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 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.

1 comment:

mikezoe said...

I wish you all the very best for a successful operation and will be following your experience with great interest (as you know). For others I have very similar lumbar issues as Kirk and am fearful of needing to trigger a similar trip to Germany in the next few months.
Kirk, please (assuming you are feeling well enough to do so) comment on anything (about the adventure) you would have done differently so those of us following you may learn from your experience. Good luck!!