In late May of 2005, Dr. Oliver Langley*, the anesthesiologist — who was also a pain management specialist — performed the discogram, a procedure that attempts to replicate pain and is consequently, extraordinarily painful.

The three horizontal lines in the picture (adjacent) were the needles Dr. Langley inserted into my spine. The bottom two discs were pretty much flat (those are L5-S1, the largest vertebra in the spine; L4-5 is the one above it) but the disc in the L3-4 space, the top one (with the black blob in the middle), was still tall and thick. It confirmed L4-5 as the primary pain generator with L5-S1 also positive. Additionally we discovered an annular tear in L3-4.

This was not good news, as it meant the degeneration was already moving up my spine.

Dr. Langley and I talked about pain management options. Any pain meds I tried made me nauseous and throw up; after a few false starts we discovered I could tolerate dilaudid. It brought some pain relief but made me feel foggy-headed. I began to use it for breakthrough pain, but I couldn’t take it at work. Dr. Langley warned me he was ramping down his pain practice, but when he stopped returning my calls I was surprised. Narcotics prescriptions were un-refillable, so I hoarded the dilaudid and suffered through workdays, and counted the hours until I went home to medicate.

I was athletic. I played team sports. I ran marathons. I came to love surfing and snowboarding when I moved to Northern California. (You can go surf in the morning and then three hours later, go snowboarding in a single day. How cool is that?) The idea of having my bones screwed together did not feel okay… At all.

If I were to have a fusion rather than ADR, this could mean I'd need to have all 3 levels fused. ADR was a better option because it preserves mobility and doesn't translate the load from the unhealthy disc to the adjacent one. Instead, it gives you back the shock absorber your disc was originally meant to be.

I knew I probably needed 2 levels replaced and I continued my research. I discovered that this ruled me out as a candidate for ADR in the US since Charité, the only FDA-approved artificial disc, was approved for single-level replacements only. The more I realized I needed ADR — and multiple levels replaced — the more I came to understand that no one in the US was going to provide what I needed.