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I WISH I HAD HEARD the term “prehab” long ago. I think it would have prevented my current physical disability.
Many people delay surgery. Why not put off a potentially long recovery period—and a big medical bill? Often, this wait-and-see approach is harmless. But not always.
A little history might be useful. A couple of years after college, I joined my dad in his cash register business. Back in 1970, cash registers were massive and heavy—150 pounds or more. Just one wrong twist or turn was all that it took to induce unbelievable shooting pains down my leg.
My first surgery was in 1973. Too much Dilaudid after the surgery, and I was addicted. I went cold turkey and beat it in a few months.
I got better and, three years later, started playing tennis. Oops, I should have let that one go, because it meant surgery No. 2: in for another laminectomy to relieve pressure and reduce back pain.
The electronics industry was looking for new applications for their fancy computer chips, and discovered they could imitate the functions of a calculator, cash register and typewriter. The benefit to me was lighter cash registers and less risk of back pain.
Fast forward to 2000. My wife wanted the couch moved. I didn’t want to do it, got angry, pushed too hard and—pop—I was in line for my third back surgery. I was older, so the recovery took a bit longer this time.
By 2017, I’d been semi-retired for nearly 20 years. While on vacation in Aruba, I found it difficult to walk to the beach, or more than a block or two to dinner. I made an appointment with my favorite neurosurgeon.
Since he was doing more brain than back surgeries, he brought in a young surgeon who specializes in spinal reconstruction, among other things. After reviewing my images and history, they had just two questions: How are you even walking? Why aren’t you in more pain?
They felt that the surgery I needed was extensive—a fusion with rods and screws on an unknown number of levels. Yet they couldn’t recommend the surgery because I wasn’t in enough pain.
To control what little pain I had, they suggested that I take Gabapentin. For me, it was a miracle drug. There was just one side-effect: drowsiness in the afternoon. It was non-addictive, safe and—with my doctors’ supervision—the dosage was increased until it worked.
I started to live a pain-free life. I was happy and unconcerned because the doctors were sure the window for a future surgery was open for years, or even a decade or two, and there was no downside to waiting. I did give up golf, however, as the pain pills were no longer getting the job done after 12 holes.
Two years later, it was summertime, I was wearing shorts to the gym and happened by a mirror. I noticed that my left calf was much thinner than my right one. I decided to visit my doctors again, even though I still wasn’t in pain.
After taking new images, they were now ready to recommend surgery. Things had deteriorated some and there was a sense of urgency to schedule me. Their first opening was just after a planned trip to Iceland. That was good timing, as I really wanted to go on the trip.
I’m going to skip the infection part. Needless to say, bad stuff happens. I ended up with two rods and 18 screws for a nine-level fusion of my entire lower back. They said I could play golf again, but my swing would be ugly. How did they know I had an ugly swing?
What nobody had realized was that there was harm in waiting, which brings me to where I am today. I have a pinched nerve, resulting in foot drop. The nerve was pinched too long and never recovered.
Prehab could have helped. What’s that? It’s not rehabilitation but preventive monitoring. Anyone who is waiting for surgery to fix a physical problem should visit a physical therapist, not necessarily to work on the problem, but to be monitored for changes that could affect the timing of the surgery.
Had I been monitored by a professional, I might have had the surgery—pain-free or not—earlier. The nerve could have been less damaged and I might have recovered fuller function. Pain is your body’s way of telling you something is wrong. Mask that pain with medication and you’ll need monitoring to see if all is well—or not.
Now, I’m working hard to stand upright and keep walking. Each week, I have four visits to physical therapists, plus three gym sessions, two of them with a personal trainer. After they trained me to walk properly with a cane, I am using it more often when I go out. Sometimes—when I want to be treated as a younger, healthier person—I use two walking sticks.
The operation was a great success. I am totally pain-free and no longer cringe before a sneeze, which used to cause shooting pains from my hip to my ankle. I know one thing for sure, though. I’m never golfing again. I often wonder where I’d be if I’d had that “too big” operation sooner.
Richard Hayman is a second-generation family business owner and inventor with three patents. He studied engineering at Cornell University and received a master’s degree from George Washington University. After his family’s business was purchased by a public company in 1999, Richard went on to enjoy several additional careers. He’s also been a STEM instructor for middle and high school students in after-school technology programs. Richard’s previous articles were Answers to Everything and Investing in Family.
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Richard, thank you for sharing your story and I wish you the best.
Summary: To me, ‘pre-hab’ is daily exercise.
I have a different approach. Injuries include compressed disks from jumping out of airplanes in the Army (it is really landing on the ground that hurts) and 4 fractured lumbar vertebrea from blunt force trauma to the back during a rugby game.
Spine Docs offered surgery or physical therapy. I opted for aggressive PT which is 40 minutes of exercise every day followed by a 3 mile run. I really mean every day — but it works.
I’ve had the nerve pain down the leg that prevents me from walking around the block and that is resolved. I have the lower back and hip pain from sleeping — -and still have it each day. But the morning exercises relieve that pain.
I take 600 mg of Gabopentin each night as that allows me to sleep through the night — just wake a bit groggy — but again, morning exercise and running fix that.
I assume I will live with this forever. But it is liveable — with the PT and running.
Happy your surgery worked well — but I also hear about people who’s surgery does not work.
So to me — ‘pre-habbing’ is that daily exercise that not only addresses the back pain, but also allows me to lead a physical life as I age (currently 66). I realize daily exercise is not everyone’s ‘cup of tea,’ but I’ve found that it really does work. The whole discipline of physical therapy is built upon that fact.
Good luck going forward
One should usually elect to get a surgery that will allow you to maintain your mobility. If you forego a knee or hip operation, for example, you will inevitably get sedentary, and that is the path toward decline for a lot more than your hip or knee. I’ve watched people wind up sitting all day, and shortening their lives in the process. And with some operations, if you delay it too long, it becomes too late to do any good, or perhaps they can no longer do it.
Richard, you have really been through it! After going through a little myself and a lot with my wife, I know that back problems are a special hell.
Thanks for sharing the concept of “prehab”—very helpful.
Richard, thanks for the thoughtful article. I wish you the best with your health. You are so right that we tend to ignore medical issues until we’ve done lasting damage. I waited far too long to get my right knee replaced. the last year was constant pain, and I wasted a great trip to Italy. I like the concept of “prehab”. I’m preparing to have my left knee replace in a month and am exercising as much as possible to be ready.
I injured my back in the mid-90s, and suffered a foot drop. Luckily I was able to have surgery quickly and fix the issue. It still droops a bit if I’m very tired.
Richard, I’m sorry to hear of the suffering you’ve been through. I hope there is potential for that foot drop to improve. Thanks for sharing.