A Paperclip Spinal Fusion

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[00:01:07] speak to the patient and at the end hit Carpahen and a soap note generated. I love it and you will too. Welcome back to Untold Physio Stories Podcast. I'm a host doctorate with my domaniotherapy edge mobility system and our four month online mentoring program

[00:01:25] writer Greta Mastery and I'm back with Andrew Rothschild. How's it going? Yeah, in person, go well, or something. How are you? I know this would be a really fancy asynchronous recording if I managed to do this. Yeah. Yeah. So, I think I don't know if we've

[00:01:44] ever told if Andrew has ever told a story. I know the funny because I've ever taken this course or heard him speak, he often tells about his spinal fusion. But I think that ever and knows you

[00:01:56] got one. I don't know why you've got one and it was definitely before your PT. So, once you wanted to tell us that story. So, I had this surgery when I was 23 years old and I'm 46 now.

[00:02:10] So, it's been basically a cathedine life and I was an athlete, I played soccer in high school I played for a couple of years in college and it was during high school. I kind of grew late

[00:02:23] at early growth. I was like 16 and I was like 5-4 and I also had a group like 60 inches one year and I wasn't necessarily because of that per se but I remember my junior year, I think

[00:02:36] maybe it may as you can see in your year, I played goalkeeper in soccer. Now, it would go through a period where I felt like I couldn't bend forward. I felt like I was like stuck.

[00:02:45] It wasn't painful. It wasn't sore. It wasn't like stiff. I literally just felt like I could not bend forward. It would last for a few days and it would go away. I didn't think anything of it.

[00:02:55] I didn't do anything about it. And, you know, I guess that would happen very periodically, very intermittently, didn't seem to be any rhyme or reason, nothing like that. And then when I graduated college, you know, it's sort of like this IT kind of tech job,

[00:03:12] working, you know, sitting all the side to sitting all day. So, you know, you go from being a college student to all of a sudden sitting eight hours a day. So, I started getting to say, you know, you're

[00:03:21] normal like back, sort of this and stiffness and that kind of thing. I was playing a little indoor soccer with friends. And then I was doing like deathlifts at the gym. And it wasn't even very heavy.

[00:03:35] It was like doing some warm-up stuff with like 95 pounds. And all of a sudden, I had shooting pain down my left leg. And it was, you know, most of the most intense pain I've ever had,

[00:03:49] you know, had no idea what it was. I kind of didn't do anything about it for a week. Really didn't get better. Really just kind of got worse. Finally, went and saw a spinoff

[00:03:59] of a pediatric surgeon. And he basically was like, you know, kind of, you know, had me just like be down for a few days. I think if it's an oral steroids,

[00:04:09] didn't change too much. I can't, yeah, I can't have a roll of timeline for some of this stuff. But finally sent me to see a spinoff surgeon at, I think it was like even like six months later,

[00:04:22] even longer. So, really went almost over a year before you ended up having the surgery. I was saw a spinoff surgeon at Georgetown Hospital in DC. You know, had all the x-rays done,

[00:04:34] had MRIs done, and then they showed that they said it was a spinoff surgeon. I don't remember them saying anything about what greater was. I would be doing what it was at that time. And then ended up having, you know, decided that they, optioned. They did some physical

[00:04:51] therapy. Remember they prescribed physical therapy for a little while. I remember going to a couple sessions. And there's one of those ones like I went to a session and I remember the

[00:05:00] therapist looked at my feet a lot. And I have a very wide and high arch foot. Like I'm six feet tall, I wear a size 10 shoe. I have a very short foot. It's like as wide as half as wide as it is

[00:05:19] long. It's crazy. That's definitely an oddly small size for some of these six foot. I have a very small size. I also have a question too because like, no, I have this a lot of

[00:05:30] people tell their story. But did you say you had a job and IT before? Like what's really IT? It was like I worked for like a company, like Verizon owns that now. But it was like out in

[00:05:43] like, there's like world combat in the day if you remember them. Not really, but I mean, so what was your major? I just assumed you were always some sort of bio or PT, oh yeah, this is this is

[00:05:55] even worse because I was a geography major. Okay, wow. And I had my job had nothing to do with geography and nothing to do with physical therapy. Not in the show how I got the job and I also

[00:06:07] didn't know what the hell I was doing. Well, I'll do it in the job. And the lead packs have a person you know. Yeah, that's pretty sure. Like what I've had in the weeds? He's not tax savvy. He was

[00:06:22] an eye on me. Not at all. That doesn't do us like to check part and have to do with like setting up laying the company laying down like T1 and big OC48 cables that you know that runs on.

[00:06:36] That's basically what I call it. It was the eye of the tea. Yes, pretty much, basically. So you had, so you got a fusion. Yeah, so this is even before that I had the guy told me to get

[00:06:54] like orthotics. You know he said he thought this was coming from my feet. You know, it's all like like, it's alright. It's like two PT visits. Even though both your feet are obviously

[00:07:05] like this and you're yes, do you have a lateral symptoms? Yeah, I got these rigid orthotics that were like $400 every of the most uncomfortable things in the world. And if you know anything,

[00:07:14] you rigid, either rigid, high arch foot, the worst thing for them is a rigid orthotic. You don't need it. Yeah, the foot's already. It's already rigid. It was awful. And then, you know, that

[00:07:27] obviously did not do anything. I think I went to like two visits for some of those. I didn't go back and remember them like asking me to come back to therapy or anything. So obviously things didn't

[00:07:35] get better. My back pain actually at some point did get, but I was still like working out of doing all these things. I had the very classic sparty symptoms extension, but you know symptoms down

[00:07:45] the leg if I extended my hip, symptoms down the leg if I tried to run it all, symptoms down the leg, you know? So you know, sitting too long, any position for too long was just, you know,

[00:07:55] kind of miserable. And at some point I had a follow-up with a doctor. He was like, how are you doing those? I was like, oh my back is better. My back pain was a little bit better. But my leg is kind

[00:08:05] of a rush. You know, it's like now it's going into my calf and he's like, all right, now we're talking like, that's when I decided this is what you need fusion. Did you have

[00:08:16] actually a neuroides or anything you don't even know, right? I do have acerphate. I didn't have any loss of sensation. I must have had some weakness because if you look, I did not even notice this

[00:08:29] until after a year as a like, how often do I look at my own calves, you know, another body builder. I noticed like a year's after my surgery that my death thing, my left calf is small of them

[00:08:41] on a right. I think I had some weakness with like a great toe extension, but then again, it's like how often can you tell you a great toe extension and weakness? You know, like it's not never,

[00:08:51] I know, foot drop or anything like that. So it wasn't like probably super hard neuroscientific but it's definitely a little bit of a matter of maybe a little bit of weakness. Yeah, and I had

[00:09:02] I had the fusion when I was 23 and I did really well probably for that first year, year and a half. It's a very standard class recovery went to PT did, you know, your traditional core exercises of course. That was very diligent because I'm like go to the gym

[00:09:21] and then after that a year and a half, I started kind of going downhill where there was nothing, you know, the leg pain resolved instantly and that was never ever an issue really going after that

[00:09:31] but it was just this constant sort of nagging back. It was like deep ache, you know, and it's like a goodness, I, you know, nothing really, certain things made it worse again, like standing too long, sitting too long, bending too long, you know, walking too long

[00:09:47] but nothing really made it that much better exercise felt good but it was just there. And I can't go back to the doctor. He's like, well, you know, the classical to getting surgeon, the surgery looks great. Everything looks good, you know. You know, you know,

[00:10:00] you're alive. You're still alive. The hardware wasn't rejected. It was good. I mean, straight hardware is beautiful. Look at this, you know, go back to go to more physical therapy do that, you know, again, it's still certainly was fine but it didn't, it didn't,

[00:10:13] we didn't change things significantly and I went like every few months back to the doctor because it wasn't changing. And finally, on the, you know, we actually weren't changing, you still had leg pain? No, the leg pain has been gone. It was just a back pain.

