The Definitive Back Injury Update Post

Well, the jury   neurosurgeons are in, folks! Over the past few weeks, I have been to various doctor’s offices and imaging centers hoping to get an answer about what is going on with my back and how to deal with it.

Brief recap for those just joining my pity party: I have had back issues since I was 16 and have two bulging discs at L4-L5 and L5-S1. I have constant mild-moderate pain and sciatica most of the time as a result with several more severe flare ups per year. The most recent flare up occurred on the morning of the Charleston Marathon – January 18, 2014 – which I was unable to finish as a result of the pain.

The first stop was a neurosurgery/spine center in Greenwood that I had never been to before. For those of you not from South Carolina, Greenwood is definitely not the city in our state that one would think of when one thinks of outstanding medical centers, but it was recommended by a very helpful reader and received high ratings, so I figured I’d give it a shot.

My appointment was on March 17, the day after I got back from Chicago. I had an amazing appointment – my doctor was so caring and helpful. He not only gave me a thorough exam and lots of new information about the symptoms I was experiencing, he also answered all my questions and didn’t make an annoyed face when I told him about all of my running (much more rare than you’d think). He said that he had a pretty good idea of what was going on but wanted to get an updated MRI (my last one was from May 2012 after the Flying Pig Marathon incident). He also wanted to get some x-rays of me bending over in various positions, which surprised me because out of all of the spine doctors that I have seen over the years, no one has ever suggested that. I left feeling really hopeful that I would get some new insight.

I went the next morning first thing for an MRI and x-rays and was, for once, actually given the images on a CD when I asked for them. Normally, they just lie and say they’ll send them to you but never actually do until months later after you’ve fought them tooth and nail, at least in my experience. Anyway, I got a call the next day from the nurse at the office I had been to on Monday, and the news wasn’t good.

“You have degenerative disc disease,” she said. “The doctor is recommending that you see a neurosurgeon because you will likely need surgery.”

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I have to say, I was pretty floored. My last MRI just showed my same old dumb bulging discs, pressing on my same old dumb nerves and generally being annoying. I never expected to hear that my condition had worsened, even though I was in more pain. Yes, I realize that doesn’t make sense. I spent the next few days reading every article I could find about degenerative disc disease. It turns out it’s not actually a disease – it just means that your discs have deteriorated and are basically disintegrating, causing your spine to compress. My google search history looked something like this:

“degenerative disc disease”

“degenerative disc disease treatment”

“degenerative disc disease surgery”

“degenerative disc disease running”

“running after spinal fusion surgery”

“how to control a panic attack”

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One of my millions of searches took me to the website for the Boulder Neurological & Spine Associates in Boulder, Colorado. I had read (ok, fine, on a triathlon forum) that Dr. Villavicencio, also known as Dr. V, was doing incredible research on minimally invasive back surgeries AND IS ALSO A 32-TIME MARATHONER who has competed multiple times at Ironman Kona. As luck would have it, BNSA does free MRI reviews, so I overnighted my images to them (which I actually had, thanks to the CD!) in hopes of having one of their surgeons take a look at them. I thought Dr. V would be way too busy for my nonsense, but the very helpful office manager called me and asked if I had a specific physician in mind for my case and then suggested Dr. V based on my running history. Amazing! And Dr. V himself called me the next day. Note: This entire situation was as shocking to me as when AJ and I started dating and he actually did the things he said he was going to do at the exact time he said he was going to do them. Finding the right doctor is not unlike dating.

At this point, I hadn’t been told many details about my MRI since I was waiting for my appointment with the neurosurgeon down here, so he went over the whole thing with me, issue by issue. I was a bit taken aback by the list:

  • Serious degeneration at L4-L5 and L5-S1 (the bottom two discs of the spine), the worst of which is at L5-S1
  • Bulging discs at L4-L5 and L5-S1
  • An annular tear at L4-L5

Sounds horrible, right? Well, it’s actually “moderate” in the world of back issues, which is just crazy to think about since I can’t do anything without pain right now. I’d hate to see what “severe” looks like!

Dr. V explained that I will need a two-level spinal fusion to fix the pain and nerve issues I have, which was my worst fear. He also explained that because I’m 28 years old, he hopes we can avoid doing that for awhile, because basically, fusion is hell. He suggested trying a microdiscectomy first, which is much less invasive and requires much less recovery, to see if that would help enough to put a fusion off for a few more years. He was confident that I will be able to run again regardless because an elite triathlete (and 5 time Kona winner) that he operated on had the exact same issues I have, received a two-level fusion (at age 42), and continued competing professionally for 2 years before choosing to retire to spend more time with his kids. On a related note, I am somewhat concerned that he thinks I am an elite athlete, but it’s fine.

My appointment with the neurosurgeon in South Carolina was today, and I have to say, I am so glad I spoke to Dr. V first. There was nothing wrong with this guy at all – he was perfectly nice (from Canada, after all) – but holy crap, it was like he thought of ways to break the news to me in the most depressing possible fashion before he came into the room. Examples from the conversation:

“If I didn’t know any better, I would think I was looking at the MRI of a 60-year-old, but here you are!”

“You’re not going to be running anymore, so go ahead and get that out of your head now.”

“The only thing that will help you is a multi-level spinal fusion.”

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Thankfully, I was prepared for the conversation thanks to my discussion with Dr. V. All my research came in handy as I asked this doctor about other surgical options, which he agreed did have some chance of success, but admitted that he was not the most qualified to perform them because of the complexity of my case. He was impressed/possibly disturbed by how informed I was about the various procedures and latest research, and I found myself so glad that I love compulsively googling things. He was very friendly and honest but came across so much more pessimistically than Dr. V. If I had spoken to him first, I likely would have considered running/hobbling directly out of his office and into oncoming traffic because it seemed like my life was over. Perhaps I will write him an email with suggestions on patient approach, to include lines such as “You are so pretty; it’s amazing how degenerated your discs are!”

Isn’t it funny how it seems like nothing happens for such a long time and then everything happens at once? That is kind of what this feels like. I’ve been dealing with this issue for 12 years, and then all of a sudden, in the span of a week and a half, all of this happens. It’s nuts. 

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The end result is this: I scheduled a microdiscectomy with Dr. V in Boulder on April 24, assuming the pre-operative exam goes as anticipated. If it works, I’ll be able to start running verrryyyyyyy lightly about 6 weeks after that (beginning of June) and resume training around the beginning of August. If it doesn’t, I’m looking at a fusion at the end of the summer.

My best friend asked me bluntly if I scheduled the surgery with Dr. V because he told me I’ll be able to run again. It’s a fair question, but one that I can answer definitively – no. As we know, nothing in life is certain, so just because he says I will be able to run again doesn’t mean that I will for sure, and just because the other guy says I won’t doesn’t mean that I couldn’t. I think as a runner and an athlete, Dr. V definitely views mobility and activity differently than the other surgeon, but I picked him because he’s the most qualified and made me feel extremely at ease with my options and the entire process. Too bad I have to go to Colorado to see him, but it is what it is.

While the diagnosis and the treatment options certainly aren’t what I had hoped for, I already feel much more at peace about the entire situation simply because I have a definitive path forward and a doctor I feel comfortable with. It doesn’t hurt that it looks like my running career isn’t over just yet, either.

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June will be here before I know it!

55 thoughts on “The Definitive Back Injury Update Post

  1. Just glad you have answers and a plan. Me too. Answers and a plan. I thought of you w1 d1. My surgery is hernia and stomach repair this Summer.

    1. I’m glad you’re back to running!! And I hope your surgery goes really well and you get back out there quickly!

  2. I hate the idea you have to have surgery but I hate the fact you are in so much pain even more. FYI you can’t stop running till I see you run! Though reading your post made me think of when I had my surgery, there was no guarantee I’d be able to hear music (some can some can’t but thankfully I can. or being able to hear on the phone wasn’t guaranteed again I can just hard to hear on my current phone I can’t wait to get a new phone someday.) I will so be thinking of you!! Love you muchly!!xoxo

  3. At least you have answers and a plan which should be comforting. I hope the surgery is a huge success and you’re feeling better soon!

  4. I’m glad you got some answers! And really glad you did research and found Dr. V. I would definitely go the same direction you are!! I’m sorry but they should have a class in medical school to teach doctors to be positive!! If they don’t pass they can’t be doctors!

  5. Thanks for writing this post. I know just how punch-to-the-gut an unexpectedly bad spine MRI is. Good job finding a surgeon that you trust and has good ideas. I just found out that my neurosurgeon ran the NYC marathon, and was ELATED, so I completely understand.

    1. Isn’t it crazy how exciting it is to find a doctor that is a runner?? I’m so glad we’ve been able to swap stories. Thank you for the support!

  6. You know how I feel about this already. Know that I am 150% behind you and will piggy back ride you across the finish line of marathons if need be. Literal and figurative support all the way. And bretzels and beer will be provided 🙂 ps I sent an email bw you and Alex so that you can bad mouth me behind my (nonsurgeried but nevertheless not structurally competent) back. Bone crushin hug.

  7. I have degenerative disc disease too (L3-5 are totally jacked), I feel your pain. I was also told surgery it’s my only option. That was ten years ago, and since I didn’t really want to undergo spinal fusion at 24 I didn’t do it. I was told old need surgery by 30 to even be able to walk and I’m almost 35. Sure I have days of agony and last year I couldn’t walk for two months but surgery terrifies me, at least until they perfect artificial discs and I can just get them replaced. But if yours goes well I might follow suit and throw my Vocodin and muscle relaxers! Good luck!

    1. I’m so impressed you have avoided surgery for so long! I looked into artificial discs too but was told that wasn’t really a great option for me because of some specifics of my case. I know it’s new technology and things are changing constantly, so maybe it will be in the future! I’ll let you know how mine goes, of course 🙂

  8. Hullo! I writing to you from post spinal fusion land (1 level only, l5/S1) to let you know that running and free movement and such can happen again. In my case we decided to go direct to fusion as I didn’t want to surgery twice if once would do it (and MRI was quite clear on problem vertebra). I wish you the best of luck! Recovery is a pest but it does get better, I promise. Oh – and don’t hang out on back surgery patient message boards. They can make it seem like surgery never helps / gets better – but that’s because everyone who did get better is out there living their lives (not on the boards!)

    1. Hooray! Thank you so much! I definitely understand not wanting to do surgery twice – I thought very hard about that decision as well. I can see pluses and minuses to both approaches. Yeah, I made the mistake of going on the message boards a few times and learned my lesson quickly! They are horrible, but you’re totally right – all the people who had great experiences are out there living life. I will definitely avoid those in the future 🙂

  9. Hey Danielle… Small world. Although younger than I am, Alan Villavicencio was raised in the same small town in California as me. His brother and I both returned here to raise our families. These two guys are amazing in so many aspects: their careers, their athletic feats, their business sense, their community service, their commitment to their families. They are wonderful, extraordinary men. You will be in good hands, I guarantee it. My best to you.

    1. Wow, that is CRAZY! What a small world! Thank you so much for this comment. Dr. V seems completely amazing and it is so nice to have that confirmed.

  10. I know I don’t know you at all or anything, but I just moved to Denver (from Boulder) and have a large house with plenty of guest rooms if you need to recuperate while in Colorado. And now I know about Dr. V in case I ever have back issues. And I know never to let some old doctor tell me I have the spine of a 60 year old. Jeesh-and the medical field wonders why people are so skeptical of these ‘experts.’

    1. Wow, thank you so much for the offer, Amy! I think I am staying in my friend’s vacation home, but if that doesn’t work out, I will definitely let you know! I think Dr. V’s practice has an office near Denver as well if you ever need it 🙂

  11. This is great, Danielle. I’m glad you have a plan and that you found someone who is a runner that can understand how important this is to you. I think this approach sounds smart. I hope the surgery goes perfectly and that you can get many years of relief and running success with the microdiscectomy.

  12. Hoping surgery and recovery go well for you!!

    I would have picked the doctor you did too. A doctor offering alternatives first is always nice! A doctor that understands running & works with athletes is even better!

    I have foot & ankle issues, and was sure after I went in with pain after my first half that my dr would tell me that my feet are in no shape for that. Instead, I learned she runs marathons, so she “got” it and pointed me in the right direction to avoid further issues.

    Crossing my fingers for you!!!

    1. That is wonderful, Anne! I love doctors like that. I have always tried to look for doctors who are runners or are at least very active because they understand how important it is to stay out there! Thank you so much for your support! I hope your foot and ankle issues are better now.

  13. Best wishes with your microdisectomy! I could really relate to your post. Had to have surgery for a problem several years ago. The first doc (well-recommended) told me I had only one option (very invasive). I was training for a marathon (important to me) and didn’t want to be laid-up for six weeks or more. I did T-Rex style research and found another doc. He just took such a different approach to problem-solving. I still think he walks on water. (Oh, and I was cleared to run 2 weeks after surgery–ran a 5K w/o incident…and completed the marathon several months later.) I hope Dr. V is similarly a Godsend for you.

    1. Thank you, Judy! I already think Dr. V walks on water so I hope that turns out to be true. I’m so glad you were able to find another option!

  14. Interesting. and I though that type of comments were reserved to doctors here.
    After getting my back x-rayed last year (that’s the first thing they did when I said I had back pain), the doctor told me after seeing the pictures (they came on CD), that it looked like the back injury of someone in their 60s or a professional athlete and not a young person (albeit I’m not that young – 35).
    And basically she couldn’t tell me why it happened but she did tell me it’s probably progressive. 🙁
    I must say I’m rather satisfied now after reading there are always multiple possibilities and basically, after therapy, running is always an option.
    Runners know, after all, mind over body. 😉

    1. Aww, I’m sorry to hear you have had this experience too! Young people with old backs, unite 🙂 I’m glad the blog post gave you a little hope for the future in terms of running after treatment. Obviously, we’ll have to see how it goes in the future, but I’m optimistic!

