Question of the Month
March 2014
Five and a half weeks after surgery I shot this image of a black bear at a den, amazingly close to a road within 1.5 miles of our house. Thankfully, Mary set me up with the heavy lens, but I was on my feet and on site for about 6 hours. I am not superman.
Back Surgery?
What does that have to do with Photography?
Less than 4 weeks ago I had back surgery, mainly for stenosis, which is a constriction of the nerve canal passing through the vertebrae, the spinal cord going through the background. Rarely, if ever, do I post anything personal on our web site -- devoting this space to photography, natural history, or conservation. However, with an ageing population of my friends and colleagues, my experience might be faced by others as well, and I hope this posting will dispel some misgivings. So, if back surgery may be in your future, or in that of someone you know, you may wish to read on.
Before you read on, let me stress that if you are considering back surgery in the future (and mine went great!) and would like to talk to someone who has gone through this, and who might be able to answer some of your questions or help in what can be a scary decision, call me and I'll be happy to help.
My symptoms began about six years ago when I began to experience numbness in my legs and aches in my hamstrings, and occasional real numbness in my feet. Until then, I felt like a really well oiled machine, so this sudden change bothered me immensely, hurt, and worried me enough that I went to a doctor.
An MRI confirmed that I had severe stenosis, a narrowing of the nerve canal below the actual spinal cord but in the area where individual nerve bundles lead to the legs, bladder, bowels, and who knows where else. It looked like the canal went from a dime-sized opening to a pencil lead-sized opening, a severe hour glass constriction. The tech guy who reviewed the MRI was pretty negative about what he was seeing.
When I spoke to the first of three surgeons I interviewed, I asked what all this meant, and if, and when, I'd need surgery. I was told I might never need it, or I might need it tomorrow, depending upon what pain might develop or whether or not I could walk. A sure sign, he said, was if I had to stop and rest after short walks, because of pain or weakness in my legs. I interviewed another surgeon, at a larger hospital, and his unsettling answer when I asked him about surgery was something like 'Well, it will be a life-changing experience." As scary as that answer was, I never got a satisfactory clarification on that statement, so I didn't have a great of confidence here. We had experience with the third surgeon, who had performed a cervical disk replacement on Mary's neck, as part of a clinical trial that eventually led to FDA approval for the procedure. This surgeon was almost dismissive in his beaming confidence, and expressed virtually no doubt that I'd be as good as new. Obviously, that's the kind of words I wanted to hear, and that's the surgeon I went with.
That decision was over two years ago, and in the interim Mary and I hiked the mountains and ridges of the Himalayas for snow leopards, the foothills of Chile for pumas, the volcano slopes of Rwanda for mountain gorillas, and much more. During that time I'd have some back pain, and occasional leg or foot numbness, and I could
usually relieve the numbness by leaning forward, and this reduced pressure on the spine and the numbness disappeared.
I could live with that situation forever, but in April of 2013 I had two almost back-to-back bouts with sciatica, with the second feeling as if I'd just been speared by a Maasai. I almost fainted, and I wondered if I'd be able to pick myself up and move from the rock pile I tumbled in to. Worried that this my start happening more often, especially if we'd be on a trip, I visited our surgeon and scheduled the operation for about 8 months later.
Afterwards, except for some numbness, I had almost no further symptoms and I was, except for the numbness which was increasing when I walked on hard surfaces or stood still for a period of time, almost normal. So as the time to surgery neared, I was beginning to have second thoughts. Did I need the surgery now?
The MRI didn't lie, however, and I knew surgery was practically inevitable. I had scheduled time off for this, and quite honestly, I was worried that with the 'affordable health act' that in putting this off I might later find myself on a waiting list, or without insurance, or who know's what. My doctor friends almost universally agreed on this.
The Surgery and Recovery
The surgery went well, and I had surprisingly little pain, although I always lied and rated my pain (0-10) at a higher level to keep my pain medication going, as I was told to keep ahead of the pain. I had to lie on my back for two full days, although some surgeries patients are up and walking a bit the day after surgery. On the third day, when I was to sit up and walk a short distance to a chair, leaving the bed for the first time, I almost fainted, and my heart went into an atrial fibrillation.
My PT girls, and the nurses, went into a bit of a panic as I knew little about A-fib, which they said could result in my heart just getting tired and stop beating, or not clearing the chambers and causing a blood clot that could cause a stroke or heart attack. This seemed serious! My dad died of a stroke/heart attack at 63, so we had some family history here, which doubly concerned the hospital folks.
I was moved from the recovery floor for back operations to a cardiac monitoring floor, which was, to me, like becoming a part of Dan Brown's book 'Inferno' where Dante' describes the various levels of hell. I'd been 'in heaven' before, with great nurses and staff, and extremely attentive care, and I was now on a floor where, by the end of two days, I felt I was in hell. This was all
based upon the attitude of the staff, where some, I felt, considered it an enormous effort to straighten out a 'sweat pad' that would crinkle beneath my back, driving me crazy with discomfort. I could relate several anecdotes here, but it's all whining stuff now so let's just say I was more than ecstatic to return to the back recovery floor later.
The Catheter
Since I couldn't get out of bed, I had a catheter inserted for urinating, and early on, I scratched and bumped the tube, and worried that I dislodged the darn thing. Later, I learned that this is almost impossible to do, since the device is held in place by a balloon inside that must be deflated for the tube to be removed. Then my tube twisted a bit, and stopped regular flow, so I was bothered by a constant feeling of having to pee. That's fixed by rotating the tube a bit to get an opening that starting urine flow again, but this happened several times and was annoying.
Most guys probably worry about removing the device when it is no longer needed, and I was, even though folks had told me that it was no big deal. This proved to be true -- just a quick pinch, if I can describe it even as that -- and it was out.
I then worried about having control myself, since the tube had been doing the work. No worries here, instead, the problem was simply going, and I felt like I was waiting for a glacier to melt to start a flow. This lasted for days, even after I left the hospital.
Therapy
I had three big surprises in all of this. One, I never experienced a lot of pain when I was just lying in bed. Discomfort, yes, but I'd lived with back discomfort for five years, so that was barely a consideration. There was some pain when I'd roll on my side to dry or cool off my back after laying on the heat-trapping, moisture-catching pad I was on, but it wasn't too bad. Two, when I did sit up for the first time, I had a lot of pain, as I felt that the weight of my back and shoulders pushed down upon the lower back and I felt as if I had no core strength, or sense of awareness as to how to adjust or keep upright. To alleviate that pain, I would push down on the bed with both arms, trying to support my weight with my arms, and I'd be told to let my back do the work. That hurt, and to get used to the feeling, and to condition myself either to the pain or to strengthen the area (I don't know which!) I'd raise one arm up, supporting myself on the bed with the other, then switch and raise the other arm. Then I'd lift both, so that all my weight would be on my torso.
The first few times I did any of this it hurt, but each time it got a bit easier and less painful. Once the A-fib situation stabilized ten hours later,
I had to remain in bed another day before I had my first PT, when a little PT girl helped me to walk across the length of my hospital room. I emphasize the little, because I worried that if I had another near fainting spell as I did the first time, she'd be too small to keep me up. Fortunately, nothing happened, but I was beat.
The following day I had a second walk, about forty yards in total, at best, and that went easier. I expected a second session but on Sunday's they only did one, so I was worried that I'd have to do two on Monday and not be released to Tuesday, a full week in the hospital. On Monday, everyone knew I wanted out, and provided I passed the PT tests of climbing a stairs, getting into and out of a car (all simulations in the PT room), and other tasks, I'd be released. Frankly, I would have climbed a ladder at that point if I had to prove I could go home! I passed, and was released.
At Home
Remarkably, once home and a bit more confident about my abilities I started walking more, and each day I could really feel my strength returning. For the first few days I spent a lot of time catching up on nature videos, reading, doing some writing, and sleeping, but surprising little of the latter. However, once I really felt strong, and the weather cleared that I could walk outside, starting with a walk of 100 yards or so, followed in the days ahead to 200, 400, etc. until now, just over three weeks later, more than a mile, and 15-20 minute swims, too, I find that the extra exercise eventually catches up with me and I crash some time that day or the next. I'll be watching TV and zonk out for 2 or more hours, waking up like a drugged zombie.
