Thursday, February 28, 2008

Follow-ups

All further follow-ups at:

http://adrsupport.org/eve/forums/a/tpc/f/3511036081/m/4321030303

I'd be glad to answer any questions for folks who are considering this surgery.

Tuesday, February 26, 2008

Post-flight update

Well, I really turned a corner on Sunday. No pain whatsover, and only some stiffness (and decreasing at that) upon prolonged sitting.

A very long day yesterday. I raced down to the Marienplatz in a cab at 8 AM to get Mateo his German National Team "away" soccer jersey. It is a pretty cool red and black one. Then it was off to the airport at 10:30.

First, our leg on British Airways to London had somehow been cancelled, but the agent just put us on the flight - said this happened with American all the time. I made sure that we were to have wheelchairs waiting there, but alas there were none, so we had to hoof it over to the American terminal, which is a pretty far walk. I actually welcomed the walk after sitting, but my Mom would have preferred a wheelchair.

After a two-hour layover, we got on the flight to JFK. That was a little over 7 hours. I slept very briefly, and got up and moved around every hour or so. We got into JFK at 7:20 PM, and then had a layover until 10:30 PM, when we took American Eagle (small plane) to Washington, DC. Just a 45 minute flight. It was great to see Danielle and Mateo (who insisted on waiting up) at the airport.

So the entire day was about 22 hours, since we did not actually walk into the house until about midnight (6 AM Munich time). I am glad to be able to report that I had NO PAIN during this trip. Some stiffness from sitting, but no pain. And this after a 22 hour day, dealing with lots of sitting, handling suitcases, etc.

As I write this on Tuesday morning, I have not taken pain meds for about 18 hours and feel fine. No pain, and dramatically decreased stiffness. So, I'm feeling good about everything at this point. I have to remember to take it easy!! Even though I feel great, I will probably just hang out today, and let my body recover.

Sunday, February 24, 2008

Sunday morning update

We´ll be venturing out today, finally. Headed to the Marienplatz. My back is feeling good this morning. Over the last 2-3 days I had been having some pain, with the accompanying pain-avoiding posture. It appeared mostly after sitting for long periods. So, last night, I decided to try to go a 24-hour Alleve regimen - I felt great when I woke up last night, and so far this morning.

I don´t even really notice the incision anymore - pain 99% gone. My left leg is still weaker than my right leg, and my walking stride is not yet quite normal. It is slower, and more shuffling than before - again, very common post-op. All in all, I can´t really complain nine days post-up.

Tomorrow, we have our 16 hour return (including layovers) to Washington. We flew here on frequent flyer miles - in retrospect, paying for a direct flight would have made more sense.

Friday, February 22, 2008

Friday update

Not much to report. Continued back improvement. An hour of physical therapy and hour-long massage (nice). Other than that, just getting through the entire first season of "24", since we lived overseas when that show came out.

Tomorrow we will try to tour Munich. It will be a good mini-test, to see how my back will hold up on the plane Monday. I also have to find the German National Soccer team "away" jersey for Mateo.

Thursday, February 21, 2008

Thursday update


I had my last consultation with Dr. Zeegers today, before our flight home on Monday. That's him in the picture with me. Everything is going well. The weakness in the left leg is much better and hardly noticeable.
I also picked up some pain meds from the pharmacy for the 16-hour (including layovers) flight home, just in case.
Then I had physical therapy. I had been having some difficulty getting up from sitting, but today's therapist showed my some spine/pelvic rolling exercises, right at the end of our session, which helped immensely. I wish they had shown me the first day. After doing them I stood right up as if my back was normal. Amazing.

Wednesday, February 20, 2008

Wednesday update

The back was still feeling not too great this morning, but my physical therapy session, where a broad-shouldered, blonde German fraulein did a fair amount of muscle work on my left side lower back and hip really helped a lot. Felt better immediately after. Feeling much better this afternoon and evening, no pain-killer needed at all. Will have the same tomorrow, along with a follow-up appointment with Dr. Zeegers.

Hoping to see the sights this weekend if things improve.

Ah, one word of caution. If you are using frequent flyer miles to come here on American, you cannot upgrade to Business for the 25,000 miles plus $300, as you normally can when you pay for the original ticket. So, hopefully the gate agents take mercy on a guy with a back brace and his 77 year-old mother, both in wheelchairs!

Tuesday, February 19, 2008

Tuesday update

Felt very good this morning. Then I was running around getting the bills paid before we left the hospital, and had very light physical therapy in the early afternoon. The back began to act up a bit later on in the afternoon and early evening, so I did have to break into the Oxycontin. Not the old pain, though, so no worries. Will be taking it a little easier tomorrow.

Monday, February 18, 2008

Monday update

All is well. I had the first post-op x-ray today, and everything is where it should be.

Pain continues to be minimal. I had some left leg weakness in the first couple days after surgery, but that is getting better. There is a very small amount of left heel pain - normal.

The best thing is that my "pain avoiding posture to the left", which I have essentially had most of the time for years, is gone. I look like a normal person with a straight torso again!

Tomorrow I start physical therapy and will be discharged to the hotel.

Sunday, February 17, 2008

Sunday update

Mom and I walked upstairs with Dr. Blome to get a look at my veins with the sonogram. We have to make sure there is no thrombosis. I am wearing special stockings to prevent the same, thus receiving the added bonus of getting in touch with my female side! All blood is flowing as normal.

The incision continues to hurt less and less. I have taken a couple of mild pain-killers, but nothing too serious. Walking is fine. The left leg is a little weak for some reason, but that is not outside of the norm, with the body getting used to a normal alignment and new hardware.

On tap tonight: the last two parts of Band of Brothers.

