I'm a Surgeon With Severe Stenosis. My Own Chart Says I'm Exaggerating My Neck Pain.

•••

I'm 44. I've had a bad neck since I played linebacker in high school.

Back then it was a stinger here and there. Coach would tell me to shake it off, and I would.

It got a lot worse in residency.

Eighteen years of standing over an operating table with my head bent down. Loupes on. Lights hot. Four, five, six hours without looking up.

Every surgeon I know has a bad neck. We joke about it in the lounge.

By 38, it wasn't a joke anymore. It was every day.

Two years ago, I ordered my own MRI. I know, I know.

I read it in my car in the doctors' lot before anybody called me.

Cervical stenosis. Moderate to severe, C5 through C7.

The radiologist used the word "severe."

I sat there with the engine off for a long time. And honestly? I felt relieved.

I finally had proof. A real word. A word nobody could argue with.

Turns out they could.

•••

My neck is tight every single day. Not some days. Every day.

My left trap feels like it's full of rocks.

The inside of my shoulder blade burns, like a hot coal sitting under the skin.

My neck grinds when I turn it.

One afternoon in clinic I turned to look at a patient's X ray on the screen, and it made that sound. Like gravel in a blender.

The patient, a big guy who drives a cement truck, stared at me.

"Doc. You good?"

He was the one with the hernia. And he was asking me.

On bad days, the pain climbs up the back of my skull and parks behind my left eye. Like somebody pressing a thumb in from the inside.

Some nights I don't sleep at all.

I lie there trying to find a spot where my head doesn't feel like a bowling ball on a broken stick.

Left side. Right side. Two pillows. No pillow. A rolled up towel.

By 3am I'm usually in the recliner in the den.

•••

I didn't tell anybody. Not really.

Surgeons don't have bad necks. Surgeons who can't operate have early retirement.

And the few times I said something, the guys would say, "Yeah, my neck's killing me too." And then tell me about the time they slept wrong in a hotel.

So I did what doctors do. I curbsided everybody.

My buddy in ortho said see pain management. Pain management said back to PT. PT said strengthen. Everybody had an answer. Nobody had a fix.

PT helped. For about an hour after each session.

I'd walk out to my truck feeling loose. By the time I pulled into the driveway, the rocks were back.

Gabapentin made my hands feel like I was wearing a second pair of gloves under my gloves.

One morning I was ten minutes into a gallbladder and I couldn't feel the tip of the instrument the way I'm supposed to.

I stepped back and let my senior resident take it.

I told everyone I had a migraine.

I went home that afternoon and threw the bottle in the trash.

I'm not going to hurt somebody because my neck hurts.

But I couldn't stop thinking about it.

If I'd kept going, and something went wrong, it wouldn't just be my neck. It would be my career. My license. A lawsuit with my name on it.

I trained with a guy who stopped operating at 47 because of his neck. He reviews insurance claims from his kitchen table now.

He's not the same guy.

I lay awake doing the math. Mortgage. Two kids headed for college. How many more years do I have in these hands?

Muscle relaxers worked. But you can't take them and then hold a scalpel.

A steroid taper made me feel like I was 30 again for six days.

Then I couldn't sleep, I snapped at my son over nothing, and when it ended the pain came right back.

A cortisone shot gave me two good weeks. Two.

•••

Then I saw the spine guy. Good surgeon. I'd refer my own family to him.

He pulled my MRI up, scrolled through it, and spun around on his stool.

"You may need surgery someday," he said. "But not yet."

"So what do I do until then?"

He shrugged. "Keep doing what you're doing, man."

What I was doing wasn't working. That's why I was sitting on his table.

And after that, every time my fingers tingled while I was tying a knot, I'd freeze.

Is this it? Is this the day "not yet" turns into "now"?

I know exactly what "now" looks like. I've seen those patients on the floor. The collar. The drain. The guy who can't turn his head to back his truck out of the driveway.

So I live in the in between. Not bad enough for surgery. Too bad to feel normal. And scared every day of which way it's going.

•••

The only thing that ever really helped was heat.

I slept with a heating pad on my neck. Me. A 220 pound guy with a heating pad.

It had an auto shutoff, so at 2am it would click off, the cold would wake me up, and I'd reach over in the dark and turn it back on.

Every night.

My wife Megan said I was like an old dog looking for the sunny spot on the floor.

Heat helps. For a while.

But you can't wear a heating pad in the OR.

And by the fourth case of the day, my head feels like it weighs fifty pounds.

The Saturday foursome stopped asking me to play.

I'd been bailing for months. I'd make up something. Kids' stuff. On call.

The truth was I couldn't make a full turn on my backswing anymore. The last time I played, I shanked three drives in a row and Mike laughed and said, "What happened to you, old man?"