  15. I am glad you know what is going on, but that doesn’t make it suck any less. You kinda knew it was headed this way, but again – doesn’t make it suck less.

    Finding the right doctor is very important – I know for years and years they were looking at my wife’s digestive issues invasively, and only recently have they started looking at food sensitivities. All because of one doctor who asked the basic question ‘if they haven’t found it yet, maybe they were looking in the wrong place’.

    Maybe in addition to “You are so pretty; it’s amazing how degenerated your discs are!” you could add “We just need your luxurious hair to share some of its awesomeness with your disks” 🙂

    1. I am so glad to hear that things are on the right path with your wife! Amanda has a lot of food sensitivity issues as well that cause a wide range of symptoms. It’s pretty crazy how much something like that can impact your whole body!

      I like your addition to the list 🙂

  16. I hope the surgery goes well for you along with the recovery, trip to Colorado, and all of it. You *will* get back on the roads and so many before you have done it, so the doctor here who told you no has no clue about that. Obviously he hasn’t done the research on Dr. V or running, and if he says that about 60 year olds, maybe most of his patients are older and are not running anyway. The population in Colorado is definitely more active than SC and I think sometimes that influences the health professionals as well. Glad to keep up with you on here and thank you for keeping us updated on things :).

    1. I definitely agree that the population makes a huge difference. I’ve had that experience a lot since I moved here – doctors aren’t focused on keeping people active because it’s not the norm and most people just aren’t that concerned about it. I frequently find myself wishing that I lived in a more active area for that reason alone!

  17. I’m so glad you contacted the other doctor. It makes such a difference in the beliefs of the doc. My Ortho is a runner as well & continues to push me to run – & I have the same bulging discs… good ole low back… (suck it)
    Sounds like this guy is going to do whatever he can to make sure you can run again where as others would be like “Oh well – no running”… you’re going to be great!
    & now I’m nervous my buldging discs are going to turn into this 🙁

    1. Exactly! People who don’t run just write it off or believe a lot of the old stereotypes and information. It’s such a relief to talk to someone who gets it 🙂

      Well, if it makes you feel better, I had bulging discs for at least 10 years before this happened, so hopefully yours won’t get worse!

  18. I’m so glad you’re a research crazy person and that you found a doctor you trust to help you. I’ve had doctors tell me super crazy things about my back, thankfully I’m also crazy about research.

  19. Oh sweetie, I’m so sorry. I guess even though you know, you just don’t want to believe it. I also have DDD but in my neck. It only prevents me from running when I have a migraine – which usually ends up with a fun round of Nausea (YAY).
    I cannot wait for you to be pain free and being back at what you love! You’ll get there! We are all behind you and know that TREX will be out there again soon!

    1. Thank you, Kandace! I’m sorry to hear that you are dealing with DDD too – the migraines do not sound fun!

  20. Yes you’ll run again. My doctor experience was the same. Wheelchair was my prognosis until I found the right doctor. You may have flare ups and need more rest than others. Your gait may need adjustment and I suggest no more high heals. I have lots of problems. DDD, 2 herniated, 2 bulging discs, scoliosis, bone spurs and nerve damage. Focus on strength training, get back in the pool, short training runs, more shuffle less ass-kick strides. I did an Ironman in Nov and 4:32 Atl Publix marathon last week with only 6-weeks training 5 miles twice a week and 10 miles on Saturdays. Good luck!

    1. This is so encouraging, Maggie! Thank you so much for leaving this comment. A gait analysis is a great idea. Congratulations on the Publix Marathon and your Ironman! You have given me hope 🙂

  21. As a nurse, I would have paid money to be a fly on the wall with that discussion with the original neurosurgeon. I have gotten in some arguments with the ones I know regarding what message to give patients. I love it when the patient has done their research and has a say in what happens.

    I recently have revamped my medical doctors to focus on ones that understand endurance running better. I find our discussions are much less pessimistic and more focused on what will keep me running.

  22. My MRI is pretty much the same and I love running. It is my therapy. I have stopped for now, ugh. I am curious how you are doing and whether you went on to have surgery. If so, are you running still? I noticed this was a while ago. I am having my MRI repeated soon. I am having a flare up at the moment and feeling very sorry for myself so love reading your positive humorous spin on it. My doctor is talking injections or possible surgery.

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