Four weeks after surgery #2 — early October, 2006 — I had a follow-up visit with Dr. Z's physician's assistant, Malia*. She did a cursory exam and said my wound looked fine (a matter of perspective, surely). She cleared me for physical therapy (PT), which I was to start immediately. We agreed to check in again in six weeks, to determine whether I was ready for the discogram I was about to do just after my L5-S1 disc ruptured. The additional discogram was to determine whether I needed two or three discs replaced.
I told her about the neurological issues in my leg and foot. She was disinterested, more excited to deliver her own news: Dr. Z had just received permission from Synthes (ProDisc manufacturer) to perform multi-level replacements off-label. Apparently Synthes granted permission to Dr. David Dillingham* (a bigwig in LA), Dr. Z got wind of it, and they agreed to do the same for him.
This meant I could have the surgery here in San Francisco, with Dr. Z. No travel, no entrusting my spine to a doctor far away whom I've never met, no struggling with the conservative German perspective on pain medication, no having to pay for the whole thing (surgery, plane tickets, hotel, etc.) in cash. None of it. I could stay home and avoid all of it. My insurance would probably pay for the surgery and one prosthetic, saving me tens of thousands of dollars. I left the office decidedly upbeat.
Except I didn’t want Dr. Z to do my surgery. Now that was a real possibility, I realized I couldn’t do it. It wasn’t the hideous experience I had at Saint Mary’s (where Dr. Z does his surgeries) or that I didn’t like or trust him — I did.
It was bigger than that.
The state of my spine defined my life. It determined whether I could leave the house, go to work, walk my dogs, sit, go out to dinner, do my own laundry, carry a bag of groceries, put on my own socks, or tie my own shoes. It described the limit of my physical abilities. It confined my very existence.
There was a surgeon in Germany who was more qualified than anyone else on the planet to do this surgery, especially if I needed three levels replaced. I had access to him. I had stock options I could sell. I had an excellent surgeon here — Dr. Z — who agreed to provide my follow-up care back in the States. I had the support of my partner and my family.
Where once it was murky and confusing, now the time had come, it seemed perfectly clear.
Didn’t it?