Just Another Posterior Atlanto-Axial Arthrodesis

A few days passed before I saw the next doctor. He was young, maybe in his middle 30's, and insisted without ever seeing a single x-ray, that my pain was caused by a herniated disc in my cervical spine. Right away, he referred me to a neurosurgeon to be operated on. More time passed before I was able to see the next doctor.

Finally, I paid a visit to the neurosurgeon. At that point I was no longer suffering any pains and was completely asymptomatic. I was ready to return to full duty at work and to get away from the monotany of an office environment (which they had me doing until the doctor cleared me to return to patrol). From the beginning, I didn't care for the neurosurgeon's demeanor. He was abrupt, curt, and not much of a conversationalist. Let's face it, an individual whom you are going to let probe, prod, and poke around your body should really make a concerted effort to establish some type of repoire with you, shouldn't he (or she)? I was ordered an MRI which, as luck would have it, couldn't be scheduled for another two weeks. Off to work I went to report to my supervisors that even though I felt great, I could not yet return to the road.

The day of the MRI finally came, and I went to the imaging center accompanied by my father. I needed him to drive because during my previous MRI several years ago, I discovered that I had become extremely claustrophobic inside that metal tube, hence the need for much Valium. In the huge magnetic sleeve I went where I quickly slipped into dreamland as my friend Diazepram sung me a lullaby.

As expected, it took another week to see the neurosurgeon again to evaluate the MRI's charts. After reading an outdated issue of People Magazine in the freezing waiting room of the doctor's office, I was called into the examination room where I must have waited another half hour before the bringer of all news bad came to see me. Isn't it great that we have to make an appointment at the most innopportune time of our day, yet we have to wait hours beyond that time if it's not convenient for the doctor? Upon examining the films, Doctor Personality's expression turned for the worse. He pointed out a problem-a rather major problem-in my cervical spine-C1 to be exact (I will go into detail about that "problem" later on). Rather rudely, the doctor told me that due to this problem, I will never return to my police career and that I will need immediate surgery or face the possibility of quadrapalegia or death. He shattered me. I didn't know what to think, say, or feel. I wasn't upset or angry. It was simply surreal. My first thought was, "Wonderful, I've been thinking everything was fine, and now I have to report to work that I STILL can't return to full duty". I was dissappointed. That's probably the best word for what I was feeling. Being told that I could never do what I loved doing, what I dreamed of doing since I was a child, and what I hoped to do until I couldn't do it anymore, was a thought I had a very hard time swallowing. Through all the thoughts that I had that this highly skilled, highly educated, highly experienced surgeon was obviously misdiagnosing me, I was soon to find out that he was dead to rights. I did have a big problem, and one that did, in fact, require immediate attention. Attention that promised to bring months of pain, aggravation, and discomfort with it.

Now, about the injury...

The doctor first noticed the problem when he looked at the regular X-rays of my neck in flexion (bent forward chin to chest) and extension (head tilted back)views. Here's a brief lesson in anatomy: The first vertebrae of the spine, C1(C for cervical), is located directly below the skull. It is the bone that supports the skull and turns and rotates when the head is moved. C1 sits directly on top C2, the second vertebrae in the spinal column. The anterior side of C2, or the part that is closest to the inside of the body, has a small bone on it's top called the odontoid. The odontoid sticks up from C2 like a small finger, about the size and shape of the last joint of the pinkie finger. It actually protrudes into the hollow bottom of C1, and serves to guide C1 in the spine's movements and keeps the two vertebrae working in unison. The spine should look like a snake when bent-curved smoothly over it's length with each vertebrae in line with the next. Obviously, the odontoid serves a rather important purpose. A fracture to the odontoid could be catastrophic. Fractures to this bone are classified into three types, appropriately called Type I, Type II, and Type III. A Type I odontoid fracture is when the bone is broken at or near it's tip. A Type II fracture is a crack in the bone more centralized in it's body. Finally, a Type III fracture is when the odontoid breaks below it's base taking a piece of the main body of C2 with it. I don't know which would be worse, but any odontoid fracture can have extremely serious ramifications. We're not talking mere fibergalss casts or soft braces. A fracture of this type can mean quadrapalegia or even death if not attended to immediately. My friendly doctor pointed out his first concern in my flexion view X-ray--I had an old Type II odontoid fracture and what was left of it was virtually non-existent.

An odontoid fracture is most commonly caused by a trauma to the cervical spine or surrounding area. I can't recall exactly when I suffered any type of injury that could have had such a result. I spoke to my parents about it and they recalled an incident in 1976 when I was two years old. Apparently, I fell out of my crib and onto the hard floor, landing on my neck. After being rushed to the emergency room, I was x-rayed. The radiologist and examining doctor had contrasting opinions. It seems the radiologist felt that I had fractured this very same area discovered in my 27th year. The doctor disagreed, stating that due to my tender age at the time, it is more likely that bones in my neck had not fully developed yet. Either way, I was sent home with Mom and Dad. To date, I have spent several years studying the martial arts with rigorous training that included breakfalls onto hardwood floors and taking full-on strikes to numerous parts of my body. I have been through two police academies and endured hours of physical training. I've been jarred and jolted through five car crashes, including an incident in which the Isuzu Trooper I was a passenger in rolled over twice on I-95, leaving a wake of two capsized vehicles and one totalled Toyota MR2. Throughout all of these situations, I never had any pain in the neck or shoulder area, or exhibited any signs or symptoms of a cervical trauma.

The doctor's attention then focused on the MRI films. Those didn't look too good either. There was damage to my spinal canal and spinal cord. (Here comes another quick anatomy lesson) The area where the brain stem joins (really "becomes" is a better word) the spinal cord is called the cervicomedullary junction. Cervico as in cervical spine and medullary as in medula, or of the brain stem. In that area of the spinal cord, which parallels the location of C1 and C2, there is a spot that is visibly different than the rest of the cord. On the MRI film, the damage is seen as a light grey spot about an inch or so in length whereas the rest of the cord is darker throughout it's entirety. The damage to my cord is called myelomalacia. In the simplest of terms, that is a basically a "dead" area of the cord. It's also recognizable in the films by the way the cord taper in the same section. The spinal canal, which houses the spinal cord within the spine itself, also shows narrowing by as much as 50% in one area. All of this is indicative of a trauma. But when did this happen? When I was two? It still remains a mystery.

