I am an active 74-year-old male with good overall health.
My first back problem occurred in 1974 when I was 31 years old. I was building a deck and twisted around putting a stairway landing in place. The next thing I knew, I was down on all fours and had to crawl to the front door of the house. An osteopath performed a gentle manipulation treatment that was almost miraculous, and I was almost immediately as good as new. He was to be my savior for many years.
Between 1974 and 1999, I had problems every couple of years. These were sciatica in my right hamstring or, less frequently, back spasms. (For a long time, I mistook the sciatica for a recurring hamstring problem.) After the osteopath, these were treated mainly by chiropractors. I had been an active runner since the mid-1960’s. I adjusted my daily running routine according to my back problems. But I managed to compete competitively in occasional 10K races. In the late 1980’s, a chiropractor I saw when having problems on vacation advised that I should stop running. After that, I switched to bicycling and other low impact exercises.
In late 1999, after moving and starting a new job, I missed two weeks of work after a business trip with extended sitting in airline flights and meetings. Based on X-rays, a chiropractor advised the disks in my lower back (L4-L5) were quite thin and suggested I was headed for problems. I don’t know if the causes of my early back problems and those that were being identified 25 years later were the same, but the effects were.
From 1999-2012 I had relief from occasional chiropractic treatments, usually with electrical stimulation, and very rarely doctor-prescribed Prednisone 6-day packs.
Despite the preceding focus on back problems, I should emphasize that the incidents that began in 1974 were sporadic and unpredictable. Most of the time, I lived a normal pain-free life.
In mid-2012 I experienced severe lower back pain and spasms. While waiting for my appointment with a spine specialist, out of desperation, I even tried acupuncture. It did absolutely nothing to relieve the pain.
By the time of my appointment with the specialist, my wife had to push me into the office in a wheelchair. X-rays showed the disks in the L4-L5 area were very thin and there was also some disk bulging. The narrowed gap between the vertebrae was putting pressure on the nerves. I was scheduled for lumbar fusion surgery several weeks later, with the option of two epidural shots prior to that.
I went to my family doctor for a second opinion. He recommended that I take the epidural shots and have physical therapy. He gave me a referral to a therapist that had done good work with backs. Even though I was in a lot of pain, he recommended against surgery until I had exhausted the other options.
He said the success rate of back surgeries was very “iffy”. I followed his advice and after the second epidural shot and several months of therapy, was feeling good.
I also needed two epidural shots and physical therapy each year from 2014-16. The periodic primary pain I experienced was sciatica in my right hamstring when I walked or stood. I had to reduce the frequency of my daily 2+ mile walks and other activities. Only very rarely did I again have back spasms and they were minor.
The 2016, epidurals were not very effective. There was the complicating factor that right after the shots, we moved from the Richmond area to Hampton Roads. I am sure the physical activity associated with moving compounded my problems. At times, I seriously questioned whether I was going to survive the move without surgery.
After our move, I asked my daughter for recommendations for a spine specialist. She has lived here for numerous years and has a best friend who is a surgeon. After discussion with his colleagues, he gave her two names. Dr. Jeffrey Carlson was one of them. I made an appointment with Dr. Carlson first. This was based mainly on his reputation for a conservative approach and his experience with minimally-invasive surgical techniques.
Based on his examination of me and X-rays, Dr. Carlson recommended six weeks of physical therapy and then a follow-up appointment. The physical therapy did nothing. I had the follow-up appointment and he scheduled an MRI on my lower back. At the MRI follow-up appointment, Dr. Carlson said I had severe spinal stenosis. I had two options, epidural shots or surgery. He said shots weren’t usually very effective for someone with a problem of my severity. I told him I had already been down that road and could personally attest to what he said.
Regarding surgery with his techniques, he said many people returned to work about two weeks after surgery (No! I’m retired!). I would wear a back brace for six weeks. Also, I would wear a harness-type electrical stimulator two hours a day for three months to speed healing and bone growth.
Based on being “surgeon-recommended”, Dr. Carlson’s extensive resume, the huge number of surgeries he has performed, his experience with minimally-invasive techniques and a reported 95% success rate, I scheduled surgery for about a month later. I elected to not even get a second opinion. There was absolutely no pressure on me to have the surgery. The doctor said it was up to me how long I wanted to continue living with my existing condition.
The month before surgery was an emotional roller coaster for me. There were good days and bad days for the level of my sciatica pain. Also, the pain was worse in the mornings, but diminished during the day. A minimal dose of Ibuprofen most days helped, but I wasn\’t supposed to be taking it or any any other NSAIDs, due to a history of ulcers.
When the pain was bad, I thought I couldn’t get the surgery done fast enough. When the pain was less, I had thoughts that maybe I could continue to avoid surgery. Complicating this was my inexperience with surgery. My only surgery was over 50 years ago. My family doctor\’s 2012 caution about back surgery also continued to ring in my ears. Testimonials and information on this Website plus some videos by Dr. Carlson on YouTube helped reduce my concerns during this time. I especially recommend his comprehensive “Management of the Deterioration of the Lumbar Spine” at the following link https://youtu.be/oJTX4Tcz0Gw
Dr. Carlson performed a fusion of L4-L5-S1 in mid-January 2017. The surgery took about two hours, which was 45 minutes longer than estimated. I went home in the evening the day after the surgery. I used a walker in my home for a day or two and then switched to a cane (which I occasionally forgot to take with me!). A nurse and physical therapist did home follow-up every couple of days for about two weeks and then both released me. After three weeks, I was up to my goal of daily 2+ miles, 40-minute walks. I no longer had any leg or back pain, except near the incision. That pain was very minor. After tapering off, I stopped taking any pain medication 2-½ weeks after the surgery. After my six-week follow-up appointment, I no longer wear the back brace. Healing is progressing nicely. I have no restrictions. As originally planned, I will continue to wear the electrical stimulator 2 hrs./day for another 6 weeks. I will also have physical therapy 2x/wk. for six weeks to strengthen my back muscles.
In conclusion, based on my surgical outcome, I cannot recommend Dr. Jeffrey Carlson highly enough. The good doctor definitely knows what he is doing and has the skills to support the knowledge. Moving to the Hampton Roads area and having him recommended as a surgeon has been life-changing for both me and, indirectly, for my wife. Kudos also to the doctor’s staff, including nurse Kaye Dame, the staff of Bon Secours Mary Immaculate Hospital and the Personal-Touch nurse, Margaret, and physical therapist, Julie, who did home follow-up. They all were instrumental in guiding this surgical-newbie through the process.
I hope that some of this information may be helpful to others who are considering similar surgery.
William Busby