Why I needed Back Surgery

My first memory of injuring my back was during my 1989-1990 overseas tour in South Korea. I would like to say this injury occurred while I was doing something brave and daring. The truth however is pretty mundane and actually reflects how most of these type injuries occur.

My roommate, Steve Perkins had encouraged me to join the bowling league with him and some of his friends. There wasn’t a lot you could do on base at Camp Humphreys, South Korea, that didn’t cost a lot of money and league bowling gave us something to do one evening a week. Activities not costing a lot of money were high on my list of priorities as my budget was $300.00 a month.  I earned spare cash by covering Staff Duty Officer (SDO) for those who liked to sleep at night and making Australian fold map books for new pilots in the unit. ($50.00 for weekday staff duty and a map book, $100 for weekend duty.)

The bowling alley was about a ten-minute walk from our Bachelor’s Officer Quarters (BOQ) and like most buildings on post it had been repurposed from another use. It had eight lanes and was otherwise pretty much the same as any other bowling alley. It had beer and bar food, and the place was fairly noisy.

We’d been in the league for five or six weeks and we were in the middle of the pack as far as our scores. Steve was the best bowler and I was making progress and becoming more consistent with my throws. About half-way through the second of three games, Steve bowled a strike. I was at a table behind the pits, eating a piece of pizza and I leaned over the row of seats behind the pits to give him a high-five when I felt a small twinge in my lower left back. It really didn’t seem like much, maybe a pulled muscle and I tried to ignore it. I managed to get through the next game and a half without a great deal of pain and then I started walking back to the BOQ. After walking around 100 yards or so, the pain became so intense that I had to stop in the Burger King parking lot and squat to get some relief. I’d get up and walk another 50 to 100 yards and repeat this process until I made it back to the room sometime after 2300.

I woke up the next morning and the problem and my back problem was unchanged, so I went on sick call where I was seen by our flight surgeon CW2 Glenn Farris. Glenn put me on 72-hours bed rest in my quarters and of course he grounded me. He prescribed Flexeril and told me to get some rest. The next 72 hours were pretty much a blurry haze. I remember getting out of bed, going to the bathroom and crawling back to bed. After the third day, I was feeling better and I was really bored having seen nothing more than my glorified hotel room. I decided to go to the Gym when it opened at 0600 that Sunday morning just to get a change of scenery.

The gym was pretty well equipped for a small base and they had a weight machine circuit that I used a lot. There was a laydown back machine and I had tried that first with no results one way or another. I then moved through the different upper and lower back and abdominal exercises without any progress. I continued through the circuit to the hip abduction machines where you were either pressing your legs apart or pressing them together. The inward press required you to pull on a lever to spread your legs as far as you could comfortably stand to get the largest leg motion for your press. I pulled until I had tension as far as I could spread my legs naturally, and then I gave the lever a tug to get just a bit more tension. As I pulled to get the tension, I heard a loud pop and felt an intense stabbing pain I accompanied with a loud yell. It was a good thing I was alone in the gym at the time.

After the pain had subsided and I caught my breath, I noticed that the nagging back pain I had been suffering was gone. I had managed to do my own chiropractic adjustment and apparently re-aligned a slipped lumbar disc. I went on sick call that morning and Glenn cleared me for flight since my issues were resolved. That was the end of my back problem for the moment. I continued serving my tour for the next six months and had no residual after effects.

In May 1990 I was transferred back to the United States for an assignment at Fort Campbell, Kentucky with the 101^st Airborne Division, (Air Assault). I was barely in readiness training when we started to prepare for deployment in Saudi Arabia and the Gulf War in August 1990. We deployed and I spent all of Desert Shield/Desert Storm in the desert with no issues with my back. We returned in April of 1991 and my next encounter with my back occurred around October 1991 while training at Fort Chaffee, Arkansas, the Joint Readiness Training Center (JRTC).

We had staged for this exercise out of Little Rock where we’d setup on the 1000-yard rifle range with our Chinooks. From there we were flying missions to Chaffee and then we’d either return to Little Rock or land at a local site on Chaffee waiting for the next mission. I’d been sent back to Chaffee on a mission with instructions to return when the mission was complete. We were hauling internal cargo so we only took our ruck sacks to leave room for the cargo. So of course, when we completed that mission we were given a mission change and told to meet with five other aircraft for another mission the next morning. Since most of our equipment was back in Little Rock, we were left with what little we have kept on the aircraft for our equipment that night.

I ended up sleeping on the bench seats that lined the sides of the cargo area in the back of the aircraft in my sweats and wrapped in a poncho liner. In the middle of the night I can remember rolling over and twisting around to keep from falling off the seat and I felt a familiar twinge in my lower left back. I didn’t think much about it and went back to sleep. The next morning, I walked over to the next aircraft to gather intelligence on the mission I was diverted there to fly, only to learn we were only a backup in case something went wrong. Disappointed that I had spent the night freezing in my aircraft for no really good reason, I started the walk back to my bird. I again encountered back pain so severe I had to stop and squat. I repeated my walk, squat, walk, squat routine until I made it back to the aircraft.

The next twelve hours were the most miserable period of my life. I was trying everything I could to find some position where I could just keep the pain at bay. From about 0600 to 0800 I tried every sitting, standing, squatting, and laying position that I could think of with ever-increasing levels of pain. Nothing was giving me any relief. I have no recollection of how it came about, but I do remember finally finding that laying over a full rucksack, face down with my left knee pulled up to my chest was the position of choice that finally, allowed me some relief. It was quite evident that I wasn’t going to be flying the aircraft and the other 5 helicopters flew off for their mission leaving me and my crew behind in a big field.

Sometime during that endless afternoon, we figured out I could lay face down on a cot, again with my left knee pulled to my chest. I guess some where in that period I dozed from time to time. I managed to eat a Meal, Ready to Eat (MRE) in a face down position which was creative and I can clearly remember putting off going to pee as log as possible. I wanted to avoid the pain of standing up. At about 4PM another aircraft returned and I had hoped it would be with another pilot to fly us back to Little Rock. I was right about the pilot, but wrong about going back to Little Rock. They wanted the aircraft for a mission and I was moved into the tree line with a couple of crew members and our equipment while the aircraft took off for parts unknown. They told us someone would come and get us before dark. This day was getting better and better. Finally, another Chinook showed about 1830 to take us back to Little Rock.

The problem I encountered when I walked up to the aircraft was that the helicopter was nearly full to capacity with cargo. There were three seats available for us and I had to make some awkward gyrations just to get into the seat. I finally managed to get into the seat and I was concerned how I was going to deal with the pain of a very turbulent hour-long flight back to Little Rock. We finished the passenger briefing and we were told to buckle up for flight. As I cinched up my seat-belt, I felt a familiar pop in my lower back and the discomfort was somewhat relieved, but not resolved like it had been in Korea. At least I wasn’t howling in pain on the flight back.

The best part of being back at Little Rock was having my cot and sleeping bag back, but the back issue wasn’t resolved and the had officially grounded me. The next day, our unit recovered back to Fort Campbell and I was tasked as navigator on my flight (I don’t remember why). I managed to get us there in just about record time thanks to an internal 600-gallon tank of fuel that allowed us to make the flight non-stop. Once were got back to the base, I called my wife to come get me and she showed with the van and all our kids. This was good because I needed the boys carry my equipment to the van and they later carried it into the house for me. I can remember Anna did me one of the biggest favors of my life when she took off my boots (Something she’d never done in my military career.), because she could see how much effort it was taking me to reach them. She also helped me get my one-piece army flight suit off.

I laid down on our living room floor because it was carpeted and I wanted to try and give myself a hip roll to get some relief. Anna was playing on the floor with my youngest son Timothy. I was lying on my back with my left leg bent and I rolled to my right to try and get my back to relocate. Timothy was being quite aggressive wrestling with his mom and the next thing I know she fell backwards onto my leg. I heard a loud “POP” and howled in pain. Anna turned over to me and was telling me she sorry for hurting me. I told her that is was okay and that it hurt he right way. She had gotten my back aligned again. From there I got up cautiously and took a shower. I’d been in the field a week, I was pretty grungy.

