Believe me this is not the most exciting web page you will read but my only excuse is that when I wrote it I had spent the previous 5 or 6 months with little to do but lie on my back or hobble about awaiting the next event and ponder on what has happened to me. Originally it was a page put on the web with no links so my relatives in the UK could read it but somehow a web crawler must have found it because I started to receive e-mail asking me about the operation. After many such enquiries I decided it might as well become a public page.
OK, I am sorry, right? either go back to where you were or get on with reading the sorry tale of my lower back:
If you have read this page before I have added a few progress reports which you can jump straight to:
Then the Thanks
I have to say "Thank you", to the wonderful nurses in Ward 17 at Wollongong Hospital who look after their patients with such kindness. How they do it is beyond me.
On the evening of the 20 August 1998 I was walking with the kids down to the video shop when I noticed a stiffness in my back. Over the evening it got worse and by the morning it was bad enough for me to visit the doctor and have a sickie from work.
My doctor said the muscles on the left side of my lower back had gone into spasm, gave me some tablets, told me to return the following week and recommended seeing the sports physiotherapist who's rooms were at the end of my street. Slowly over the next week the muscles freed up and by the following Friday felt fine. When I asked what was causing the problem the physiotherapist had mentioned that the spasm could be the result of an underlying problem such as a damaged disk but that was the extreme case and it was probably just a pulled muscle or trapped nerve.
I returned to work on the 31st August with a developing pain in the back of my left leg, this pain was similar to the sciatica I had a few months previously (April/May 1998) but that week it slowly got worse. Driving to work on Friday 4th September I was in considerable discomfort and only continued on because I was closer to work than home and I hoped the pain would ease as the day went on. It did not and after only a couple of hours I left work and went home.
Now my leg was in considerable pain, it was all I could do to get to the doctor (20 metres away), a couple of further visits to the physiotherapist brought no improvement and he suggested it was much more serious than he could deal with and recommended I get a CT Scan. Back to my GP for a referral and off for the scan, again conveniently situated at the end of my street - This took place on the 15th September 1998. The biggest problem for me was that while I could lie down or stand, sitting was just about impossible
I spent most of this time in considerable pain lying on a sofa bed in the lounge, armed with my stereo and video remote controls, listening to records, CDs, the radio and watching innumerable videos (varying in quality from appalling to excellent). Nine months earlier I had purchased a ticket for OzOpera's performance of Rossini's "The Barber of Seville" performed in Wollongong the day before the CT Scan and I made an attempt to attend but abandoned it after a couple of kilometres as the pain was just too great even though I taken two Endone tablets.
My next visit to the doctor was for the results of the CT Scan, it noted a 'significant' disc protrusion between L5 and S1 (make what you will of that) so an appointment was made with a local neurosurgeon for the 22nd September. On this first visit, after examining the scan pictures, he basically explained the options as:
It was decided that an epidural would be tried first so on the 24th September I entered hospital for the injection and returned home the following morning with considerably less pain than I had previously.
Whilst there was still some pain I was now able to walk about (with a limp), ride my bicycle (slowly) and take a more active roll in day to day life while also being aware that there were limits to what I could do. Unfortunately as time went on the pain increased and I was still only able to sit for short periods of time - travelling in a normal car was just about impossible though, because of the different driving position, I was able to drive my van for about 15 minutes before needing to stand for a while.
My next appointment with my specialist was not until 26th October but by then it was quite evident that further treatment was needed, he agreed that a micro endoscopic discectomy was probably the best way to proceed and he would approach the health service for funds as this operation had to be carried out at Figtree Private Hospital because Wollongong Hospital did not have the necessary equipment.
During this period I missed participating in the Sydney to Gong Cycle Ride for the first time in years
The wait and the pain continued until 25th November when the decision was taken out of our hands - getting up to go to bed I suddenly found I couldn't move - thank gawd I had taken to carrying my mobile phone with me everywhere, my only solution was to call an ambulance. While the ambulance men were helping me down the front steps out to the stretcher the most excruciating pain shot up my leg to my lower back, I have never felt pain like it, it was agonising, the final inches to the stretcher were accomplished very slowly hopping on my good leg. Once in the ambulance I was given a gas which didn't exactly take away the pain but meant I no longer cared about it - bliss!
My specialist saw me at the hospital in the morning and tried to make arrangements for an operation the following day, as it turned out unsuccessfully, in the meantime I had fresh X-rays and CT Scan with a special dye injected into my spinal column to provide a contrast medium - apparently these pictures showed the disc protrusion to be 'massive'.
The operation was eventually scheduled for the 4th December at Figtree Private Hospital.
When the day finally arrived I was taken by ambulance to Figtree, admitted and prepared for surgery, the operating room, which I saw only briefly before succumbing to the anaesthetic, looked more like a computer room than an operating theatre, with electronics and monitors everywhere.
I awoke several hours later in bed and not in any great pain, in fact at worst I was slightly uncomfortable.
The next morning (Saturday) an ambulance took me back to Wollongong Hospital (thank goodness - Wollongong had much better food!) and the same afternoon the hospital physiotherapist showed me how to get out of bed and took me for a walk down the corridor. On Sunday she returned to see if I was able to climb stairs and having satisfied herself I could, left. By Monday I was moving faster than I had for months and looking forward to going home; Tuesday afternoon, I was home.
Wednesday, 9th December, I woke, sat up and instantly had a massive headache, by the evening it was worse and I was crawling around the floor to get from room to room. The radio doctor was called, he reckoned it was a migraine. On Thursday the Home Nurses came to remove the staples holding the wound in my back together, they didn't seem to think my headache was a migraine so the following day I rang my GP to come and visit me. He immediately diagnosed a cerebral fluid leak and rang the specialist to find out what to do, it was decided to wait 48hrs and on Monday work out what was to be done.