The Results
Before the surgery, the 1.3 mile walk I'm doing now on a macadam road would almost always result in leg pain, numbness, and 'dead,' numb feet. That's gone, and except for a pinching or flinching pain at times in my back -- natural as it heals, I'm feeling great. I'm not walking with the speed or spryness that I did prior to surgery, but I'm not worried that that will return soon enough. My bigger concern is the limitation I have on lifting any weight -- nothing heavier than a gallon of milk (8 pounds or so) for 6 weeks, so my upper body strength is declining while my legs are getting stronger. The first time I swam, I lasted 5 minutes, but four days later I lasted 21, although I felt it most in the lack of strength in my shoulders and lats.
Recommendations
I was told to look for an experienced surgeon, and regardless of the type of surgery one has done, go to the best hospital you can. Your local community hospital may have adequate equipment, but not state of the art, while a university or research hospital, or one dedicated to a type of treatment, may have the latest, cutting edge technology, and that's what you want. Our surgeon and that hospital was three hours from home, but worth it, and I'd recommend enduring the inconvenience of extra travel for the benefits of the best care you can receive.
Unless things change, if you are faced with back surgery like I inevitably was, I'd say get it done sooner than later, as every year you wait your personal strength, health, and recovery time will probably decline (it is the age thing), and the sooner you're up and about, the better off you'll be.
A final, funny note
With the misgivings I had about having surgery when I didn't have many symptoms, I talked with a very good friend of mine who is a doctor. In rationalizing the decision, I suggested that aside from a slip of the knife, where the doc might paralyze me, there really was no real risk. My friend laughed heartily, and said there's always risk to surgery. He didn't elaborate, but my bout with A-fib sure proved him correct, and he was the first person I called when I returned home to tell him he was so right! But it all ended fine.
So, potential surgical candidates, I hope this helps you.
Questions of the Month
How can so many people be so wrong about pumas?
What gear do you need for Antarctica?
What gear is essential for being in the field?
How Easy is NIK's HDR Program to use?
What is the most endangered big cat to photograph?
Why did we drop our NANPA membership?
What is the best $69 you can spend in photography?
More Questions about Pumas in Pennsylvania
Are the Latest Fast CF Cards worth the Expense?
How does the 7D hold up in a recent shoot?
Which is the better camera, the Mark IV or the 7D?
Are there Mountain Lions (Pumas, Cougars) in Pennsylvania and the Mid-Atlantic States?
Why is bat photography so difficult?
What do I think of the Canon 1D Mark IV?
Why do I advocate manual exposure so avidly?
Where can I find Depth of Field reference charts?
What is the Keboko backpack? Is it the New Best Pack?
Is there a correct position for the upright on a Wimberley actionhead?
How, Who, and Why? The story behind our new web site.
Archived Questions of the Month
Most of my original Questions of the Month for the last several
years are available through this link. The 'look' is from my
original web site, although if I ever have enough time I might
redo these pages to match the new web site But that's not
a high priority.
Question of the Month
March 2014
Five and a half weeks after surgery I shot this image of a black bear at a den, amazingly close to a road within 1.5 miles of our house. Thankfully, Mary set me up with the heavy lens, but I was on my feet and on site for about 6 hours. I am not superman.
Back Surgery?
What does that have to do with Photography?
Less than 4 weeks ago I had back surgery, mainly for stenosis, which is a constriction of the nerve canal passing through the vertebrae, the spinal cord going through the background. Rarely, if ever, do I post anything personal on our web site -- devoting this space to photography, natural history, or conservation. However, with an ageing population of my friends and colleagues, my experience might be faced by others as well, and I hope this posting will dispel some misgivings. So, if back surgery may be in your future, or in that of someone you know, you may wish to read on.
Before you read on, let me stress that if you are considering back surgery in the future (and mine went great!) and would like to talk to someone who has gone through this, and who might be able to answer some of your questions or help in what can be a scary decision, call me and I'll be happy to help.
My symptoms began about six years ago when I began to experience numbness in my legs and aches in my hamstrings, and occasional real numbness in my feet. Until then, I felt like a really well oiled machine, so this sudden change bothered me immensely, hurt, and worried me enough that I went to a doctor.
An MRI confirmed that I had severe stenosis, a narrowing of the nerve canal below the actual spinal cord but in the area where individual nerve bundles lead to the legs, bladder, bowels, and who knows where else. It looked like the canal went from a dime-sized opening to a pencil lead-sized opening, a severe hour glass constriction. The tech guy who reviewed the MRI was pretty negative about what he was seeing.
When I spoke to the first of three surgeons I interviewed, I asked what all this meant, and if, and when, I'd need surgery. I was told I might never need it, or I might need it tomorrow, depending upon what pain might develop or whether or not I could walk. A sure sign, he said, was if I had to stop and rest after short walks, because of pain or weakness in my legs. I interviewed another surgeon, at a larger hospital, and his unsettling answer when I asked him about surgery was something like 'Well, it will be a life-changing experience." As scary as that answer was, I never got a satisfactory clarification on that statement, so I didn't have a great of confidence here. We had experience with the third surgeon, who had performed a cervical disk replacement on Mary's neck, as part of a clinical trial that eventually led to FDA approval for the procedure. This surgeon was almost dismissive in his beaming confidence, and expressed virtually no doubt that I'd be as good as new. Obviously, that's the kind of words I wanted to hear, and that's the surgeon I went with.
That decision was over two years ago, and in the interim Mary and I hiked the mountains and ridges of the Himalayas for snow leopards, the foothills of Chile for pumas, the volcano slopes of Rwanda for mountain gorillas, and much more. During that time I'd have some back pain, and occasional leg or foot numbness, and I could
usually relieve the numbness by leaning forward, and this reduced pressure on the spine and the numbness disappeared.
I could live with that situation forever, but in April of 2013 I had two almost back-to-back bouts with sciatica, with the second feeling as if I'd just been speared by a Maasai. I almost fainted, and I wondered if I'd be able to pick myself up and move from the rock pile I tumbled in to. Worried that this my start happening more often, especially if we'd be on a trip, I visited our surgeon and scheduled the operation for about 8 months later.
Afterwards, except for some numbness, I had almost no further symptoms and I was, except for the numbness which was increasing when I walked on hard surfaces or stood still for a period of time, almost normal. So as the time to surgery neared, I was beginning to have second thoughts. Did I need the surgery now?
The MRI didn't lie, however, and I knew surgery was practically inevitable. I had scheduled time off for this, and quite honestly, I was worried that with the 'affordable health act' that in putting this off I might later find myself on a waiting list, or without insurance, or who know's what. My doctor friends almost universally agreed on this.
The Surgery and Recovery
The surgery went well, and I had surprisingly little pain, although I always lied and rated my pain (0-10) at a higher level to keep my pain medication going, as I was told to keep ahead of the pain. I had to lie on my back for two full days, although some surgeries patients are up and walking a bit the day after surgery. On the third day, when I was to sit up and walk a short distance to a chair, leaving the bed for the first time, I almost fainted, and my heart went into an atrial fibrillation.
My PT girls, and the nurses, went into a bit of a panic as I knew little about A-fib, which they said could result in my heart just getting tired and stop beating, or not clearing the chambers and causing a blood clot that could cause a stroke or heart attack. This seemed serious! My dad died of a stroke/heart attack at 63, so we had some family history here, which doubly concerned the hospital folks.
I was moved from the recovery floor for back operations to a cardiac monitoring floor, which was, to me, like becoming a part of Dan Brown's book 'Inferno' where Dante' describes the various levels of hell. I'd been 'in heaven' before, with great nurses and staff, and extremely attentive care, and I was now on a floor where, by the end of two days, I felt I was in hell. This was all
based upon the attitude of the staff, where some, I felt, considered it an enormous effort to straighten out a 'sweat pad' that would crinkle beneath my back, driving me crazy with discomfort. I could relate several anecdotes here, but it's all whining stuff now so let's just say I was more than ecstatic to return to the back recovery floor later.
The Catheter
Since I couldn't get out of bed, I had a catheter inserted for urinating, and early on, I scratched and bumped the tube, and worried that I dislodged the darn thing. Later, I learned that this is almost impossible to do, since the device is held in place by a balloon inside that must be deflated for the tube to be removed. Then my tube twisted a bit, and stopped regular flow, so I was bothered by a constant feeling of having to pee. That's fixed by rotating the tube a bit to get an opening that starting urine flow again, but this happened several times and was annoying.
