Spinal Fusion Surgery

Back Story

I have been to a lot of hospitals. When we were little, my dad would take me and my brother with him on Friday evenings when he went to visit his Yutan parishioners in various Omaha hospitals. We would stay downstairs, usually haunting the gift shop, as he went up to do what good pastors do. Emmanuel, Methodist, St. Joseph’s, among others were the staples of my youth. In addition, I myself have had several surgeries starting with tonsils and adenoids at about age 5 to my most recent Achilles reconstruction at a small clinic in Omaha.

There is always something weird about walking through a hospital. I never know where I can and cannot go. I feel like someone is going to yell at me for being in the wrong place. That, of course, likely comes from my childhood when my brother and I would chase each other through the halls and tunnels of hospitals until someone told us to stop.

My Back

I guess that is more of an introduction than a “back story.” The real back story is why I am sitting here typing this blog post from the Ventspils Hospital right now. The official name is Ziemeļkurzemes reģionālā slimnīca and it is the regional hospital in northwest Latvia. I went there because the doctor who performed my surgery, Dr. Osītis (means little ash tree) is performing his surgeries there despite having a private office in Riga. The process is still a bit hard for me to understand, but the basic idea was that I had the option to have surgery and pay around €5000 upfront, or I could get on a list for a no-cost state-sponsored surgery and wait a few months. I went with the latter option.

How did I get here? About five years ago, I started having this strange pain in my left leg. It was originally diagnosed as Piriformis Syndrome and I started seeing a chiropractor. I was still pretty active—rock climbing, cycling and working—but I was also constantly having this pain that made it difficult to sleep or walk long distances. This was after my Achilles surgery a few years before. Yes, something is always wrong with me.

After two years of treatments, just before I left for Latvia, my chiropractor realized I was not improving, so she scheduled an MRI to see if something else was wrong. I had the MRI, and then got the results after I moved here. The symptoms had subsided, and I was actually feeling mostly okay, so I didn’t really worry about it until Rita and I went on an excursion through the Latvian ghetto. We walked a few kilometers, and by the end, I was in so much pain that I could hardly walk. I struggled to keep up with the rest of the group as I limped slowly behind trying not to show weakness.

At that point, I decided to find a back doctor here to look at my MRI to see why I was in so much pain. It turns out that I had a small fracture and part of the spine was pinching the nerve root. This is called splondylosis and it leads to sciatica (man I have trouble remembering medical terminology). This is a really good explanation of the whole problem, and it seems to be very common.

Many people ask how this happened, and my thought is that I fell down at some point (slipped on ice, fell off my scooter when I had my Achilles surgery, or most likely, crashed my bike pretty seriously on a ride with teacher friends). I am not 100% sure, but the Latvian back doctor was pretty sure my back was what was causing my leg pain. The pain starts in the buttocks and then starts shooting down the side of the leg like fire or electricity. It can continue down all the way through the foot. It is the worst at night, when I would try to sleep, and leg spasms would start. The explanation is that the nerve root is under pressure all day, and once the pressure is released when lying down, it kind of has a party and just starts sending signals. Not fun! The doctor showed me a picture of the nerve roots and where it connects all down the leg, and this was exactly where my pain had been. His suggestion was to have spinal injections after confirming that I had been doing chiropractic sessions and physical therapy already for years.

I had four rounds of spinal injections over the course of a year. The first one was amazing. I went three months without any pain. I was sleeping without any pain killers and life was good. By the fourth injection a year later, it did absolutely nothing. So now we had to discuss the  next options. He consulted with other surgeons, and recommended that spinal fusion was really the only way to permanently release the nerve root. My family doctor recommended Doctor Jānis Osītis, and everyone I talk to says he is literally the best spinal surgeon in all of Latvia. I felt like I was in good hands. I consulted with him, and explained my situation, and he agreed that spinal fusion was the way to go.

Fear and Second Thoughts

With the state medical system in Latvia, to have a surgery, you get put on a list and they schedule it months in advance. I was able to get in fairly quickly. I believe I met with Osītis in the summer, and he found that the earliest date would be December 10. The closer the date got, the more I felt uncertain as to whether I was doing the right thing or not.

I had to inform my workplaces that I would be missing two months of work as I recovered. The nice thing is that in Latvia, the law is that you get ten days of salary for an illness from your work, and then after that you get 80% of your salary from the state until you recover. I am not sure how it will work with my part-time jobs, but hopefully I will see some money in my bank account at the end of the month.

Like any postmodern patient, I started to research spinal fusion, and I found lots of scary stories. It seems that many people have the surgery for back pain, but it doesn’t really relieve the back pain. However, many of the websites said that it does relieve nerve pain, so I started to feel a bit better. The surgery is quite invasive, and since my surgeon spoke English as a third or fourth language, it was hard to fully understand all that he was planning to do.

Because of all this, I kept wondering if I should go ahead with it or not. I felt obligated and actually honored that I was able to have such a serious procedure done by such an amazing surgeon basically at no cost to me. But for months, I had not really had any major pain. I was riding my bike to and from work, and sitting while teaching, so the pressure was off my spine. I decided to walk until I felt the pain again, just to remind myself what it was like. I was impressed that I actually could walk quite far before the shooting pains started. I could go on living like this for a long time, or I could take care of it now.

My main driving thought was imagining long walks with Rita and Max and not having to constantly worry about being in pain. I was thinking about the last few sibling gatherings and how others went for walks for miles through mountainous trails, and I was unable to participate. And most of all, the pain I had experienced as we walked on the beach together a year before was haunting me.

These hopes and dreams and fears are what really pushed me to go through with it.

Part 2: The Latvian Hospital Experience