Fusion. NOT the nuclear kind.
Ok, now this has been an experience.
My neck has been a sore spot with me for years. Literally. It got to the point that maybe twelve years or so ago, I decided to go to a Chiropractor for a consultation and adjustment. For me that was a big step. I always was a bit snotty about Chiropractic, but boy was I wrong! One of the guys I worked with really talked up Dr. John Cassara (Erie, PA), so I made an appointment, and went to see him. He first took a motion x-ray of my neck, and showed me exactly where the problem was. He then described what he could do for me, and I decided to go for it. My first adjustment was about as scary as anything I have ever done. Here’s this huge guy (John is a body builder and formerly excelled at the shot put in college) bending over me and messing with my neck. He got me loosened up, and let me know he was about to do the adjustment, and CRACK! My neck sounded like a stick breaking. I remember a minor explosion of air shooting out of my mouth, and as unobtrusively as I could, I wiggled my toes and moved my hands around a little. Ok, I guess all is well. Whew! But as I drove back down Peach Street, I realized that the lateral range of motion in my neck had just increased about thirty percent. I drove down Peach Street just moving my head side to side saying, “Look at that! Hey, look at that!” I hadn’t been able to move my neck that well in a long time. Well done, John. My Chiropractor has become my friend as well, and our mutually beneficial sessions were regularly scheduled. I have no idea how the past decade or so would have been bearable if I hadn’t had my neck adjusted as much as I have.
Further, when Chiropractic couldn’t do it on its own, I went to see Dr. Joseph Thomas, also in Erie. Doc Thomas specializes in pain management, and I received steroid shots for the past several years. They also have been helping control the pain. However, a couple of years ago, Doc Thomas advised me that my neck was getting to the point that I would need more. “Need more” is code for surgery, and he referred me to Dr. James Kang in Pittsburgh.
Beth and I travelled down to Pittsburgh a couple of years ago, and met with Dr. Kang. He went over my x-rays, and explained what the root problem was. I had two discs, C-4 and C-6 that were degenerative. Basically, they were slowly melting. This is what he does for a living, and he was pretty matter of fact about the whole thing, which I found reassuring. What he explained was that at the time, I was in a gray area. At some point, surgery was going to become mandatory. I wasn’t at that point yet, but I was well within the range of “it could be done, no question.” I opted to wait, which he supported.
This changed late last year, when I went to get a shot from Dr. Thomas again. He realized I had not had a series of x-rays in some time, and so we x-rayed my neck. I’ll not soon forget the appointment when he looked at the x-rays with me.
Thomas is an interesting guy, profane and funny. But this day, he was all serious. He looked at the x-rays, looked at me like I had just sprouted a second head, looked back at the x-rays, and then back to me. In a totally serious voice, he said, “Do you want something for the pain?” I answered that no, I was ok. He said, “Are you sure?” When I again answered in the negative, he just looked at me like I had suddenly changed form into a mutant. Apparently, my neck had degenerated to the point that he believed I should be in major pain, or perhaps not even mobile. I told him that no, I was in pain, pretty much always, but nothing I couldn’t handle. Doc Thomas immediately set up a new appointment with Dr. Kang, and Beth and I went down again to Pittsburgh. We looked over the x-rays, and although Dr. Kang felt it was no emergency, we agreed that the surgery could take place now. Beth and I returned home, having set up a tentative date for surgery for the end of summer 2012.
It seems the timing was very good on the surgery. I have written about my new V-Star, and how much fun it has been to ride. But about a month and a half ago I could feel that my left hand was not gripping as well as I thought it should. Further, when I qualified two weeks ago, we had to set up the range. I grabbed two 4×8 sheets of fiberboard to take down range (we use these to tack the targets on). I easily picked up one using my right hand alone, but not so my left. I couldn’t pick it up at all. Further, I have noticed a bit of tingling in my left arm, and my left hand has had a minor case of “the shakes” starting up as well.
My degenerative vertebrae have their genesis back to when I was a teenager, maybe 16 or 17. My family went to Kinzua Bridge with another family, just to look around and have a nice time. The other family had a son, Dale Shatto, that I had become good friends with; his family and mine camped in the same location for several summers. We had gotten close, Dale called my folks “Mom and Dad,” and I did the same with his.
Well, on this day, Dale and I were ahead of the old people, and went out on the observation rock to look at the bridge.
Kinzua Bridge, near Kinzua Dam in PA, is an old railroad bridge spanning (you guessed it) the Kinzua River. At one time it was the world’s highest, longest wooden railroad bridge, and the view is amazing. The railroad had largely abandoned it, and it had been renovated into a tourist attraction. One could walk across it, and look up and down the valley. Especially in fall when the leaves turn color, the view is stunning. Unfortunately, a tornado has claimed half the bridge, and I have no idea what its condition is at this time.
