Log of a Discectomy

This is the story of a painful part of my life. I am writing it for the unfortunate few who have to deal with lumbar disc herniation. This story gives hope to people who suffer from sciatica, and it gives encouragement to people who are in the recovery phase of their discectomy surgery.

Today, several years after my sciatica started, I am sitting in my chair, writing this story pain free. Memories of that October morning when it all started are fading.

--------------- Pre-Discectomy

October 2013
I woke up with a dull pain in my back. Sitting down makes the pain worse. I continue with my daily activities. It has happened before so I ignore it.

December 2013
Months later, my back is still sore. This is unusual.

March 2013
The back pain has increased in intensity. Some days, my calf has a dull pain. I can relate this dull calf pain to growing up pain I had when I was in my teens.

April 2014
I tow a light aircraft by its strut, and suddenly I have a sharp pain in my back. I have to sit down. My friend drives me back home. The sharp pain is gone the next day, but the dull pain remains.

May 2014
I am standing in my office with my hand on a cubicle wall. I sneeze and have a sharp pain from lower back to upper thigh that knocks me to the ground. It takes me fifteen minutes to get back up.

I see my family physician who recommends physical therapy. I do four weeks of physical therapy. The dull pain remains.

I am sitting and suddenly, I have sharp pain in the same general area. I take the day off from work. At night, I am watching Pulp Fiction for the twentieth time, and I am in tears. When I laugh, my abdomen muscles cramp up.

My family physician recommends me to get an MRI. The MRI shows slight disc herniation/protrusion of L5-S1. Nothing to worry about.

Slight disc herniation of L5-S1. S1 Right nerve is slightly compressed (on left side of image)

June 2014
Life goes on. I have accepted these occasional flare ups. I am particular about PT which I do at home now.

December 2014
The pain in the back has decreased. The pain in the upper thigh area remains but is manageable. I travel to Utah and do bunch of driving and hiking.

April 2015
I travel to Turkey. I walk ten miles a day. The back pain comes and goes. I can deal with it. I am still on physical therapy. My core is rock hard.

May 2015
The pain is gone from back and thigh. I feel cured. Then after one week of no pain, I have another flare up and the pain is moving downward in the leg.

July 2015
I hike Mount Washington.

August 2015  
I have a bad flare up. Sitting now brings a full blown leg pain on the right side, all the way to the calf. Standing or lying down is not an issue.

September 2015
I am unable to drive now. I grind my teeth while driving. The pain has moved down to the foot. I am still doing PT but it is painful. I am walking on treadmill to keep my cardio health.

October 2015 
I travel to Italy. It is painful in the airplane. Advil does not help much. I am in pain throughout the trip. Pain runs from lower back to foot.

November 2015  
The pain is now unbearable. I cannot walk/stand for more than ten minutes without pain. I cannot sit at all.
I see a neurologist and have another MRI.

Right S1 nerve (left on the image) is pushed out of view due to large herniation. Left S1 nerve is in correct location.

The herniation is pushing the S1 nerve. The herniation is much larger than a year ago. The neurologist recommends McKenzie exercises. I try McKenzie for a couple of weeks with no change. I am taking Medrol, and Advil. I have a lumbar epidural steroid (Depo-Medrol) injection.

The ESI is painful but has no effect even after several weeks. Two weeks after ESI, I have had enough. I decide to go for discectomy surgery.

Depo-Medrol Shot: It was a painful experience. You lie face down, while the doctor inserts a needle in your spine epidural area. It sounds painful, and it was painful! It did not help, and I later found out that this is a risky procedure with a small chance of relief.

November 16, 2015   
I have stopped going to office. I am working from home, lying on the bed. Lying down is the only pain free position.

--------------- Post-Discectomy

I had a rocky recovery from the L5-S1 discectomy.
 
Surgery Day
Life halts today completely. I have a L5-S1 discectomy operation. The operation was not painful. I enjoyed the medications that knocked me out.
I am up and chatty a few hours after the operation. I will stay in the hospital for one night.

