over the past 6 months I have had worsening neurological symptoms (drop foot, altered gait, poor balance, etc.) which I attributed to a possible herniaated disc or rupture at L5. I had been treated for a ruptured disc at the same level 6 yers ago with some of the same symptoms, most notably the dropped foot. I was not overly worried though, as the pain was far less severe, although the gait and balance issues were far more pronounced. I work in sales with healthcare professionals, many of whom treat the specific spine issues I have (degenerative disc disease, spinal stenosis, arthritis, and previous fusion at C4-C6 10 years ago). Despite having significant knowledge regarding my disease state and working with providers on a daily basis, I kicked the can down the road for several months before discussing it with a neurologist over coffee about 3 weeks ago. Given my symptoms and history, he sent me to a common friend and colleague who specializes in pain management (the spine surgeon who had performed my previous surgery and lumbar injections was no longer practicing). As expected, an MRI was performed of my entire spine, and sure enough, L5 was an issue. Unfortunately, it became immediately clear that it was a minor concern relative to the other findings in my MRI report. 2 days later when I arrived to schedule my appointment, the doctor - a man I’ve known professionally and socially for 16 years (our daughters play volleyball for rival club teams so we see each other virtually every other weekend between January and May) - sees me at the front desk and immediately ushers me back into his office. I could tell something was very wrong by the look on his face and his demeanor. The first words out of his mouth were “I’m surprised you’re walking...” With that he started going over the report and the imaging, at which point my knowledge and professional experience (I’ve looked at images and worked in pain management for 2 decades) kicked in and I realized that this train wreck wasn’t in a textbook or a power point presentation at some medical conference, but it was MY SPINE. And it was about as bad as I’d ever seen in an ambulatory patient. While multiple levels will require attention at some point, the most critical is the failure of my prior fusion at C4-C6 accompanied by the impingement of the adjacent disc and spurs at C7, which have compressed and flattened the cord to the right of the midline. Severe stenosis with cord myelomalacia and atrophy are noted in the report, and the image is truly frightening, knowing the impact of damage to my cord at this level. In addition, my spine is impinged and compressed at several other levels, most notably at T11-12 and L5-S1, which will most likely require surgical intervention as well, but the initial impression from my pain doctor, as well as the physiatrist I followed up with for a disability pre-op assessment, is the the cervical issue is the most dire.
Coincidentally, the PA for the physiatrist made the same comment as my friend (the pain doc) upon entering the exam room (“I’m surprised you’re walking”...). I think I’m beginning to notice a pattern. The concern of the physiatrist was that my surgical consult was too far out given what he felt was the urgency of my condition, and a call from my pain doc (and a text of a cervical image) helped move up my consult by nearly a month. I have an EMG coming up (unpleasant but necessary) and hopefully after the consult I will have a much clearer view of the timeline I’m looking at for my procedure, recovery, and unfortunately, follow-on procedures to decompress my spine and maintain as much function as possible. My goals are to (1) maintain my ability to walk - preferably unassisted-and use my arms, (2) to provide for my wife and two teenage children (thankfully I have good health and disability insurance), and (3) continue working as long as I can without jeopardizing my health. I travel extensively in my present role, and while that may have to change, I still want to have a purpose and a reason to get out of bed each day. I will turn 56 in a few weeks, and I have worked my entire life, starting out as a paperboy at 11 and working my way through high school and college with a 6 year stint on active duty in the military prior to joining my current employer nearly 30 years ago. I want to go on with the life I had planned but I am scared to death that I might not achieve all - or even any - of the goals I listed. At the moment I feel extremely vulnerable, knowing one bad fall or a simple rear-end accident out in my sales territory could result in quadriplegia. And even when I get to the OR, I know my case will be fairly complex given the existing hardware from my prior fusion and the general worsening condition of my cervical spine. I know this recovery and rehab will be far longer and difficult (being 10 years older doesn’t help either), but knowing I will be undergoing further procedures is undoubtedly going to weigh on my mind and I can’t help but wonder if I’ll ever get cleared to come back to work, and if so at what capacity? Will they even keep me on the payroll or just keep me on long-term disability? I have had a conversation with the corporate ombudsman (confidential resource for colleagues) but will need to have another prior to speaking with HR about my status as I initiate short-term disability (when I go under the knife).
It is so much to get my head around. While I’ve had spine issues and sought treatment for the better part of 2 decades, I never envisioned it being this bad at my age. I had big dreams and plans of an active and financially secure retirement, and now I just don’t know. I have always been a working man, a provider, a leader, and the rock that my family depends on. I don’t want to be a burden and I don’t want to be pitied. I just want my life to resemble what I’ve been working 40+ years to achieve, and I’m scared to death that it is all about to slip through my fingers. I don’t know, maybe I am over reacting. Maybe it will all work out, my surgeries and rehab will go well, and the health and disability insurers will pay out my claims. But it’s this foreboding sense of doom and the sense that I have little to no control over what is about to transpire that just grips me with fear. I was in combat in the military as a young man and yet I was never this scared. I know no one can assure me that it’ll be alright, but if anyone has had a history of multiple procedures on their spine with successful outcomes, I could sure use the pep talk right now. I’m not looking to do adventure sports or dance like John Travolta (circa 1977), I just want to walk my daughter down the aisle some day, to walk up and congratulate my son when he graduates college, to slow dance with my wife on our anniversary, to finish my career on my terms and have some healthy years in retirement. I know my case is specific to me, but has anyone come out the other side of something like this “whole”? Anybody?