Most guys probably worry about removing the device when it is no longer needed, and I was, even though folks had told me that it was no big deal. This proved to be true -- just a quick pinch, if I can describe it even as that -- and it was out.
I then worried about having control myself, since the tube had been doing the work. No worries here, instead, the problem was simply going, and I felt like I was waiting for a glacier to melt to start a flow. This lasted for days, even after I left the hospital.
Therapy
I had three big surprises in all of this. One, I never experienced a lot of pain when I was just lying in bed. Discomfort, yes, but I'd lived with back discomfort for five years, so that was barely a consideration. There was some pain when I'd roll on my side to dry or cool off my back after laying on the heat-trapping, moisture-catching pad I was on, but it wasn't too bad. Two, when I did sit up for the first time, I had a lot of pain, as I felt that the weight of my back and shoulders pushed down upon the lower back and I felt as if I had no core strength, or sense of awareness as to how to adjust or keep upright. To alleviate that pain, I would push down on the bed with both arms, trying to support my weight with my arms, and I'd be told to let my back do the work. That hurt, and to get used to the feeling, and to condition myself either to the pain or to strengthen the area (I don't know which!) I'd raise one arm up, supporting myself on the bed with the other, then switch and raise the other arm. Then I'd lift both, so that all my weight would be on my torso.
The first few times I did any of this it hurt, but each time it got a bit easier and less painful. Once the A-fib situation stabilized ten hours later,
I had to remain in bed another day before I had my first PT, when a little PT girl helped me to walk across the length of my hospital room. I emphasize the little, because I worried that if I had another near fainting spell as I did the first time, she'd be too small to keep me up. Fortunately, nothing happened, but I was beat.
The following day I had a second walk, about forty yards in total, at best, and that went easier. I expected a second session but on Sunday's they only did one, so I was worried that I'd have to do two on Monday and not be released to Tuesday, a full week in the hospital. On Monday, everyone knew I wanted out, and provided I passed the PT tests of climbing a stairs, getting into and out of a car (all simulations in the PT room), and other tasks, I'd be released. Frankly, I would have climbed a ladder at that point if I had to prove I could go home! I passed, and was released.
At Home
Remarkably, once home and a bit more confident about my abilities I started walking more, and each day I could really feel my strength returning. For the first few days I spent a lot of time catching up on nature videos, reading, doing some writing, and sleeping, but surprising little of the latter. However, once I really felt strong, and the weather cleared that I could walk outside, starting with a walk of 100 yards or so, followed in the days ahead to 200, 400, etc. until now, just over three weeks later, more than a mile, and 15-20 minute swims, too, I find that the extra exercise eventually catches up with me and I crash some time that day or the next. I'll be watching TV and zonk out for 2 or more hours, waking up like a drugged zombie.
The Results
Before the surgery, the 1.3 mile walk I'm doing now on a macadam road would almost always result in leg pain, numbness, and 'dead,' numb feet. That's gone, and except for a pinching or flinching pain at times in my back -- natural as it heals, I'm feeling great. I'm not walking with the speed or spryness that I did prior to surgery, but I'm not worried that that will return soon enough. My bigger concern is the limitation I have on lifting any weight -- nothing heavier than a gallon of milk (8 pounds or so) for 6 weeks, so my upper body strength is declining while my legs are getting stronger. The first time I swam, I lasted 5 minutes, but four days later I lasted 21, although I felt it most in the lack of strength in my shoulders and lats.
Recommendations
I was told to look for an experienced surgeon, and regardless of the type of surgery one has done, go to the best hospital you can. Your local community hospital may have adequate equipment, but not state of the art, while a university or research hospital, or one dedicated to a type of treatment, may have the latest, cutting edge technology, and that's what you want. Our surgeon and that hospital was three hours from home, but worth it, and I'd recommend enduring the inconvenience of extra travel for the benefits of the best care you can receive.
Unless things change, if you are faced with back surgery like I inevitably was, I'd say get it done sooner than later, as every year you wait your personal strength, health, and recovery time will probably decline (it is the age thing), and the sooner you're up and about, the better off you'll be.
A final, funny note
With the misgivings I had about having surgery when I didn't have many symptoms, I talked with a very good friend of mine who is a doctor. In rationalizing the decision, I suggested that aside from a slip of the knife, where the doc might paralyze me, there really was no real risk. My friend laughed heartily, and said there's always risk to surgery. He didn't elaborate, but my bout with A-fib sure proved him correct, and he was the first person I called when I returned home to tell him he was so right! But it all ended fine.
So, potential surgical candidates, I hope this helps you.
Questions of the Month
How can so many people be so wrong about pumas?
What gear do you need for Antarctica?
What gear is essential for being in the field?
How Easy is NIK's HDR Program to use?
What is the most endangered big cat to photograph?
Why did we drop our NANPA membership?
What is the best $69 you can spend in photography?
More Questions about Pumas in Pennsylvania
Are the Latest Fast CF Cards worth the Expense?
How does the 7D hold up in a recent shoot?
Which is the better camera, the Mark IV or the 7D?
Are there Mountain Lions (Pumas, Cougars) in Pennsylvania and the Mid-Atlantic States?
Why is bat photography so difficult?
What do I think of the Canon 1D Mark IV?
Why do I advocate manual exposure so avidly?
Where can I find Depth of Field reference charts?
What is the Keboko backpack? Is it the New Best Pack?
Is there a correct position for the upright on a Wimberley actionhead?
How, Who, and Why? The story behind our new web site.
Archived Questions of the Month
Most of my original Questions of the Month for the last several
years are available through this link. The 'look' is from my
original web site, although if I ever have enough time I might
redo these pages to match the new web site But that's not
a high priority.
Question of the Month
March 2014
Five and a half weeks after surgery I shot this image of a black bear at a den, amazingly close to a road within 1.5 miles of our house. Thankfully, Mary set me up with the heavy lens, but I was on my feet and on site for about 6 hours. I am not superman.
Back Surgery?
What does that have to do with Photography?
Less than 4 weeks ago I had back surgery, mainly for stenosis, which is a constriction of the nerve canal passing through the vertebrae, the spinal cord going through the background. Rarely, if ever, do I post anything personal on our web site -- devoting this space to photography, natural history, or conservation. However, with an ageing population of my friends and colleagues, my experience might be faced by others as well, and I hope this posting will dispel some misgivings. So, if back surgery may be in your future, or in that of someone you know, you may wish to read on.
Before you read on, let me stress that if you are considering back surgery in the future (and mine went great!) and would like to talk to someone who has gone through this, and who might be able to answer some of your questions or help in what can be a scary decision, call me and I'll be happy to help.
My symptoms began about six years ago when I began to experience numbness in my legs and aches in my hamstrings, and occasional real numbness in my feet. Until then, I felt like a really well oiled machine, so this sudden change bothered me immensely, hurt, and worried me enough that I went to a doctor.
An MRI confirmed that I had severe stenosis, a narrowing of the nerve canal below the actual spinal cord but in the area where individual nerve bundles lead to the legs, bladder, bowels, and who knows where else. It looked like the canal went from a dime-sized opening to a pencil lead-sized opening, a severe hour glass constriction. The tech guy who reviewed the MRI was pretty negative about what he was seeing.
When I spoke to the first of three surgeons I interviewed, I asked what all this meant, and if, and when, I'd need surgery. I was told I might never need it, or I might need it tomorrow, depending upon what pain might develop or whether or not I could walk. A sure sign, he said, was if I had to stop and rest after short walks, because of pain or weakness in my legs. I interviewed another surgeon, at a larger hospital, and his unsettling answer when I asked him about surgery was something like 'Well, it will be a life-changing experience." As scary as that answer was, I never got a satisfactory clarification on that statement, so I didn't have a great of confidence here. We had experience with the third surgeon, who had performed a cervical disk replacement on Mary's neck, as part of a clinical trial that eventually led to FDA approval for the procedure. This surgeon was almost dismissive in his beaming confidence, and expressed virtually no doubt that I'd be as good as new. Obviously, that's the kind of words I wanted to hear, and that's the surgeon I went with.
That decision was over two years ago, and in the interim Mary and I hiked the mountains and ridges of the Himalayas for snow leopards, the foothills of Chile for pumas, the volcano slopes of Rwanda for mountain gorillas, and much more. During that time I'd have some back pain, and occasional leg or foot numbness, and I could
usually relieve the numbness by leaning forward, and this reduced pressure on the spine and the numbness disappeared.