I walk, then feel the same sciatica pain I had before the surgery. I have good amount of incision pain. The sciatica pain subsides in the next 24 hours, but incision pain is quite annoying.

Day 1 after surgery
I am at home. I am taking 30 mg of Oxycodone, and 3900 mg of Tylenol mostly for incision pain.

I walk around the house.

Day 3 after surgery
I am walking outside on the road. I walk 1/4 miles. I have little sciatica. Sometimes I feel a little stretch in the sciatic nerve.

Day 4 after surgery
I walk a mile outside. I have no pain.


Day 5 after surgery
I walk three miles outside. I have no pain.

 
Day 6 after surgery
I walked five miles outside. I have no pain. I love my new found freedom. Freedom from pain. But I am naive because what lies ahead will change this. This was my last walk outside for next one month.

Week 1 after surgery
I go out for lunch and feel sciatica. I think I have re-herniated. I relax in the bed for next two days but sciatica intensifies. It is less than what I had before operation. I am pretty sure that I have re-herniated.
I call my surgeon's office and am given Medrol (steroid). I take Medrol and the sciatica pain subsides on the last pill.

Incision pain is gone.

Week 2 after surgery

I am off of oxycodone and taking 1300 mg of Tylenol. My sciatica is gone (once again), so I did not re-herniate.

I am lying down. I sneeze and hear a pop in my back. Sciatica comes back the night of the sneeze and now my back hurts too. Getting out of bed is quite painful now. This time I am certain that I re-herniated. I call my surgeon's office and was prescribed another steroid Decadron. I do not take it because I am beginning to hate pills by now.

I do not feel like eating. I feel tired. I know its the stress from not getting well that is making me feel sick.

I will be wrong in everything I assumed.

Week 3 after surgery
Its day before Christmas morning. My back pain is so bad that I call my surgeons office again. They tell me to come to ER for an MRI. I am excited as now from the MRI they could tell if I re-herniated.

I am admitted to ER, and am taken for MRI. I am barely able to stay on the MRI table due to back pain. After I return to ER, they admit me indefinitely. I start shivering uncontrollably. I get up to get some water from the ER bed and faint. I am confused as to why they admitted me. I just need to be assured that there is no re-herniation, and then be sent home.

They took blood samples and fluid from my back to check for infection. They admitted me for three days till infection culture comes back, and put me on Vancomycin IV. They told me they suspect infection because CRP was eight times the maximum limit, and Sed rate was quite high too.

Week 4 after surgery
After being on Vancomycin for a day, my back pain reduces. I stay on Vancomycin for three days in the hospital. I am walking in the hospital with little sciatica and little back pain.

Since the MRI is done so close to surgery, it is inconclusive. The radiologist suspects a small re-herniation, scar tissue, inflammation, and a fluid collection that might be infected.

MRI at week 4. Right S1 nerve is not visible.

Culture from my back comes positive for Staph (MSSA). I am excited to learn that its not MRSA. Surgeon's assistant assures me that I will be sent home with couple of weeks of oral antibiotics.

Then the nurse comes in with an X-Ray machine, and an ultrasound machine. She  breaks the news to me that I will be put on IV antibiotics for 6 to 8 weeks. The machines are brought to insert a PICC line in my arm. I will be tied to a pump 24/7 for the next 6 weeks. The pump will continuously pump Oxacillin near my heart.

Sometimes it takes time to digest all this bad news, and I lash at the nurse for I was told something else.

PICC line is inserted and I am discharged from the hospital. An IV company comes home to hook me up with the IV pump and medication.

PICC line. It goes from arm to top of heart. It "bites" for a couple of days but then you do not feel it. Used for Oxacillin 6 weeks course.

