Mr. Boeree has passed away...

I can't believe this. Mr. Boeree was involved in a motorcycle accident and has passed away.

I feel honored to have had his wonderful work improve my life.

There's just nothing more I can say. I have no words.

MARCH UPDATES! Carnaval, Facet Blocks, etc.

Hello my fellow followers. Bow down to your guinea pig! lol There's a few things I want to cover with this post. But first I wanted to apologize for not updating more often.

It's been 1 year, 4 months, and 10 days. 496 days with my M6-L at L4/5. I've been in contact with Mr. