Surgery scheduled: Ronald Wisneski will perform a microdiscectomy on Friday, April 4 at the Medical Center at Princeton. After a night or two in the hospital, Lynne will return home to recover during a medical leave generously granted by Haverford College.
Thanks to colleagues: Lynne is grateful to colleagues and students at Haverford for their support, especially to Jeff Tecosky for teaching Math 117 this spring. She was relieved that the course did not have to be cancelled, and delighted that her Math 116 students would have such a fine instructor. Her Haverford College physician, Joel Lowenthal, was a math major at Haverford. His compassion and constant attention to her medical needs is deeply reassuring.
Surgery was a last resort: Lynne suffered crippling leg pain for 6 months before electing surgery. During 4 of those months she relied on non-prescription medication (2400 mg Ibuprofen per day) and the kindness of family and friends (who drove her to and from the college and lightened her workload at school and at home), managing to teach her classes and help hire a new member of the mathematics department. In late February, after 3 months of physical therapy during which her endurance very slowly improved, a reherniation caused oversensitivity to vibrations in the 4-5 Hz range that made commuting intolerable. She scheduled surgery after experiencing little improvement from an epidural steroid injection on March 18.
The gory details: Surgery was suggested by Lynne’s neurologist on November 5, when he examined her and studied an MRI scan of her lumbar spine. MRI stands for Magnetic Resonance Imaging (the same technology behind our chemistry department’s NMR machine). Her MRI in October showed a herniation of the disc between the L4 and L5 vertebrae in her lower back. A second MRI in March revealed that the herniation had increased in size (from invading 60% to 90% of the area through which nerves pass). This area was smaller than in most people even before the first herniation, since Lynne has a genetic defect known as spinal stenosis. The extruded material puts pressure on the nerves, causing pain down the left leg. Surgery will remove the extruded material. Lynne is a participant in a clinical trial designed to compare surgical and non-surgical treatment of lumbar radiculopathy caused by herniated discs.
Recovery: Less than three weeks after surgery Lynne is walking four miles a day, but sitting for at most thirty minutes. Obeying her surgeon, she doesn’t drive yet but takes short car trips and wears an elastic back support brace when up and about. She is walking and sitting with head up and shoulders back. Her twin, mother-in-law and father-in-law, who took care of her for two weeks, all noticed her perfect posture and improved diet (asparagus and spinach, fish and chicken). Her husband remarks how she is smiling and laughing all the time!
Lynne’s surgeon: Here is some information for folks who reached this page by searching on Google for Ronald Wisneski. Formerly of the Hospital for Special Surgery in NYC, he is an author of the chapter on Lumbar Disc Disease in Rothman-Simeone: The Spine. He has performed 1500 microdiscectomies in his career (50 per year at the age of 52), with over a 95 percent success rate and a remarkably low reherniation rate of 3 percent. In 2004 he left his private practice in Princeton to do spinal reconstructive surgery at South Florida Orthopaedics. He takes the time to explain your injury as precisely as you can comprehend, but also called Lynne “tough”, described the size of her herniation by comparing it to a “small grape”, and reassured her before surgery by calling it a “chip shot”.
Postscript: Six months after surgery, Lynne is still walking four miles a day, often in Tyler park with her husband Miller Maley or colleague Curtis Greene. This habit wards off painful episodes (mornings she is unable to stand still or walk quickly without sciatic pain, following days she spent more than 4 hours sitting in chairs other than her Steelcase Leap) and keeps her weight down (the 30 pounds she lost while temporarily disabled is not coming back). She thinks often of those who supported her when she was injured (including online friends at MediBoard) and looks forward to advances in spine medicine (a surgeon she consulted, Edward Vresilovic, is developing two polymer-based hydrogels which, when inserted or injected into the center gel-like region of the spine’s intervertebral discs, will relieve pain and restore motion to patients suffering from degenerative disc disease of the lower back.)