I laughed too. I went home and sat in the truck in the garage for twenty minutes before I went inside.

•••

So that night, after I read my chart, I didn't go back to bed.

I went out to the garage so I wouldn't wake Megan. I sat in the truck with the dome light off and the heating pad plugged into the outlet by my workbench.

And I'll be honest with you. I lost it a little.

Not because of the pain. I'm used to the pain.

Because a guy I trained alongside had written down that I was making it up.

And now it was in my chart. Every doctor I saw from now on would read that sentence before they ever met me.

And the worst part?

Sitting there in the dark, a little voice in my head said, what if he's right?

What if other guys with my MRI are fine, and I'm just soft?

I hated that voice. But I heard it.

And then the scarier thought.

What if this is just my life now?

Not for a year. Forever. Twenty more years of rocks in my trap and a heating pad in the garage. Watching my son's games from the bleachers because I can't throw with him anymore.

•••

Two weeks later, I was rounding at 6am.

I had a patient named Walt. 77 years old. Retired union electrician. Forty years on ladders, looking up at ceilings.

He was in for his gallbladder. Asked me three times if he could still make his grandson's ball game on Saturday.

I was standing at the foot of his bed, reading his chart, and without thinking about it I reached up and dug my fingers into my left trap.

My hand just goes there now.

Walt watched me.

"Stenosis?" he said.

I looked up from the chart.

"How the heck did you know that?"

"Because I've had it for twenty years," he said. "C4 to C6. I know that face. And I know that hand. I did that for ten years before I figured anything out."

I pulled the chair over and sat down.

Surgeons don't sit down on rounds. I had eleven more patients. I sat down anyway.

"Can I ask you something?" I said. It came out quieter than I meant it to. "Does it get better?"

He looked at me for a long second. I think he could tell I wasn't asking as his surgeon.

"The stenosis doesn't go anywhere," he said. "But the part that ruins your day? That part, yeah."

"What do you mean?"

"Your neck muscles," he said. "When something's wrong in there, the muscles around it clamp down. To protect it. And they stay clamped. All day. Every day. You know this, Doc. You probably explain it to people."

"That's the tightness. The rocks in your trap. The burning in your shoulder blade."

I knew that. Of course I knew that. I've explained muscle guarding to a hundred patients.

I'd just never thought about what it meant for me.

"So when you do PT, or heat, those muscles let go. For an hour. And then they clamp right back down. Because the reason they clamped down is still there."

"You don't need to fix them once," he said. "You need to let them go every single day. Because they tighten up every single day."

"And every day you don't, they win another one. Ten years I lost like that. My grandson's whole Little League career, I watched from a lawn chair. My retirement golf trip to Myrtle Beach, I spent in the hotel room with a bag of frozen peas on my neck."

He pointed his finger at me.

"Don't do what I did."

I sat there with his IV pump ticking.

Years of PT, shots, pills and heating pads. And every one of them had worked.

For an hour. A day. Two weeks.

The relief was never the problem. How often I got it was.

•••

"So what do you do?" I asked.

He nodded at the duffel bag on the window ledge.

"Look in there."

I unzipped it.

On top of his flannel shirt was a gray, curved cushion with a raised ridge down the middle and a little round orange panel of buttons on one end.

A tag on the side said Lanarie Atlas Relief.

"You brought this to the hospital?"

"Don't go anywhere without it," he said. "My wife calls it my girlfriend."

"What does it do?"

"You lie back on it. That curve goes right under the base of your skull. It heats up right there. It vibrates on the knots. And it slowly fills with air and stretches your neck out a little, so it's not holding your head up for once."

"Fifteen minutes in the morning. Fifteen at night. Every day. Because the tightness is every day."

Then he said, "Take it. Use it on your lunch. I'm not going anywhere with this tube in my belly."

I said no. Twice. He didn't let me.

•••

At noon, between cases, I went into the call room.

It smelled like old coffee and somebody's microwave burrito. I shut the blinds.

I lay back on the bunk, put it under my head, and felt pretty stupid.

I set the heat on low.

The first thing I noticed was that I wasn't holding my head up.

That sounds like nothing. But I hadn't realized I was always doing it.

Even lying down. Even on a pillow. Some part of my neck was always on duty.

Then the warmth came in. Right at the base of my skull.

Deeper than my heating pad ever got, because I was lying on it instead of having it draped over me.

Then the vibration found the rocks in my left trap. It didn't hammer on them. It just kind of hummed into them.

Then it started to fill with air, slow, and I felt my neck lengthen a little.

Like somebody reached in and took the weight of my head off my shoulders.

Around ten minutes in, my left shoulder came down.

I didn't drop it. It just came away from my ear on its own.

