“I’d get a pinched nerve that affected my left glute every so often,” she relates. “I couldn’t get rid of it on my own, but massage would help. But then the pain started going down my leg — sciatica — and my doctor sent me for physical therapy. By this time, it hurt so bad I couldn’t even get up on the PT table.”
Her PT team thought pain management was in order, so Church was referred to Eisenhower Desert Orthopedic Center’s (EDOC’s) P. Jeffrey Smith, DO, who is Board Certified in Physical Medicine and Rehabilitation and fellowship-trained in pain management and interventional spine care. She underwent a series of three epidural injections in which a local anesthetic and a steroid medication were injected directly into the space that surrounds the spinal cord and affected nerve roots.
“The first time, I thought they’d found the ‘the spot,’” Church says, “but the pain relief worked for only three days.” Subsequent injections had no impact on her pain, which by this time was severe.
Dr. Smith’s physician assistant, Michael Guiles, PA-C, broached the subject of surgery.
“The thought of having surgery on my back really bothered me,” Church admits. “But I knew I couldn’t stand the pain any longer; it was agonizing at times, beyond anything I’d ever experienced.”
In January, Church met with EDOC’s Reginald Fayssoux, MD. He is fellowship-trained and Board Certified in Orthopedic Surgery and specializes in the operative and nonoperative care of patients with spinal problems.
“He showed me my imaging results and explained what was happening with my spine,” Church says. “I was nervous and he spent a lot of time with me. He was articulate, gentle and patient. I knew at the end of that appointment that I’d have the surgery.”
“Mrs. Church’s MRI showed that she had a large disc herniation at L2-3 (referring to the second and third vertebrae in her lumbar, or lower, spine),” Dr. Fayssoux notes. A herniated disc, also called a bulging, slipped or ruptured disc, is when the cushioning pads between the vertebrae move out of position and encroach on nerve roots that branch off the spinal cord. “She also had chronic wear-and-tear issues at L4-5,” he adds.
“While the imaging showed there were two areas of abnormality on her spine, clinically only one was causing the more severe pain,” he continues. “So we did a diagnostic injection to make sure the herniation at L2-3 was the culprit before moving ahead with surgery.
“Disc herniations are a very common problem, particularly as we age,” Dr. Fayssoux explains. “It’s also common for imaging to reveal multiple spinal abnormalities. It’s important to identify the area that’s causing the greatest problem versus operating on all the issues that may show up. We want to focus on the problem that we know can be surgically treated and resolved.”
He also notes that conservative (nonsurgical) care will work for spinal problems — including disc herniations — about 90 percent of the time.
“What usually happens is that the body reabsorbs the herniation,” he says. “There is temporary pain that goes away in time — we like to give it six weeks. But if it doesn’t reabsorb or the pain stays severe enough that waiting is torture, then we discuss surgery.”
Church was among the ten percent of patients in whom spinal surgery is indicated. Dr. Fayssoux performed what’s called a microdiscectomy, or microdecompression. It’s a minimally invasive procedure in which he removes the part of the disc that is putting pressure on the nerve and causing pain.
“I went in the hospital around 5:30 a.m., had surgery at 7:30, and was home by noon,” Church says. “When I came out of surgery, my pain was completely gone. The pressure was finally off those nerves.”
Church followed her postoperative instructions “to the letter.”
“I wasn’t going to risk anything,” she says. “I rolled out of bed as I was taught. I put everything I needed in the kitchen within reach so there was no bending or crouching required. After a week, I could drive, getting in and out of the car very carefully.
“I’d been given heavy-duty painkillers but used only one,” she adds. “I took some Tylenol® but didn’t need it every day. I’d rented a walker but didn’t need it. I did gentle stretches and just kept moving. In less than two months, I was feeling fantastic.”
“Patient attitude and postoperative compliance are a huge component of achieving a successful surgical outcome,” Dr. Fayssoux states. “My part is a small one.
“There’s so much a patient can do in terms of proper body mechanics, managing systemic inflammation, and the whole world of nonsurgical management that everyone should understand,” he adds. “In most cases, these same techniques can also help prevent a lot of back pain and avoid the need for surgery in the first place.
“Surgery should be used only as a last resort,” he stresses.
Church is grateful that she pursued surgery. Today, the transplanted Brit (she and her late husband moved to the States nearly 50 years ago) enjoys her role as a board member of the Palm Springs Women in Film & Television (PSWIFT), which not only honors women in the industry but also gives scholarships and books to local students. A retired actress (her credits include a co-starring role in “Justine,” one of the last films George Cukor directed), Church is involved in organizing the PSWIFT’s 20th anniversary celebration this fall.
And she is back to her yoga practice. “My back feels strong again,” she says.
“I look at photos of myself from when I was in pain and I looked ill; the strain showed in my face,” she adds. “Now my skin is glowing…I look better now that I’m not in pain. I’m energized. The surgery helped me to be healthy again.”
For more information or to find a physician at Eisenhower Desert Orthopedic Center, call 760.773.4545. Or visit EisenhowerHealth.org/EDOC.