Back home (Week 4)

I am beginning to digest the reality of being tied to a pump for next 6 weeks. This night I wake up with excruciating pain in my leg. The sciatica has returned and this time its several times worse than before the operation. I am screaming with pain. I cannot move an inch on the bed. The pain is equal in intensity to the pain I had when I fractured my elbow. I call surgeon's office and am told by the surgeon's assistant that I probably re-herniated and I need to come back to ER. I hate hospital by now so decide to wait a couple of days. I take full oxycodone, and other pain killers. I wake up the next morning and am afraid to get off the bed. It takes me half an hour to get off the bed, then on to my dad's walker. I am barely able to walk.
I start Gabapentin 300 mg, three times a day.

Week 5 after surgery
Sciatica is manageable again. I get another MRI. There is no change from last MRI. I am happy that a small herniation from the last report has not increased in size.

MRI at week 5. Right S1 nerve is barely visible, and still compressed/displaced. The inflammation/collection is reduced compared to last MRI.

The surgeon assures me that all this is temporary, and I am one out of a hundred that have a rocky recovery.
I hate the sound of the IV pump. Its hard to sleep when the pump is going. I make a box for it to mute its sound. The IV incision site of the PICC line oozes blood all the time but does not hurt.

Week 6 after surgery
I am coming off medication. I still have constant sciatica. Good sleep is a distant dream now. I get Charly horses at night. I feel like there is something crawling in my feet under the skin along with awful cramps.

Week 7 after surgery
Sciatica is gone for a day then comes back. Its manageable but I cannot walk much. I cannot sit for long either. I cannot sleep due to back discomfort and IV line. I am in worse shape than before surgery.
Nurse from IV company comes for blood draw, and gives me cold. I am hating myself.

Week 8 after surgery
I had my wife drive me to work so I can say hi to my colleagues. I show them my pump and gather sympathy. I have not worked for two months.

Week 9 after surgery
Sciatica is ON and OFF. The duration of ON is getting shorter than the duration of OFF. I work for 4 hours in office on Friday.

Week 10 after surgery
I work in office for five days, four hours each day.

Week 11 after surgery
I get another MRI to confirm that the infection has not affected the bone. It has not.

MRI showing Right S1 nerve almost back to its original place (place where it is supposed to be).

The doctor decides to stop my IV, and remove the PICC line on Wednesday. Is this the happiest day of my life?

PICC line removal day. Removing PICC line does not hurt.

I am told by the surgeon that I will make full recovery and the nerve will heal. The ON/OFF pain, and cramps is the nerve healing. He thinks that the earlier MRI report of a small re-herniation may be incorrect.

I go out flying with friends. This is my first day out for fun after first week of surgery. Sciatica bothers me for next two days.

I have started swimming and PT. Both these physical activities irritate the nerve. I am trying to figure the right amount of activity through experiments.

Week 12 after surgery

On the pain scale I am at 1, but sometimes it goes to 3. Before surgery it was 8. For some days after surgery it was 10.

I worked 35 hours this week at office.

I am swimming 30 minutes (14 laps of back stroke), and doing light PT every day. I am not doing PT portions that irritate the nerve.

On the weekend, I am out and about all day long, walking in Newbury street, flying aircraft with friend, and eating out. I have one instance of sciatica (3 out of 10) that lasted half hour.

The more I am out and about, the better I sleep. I am off of ALL medication for one week.

I am sitting, typing this from my chair pain free. I get up and walk about. I feel a stretch in my sciatic nerve. I know it will hurt again, but I know it will get better like it always did.

Italy

(Edit: Some pictures appear hazy. Click on any picture to see it at full resolution)

Italy is magnificent, and it is no secret to tourists as they flock to it. To avoid crowds, we took the kids off school for a week in October. The teachers were not happy. If they resisted an iota, I would have complained tit-for-tat about wasting three schools days on a trip to Salisbury Beach.

Out first stop was Rome via Istanbul on Turkish Airlines.

The trip started rather scary. My dad got ill, and we were just about to cancel when some timely family help gave us the confidence to move on with the plan.