What all this means is that there is a serious instability issue in regards to my neck. When the doctor says "instability", he is referring to the spine's ability to support the skull as it is supposed to. Because I suffered an odontoid fracture, C1 is sliding fore and aft, anteriorly and posteriorly, off of C2 each time my neck is extended or flexed. It no longer stays in line with C2 and comes perilously close to my spinal cord when my head is nodded up or down. Ultimately, one solid jolt, bump, or fall, could leave me crippled or dead. Doctor Good News wanted me admitted to the hospital that same night with surgery to be performed several days later. "But wait", I thought, "if I have had this injury for 27 years and have endured numerous falls, hits, impacts, and crashes with no adverse effect, why is there such a need for immediate surgery?" In a nutshell--I've been one lucky individual.

Being told I needed this painful operation that would leave me searching for a new career made me think of two words--second opinion. A family in the medical field recommended two doctors, neurosurgeons in the local area that have a reputation for being the doctors that other doctors go to when they need surgery on themselves. I made an appointment for the following week with the hopes that somehow, in whatever way possible, the first doctor was horribly wrong.

I made it to the next doctor's appointment with great anticipation of good news, but I still had butterflies churning in my stomach. As expected, I waited for nearly an hour past my scheduled appointment before I was finally called in to the examination room. I met with my new doctor who shared the same views of my films as doctor number one. Once again, I was told that surgery is the only means of repairing the damage. From my examination, the following was deduced: I would need to have C1 and C2 fused together to add the stability to my neck; If I did not have the surgery, I would definitely never return to police work; Not having the surgery also meant that I was at a great risk that one day I would wind up crippled or would be killed when C1 finally slips futher away from the rest of the spine and severs my spinal cord; The damage to my spinal cord is permanent. Surgery will only prevent future damage from occurring; The physician's assistant used a little rubber hammer to test my reflexes. This was like when you're hit just below the kneecap and your lower leg automatically kicks outward. Only during this test, I had no reflex in my arms signifying the damage to my spinal cord has already affected my upper extremities. Fortunately, I have no pain or other negative sensations or loss of use in either arm or hand. We caught this in good time.

None of this was received as positive news, though looking at it objectively, it is great news. A potentially deadly threat was located and dealt with before it had a chance to claim my limbs or life. Now onto the surgery itself. The procedure involves a bone graft-the taking of bone from one area to be transplanted to another. A large piece of bone will be surgically removed from an area of my hip, called the iliac crest, located above the buttocks in my lower back. C1 will be pulled into alignment with C2, and the bone is set in place behind the two vertebrae. Thin gauge metal wire is then wrapped around both vertebrae and around the hip graft to secure them together where they will eventually fuse together forming one large bone. Here is where the interesting part comes into play.

My doctor and his partner use a software program called "Stealth Station", which allows them to perform intricate procedures with the guidance and accuracy of a computer which assists them in placing their intstruments within the spine, and an infra-red sensor/processor mounted over the operating table, pinpoints on a video monitor exactly where in the body their tools are. (Dr. Ignacio Magana and Dr. Heldo Gomez were principal investigaotrs in the design and implementation of this software/hardware). In my case, this program will help determine whether or not my bone structure will support two titanium cortical screws which will be used to supplement the wire and bone graft in holding the vertebrae together safely and securely for the remainder of my life. This is all permanent, nothing will ever be removed. The hardest part to swallow for me throughout all of this, is the fact that a Halo apparatus will be fastenened to my head to temporarily immobilize my neck and spread the weight of my head to my shoulders while my spine fuses and heals. A Halo is comprised of several parts, the first being a band worn around the head above the eyes. This band is secured to the head by means of screws, or pins in medical terms, literally fastenened into the skull. Two screws will be placed in my forehead and two will take a position in the rear. Four metal struts join the head band to shoulder pads, or supports. The shoulder portion of the Halo is part of a larger fiberglass vest which finally ends mid-torso. It is made for anything but comfort, but that is the price you must pay for a healthy recovery.

I now have less than two weeks until the date of my operation, and to say I'm not nervous would be completely untruthful. However, I have the utmost faith in my doctors and in modern medicine. I don't feel very nervous, but I do notice I am sleeping a great deal more and biting my nails as if I've been deprived of food. Fortunately, I have the support of a great brother and wonderful parents along with some excellent friends. I probably won't be updating this page until the day before my surgery. After that, I will post any information as soon as I am able to return to my computer. Until then, my fingers are crossed, and if as many people that say they will pray for me actually do, I should be very well taken care of.

Forgive me friends, it has been a week since I have last typed. It is now Friday the 24th, one week after the procedure. What came at a a snail's pace- a butcher-knife weilding, serial killing, snail with a smile for causing pain's face-shot by and left our heads whurring and wondering where the time went. I'm into week two of recovery and what has unfolded until now, I shall now share with you. I will also tell you one of the lessons I have greatly learned along this road about friendship and family.

I checked into the hospital on the morning of November 16th. It was a very nice, clean hospital. A tremendous lot of super-pleasant, very warm people that for some reason in this day and age, still seem to really have a true sense of pride in their purpose. Seems there are some people out there that truly care. Best of luck in coming across them like I did.

Honestly, details are moot. I prepped calmy, patiently, even somewhat faithfully, for what though I knew would be a "normal procedure for the medical staff", could have very well have been the last time I breathed on my own, or felt a tickle on the tip of my nose. ...and that was it. I was administered my medications and sedatives intraveneously, and very soon slipped into controlled unconcsciousness.

