Zebra Files 47) Brain and Spine

Brain and Spine

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New Patient- UC Health Brain and Spine Clinic

Last week I had my New Patient appointment at the UC Health Brain and Spine Clinic with Gene Cook PA.

I found everyone in the office to be friendly and helpful.

The clinic is located in the South Medical building of the Medical Center of the Rockies. This bit of information is especially important if you need to avoid excessive walking.

Beginning the appointment, I had some confusion, because I believe that I have multiple outstanding referrals to the Brain and Spine clinic. I know that I was referred for my lower back, but I also thought I was referred for my neuropathic pain. (By neuropathic pain I mean the carpel tunnel, sciatica, shoulder impingement, toe pain, etc.)

Gene was very kind and direct. I could tell that he really wished he had better news for me. I am NOT a candidate for surgery because of my weight.

I want to be very clear here. Gene did not fat shame me in any way. In contrast, he was actually incredibly compassionate. I have ABSOLUTELY been fat shamed in doctors appointments before, and this was NOT that.

They will not do this surgery in the lower back on anyone over 40 BMI, because there is strong empirical evidence that people with BMIs over 40 have poor outcomes post surgery.

These poor outcomes manifest in a variety of ways ranging from infections, to requiring additional surgery.

Gene said they do not perform surgeries where poor outcomes are likely.

That being said, I still broke into tears explaining how much more difficult it has been to control my weight since I can no longer dance, and it’s my back that’s keeping me from doing so.

I miss moving my body, and dance has been a lot to lose.

I explained that at my best, working on my feet all day for 6 days a week, and eating the least carbs of my life, the best I ever got down to is 200 lbs. The pain keeps me from even taking a neighborhood walk now.

We talked about physical therapy, and I explained that no matter how many reps I do on the back extensions, it’s not strengthening the small muscles in my lower back. (I could do that machine all day. Being in motion feels so much better than sitting still. )

The problems in my lower back are structural.

Gene very patiently guided me through my MRIs and X-rays to explain what is wrong and what options exist. I have Spondylolisthesis, meaning one of my disks slides out of place, and onto the bone below it.

The wildest part for me was seeing it way out of position on the X-Ray (for which I was standing) and IN POSITION for the MRI that came later (for which I was on my back).

Are you and your partner on the SAME TEAM?

With my incompetent connective tissues, this disk pushes its way out of place, and continues to push the longer I stay in the aggravating position.

When I said at the beginning of this journey that as the day would progress I would feel more and more like my back was being ripped apart, and that as my connective tissues continue to stretch it just gets worse and worse, I was pretty on-point.

The surgical fix is to pin that vertebra in place using a neighboring vertebra as the anchor. This usually gives relief for quite a while, but in time those neighboring vertebrae will pull out of place as well.

So- No surgery.

Even if I can get my BMI under 40, which I still aim to do, back surgery is a LOT to go through for something that will reemerge.

I learned a lot going through the MRIs with Gene. I learned that much of my cushion is gone, that my bones are growing bone tissue in the aggravated places. I have “significant changes” to my facet joints. This is going to continue.

Gene also showed me my back muscles, and he explained that in unused muscle you find marbling, and that my lean back muscles indicate significant regular use.

I also learned that my sciatic nerve is not impinged. This suggests that my neuropathic pain is from inflammation of the nerves, rather than structural compression.

Then he told me that he’s not the neuropathic pain guy. Who is the neuropathic pain guy?

Gene said I can come back if anything escalates, or if I get below 40 BMI.

With surgery ruled out, the next option is the Spinal Cord Stimulator.

I’m really not sure what to do with the neuropathic pain, so I’ll be reaching out to my PCP to follow up on it.

In some ways this may feel like a dead end, but the information I was able to understand during this appointment is vital.

I have more loose ends to chase, but it’s nice having this checked off the list for now.

Thanks for reading!

If you have any questions or feedback, contact me at ProtyusAGendher@gmail.com

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