I could live with that situation forever, but in April of 2013 I had two almost back-to-back bouts with sciatica, with the second feeling as if I'd just been speared by a Maasai. I almost fainted, and I wondered if I'd be able to pick myself up and move from the rock pile I tumbled in to. Worried that this my start happening more often, especially if we'd be on a trip, I visited our surgeon and scheduled the operation for about 8 months later.
Afterwards, except for some numbness, I had almost no further symptoms and I was, except for the numbness which was increasing when I walked on hard surfaces or stood still for a period of time, almost normal. So as the time to surgery neared, I was beginning to have second thoughts. Did I need the surgery now?
The MRI didn't lie, however, and I knew surgery was practically inevitable. I had scheduled time off for this, and quite honestly, I was worried that with the 'affordable health act' that in putting this off I might later find myself on a waiting list, or without insurance, or who know's what. My doctor friends almost universally agreed on this.
The Surgery and Recovery
The surgery went well, and I had surprisingly little pain, although I always lied and rated my pain (0-10) at a higher level to keep my pain medication going, as I was told to keep ahead of the pain. I had to lie on my back for two full days, although some surgeries patients are up and walking a bit the day after surgery. On the third day, when I was to sit up and walk a short distance to a chair, leaving the bed for the first time, I almost fainted, and my heart went into an atrial fibrillation.
My PT girls, and the nurses, went into a bit of a panic as I knew little about A-fib, which they said could result in my heart just getting tired and stop beating, or not clearing the chambers and causing a blood clot that could cause a stroke or heart attack. This seemed serious! My dad died of a stroke/heart attack at 63, so we had some family history here, which doubly concerned the hospital folks.
I was moved from the recovery floor for back operations to a cardiac monitoring floor, which was, to me, like becoming a part of Dan Brown's book 'Inferno' where Dante' describes the various levels of hell. I'd been 'in heaven' before, with great nurses and staff, and extremely attentive care, and I was now on a floor where, by the end of two days, I felt I was in hell. This was all
based upon the attitude of the staff, where some, I felt, considered it an enormous effort to straighten out a 'sweat pad' that would crinkle beneath my back, driving me crazy with discomfort. I could relate several anecdotes here, but it's all whining stuff now so let's just say I was more than ecstatic to return to the back recovery floor later.
The Catheter
Since I couldn't get out of bed, I had a catheter inserted for urinating, and early on, I scratched and bumped the tube, and worried that I dislodged the darn thing. Later, I learned that this is almost impossible to do, since the device is held in place by a balloon inside that must be deflated for the tube to be removed. Then my tube twisted a bit, and stopped regular flow, so I was bothered by a constant feeling of having to pee. That's fixed by rotating the tube a bit to get an opening that starting urine flow again, but this happened several times and was annoying.
Most guys probably worry about removing the device when it is no longer needed, and I was, even though folks had told me that it was no big deal. This proved to be true -- just a quick pinch, if I can describe it even as that -- and it was out.
I then worried about having control myself, since the tube had been doing the work. No worries here, instead, the problem was simply going, and I felt like I was waiting for a glacier to melt to start a flow. This lasted for days, even after I left the hospital.
Therapy
I had three big surprises in all of this. One, I never experienced a lot of pain when I was just lying in bed. Discomfort, yes, but I'd lived with back discomfort for five years, so that was barely a consideration. There was some pain when I'd roll on my side to dry or cool off my back after laying on the heat-trapping, moisture-catching pad I was on, but it wasn't too bad. Two, when I did sit up for the first time, I had a lot of pain, as I felt that the weight of my back and shoulders pushed down upon the lower back and I felt as if I had no core strength, or sense of awareness as to how to adjust or keep upright. To alleviate that pain, I would push down on the bed with both arms, trying to support my weight with my arms, and I'd be told to let my back do the work. That hurt, and to get used to the feeling, and to condition myself either to the pain or to strengthen the area (I don't know which!) I'd raise one arm up, supporting myself on the bed with the other, then switch and raise the other arm. Then I'd lift both, so that all my weight would be on my torso.
The first few times I did any of this it hurt, but each time it got a bit easier and less painful. Once the A-fib situation stabilized ten hours later,
I had to remain in bed another day before I had my first PT, when a little PT girl helped me to walk across the length of my hospital room. I emphasize the little, because I worried that if I had another near fainting spell as I did the first time, she'd be too small to keep me up. Fortunately, nothing happened, but I was beat.
The following day I had a second walk, about forty yards in total, at best, and that went easier. I expected a second session but on Sunday's they only did one, so I was worried that I'd have to do two on Monday and not be released to Tuesday, a full week in the hospital. On Monday, everyone knew I wanted out, and provided I passed the PT tests of climbing a stairs, getting into and out of a car (all simulations in the PT room), and other tasks, I'd be released. Frankly, I would have climbed a ladder at that point if I had to prove I could go home! I passed, and was released.
At Home
Remarkably, once home and a bit more confident about my abilities I started walking more, and each day I could really feel my strength returning. For the first few days I spent a lot of time catching up on nature videos, reading, doing some writing, and sleeping, but surprising little of the latter. However, once I really felt strong, and the weather cleared that I could walk outside, starting with a walk of 100 yards or so, followed in the days ahead to 200, 400, etc. until now, just over three weeks later, more than a mile, and 15-20 minute swims, too, I find that the extra exercise eventually catches up with me and I crash some time that day or the next. I'll be watching TV and zonk out for 2 or more hours, waking up like a drugged zombie.
The Results
Before the surgery, the 1.3 mile walk I'm doing now on a macadam road would almost always result in leg pain, numbness, and 'dead,' numb feet. That's gone, and except for a pinching or flinching pain at times in my back -- natural as it heals, I'm feeling great. I'm not walking with the speed or spryness that I did prior to surgery, but I'm not worried that that will return soon enough. My bigger concern is the limitation I have on lifting any weight -- nothing heavier than a gallon of milk (8 pounds or so) for 6 weeks, so my upper body strength is declining while my legs are getting stronger. The first time I swam, I lasted 5 minutes, but four days later I lasted 21, although I felt it most in the lack of strength in my shoulders and lats.
Recommendations
I was told to look for an experienced surgeon, and regardless of the type of surgery one has done, go to the best hospital you can. Your local community hospital may have adequate equipment, but not state of the art, while a university or research hospital, or one dedicated to a type of treatment, may have the latest, cutting edge technology, and that's what you want. Our surgeon and that hospital was three hours from home, but worth it, and I'd recommend enduring the inconvenience of extra travel for the benefits of the best care you can receive.
Unless things change, if you are faced with back surgery like I inevitably was, I'd say get it done sooner than later, as every year you wait your personal strength, health, and recovery time will probably decline (it is the age thing), and the sooner you're up and about, the better off you'll be.
A final, funny note
With the misgivings I had about having surgery when I didn't have many symptoms, I talked with a very good friend of mine who is a doctor. In rationalizing the decision, I suggested that aside from a slip of the knife, where the doc might paralyze me, there really was no real risk. My friend laughed heartily, and said there's always risk to surgery. He didn't elaborate, but my bout with A-fib sure proved him correct, and he was the first person I called when I returned home to tell him he was so right! But it all ended fine.
So, potential surgical candidates, I hope this helps you.
Questions of the Month
How can so many people be so wrong about pumas?
What gear do you need for Antarctica?
What gear is essential for being in the field?
How Easy is NIK's HDR Program to use?
What is the most endangered big cat to photograph?
Why did we drop our NANPA membership?
What is the best $69 you can spend in photography?
More Questions about Pumas in Pennsylvania
Are the Latest Fast CF Cards worth the Expense?
How does the 7D hold up in a recent shoot?
Which is the better camera, the Mark IV or the 7D?
Are there Mountain Lions (Pumas, Cougars) in Pennsylvania and the Mid-Atlantic States?
Why is bat photography so difficult?
What do I think of the Canon 1D Mark IV?
Why do I advocate manual exposure so avidly?
Where can I find Depth of Field reference charts?
What is the Keboko backpack? Is it the New Best Pack?
Is there a correct position for the upright on a Wimberley actionhead?
How, Who, and Why? The story behind our new web site.
Archived Questions of the Month
Most of my original Questions of the Month for the last several
years are available through this link. The 'look' is from my
original web site, although if I ever have enough time I might
redo these pages to match the new web site But that's not
a high priority.
