Friday, July 31, 2009

A Tale Of Spinal Torment - Part 3 of 3

There were other treatments I may try next time. One is chiropractic. Dr. Philip Striano of Hudson Rivertowns Chiropractic in Dobbs Ferry suggests a course of stretching on the DRX9000, the latest high-tech device for relieving pressure on the disc. In my case, he said, “The machine is able to slowly stretch the scar tissue to make it more linear, actually remodeling it to allow the nerve more room.”

Dr. Sharma agrees, with a caveat. “That traction can be helpful because it temporarily opens up that space where the nerve roots are,” he says, adding, “But it’s not permanent.” That’s okay by me. Apparently, neither was my surgery.

In a demonstration session, I started with a heat pack to loosen the muscles, then I laid on my back strapped to the machine with my knees supported. Striano explained, “It pulls in an algorithm of pull-and-relax, pull-and-relax, so the muscles don’t go into a protective reflex spasm.” In English, he meant that a steady pull would cause the muscles to pull back—hard. During the session, I felt my torso lengthening slowly as it was stretched, then relaxing as the pull was decreased. It would have been easy to fall asleep. At the end of the session, I felt like an accordion relaxing back to a normal posture under the influence of gravity.

The other alternative isn’t whiz-bang new; it’s an ancient treatment first described in 475 BC in Chinese literature. I’m talking about acupuncture, of course, or the insertion of fine needles into the body at specific points. Dr. Sharma says it helps about two-thirds of back pain sufferers, although more frequently simply by relieving chronic pain for an indeterminate period of time. When I described my symptoms to Dr. Gabriel Po-Jen Lu, a Scarsdale MD who practices the ancient art in a highly scientific and quite modern way, he said, “The acupuncture itself doesn’t decompress the disc, but it will relieve the muscle spasms, decrease cramping, improve circulation, and release endorphins, which is your body’s natural pain killer. It isn’t a cure, but it will make your life better by relieving the symptoms.” A typical session lasts fifteen to twenty minutes and costs $75 if administered by an MD like Dr. Lu. Most practitioners recommend a course of three treatments to evaluate the effectiveness in a given patient.

The docs tell me that I’ll be facing this the rest of my life and probably will have some arthritis problems in the back at some point too, so acupuncture sounds fine to me. In fact, just about any of the many treatments available—body-numbing drugs, endless rounds of abdominal crunches, injections in the spine, sweaty contortions in the hot Yoga studio, machines that pull me like taffy, or needles that re-channel my chi—are better than flopping around helplessly on the tile floor like a fresh-caught mackerel.

Part 3 of 3 (originally published in a slightly different version in Westchester Magazine)

Dave Donelson, author of Heart of Diamonds a about in the

Friday, July 24, 2009

A Tale Of Spinal Torment - Part 2 of 3

Ten years ago, my diagnosis was based on an X-ray. Now, I also had an MRI and an EMG, or electromyogram, where they shot electrical current through needles into my legs at various places and recorded what happened in the nerve roots. It wasn’t fun, but it could have been worse.

Dr. Sharma told me I had three treatment options: non-operative (medication and physical therapy), interventional (a steroid injection in the spine), or surgery. When I immediately opted for door number three, he suggested I rethink my choice. In my case, he said, “The likelihood is that the scar tissue will come back, so surgery probably wouldn’t have a long-term effect.” Plus, as Dr. Sharma so graphically put it, “Nerves in general don’t take a joke well, so the more you manipulate one, the more likely it is to have a more persistent dysfunction. If you had a big honking disc fragment causing the pain, we could have gone in again, but your imaging studies didn’t indicate anything other than some scar tissue and a slight herniation.”

So we started with anti-inflammatory medication and some aggressive physical therapy under the guidance of Debbie Bisaccia of Reforming Rehab in Harrison. Bisaccia gave me a vigorous core-strengthening regime to follow that included several different kinds of crunches, routines with the Swiss exercise ball, resistance bands, and Pilates reformer. The goal is to strengthen the complex net of muscles that surround the spine, reinforcing it and making it less susceptible to pain-inducing movement.

I got stronger, but the problems didn’t go away so I went for an epidural steroid injection, which is a cortisone shot like you might get for tendonitis. In this case, it goes into the spine while you lie wide awake and very, very still. I wasn’t worried, because the shot was administered by Dr. Maria Cabodevilla-Conn, the same angel with the needle who gave me the EMG, so I knew she had a steady hand. Believe it or not, the treatment hurt like hell for just a moment as the painkiller took effect, then was no more painful than a normal injection.

The epidural made a big, big difference. It looked like I wasn’t going to need surgery after all, but my leg and foot still acted up more often than I liked, so I started considering non-traditional options while I kept up my therapy routine at the gym (my generous insurance company refused to pay for further physical therapy, apparently because I no longer had one foot in the operating room).

