Crystal is a woman from the southern part of Washington. She is 72 years old and lives on her own. Her family lives in California. When I met her, she had severe spinal stenosis in her lumbar spine at multiple levels. This is a condition where bone and ligaments grow around the spinal canal and cause a constriction of the nerves passing through. This causes the spinal canal to resemble the narrow part of an hourglass. As the nerve compression gets worse, standing and walking become increasingly difficult. The classic symptoms are numbness, weakness, fatigue, and pain in your legs whenever you are upright. She could not walk for more than half of a block without having to sit down. As she had been this way for several years, she was becoming increasingly weaker. She was very unhappy at the prospect of losing her independence in addition to experiencing a lot of discomfort. Because of this, her anxiety was through the roof.
I performed a laminectomy on her at L2-3, L3-4, and L4-5 This procedure removes the narrowing and about 70% of the time patients are able to walk without pain. It takes a while for the strength and endurance to return. Most patients don’t engage in the rehab enough to experience the full benefit of the surgery. As she was so frail, my optimism for her was tempered. I knew her leg pain would improve but probably not her strength. She also just did not seem like the person who would engage in a full rehab program. I never give up though, so I talked to her about the DOC project and gave her this web site.
The surgery went well and her legs felt better. During our first phone appointment, she began to ask a lot of questions about the web site and had begun the writing exercises. She was slightly encouraged and I was pleasantly surprised. The talk evolved into a somewhat extended conversation about the central nervous system and conditioning. It is difficult to make the effort to exercise when you have a lot of anxiety. To see a full recovery, I want all of my patients in the gym working out with weights three to five hours per week. She was interested in getting completely involved in the process.
One month after the surgery, she was sleeping better and felt her anxiety was dissipating. She would go out for small walks every now and then. I encouraged her to join a gym. I really did not expect her to do so. When I talked to her a few months ago, she was a different person. Her voice was energized. She had joined a gym and was working out four or five times a week. She felt a dramatic increase in her strength and endurance. Her anxiety was down by 80-90%. She was going out with her friends and socializing. She was ecstatic.
I asked her to write a followup letter about her experience, which is about a year from her surgery.
Feb 3, 2012
Dear Dr. Hanscom
How nice it is to feel better! It’s great to be able to do some of the things again that I used to do. I am doing everything that I have been asked to do. I am working out in the gym every week. I am also working through all of the stages of the web site. All of the books have been interesting and helpful. My friends tell me how good I look. They say that they no longer see the look of pain in my face. I feel like I have my life back.
I have kept in touch with her and we talk every three months. Four years later she is still works out in the gym and her strength and endurance have continued to improve. She is active in the community with a nice circle of friends. This in sharp contrast to the days when she was lying around her house and at the mercy of her pain.
The tools on this website are self-directed. My observation is that there is no question of “if” you’ll better but only a question of “when.” The decisive factor is a patient’s willingness to engage. It is stories like Crystal’s that keep me moving forward with this project.