October 21, 2010
“Piece of cake,” the orthopedic surgeon said. Then he smiled at me with a cocky grin as we peered together over my MRI films and discussed my imminent back surgery. I didn’t pretend I understood what I was seeing—but I liked the guy. I trusted him. “As a matter of fact, I did a lumbar laminectomy just the other day,” the doctor continued. “The guy was pain-free the next day.”
I was at one of the great orthopedic hospitals in New York City, and I was there because the lightning-sharp leg pain from a herniated lumbar disc was making my life miserable. I wasn’t sure if I needed a neurosurgeon or an orthopedist. Either would be fine, a Harvard doctor I know and trust told me, as long as he or she had done the procedure a thousand times.
The morning of my surgery, I was administered a cocktail of drugs and wheeled into an ice-cold OR. Pink Floyd was blaring. It had been Bruce Springsteen when the same guy had fixed my knee years ago. This time the anesthesia numbed me into a quiet confidence that my victory over pain would soon be complete, the enemy having been put in its place.
“You’ll have some pain,” the surgeon casually mentioned afterwards, as he said goodbye. When a nurse handed me a prescription for pain medicine and suggested I fill it on my way home, I thought nothing of it. The fact that the prescription was for oxycodone, commonly used to combat severe pain, went whizzing over my head.
The pain began the next day, as if a conductor had tapped his music stand and started waving a long white baton. The timpani thundered as shots of jagged pain travelled down one leg. I rode with it for a while, but soon the top came off the container of pills. The pills blunted the pain somewhat, but I fled to bed anyway, each step reinforcing the sensation of razor blades in my left leg. Lying down turned out to be even worse.
When morning came, I pulled myself up by the bedpost, struggled to my feet and hoped not to fall. What about that pain-free guy the surgeon had described? That piece of cake? I was not expecting this.
Five days after surgery, and after an endless weekend, I began to question everything. Had I been at the wrong kind of hospital? Should I have seen a neurosurgeon first? Did my doctor, my friend of decades, mess the surgery up? He had, I just knew. I was losing faith. This was my spine, after all, the cable down my back, holding me together.
This would be my new normal, I feared—excruciating pain morning, noon and night. I called the doctor’s office. Any fever? Leakage? Incision site look okay? “I think you have to be patient. You will get better,” the surgeon told me. Five more days passed with no change. By now, I had pushed everyone away.
My isolation became a multiplier for everything I was feeling. I was not necessarily rational, but there were no dissenting voices to talk me down. Ten days after the surgery, I connected with a pain specialist from the hospital. We spoke for a while. “They tore muscle and nerves from your body,” she said. “It is going to take a while.”
Almost two weeks after the surgery, the pain did move on. But I was spent and demoralized. I usually have a high threshold for pain, but this had been different. Nobody had warned me. Why hadn’t the surgeon, or a resident, or a nurse, or even a janitor sat with me before I left the hospital and told me I might be embarking on the worst two weeks of my life? Why didn’t a pain specialist take me through the process? These are busy people, I understand, but we are talking about short conversations.
The truth is, many doctors just don’t do that. Stitch ’em up and adios. I asked female friends, mothers, if their OB/GYN docs had prepared them for childbirth. Some laughed. All said: No, we were on our own.
We patients are so vulnerable when we make it home from the hospital. The absence of information plays to our worst fears.
If anyone at the hospital had made sure I got an unvarnished view of what lay ahead, that two-week trip through hell could have been different. I feel I can survive anything, if I know what is going on.
So talk to us. Please. Otherwise, it’s too easy to lose faith as we struggle toward recovery.