The surgery lasted a hair under seven (7) hours. It could not have been more successfull. The screws took perfectly, the bone braft went just fine, and obviously there were no complications. I was just a martian Friday night, though. Waking up without movement of your head is just plain odd. This halo is heavier than I ever imagined it could ever be. I need help laying down and getting up. Sometimes I need help picking up my shorts in case I drop then when I urinate. Embarassing, but you get the point. This is anything but easy. This is anything but fun. But I am alive. I am well. I am making a very fast recovery with no ill effects.

On the first night I awoke surrounded by my father, brother, mother, step families and soon to be sister in law. I looked around, peering my eyes from corner to corner at all of their silent mouths. I cried. I was okay. I was not crippled. I was not damaged, injured, or hurt. It was still plain o'e me. I cried. Instinctively, uncontrollably, and when my mother looked over my face with tears of her own escaping from her eyes and asked me why I was crying, if I was in pain, if I was hurting I said, "No Mom, I'm happy. That's all."

Saturday, I was on my feet from time to time. And I will tell you this hospital has plemtly of employee related reasons to keep you on your feet. I began eating on Monday I believe, and my stomach was settled calmly. I actually had some pretty good laughs at the hospital. The staff, for the most part, was so pleasant it was hard not to.

So friends, I will return to write. As I said in the beginning of this, my goal is to assist others who have this procedure in maintining a level of comfort to help get through it. As of now, I have not yet found it. The lesson I mentioned about family and friends? I will get into that later on, another verse at another time. The point of that however, is that you MUST choose them wisely. I have much fewer friends than I thought as I found out through this incident. Much more people that care with a tongue than with a finger, with paper not a gesture. I don't expect much from anyone. But you shouldn't have to from those that supposedly love you. I have learned who my closest, deepest friends are. To those of you, I can't tell you how much your love and assistance means to me. You are angels in a world of wannabes. But, like I said, that's a topic for a whole other day. Love you all. I'll be in touch. I'm alive, and I'm okay.

Halodate: 29 Novemeber,2001. I had my first post-operative doctor's visit today. He's doing well since the surgery. That was a joke. It's ok to laugh. I had all of my staples removed while I was there. That was an ordeal. The incision, despite the surgery being for and on C1 and C2, actually went all the way down to about C6, necessitating the removal of my halo and halo vest to cut some of the nasty buggers out. But, they are gone and it is one less obstacle to stand in the way of my recovery.

I started the day by going for an x-ray. I was assisted by a lovely young woman named Krista who graciously got me in and out of there very quickly. The doctor read the film and reported nothing but the best of conditions. The screws were perfectly in place, the wire was in tact, and I still had some semblance of a brain floating around up there. So for now friends, I don't have a complaint in the world. Except of course, I have 10 weeks to go with this halo on. The spasms in my shoulders have increased a bit, but ice has been helping. Other than that, I will keep you all posted with any further information. January 3rd is my follow up appointment. That's a milestone date--it's my 6 week mark and my halfway point to halo freedom.

It's been a few days since I've posted again. It's now Tuesday December 4th. This weekend has been pure hell. The pains in my neck have increased tenfold and I now have spasms in my shoulders radiating halfway down my back. I've been trying to get into the doctor's office today because I think when the halo vest was reinstalled it was put on in a slightly different position. I can't sleep on my back anymore, not since it was adjusted. I feel like there are rocks digging into my back, the rocks being the molded shapes of the vest. I've resorted to sleeping sitting straight up. I've been a little down and depressed over the weekend, too. It dawned on me that I have three more months of this to go, then the collar, then the therapy. I know there are people out there with permanent disabilities, "real" problems compared to mine, but three months of this is really going to be a test of will and inner strength. I'll let you know how the doctor's appointment goes. And for those of you who have e-mailed me, thank you. Your words mean more than you can imagine. You know, all I want to do is pin my badge on, snap in my gun, slide in behind the wheel of my cruiser, and go back to work. I want to shower, I want to jog, to go outside for a long walk, enjoy the breeze and the scenery, drop the top on the car and go for a long Sunday cruise. I guess in reflection, the point is: don't waste your life wanting, get out there and do it without hesitation because you never know when something will arise that can prevent you from living a "normal" life.

Well, it's Saturday the 8th. Nothing really new to report. The latest X-ray shows continued progressive healing with the fusion and I'm adjusting as much as possible to the halo after only three short weeks. My family continues to be a huge help, especially my brother and sister-in-law. I'm doing well and I am relatively pain free. I still get spasms in my shoulders and neck, and my hip has started to hurt from where the graft was taken. That pain is from healing I have been told. That being the case, bring on the pain!

Well, I passed the fourth week mark and I am now into my fifth week. That leaves about eight weeks left of having to wear the halo. As time has gone on, I have started experiencing a lot of weakness in my shoulders. This leads to pain throughout the day, mostly in the intersection of my neck and trapezius muscles as well as in my shoulder blade areas. I've made a few adjustments to the straps on the vest to make it slightly more comfortable now that I have learned that I can do that. It also aids in washing. Nothing new to report. My brother's wedding is in three weeks and I have to figure out how we are going to dress me for it. I'll let you know as soon as I find out because that will indeed be interesting.

Well, my luck had run out. I thought for the first three or four weeks that I was some type of genetic freak, some super-strong ball of testosterone that was somehow exempt from feeling pain. WRONG. The incision on my hip is the most recent addition to the list of gripes and complaints. And it is turning into a very lengthy list. The gluteus maximus, or ass, as I like to refer to it, is the largest muscle in the body. That is the muscle that needed to be moved for the medical staff to remove the donor piece of bone from my hip for the fusion. Well, that's a big mass of muscle, and on me, probably a little bigger than most. Each step sends a "Charlie-horse" like sensation right through my left buttock, starting from the incision, which is around the area of where vertebrae L5 would be, and flaring down to where the rear of my left thigh begins.