Monday, 14th December readmitted to hospital for a blood patch the next day.
A blood patch is an epidural where a person's own blood is injected into the spinal column to try to seal the leak (The headache is caused by the brain being subjected to a negative pressure as the fluid leaks out). BTW if you are ever offered a choice between an Epidural and something else, investigate the something else - epidurals don't actually hurt but are a very uncomfortable, unpleasant sensation.
Unfortunately the blood patch was not successful so the rest of the week was spent looking for all possible causes of severe headache starting at brain tumour and working down through sinus problems to caffeine withdrawal symptoms.
Tuesday, 22nd December a second blood patch was performed - this one still didn't cure the problem but made it much better, I was discharged on the afternoon of the 25th December after a visit from Santa and his Elves, one of the latter gave me a lolly bag, Ho Ho Ho!
I was readmitted to Wollongong Hospital for a final blood patch on the 7th January 1999 and discharged on the 11th January, if this patch didn't work then my back will have to be opened up to see exactly what the problem is.
29th January - the last blood patch appears to have been a success. my fitness is coming on in leaps and bounds and I should be back at work next week.
I have been back at work since the beginning of February and am now working full 8 hour shifts. I still have some restrictions placed on me, I am not allowed to climb ladders or operate large, stiff valves. My main problem has been getting my fitness back, by the end of the working week I am getting pretty tired. I still walk with a slight limp and have some weakness in my left ankle but I am back riding my bicycle a couple of times a week .
Since starting work I have experienced some slight lower back pain as the day progresses but this tends to be on the right hand side (ie the opposite side to the original problem) and lying down alleviates this pain.
As I understand it the complications I experienced with the leaking cerebral fluid are the exception rather than the rule so generally speaking I am pleased with the improvement after the operation, I am not as mobile as I was originally but no longer in great pain.
It is now over a year since I returned to work and my progress has been great. My strength has improved and while it seemed a slow business looking back it is unbelievable to think that I was crippled by this illness in the way I was - Since returning to work I have not had a day off work caused by, or related to, my back. When I read the above story it is almost as if it happened to someone else and least physical pain is soon forgotten once it has ceased.
I am back riding my bike to work on a daily basis (if the weather is reasonable - I must admit I avoid bad weather these days) and I now work 12 hour shifts with no problems. I still have some loss of control and feeling in my left leg which is nothing like as strong as my right and I get some aches and pain in my lower back but rarely need pain killers of any sort , when I do Panadol Forte is all that is required.
The one thing I don't think I have mentioned is that my specialist warned me that this operation is not a cure, the disc is still damaged and between five and ten years down the track more action will be required. Currently the procedure is to fuse the bones together but he pointed out that ten years is a long time in medical terms and there may be totally new treatments by then.
For me the operation has been a great success, I have been able to work and continue life nearly as normal for another year with no great pain or inconvenience. I hope it will continue this way.
Since the first operation about five years ago I have had my up and downs but generally speaking my back has been fine and the only problems have been when I have attempted to do very strenuous activities. Since returning to work I have only been off work due to sickness for three days and only two of those days were due to a bad back.
In February 2004 I was about to go off on leave for an extended period to use up my accumulated leave and just before my first week of leave I managed to hurt my back. Within a week it had got worse to the point that I had lost some function in my left foot and I managed to fall over a couple of times walking on uneven ground.
My doctor arranged a CT scan which raised enough concerns to once again send me to a specialist. As my doctor predicted the specialist immediately arranged for an MRI scan because he thought the problem might have been scar tissue from my previous operation attaching itself to the sciatic nerve. However the MRI scan revealed a totally different problem.
The disk between L4/L5 was protruding but instead of impinging on the nerves at that level was actually bulging down between the nerve and the bone and affecting the nerves at the L5/S1 level. This is what gave the similar symptoms as the original problem. Fortunately the symptoms reduced to a less dramatic level and it was just a question of waiting for another operation.
In August 2004 I spent a few days in hospital having another discectomy to fix this new problem. I had no complications after this operation and was back at work a couple of weeks later. Since then things have been good.
A bit of self inflicted suffering. In July I lifted a floor sander in and out of my van and hurt my back again.
A CT Scan has revealed some disc impinging on the nerves and in early September a Periradicular Spinal Therapy is booked in. This is similar to the treatment I first received 10 years ago but this time epidural, periradicular corticosteroids and local anaesthetic are injected under CT guidance using a very high definition CT scanner. According to the information sheet the radiologist can place the needle very accurately and the needle tip position is confirmed with a small amount of Xray contrast dye.
After the above mentioned 'therapy' the pain eased for a few weeks but there was a residual weakness in my left foot. An MRI revealed scarring as well as disc affecting the spinal column.
On 12th December I visited my specialist and much to my amazement I found myself on his list for an operation the next day. I spent the afternoon following my appointment at Wollongong Hospital going through the pre admission procedures having blood tests, seeing anaesthetists etc.
The operation was carried out on the 13th December and my left foot showed an immediate improvement in strength and mobility. It is now three weeks since the operation and I am out of that terrible period where any progress seems to be so slow, movement is difficult and painful etc. Now I am just waiting for the 4-6 week period when I cannot drive to end and things will start to go back to normal.
I hope this will be the last of these operations for a few more years (please!)
As usual the nurses and doctors at Wollongong Hospital were wonderful and for all its faults you cannot complain too much about the Medicare system, the 1.5% Medicare levy is money well spent. My kids were so good and so helpful too.