In any event, there was a large rock that kind of hung over the valley. The Park Service had cleared brush from in front of it, and it offered a great view of the bridge. Along the trail, and on the top of the rock was a fence, designed to keep people from falling over the edge. Being teenagers, we were clearly smarter than the Park Service, so Dale and I jumped the fence and stood on the edge, looking out, looking down. We couldn’t actually see the bottom, so I have no idea how high we were. Dale had the genius idea to stand on the edge with our hands on the top, and wait for the parents to come down the trail. He told me later he meant to go to the top beside the rock and walk down to the point where we could reach up and put our hands on top, but he didn’t say that at the time. Thanks, Dale. Your great idea led to my stupid decision, so naturally I’m blaming you. 🙂 Down about six feet, I saw a little ledge, probably three or four inches deep and a foot wide. I figured I could easily get down on it, so with Dale’s suggestion still clearly ringing in my head (Thanks, Dale), I sat down, aimed for the ledge, and launched. Well, I hit the ledge alright. With my heels. And I slowly, slowly toppled forward and fell off the rock. Now a lot of people would say this explains a great deal, but I remember doing a pile driver, and landing squarely on my head, as straight as if I had planned it. I think I blacked out for a minute, but I remember Dale screaming for the parents, that I had fallen off the rock. I yelled up that I was ok, and climbed up beside the rock (where Dale had actually meant for us to stand), and back onto the trail. In those days, people didn’t just dart to the Doctor, and this was no exception. My Dad basically just called me a Dumb Ass, and told me to get in the car. Well, I was, and I did. In retrospect, I’m fairly certain I cracked a couple of vertebrae, as I couldn’t rotate my neck for about a year. It finally loosened up, and all was well (not). And then I fell on my head a second time, but we don’t need to go into that.
So here I am, fifty-five years old, needing surgery, and scheduled for it. I got all the advance preparations done, and once again, down to Pittsburgh we went on August 6, with the surgery scheduled for August 7. I wasn’t really worried, I knew the surgery needed done, and the pain and necessity came from the sins of my youth, so what can I say? I was concerned, as there is always a chance of “something bad happening,” but I trusted my surgeon, and knew I needed the procedure, so let’s get ‘er done.
The technical name for my procedure is Anterior Cervical Discectomy and Fusion (ACDF). I went into the prep room, and when they were ready, I was wheeled into the Operating Room. I already had an IV in, and some blood drawn, so when we went into the OR, we were pretty much ready to get the show started. The anesthesiologist gave me a shot, and said that it would take effect soon. They then put the oxygen mask on, and I remember saying, “Whoh! There it is,” and that’s it. Gone. Lights out. My next memory is…I don’t remember what my next memory is! Boy, that stuff did it’s job. However, while I was unconscious, Dr. Kang opened up my neck from the front, laterally on the left side. After I was intubated, they then moved my trachea to the side, and exposed my vertebrae. They then removed the spongy bone in vertebrae C-4 and C-6. He also removed a couple of bone spurs that had conveniently decided to grow into my spinal column, and were causing pain. He then fused C-4 to C-5, and C-5 to C-6. Many surgeons use cadaver bone, or even artificial joints, but Dr. Kang uses bone from the patient’s hip. It is inserted into the spot where the old spongy bone used to be, and held in place. I now have a titanium plate in my neck that I had not had before. Kind of like Wolverine, but without all the cool stuff that goes with it. And from what I understand, this is what the fuss was about. Fusing on two levels is geometrically more difficult that fusing one vertebra. So.
The next day was kind of pain filled. Hip, neck, upper back, shoulders. Dr. Kang came in and explained that the discs had degenerated so badly that he had to build them back up to where they should have been. In order to do this, they (in essence) had to push down on my shoulders and pull on my head. I am now about a half-inch taller than I was a week ago. Dr. Kang said this explains the pain in the muscles in the back of my neck. They are basically confused, and spazzing, trying to get back where they think they should be. Honestly, that was the worst of the pain. My hip hurt, my neck hurt, but no big deal. But the back of my neck! Wow!! I was more than happy for the pain meds for my neck. I had one of those push button happy shot things that I could use to self-medicate. I used it more for the muscles in the back of my neck than anything.
The surgery was on Tuesday, and I came home Wednesday. The pain was manageable, and the physical therapist was satisfied that I could navigate walking and stairs as needed. I think several people were surprised that I got out of there as quickly as I did, but I attribute this to two things. First, I was on the City of Erie’s SWAT team for a long time, and one of the things I learned was to fight through the pain. Too many people, I think, get all whiney about pain, but really, it’s no big thing. The human body is capable of so much more than any single person believes. Just gotta keep going. And second (and most importantly), I had so many people praying for me. Friends and family in church, on Facebook, and over the country have been lifting me up in prayer, and it shows. My recovery is still slower than I would like, but it has been so much faster than most who have this surgery. Many people are in the hospital for days. Many are on huge doses of painkillers for a week or longer. Me, I got out of the hospital the next day, and my use of painkillers even now is judicious. I pop ’em when I really need ’em. And that’s not so much.
Right now, Beth has taken off work to be with me for the week, and her care has been both amazing and appreciated. I will be off work until the August 28, which is my followup appointment with Dr. Kang. My hugest worry now is that I do nothing that will hinder the bone grafting to the vertebrae, and fusing as it should. I do not want them to have to go back in. I am wearing the collar as they required. I am walking every day. I’m taking all prescriptions as directed, and behaving as much as possible.
Already I feel better. I think the procedure did what it was supposed to, and I am hopeful for a complete recovery. It’s kind of exciting to think of my neck being pain-free for the first time in (twenty? thirty?) years. My range of motion may be somewhat limited nodding up and down, but I couldn’t touch my chest with my chin before the surgery anyhow. I don’t wanna look at my toes, so what’s the big deal with that? I know my scuba season is done for the year, as likely is my motorcycling, but I am hopeful that I will be up and ready to go for next season. I am grateful to all my doctors, and to God for His benevolence. I am grateful to friends and family, for their thoughts, prayers and support. And I cannot tell you how grateful I am to Beth for her attention, hovering, and reminders to behave. She’s the best. Now I just gotta be patient for the next few weeks. And that could be a problem…