My emergency back surgery was ten years ago today, on September 20th, 2007. I've told parts of the story before, but it seems appropriate to gather my recollections in one place.
I'm not sure precisely when my back pain began. My feet, ankles, and lower back have always been kinda fragile. I hurt my right heel when I was ten or eleven, when I made the bright decision to leap off the scoreboard at Syracuse's MacArthur Stadium. Foot, meet ground. Ground, foot. Persistent bursitis in both ankles has dogged me since I was in my late twenties, and I occasionally pulled my back while carrying things at work, from at least the late '80s on. These were all, I guess, part of the patchwork genesis of things going wrong. I've also tended to weigh too much throughout most of my life, and that certainly didn't help anything other than my ability to tackle opponents in backyard football games in the early '70s.
I was in a couple of car accidents in that first decade of the 21st century. I wasn't injured in either of them, but my wife Brenda wondered if they were a factor in weakening my joints. I don't know. The 2006 collision totaled my car--my own stupid fault--so I suppose it's possible, though I don't recall any real discomfort at the time.
The spring and summer of 2007 offered some specific physical gotchas. I fell right outside the door of my bank, just misstepped and went down hard. I walked with a limp for weeks thereafter. Helping to clear some brush in the woods behind Brenda's school, I got cut by the weeds and wound up falling again. Attempting to clear rocks from the garden in front of my picture window at home, I heaved the stones with perhaps a bit less care than would have been prudent. Trying to help Brenda paint the front of the house, I stretched and bent more than I should have. And working out at the gym one day--no, honest, I was!--I was positioned wrong with too much weight and too little technique, and I felt a distinct ping in my lower back, a place one would prefer not ping at all. It ached there for at least a few days, and then subsided for the time being.
But Brenda's health was really a bigger concern that summer. She developed pronounced lower back pain, a persistent ache of frightening intensity. It was diagnosed as spinal stenosis, and surgery was discussed. Her doctor put her on a regimen of physical therapy instead. It was scary, but the PT seemed to help. We drove with our daughter Meghan to Maryland for a cousin's bat mitzvah in August, and Brenda battled her discomfort as best she could. Stairs were tough, but she managed somehow, and the physical therapy gradually alleviated her pain. It felt like we'd dodged a freaking bullet.
I didn't take the bullet. It just found me anyway.
I'm not sure of the precise date, but it was in late August, probably a Monday morning. I was getting ready for work, making the bed, and as I bent to tuck in the sheets, pain shot through my lower back again. It was the same spot that had ached a few weeks or whatever before, when I'd screwed up my exercise at the gym, but now it hurt much more than it had then. I struggled to finish making the bed, swallowed some Advil, and hobbled off to work. As the pain continued over the next day or two, transitions in and out of the car proved increasingly troublesome, nor was I really comfortable even just sitting. Yeah, I was ready to go to the doctor.
But my doctor wasn't ready for me. I had a very popular doctor who tended to overbook, and it was just impossible to get in to see him, my pain be damned. I wound up being seen by a nurse practitioner instead. She figured it was a pulled muscle. Try some painkillers. Now, get outta here, ya big lug! Go feel better!
The painkillers were nearly as effective as Certs Breath Mints, just without the fresh and tingly taste. Back to the nurse practitioner. Stronger painkiller prescription. Same lack of relief.
I didn't want to be the wimp I clearly was. I tried to go about my business. The discomfort was persistent, but not debilitating. I could manage, albeit with some difficulty. On September 2nd, Brenda, Meghan, and I went to the New York State Fair for a day of fun and family time, culminating in a live concert by the American Idol Top 10 finalists. Meghan's music teacher was also playing at the Fairgrounds with his Civil War appreciation group, so we made a point of catching that performance, too. Wandering the midway, an unknown guy--presumably the disgruntled boyfriend of some inattentive, underappreciative soon-to-be-ex-girlfriend--shoved a huge, ersatz Winnie the Pooh stuffed bear into Meghan's hands and said Here! before scurrying away. I named the bear Herbert and hobbled off to our car to store him before the beginning of the Idol show.
My hipness cred is non-existent, so I can freely admit that the American Idol concert was enjoyable, headlined by our favorite contestant Jordin Sparks, but highlighted by a mini-set of the male Idols playing as a self-contained rock 'n' roll combo. It reminded me of The Monkees, the classic case of a manufactured group transcending its origin, especially when tambourine-shakin' Idol Sanjaya Malaker warbled "You Really Got Me," channeling some unique vision of Davy Jones sings The Kinks. It was a good show. It would have been a better show if I hadn't needed to continuously shift in my luxurious folding chair, trying to achieve some acceptable level of comfort.
