•