Saturday, February 16, 2008

Saturday update

All is well. I have been walking around the halls every couple hours or so. No sign of the old back pain. Just a very little incision pain, but not enough for painkillers.

Dr. Blome, who did the initial check-up on Thursday came riding into my room on his scooter to check up on me.

I got the Skype up and running, and called a couple people. Watching Band of Brothers on DVD right now. If you are coming, and bring DVDs from the U.S. be sure to bring a personal DVD player, because the ones they have here do not work with U.S. DVDs.

Friday, February 15, 2008

Post-op

I am almost ten hours post-op. All went well. Dr. Zeegers is pleased. He showed me the films, which look good. The discs he took out were "worn out".

I have some numbness in my left hand - not sure what that is about. The old back twinges are gone. Incision hurts a bit, but not too bad. Haven't had to ask for any pain meds. Can get up on my own and walk to the bathroom. Haven't ventured into the hall yet.

Sorry, this isn't a great literary effort, but I am still pretty wiped out.

Thanks for all the good wishes!

Thursday, February 14, 2008

Flights and Pre-op update

We had quite the odyssey getting here, but it was not all bad. Due to some weather in JFK, we were delayed getting there, and just barely missed our 7 PM connection to London at JFK. It was snowing at JFK. So, I left Mom at the gate for the 9 PM flight, and went out to the American desk, to find a long line of folks. Finally got through that, and the agent told me they were sold out. I asked him to check business, and voila, there were seats. So we did the trans-atlantic in business, which was wonderful. We took off a couple of hours late in JFK due to de-icing, so missed the connection to Munich in London. And the next flight was cancelled. And the next flight was delayed. You get the idea. We finally got to the hotel in Munich around 7PM.

The Holiday Inn is fine, and a relative bargain at 120 euros. A little further from the Alpha Klinik than the Sheraton, but easily walkable, unless one were really disabled.

Germany, at least the few parts I have seen, is quite nice. Clean, well-maintained roads, very polite people. We passed the Bayern Munich Stadium coming from the airport. A huge red lit-up stadium.

We spent about 4.5 hours at the Alpha Klinik. Everything was first-class. Dr. Zeegers spent about 1.5 hours with us reviewing everything. I had to get a new MRI, because there was a problem reading the CD, which apparently happens all the time with people coming from the U.S. So bring the physical films if you are coming here. They also did a sonogram of all my insides, and an EKG. Doc says all looks good, and I should live to 200!

The good news is that I only need two levels done. The other good news was that we did not need another discography to determine this! Dr. Zeegers confirmed that my facet joints look good.

So, the surgery will be tomorrow at 7:30 AM. I will perhaps post tomorrow night, if I am not too doped up on pain meds. Wireless internet in the Klinik!

Tuesday, February 12, 2008

Sunday, February 10, 2008

Off to Germany on Tuesday for ADR

This blog will chronicle my trip to Germany to get artificial disc replacement (ADR). It is intended to inform those who may be considering the procedure, and to keep my family and friends apprised of my situation.

My tale of woe:

The Early Years
I first threw back out in 1986 at 21 years old leaning over brushing my teeth. Lower back spasms with no sciatica. I recovered in a few days. I similarly threw my back out again in 1988, 1991, and 1993.

Chronic
Chronic episodic pain began in 1993. An MRI in 1994 showed early disc degeneration. I quit playing basketball in 1994. The pain gradually worsened through. I didn't do myself any favors by continuing to play tennis through all this - twisting and bending were the two things that most exacerbated the pain.

In December 1999 I had a positive three-level discography at L2-3, L3-L4, L4-L5. If you ever have discography, make sure you get enough pain drugs. I didn't for some reason and it felt like medieval torture.

Here is a description of the procedure:

"A needle is inserted into the disc and a contrast dye is injected. This extra fluid in the disc increases the pressure in the disc. Patients with an injured disc may then experience pain that can mimic the pain they have been experiencing. The intensity of the pain is recorded on a 0-10 scale. Based upon this information, the diagnosis of a particular disc injury can be made. The doctor can then determine what the optimal treatment options are for relief of the underlying pain."

One is supposed to be able to tell the doctor if it hurts during the procedure, but not remember it afterwards. I still remember it like it was yesterday, despite telling the doctor to give me the maximum dosage!

The CT scan and MRI at the time showed tears and bulges/slight herniations in the discs, along with degeneration. I was offered a three-level fusion, but rejected it, having heard too many horror stories about the results of lumbar fusions. I did quit tennis that year.

More Recently
In this decade I have mostly been able to just run, bike and do a little weightlifting. The chronic moderate pain has continued with occasional major flare-ups. The list of failed treatments includes physical therapy, massage, yoga, acupuncture and chiropractic.

I have been waiting a long time for artificial disc technology to develope, since having first heard about it about ten years ago. The Germans pioneered Artificial Disc Surgery in the '80s, and are the acknowledged world leaders in the procedure.

I am biting the bullet and having surgery with Dr. Willem Zeegers of the Alpha Klinik in Munich, Germany on February 15th, 2008. It will be either two or three artificial discs - the new discography, on 2/14, will guide us. I am still in decent condition, and am hoping to live an active, athletic, pain-free life soon!

At this point, you may be asking: "Why not have ADR in the good ol' USA"? I would love to have ADR here, but the FDA only just approved single-level ADR in the U.S. in 2005. There is no time table for approving multiple-level ADR, although clinical trials are underway. It is possible to apply to get into a clinical trial, but I opted to go with a surgeon who has done over 1700 procedures rather than be the guinea pig for surgeons whose major experience (and comparatively small at that) has been one-level procedures.

Escorting me on this adventure will be my mother, Arden. We lived in Germany for a couple years from 1969 to 1971, so it will be fun for her to get back there. We leave on 2/12, flying through London, and arriving in Munich at noon on 2/13.