My wife arranged a session for me with Toni Goodrich of the Yoga Center of Greenwich. She helped me into some Bikram Yoga poses and talked me through some stretches to open up the channels the nerves follow from the back, through the butt, and down the legs to the feet. When I told Dr. Sharma about the experience, he explained, “The sciatic nerve passes in and around the muscles in your buttocks and your legs. Those stretches keep those muscles from compressing and irritating those nerves.” Whatever. The yoga stretches really helped. I added them to my time at the gym and good things began to happen.

Part 2 of 3 (originally published in a slightly different version in Westchester Magazine)

Dave Donelson, author of Heart of Diamonds a about in the

Friday, July 17, 2009

A Tale Of Spinal Torment - Part 1 of 3

The day I decided to have back surgery, I was in Seattle on a business trip. Just as I stepped into my hotel room’s shower, I sneezed, sending a bolt of pain down my leg that literally knocked me down. There I lay, hoping desperately the seizure would stop so I wouldn’t have to scream for help. I didn’t want the bellman to come into my room and find me writhing naked on the tile floor.

That episode was the culmination of years of back problems, debilitating muscle spasms from my neck to my butt, days when one of my arms was paralyzed, nights when I couldn’t turn over in bed and mornings when I couldn’t get out of it. When I collapsed to the bathroom floor in Seattle ten years ago, I had undergone months of treatment for a garden variety herniated disc—muscle relaxants, pain medication, physical therapy, bed rest, ice, heat, you name it, I’d tried it. The pain, primarily sciatica (a severe stabbing pain that shot from my lower back down my leg to my foot), came and went—but mostly it came—until the day it decided to stay.

Every case is different, of course, but according to the Annals of Internal Medicine, low back pain like mine is the second most frequent reason for physician visits, vying with sniffles and other symptoms of colds and flu for the top spot. Rumor (and educated opinion) has it that so many of us suffer from back problems because our bodies evolved to run on all fours across the savannah rather than walk around upright lugging golf clubs or shopping bags. There was also no notch on the evolutionary ladder that rewards sitting behind a desk pecking at a keyboard all day.

My herniated disc was L5-S1, a common problem area between the lowest lumbar vertebrate and the sacrum, or tailbone. The doctors I saw explained that a disc acts as a shock absorber sitting between the bones in your back. It looks kind of like a jelly donut. If you damage your back, either through a cumulative, repetitive injury over time or in an acute, one-time incident, some of the jelly stuff in the middle squirts out. When it pinches a nerve, you fall down naked on the floor.

Not wanting that to happen any more, I underwent a discectomy, where the surgeon cuts away a little bit of bone and ligament in the affected area, moves the nerve—gently, please—out of the way, then scrapes away the offending hernia so it no longer bothers the nerve. Instant relief.

Except…there was some numbness in my right foot and a little tingling in that leg from time to time. It wasn’t much though, and the surgeon said it would probably go away with time. I gratefully learned to live with it—it wasn’t pain.

Fast-forward ten years. I started having severe cramps in my legs and greater numbness in my foot. The spasms bothered me first at night, then during the day if I sat for long periods, finally even while I was walking around. I went to my family physician, Dr. Robert Fusco, who eliminated as many possible causes as he could and sent me to a back specialist.

Orthopedic surgeon Dr. Krishn Sharma of NY-Conn Orthopedic in West Harrison explains what had happened in the ten years since my back operation: “Anytime you do surgery, scar tissue forms. If we take away some ligament and bone in your back, your body will fill in with a fibrous, scar-like material. That can trap the nerve root and cause you to have some new symptoms, especially if you re-aggravate it.” My pain moved from my back, which doesn’t hurt at all most of the time, to my legs.

Part 1 of 3 (originally published in a slightly different version in Westchester Magazine)

Dave Donelson, author of Heart of Diamonds a about in the

Friday, July 10, 2009

Support For Library Book Sales

Library book sales are one life's great opportunities. They're usually sponsored by friends' groups or other non-profit organizations who use them to raise money for programs and other special library events that enrich our communities. Almost invariably, they're operated by volunteers and depend entirely on donated books from library patrons for inventory, so nearly every dollar spent at a library book sale goes toward the library itself. You gotta love 'em!

Unfortunately, library book sales are also often poorly publicized. That's where a new online service comes into play. It's, a simple yet promising directory of library book stores and book sales recently launched to supply book lovers with an easy source of information on sales near them. The site is still in beta stage, so the volume of listings is in growth stage, but it looks like the service has great potential.

Listings are free, as is use of the site by book buyers looking for sales to attend. You can search for sites by state, zip code, and date, and also set up your own calendar to save sales you've spotted that you don't want to miss. It should be a boon to book lovers everywhere and hopefully help library supporters hold even more successful sales.

Dave Donelson, author of Heart of Diamonds a about in the