Spinal Stenosis Patient's Quality of Life Improves after Surgery

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Arnold Honkofsky Credits UMMC's Team Approach With Getting Him on the Road to Recovery

Before coming to the University of Maryland, I had five previous spinal surgeries at three different hospitals. I would do well for a while but it seemed like every three to four years I'd have more problems, and then I'd be back in for more surgery. My back locked and I couldn't move because of major spinal stenosis from L2 - S1, advanced osteoarthritis, and scar tissue from previous surgeries. It took months to recuperate after these surgeries and each successive surgery, even when successful, is more difficult and more painful.

After my lumbar surgery in May 2002, I was still not able to walk or stand for longer than 10-15 minutes, even after extensive physical therapy. I never really recuperated from that surgery and could not walk or stand for more than 10-15 minutes after 6 months of therapy. By January of 2004, I was frustrated and disappointed since I was still in such poor condition with no improvement in sight. Furthermore, I was aware that the chances of success are diminished each time you have spine surgery since the scar tissue becomes more of a problem in that it contributes to the stenosis too.

My quality of life was drastically reduced due to the lack of being able to stand, lift, bend, twist or walk. It was very difficult to find a comfortable position even while sitting, and lying down was not much better. Standing and walking became nearly impossible. Before my most recent surgery at the University of Maryland, I was in much pain even though I was taking anti-inflammatory medications and narcotics. Even with the drugs, my quality of life was diminished drastically. I had little stamina, and was unable to work. I was not sure what the future held in store.

Luckily, a dear friend, convinced me to participate in the warm water aquatic program. That kept me physically active and enabled me to get some aerobic exercise while strengthening my muscles and lifting my spirits as I was preparing for more surgery. It turns out that this aquatic therapy and conditioning made a tremendous difference when I did finally undergo surgery at University of Maryland Hospital with doctors Francois Aldrich (associate professor of neurosurgery at the University of Maryland School of Medicine) and Steven Ludwig (assistant professor of surgery at the University of Maryland School of Medicine and co-director of the University of Maryland Spine Center) in May of 2004.

My cardiologist watched me go through this process and knew how disappointed I was with the outcome of my fifth spinal surgery. Since I had such a complicated situation, he recommended that it was time to come into the University of Maryland Medical Center (UMMC) and see Dr. Aldrich. He said, "Let's find out exactly what's going on in your spine and what needs to be done to get you fixed."

Dr. Aldrich saw me in January of 2003. He reviewed my previous studies and spent a great deal of time with me during my initial examination. He said that I indeed did have some major stenosis in the spine, still, which had to be corrected and that additional studies would be necessary so that there would be no surprises or oversights after the sixth spinal surgery. He also referred me to orthopaedic surgeon and spine specialist Dr. Ludwig for another opinion and to assist in the upcoming fusion surgery. Dr. Ludwig also referred me to another orthopaedic surgeon who specializes in joint replacement, who diagnosed me with severe arthritis of the hips and that would require one or maybe two hip replacements after the spinal stenosis was fixed.

The Surgery

I had a 5 Level Lumbar (Spinal) Fusion from L1-S1 on May 11, 2004. Dr. Ludwig did the spinal fusions and instrumentation while Dr. Aldrich did the decompression of the spine. I came through the surgery successfully. According to my surgeons, the operation took about six to seven hours and they did remove much of the spinal stenosis.

Everything went well -- both the surgery and the recuperation in the hospital. The attention and nursing care could not have been better. I was told by the doctors that I might have to go into an inpatient rehabilitation facility after surgery but luckily I did so well that I was able to go home seven days after surgery and recuperate there.

I was able to start physical therapy early as I was eager to begin exercising since I had done so well in aquatic therapy prior to the surgery. My son, also a physical therapist, recommended that I see John Mahoney, Chief of Physical Therapy at Kernan, who has an excellent medically based orthopaedic rehabilitation program and works closely with the orthopaedic surgeons within the University of Maryland as well as the private physicians in the area. Mr. Mahoney was eager to get started with a gradual physical therapy program for me and explained that starting therapy so early after surgery would be a head start and major benefit to my rehabilitation.

I have been seeing Mr. Mahoney three times a week since I started in July and I am ahead of schedule in my progress. I've had nearly six months of therapy now and participate in a closely supervised exercise program for about two hours three times a week. While I still have serious problems to overcome and additional surgeries to undergo, I am on a program to get strong enough to undergo hip replacement and rehabilitation from the multilevel spinal fusion.

"Fabulous Care"

The care throughout the University of Maryland Medical Center has been fabulous, from the physicians, to my stay in the hospital, to Carmelina Busuttil, PA-C, who assisted Dr. Ludwig and Dr. Aldrich in surgery. Carmelina spent a lot of time with me before, during and after surgery, including the several postop visits in Timonium. All of my questions were answered completely. After surgery I was watched like a hawk both in the neurosurgical ICU and in my room. I was really impressed with the pain management team too. They kept my pain levels tolerable and made sure that I was using my "PCA" (patient controlled analgesia) button correctly. I received prompt and friendly attention from everyone on the floor until the time that I was discharged.

Dr. Aldrich and Ludwig were very reassuring and spent a lot of time with me. I had at least four visits with each surgeon prior to surgery. Part of the greatness at the University of Maryland is that all of the doctors involved with my case worked together as a team to figure out what to do, how to do it and when to do it (with my hip and spine). Once I entered the University of Maryland system, the diagnosis, treatment and follow-up was coordinated and that was very reassuring for me. My team stayed in close touch and made sure than any complications would be addressed quickly and nothing was taken for granted. All of my doctors were caring and professional individuals who listened to me and spent the necessary time to get the complete history in order to facilitate a successful outcome.

I am also very fortunate to have great doctors such as Dr. Barry Handwerger, Dr. Robert A. Shaw, and Dr. Richard Berg as friends who helped me make some very difficult decisions and suggested that I come to UMMC. Their support and friendship help sustain me and keep me positive throughout this ordeal.

For more information about UM Orthopaedics or to make an appointment, call 410-448-6400.