Rome

The flight arrived in Rome at 11 PM, and then Turkish Airlines lost our bag. We had no clothes for our first day in Rome other than what we wore on our flight.

We took the taxi to Airbnb condo in Rome, slept for a few hours, then off to exploration.

Day - 1
Rome has excellent public transportation. We got to Piazza Venezia on a tram, then walked all day to everywhere we wanted to go. We walked 14 miles on the first day, then took the tram back from Piazza Venezia to the condo.

The White Marble Memorial is at Piazza Venezia. You can climb its stairs up to get views of the Roman Forum, and the Colosseum from high up.

White Marble Memorial

A short walk from Piazza Venezia is St. Maria Sopra Minerva Basilica near the Pantheon. The church is worth visiting if Pantheon is closed.

St Maria Sopra Minerva Basilica

Clever lighting in the Sopra Church

Right next to St. Maria Sopra Minerva Basilica lies Pantheon. This is a must see building made by Romans two thousand years ago. You Marvel at the grand scale of its dome. It has been converted to a church.

Pantheon Dome

Church in Pantheon

People looking up at the Pantheon Dome

Right next to Pantheon is Piazza Novona. This is worth visiting. Its a nice place to relax on a marble bench if your back is hurting from all the walking. Kids can feed the pigeons. You can wait here if Church of St. Louis of the French is closed. 

Note: All churches close several times during the day for prayers and lunch, and reopen for tourists close to the advertised times. I researched the schedules beforehand to reduce or avoid waiting times.

Momina at Piazza Novona

Church of St. Louis of the French

Church of St. Louis of the French (family on the right)

You can walk to Spanish Steps from Piazza Novona. Spanish Steps is a shopping area with abundant brand name clothing. Keep the wife distracted, otherwise be ready to waste time on shopping. When you climb up on the steps, you have good city views.

Top of Spanish Steps

There is a church on top of the Spanish Steps area that is worth visiting.

From Spanish Steps, we walked to Trevi Fountain. Since we were ahead of schedule, we visited it during the day, and found no real attraction. The fountains were closed for repairs and the place was full of tourists. You throw coins in the fountain so your wishes come true. We wished for timely delivery of our clothes by Turkish Airlines.

Trevi Fountain

 From Trevi Fountain, we walked back to Piazza Venezia. Since we had plenty of time, and had seen everything we wanted to see on the day 1 list, we relaxed at Piazza Venezia, then walked to the river.

Piazza Venezia

Ruins near Piazza Venezia

View from the Marble Monument

Another view from the Marble Monument

Marble Monument

From Piazza Venezia, we walked across Tiber River to Trastevere area.

Trastevere is less touristy, and offers good food. The narrow, winding streets of Trastevere lead you to Basilica de Santa Maria. This is a magnificent church. We got to it when it was in session. Since I had a camera, I got some stares in the church, and hence I decided to leave. I visited it again on day 2 when it was not in session.

River Tiber (Family in the middle-left)

A church (Too many churches to remember by name)

We were told that Trastevere is not a good place for kids at night so we ate our dinner and took the tram back.

Day-2

Thanks to the God at Trevi Fountain, Turkish Airlines delivered our clothes and perfumes.

We took the tram to Piazza Venezia, then walked to the Roman Forum. The Forum, the Colosseum, and the Palatine Hill are co-located, and are paid sites. One ticket per person covers the entire area, and kids are free. We took the audio guide, and explored the Forum. The Forum and the Palatine Hill is a large area, and requires a lot of patience to cover. After all, its ruins, and if you are not interested in history, it will turn out to be very boring. So read something about Roman history before going there. I enjoyed it because I have some knowledge of the Roman history.
 

Roman Forum

Forum from Palatine Hill

Chariots raced here - killing the damned

Walking to Colosseum

Half of it fell due to an earthquake

Long lines at Colosseum

Sun shining on the Colosseum ruins

Well here we are! at the Colosseum

Exploring the Forum area took about three quarters of the day, then we walked to Trastevere to eat, and to photograph Basilica de Santa Maria.

