Well, I’m going to be out for a while. At least, out of what I usually do to fill my time.

Yesterday, November 2nd, I had surgery for only the second time in my life, and for the first time on my back.

Things moved pretty quickly this week. On Sunday, I developed a strong, sharp pain in my left hip that overnight became fairly severe and kept me from sleeping. By 4 am I was laying on the floor of my living room crying, trying not to wake up the house. On Monday, I was able to walk around, but the muscles of my left glute, thigh, and lateral calf were twitching. I went for a massage instead of going to jiu-jitsu, and it was absolute murder getting those muscles worked on.

Tuesday, I went to work in the ER. The pain was a little bit better, but during the day I started to feel numbness in my left foot. I wondered if I was walking wrong or just couldn’t feel my toes quite right. Wednesday morning, I went to see sports medicine and ER doc Mark Goodman, who was kind enough to squeeze me into a cancellation spot. He examined me, and only then did I see the weirdness: my left foot wasn’t working right. Walk on your tip toes, now walk on your heels. When I tried to walk on my heels, my left foot would slap to the floor. There was no holding it up, and I had no ability to extend my left big toe against any resistance. That was a weird thing to see. I felt like I gained a small appreciation for what it’s like to have a stroke.

Thursday evening I was back in the ER and worried that the weakness was getting worse, so at the end of my shift I decided to check in and get the MRI done. The result is below.

Lumbar MRI showing a not-subtle ball of disc herniating back into my spinal canal.

“IMPRESSION:
L5/S1 severe left and mild right neural foraminal narrowing secondary to disc extrusion with associated left foraminal disc extrusion fragment and compression of the exiting left L5 nerve root.”

Translation, my disc herniated and was pushing on my nerve. The fact that I had weakness to accompany it meant that there was more than just pain, there was a risk of permanent damage to the nerve if it didn’t improve soon.

I’m grateful that I am a member of the healthcare system, and because of that I’m able make things happen much faster than the public. If I had to navigate this without that insight, the only hope would have been to come to the ER when my symptoms became too worrisome and hope that I got connected with the care I needed. By Firday morning, I was able to see an ortho-spine surgeon who reviewed the MRI, recommended surgery vs an epidural injection and observation. I decided on the injection, not wanting to be too hasty to let someone cut on my back. But that evening, I spoke with a well-regarded neurosurgeon on the phone. “Don’t wait on weakness” she said, “with your activity level, you should only watch it if you’d be ok with having this deficit for the rest of your life”.

Herniation or not, it’s Movember.

That sealed it. By Saturday morning 9am, 7 days after things first flared, I checked into the Bend ER and went from there to pre-op. In just an hour under the knife, a chunk of my disc came out through a one-inch incision in my back, and I woke groggily in recovery.

A chunk of my L5/S1 disc that will plague me no longer.

My foot isn’t normal, but it’s much, much better. maybe 80% better, and expected to improve. I was able to walk three careful miles today down along the river and back, and I have just soreness where I was cut, none of the searing nerve pain.  I’m lucky to be able to get this done so quickly, and lucky that we live in an era where this is possible.

Everyone has been asking me, what was the trigger? I have no idea. Since around 2020 I’ve had intermittent left-sided back and hip spasms that I attributed to pulling toddlers out of cribs or having some kind of muscle imbalance, dumb butt syndrome, or other musculoskeletal explanation. The spine surgeon that I saw on Friday told me that the spasms I’d been having in my glute were the symptoms of my budding disc bulge. The outside of a disc, the annulus fibrosis, is pretty tough stuff, like the belting on a tire. I must have weakened this over time with old injuries or repetitive movement patterns that weren’t ideal. Then, at some point last weekend, I finally popped the balloon. L5/S1 is the most common level for this kind of thing to happen because that’s where there’s the most load above the disc, and it’s also where the mobile spine articulates with the relatively immobile pelvis.

I think that I have probably suffered poor mechanics at that level for a while, with tight hip flexors (the plague of the sitting worker) putting me into an anterior pelvic tilt, squishing at that disc. Then over the last year and a half as I’ve added more weight and strength training to my regimen, I eventually taxed that disc beyond what it could handle.

I’m now looking at 6 weeks of no bending  or twisting of the spine and no lifting over 8 lbs (gallon of milk). I can’t put on my own socks or lift my kids. After that, it will be about 3 months until I can return to normal activities. Future-proofing myself is going to involve a ton of core strengthening and review of movement mechanics to avoid putting myself back in this position. And I’m probably going to ditch the deadlifting. Someone else can lift the 240 lb guy off the floor.