Spinal Fusion at L5-S1

Note: This is part 2 out a 3 part series. Click here for part 1.

As I got used to the idea of the surgery, I made one last trip to the Physiatry team at Stanford. A physiatrist is an MD or DO who specializes in nonsurgical treatments for the musculoskeletal system, so I wanted to make sure I wasn’t missing anything. When even they recommended going under the knife, I started interviewing surgeons.

First I saw one of the top orthopedic surgeons at UCSF. His manner was off-putting and he couldn’t guarantee that he would be the one performing the surgery, as UCSF is a teaching hospital. So I went with Dr. John Gray at California Pacific Medical Center. He was warm and took time to explain the process. He reassured me that he works closely with a neurosurgeon throughout the 4–6 hour ordeal.

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I left his office with a date on the calendar 03/03/03. And with that, I began preparing. One of the hardest parts was donating blood. I am not a fan of needles, and I donated once a month for three months in case I needed a blood transfusion, which I thankfully did not. The next hardest part was being off NSAIDs (Non-steroidal Anti-inflammataory Drugs) for 2 months because of their effect on blood clotting. Instead I tried Neurontin, but the side effect of dizziness and general weakness made me hesitant to take it.

As March neared, I was nervous but confident that I made the right decision. I listened daily to a meditation tape of Successful Surgery and Recovery Visualization, which I actually think helped a lot to prepare myself emotionally. My mom moved into my San Francisco apartment, prepared to stay a month to cook and take care of me. My dad stayed home in Portland with my younger brother.

On the morning of 03/03/03, at 5am, my mom and I took a cab even though CPMC was walking distance from my apartment. Unceremoniously I walked into a little cubby and changed into a hospital gown, I climbed onto a bed and waved to my mom as I was wheeled down the hallway, and the next thing I remember is waking up in a hospital bed.

Even before opening my eyes, I knew the familiar nerve pain in my leg was gone. It had been with me constantly since I was 15, when I thought I had a hamstring pull. Just like that, I had four titanium screws and rods connecting those, placed in L5 and S1. The surgery was successful and my recollection of my time at CPMC is all extremely positive, except for all my co-workers seeing me in a hospital gown. I spent the next 3 days lying flat, and one week total in the hospital.

I went home with back brace that prevented bending and twisting. I wore it for 3 months, whenever I wasn’t in bed. I wore slip-on tennis shoes so no need to bend forward to tie laces. And I purchased a brand new Tempurpedic bed.

At first it was a herculean effort to walk to the bathroom. But by the next week I could walk around the apartment. Then down the hallway of the building, and then down the block. The process was slow, but I was grateful to no longer be managing chronic pain. It was a turning point in my life.

Surprisingly, Dr. Gray did not prescribe any physical therapy or rehabilitation. My post-surgery check-ups looked good. The chips of bone they took from my hip to fill in the space where the disc had been was grafting well.

One year after the surgery, as I walked down the street in San Francisco and I saw a sign for a Feldenkrais practitioner. Ah-ha! I remembered having a few sessions years ago back in Portland, and feeling increased flexibility and pain relief. I wondered if they could help me recover further.

Me before

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I was not a happy teenager. My thoughts revolved around back pain. Can I make it through class without standing up? When did I last take Advil? How far will I have to carry my backpack? In high school, those metal seats with the desk attached were my enemies; I wondered if I could make it through a whole class without standing up for a break. Like most people I tried hard to be cool but my main preoccupation was managing pain.

At 15 I began complaining of a pulled hamstring, and when I was still complaining a year later I was taken to an orthopedist, where x-rays revealed Spondylolisthesis in my low back. A fracture in the facet joints had allowed the vertebrae to fall forward, narrowing the nerve canal and causing shooting pain down my right leg.

The surgeon suggested a spinal fusion but I wasn’t in enough pain to fathom that option. I remember him saying, “You’ll know when you need surgery, because you’ll be crawling in here.” Thus began my introduction to every other type of rehabilitation.

My first stop was physical therapy. A stinging electromyography test showed nerve damage in my right foot. Electric stimulation and massage provided no relief for the constant low-level and occasionally shooting nerve pain. Next I tried a series of acupuncture treatments but again, no change.