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| Hey, hey, I'm an Idol! |
That discomfort I'd been feeling the past few weeks? That mere ache I'd mislabeled as pain? That was nothing. This was pain. My mind flooded with panic, partially crowded out by just how much my back hurt. I crawled upstairs, hoping I would feel better in the morning.
I did not feel better in the morning.
I was alone in the house. Meghan was at school. Brenda was at work. I called in sick to work, and I called my doctor's office. He couldn't see me. Fuck him, then. Get me a doctor. Any doctor. NOW!! I made an appointment, and lurched to get ready. It hurt so goddamned much.
It still didn't occur to me to call an ambulance. I got into my little Ford Focus--the most painful transition yet--and piloted it in the direction of the medical center. The brakes didn't seem to be working all that well--man, it just rains and pours, dunnit? I struggled to get the car to do what I wanted it to do, and I made it to the office suite of my new doctor.
I sat in the waiting room. I couldn't hold it in. I started weeping, whimpering--I couldn't help it. I felt so embarrassed, and I tried to contain it. But it hurt. It hurt. My God, it hurt. I wasn't trying to draw attention to myself--I would have preferred to just fade away and disappear entirely--but I couldn't prevent the sobs and low moans that escaped me. I wanted to be stronger, better. I failed.
What happened next remains a blur. I met my new doctor. An attempt at immediate pain relief was ineffectual. He wrote me a significantly stronger prescription, and possibly suggested an MRI. I don't remember how immediate the prospect of the MRI was, but I do recall it needed to be scheduled and that he wanted to manage my pain first. I thanked him, and crawled off to my car. The Painmobile. Damned brakes still weren't working like they oughtta. It wasn't until much later that I realized I'd lost most (if not all) feeling in my right foot. The brakes weren't working because my foot had no power to operate them properly.
Got the car to the pharmacy. The pharmacist, bless 'im, tried to comfort me as I waited for the prescription to be filled. I was miserable, but grateful. I made it home. The new prescription took some of the edge off. It did not eliminate the pain entirely.
The next week and a half was a cascade of pain and attempts to conquer it. Getting into or out of a car was pure torture, even as a passenger, which was all I was going to be for the foreseeable future. Going to work was out of the question. I spent most of my time on the floor at home--getting into bed was too much effort--doing nothing. I didn't feel like reading. I didn't feel like watching TV. I didn't feel like a human being. I didn't feel hope.
Brenda tried to keep her cheer around me, while no doubt scared out of her mind as well. She tried to maintain normalcy. She went to work. Meghan went to school, and to her swim practices. They brought me a delicious steak sandwich and a sweet treat from the Italian Festival in Syracuse. Brenda took me to doctor's appointments. I used a walker to assist myself, but damn it, car rides were such an ordeal. My claustrophobia prompted me to insist on an open MRI, unnecessarily delaying that process by several days, days I couldn't spare. I was stupid, and I paid the price for that stupidity.
On the afternoon of September 20th, Brenda and I went to my doctor's office to review the results of my MRI. I've often joked about this meeting, claiming that the doctor said, Well, let's have a look at your...OH MY SWEET LORD JESUS!! In fact, his face was grave, almost ashen, his tone subdued. He told us that I needed to speak with a surgeon immediately. We had already waited too long.
A surgeon named Nolan had an office down the hall, and he was expecting us. Nolan was direct: Cauda equina syndrome. Sounds like a sci-fi film, or a horse disease. In my case, it meant a herniated disc intruding upon my spinal cord. My pain, the numbness of my right foot, the other symptoms either ignored or glossed over--cauda equina syndrome was the root of it all.
This is an emergency, Dr. Nolan said calmly and firmly. He directed Brenda to take me to the ER at St. Joseph's Hospital in Syracuse immediately; he would perform the surgery that night. With the fear welling up inside me, I asked him if the damage to my body would be permanent. He paused for a half second, and said that the surgery should have been done a week ago. He tried not to be harsh, but there was no way to cushion the effect of what he said: The damage may indeed be permanent.
