Back surgery, v2

This is an update on my back pain saga. I'm posting it here, not because I feel like sharing it with the world, but because it's easier to post somewhere and then send a link to it when someone asks or I need to send an update.

The short version: I have to have more back surgery, which is now scheduled for May 17th. I'm expected to fully recover, but that recovery will take months.

The longer version...

Recovery from the last surgery went well through January, February, and into March. The surgical wound healed down to a nice clean little scar. My back improved. My leg pain slowly decreased. I started training on a bike indoors, and I went to physical therapy, showing excellent progress. I even made it to yoga class. It looked like I had a full, healthy summer coming at me, so I signed up for a couple of cool bike trips and few other things.

Then, in March, while on a business trip to Basel, after a long day of walking around campus and giving talks, I started to feel an old, familiar pain in my lower back and down my leg. It started to hurt a lot, so much that I had no choice but to sit down to recover. It was EXACTLY what I felt last year in May.

Except this time, it was in my LEFT leg. Last year, it was in my right.

"Oh no," I thought. "This isn't happening. It's just in my head."

So, like a male, I ignored it, and it went away.

And then it came back a few days later, after I spent about an hour standing up.

I checked in with my physical therapist. She looked concerned. "That's not supposed to happen."

I called my surgeon, and after a bit of discussion, he sent me to get an MRI.

He called me over a spotty cell connection a few days later when he got the MRI readoutand said "well, you're right, there's a problem. It's complicated. You need to come into the office so we can talk through the situation and your options."

A week or so later, in the office, here's what we learned:

  • The problem is that I have a 'facet joint', a bone in my spine, that is too close to the L4 and L5 vertebrae. Nerves come down the spinal column and then exit the spine via gaps between the facet joint and the vertebrae. The holes in my spinal column at this one facet joint are too narrow. So the bone is rubbing on the nerve, putting pressure on it and causing pain.

  • This is probably more about how I'm built (genetics) than from some accident or posture thing - but we don't know for sure. It wouldn't surprise me to learn it's a combination of the two.

  • This is exactly the spot in my back where I had the disc herniation on the right, and is probably an underlying cause of that herniation.

  • This problem is not like a disc herniation. This is bone on nerve - on both sides. It will not get better over time. It will get worse, and worse, and worse.

  • The only real option is to remove the facet joint and to fuse the L4 and L5 vertebrae which involves removing the disc that's in there and putting some metal rods in my spine. Yay, more metal in my body!

  • As my surgeon said, "this is not a matter of if, it's just a matter of when".

  • The surgery will be more complicated. It will take ~4 hours, and I'll be in the hospital for a few days after. There's some kind of fluid drip thing. A lot of muscles have to be moved around. I'm going to be sore and doped up for quite a while after it, and will have anesthesia fatigue for months.

  • ... and then, after surgical recovery, and then after another 3-4months of rehab, I should be back to physically normal, with all the pain and related symptoms gone.

  • There are risks, there are potential side effects, there may be problems in 10-15 years with other parts of my back that will have to do a bit more bending to make up for the L4/L5...

  • ... and there is no choice.

Michele and I debated when to do it. I can still walk for about an hour at a time, I can ride my bike for about 90 minutes, and most of life (e.g. sleeping, sitting, drinking coffee) is pain free. So it's not quite a rush to have the surgery done. But at the same time, I can't go on day hikes, I can't give a talk at work without sitting on something, I can't go on long bike rides... and it seems to be getting worse quickly.

So, rather than delay it through the summer, in hopes that I can do those awesome bike rides I had planned, and just plain old enjoy the summer, it seems best to do it as soon as possible and start recovery right away.

My surgeon agreed and was able to open up some time in May (it had been looking like August would be the first chance.)

At this point, I'm trying not to be depressed about losing another summer of being active, hanging with friends on adventures, and exploring places with my kids. It sucks, but it is what it is. And it could be a lot worse.

Theoretically, the fitter I am before surgery, the faster I will recover. I've got two weeks to keep hitting the gym, to ride hard, and to chow down on my power greens. But I gotta say, drowning myself in mac & cheese, chocolate chip cookies and a couple of deep Netflix binges is awfully tempting.