My Back Surgery (L4-5 Discectomy)

I haven't been much of a blogger lately. The few of you who know me and actually follow this blog will be shocked to see a post. But I am really writing this post for people I don't know, specifically for people who are having sciatic nerve pain and considering back surgery. When I was in this position, I scoured the internet for other people's experiences with back surgery. Most of the anecdotal reports that I found were horror stories. But every real-life person I talked to had a good story. So I am putting my good story on the internet, in the hopes that maybe a few people searching for answers will find some comfort in my experience.

I am 33 years old, and my back surgery (L4-5 discectomy) was over 3 months ago. My surgeon was Dr. Lynn Gaufin, and he did a perfect job. I knew my nerve pain was completely gone from the moment I woke up from surgery, because I could lie flat on my back without my legs going numb. It was amazing. I did a couple of months of rehab physical therapy, and while I still have occasional lower back pain, and my back is still really stiff and achy in the mornings, I am almost back to my normal activity level. I am so much better than I was before surgery. I know that the next few years are still crucial to determining the total "success" of my back surgery (because there is the possibility of a re-herniation), but for now I am calling it a success.

I am not advocating back surgery for everyone. Most back pain will resolve itself in about 6 weeks. And many people have herniated disks with few or no symptoms. So just because you are having back pain, or just because your MRI shows a herniated disk, does not mean you need surgery. However, I am convinced it was ultimately the best solution for me. Here's where I get super detailed and long-winded, so don't feel bad if you're too bored to go on. I'm hoping the details might help someone in a similar situation to mine.

My problems began in October of last year, as a sharp pain in my lower back, particularly when I bent to lift my 12-month-old baby out of his crib. I had had this sort of pain before, and it usually resolved itself in a week or two. But after a newborn photoshoot I did one day, I found myself unable to stand straight. The next few days were a blur of pain. I discovered that if I could force my body straight (a nauseatingly painful process), the pain would be nearly gone while I stood on my feet. Sitting down brought on sharp pains in my legs, but again, once I sat for several seconds, the pain would mostly subside. After a few days of this, and the agony every time I had to change position (riding in the car was particularly painful, from the jarring motion of the car to getting out at the end of the ride), I became desperate for help. But I didn't know who to go to for help! A doctor? A chiropractor? A physical therapist? Emotional counseling?There is a huge amount of information on the internet, and all of it seems to come down to one truth: no one really understands back pain. The best resource I eventually found was spine-health.com. Don't waste your time on too many other websites (especially blogs, where you'll just find anecdotal evidence that may or may not be at all useful....)

So I finally tried a physical therapist, but man, did I go to the wrong one. I picked the cheapest guy in town. He figured it was my SI joint. He put me in traction. Ouch! I was so much worse the next day! After one more appointment with him, I reached a day where I literally could not get out of bed. Lying curled on my side was painful, but any kind of movement in any direction caused shooting pain down my legs to my toes. 1600 mg of ibuprofen did nothing. I finally dragged myself and my baby to the car and got to my doctor's office. He gave me some muscle relaxers, which started working within the hour. Hooray. I was finally able to function. I could sit and stand without excruciating pain. My doctor also sent me to a better physical therapist, who I really liked, but who couldn't fix me. She gave me exercises and we did stretches and e-stim, but after about 6 weeks I wasn't getting any better. At this point the pain, while on muscle relaxers 24-7, was mostly a dull ache with occasional painful spasms.

I decided to try a chiropractor. Again, I really liked him, but he couldn't fix me. He adjusted everything he could, and even had his massage therapist really work hard on my piriformis muscle (in case that was pinching my sciatic nerve). He had me get x-rays in case I had some spondylolisthesis thingy. The pain in my legs was turning into numbness and tingling that was worst when my body was straight (lying down or standing). I was turning into one of those bent-over old people, leaning on my grocery cart. After 6 weeks of treatment it finally came down to, "well, you should be better by now. Maybe you'd better get an MRI, so we can see if it is a herniated disk. But whatever you do, DON'T LET THOSE DOCTORS TALK YOU INTO SURGERY!"

So I went to an orthopedic specialist. He immediately ordered an MRI which showed a very large herniated disk. He said my two choices were 1)surgery, or 2)no surgery. The second choice came with a "we can try a cortisone shot. It might work." So I tried the cortisone shot. The morning before I went to go get the shot, I turned over in bed and tweaked something that caused a horrible burning pins and needles sensation all down my right leg. The shot didn't work. Not even a little bit.