Brenda got me to the ER, somehow containing her own panic, determined to be reassuring, comforting. I believe I tried to put on a smiley face of my own. Once I was admitted, there was nothing more that Brenda could do. Meghan's first swim meet was that night. Go! I said. I'll be okay. I love you. We wanted to preserve that illusion of normalcy for at least a few more hours. Reluctantly, she went off to the swim meet.
In the ER, my sheer terror finally triumphed over my own feeble attempt to stiffen the ol' upper lip. I was so scared, irrational, inconsolable. I didn't want Brenda or Meghan or anyone to see me like that. A nurse tried her damnedest to keep me calm, reassuring me, telling me I was going to be all right. But one thought kept racing through my horrified mind: Who's going to take care of my girls? Who's going to take care of my girls...?!
Meanwhile, Brenda arrived late to Meghan's swim meet. Meghan was puzzled by her characteristically punctual mother's tardiness, but didn't learn what had happened until after the meet. She was pissed that we hadn't pulled her from the meet; she felt that she and Brenda should have gone straight to the hospital instead. I still think we did the right thing. The illusion of normalcy.
The surgery went well. While I was still unconscious, Dr. Nolan met with Brenda, and chuckled while telling her it was the largest herniated disc he'd ever seen. After he left her, Brenda sat by herself, crying, wondering what would happen next.
Brenda was with me when I woke up after surgery. It was around midnight, I think. I felt...well, relieved. There was a sense of contentment, hope, growing within me. I love you, Brenda. I smiled. and I meant it. Go home and get some rest. Everything's gonna be fine now.
"Fine" was a bit more elusive than I thought it would be at first. Overnight at the hospital, I found I couldn't sleep, but I was okay with that. I was discharged the following morning (or early afternoon), and commenced with a frustrating series of days and nights in which I tried to re-calibrate myself. It was tough to do. In-home therapy sessions followed, all with the goal of strengthening my body and reversing as much damage as possible. My right foot was nearly useless. I was constipated. I was still in some pain, though nothing like it had been before. The helplessness and hopefulness returned.
I hit bottom on Tuesday, the 25th. Then, magically, I started to feel...possibility. My constipation ended. After a doctor's appointment, Brenda stopped at my workplace to allow me a quick visit with my co-workers (though, to avoid the extra transition, I remained in the car and my comrades came out to the parking lot to see me). Later on, my boss--with whom I'd had an occasionally contentious relationship for years--called me at home to offer additional encouragement. It was the right call at exactly the right time. I allowed myself the balm of hope. This time, the hope stuck around.
PT put me on a regimen of exercises to be repeated three times a day. A couple of these involved me trying to do things with both feet at the same time; the right foot wouldn't respond to my brain's command, but the intent was to put me in the habit of telling my right foot to do what the left foot was doing. And, over time, it started to work. I graduated from my walker to a cane. I went back to the hospital with a blood cot, and was released again the next day. PT continued, both at home and twice a week at a facility in North Syracuse.
I got better. Not all the way better, but better. In late October, Dr. Nolan cleared me to return to work, expressing amazement at the extent of my recovery. I was able to ditch the cane by Thanksgiving. I was able to drive again around that time. I was free.
Writing is a catharsis. I'm not quite so narcissistic that I don't recognize the fact that my tale of woe is neither unique nor even particularly egregious. I have friends who are cancer survivors, another friend who had lung transplants, people who've suffered, people who've died, people who are undergoing their own path through Hell even now, not ten years in the past. Their journeys make mine seem like a pleasant stroll. I apologize if this pause to reflect on my own travails gives anyone the impression that I'm not fully aware of how grateful I should be for my good fortune, or if my reminiscence doesn't reflect that I am grateful. Things could have been much, much worse...but they weren't worse. They were better.
Ten years ago, there was no guarantee I would be able to walk unaided, that I would retain control over my body and its functions, that I could live a life with little worse than occasional discomfort. I could not have transcended that without the will to do so, and I would not have been able to summon that will without the loving support of family and friends, especially Brenda. My right foot is still numb, some days more so than others, but it does its job. Two weeks ago, my lower back flared up with pain again--not with the intensity of a decade ago, but still the worst it had been since then. It was...worrisome. But it was manageable, with regular stretching exercises and occasional Advil, and it abated. My evil nurse practitioner from 2007 may have finally been right about something: I probably just pulled a muscle. See, her diagnosis was just ten years too early.
So Happy Tenth Birthday, back. Howzabout we share a toast with Herbert? He's ten years old now, too.
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| The Kasteel is mine, of course; Herbert's still underage. |
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