Unlike my last encounter, the flight surgeon wasn’t letting me get away without further medical attention. After a plethora of x-rays and an MRI, I was sent to physical therapy three days a week for a month. Therapy was interesting. I was given pelvic traction for thirty-minute sessions and then ice for ten minutes and heat for another ten. I quickly learned how to configure my table for traction and the attendant would only check my setup and setting before turning it on. I had become a “regular” in the PT clinic. The traction was extremely relaxing and it was not unusual for me to sleep through a 240-lb. pull (the table cycled every two minutes.) After my course of treatment was completed, I was given a temporary physical profile but I was allowed to fly again.

In the months following, I learned that while my back was manageable, it meant that I had to take some steps that could be (as was) career challenging. I had learned that running long distance greatly aggravated my back injury and that many other army exercises were contributing to my problems. I was approved for a permanent physical profile (P3) which essentially said I didn’t have to run, do push-ups or sit-ups.  For my physical fitness test, I was allowed an alternate test with a 6.2-mile bicycle ride. While the profile was not an issue for my command, the army promotion board was another story. My flight surgeon told me straight up, I could walk or get promoted, my choice. I chose being able to walk.

I had no major issues for a couple of years of years and then the next episode occurred while I was in the Degree Completion Program. After three years with the 101^st Airborne Division, the army saw fit to send me for more formal education For eighteen months, my duty station was Austin Peay State University. It was the easiest change of duty ever, I didn’t even have to move out of my quarters at Fort Campbell as Austin Peay was the local college. My back problem arose again doing a favor for my neighbor across the street.

Jeanne was the wife of an Air Force officer who was on assignment with the 160^th Special Operations Aviation Regiment (SOAR) and her husband was deployed overseas. Jeanne had two boys, one in Kindergarten and the other an infant. She had developed a stress fracture in her right foot and she couldn’t drive. My wife Anna was often her driver. One day, Jeanne needed to make a trip into town and I volunteered to watch the baby, Mark, (her other son was at school) while they were away. We always kidded Jeanne about her going out and not turning on her cell phone so she made a rather large production about turning it on before she left. (This was the early 1990’s and you only turned on a cell phone when you thought you might need it as the batteries were so lame.) I placed Mark in his playpen and sat down on the loveseat as the ladies walked out the door. As I started to get comfortable, I slid my left foot forward a few inches and all hell broke loose.

It is hard to explain a massive back spasm to anyone who hasn’t experienced one. If you have ever had a cramp in your calf, imagine that pain, magnified by a factor of ten, in your lower back. Unlike the calf, you have no way of stretching it out to relive the pain. Your vision goes white, maybe it seems like 100 strobe lights are going off all around you, and you collapse on the floor screaming because it feels like someone has just stabbed you in the back with a glowing red broadsword that was recently pulled out of a blacksmith’s forge.

Anna and Jeanne are just pulling out of the driveway when this occurred. Mark was in his playpen screaming because I had scared him to death. I was lying on the floor whimpering and trying to curl up in a ball to find some sort of relief for a pain. Pain so intense I had no reference of how it could hurt so bad. Apparently, my previous experiences had been a mere warm up.

After an eternity of blinding pain (in reality maybe a minute or two) I was able to move, somewhat. Standing up was out of the question, but I could manage a very awkward low crawl with my knee pulled up to my chest. My mission of the moment, was to find the telephone. Jeanne and her husband always had all the newest, greatest toys. So of course, they had a wireless home phone. (Yeah, common now, but it was fancy then.) Unfortunately for me, Jeanne also had a bad habit of leaving the handset just about anywhere. She walked and talked a lot and when she was finished, she’d just set the handset down where ever she was at that moment. Often, she left the phone on the dining room table. I was only a few feet away, so I made that my first place to look.

I slithered across the tile floor to the table, then I gathered up my courage and pulled myself up on the edge of the table. It was similar to the way the toddler I was in charge of would on the coffee table. Alas, there no phone on the table. The cradle for the phone was on a desk in the kitchen, again a few feet away, and into the kitchen I crawled. I pulled myself up on the desk, to see an empty cradle. Defeated, I collapsed on the floor and dreaded what was coming next. There was a wired land line in the house, in the back of the hallway and in the far corner of a very crowded bedroom. The thought of trying to maneuver through that room was haunting me. I started my journey crawling to the back of the house by crawling through the galley kitchen to the front foyer.