So this is the point at which I decided surgery was my best option, after 5 months of pain that kept increasing, and after trying every other option (besides alternative therapies, which I was open to, but out of patience). I was completely hunched over any time I tried to stand on my feet, and even then, could only stand for a few minutes at a time before the burning, numbness, and pain in my legs became unbearable and I had to sit down. I couldn't take care of my two kids. I was basically useless, and I say that with the utmost respect for people who live without the use of their legs, and do so very gracefully. I don't know how they do it. I'm sure it's harder than I can possibly imagine. I decided, after doing some research and talking to others who had done surgery, to use a neurosurgeon rather than an orthopedic surgeon. I called up Dr. Gaufin's office and they got me in the next day, based on my medical records and symptoms. My surgery was 3 weeks later, approximately 6 months after my initial pain began. I had an L4-5 discectomy, which means they shaved off the herniated portion of the disk between the L4 and L5 vertebrae (the link goes to info about a "microdiscectomy," which I'm not totally sure if I had--my incision was about 2 inches). Since the actual pain in my back was minor compared to the nerve pain in my legs, they did not fuse the vertebrae. This means I will probably always have a moderate amount of back pain, because the disk is damaged and not providing a good cushion between the vertebrae. But like I said before, my nerve pain was immediately gone after the surgery and hasn't returned, and that is good enough for me.

Some thoughts about my recovery. It was about 4 weeks before I could lift my 25-pound baby. I wish I had taken 2 weeks off work instead of just one—and I only work 12 hours a week. If I had been working full time, I would have still struggled to return after 2 weeks. If you have the option of completely taking off 2 weeks and then working part time for 2 more, that might be ideal--although that is understandably unrealistic. Same goes for help with kids—if you can get someone to stay with you for 2 weeks, do it. My mom stayed for one week, which was awesome, but I was still kind of useless for the next few weeks. I had to put my 18-month old in a regular bed instead of a crib, which he wasn't really ready for. I also had to call a neighbor to put him in his carseat anytime I wanted to go anywhere. And he learned really quickly that I couldn't chase him or grab him if he wanted to cause trouble. So that was tough for a few weeks.

One other thing about my recovery physical therapist, Von Hill at Peak Physical Therapy here in Spanish Fork, Utah. If you live in my area, I absolutely recommend Peak and especially Von. I am confident if I had gone to him in the first place instead of the cheapo guy I went to, he would have been able to immediately tell me I had a herniated disk, and he would have given me the best therapy possible. I'm not saying I would have avoided surgery, but I honestly think he would have been my best chance.

New Tricks

3 short videos. I know 30 seconds is about all I can expect you to watch. :)

Here is Dexter's newest trick. I have a similar video of Dorian when he was a baby. It's an important milestone. (Also, I think Dorian's monologue in the background is kind of adorable. I think he knew he was being recorded and was trying to think of stuff to say.)

Next trick. Yes, I am getting this kid into a gymnastics class. (And I could have edited the video to be a bit shorter, but I thought Dexter in the background was kind of cute, so if you get bored of Dorian just watch Dexter...)

Last one. I uploaded one like this a while ago to facebook, but this one is even better. I just think these brothers are cute.

help again?

Seems like I only use this blog to ask for advice these days....

Dorian will be 3 in a few weeks. He is still adjusting to his baby brother who is now 8 months old. But it seems in the last month or so he has gotten very aggressive with Dexter. From the beginning, I think Dorian viewed little Dexter both as a threat and as a toy. And now that the baby is crawling and pulling up on things, Dorian is 1)even more threatened because the baby can get his toys, and 2)seeing Dexter as even more of a fun "plaything" because he can do more things now.

I know aggression between two close brothers is normal, but I am actually worried for the safety of the baby! Dorian does things like knock Dexter down when he has pulled himself up on the coffee table, or lie on top of him, or try to pick him up, or throw toys at him, or forcefully put things in his mouth. Dorian seems to get over-excited when he interacts with Dexter—he gets right in his face and screams, or pinches his cheeks, or buzzes his lips so that he spits all over Dexter.

I have talked to Dorian about how his little brother is not a toy, but a person with feelings and rights. We have talked about how he might feel if someone were to scream at him, or pinch him, or spit on him. I have tried to spend extra alone time with Dorian while the baby is sleeping. I have sent him to timeout 1000 times for hurting the baby. I have praised him for good interactions with the baby. What else can I try? I know he loves his baby brother, but he obviously doesn't feel like he has power over his world right now.