My deltoids are the newest addition to the "Nope, can't use those anymore" muscles. (The "delts" are the outer portion of the shoulder muscles located at the top of the arms above and to the outside of the bicep). I wouldn't describe a lot of the sensations I feel in my neck, back, shoulders, and deltoids as pain, they are definitely considered "aches". However, my muscles in the neck have become so weak that even swallowing causes a spasm in the rear of my neck and sometimes in my trapezius muscles (tops of the shoulders where they meet your neck). It's going to be a long road. I've finally come to realize that. Each day the halo seems to get heavier as my muscles become weaker from non-use. Now, as opposed to just one week ago, if I lean too far forward, the weight of the halo combined with gravity, of course, pull be forward and off balance, but I don't have the strength in my upper body to proportion my stance meaning I had better not lean forward or I will fall-down-go-big-boom. And that probably would not be good. I did, however, run all this info by my Physician's Assistant, and he said that this was all a normal part of healing, and it will only get worse before it gets better. What a joy that is to know, because I am such a joy to deal with now. So, I will update again as anything occurs. Still waiting for January 3rd for my next appointment and X-ray. Happy Hanukkah and Merry Christmas to all of you! Hope everyone is healthy and pain free.

Some time has passed since I sat here to update this page. It is now January 2nd, 2002. The new year. For the most part, the spasms have subsided greatly, lessenning pain with their disappearance. I have had a few rather intense spasms in my neck which were not only painful, but caused tingling in my fingers and toes. Frankly, they scared the hell out of me. My fifth week in the halo I had finally felt somewhat comfortable with it. My sixth week was a breeze; "Hey, this isn't THAT bad. Week seven: GET ME THE HELL OUT OF THIS THING! It's enough. I now feel trapped inside a mobile prison. I want out in the worst way.

I have lost a lot of hair and I have found that my skin likes to dry up now as if I'm sunburnt. A medical field employee advised me that when the body undergoes major stress or trauma such as a surgery of this scale, it concentrates its resources on the areas in need, and sometimes it neglects the minute spots such as skin cells and hair follicles. So, these side effects are to be expected and will subside when the healing process is finally over. WHEN it is finally over. My hip has healed pretty well. My neck is healing too but the scar, which is massive, is still a "valley", as if it still has yet to join together. I wish I could report it was a Happy New Year, but at this point, I will rejoice in 5 weeks when this hellish, medeival torture device is unscrewed from my skull. One of my closest friends and fellow officers bought me a foam "eggcrate" and firm pillow for my bed. It made a world of difference. Now, instead of all the protruding parts of the halo literally digging into my back all night long because of the rocklike nature of the hospital bed matress, they now are absorbed into the foam allowing me to lay pretty flat and actually as comfortably as I think I can get given the circumstances. Still, it's removal is going to be the highlight of my life. Forget my first kiss, my first drive, that February fifth so many years ago when a girl named Carol took my virginity, or even when I first pinned on my badge; this beats it all. To turn my head, to sleep on my side, to shower, to bend at the waist, to get in my car and drive to get meals. There were days when I didn't eat because my roommates were working and no one was around to take me to get food. Okay, I'm ranting. I've recently been told by someone that I do that too much. The clock is ticking. No further information. See that. "No further information". It's time I got my damned uniform on again and hit the streets.

On January 3rd I went back for x-rays and a follow up visit. All is wonderful. The fusion is continuing to heal "fast and well". Three weeks until some more pictures and then another two weeks until we will review the possibility of removing the halo. So, we're looking at the second week of February. That ought to be a moving experience. I will tell you something about this experience. I have done a lot of self-discovery, soul searching and thinking, as well as looking at people, handicapped or otherwise differently. My outlook on many things has changed and I have discovered that there are some simply angelic people in my life. This operation saved me from what would eventually have left me a quadrapalegic. But all the pain and discomfort has been worth all the positives that have come from this, and I am not even thinking of the one I just mentioned. Regardless of your spirituality, despite your belief or disbelief in God, whatever you choose to accept, this whole story goes beyond mere luck. I have been blessed to have been given the opportunity to use my fingers to type this and share this with you all.

I've had some new pains in my neck. It now hurts to the touch. My surgeon said that is a great sign, that the feeling is coming back. My physical pain is a sign of further healing. Just another couple of months and I will be back behind the wheel of my patrolcar.

It is now the 20th of January and I should have 18 days left until the halo is removed assuming the fusion continues to heal properly. I spent a few days in the past week visiting the hospital and speaking with spinal surgery patients. One was a 19 year old boy who had cervical surgery and halo placement. I think my visit did his parents a lot of good-relief that in just 10 weeks, their son will be up and about and feeling great like I am. Adam, however, was drifting in and out as he was under the influence of morphine. I plan on revisitin next week. What amazes me is how much knowledge one can possess if something fascinates him or her enough. If you asked me three months ago what a posterior atlanto-axial arthrodesis with transarticular cortical screw fixation was, I would looked at you like you were blue and speaking French. Now I can not only break down and define what each syllable represents in medicalese, but I can tell you exactly how the procedure was performed.

My family continues to be a great support as do my close friends. I am counting down the days now. No more weeks and months. 18 to go and feeling good. From what I understand, the removal of the halo will lead to phase II of pain and discomfort as my cervical spine starts to support the 15 pounds of my large noggin again. Oh well, I've made it this far and at this point, there is nothing I can't handle. My next report will be on or after the 24th-my next X-ray and doctor follow-up. After that my friends, I will post pictures of the removal and start speaking of my rehabilitation and therapy. Until then...

It's the 26th of January at 0114 hours. I was sitting here at my dimly lit computer desk with "A Small Cigar" by Jethro Tull echoing throughout the apartment when my little MSN icon buddy told me that my Dad had sent me an e-mail. Happily and curiously, because of the late time, I went to read my pop's letter. I give you a quote from the wise man himself: "Update your website from the 24th, get a move on!!!". No matter how old you get, a good swift kick in the ass from dad always motivates you!