Basilica de Santa Maria ceiling

Basilica de Santa Maria

Basilica de Santa Maria

Basilica de Santa Maria, one of several ceilings

Basilica de Santa Maria

Tiber at night

Then we took the tram back to our condo.

These last two pictures are view of the Colosseum area at night after we visited Vatican on Day 3.

Vatican

Day - 3

Vatican Museums. Magnificento! This was the highlight of our days in Rome.

The line to St. Peter Basilica starts under the lion on the left, curves behind me, then to the right into the dome behind Momina

We reached the Vatican from Saint Peter's Basilica side. This is a large courtyard. The line to St. Peter Basilica starts under the lion on the left, curves behind me, then to the right, then into the dome behind Momina. The line was a quarter mile long, and this too in off season. The museums are on the other side of the Vatican.

Hint: Purchase Vatican Museum tickets online several weeks before arrival, then visit the museums to avoid long lines, and a possibility of denied entry.

The Vatican Museums are a must see, although the Egyptian Museums in it are a waste of time.

The grandest of all is the Sistine Chapel.

Raphael! This place has so much art.

Art everywhere

Pantheon like dome in Vatican. Statue of Hercules on the right.

More art. More gold.

Quarter mile long ceiling, full of art.

Largest canvas that is not a wall. 30 square meters?

More work by Raphael. This is a ceiling!

Another ceiling.

Another ceiling. These paintings tell stories.

Sistine Chapel is the highlight of the museum. Expect half of Rome present there, looking up.

Taking pictures are not allowed in Sistine Chapel. However, I placed my camera on timer, and left it in a corner, then acted like I was just relaxing. The aperture was open for thirty seconds because flash was off, and ISO was low. The Chapel is so grand, that a multi story ladder fails to reach the roof in the picture below.

Grandest canvas of all. Sistine Chapel. Michaelangelo.

Sistine Chapel. Bible in Paintings.

After Sistine Chapel, all art looks ordinary in comparison, and you quickly walk through the remaining hallways.

Either the blue cheese pizza in the Vatican Museum Cafe was excellent, or we were too starved from a long walk in a crowded museum, or both. We came out, then headed back to St. Peter Basilica.

No Pope, no audience?

After sitting, standing, and lying in the line for several hours, we entered St. Peter Basilica.

Grandest church of all: St Peter Basilica (ceiling)

This is much bigger than it looks in the photo

St. Peter Basilica

The dome of St. Peter Basilica rises 180 feet as seen here

We took the bus back to our condo. Packed up, then on Day 4, took a train to Venice.

Murano and Venice

Day - 4. Travel and stroll around Murano.

I like to stay away from tourist hustle-bustle. I chose to stay away from touristy Venice and got an Airbnb condo in the Island of Murano. This was the best decision of the trip. Murano is mini Venice, about ten minute boat ride from Venice. Yet Murano offers what Venice does not... World class glass factories.
Our Airbnb host was Marco. Marco's condo is right on the water where the water bus stops.

Kids in Murano, in front of the condo we stayed in

Day - 5.

Our host, Marco took us to his uncle's factory where kids learned how to make glass figures.

Inside of a one man glass factory

A glass elephant under the flame

Salt water corrodes everything. In the streets of Murano.

Time for coffee. Wonder what is being explained.

In front of Marco's glass shop.

At a bigger glass factory, a ceiling fixture under work.

We got to blow the glass.

An interesting glass/gold chandelier under work

Glass kiln

By the time we were done with Marco's glass factory tour, the water had risen several feet, and was covering the side walks. What fun for kids, and nightmare for parents!

Maheen looking for ways to cross the street

We took the water bus from Murano to Venice, then through the narrow Venice streets to Realto Bridge.

Narrow alleys of Venice

Streets near Realto Bridge are flooded, and people are walking on tables.

