Going Under the Knife for Back Pain?
by Peter Kravitz
The sudden onset of severe back pain stunned me a year ago. I’d never had back pain before and was uncertain what to do. The pain stabbed my lower back as I walked and stood, although, surprisingly, skating and swinging a golf club were pain-free.
At first, I thought the culprit was sciatica, which I have in my right hip. My wife, who has dealt with back pain, directed me to a back clinic near us on Long Island. I saw a doctor there and got an MRI. He diagnosed my problem as stenosis, a narrowing of the vertebrae that he said was compressing the nerve root.
Not completely sure of the diagnosis, I tried another doctor, a pain-management specialist, who agreed with the stenosis diagnosis. She also said I also had arthritis and the back of a ninety-year-old. Well, my mom is ninety, and her back is much better than mine, so maybe I have the back of a 100-year-old.
After trying physical therapy and medical massage, I received two epidural steroid injections. My back felt great for about forty-eight hours after each shot, and then the pain returned, a searing, mind-numbing surge across the left side of my lower back. I had to bend and stretch to alleviate the pain every 100 yards of walking and every two minutes of standing.
My wife then rescued me. She posted the following three months ago on the app Nextdoor: “Can anyone recommend a back surgeon on Long Island they were happy with? My husband has stenosis, and so far nothing has worked. Thank you.”
There are now 170 comments to that post, with additional responses each day.
Many respondents recounted horror stories, warning me to avoid back surgery. One man said he had three back surgeries over six years, and each took a year to heal. Another person said her grandmother is now paralyzed after back surgery.
Perhaps the best advice came from a woman with the same name as my wife, Jennifer. She said, “Going to a surgeon on Long Island is convenient, but I strongly urge you to go to HSS in Manhattan. I had a cervical spinal fusion there, and today my range of motion is beyond belief. It’s worth the ride into the city.”
Another person echoed that advice: “Don’t waste your time on Long Island. Go to Hospital for Special Surgery (HSS). The surgeons are the best in the world. I had severe stenosis and spondylolisthesis. I thought I’d never walk again. After being operated on at HSS, today I hike, bike, and downhill ski.”
So I chose Dr. James E. Dowdell III, a spinal surgeon at HSS. I made about five trips to the Upper East Side, sitting in brutal Long Island Expressway traffic on the return home each time. But, despite the hours of LIE stop-and-go driving, it was worth it.
Right away I saw the benefits of HSS as compared to the Long Island doctors. It’s not that the Long Island doctors weren’t good. Rather, the HSS MRI machine was superior to the Long Island one. Dr. Dowdell had me get an MRI at HSS immediately. I’m claustrophobic, so thinking about the MRI kept me awake at night. However, the technician gave me glasses that enabled me to see outside of the machine. That helped.
After seeing my clearer and more-detailed MRI, Dr. Dowdell gave me an eighty-percent chance of significantly less pain after the procedure he recommended. There was also risk—a two- to four-percent chance of a complication requiring a much longer recovery.
I was fearful. I could still golf, using a cart, and play ice hockey at age sixty-one. If a surgical complication arose, my ice hockey and golf might be finished. But if I did nothing, the pain might worsen, and my sports might still be finished. I realized I had to go for the surgery, and my wife was supportive and very positive, telling me I’d be fine. Meanwhile, I envisioned worst-case scenarios—paralysis or death.
But I couldn’t wimp out. I nonetheless made sure my wife knew where I kept our will and my zillion passwords and log-ins.
I had to be there at 5:30 a.m., so I drove into the city. My wife planned to take the train into Manhattan and then drive me home. I hoped to keep her from waiting for hours.
Unfortunately, I had to stay overnight because I couldn’t urinate and needed a catheter, a result of the anesthesia. So my wife still waited for hours and then slogged through brutal traffic. But that was a small price to pay for a surgical procedure that worked incredibly well—beyond my wildest expectations. The procedure was a minimally invasive, left posterior tubular decompression L2–L3 with Stryker navigation. Dr. Dowdell made a small incision, slipped a tube under the muscle, and cut away a bit of ligament that had compressed the nerve sac and nerve root.
I went home the next day with little pain. I took Tylenol, passing on opioids. The incision was sensitive, but Dr. Dowdell told me to walk as much as I could, and I walked a mile—the most I had walked in a year—two days after surgery. The searing pain that had tortured me was gone.
It’s shocking to suddenly be pain free. Two weeks after the procedure, Dr. Dowdell gave me the go-ahead to return to the gym, with caveats. I did twenty minutes on an elliptical machine with no pain. I had barely done ten minutes on that machine, fighting pain, for the entire previous year.
No doubt those Nextdoor folks were right about HSS. Every aspect of my treatment and care there, from the nurses to the doctors, was perfect. While I have a little stiffness in my lower back, I can walk and stand again.
Dr. Dowdell soon cleared me for all activities, and, six weeks after my surgery I was back on the ice playing hockey. I feel like I’ve gotten a second chance at health.
Photo credit by Sasha Lebedeva (Kyiv, Ukraine) https://www.behance.net/lebedeva
Peter Kravitz is the author of So You Wanna Be a Teacher, a former Philadelphia reporter and retired New York public high school Journalism teacher. He's a regular contributor to Silver Sage Magazine.