I went for more x-rays and a follow up visit on the 24th. It went wonderfully. Long and short of it: The fusion at the spinous processes (the points at the rear of the vertebrae) have already started union (medicalese for bonding or fusion). Nothing has moved (a great thing)as far as the fusion and graft are concerned. The doctor seemed to have a proud look on his face when he assured me that as fast and beautifully as I am healing (very much to his pleasure being that this surgery doesn't always hold up too well), that the halo WILL BE COMING OFF on February 7th at 1pm after the flexion/extension x-rays show (crossing fingers) that the fusion is staying in place when my neck moves. After he told me that, he gave me a confident pat on the shoulder and said, "I think you're going to be 99% perfect". That was a full-on symphony to my ears conducted by an extremely competent and well respected member of the neurosurgery field. I had full faith in him going in to this due to his reputation, and to hear him say those (let me go count) nine words to me was one of the downright happiest memories I can recall in a very long time. After the halo comes off, I have a week to physiologically destress and let my body adjust to the difference in balance and give my spine and muscles the opportunity to adjust somewhat to holding up my large cranium again after a three month break. Well, not much of a break for them I guess.

What almost made me teary is that he smiled when he said that after six to eight weeks of light duty, I will be ready to put the blue uniform back on and hit the streets again. Remember now - my first doctor, I can hardly recall his name anymore, I think it rhymed with gashole though - told me I would never be a police officer again and that I was looking at a year to recover while i reevaluated my career. Well, thank God for doctors like my surgeon who are true medical geniuses who pride themselves in their dedication to the advancement of medical science and actually care about their patients. He not only saved my life, but gave me the opportunity to live it how I want to live it. So, 13 days left and I am halo-less. WOOHOO!. Lastly, doc said after my one-year surgical anniversary, November 16th, I will be able to get back into a normal life just as it was, including working out and martial arts training. I'd like him to meet my first doctor. Maybe teach him a few things about being a humanitarian and most importantly, a doctor.

Doctors, like police officers, can make you or break you. Either profession, no matter what the outcome of the dealing with that person, should be professional and as pleasant as possible. When I write a citizen a citation, I am as cordial and respectful as if it were my mother in that car (who wouldn't be getting a ticket so that's a bad analogy). Well, when a doctor tells you that your life is in immediate danger if you even just bump your head and you need immediate admittance to a hospital for severe spinal reconstruction, you'd think he could deliver the message with some tact. Oh well. I'm great and riding the cloud of happiness until the big day. And as always, Dad will be right there holding my hand and supporting me. I could not have made it through this without him. Anyone who has visited my poetry page knows that. There's a lot of thanks that need to go around including my wonderful brother Matt and his beautiful new bride Amanda but I will stop there. The ride isn't over yet but I'm beginning to see the light at the end of the tunnel. Finally. Almost onto Phase II. Next report coming soon.

My God it's February fifth and in two days the halo is (crossing fingers again) coming off. Truthfully, I am not excited or relieved or anything other than what I have been throughout the latter part of this ordeal-taking things day by day. It's almost time to return to work at light duty, time for therapy, time for a new sensation of discomfort and pain that I'm sure the large amount of atrophy and muscle loss I have endured will tote along. There's a price to pay for everything and sometimes the toll is worth the trip. It will be a long road but my bags are packed and I'm ready to go. My father will be there with me in the x-ray room (being subjected to harmful radiation in the name of sustaining this website, THANKS DAD!) to photograph the event, and to share this most momentous of occasions with me. My brother will be there in thought, because he is now scheduled for lumbar surgery in just a few short weeks and will be getting fitted for his back brace that day. The wonderful part of his situation is that he is in intolerable pain and his operation will bring him immediate relief. Another emotional day indeed as it has been ten years of suffering for him, and he is only 30 years young. So, those of you have have prayed for me, toss in another for my brother if you wouldn't mind.

I'll be back shortly, and the next submission I contribute to this page will be without this metal crown fastened to my head. What a day it will be. What a day.

It's Friday the Eight. Removal went smooth and the doctor was extremely ecstatic with the amount of bone growth that has taken place in the surgery site. I was left scarred beyond the point I thought would be a "good war wound". Hopefully that will dissipate with time. I am in excrutiating pain as the muscles that have atrophied to nothing over three months are now being forced to work again. The worst is that because of that, they are now sore from overuse in addition to the pain attributed to being reintroduced to the world. Don't get me wrong, this beats that damned halo anyday because I know this will pass. But - I was completely overestimating how this would go. I can't move my head at all except for nodding down. I lost so much muscle in my shoulders that a light touch, even from behind, puts your finger right on my clavicle. That's about it for me for now. Therapy will be calling soon to start that route. What a joy that will be. Until I can type again....

It's been a while since I sat here in front of my CRT and had the desire to type. It's been a long haul folks, but gradually I see small differences in progression. The first week without the halo was very rough, the second was only the slightest bit better. I had finally received a telephone call from my physical therapy provider at the end of the second haloless week and scheduled an evaluation. I was given stretches and light neck exercises to do, which now that I am in the third week without that horrible device I think I am noticing a little more mobility in lateral movement of my head. Still, my neck continues to be very tight though.

I had my first official therapy appointment on Monday the 25th of February. It came after a long day at work - my first day back since October. I am assigned to the Crime Scene Unit on desk duty until I am cleared for the road again. I have a feeling that will not be anytime in the immediate future. But - I am back at work, driving my Mustang, restoring my freedom and trying to enjoy myself again despite the discomfort. I have more therapy scheduled for Thursday and Friday of this week (it is now Tuesday the 26th) so I will post with any progress over the weekend.

I want to take this time to speak of my brother, Matt. He had a lumbar laminectomy of L5/S1 - the very bottom lumbar disk that separates the lumbar vertebral body from the sacrum - ten years ago. That procedure involved the "shaving" of the bulbous, protruding portion of the bulging disk at the L5/S1 junction. He suffered from sciatic, radiating pain for a long time since then, but it never was as horrible as it became after a car crash in October of last year, 2001. I never saw my brother in such pain - sometimes agony would have been a much better word. He visited Dr. Magana, the surgeon who toyed with my broken neck, and immediately upon reviewing my brother's MRI films, told him he needed to have surgery or face permanent damage to the nerve root.