Um...I need help...

Right, so here is the potty training rundown:

Dorian has been out of diapers for 5 weeks now. He did great the first 3 weeks as long as I reminded him to go periodically (we had treats and a fun iPhone app and all that). He had a little trouble with the pooping, but we finally bribed him to do that (Thomas trains and matchbox cars). Then it started becoming a power struggle (he absolutely wouldn't go if i asked him to). I figured that was normal and he just needed me to stay out of it, so I stopped reminding him to go. He had a few accidents, but then actually started telling me when he needed to go, and for about 3 days i thought we were almost done.

But then, since he wouldn't go when I asked (like right before leaving the house), he started having accidents in the car, or while I was feeding Dexter or taking a shower and couldn't help him. I started taking away the trains he had earned whenever he had an accident. I didn't make a big deal out of it or try to make him feel bad, I just told him I was putting Thomas or Spencer back up on the wall. He seemed to understand why I was doing it, and how to earn them back, and didn't seem overly distressed about it.

But then I guess I started making a bigger deal out of him going by himself because I needed him to be able to go when I couldn't help him (and for the record, I knew he could do it by himself; I usually just sit by and watch when I am "helping" him). Maybe that was what ruined it? Because now, for about the past week and a half, he has just completely stopped going in the potty (unless grandma asks, he'll go for her!). Five accidents today, including one involving sticky poop (as opposed to the non-sticky kind, you know...sorry...TMI). Not a single success (oh, unless you count when he went for Grandma!). He knows what an accident is, and he will even sit in the bathroom after he gets cleaned up and count on his fingers "One: go in the potty, two: by myself, three: no accidents" (those are the 3 criteria I have given him for earning his Thomas and Spencer trains back). I don't get upset with him when he has an accident, I just clean him up and remind him to go in the potty next time. I think he knows what needs to be done, but is just pushing against any kind of control. I think.

I have asked him if he would rather just wear diapers, and he says no. He likes to wear underwear. But I did actually put him back in diapers for a couple of days last week and he didn't complain at all. In fact, he seemed a little more relaxed. I know every kid is different and all that, but I'd love to hear how you handled things with your potty-training kids (unless it's one of those, "she just climbed on the potty one day and we never went back to diapers" kind of stories...I don't need to hear those :) and how you dealt with similar challenges. Should I just go back to diapers for a few months and then try again? Or is it possible that we're getting really close and I should just hang in there?

Dexter wants an iPhone

Dexter, 5 months 23 days:

(Does it remind you of anyone?)

Dorian needs more money

Parenting with Love and Logic

Dorian loves his little brother. He loves to hold him, and pat him, and kiss him, and he is always sharing his cars with him. But. He doesn't love sharing his mom. Really hates it, in fact. He constantly wants me to play with him, hold him, carry him, help him....this from the kid who just a few months ago didn't want help with anything. My number one strategy for getting him to do what I wanted was, "do you want to do it by yourself, or do you want me to do it for you?" "By taself!" Fortunately this worked for my whole pregnancy, when I had zero energy—but it hardly ever works now, and really backfires when he wants me to carry him while I'm also carrying a baby in a carseat, a diaper bag, and everybody's jackets. Don't even get me started on the grocery store.

Combine this new-found clinginess with a defiant streak a mile wide, and an exhausted set of parents who are overwhelmed by the requirements of two children (how do people have more than 2? don't answer that)...and I finally decided to pull out Parenting with Love and Logic, which my sister Lorinda gave to me while I was pregnant with Dorian. I read it, liked it, and have been applying some of it with some success, but I need to think through it some more, and also summarize it for Russell so that he doesn't have to read it. :) So here are the main points, in case anyone else also doesn't want to read it (I'm trying hard not to write a book myself...sorry this is so long...):

Love and Logic is about allowing kids to experience the logical consequences of their behavior (as opposed to artificially imposed made-up consequences). This teaches kids responsibility because they learn to think for themselves instead of always being told what to do and how to act. They learn which behaviors are effective and which aren't, while gaining confidence in their own ability to choose and think.