I didn't even know it had been up there.

I stared at the ceiling tiles and had to blink a couple times.

When it clicked off, I sat up and turned my head.

It still clicked a little. But the burning in my shoulder blade was quiet.

Don't get excited, I told myself. You know how this goes. Everything works for an hour. It'll be back by the second case.

I scrubbed in and waited for it.

At 2pm I was three hours into a bowel resection, head down, loupes on. My neck didn't fight me.

At 4pm I was still waiting.

It never came back.

I brought Walt his cushion before I left. He looked at my face and grinned.

"Told you, Doc."

I ordered my own in the parking lot before I started the truck.

Every morning before I scrub. Every night before bed. Fifteen minutes.

I put it in my phone calendar like it was a case.

The first week, I slept through the night three times. I couldn't remember the last time.

The first time, I woke up at 6:45 in a panic, sure I'd missed my alarm.

I hadn't. I'd just slept.

The second week, the heating pad stayed in the garage. Megan noticed before I did.

"No sunny spot?" she said.

The third week was the one I watched.

Because that's where everything I'd ever tried fell apart. The shot. The steroids. PT. Always right around week three.

It held.

•••

Then I took a week of call. Four nights in a row, two emergency surgeries a night.

I was too tired to use it. I'd just fall into bed at 5am still smelling like the OR.

By the fourth day, the rocks were back in my trap and the headache was parked behind my eye.

That night, closing up an appendix at 3am, my fingers tingled.

My stomach dropped.

I finished the case. Then I went into the locker room, sat on the bench, and stared at my hands.

I can't go back, I thought. I can't do another two years of that.

And that old voice came right back.

See? Nothing works for you.

That morning I almost didn't bother. I lay on top of the covers and thought, what's the point.

Then I made myself get up and get it out of the closet.

Ten minutes in, my shoulder came down.

That's when I really got what Walt meant.

It doesn't touch my stenosis. Nothing I lie on is going to do that.

It just lets go of the muscles that clamp down around it. Every single day.

And when I skip days, they clamp right back down. Exactly like he said.

It hadn't stopped working. I'd stopped using it.

I haven't skipped since.

•••

Three weeks later Mike texted the group. "Saturday. 7:40 tee time. You in or you still busy, old man?"

I was in.

First tee, I made a full turn for the first time in two years. Didn't think about it. Just turned.

It went 260, down the middle.

Mike stood there holding his driver. "Okay. What's different with you?"

I just picked up my tee.

That afternoon my son came out to the garage holding two gloves.

"Wanna throw?"

I said yes before I could think of an excuse.

We threw until the streetlights came on. I didn't brace once.

I still have stenosis. I may still need surgery someday. I'm not going to pretend I won't.

And that note is still in my chart. "Inconsistent with imaging." Every doctor I see will read it before they meet me.

I stopped waiting for them to believe me.

•••

But I want to talk to you for a second. Not as a surgeon. As the guy in the truck in the garage at 1am.

If you're reading this, somebody has probably said something like that to you too.

"Your MRI isn't that bad."

"Not yet."

"Keep doing what you're doing."

And you went home with nothing for the pain you'll have tonight.

Here's what I know from standing at the foot of a lot of hospital beds.

The in between doesn't feel dangerous. That's what makes it dangerous.

Every month you spend there, your life gets a little smaller. You sleep a little less. You skip a few more things. You turn your whole body instead of your head and stop noticing you do it.

And the whole time, you're watching your hands. Waiting for the morning the tingling in the shower doesn't stop.

I've seen the people who waited for that morning. They come in braced and scared and out of options. The collar. The drain. Months they never planned on losing.

Walt waited ten years for something to change. He's not getting his grandson's Little League back.

You won't get these years back either.

If your MRI says one thing and your doctor acts like you're making it up.

If your trap feels full of rocks and your shoulder blade burns.

If PT helps for an hour, heat helps for a while, and then it's right back.

If you're stuck between "not bad enough for surgery" and "too bad to feel normal."

I was you. Walt was you for ten years.

Don't wait as long as we did.

The one Walt showed me is the Lanarie Atlas Relief. Fifteen minutes in the morning. Fifteen at night. At home, lying down.

Right now it's 50% off. Less than one chiropractor visit, for relief you can use every single day.

That price ends tonight at midnight.

And tonight is going to happen either way. You're going to lie down tonight.

The only question is whether you lie down braced, with the heating pad, waiting for it to click off at 2am.

It comes with a 90 day money back guarantee. That's long enough to get past week three, where everything else fell apart. If it doesn't last, send it back and get every dollar back.

It also comes with a one year warranty and a free little book on pressure points.

Every day you don't is a day they win. And you don't get those days back.

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