On February 18th, 2001, my brother underwent a lumbar interbody fusion performed by Dr. Magana. The surgery technique used is relatively new to the spinal fusion community: only about two years or so. Dr. Magana has still managed to perform over two hundred of these procedures in that time. The surgery involved approaching Matt's lumbar spine from the anterior side of the vertebrae. In other words: through his belly. He was incised from the naval to the pubic region, his internals temporarily relocated, and two cylindrical metal coils filled with cadaver bone were implanted between the vertebral bodies of L5 and S1 after the deteriorated, collapsed disk was removed. Matt is wearing a large brace now and is under the care of Dr. Wife now, but he is doing wonderfully. Obviously, he is having discomfort in his belly, but the sciatic pain that literally left him hobbling and limping on both legs is gone. I needed to share that here since it fits the theme of the site and also to express how wonderful it is to see someone I care about so much free from a suffering that was killing me to watch.

I might just have to make another page for him now. Well, I'll be back with more news as it unfolds...

Once again it has been a long time since I have updated this page. Almost a whole month actually. I have been back to work at a desk and attending physical therapy three times weekly for the past three weeks. It has helped tremendously. I have gained a lot of muscle back rather quickly in my shoulders and neck, but there is still a long road to go. My mobility is shot to hell for the most part. I can now look 62 degrees to my right. I will probably max out at about 70 at best. I can not look down and put my chin to my chest - the fusion prevents that movement completely. It's hard to explain to people how that feels. Discovering a newfound handicap is rather odd, and I would definitely call not being able to look down a handicap. While there are people with worse afflictions, I get upset rather easily when I think about how uncomfortable my life has become since the surgery; especially considering I had no symptoms whatsoever prior to my operation. It's hard to remember what the alternatives to surgery were. Certainly, I can bend over using my upper back and see the ground, but I will never look at my chest again without a mirror. I can't lay in bed and prop my head up to watch television. I guess one day that will feel normal.

I still have a great deal of discomfort in my muscles, especially in the back of my head at the base of my skull. The muscles that start there at the occipital region of the skull connect to the trapezious muscles of the shoulders. It amazing how all of the muscles are somehow connected. Turning or nodding my head is an effort. I do the stretches my therapist gave me every day like I am supposed to and sometimes they are rather painful. Eventually, they should become easy to perform. That is a long way off into the future though. I am scheduled for my next x-ray and follow up appointment in six weeks. I will update then unless something noteworthy should occur prior to that date.

Here it is: April 21st. My 28th birthday is just a few weeks away and thinking about that puts a whole new twist on my sense of time. It was just a bit over five months ago when I checked into the hospital for what has led me to feel like I do now. Is that bad? Not necessarily. I constantly remind myself of how lucky I am, and today I was reading about Christopher Reeve online and felt even better about the pain I am FEELING. Exactly, I am FEELING something, anything, even the crappiest of days means I am FEELING. That's not always an option after spinal trauma. So in that regard, I guess I can't complain.

My insurance company, Blue Cross Health options, decided that they were no longer going to approve physical therapy for me despite my therapist's recommendations. It seems they can't differentiate between patients who have broken their necks and a patient with inflamed hemmaroids. I do the gammut of exercises at home now with a couple of light dumbbells my dad picked up for me. Today I find myself sniffling with a sore throat so I haven't exercised other than my neck and shoulder stretches in a couple of days.

I return to full duty at work in two weeks. Am I ready? Well that depends. Psychologically, I have been ready for while. I really miss working out there on the road and getting out of the office. Physically, I don't think I will actually be ready for a long time. It still requires a great deal of effort to turn and pivot my head. Dr. Magana said there is no risk of further injury to my spine due to the fusion, so physiologically I believe it is safe to go back to work. There are still a bunch questions I have for the doctor, and those will be answered on May 2nd after my x-ray when I meet with him once again. At this point, let's hope with crossed fingers that the x-ray shows a solid fusion with no negative setbacks.

Back again, June 17th. It's been raining like it's a freaking biblical plague here in sunny South Florida AKA God's waiting room, land of the newly wed or nearly dead. This weather has made me realize what a lifetime of miserable suffering I am in for. I'm in good spirits (really, I am)so don't get me wrong, but this pain has been intolerable at times. It feels as if there is an ice pick jammed into the space between the base of my skull and the top of my spine. I feel it when I least expect it, i.e. when I turn my head "the wrong way" or when I swallow. I've been researching pain managament clinics in town and found one that is affiliated with the hospital where I had my operation. I'll be checking that out very soon. Other than that, same ole same ole. Well, not entirely, I did break my left pinkie finger on Friday the 14th, but in comparison to everything that has been going on in my life, I would have noticed it just the same if I accidentally bit the entire finger off. Irregardless, I have nothing new to report. I'll post a little bit of my doctor's pre-operative notes. Enjoy the read:

"I held a lengthy discussion with the patient and his father. Although he is relatively asymptomatic he has significant instability andf there is grave risk of neurolgical compromise, even with just minor trauma. It is possible that even without trauma this condition could progress. I agree that it is unwise for him to work as a police officer and agree that he should be placed on a no work status. I discussed with the patient the following options, if he chooses not to do surgery there is really no sure way to protect him. The older he gets, the less likely surgery would stabilize his condition. If he neurologically deteriorates, permanent damage or death could occur before he has the chance to undergo surgery... "...I explained the risks of surgery including death, infection, hemmorhage, paralysis, transfusion, reoperation and chronic pain (no shit doc)...The patient understands he would need to be immobilized for several months. He understands he might be left with chronic pain (another big no shit for the doc!). It is likely he is going to have to make some permanent changes in his work and lifestyle."

