Observing Subject A:
My Patient Recovery Experiment
To better understand what my patients go through during recovery, I started an experiment: observing my patient like Jane Goodall, you know what I mean?!
Post-Op 3hrs
This patient had a severe lumbar disc herniation at L5-S1, his pain was a 9 to 10, and he couldn’t walk. 3 hours after surgery, I drove him to my home myself to observe him. We had removed tons of corrupt disc fragments endoscopically through just a little poke hole in the back, and Subject A went from miserable and unable to walk to completely pain-free.
Post-Op Day 2
As he put it, “Kinda crazy to think that just about 48 hours ago I was in surgery.” After flight delays got him back to Florida at 2:30 AM, my patient checked in with me feeling really good. He’s taking a nice, slow walk along the beach now, while letting pain be his guide.
Post-Op Day 7
One week after surgery, I told him to skip his Monday business trip but guess what he did? He felt good enough to go… He’s off Motrin (pain reliever), walking every day, has his first PT session done, and is already back in the gym. Not bad for someone whose pain was a 9 to 10 just a week earlier, all thanks to the LESS procedure: Lumbar Endoscopic Spine Surgery.
What Every Surgeon Needs…
Happy PA Week!
Last week, we celebrated our beloved PAs. I don’t know what I’d do without my physician assistants. Everyone needs someone who can look at the same situation from a completely different perspective and offer insights they might never have considered, and I’m fortunate to have that by my side every day. If you haven’t already, meet my PA, Alex!! To all the incredible PAs, thank you for your dedication, expertise, and everything you do for your patients and teams!!!
A herniated disc that looks small on MRI can still cause severe nerve pain if it sits in exactly the wrong spot. Size alone does NOT determine pain. This patient, a 48-year-old spine device rep, traveled across the country with pain running from the low back into the right buttock, thigh, calf, and foot.
The MRI showed a right L5-S1 disc extrusion pushing on the S1 nerve root, and a diagnostic injection dropped the pain from 10/10 to 2/10, confirming the source, but the relief didn’t last. Using LESS through a small poke hole, I found a red, severely inflamed nerve. Blue dye pinpointed the herniation, and what came out was the iceberg beneath the surface, far larger than the MRI showed…
In this surgery, I explain how continuous irrigation reveals inflammation that open surgery misses. In open surgery, we don’t appreciate that the nerve is inflamed because it’s stained with blood, like driving in bad weather with windshield wipers that suck!!