A Good Talk

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disk extrusion extending up from the line

I had a good talk with my sports medicine doctor yesterday that helped settle my mind. Dr. A. said that it’s good in a way that it’s hard to decide what to do in my case. If my back injury had been worse, it would have been obvious to everyone that I needed surgery and I would have had it earlier on. But a worse case like that would also have had less chance of turning out well.

He also said that “although it’s easy for me to say because I’m not your surgeon,” he thought I would have a better chance than average of having a back surgery turn out well. The statistics for back surgeries include people with all kinds of factors like smoking, obesity, being very out of shape, difficult traumatic injuries, and the need to return to heavy manual work. He said that some surgeons won’t even take on smokers and obese patients because they don’t tend to do well. He noted that I don’t have any of those risk factors and already have good body awareness and posture.

Dr. A. also gave me advice on picking out a surgeon and talked about different experiences he’d had  with spine surgeons during his training, including a famous surgeon in California who’d helped shape his thinking. This surgeon used to have all his patients do physical therapy before their surgeries. He would even do exercises with his patients in the gym. This surgeon’s rationale was that the PT might solve their patient’s problem so that they would not need surgery, and if it didn’t, they would recover more quickly.

A different spine surgeon Dr. A. had encountered in his training used to scare his patients into surgery by saying that if they didn’t have surgery right away they would be paralyzed. From my own experience in midwifery school, I know how hard it is to be a student witnessing behavior from your preceptor that you don’t agree with but are not in a position to speak up about. I’m not at all surprised that it stuck in his memory.

So Dr. A. said that no one knows for sure what the optimal timing is for for surgery and anyone who tries to give me a definite answer on that is lying. He said he’d have more confidence in a surgeon who said that it might be OK for me to wait a month or two and see what happens than one who would promise me that I would not need surgery at all.

He encouraged me to stay away from surgeons with the stereotypically brusque surgeon personality. He hoped I’d find someone communicative who would follow me properly and help me resolve any problems that might come up after surgery. Basically I just need to get my consults and see what I think.

I’m glad I have Dr. A., who I’ve seen for over 20 years, to help me get some perspective. My consult with the neurosurgeon is tomorrow and I do feel more ready for it now.