Question of the Month
March 2014
Five and a half weeks after surgery I shot this image of a black bear at a den, amazingly close to a road within 1.5 miles of our house. Thankfully, Mary set me up with the heavy lens, but I was on my feet and on site for about 6 hours. I am not superman.
Back Surgery?
What does that have to do with Photography?
Less than 4 weeks ago I had back surgery, mainly for stenosis, which is a constriction of the nerve canal passing through the vertebrae, the spinal cord going through the background. Rarely, if ever, do I post anything personal on our web site -- devoting this space to photography, natural history, or conservation. However, with an ageing population of my friends and colleagues, my experience might be faced by others as well, and I hope this posting will dispel some misgivings. So, if back surgery may be in your future, or in that of someone you know, you may wish to read on.
Before you read on, let me stress that if you are considering back surgery in the future (and mine went great!) and would like to talk to someone who has gone through this, and who might be able to answer some of your questions or help in what can be a scary decision, call me and I'll be happy to help.
My symptoms began about six years ago when I began to experience numbness in my legs and aches in my hamstrings, and occasional real numbness in my feet. Until then, I felt like a really well oiled machine, so this sudden change bothered me immensely, hurt, and worried me enough that I went to a doctor.
An MRI confirmed that I had severe stenosis, a narrowing of the nerve canal below the actual spinal cord but in the area where individual nerve bundles lead to the legs, bladder, bowels, and who knows where else. It looked like the canal went from a dime-sized opening to a pencil lead-sized opening, a severe hour glass constriction. The tech guy who reviewed the MRI was pretty negative about what he was seeing.
When I spoke to the first of three surgeons I interviewed, I asked what all this meant, and if, and when, I'd need surgery. I was told I might never need it, or I might need it tomorrow, depending upon what pain might develop or whether or not I could walk. A sure sign, he said, was if I had to stop and rest after short walks, because of pain or weakness in my legs. I interviewed another surgeon, at a larger hospital, and his unsettling answer when I asked him about surgery was something like 'Well, it will be a life-changing experience." As scary as that answer was, I never got a satisfactory clarification on that statement, so I didn't have a great of confidence here. We had experience with the third surgeon, who had performed a cervical disk replacement on Mary's neck, as part of a clinical trial that eventually led to FDA approval for the procedure. This surgeon was almost dismissive in his beaming confidence, and expressed virtually no doubt that I'd be as good as new. Obviously, that's the kind of words I wanted to hear, and that's the surgeon I went with.
That decision was over two years ago, and in the interim Mary and I hiked the mountains and ridges of the Himalayas for snow leopards, the foothills of Chile for pumas, the volcano slopes of Rwanda for mountain gorillas, and much more. During that time I'd have some back pain, and occasional leg or foot numbness, and I could
usually relieve the numbness by leaning forward, and this reduced pressure on the spine and the numbness disappeared.
I could live with that situation forever, but in April of 2013 I had two almost back-to-back bouts with sciatica, with the second feeling as if I'd just been speared by a Maasai. I almost fainted, and I wondered if I'd be able to pick myself up and move from the rock pile I tumbled in to. Worried that this my start happening more often, especially if we'd be on a trip, I visited our surgeon and scheduled the operation for about 8 months later.
Afterwards, except for some numbness, I had almost no further symptoms and I was, except for the numbness which was increasing when I walked on hard surfaces or stood still for a period of time, almost normal. So as the time to surgery neared, I was beginning to have second thoughts. Did I need the surgery now?
The MRI didn't lie, however, and I knew surgery was practically inevitable. I had scheduled time off for this, and quite honestly, I was worried that with the 'affordable health act' that in putting this off I might later find myself on a waiting list, or without insurance, or who know's what. My doctor friends almost universally agreed on this.
The Surgery and Recovery
The surgery went well, and I had surprisingly little pain, although I always lied and rated my pain (0-10) at a higher level to keep my pain medication going, as I was told to keep ahead of the pain. I had to lie on my back for two full days, although some surgeries patients are up and walking a bit the day after surgery. On the third day, when I was to sit up and walk a short distance to a chair, leaving the bed for the first time, I almost fainted, and my heart went into an atrial fibrillation.
My PT girls, and the nurses, went into a bit of a panic as I knew little about A-fib, which they said could result in my heart just getting tired and stop beating, or not clearing the chambers and causing a blood clot that could cause a stroke or heart attack. This seemed serious! My dad died of a stroke/heart attack at 63, so we had some family history here, which doubly concerned the hospital folks.
I was moved from the recovery floor for back operations to a cardiac monitoring floor, which was, to me, like becoming a part of Dan Brown's book 'Inferno' where Dante' describes the various levels of hell. I'd been 'in heaven' before, with great nurses and staff, and extremely attentive care, and I was now on a floor where, by the end of two days, I felt I was in hell. This was all
based upon the attitude of the staff, where some, I felt, considered it an enormous effort to straighten out a 'sweat pad' that would crinkle beneath my back, driving me crazy with discomfort. I could relate several anecdotes here, but it's all whining stuff now so let's just say I was more than ecstatic to return to the back recovery floor later.
The Catheter
Since I couldn't get out of bed, I had a catheter inserted for urinating, and early on, I scratched and bumped the tube, and worried that I dislodged the darn thing. Later, I learned that this is almost impossible to do, since the device is held in place by a balloon inside that must be deflated for the tube to be removed. Then my tube twisted a bit, and stopped regular flow, so I was bothered by a constant feeling of having to pee. That's fixed by rotating the tube a bit to get an opening that starting urine flow again, but this happened several times and was annoying.
Most guys probably worry about removing the device when it is no longer needed, and I was, even though folks had told me that it was no big deal. This proved to be true -- just a quick pinch, if I can describe it even as that -- and it was out.
I then worried about having control myself, since the tube had been doing the work. No worries here, instead, the problem was simply going, and I felt like I was waiting for a glacier to melt to start a flow. This lasted for days, even after I left the hospital.
Therapy
I had three big surprises in all of this. One, I never experienced a lot of pain when I was just lying in bed. Discomfort, yes, but I'd lived with back discomfort for five years, so that was barely a consideration. There was some pain when I'd roll on my side to dry or cool off my back after laying on the heat-trapping, moisture-catching pad I was on, but it wasn't too bad. Two, when I did sit up for the first time, I had a lot of pain, as I felt that the weight of my back and shoulders pushed down upon the lower back and I felt as if I had no core strength, or sense of awareness as to how to adjust or keep upright. To alleviate that pain, I would push down on the bed with both arms, trying to support my weight with my arms, and I'd be told to let my back do the work. That hurt, and to get used to the feeling, and to condition myself either to the pain or to strengthen the area (I don't know which!) I'd raise one arm up, supporting myself on the bed with the other, then switch and raise the other arm. Then I'd lift both, so that all my weight would be on my torso.
The first few times I did any of this it hurt, but each time it got a bit easier and less painful. Once the A-fib situation stabilized ten hours later,
I had to remain in bed another day before I had my first PT, when a little PT girl helped me to walk across the length of my hospital room. I emphasize the little, because I worried that if I had another near fainting spell as I did the first time, she'd be too small to keep me up. Fortunately, nothing happened, but I was beat.
The following day I had a second walk, about forty yards in total, at best, and that went easier. I expected a second session but on Sunday's they only did one, so I was worried that I'd have to do two on Monday and not be released to Tuesday, a full week in the hospital. On Monday, everyone knew I wanted out, and provided I passed the PT tests of climbing a stairs, getting into and out of a car (all simulations in the PT room), and other tasks, I'd be released. Frankly, I would have climbed a ladder at that point if I had to prove I could go home! I passed, and was released.
At Home
Remarkably, once home and a bit more confident about my abilities I started walking more, and each day I could really feel my strength returning. For the first few days I spent a lot of time catching up on nature videos, reading, doing some writing, and sleeping, but surprising little of the latter. However, once I really felt strong, and the weather cleared that I could walk outside, starting with a walk of 100 yards or so, followed in the days ahead to 200, 400, etc. until now, just over three weeks later, more than a mile, and 15-20 minute swims, too, I find that the extra exercise eventually catches up with me and I crash some time that day or the next. I'll be watching TV and zonk out for 2 or more hours, waking up like a drugged zombie.