A physiatrist, who specialized in physical medicine and rehabilitation, had nothing to offer except a referral to a little known specialty with a funny name; Feldenkrais. Surprisingly, I had a few hours of increased flexibility and pain relief after this gentle series of directed movements. But the pain came back quickly and soon I was off to college and still managing chronic pain.

Throughout college I diligently did sit-ups because I heard the key to a strong back is a strong stomach. Despite this effort, the constant nerve pain remained and my back began to ache in the mornings and evenings. I felt unstable and broken in the middle. And over 4 years of playing girls division III tennis in college, the thing that increased most was my Advil intake.

After college I moved to San Francisco and landed my first desk job. 8 hours a day of sitting brought more stiffness and aches. Stiffness while I watched my friends run to catch the bus in the morning and I walked gingerly until my back warmed up. And aches as I left the happy hour early because my back was so tired I could not stay upright a moment longer. I began gentle yoga, which didn’t change my back pain but did increase my flexibility. I enjoyed the grounding, calming effect, but if I missed a few days I lost the flexibility I had gained. When I finally got into Feldenkrais again later, I gained the flexibility and didn’t lose it. But more about that later.

Over time, managing pain became larger than the pain itself. It affected my habits in thinking, my emotions, and my experience of life. For 8 years managing pain framed my entire life experience. By the time I was 23 I felt like I was 80. As the aches and pain increased, the surgeon’s warning from years ago came back to me. I was ready to crawl.

The narrow focus of pain

Last week my 10+ year old, recently adopted chihuahua, Gina, was diagnosed with severe degenerative disc disease and was having a hard time walking. Maybe it was sympathy pain, but my back started to hurt too! It felt like I pulled a muscle in the right mid back. My breathing got more shallow, I was less comfortable in bed, I took ibuprofen regularly, I felt stiff, and my mood darkened as the pain grabbed my attention.

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The strange part is that this is felt new to me. 15 years ago this was my life, every day, for 8 years. I remember feeling 80 years old, stiff in the mornings, unable to run to catch a bus with my friends, unable to stay out in the evenings with friends, falling into bed because I could not stay upright one more moment. But ever since my spinal fusion on 03/03/03 > Feldenkrais Training > Anat Baniel Method training, I have felt better and better all the time, just like the Beatles song. :)

My re-introduction to this once familiar feeling has got me thinking back on my journey with chronic pain. So I’m going to share my story, in hopes that might be useful to you. And FYI, my dog is feeling better on pain meds and a round of steroids. Hopefully she won’t need surgery, like her mom.

Super-Intensives for kids!

I am teaming up with Kathy Sean-Jones and Phoebe Macrae to create ABM Northwest, a collective of experienced Portland ABM Practitioners that offer Super-Intensives for children with special needs. 

These three day intensives include 9 NeuroMovement sessions for your child (3 per day), plus three parent education segments (1 per day) to maximize your child's benefit.

Email me at joanna@neurobodyworks.com to register. Our upcoming Super-Intensive dates are:

  • September 27-29    (2 spots left!)
  • October 25-27
  • November 8-10

 

New Location!

NeuroBodyWorks has moved to 2301 NW Thurman Street. We are in the same NW neighborhood, actually closer to shops and restaurants, but our new location has a client parking lot. We are very excited to relieve the stress of looking for a spot in a crowded neighborhood. We are now located on Thurman at NW 23rd, close to the freeway entrance, and steps away from the French bakery. 

During your appointment, you are welcome to park in any spot labeled "Executive Office Suite Customers." Looking forward to seeing you soon in our new office.

 

Variation rules!

Researchers at Johns Hopkins are discovering what Anat and Moshe realized long ago; that variation is a key to learning. They even noted that the variation has to be very close to what you're already doing, just like Anat calls, "differentiating around the edges." In the end, they even recognize the "strong implications for rehabilitation," something we already make great use of.

http://www.fastcoexist.com/3056223/the-secret-to-learning-new-skills-twice-as-fast

What we found is if you practice a slightly modified version of a task you want to master, you actually learn more and faster than if you just keep practicing the exact same thing multiple times in a row.
— Pablo Celnik, Johns Hopkins

Next Group Class Series

I have had many inquiries regarding my next Group Class Series. I am planning the next one for Summer 2016, though the dates and location are still TBD. While the last space was cozy, I am looking into a more suitable space. Let me know if you'd like to be added to my email newsletter list, so you can be informed when the Group Class Series is scheduled.

Thanks!
Joanna