Responsibility

We have 18 years to help our kids become responsible adults. We start by allowing them to learn to solve their own problems and take responsibility for their own choices. Obviously we can't let a 2-year old make every decision in his life, but we can let him make a lot of them. Which shirt would you like to wear? Do you want to wear a jacket? (he won't freeze to death if he doesn't, and you can bring it along in case he changes his mind—or not, to really drive the point home) What would you like for lunch? etc. More on choices later, but the point is that kids need lots of practice making choices so that when they get older and the choices get harder, they will be able to think for themselves in a mature and sensible way.

Two ineffective parenting styles:

Helicopter Parents: These parents hover over their children and rescue them from every problem. They feel like they are saving their children from unnecessary pain, but instead they are robbing their children of important learning experiences, and setting them up for a lot more pain when the learning experiences are a lot bigger later on. These kids are not prepared to meet the consequences of real life, and don't know how to cope without the help of their parents.

Drill Sargeant Parents: These parents feel that their job is to force their children to behave correctly, and that the children will continue to act right as adults out of habit. The problem is that since these children are never allowed to make any decisions for themselves, when they are presented with choices as teenagers and adults, they often make terrible decisions. They don't feel like they are thinking for themselves unless they make a decision that is completely opposite from what their parents would have decided for them.

We have to keep in mind that as we give our children the freedom to make choices and think for themselves, they will probably do things we don't approve of. I like this quote from page 27 of the book: "Just as God gave us a good mind and the ability to excel, He has given us the right, or at least the capability, to blow up the planet. However, a race capable of blowing up the planet is also capable of flying to Saturn. High success and high achievement carry with them the risks of abysmal losses. But the loving and concerned parents who allow for failure wind up with kids who tend to choose success."

Every learning experience a child is allowed to have today will save him from a more expensive learning experience tomorrow.

Self-Concept

Responsible kids feel good about themselves, and kids who feel good about themselves tend to be more responsible. Here is a great article from babycenter.com on building a 2-year old's self esteem (since that is the age I am most concerned with right now...) Unfortunately, we sometimes send our kids negative messages about themselves without even intending to. When we say things like "why would you do that?" or "what were you thinking?", we are really sending an implied message to our kids that they are kind of dumb, and not very capable. Our kids deserve just as much respect as adults, and they will feel better about themselves if we treat them like they are competent and intelligent, and show them that we love them unconditionally. I love this idea from page 39: "kids can't get better until we prove to them, beyond a shadow of a doubt, that they're good enough the way they are." Kids need to know we love them.

If we are constantly telling our children what to do or how to feel ("put on your jacket," "eat your dinner," "you're not really hungry," etc.) we are sending them the message that they can't think for themselves, and they need us to do it for them. Instead, we need to send them the message that they have the skills they need to handle life, and that they can make their own decisions.

As a side note, the book points out that kids learn just about everything by modeling, including self image. They watch the way we (their parents) make decisions, handle arguments, and solve problems, and they model their behavior after ours. This means, among other things, that they need to see us taking care of ourselves, so that they will learn to take care of themselves. If we always put ourselves last, we may end up with kids who don't think very highly of themselves.

Mistakes as Opportunities

When we automatically jump to rescue our children from their mistakes, we rob them of the opportunity to learn responsibility. Or when we get angry over their mistakes, we teach them that the "logical consequence of messing up is making adults mad," (p. 49) which doesn't give them any responsibility for the real problem. "The best solution to any problem lives within the skin of the person who owns the problem." (p. 49) As a teacher I have learned that the more energy I expend to solve a problem in a lesson, the less the student will worry about solving it. If I sit back and allow them to work it out, they will take responsibility for it. "Kids who deal directly with their own problems are moved to solve them." (p. 50)

There are only 2 times when we should step in to help our kids solve their problems:

1. When our children are in immediate physical danger.
2. When the problem is really beyond the capacity of the child to deal with, and the consequences will be lifelong or otherwise too significant to simply teach a lesson. Be careful with this one, because "everything we fix for our kids, our kids will be unable to fix for themselves." (p. 51)

Separation of Problems

If the child's problem is causing a problem for us, then we need to deal with it (so our children see us standing up for ourselves). Not by solving the problem for the child, but by giving them ownership of the problem. For instance, if the child is not taking care of their pet, that becomes a problem for us, but rather than feeding it and cleaning its cage for them, we could take the pet away [arrange for it stay at a neighbor's house for a day?] while the child considers how much they really want to own a pet (this does require having good neighbors, but you can probably return the favor in some way).