[00:10:27] So the leg pain was like, leg pain was all right after the surgery and really never, that was never an issue again. You know, maybe something intermittent stuff, I can to the buttocks of the hip and that kind of stuff but not like the electric shooting,

[00:10:38] classic kind of stuff. But then finally, at one point an x-ray showed that I broke the hardware at one point and broke a screw, I dislodged a screw and he couldn't say for sure if that was

[00:10:50] why I don't remember any event and incident, you know, just, you know, just these things and that, you know, down and good, you know, jumping ahead but like at some point down the road

[00:11:00] I started getting letters about a class action suit. Like I think there was a recall on the hardware on someone, on some of the screws that I never got involved with it, because up by that point

[00:11:11] I was like am fine. Okay. If you know, I've dollars three years later. Yeah, exactly. Like every class action suit. And this were like $10 billion, but it spread out across like 50 billion people.

[00:11:22] But exactly. So again, as well as things was at the screw issue, it was a like being, you know, young active person just did stuff, you know, not the hilarious thing was at one point I had to

[00:11:34] see my surgeons partner because he had taken like a three months of batical and the other guy he's also a surgeon, but he was like, yeah, it's kind of like a paperclip you've been into

[00:11:43] enough. It breaks. I was like, what? I don't think that's supposed to happen. What do you mean you've been into nothing? Branks is that the opposite of what a fusion is? Yeah. I mean,

[00:11:56] really inspire a lot of content. I know. It's like every fusion get a fail then it sounds terrible. So even like I didn't know anything of course that still didn't make sense to me at the time.

[00:12:07] Well, so you know, it wasn't like the fusion patient I just talked about where she was basically told never to do anything at the activity ever again. Yeah, they only things they told me I could not do basically was skydiving and bungee jumping.

[00:12:21] So retrospect I wish I got a skydiving before the surgery because I don't know if it feels like they'll have a fun thing to do. But yeah, after that is they really have no limitations

[00:12:29] other than you know how things feel essentially. So that was always a very positive thing. skydiving or bungee jumping because I think it's just a story. What's that? What happens if like you're boldering? What if it happens if you're boldering and you're not

[00:12:42] top or a finger or something if you're rock climbing and you just land from 10 feet up that's very similar. Well, I've done that. I did that. Yeah, and I'm laying you walk with the on one leg and that really

[00:12:52] aggravated things for like several weeks. But I think it's like the following following following this like a quick reverse force you know forever reason I'm guessing that was there. That's the brush. Oh yeah, I think it's the deployment of the parachute versus like oh land here if you're

[00:13:07] not the landing I see I see yeah, I think with a bunch of jumpers like that rapid like reversal is my own one. That would be a force to snap that paper clip. Yeah, I did it already.

[00:13:20] Paper clip wow talk about like one of those fragile things like like every young child can bend the paper clip. Right. Now, and I guess I'm also fortunate in the sense that I don't

[00:13:32] I don't I don't I never internalize that stuff like an negative way. I was just like I whatever like it I didn't you know it didn't give me any fear I guess which was a good thing.

[00:13:42] Yeah, but you know I had the broken hardware and it was just kind of sitting there and but of any I did have doing some different things I ended up seeing like a

[00:13:52] a physiatrist also a drawer chair and he sort of you know I even a lot of hands on stuff and it was like you know mobilization in different things and a couple of exercises and that's sort of what

[00:14:01] ultimately jump started my recovery and then it was more just sort of like self-treatment after that. But you know I decided to be a PT. I decided to be a PT before that.

[00:14:14] You could know then of this stuff worked on you? Yes exactly. Now, how is the irony of that? It was better than these guys that to a certain degree I think that was sort of my

[00:14:25] motivation. I think part of the two is even though I had never had an I'd always had minor injuries but never anything that had required PT so I never had exposure to it

[00:14:34] but I was like I absolutely didn't like what I was doing for work. I always knew I was going to go back to school at some point because I needed to degree that was my pay money that was not geography.

