Friday, December 5, 2008

well, good news with the back doctor

When you've had back problems for as long as I have, it's just nice to know what is going on sometimes and that something can be done and that you are not crazy in the head or making things up.

I saw my back doctor today. His name is James Reynolds, and he's part of a group that does nothing but state-of-the-art spine stuff. Period. He's been my doctor since eight months after my on-the-job injury at the Soledad Prison. It took me that long to get to him because I was trying to stay local (a big mistake if you are living in a rural area and there are no hotshot doctors who care about publishing and teaching other doctors about the complexities of the spine), but had been released to return to work when I couldn't stand up straight or barely walk.

You see, my diagnostic tests were "normal" in the local doctor's mind. I did not have a big nasty herniated disc that would explain the severity of my symptoms. So, no disc herniation = no problem, and my inability to do anything was malingering. I was referred to the prison's "official" comp doctor who immediately referred me to Spinecare, two hours north of where I lived.

Spinecare's head doctor, Dr. White, had recently operated on the SF 49er's Joe Montana. We know how well that one went. The doctor I was assigned had assisted Dr. White with Joe's surgery, so I knew I was in good hands.

Right off the bat Dr. Reynolds knew why my back hurt. I had dessicated discs, and they were leaking disc fluid onto my nerves. So rather than the pain being due to compression it was due to a chemical reaction. As part of one special but very painful x-ray procedure, I could clearly see what he meant by dessicated—the disc itself looked as if it had been scratched by a cat.

Two months after I found this doctor, I had my first surgery, a two-level laminectomy, which worked beautifully. But I messed it up two years later cleaning horse poo out of a stall. I then had a two-level fusion, fused front and back (nasty surgery!) and then 18 months later, had the hardware removed (a normal thing for that kind of surgery).

So I have had a good 16 years that I wouldn't have had if I hadn't found a doctor willing to think somewhat outside what was then the conventional way of thinking.

So what's wrong with me? Normal for someone who has been fused where I am. The vertebra immediately above the fused area (I'm fused at L4-5 and L5-S1) are not designed to bear the load they now must deal with because the area below is one big fused bunch of bone. So last year I had only one level that was problematic, at L3-4, on the right side. Now I'm at two levels, L3-4 and L2-3, and both sides. But because I had great results last year, there will be no need for diagnostic blocks; they will be able to go right to the offending areas and electrocute the offending nerve. The procedure is called a median branch neurotomy or rhizotomy. It doesn't hurt to have it done; the doctors give conscious sedation medication and not only do I not remember the procedure, it doesn't hurt at the time. It does hurt for about a week, then I am good to go again.

The doctor told me I can have this procedure done as often as I need, and now that I have an established pattern, I can expect about 11 1/2 months of a decent functioning back. And I guess the best thing is I never see a bill! Worker's comp is a pain, but I suppose one could argue I am lucky in that I was hurt when I was, under the old law. I have fewer games I need to play, but worker's comp doesn't move quickly on back procedures anymore.

I sure hope this can be done by Christmas. I want my life back!


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