The Results
Before the surgery, the 1.3 mile walk I'm doing now on a macadam road would almost always result in leg pain, numbness, and 'dead,' numb feet. That's gone, and except for a pinching or flinching pain at times in my back -- natural as it heals, I'm feeling great. I'm not walking with the speed or spryness that I did prior to surgery, but I'm not worried that that will return soon enough. My bigger concern is the limitation I have on lifting any weight -- nothing heavier than a gallon of milk (8 pounds or so) for 6 weeks, so my upper body strength is declining while my legs are getting stronger. The first time I swam, I lasted 5 minutes, but four days later I lasted 21, although I felt it most in the lack of strength in my shoulders and lats.
Recommendations
I was told to look for an experienced surgeon, and regardless of the type of surgery one has done, go to the best hospital you can. Your local community hospital may have adequate equipment, but not state of the art, while a university or research hospital, or one dedicated to a type of treatment, may have the latest, cutting edge technology, and that's what you want. Our surgeon and that hospital was three hours from home, but worth it, and I'd recommend enduring the inconvenience of extra travel for the benefits of the best care you can receive.
Unless things change, if you are faced with back surgery like I inevitably was, I'd say get it done sooner than later, as every year you wait your personal strength, health, and recovery time will probably decline (it is the age thing), and the sooner you're up and about, the better off you'll be.
A final, funny note
With the misgivings I had about having surgery when I didn't have many symptoms, I talked with a very good friend of mine who is a doctor. In rationalizing the decision, I suggested that aside from a slip of the knife, where the doc might paralyze me, there really was no real risk. My friend laughed heartily, and said there's always risk to surgery. He didn't elaborate, but my bout with A-fib sure proved him correct, and he was the first person I called when I returned home to tell him he was so right! But it all ended fine.
So, potential surgical candidates, I hope this helps you.
Questions of the Month
How can so many people be so wrong about pumas?
What gear do you need for Antarctica?
What gear is essential for being in the field?
How Easy is NIK's HDR Program to use?
What is the most endangered big cat to photograph?
Why did we drop our NANPA membership?
What is the best $69 you can spend in photography?
More Questions about Pumas in Pennsylvania
Are the Latest Fast CF Cards worth the Expense?
How does the 7D hold up in a recent shoot?
Which is the better camera, the Mark IV or the 7D?
Are there Mountain Lions (Pumas, Cougars) in Pennsylvania and the Mid-Atlantic States?
Why is bat photography so difficult?
What do I think of the Canon 1D Mark IV?
Why do I advocate manual exposure so avidly?
Where can I find Depth of Field reference charts?
What is the Keboko backpack? Is it the New Best Pack?
Is there a correct position for the upright on a Wimberley actionhead?
How, Who, and Why? The story behind our new web site.
Archived Questions of the Month
Most of my original Questions of the Month for the last several
years are available through this link. The 'look' is from my
original web site, although if I ever have enough time I might
redo these pages to match the new web site But that's not
a high priority.
Question of the Month
March 2014
Five and a half weeks after surgery I shot this image of a black bear at a den, amazingly close to a road within 1.5 miles of our house. Thankfully, Mary set me up with the heavy lens, but I was on my feet and on site for about 6 hours. I am not superman.
Back Surgery?
What does that have to do with Photography?
Less than 4 weeks ago I had back surgery, mainly for stenosis, which is a constriction of the nerve canal passing through the vertebrae, the spinal cord going through the background. Rarely, if ever, do I post anything personal on our web site -- devoting this space to photography, natural history, or conservation. However, with an ageing population of my friends and colleagues, my experience might be faced by others as well, and I hope this posting will dispel some misgivings. So, if back surgery may be in your future, or in that of someone you know, you may wish to read on.
Before you read on, let me stress that if you are considering back surgery in the future (and mine went great!) and would like to talk to someone who has gone through this, and who might be able to answer some of your questions or help in what can be a scary decision, call me and I'll be happy to help.
My symptoms began about six years ago when I began to experience numbness in my legs and aches in my hamstrings, and occasional real numbness in my feet. Until then, I felt like a really well oiled machine, so this sudden change bothered me immensely, hurt, and worried me enough that I went to a doctor.
An MRI confirmed that I had severe stenosis, a narrowing of the nerve canal below the actual spinal cord but in the area where individual nerve bundles lead to the legs, bladder, bowels, and who knows where else. It looked like the canal went from a dime-sized opening to a pencil lead-sized opening, a severe hour glass constriction. The tech guy who reviewed the MRI was pretty negative about what he was seeing.
When I spoke to the first of three surgeons I interviewed, I asked what all this meant, and if, and when, I'd need surgery. I was told I might never need it, or I might need it tomorrow, depending upon what pain might develop or whether or not I could walk. A sure sign, he said, was if I had to stop and rest after short walks, because of pain or weakness in my legs. I interviewed another surgeon, at a larger hospital, and his unsettling answer when I asked him about surgery was something like 'Well, it will be a life-changing experience." As scary as that answer was, I never got a satisfactory clarification on that statement, so I didn't have a great of confidence here. We had experience with the third surgeon, who had performed a cervical disk replacement on Mary's neck, as part of a clinical trial that eventually led to FDA approval for the procedure. This surgeon was almost dismissive in his beaming confidence, and expressed virtually no doubt that I'd be as good as new. Obviously, that's the kind of words I wanted to hear, and that's the surgeon I went with.
That decision was over two years ago, and in the interim Mary and I hiked the mountains and ridges of the Himalayas for snow leopards, the foothills of Chile for pumas, the volcano slopes of Rwanda for mountain gorillas, and much more. During that time I'd have some back pain, and occasional leg or foot numbness, and I could
usually relieve the numbness by leaning forward, and this reduced pressure on the spine and the numbness disappeared.
I could live with that situation forever, but in April of 2013 I had two almost back-to-back bouts with sciatica, with the second feeling as if I'd just been speared by a Maasai. I almost fainted, and I wondered if I'd be able to pick myself up and move from the rock pile I tumbled in to. Worried that this my start happening more often, especially if we'd be on a trip, I visited our surgeon and scheduled the operation for about 8 months later.
Afterwards, except for some numbness, I had almost no further symptoms and I was, except for the numbness which was increasing when I walked on hard surfaces or stood still for a period of time, almost normal. So as the time to surgery neared, I was beginning to have second thoughts. Did I need the surgery now?
The MRI didn't lie, however, and I knew surgery was practically inevitable. I had scheduled time off for this, and quite honestly, I was worried that with the 'affordable health act' that in putting this off I might later find myself on a waiting list, or without insurance, or who know's what. My doctor friends almost universally agreed on this.
The Surgery and Recovery
The surgery went well, and I had surprisingly little pain, although I always lied and rated my pain (0-10) at a higher level to keep my pain medication going, as I was told to keep ahead of the pain. I had to lie on my back for two full days, although some surgeries patients are up and walking a bit the day after surgery. On the third day, when I was to sit up and walk a short distance to a chair, leaving the bed for the first time, I almost fainted, and my heart went into an atrial fibrillation.
My PT girls, and the nurses, went into a bit of a panic as I knew little about A-fib, which they said could result in my heart just getting tired and stop beating, or not clearing the chambers and causing a blood clot that could cause a stroke or heart attack. This seemed serious! My dad died of a stroke/heart attack at 63, so we had some family history here, which doubly concerned the hospital folks.
I was moved from the recovery floor for back operations to a cardiac monitoring floor, which was, to me, like becoming a part of Dan Brown's book 'Inferno' where Dante' describes the various levels of hell. I'd been 'in heaven' before, with great nurses and staff, and extremely attentive care, and I was now on a floor where, by the end of two days, I felt I was in hell. This was all
based upon the attitude of the staff, where some, I felt, considered it an enormous effort to straighten out a 'sweat pad' that would crinkle beneath my back, driving me crazy with discomfort. I could relate several anecdotes here, but it's all whining stuff now so let's just say I was more than ecstatic to return to the back recovery floor later.
The Catheter
Since I couldn't get out of bed, I had a catheter inserted for urinating, and early on, I scratched and bumped the tube, and worried that I dislodged the darn thing. Later, I learned that this is almost impossible to do, since the device is held in place by a balloon inside that must be deflated for the tube to be removed. Then my tube twisted a bit, and stopped regular flow, so I was bothered by a constant feeling of having to pee. That's fixed by rotating the tube a bit to get an opening that starting urine flow again, but this happened several times and was annoying.