I managed to get the fifteen feet to the foyer before I collapsed again from the effort and I rolled onto my back because the cool concrete slab gave me some mild relief. As I did this, I spied the antenna of the house phone sticking out over the edge of a decorative table in the foyer. As I reached up and grabbed the phone I immediately panicked because didn’t know Jeanne’s cell phone number. My fortunes improved as I looked at a whiteboard Jeanne kept in her kitchen with emergency numbers for babysitters and there was Jeanne’s cell at the top of the list.

I called Jeanne and the girls were laughing at the novelty of Jeanne’s  and I let them know that I was in a bad state and needed some help. They had just left post and were only five minutes away. I just tried to move to the end of the foyer where I could talk to Mark in his play pen. (I’d managed to crawl maybe thirty feet in a circle and I was just on the other side of the playpen where all this started.) Finally, the girls came in the door with another friend as they thought they might need some help getting me off the floor. They took one look at me and Called 911.

Living on post in quarters, we were about a half-mile from the hospital and the ambulance showed up in just a couple of minutes. The paramedics came in to find me on the floor, on my back, with my knee pulled to my chest. While checking me out, one of the paramedics tried to get me to straighten out my left leg. I grabbed him by the collar and pulled him face to face with me. I told him I thought that would be rather unhealthy for him to try and that he should leave the leg alone. We compromised, I let go of him and he left the leg alone. I was efficiently strapped onto a back board, and lifted onto the gurney. They even strapped me down with the strap over my leg (That was nice as I didn’t have to hold on to it anymore.) and off we went for my first and only ambulance ride to the emergency room.

The ER was just a long, long, long, afternoon for me. After I was checked, in I was some valium and sent to x-ray. When I came back, and I was still in pain, I was given some Tylox (Codeine & Tylenol). A couple hours later, I was given a shot of Demerol. Finally, after four hours in the ER, I could straighten out my leg. The ER doctor wanted send me home with some pills and my wife enlisted the assistance of one of our chaplains and together they convinced the doctor to at least keep me overnight for observation. That night I was introduced to the wonders of a Toradol injection, and for the first time in my life I can remember looking forward to shot. I was given Toradol every four hours that night.

This time, the back pain was slower to resolve and it took some weeks of therapy and exercise, but I managed to get myself back to some sort of a happy place. I do not recall any further issues during degree completion and I was given an overseas assignment to Germany after I completed my degree.

When I had my next issue, I was stationed in Giebelstadt, Germany. My unit was deployed to Kaposvar, Hungary in support of the US mission in Bosnia and I had been sent back to Germany with by platoon leader for some task(s), I really don’t remember the specifics. What I do remember was a very ironic event where I injured my back again, while trying not to injure my back.

I needed to move an old 1950s era metal army desk (super heavy). I only needed to move it a few inches so I just walked up to it and tried to nudge it over a bit with my thighs. No bending, no twisting, no awkward movement, just a nudge with both thighs and the dreaded “pop” was heard with that little twinge that I just knew would get worse. Unfortunately for me, it did. For the first time, I had a disc dislocate to where no matter the therapy, I could not get the issue to resolve. Exercise, physical therapy, nothing was relieving the problem. I was grounded and for the first time taking some pretty heavy pain medications just to function. Even then, I wasn’t functioning very well. Every morning it was like a mini-test to see what the day was going to bring. If I could stand up, it was going to be a good day. A bad day usually consisted of my placing my left foot on the floor and then collapsing into a spastic pile on the floor, overwhelmed by a blinding unrelenting pain. (Similar to the episode at Jeanne’s house). I decided it was time to do something about this.