Realto Bridge was not very impressive. Its under construction and there was a large photo of a model on it. Probably the construction was sponsored by that advertiser. There were too many people on it.

Even the restaurants are flooded

Grand Canal trip in the city bus/boat

Water entering the buildings

Gondola at Grand Canal

San Marco Square, full of tourists

Some info about the public transport in Venice / Murano: Water taxi is expensive. No matter if you get a pass, or go ride by ride, it will cost a lot. I bought the official water bus pass for 36 hours (kids are not free) so I do not have to think about going broke on every ride. Then I used/abused the pass to go back and forth on Grand Canal couple of times, and stop in many places. The pass is the way to go. The ride to the airport is not included in the pass, and on the Alilaguna bus, you pay a fortune to get to the airport. The only other option is swimming.

The following pictures are taken at or near Grand Canal.

Blessings of sea creatures!

A church on the other side of the canal

Grand Canal

The church on grand canal is big but ordinary in decorations by Italian standards

Other side of canal

Sunset at the grand canal

The next day, we took the water bus to the airport on our flight to Naples.

Pompei

Day-6. We rented a car from Naples airport and drove to nearby Pompei. This is the ruins of an ancient city buried in 79 AD by volcanic ashes of Mount Vesuvius.  There is a Hollywood flick on it which I have not seen. I parked in the hotel we had just checked in, then walked to the ruins entry.

A human guided tour is a must. The site is big, and its all ruins. Without the guide I can imagine anyone getting lost and/or bored pretty quickly. The guides will show you places, then explain their significance in the ancient society.

This is a place kids were looking forward to throughout the trip. This was kids day. They learned a lot here through our guide.

Its all ruins. This is a theatre.

All this was buried under seven feet of ashes. This is the only roof that did not buckle.

A symbol near a brothel.

Mount Vesuvius from Pompei ruins

People of Pompei?

There is no town in Italy without a church, and Pompei has an impressive one. Pompei is a small city so I was surprised to see this big a church there. Its a short walk from the ruins, in the city centre.

Church in Pompei

Ceiling with art in Pompei

Impressive but its not St Peter Basilica

We spent one full day in Pompei, although the ruins require one half day to see.

Ravello and Positano 

Day - 7.

We got up early to spend a day in Amalfi Coast which is half an hour drive from Pompei near Salerno.

We were warned about difficulties of driving the Amalfi Coast in rental car. I think it was no big deal. In fact I had fun driving the SS163 road that visits several small towns on Amalfi Coast.

I got an automatic car (quite unusual in Italy), and folded its side mirrors. The road is narrow and you do not want to lose a side mirror to a car from the opposite side, or to a speeding Vespa.

Just practice common sense driving rules and you will be fine. If you cannot drive fast enough, slow down or stop to let people pass from behind. There are plenty of places along the road where you can stop for views but while driving, concentrate on the road.


Parking is quite expensive, but pay up and do not waste time in finding free parking as there is none.

We decided to visit Ravello and Positano.

Start of serpentine road SS163

A beach on Amalfi Coast

Gardens of Ravello.

The Gardens of Ravello is a must see. There is an entry fee to the gardens. The gardens have a spectacular unrestricted view of the coast from a high up vista point.

More views from the garden

Now I know where Kiwi comes from

More views.

Stuck van! Now thank me and back up.

Ah so clear

More views

Lucky people live here

A church not visited

View of Positano from SS163

Caves near Positano

Nice pose.

When we got to Positano, we parked on the road then descended to the beach through narrow alleys.

Descending to the beach in Positano

Climb back up will be quite strenuous. It was not.

Another church not visited. Positano.

Kids having fun on the Positano beach

Sorrento. End of our trip.

SS163 at Sorrento.

From Sorrento, we drove to Naples, then continued on to Rome. Driving a car in Italy was a good experience and it was not difficult at all.


Day - 8.

Flight back to Boston. We were dead tired, and I slept on the floor of the aircraft cabin, under my family's feet. Our next trip will have lot less travel.