[00:14:44] I mean something that was actually remarkable. You just like go to school because you were supposed to do? No I thought I was going to be like play I was able to play soccer but I also thought

[00:14:55] I might be a teacher. That was my original intent but then I couldn't stand any of the English courses I was taking. The geography courses were just took some like as like electives and they were just

[00:15:05] super interesting the professors were so great and very passionate. I was like this is really interesting. I took that not thinking about what about after college so I don't recommend that is a track for going into physical therapy school because it's a thing I was longer of course

[00:15:23] but then yeah so basically with my experience with PT like being an athlete and just it was like this kind of made sense of like oh I could kind of do this as a career if I

[00:15:33] go back to school I got to take some more courses you know for prerequisites but this seems like something interesting because I like you know movement that like sports I like you know I like helping

[00:15:42] people you know so that in a way and just ultimately being a blessing in disguise is really kind of put beyond gave my life sort of a path and direction to go in but and I tell patients all at the time

[00:15:55] too like because now me having you know been living with this for 23 years though and I tell you you know the last 10 plus years has been better for me physically than the first 10 years you know

[00:16:07] so I think it gives me a very like a long view I think patients out there in the moment when they're recovering from surgery is that they're like six months out whatever and they're still kind

[00:16:16] of miserable like yeah but it's hard even that it's very hard at that moment for them to really be able to do that but the truth is it's like just because you're feeling not great now is there's

[00:16:26] no indication of how it's going to be down the road whether it's one to new 10 years etc you know yeah that's a very positive way to look at it and I think also we we never end up seeing the patient

[00:16:38] right and we could in help 10 years later we don't know what happens to them and it's very we we just think they're gonna be like back for the rest of their life you know right and we

[00:16:47] certainly think that after surgery I mean actually we've all seen enough failed fusions especially even the patient that I just saw but yeah you man you have the most a typical spinal fusions surgery

[00:17:02] not only do I not think it wasn't indicated which is probably like a lot of them because you didn't have neuroscience and everything you probably if you had better PT maybe I had who knows right

[00:17:12] what's hard enough but I mean like you were also given like the worst thought virus and it didn't even phase you at all like you just thought it was funny like it's funny it didn't now and then your

[00:17:24] hardware broke and you still didn't have symptoms I mean that is a whole areas eight typical spinal fusions surgery and I did I didn't have like symptoms for a while in terms of like

[00:17:38] just there's just back a pain just yeah really teach more muscular tension you know the somatic kind of stuff and ironically I was actually pretty miserable in PT school and I was I was eating

[00:17:51] an adville way you know very badly like I didn't realize I didn't think about the time like how one key I am to don't have any side effects from that because I was taking sometimes between 12

[00:18:02] to 16 adville a day because it's a lot yeah I remember that being like one of the differentials for for low back pain it was like actually a case that I did for my doctorate

[00:18:16] for the farm class is that I ended up seeing someone exactly like how my differential diagnosis book said that oh if someone has back pain in lying and it's better like it's worse when there's

[00:18:30] when they're hungry and it's better when they eat and it take a lot of ivory proof in that they may have like a whole under stomach and then they like the gastric acid is dripping on the

[00:18:41] Paris by and also that's exactly what it was I was like oh this is better is this better when you eat she's like oh you know I don't know and then it was better when she ate no while yeah

[00:18:52] and then it's not because of just you know for me just being in PT school it was just the sitting so you know sitting so many hours a day again that was just so miserable and again as like

[00:19:01] I started getting better again when I started getting and I was able to go out and start working that's yeah that's also what started me on the path just a better recovery is this

[00:19:10] the job that we do were were up or down or moving it's pretty ideal actually because it's now we're we're not just sitting behind a desk all day. All right hey well thanks for shared

[00:19:22] yeah great that was great all right hey where can people find you at your people can find me Twitter Instagram at a Rothschild PT all right hey if you guys like our story here

[00:19:35] in your story if you have any comments questions DMS hit us up on social media and as always please give untold physio's stories five stars where every listen podcast especially Spotify and Apple is that helps our discoverability as always you guys have a great day