ACDF: My New, Most Important Alphabet

By John Gilstrap

Note: My bone grafts will come from the bone bank, not from my hip. Thank goodness.

If you’re looking for any solid writing advice on this Wednesday, perhaps you should move along.  This week’s post is personal.  Perhaps even indulgent.

My writing schedule has been knocked completely off course by life issues.  Yes, I realize that this contradicts a point made a few weeks ago in a post on this very blog, but I’m not trolling for sympathy, and I don’t consider this space to be “social media”.  I’ve been a regular here for long enough for all y’all to feel like family.  And I don’t look at any of this as bad news.

Tomorrow, I will undergo roughly four hours of surgery to remove three discs from my cervical spine, replace them with bone grafts, and then fuse them all together with a titanium plate.  The surgeon will go in from the front of my throat, retract my trachea and esophagus off to the side.  The procedure is called anterior cervical discectomy and fusion (ACDF), and the success rate is phenomenal.

This is not my neck, but this is what my x-ray will look like when they’re done.

For about a year now, I’ve endured pain and numbness down my left arm and shoulder, radiating down into my left shoulder blade.  Sometimes, my thumb feels as if it’s been hit with a hammer.  As I type this, I can’t feel my thumb at all.  It’s called cervical radiculopathy. I’ve tried physical therapy, and I’ve had two epidural injections, one of which helped a great deal, and one that seemed to do nothing at all.  The surgeon explained that I now have two choices:

Choice One.  I can suck it up and keep going.  There’s no danger of catastrophic degeneration from my condition, so the surgery is, by definition, elective (though insurance will cover it).  He said if I do nothing, things will never be better than they are now, and if they get worse, I always have the option for surgery down the road.

Choice Two.  Have the surgery now and make the pain go away.  This is the choice I made, and here’s why: I will never be younger than I am now, and few conditions age a person faster than chronic pain.

So, the decision is made.  I’ve decided that the risks inherent in any major surgery are worth the results.  I’ve signed on for 4-6 weeks of recovery and the inability to lift anything heavier than 5 pounds for eight weeks.  This puts a big burden on my lovely bride, and she’s signed on as well.

And I’m terrified.

It’s my cervical spine, for heaven’s sake!  The fusion will happen at three levels, C4-5, 5-6, and 6-7.  In the weeks ramping up to tomorrow, I’ve realized how counter-productive it is to be the control freak that I am.  I am literally passing my future into the hands of a man I’ve met only twice.

Since mid-March of this year, the time when this surgical rock started rolling down the hill, I have spent countless hours–hundreds, probably–researching every aspect of ACDF surgery.  I’ve watched an entire procedure, from incision to final sutures (thanks, YouTube!).  I know what the likely complications will be (difficulty swallowing and speaking for the first week or two), but I also know that the vast majority of patients who undergo ACDF surgery enjoy complete elimination of their radiculopathy as soon as they open their eyes.

Knowing these details helps me settle my fears.  This is going to happen, so why not embrace it and try not to be scared?

The real casualty of this looming episode in my life is my writing–and that’s my hook around to the topic of this blog.  Thanks to my obsessive research into my surgery, I have fallen woefully behind the power curve for my next book.  It’s a quirk of my personality that I have difficulty concentrating on the imagery necessary to write a story while my mind is consumed with unanswered questions.  No excuses, just an observation.  I’m hoping that during those days (weeks, perhaps) when I am pretty much unable to do anything but rest and take walks, I’ll be able to re-focus on what I really should be doing.

So, here we go, on into the unknown . . .

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About John Gilstrap

John Gilstrap is the New York Times bestselling author of Lethal Game, Blue Fire, Stealth Attack, Crimson Phoenix, Hellfire, Total Mayhem, Scorpion Strike, Final Target, Friendly Fire, Nick of Time, Against All Enemies, End Game, Soft Targets, High Treason, Damage Control, Threat Warning, Hostage Zero, No Mercy, Nathan’s Run, At All Costs, Even Steven, Scott Free and Six Minutes to Freedom. Four of his books have been purchased or optioned for the Big Screen. In addition, John has written four screenplays for Hollywood, adapting the works of Nelson DeMille, Norman McLean and Thomas Harris. A frequent speaker at literary events, John also teaches seminars on suspense writing techniques at a wide variety of venues, from local libraries to The Smithsonian Institution. Outside of his writing life, John is a renowned safety expert with extensive knowledge of explosives, weapons systems, hazardous materials, and fire behavior. John lives in the Eastern Panhandle of West Virginia.

27 thoughts on “ACDF: My New, Most Important Alphabet

  1. God be with you, Mr. Gilstrap. Praying we get you back fit and firm.

  2. Pulling for you, John. And I’ve never seen you write anything from which I haven’t learned something about writing and otherwise, including this post. My own future contains a similarly frightening surgery on my lower spine to alleviate pain and numbness down my legs (esp. my left one). It isn’t debilitating yet but is degenerative and progressive. Thank you for this post and good luck.

  3. Wishing you and the surgeons great success. My son and my ex-DIL had similar surgeries and it made a huge difference. And now, you won’t have cranky old ladies telling you your body language makes you unapproachable and mean-looking.
    TKZers, I had the EXTREME pleasure of attending a conference where Mr. Gilstrap was a keynote speaker and also gave a boatload of workshops, surviving not only his pain, but the challenges of what, for him, was a major adjustment in altitude.

  4. Best wishes on your procedure. Hope you are shortly pain free and as you recover and rest you can refocus your mind as you want to on your writing project.

  5. Best wishes for a manageable recovery, John. I value your blogging and You Tube videos and look forward to your return!

  6. I had a broken leg and hand last year after a hiking accident. I thought during my recovery that I’d write thousands of words every day. I had a knee scooter for short distances, showers took 20 minutes of prep pre and post, no driving, confined to my house for a month.
    My mind was so obsessed with trying to figure out how to do things without my dominant hand and leg, I had nothing left for the creativity of storylines.
    Worse still I listened to a Jeffrey Deaver book wherein explosions were taking place throughout NYC and one of the soon to be victims had a broken leg like mine and was unable to get out of her apartment, lol. I’ll never forget the real terror of that book.
    The good side was except for the few days around the surgery to fix the ankle, there was no pain involved and I made a full recovery to hike Yosemite 3 months later.
    Imagine how easy writing will be in just a few weeks without numb fingers!

  7. John, wishing your surgeon a good night’s sleep tonight and steady, skilled hands tomorrow.

    And wishing you relief from pain and a quick return to normal activities.

  8. As well as wishing you a speedy recovery, I want to give a shout out to you for the decision you made. Live with pain and hope for the best? Not the Mr. Gilstrap we love – no, he forging head-long into the breech, sword in hand, facing the monster and slaying it. Good for you! Expect to see you all better in time for your keynote at RMFW in September.

  9. I, too, know what a pain in the neck a pain in the neck can be. The very best to you on your surgery and your recovery.

  10. Positive thoughts. I KNOW all will go great for you. And you are right, so many of us feel like TKZ is like family. You have my best wishes, my brother.

  11. All the best for your surgery and recovery, John. Kia kaha- stay strong.

  12. Focus first on recovery – resting and taking walks…

    And like everyone else, “squeezing the beads” for you & yours – surgical team as well.


  13. I am just seeing this after returning from my hometown and my father’s memorial service. Life sometimes gets in the way of our plans. Hope you are recovering quickly and you are pain free. Nothing is quite as debilitating as constant pain.

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