The local hospital had orthopedics and the doctor I saw there was a reservist on active duty. His specialty was back surgery, but in the European Theatre all back surgery was done in Landstuhl and I was quickly given a referral to the Neurosurgery clinic there. At the Neurosurgery clinic I met Dr. (Maj) Gary Flangas, Dr Flangas had worked as a neurosurgeon in Houston for almost a decade before he decided to join the army and he was the head of neurosurgery in Europe. He evaluated me and he determined I was a surgery candidate so then we discussed my options. We could do the minimum necessary, a partial discectomy or we could do a spinal fusion. He noted we could do the discectomy and if needed go back and do a fusion, and if we did a fusion, then there was no more to do. I chose the discectomy.

My next surprise was to be scheduled for surgery within eleven days. Originally, it was going to be a four days, but he was already booked up that Thursday and we had to wait another week for him to have an available operating room. (He had the OR every Thursday morning.)

I made the trip back to Landstuhl and the actual surgery was fairly uneventful (for me) as I was wheeled in for surgery at 0700 and I woke in the recovery room around 1130, I was slow to wake from the anesthesia and the nurse was continuously telling me to breathe as my blood oxygen was dropping below 80% causing an alarm to go off. It was when Dr. Flangas came to the recovery room that I learned my case was more difficult than he’d expected. I was scheduled for a forty-five-minute procedure and I was in the OR for over two hours. He mentioned that the two cases behind me would be unhappy as they would have to wait another week. I was back to my room a little past noon and the nurses had me walking the halls two hours later. It was a wonderful feeling. For the first time in ages I had no issues with back pain. I was so relieved and I thought that all my problems had been resolved. I went home after two days and all seemed to be good. Five days after surgery, I woke up and couldn’t feel my left leg.

Fearing the worst, we called Dr. Flangas and I was given some steroids and told to stay in bed for seventy-two hours. They were figuring I had some swelling around the spinal cord and that it was causing the paralysis. I did get some feeling back and most of my motor function (I could walk fairly normally after the bedrest), but I could no longer lift up my toes and foot more than a couple inches. My dorsiflexors were not working right on the left leg and most of the foot felt like it was asleep. As soon as I was able to move and walk again I had a dye-contrast MRI and the results were inconclusive. Dr Flangas could see nothing that going back in would help and he hoped in time the issue would resolve. (It didn’t.)

The pain was gone and I was now permanently grounded. My aviation career was over in the army. My career was already in the toilet anyway as I had been awaiting my results from my second opportunity for promotion to Chief Warrant Officer 3 (CW3) and I was turned down again about the time I had surgery. In a way, the leg problems were beneficial as I could now apply for a disability retirement instead of just being discharged. I had to apply for disability through Walter Reed Army Medical Center in Washington as they were the approval authority for Europe. The disability process went from the end of 1996 through the summer of 1997 and I was placed on the Temporary Disability Retired List (TDRL) effective 1 August 1997.

I was given the impression that my medical retirement, at 30% disability from the Army was a done deal. I only learned afterward, during an appeal of the Army decision to reduce my disability rating to 20% and give me a Disability Discharge, that what Walter Reed decided was not the final say in the issue. All TDRL assignments were reviewed by the Army Medical Board at Fort Sam Houston, Texas, mine included. It also appeared that for the past thirty years or so, one of the main tasks the medical board undertook was to overturn decisions made by Walter Reed. In my case, since I had not run to the doctor every two weeks whining about how much pain I was in and that I could hold a job, I didn’t need the 30% retirement, with insurance for the wife and kids, and base access and the like. I was given a 20% disability discharge (capped at twelve years for pay even though I was being paid at a rate for over twenty-one years, and almost fifteen active.) Thank you very much, here is a check and go away. Oh, did I mention that if I’d had sixty-nine more days of active duty I would have qualified for an early fifteen-year retirement? That was an extra special, added bonus.

Once out of the army, I did apply for my Veterans Administration (VA) pension and learned much to my chagrin that I qualified for a VA disability pension, but that $278 a month of my pension from the VA will go to the US Army to pay back the severance pay I received for my disability discharge. At least that little special part of this story was paid off in January 2019.

I still have the foot drop to this day and I have had occasional episodes where I slip a disc ,but those are fewer and fewer as the years go by. I never had any additional surgery because no doctor could give me any decent assurance that the outcome would be significantly better than the situation I have now. It is something I have chosen to live with rather than battle in another surgery.