Most guys probably worry about removing the device when it is no longer needed, and I was, even though folks had told me that it was no big deal. This proved to be true -- just a quick pinch, if I can describe it even as that -- and it was out.
I then worried about having control myself, since the tube had been doing the work. No worries here, instead, the problem was simply going, and I felt like I was waiting for a glacier to melt to start a flow. This lasted for days, even after I left the hospital.
Therapy
I had three big surprises in all of this. One, I never experienced a lot of pain when I was just lying in bed. Discomfort, yes, but I'd lived with back discomfort for five years, so that was barely a consideration. There was some pain when I'd roll on my side to dry or cool off my back after laying on the heat-trapping, moisture-catching pad I was on, but it wasn't too bad. Two, when I did sit up for the first time, I had a lot of pain, as I felt that the weight of my back and shoulders pushed down upon the lower back and I felt as if I had no core strength, or sense of awareness as to how to adjust or keep upright. To alleviate that pain, I would push down on the bed with both arms, trying to support my weight with my arms, and I'd be told to let my back do the work. That hurt, and to get used to the feeling, and to condition myself either to the pain or to strengthen the area (I don't know which!) I'd raise one arm up, supporting myself on the bed with the other, then switch and raise the other arm. Then I'd lift both, so that all my weight would be on my torso.
The first few times I did any of this it hurt, but each time it got a bit easier and less painful. Once the A-fib situation stabilized ten hours later,
I had to remain in bed another day before I had my first PT, when a little PT girl helped me to walk across the length of my hospital room. I emphasize the little, because I worried that if I had another near fainting spell as I did the first time, she'd be too small to keep me up. Fortunately, nothing happened, but I was beat.
The following day I had a second walk, about forty yards in total, at best, and that went easier. I expected a second session but on Sunday's they only did one, so I was worried that I'd have to do two on Monday and not be released to Tuesday, a full week in the hospital. On Monday, everyone knew I wanted out, and provided I passed the PT tests of climbing a stairs, getting into and out of a car (all simulations in the PT room), and other tasks, I'd be released. Frankly, I would have climbed a ladder at that point if I had to prove I could go home! I passed, and was released.
At Home
Remarkably, once home and a bit more confident about my abilities I started walking more, and each day I could really feel my strength returning. For the first few days I spent a lot of time catching up on nature videos, reading, doing some writing, and sleeping, but surprising little of the latter. However, once I really felt strong, and the weather cleared that I could walk outside, starting with a walk of 100 yards or so, followed in the days ahead to 200, 400, etc. until now, just over three weeks later, more than a mile, and 15-20 minute swims, too, I find that the extra exercise eventually catches up with me and I crash some time that day or the next. I'll be watching TV and zonk out for 2 or more hours, waking up like a drugged zombie.
The Results
Before the surgery, the 1.3 mile walk I'm doing now on a macadam road would almost always result in leg pain, numbness, and 'dead,' numb feet. That's gone, and except for a pinching or flinching pain at times in my back -- natural as it heals, I'm feeling great. I'm not walking with the speed or spryness that I did prior to surgery, but I'm not worried that that will return soon enough. My bigger concern is the limitation I have on lifting any weight -- nothing heavier than a gallon of milk (8 pounds or so) for 6 weeks, so my upper body strength is declining while my legs are getting stronger. The first time I swam, I lasted 5 minutes, but four days later I lasted 21, although I felt it most in the lack of strength in my shoulders and lats.
Recommendations
I was told to look for an experienced surgeon, and regardless of the type of surgery one has done, go to the best hospital you can. Your local community hospital may have adequate equipment, but not state of the art, while a university or research hospital, or one dedicated to a type of treatment, may have the latest, cutting edge technology, and that's what you want. Our surgeon and that hospital was three hours from home, but worth it, and I'd recommend enduring the inconvenience of extra travel for the benefits of the best care you can receive.
Unless things change, if you are faced with back surgery like I inevitably was, I'd say get it done sooner than later, as every year you wait your personal strength, health, and recovery time will probably decline (it is the age thing), and the sooner you're up and about, the better off you'll be.
A final, funny note
With the misgivings I had about having surgery when I didn't have many symptoms, I talked with a very good friend of mine who is a doctor. In rationalizing the decision, I suggested that aside from a slip of the knife, where the doc might paralyze me, there really was no real risk. My friend laughed heartily, and said there's always risk to surgery. He didn't elaborate, but my bout with A-fib sure proved him correct, and he was the first person I called when I returned home to tell him he was so right! But it all ended fine.
So, potential surgical candidates, I hope this helps you.
Questions of the Month
How can so many people be so wrong about pumas?
What gear do you need for Antarctica?
What gear is essential for being in the field?
How Easy is NIK's HDR Program to use?
What is the most endangered big cat to photograph?
Why did we drop our NANPA membership?
What is the best $69 you can spend in photography?
More Questions about Pumas in Pennsylvania
Are the Latest Fast CF Cards worth the Expense?
How does the 7D hold up in a recent shoot?
Which is the better camera, the Mark IV or the 7D?
Are there Mountain Lions (Pumas, Cougars) in Pennsylvania and the Mid-Atlantic States?
Why is bat photography so difficult?
What do I think of the Canon 1D Mark IV?
Why do I advocate manual exposure so avidly?
Where can I find Depth of Field reference charts?
What is the Keboko backpack? Is it the New Best Pack?
Is there a correct position for the upright on a Wimberley actionhead?
How, Who, and Why? The story behind our new web site.
Archived Questions of the Month
Most of my original Questions of the Month for the last several
years are available through this link. The 'look' is from my
original web site, although if I ever have enough time I might
redo these pages to match the new web site But that's not
a high priority.
Question of the Month
March 2014
Five and a half weeks after surgery I shot this image of a black bear at a den, amazingly close to a road within 1.5 miles of our house. Thankfully, Mary set me up with the heavy lens, but I was on my feet and on site for about 6 hours. I am not superman.
Back Surgery?
What does that have to do with Photography?
Less than 4 weeks ago I had back surgery, mainly for stenosis, which is a constriction of the nerve canal passing through the vertebrae, the spinal cord going through the background. Rarely, if ever, do I post anything personal on our web site -- devoting this space to photography, natural history, or conservation. However, with an ageing population of my friends and colleagues, my experience might be faced by others as well, and I hope this posting will dispel some misgivings. So, if back surgery may be in your future, or in that of someone you know, you may wish to read on.
Before you read on, let me stress that if you are considering back surgery in the future (and mine went great!) and would like to talk to someone who has gone through this, and who might be able to answer some of your questions or help in what can be a scary decision, call me and I'll be happy to help.
My symptoms began about six years ago when I began to experience numbness in my legs and aches in my hamstrings, and occasional real numbness in my feet. Until then, I felt like a really well oiled machine, so this sudden change bothered me immensely, hurt, and worried me enough that I went to a doctor.
An MRI confirmed that I had severe stenosis, a narrowing of the nerve canal below the actual spinal cord but in the area where individual nerve bundles lead to the legs, bladder, bowels, and who knows where else. It looked like the canal went from a dime-sized opening to a pencil lead-sized opening, a severe hour glass constriction. The tech guy who reviewed the MRI was pretty negative about what he was seeing.
When I spoke to the first of three surgeons I interviewed, I asked what all this meant, and if, and when, I'd need surgery. I was told I might never need it, or I might need it tomorrow, depending upon what pain might develop or whether or not I could walk. A sure sign, he said, was if I had to stop and rest after short walks, because of pain or weakness in my legs. I interviewed another surgeon, at a larger hospital, and his unsettling answer when I asked him about surgery was something like 'Well, it will be a life-changing experience." As scary as that answer was, I never got a satisfactory clarification on that statement, so I didn't have a great of confidence here. We had experience with the third surgeon, who had performed a cervical disk replacement on Mary's neck, as part of a clinical trial that eventually led to FDA approval for the procedure. This surgeon was almost dismissive in his beaming confidence, and expressed virtually no doubt that I'd be as good as new. Obviously, that's the kind of words I wanted to hear, and that's the surgeon I went with.
That decision was over two years ago, and in the interim Mary and I hiked the mountains and ridges of the Himalayas for snow leopards, the foothills of Chile for pumas, the volcano slopes of Rwanda for mountain gorillas, and much more. During that time I'd have some back pain, and occasional leg or foot numbness, and I could
usually relieve the numbness by leaning forward, and this reduced pressure on the spine and the numbness disappeared.