So that's that. I'll post again with any significant news. Oh, and most importantly of all issues, my family continues to do wonderfully. My brother is feeling great since his surgery and today (the 17th), my mother underwent some pretty invasive surgery which turned out to go smoother and faster than anticipated with the results we had all hoped for. Dad is still Dad and as supportive as ever. See, all this freaking pain but I'm still one lucky guy, eh?

So, here I am almost ten entire months post-op. I consider my actual "post-op day to be February 7th, the day the halo was removed. That would make "my" post-op tenure approach the seven month mark. Either way, I'm still having my ups and downs. There are good days and bad; the bad days really suck. I have a follow-up appointment in October. That will be my end-all x-ray and one year check up on the fusion. Keep your fingers and toes and eyes and everything that can be crossed crossed. The newest addition to the Neurological Center is a doctor that runs a pain management clinic. I think I'll need to have some words with him. That is, if I don't have to spend the next eighteen years of my life trying to get a referral from my nimrod PPC.

On the up side of things, work is great. I'm on midnights and having a blast. My brother had his six month post-op x-rays done and his fusion is as solid as a rock. That was great news. My mom is doing well, too.

I'll be posting soon. My follow up is right around the corner so I'll be back with the results of that. Unless of course the lotto pool I threw some cash towards hits it big tonight. Then you'll have to track me down through my accountant.

It's now Holiday Season 2002. December 15th specifically. I've been feeling pretty good for the most part. Occassional rain brings constant pain, but clear days are great. Aside from the limited range of motion, I wouldn't guess that I had this type of major operation. Well, that and the foot long scar down the back of my head. But hey, no one notices that right? Right? Ok, maybe not. But I like my little scar. It's like a reminder of how lucky I am.

I finished the testing process for a new police department last week. I should have the final word this week sometime. They sent me for an MRI to check on the solidity of my fusion. That's really a waste of money since X-rays would be quicker and serve to tell a better tale than the scan. I guess if they want to spend the $600 for the MRI, let them. I found out that I've become even more claustrophic. Great eh? Even the "open" MRI had me really jittery.

Overall, things are well. It's hard to believe I'm 13 months post-op. Two months from now will be my halo removal anniversary. Sometimes I don't even know I had the surgery. Aside from the limited range of motion, I don't have any side effects yet. It's 52 degrees now, chilly by SoFlo standards. My neck gets really stiff in this colder climate, but fortunately, it's hotter than hell here most of the year.

I'll post when I get the results of my job status. I avoided my one-year post-op follow up exam due to complications with my primary care doctor. Basically, he's a putz. But, the MRI looked good. The fusion is solid and it's hard to even see it on the films.

I'll be back soon, have a wonderful holiday season and a happy new year.

Well friends and visitors, it is now March 6th, 2003. The new year has come upon us and is a quarter over already. Hard to believe that it's been over a year since the halo has come off. I remember the whole episode clearly and distinctly and recall how much pain I had, but it's hard to FEEL just how bad it was if that makes any sense. On the bright side of things, I am now gainfully employed by the "new" police department and loving every minute of it. I'm extremely happy with my decision to leave my former agency and don't have a single regret about doing so. One good thing that came of my tenure at that "old" place is my association with one of my former coworkers. At our last shift party, he brought his girlfriend who brought her friend, who has since worked her way in, through, and around my heart. Love is a wonderful thing. New job, new wonderful girlfriend, new apartment (yes, I've moved too!). Could this be my reward for the suffering I endured for those months (and the suffering my family endured, right guys?)? Whatever the case may be, life is good. Really, it's quite great. My neck feels pretty good. I still have a knot in my right shoulder blade area which comes and goes. When it comes, it hurts like hell and seriously limits my turning radius to the right, but when it goes, I feel pretty "normal", whatever that means. My new insurance kicks in soon and I'll be off to the neurosurgeon for that one year evaluation that I have put off for four months. I'll post with the findings. In the meantime, keep those e-mails coming with any questions or comments you have. They're all appreciated. And if you made it this far, SIGN MY GUESTBOOK!

Well, it's now June 16th already. I can't really believe just how fast time has flown by since my surgery, and all the things that have taken place in my life seem somewhat surreal at times. There's been so much happening to me and around me lately it's hard to identify a point where I could start explaining without feeling like I'm leaving something out. I went to the surgeon for my final follow up a few weeks ago. I was worried because I'd been having pain in my upper back and shoulder, and being cognizant of a lurking herniation at C5/6, I was deathly afriad that all of my discomfort was caused by that. I was more terrified that the doctor would confirm my suspicions and recommend another surgery. I had every intention of telling him that I suddenly made a miraculous in-office recovery as there was absolutely no way in the world I was going through any of that again. My Physician's Assistant even said, "It would be nothing like your last surgery...after that, this would be a walk in the park". Well, you know, that's one park I can stay out of. I'm not one for the great outdoors anyway.

My neurosurgeon reviewed my MRI's with me and said the fusion was "perfect". Even I could look at the X-rays and see the union of bone at C1/2 that wasn't present immediately following my operation. Back then, there was a distinct definition of each vertebrae and the bone graft from my hip. Now it's just one large, solid white piece on the films. As for the pains I've been having, Doctor G. calmed by dizzying nerves by telling me that the herniation at 5/6 is so small, that there's no way it's causing the pain I've been having lately. It's all just a byproduct of my surgery, and as he informed me, it probably will be for many years. Oddly enough, I began to feel better the next day. Funny how our minds will tell us to hurt when we think the worst.

When I was preparing to leave the office, the doctor said, "You're all set, looking good." I asked about working out, training, the risks of getting hurt at work, etc., and he politely said, "Todd, go live your life. There's no need to come back here anymore. You're totally fused." The phone calls I made immediately following that appointment had the same tone and spirit as those I made when the halo was removed after my 13 week sentence to "the hole". Relief. Finally, after all this time and all the pain and all the concerns, I was "fixed". I was back to normal for lack of better words. I still have residual pains and spasms, chronic knots in my shoulders and shoulder blades, and the occasional radiating pain down my right arm which brings it's friend numbness along with it. But my mind is rested, assured that I'm "okay" again.

