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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