I could live with that situation forever, but in April of 2013 I had two almost back-to-back bouts with sciatica, with the second feeling as if I'd just been speared by a Maasai. I almost fainted, and I wondered if I'd be able to pick myself up and move from the rock pile I tumbled in to. Worried that this my start happening more often, especially if we'd be on a trip, I visited our surgeon and scheduled the operation for about 8 months later.
Afterwards, except for some numbness, I had almost no further symptoms and I was, except for the numbness which was increasing when I walked on hard surfaces or stood still for a period of time, almost normal. So as the time to surgery neared, I was beginning to have second thoughts. Did I need the surgery now?
The MRI didn't lie, however, and I knew surgery was practically inevitable. I had scheduled time off for this, and quite honestly, I was worried that with the 'affordable health act' that in putting this off I might later find myself on a waiting list, or without insurance, or who know's what. My doctor friends almost universally agreed on this.
The Surgery and Recovery
The surgery went well, and I had surprisingly little pain, although I always lied and rated my pain (0-10) at a higher level to keep my pain medication going, as I was told to keep ahead of the pain. I had to lie on my back for two full days, although some surgeries patients are up and walking a bit the day after surgery. On the third day, when I was to sit up and walk a short distance to a chair, leaving the bed for the first time, I almost fainted, and my heart went into an atrial fibrillation.
My PT girls, and the nurses, went into a bit of a panic as I knew little about A-fib, which they said could result in my heart just getting tired and stop beating, or not clearing the chambers and causing a blood clot that could cause a stroke or heart attack. This seemed serious! My dad died of a stroke/heart attack at 63, so we had some family history here, which doubly concerned the hospital folks.
I was moved from the recovery floor for back operations to a cardiac monitoring floor, which was, to me, like becoming a part of Dan Brown's book 'Inferno' where Dante' describes the various levels of hell. I'd been 'in heaven' before, with great nurses and staff, and extremely attentive care, and I was now on a floor where, by the end of two days, I felt I was in hell. This was all
based upon the attitude of the staff, where some, I felt, considered it an enormous effort to straighten out a 'sweat pad' that would crinkle beneath my back, driving me crazy with discomfort. I could relate several anecdotes here, but it's all whining stuff now so let's just say I was more than ecstatic to return to the back recovery floor later.
The Catheter
Since I couldn't get out of bed, I had a catheter inserted for urinating, and early on, I scratched and bumped the tube, and worried that I dislodged the darn thing. Later, I learned that this is almost impossible to do, since the device is held in place by a balloon inside that must be deflated for the tube to be removed. Then my tube twisted a bit, and stopped regular flow, so I was bothered by a constant feeling of having to pee. That's fixed by rotating the tube a bit to get an opening that starting urine flow again, but this happened several times and was annoying.
Most guys probably worry about removing the device when it is no longer needed, and I was, even though folks had told me that it was no big deal. This proved to be true -- just a quick pinch, if I can describe it even as that -- and it was out.
I then worried about having control myself, since the tube had been doing the work. No worries here, instead, the problem was simply going, and I felt like I was waiting for a glacier to melt to start a flow. This lasted for days, even after I left the hospital.
Therapy
I had three big surprises in all of this. One, I never experienced a lot of pain when I was just lying in bed. Discomfort, yes, but I'd lived with back discomfort for five years, so that was barely a consideration. There was some pain when I'd roll on my side to dry or cool off my back after laying on the heat-trapping, moisture-catching pad I was on, but it wasn't too bad. Two, when I did sit up for the first time, I had a lot of pain, as I felt that the weight of my back and shoulders pushed down upon the lower back and I felt as if I had no core strength, or sense of awareness as to how to adjust or keep upright. To alleviate that pain, I would push down on the bed with both arms, trying to support my weight with my arms, and I'd be told to let my back do the work. That hurt, and to get used to the feeling, and to condition myself either to the pain or to strengthen the area (I don't know which!) I'd raise one arm up, supporting myself on the bed with the other, then switch and raise the other arm. Then I'd lift both, so that all my weight would be on my torso.
The first few times I did any of this it hurt, but each time it got a bit easier and less painful. Once the A-fib situation stabilized ten hours later,
I had to remain in bed another day before I had my first PT, when a little PT girl helped me to walk across the length of my hospital room. I emphasize the little, because I worried that if I had another near fainting spell as I did the first time, she'd be too small to keep me up. Fortunately, nothing happened, but I was beat.
The following day I had a second walk, about forty yards in total, at best, and that went easier. I expected a second session but on Sunday's they only did one, so I was worried that I'd have to do two on Monday and not be released to Tuesday, a full week in the hospital. On Monday, everyone knew I wanted out, and provided I passed the PT tests of climbing a stairs, getting into and out of a car (all simulations in the PT room), and other tasks, I'd be released. Frankly, I would have climbed a ladder at that point if I had to prove I could go home! I passed, and was released.
At Home
Remarkably, once home and a bit more confident about my abilities I started walking more, and each day I could really feel my strength returning. For the first few days I spent a lot of time catching up on nature videos, reading, doing some writing, and sleeping, but surprising little of the latter. However, once I really felt strong, and the weather cleared that I could walk outside, starting with a walk of 100 yards or so, followed in the days ahead to 200, 400, etc. until now, just over three weeks later, more than a mile, and 15-20 minute swims, too, I find that the extra exercise eventually catches up with me and I crash some time that day or the next. I'll be watching TV and zonk out for 2 or more hours, waking up like a drugged zombie.
The Results
Before the surgery, the 1.3 mile walk I'm doing now on a macadam road would almost always result in leg pain, numbness, and 'dead,' numb feet. That's gone, and except for a pinching or flinching pain at times in my back -- natural as it heals, I'm feeling great. I'm not walking with the speed or spryness that I did prior to surgery, but I'm not worried that that will return soon enough. My bigger concern is the limitation I have on lifting any weight -- nothing heavier than a gallon of milk (8 pounds or so) for 6 weeks, so my upper body strength is declining while my legs are getting stronger. The first time I swam, I lasted 5 minutes, but four days later I lasted 21, although I felt it most in the lack of strength in my shoulders and lats.
Recommendations
I was told to look for an experienced surgeon, and regardless of the type of surgery one has done, go to the best hospital you can. Your local community hospital may have adequate equipment, but not state of the art, while a university or research hospital, or one dedicated to a type of treatment, may have the latest, cutting edge technology, and that's what you want. Our surgeon and that hospital was three hours from home, but worth it, and I'd recommend enduring the inconvenience of extra travel for the benefits of the best care you can receive.
Unless things change, if you are faced with back surgery like I inevitably was, I'd say get it done sooner than later, as every year you wait your personal strength, health, and recovery time will probably decline (it is the age thing), and the sooner you're up and about, the better off you'll be.
A final, funny note
With the misgivings I had about having surgery when I didn't have many symptoms, I talked with a very good friend of mine who is a doctor. In rationalizing the decision, I suggested that aside from a slip of the knife, where the doc might paralyze me, there really was no real risk. My friend laughed heartily, and said there's always risk to surgery. He didn't elaborate, but my bout with A-fib sure proved him correct, and he was the first person I called when I returned home to tell him he was so right! But it all ended fine.
So, potential surgical candidates, I hope this helps you.
Questions of the Month
How can so many people be so wrong about pumas?
What gear do you need for Antarctica?
What gear is essential for being in the field?
How Easy is NIK's HDR Program to use?
What is the most endangered big cat to photograph?
Why did we drop our NANPA membership?
What is the best $69 you can spend in photography?
More Questions about Pumas in Pennsylvania
Are the Latest Fast CF Cards worth the Expense?
How does the 7D hold up in a recent shoot?
Which is the better camera, the Mark IV or the 7D?
Are there Mountain Lions (Pumas, Cougars) in Pennsylvania and the Mid-Atlantic States?
Why is bat photography so difficult?
What do I think of the Canon 1D Mark IV?
Why do I advocate manual exposure so avidly?
Where can I find Depth of Field reference charts?
What is the Keboko backpack? Is it the New Best Pack?
Is there a correct position for the upright on a Wimberley actionhead?
How, Who, and Why? The story behind our new web site.
Archived Questions of the Month
Most of my original Questions of the Month for the last several
years are available through this link. The 'look' is from my
original web site, although if I ever have enough time I might
redo these pages to match the new web site But that's not
a high priority.