This month brings my father's retirement from his police career. He became a policeman in 1966, and to this day, at a young 59 years and 11 months, he's still going strong. My girlfriend remains as beautiful as the day I first met her, and continues to light up my life every day, even on those that are darkened with pain and discomfort. My brother is doing pretty well since his surgery, and he and his wife, as always, continue to be my closest friends, cracking me up all the time and helping me forget just how miserable (there is NO other word for it) I was just one and half years ago.

So all in all, my life turned out pretty damned good...no, it's pretty great. I thought I had it well made before this whole fiasco crashed down on me, but the ups and downs I've endured over the past 16 months have turned my life around in so many ways. So many cliches can be applied to this whole situation, but I think the best, most fitting, most appropriate one for me is "Whatever doesn't kill you makes you stronger". How true that is.

I don't think I have anything more to add to this page. My most recent doctor's visit concluded this episode with a final note of happiness and positivity.

I have some thanks I need to send out to those who stood by me, supported me, helped me, and in some way, small or large, individually or collectively, played an important part in my recovery and in reshaping and refocusing my life. Here's the list...

Dad. Simply the best. The father everyone dreams they had. I can only think of great memories of this ordeal when it pertains to my father. He not only took me into his house (along with my hospital bed, commode, attitude and misery), but did so without complaint. Dad would lay me flat on a chaise lounge and would shampoo my hair for me since the halo prohibited me from showering. As if I was an infant all over again, he cleaned me, sponged me, helped me maintain as high a level of mental and physical comfort as possible. He defines everything a father should be. Prior to my surgery he was just as great a father. Since my surgery he continues to maintain the same level of caring and compassion for his kids. I am as proud of my father as any dad is of his successful son.

Matt and Amanda. I can't say enough about my brother. He's my best, closest, and dearest friend and always has been. Throughout every letdown I've ever endured, he remained supportive, objective, unbiased, and true to my side. This time was no different. His wife, my sister-in-law, Amanda, stands in the same light and high regard as my brother. They are two great people who make one great couple. Without their support and assistance, my recovery would have been an impossible challenge.

Brian C (LawMAN CulLAN) A great friend. A great police officer. A great person. At the time of my surgery, I only knew Brian about a year or so. In that time we became close friends, sharing a lot of personal details about each other's life without the macho veneer to hold us back. When Brian saw how much difficulty I was having sleeping with the halo apparatus screwed to my head, he bought me firm pillows and an egg crate mattress liner to help me rest more comfortably. It worked. It was probably the best thing anyone could have done for me at the given time, but it also solidified our friendship and proved to me just how much he cared about his friend.

Rob M Rob and I were roommates at the time of my surgery. We were also working at the same police department at the time. He was one of the few people at that agency that I truly trusted behind my back, and I'm saddened that we don't work together anymore. For obvious reasons, I had to move out from our apartment when surgery came knocking. He understood my dilemma, supported the move, and never once asked for a single cent from me. He called and showed his concern for my recovery and progress, and when my stay at dad's and Matt and Amanda's grew near it's end (about 7 weeks post-surgery), he welcomed me back to the apartment with open arms and no concerns for money. When I explained to him that I was still not receiving a paycheck and that my father had offered to give whatever finances he could scrape up to contribute to my portion of the bills, Robbie's reply was, "I don't care about money man, I'm just glad you're home". Say no more. Now that's a friend. Though we don't keep in touch as often as I'd like to (due to no one's fault but my own really), I still do, and will always, regard Rob as a dear friend.

Mom My mother is a great, strong woman. She lives about an hour south of me, so staying at her place wasn't an option for me at the time of my operation. Had it been, I know she would have opened her door to me as Matt and Amanda, Dad and Mary, and Rob did. She's another reason I'm so thankful to have the family that I do.

Marty G Marty is a veteran cop that I work with at my newest place of employment (and my "home" where I plan to stay until the cop has left my body). I wouldn't say we're close in any sense of the word. Actually, we don't really know much about each other. Some people say he's a little gruff; I think he's the love 'em or hate 'em type of guy. Having met Marty only one time before my surgery (about 7 or 8 months before) in passing at the county jail (dropping off, not staying), we only knew each other by name and face. During my week in the hospital, Marty came by with a box of Dunkin' Donuts "Donut Holes", announcing his entrance to my room with, "Here, I brought you some cop food". Brian had told Marty that his friend and fellow officer was hospitalized with a broken neck and Marty, remembering who I was, came by for a visit. He could do no wrong in my eyes.

Sandra and Momma O, and Jeff D. Great friends. Great people. Honest, compassionate, caring, and open. These three people would sacrifice the shirts off their backs for anyone they know, and never failed to keep me reminded just how much they cared about me and how often I was in their thoughts. As a matter of fact, Sandra visited me at my brother's place in time to decorate my halo with tinsel and ornaments for the holidays. I miss them too as we don't talk that often anymore, but I know I'm in thier thoughts as often as they are in mine.

Leslie. The newest edition to my life. Hopefully the latest permanent addition to my future. I wish Leslie could have been with me throughout this whole nightmare. I know she would have done everything in her power to comfort and support me. She has become my rock in recent months, my safe harbor where I seek shelter from my daily stressors. She is the love of my life, and if my way becomes the gospel, she will be the love of my future from here on in.

Finally, All of you who wrote me e-mails with your stories about your injuries, surgeries, inspiration, or how in some small way my sotry influenced your life or recovery, inspired and enlightened me more than I can say thanks for. Keep the e-mails coming and as always, I will respond to all of them.

This has been one hell of a ride, but I've made it through it all and came out a different person in many regards. Without the love and help of all those I just mentioned, I don't know that I would be here to say that.

With a heavy heart and wide smile, this website is now 10-7.

Click here for the synopsis of my surgery. The Operation.

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