Setting Limits with Thinking Words instead of Fighting Words

Kids need limits. They don't feel safe without them, and they will push against them until they know exactly where they are. We start building these limits for them from the time they are babies. These limits give them enough security to build self-confidence and deal effectively with their emotions. Children gain respect for parents who set and enforce good limits. However, if we attempt to set these limits with "fighting words" (i.e. "Stop whining!" or "Go practice the piano!") we are setting ourselves up for a control struggle. If we instead use "thinking words" (i.e. "You sound upset. I'll be glad to listen to you when your voice is calm like mine" or "Feel free to join us for dinner once your practicing is done"), we are still requiring respect and obedience, but also allowing our children the opportunity to think for themselves. Here is one of my favorite points in the book: "Fighting words invite disobedience. When we use them, we draw a line in the sand and dare them to cross it" (p. 65). And they will cross it.

Another way to use thinking words instead of fighting words is to use "yes" instead of "no" as often as possible. So rather than "no, you can't watch TV," say, "yes, you can watch TV as soon as your toys are picked up," etc. Then when the answer really is just "no," they are more likely to accept that as well.

Choices

Parents who want to control their children cannot win. The child will fight back. If the parent does manage to somehow retain control throughout the kid's childhood, that child will often make as many contrary decisions as possible once they are on their own. Control struggles leave parents feeling helpless, angry, and frustrated, and leave the child feeling defensive and unempowered. The way to avoid them is by offering choices—but this does require giving up some control. "We must give our children the control we don't need to keep the control we do" (p. 72). This doesn't mean giving your kids complete control (that creates brats), but it does mean recognizing which issues are yours to control and which aren't. Start by giving your toddlers a little control—over what to wear and how much of their dinner to eat. Give kids more and more control as they grow—which sport to play and how to spend their allowances. By the time they are graduating from high school, they should be responsible enough to be making basically every decision in their lives. As long as their control over their lives is always expanding, they will be satisfied with the control they have. If you give them too much at first and then have to reign them in, that will be painful for everyone. Here's a good article from babycenter on giving kids choices.

There are some things you just can't make a kid do. You can't make them eat, you can't make them sleep, you can't make them use the toilet. You can, however, give them opportunities to eat, sleep, and use the bathroom—and actually, the less control you try to exert in these situations, the more likely they are to do what you would like them to do (I've noticed this with Dorian at the dinner table—anytime he feels coerced to eat, he won't touch it, even if it's something I know he likes. But if I let him choose what goes on his plate, and if I don't make a big deal out of whether he eats it, he will usually eat, and even try something new).

You also can't make a child learn, and you can't make him believe what you believe. You can only give him opportunities to learn, and model how your beliefs make you happier. You can teach, but you can't force learning, and you can model, but you can't force belief.

Some points to remember:

1. Make sure you are always prepared to follow through with the choices you offer (don't say "hurry up or we're leaving without you" unless you have a babysitter arranged--p.s. if the child chooses to stay with the babysitter, they need to understand that they are also choosing to pay the babysitter)
2. There is always a third choice, which is that the parent will decide. The child needs to understand that this is what will happen if they don't choose for themselves.
3. Don't worry about what other people think. If they're judging you, who cares? Is it more important to impress some random people at McDonald's, or to build a lasting relationship with your child that is based on trust and responsibility? It's not going to be easy; there will be resistance and opposition. Be ready for it, and don't get worked up about it.
4. Don't turn the choice into a threat—"you can clean these toys up or you can have a timeout" is not the most effective choice. "Would you rather pick up the cars or trains first?" Or even, "would you rather pick up your own toys or hire me to do it?"
5. Be positive in your delivery—"You're welcome to ______ or ______" or "Would you rather _______ or _______"
6. Don't nag while the child is making up his mind. Don't remind him again and again what the consequences will be. Expect him to hear and understand the first time, and he will.
7. Don't give warnings and second chances. Follow through the first time and every time on the consequences the child has chosen.

Empathy

When you do have to enforce some less than pleasant consequences, don't lecture your kids; don't tell them what they just learned. They will learn it more effectively if they think through it themselves. As much as possible, let the natural consequences of their behavior teach the lesson (i.e. if they choose not to wear a jacket, let them realize how cold they are and they will probably decide to choose differently next time). But go ahead and offer empathy: "yeah, I'm cold too when I don't wear a jacket." And leave it at that.