Sunday, September 19th, 2010...10:27 pm

Not Backing Into Decisions

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At some point last weekend the fifth disc of my lumbar spine decided enough is enough.

After 29 years of cushioning my spine as I pulled softballs foul, banked in three-pointers, jumped up and down on the couch watching St. John’s lose and sat hunched over my computer playing with the internet, a disc in my back finally fragmented.

I’ve had mild back pain for much of the summer after somehow tweaking it in May. I went to my doc and he said to rest for a few weeks and then be diligent in stretching in the morning and when I exercise. I never fully recovered to 100% but was up to about 95% when I stepped onto the basketball court in my Omar Cook jersey (a hand-me-down from Bersin) last weekend. I actually don’t think I hurt it playing basketball, but rather sometime later in the day. When I woke up Sunday I couldn’t move.

I went back to my doc on Monday who was concerned by the numbness and weakness in my left leg. He was most alarmed that I couldn’t walk on my heels. I tried to tell him that heel-walking wasn’t all that important and that Vant and I could replace it with another special move in our surprise dance-off for Wolk’s wedding. In fact, foot drop kind of gives me a natural (and hopefully temporary) pimp limp.

Next up was an MRI. Experiencing an MRI is like being buried alive in a coffin at an alarm clock convention. To calm down and chill out, I followed my friend Roy’s advice from when he had an MRI and sang Billy Joel’s Greatest Hits volume 3 to myself in my head. Yup, right there in the medical imaging machine I went walking through the jungle of doubt, to the river so deep, searching for something….

According to my MRI report, disc desiccation and disc space narrowing is present in my back at L5-S1. An ovoid vertically oriented left-sided disc fragment is present at the L5 level. The fragment attains the left L4 lateral recess, coalescing with the ipsilateral L5 nerve root. Um, yeah, whatever. Let’s gingerly move down to the next paragraph to discuss what this all means.

My doc told me I have a herniated disc (L5-S1) that is pinching the nerves that run along my spine and all the way down my leg and foot. This was causing pain behind my knee, numbness in my foot and weakness throughout my leg.

Next I was referred to a neurosurgeon at Lenox Hill. This doc was thorough and detailed in explaining what was happening to my back. He used plastic spine toys and my MRI results to show how my disc had ruptured squeezing out a jelly-like substance that was exerting pressure on my spinal nerves. (This brought back the same thought I had everyday during Biology class in my sophomore year of high school — why did Hashem make the human body so damn complicated?) This pressure was causing the pain felt down my leg. The pain should eventually go away as the inflammation in my back subsides. The weakness and numbness are of more serious concern.

He outlined three different paths to treating the injury. The first is plain old rest with eventual physical therapy. The second is epidural steroid injections (cortisone) into the spine to further reduce inflammation. The third is surgery to relieve the pressure on the nerve. While his official recommendation was surgery (he did provide a disclaimer that he is a surgeon and performing surgery is how he makes a living), the doctor did suggest I give it some time for the inflammation to go down and see if my back and leg improved. He also thought it wise to get another opinion – perhaps from an Orthopedist.

At this point I hit up my good friend Doctor Beyda to help make sense of this all. Even though Dave isn’t an expert in this field, he’s a trusted friend that certainly knows more about this than me and can help advise me through the medical process. It doesn’t take long after hearing the idea of back surgery to feel a bit overwhelmed. Dave sent my MRI results around to some Ortho friends and explained to me that there are indeed a bunch of different ways to treat this injury. It was very much in-line with the options that the neurosurgeon laid out. Dave also went to work helping me figure out which doctor I should see for another opinion. Before you think Dov is a saint, realize he still has not got back to me about the mosquitoe issues.

I’ve been lucky enough to have great health in my life and never really have had any serious ailment. It’s been striking to me (at least in this particular case) to realize how much of medical treatment is still left up to human interpretation and personal preference and how unprepared the average person is to make those decisions. If you asked me last week what lumbar was I would have said it’s what Albert Pujols uses to destroy baseballs. Now, I’m trying to determine if I should consider surgery or seek additional medical opinions all with the distraction of a tight lower back and a gimpy, stingy leg. It’s a lot to deal with if you’re not up for it.

At some point during the science lesson from the neurosurgeon I realized I had this under control. Since I was overwhelmed, I was purposely slowing him down by asking really basic questions to see how he would answer them and then working my way to the more critical questions. Nothing he said seemed unreasonable and each answer was adding clarity to the situation. Then I realized that being in a really tight spot, without much experience, full understanding or complete information is what I do every day in running a cash-strapped, fledgling business. The way I get through that is by recognizing there is a optimal solution to everything…and there always will be.

As I’ve been diligently working my way through my options, it’s amazing how many people have had back injuries or herniated discs. I can’t feel sorry for myself because I would then have to feel sorry for all these other people too and eventually create a facebook group or something. Just organizing all the information is exhausting. Being a jewish dude from Long Island trying to get help on back issues is like trying to get tax credit advice at a Tea Party convention. Everybody has some magic solution that seems kind of loony!

If the worst of the pain is behind me this is not all that life-altering of a thing. Yeah, it sucks that I have to sit out the fall season of Softball and Dodgeball and I’m not sure when I’ll be able to go to the gym or run around next (let alone wake up without pain). I have a recurring bad dream that I’m a kid playing ball outside with my friends and no matter how hard I try I can’t throw/kick the ball more than a few inches. I guess I can cross that dream off my list of things to subconsciously worry about. I was able to go to see both Jay-z/Eminem and Vampire Weekend last week so the pain can’t stop the music in me. I’ve already weaned myself off of Advil and being judicious in taking pain medication. Hopefully the strength and feeling in my leg will return shortly as well. It will take some patience as it can take over a year to fully recover but it just seems so inevitable that I’ll be fine soon. With a positive attitude, I’m fine right now. Wow, I think I just gave myself a pep talk.

There’s definitely also something to be learned here (besides appreciating your good health!). I’m seeing where I can improve my decision making process and how I interact with others in working together to make decisions. I’m quick to write off people if I don’t think they are using the same thought framework as me. I’ve had trouble being patient in talking through options with my parents. Like any caring parents they’re worried and concerned for my well-being. I get wrapped up by the fact that fear is clouding their judgments and preventing them from looking at options objectively. In many ways they’re invested in my health as much as me (and worry more than me.) I probably need to figure out how to help them feel more a part of the process and let them know how they can help me. I’m also a little trigger happy in determining if someone’s advice is valuable or not. Despite what I sometimes think, I don’t know everything in the world. Funny thing is that many of my colleagues and friends might say the very same thing. Patience, L-Hoops. Patience.

Wishing you all a healthy 5771!