Managing expectations and accepting limits are virtues often lacking in youth. Bones seemingly made of rubber, and enough energy to outlast a Duracell, make life feel like an endless adventure. Reality, however, sets in for all living things, and the question morphs from “what if,” to “when.” My name is Andrew Garcia, an associate of War Games LV; I’m 27 years old and currently recovering from Lumbar Surgery.
The Lumbar
Most have probably heard the term before in an ad for mattresses, or chairs or pillows, but if anyone asked, the reply would most likely lead to a blank stare or a generalization. Our spines are categorized into five sections, all working together to keep the body flexible, rigid, and upright, among other faculties. Three sections make up the bulk of the spine; the Cervical spine is associated with stability and protection of the neck and skull; the Thoracic spine which runs through the the upper back supporting the shoulders and arms; and lastly the Lumbar spine which supports the lower back, connects the upper and lower bodies together, and is generally considered the core of the body. While the Thoracic spine is lent some support by the ribcage and shoulders, the Lumbar is only supported structurally by the surrounding muscles of the core and glutes. As long as these muscles are strong, and not overworked, the Lumbar will remain healthy and supple for the majority of a person’s life from their youth well into adulthood. Around the middle of an average lifespan however, this region of the body and spine begins to deteriorate naturally after gravity and the repercussions of youth set in. Arthritis affects most parts of the body as limberness fades and joints become less fluid from extensive use, and as it sets into the spine a new name takes shape: Degenerative Disc Disease(DDD).
Erosion of the Spine
The spine is broken up into sections, and those sections are broken up into several puck-shaped areas known as discs. Discs stack together to form the column that is the spine; however instead of being a rigid and firm column made for supporting structures made of concrete or stone, the spinal column must be flexible while remaining durable enough to withstand the trials and tribulations of daily life, whether it be sitting in an office or stacking bricks. Each disc maintains a specific shape depending on the section of the spine and is made up of two main parts, an outer wall made of fibers and an inside filled with a gel-like material; think of them as jelly donuts without a top or bottom. A layer of bone separates each disc and relies on the joints of the back-bone of the spine, or the lamina, and the discs for flexibility and shock absorption. Falling, jumping, leaping, lifting, running, skipping, bending, twisting, stretching and any combination of these is supported by the body and most importantly by the spine. The spine is the center of the body and cannot function without it.
DDD is the term used when either the joints of the spine(bones and cartilage), the discs of the spine, or both begin to break down. The joints grow abnormal bits of bone which make them less smooth. Discs lose suppleness as the gel-like substance lessens overtime from constant use or mistreatment, or the wall of the disc will rupture causing the inner gelly to leak into the spinal column; and therein lies the problem. While the spinal column aids in flexibility and durability, it also lends a path for the main nerves of the body to go from the brain to the rest of the surrounding appendages and organs. The main bundle of the nerves runs through the spinal column with very little wiggle room; so when bone or disc-gelly spills into the area, it can compress the nerve causing immense pain and bringing the body to a stifling halt.
The Solution
Modern Medicine being what it is has an immediate resolution to the problems of impinged nerves, but it has little more than suggestions on how to solve long-term problems. Removing the material impinging on the nerve can involve a few different procedures, all requiring a specialist for the surgery. A laminectomy aims to shave off parts of the bone that may be causing impingement of a nerve. A discectomy involves removing gelly from impinging the nerve. A combination of the two is what was necessary however, to solve the issue I was faced with. Over the span of my life, I overworked and took ill-care of my core muscles and spine; so much so that I developed Degenerative Disc Disease well before I should have. Normally the ailment occurs toward the middle part of a person’s life, but in rare cases it may afflict those at younger ages. I happen to be one of those rare cases. At the ripe age of 26, a disc in my lumbar spine herniated(ruptured) and the gelly-like substance leaked through into my spinal column causing pain that is normally associated with labor. I could barely walk, stand, or function as a person. My only reprieve came from lying flat on my stomach. I’ve had issues with sciatica and other back pain from playing golf in my youth, but nothing could have prepared me for the journey I was about to face.
16 May 2023
After months of rigorous correspondence with insurance and providers, and thousands of dollars, I received surgery to remove the herniation and end months of painful suffering. The procedure was an L4-L5(medical term for the disc being operated on) laminectomy and discectomy. A skilled surgeon cut through the muscle of my lower back, shaved through the middle of my lamina(the backbone of the spinal column), and removed the gel spilling out of my disc. The procedure took a little over two hours, and left me weaker than I anticipated.
I woke up to my parents in a hospital room with a nurse walking in shortly after. The nurse gave me a few pills and told me that I would be taking Percocets for the duration of my stay, along with antibiotics. Afterwards I tried to move around and reposition in my bed only to find I couldn’t lift or move my body in the slightest. Moving my legs was out of the question, so electric pumps were placed on my calves to make sure no blood-clots were formed. Every action I made came with intense strain, focus, and pain; and anything beyond basic movement required at least two people to assist me. I was the most helpless I’d ever felt in my life.
Luckily, the hospital staff were amazing and helpful with any and all requests, no matter how awkward I felt asking. A few hours after my operation, and into the evening, the surgeon visited. Dr. Jeong assured me the operation was successful and he had a positive outlook on my recovery. I stayed in the hospital two more days than anticipated because the pain was so intense, even with the medicine I was taking. Finally, on the 19th I was discharged and given instructions for recovery.
Home life
I returned home more helpless than I anticipated. My father, thankfully, stayed with me the first two weeks after the operation. For over a month I could not move without a walker, nor could I lift anything heavier than a carton of milk. For all intents and purposes I was useless, but my dad cooked for me and led me on walks to make sure I didn’t fall. I remained flat on my back with a little movement every hour, but my body was functionally halted at every turn. After two weeks and my first post-op, I was cleared to try and start taking care of myself while remaining cautious. My father came over to clean my wound and accompany me on walks, but I was feeding myself and taking care of however much I could with the limited bandwidth afforded.
Every physical action I took came with pain, and a firm reminder of my limitations. Once my meds ran out the pain escalated to the point where I thought I was going backwards in recovery. Anxiety and depression, parts of my life I’ve maintained for years, came back stronger than I’d ever felt. I started questioning where my life would lead and how useless it all might have been; I started feeling like this was the end of my life. Thankfully calmer heads prevailed and after my second post-op visit I was told the pain was natural and that all I had to do was ice my back once every hour. I felt embarrassed, but my surgeon handled it with care and assurance that it was going to take time. Dark thoughts continued to plague my mind and perspective, and I combated them with an ice-pack; and a myriad of support from my friends and loved ones.
Upwards and Onwards
After three months of rest and patience, I’m finally able to start physical therapy and begin rehabilitation of the muscles and ligaments which have been out of use and healing for sometime. Hopefully after three more months my nerve will have healed from near-irreparable damage, and maybe after a year I’ll have some semblance of a normal, healthy life. It’s up to me now, and I don’t plan on laying on an operating table anytime soon.
