[Caveat: I could have titled this piece “Too Much Information.” I realize that it’s a bit lengthy by blog standards, and for that I apologize. But I’ve received so many questions about my back in recent weeks and months that I couldn’t figure out how to adequately answer them in a couple of paragraphs. I will give you a time-saving tip, though – if you don’t care about the back story, and are just here for the pictures, skip to the end of the post – they’re worth the price of admission!]
Although my recovery from back surgery is far from over – I expect to be at it another five or six months – I would like to give my heart-felt thanks to Dr. Bill Beutler, the Medical Director of the Pennsylvania Spine Institute in Harrisburg, as well as to his partner, Dr. Walter Peppelman, who assisted in my operation. It was my extreme good fortune to find them at a time when I really, really needed a good surgeon…or two.
Judy gets the credit for that. Dr. Beutler had performed successful back surgery on her nephew, Zach, a couple of years earlier, and she was very impressed with him. I had my doubts - not about Dr. Beutler, but about the whole idea of surgery. I’d been through it before, having had a discectomy that did not go well when I was in my late twenties. After that, it was years before I was able to function without some level of pronounced back pain. Being ever the quick learner, I swore, “Never again!”
But “Never again!” becomes a lot less absolute when you’re faced with the prospect of not being able to walk, and I was fast approaching that condition last fall. And the pain was becoming worse by the day. We’d rescued an energetic (that would be the diplomatic adjective) Australian shepherd mix puppy the previous year, and getting her outside for exercise became such a challenge that I’m sure she wondered about her “luck,” being “rescued” by the likes of me. I reached a point where I couldn’t manage walking more than about a hundred feet without having to sit down and wait for the searing pain in my legs and back to subside. I tried lumbar injections, physical therapy, special exercise programs, etc., with no luck. The writing was on the wall. So I relented and called Dr. Beutler’s office, only to learn what should have been obvious – talented back surgeons have heavy demands on their time. I wasn’t even able to see Dr. Beutler for another three months.
So I made the appointment, and to be honest, I thought that having to wait several months might not be all that bad. I was still hoping against hope that maybe – just maybe - I’d be better by then, and I could cancel the appointment. It didn’t happen. The pain just got worse, and worse, as did the limitations. When I finally saw Dr. Beutler, he took one look at the MRI and X-ray and shook his head. He diligently laid out all my options, but it was pretty clear to me by this point that, if I wanted to continue walking as a means of getting from Point A to Point B, I needed surgery.
To complicate matters, I learned that I had a couple of options that affected the scheduling of this surgery. Dr. Beutler could do it with the assistance of one of his no-doubt talented residents, which would allow us to place it on the surgical calendar relatively soon. Or, as he strongly suggested, he could do it with the assistance of his highly-experienced practice partner, Dr. Peppelman. The problem with this approach was that it would be another six weeks before a slot with sufficient time would be available on both of their surgical calendars. As much as I longed to put this surgery behind me, this was a no-brainer. When Batman tells you he can help you with your problem, but he’d like to have Robin assist, you don’t ask what for. So we waited the interminably long six weeks for Batman and Robin.
Finally, the day came. My surgery was twofold - a multiple laminectomy, and a lumbar fusion. A laminectomy involves removing parts of the vertebrae so as to relieve pressure on the nerves. (Dr. Beutler told Judy after the surgery that he found my spinal column to be “highly stenotic,” a fact that was no doubt contributing significantly to my pain.) A lumbar, or spinal fusion, involves the placement of titanium implants to stabilize the portion of the spine that’s been affected by the laminectomy and by disc degeneration. In my case, Dr. Beutler also took bone from the removed lamina to use as a graft, providing additional support for the bridge between adjacent vertebrae. (If you’re interested in a more in-depth description, there’s a good one at Web MD.)
Now, if you lasted with me this long, you deserve a medal. I don’t have one for you, but at least you are about to reap something in the way of benefits. The real reason for this post, with all the background info, is that I wanted an excuse to post a couple of REALLY COOL PICS! I was able to persuade Dr. Beutler’s medical assistant, Dominique, to give me copies of the post-op x-rays. (Side note: Judy’s nephew, Zach, and I agree that there are probably a large number of patients who go to Dr. Beutler purely for the pleasure of dealing with Dominique.)
First, the full frontal photo (unfortunately, of me, not Dominique):
And now the side view:
Maybe it’s just me – I realize I do have a somewhat personal connection to these photos – but I find them absolutely amazing! There is more expensive hardware in my back than you could find in most Home Depots.
I don’t think I mentioned it earlier, but Dr. Beutler is a board-certified neurosurgeon, who also has an Orthopedic Spine Fellowship on his resume. But when you look at these pictures, you have to think that the time he spent earning his undergraduate degree in bioengineering at Johns Hopkins was time very well spent. Thanks, Doc!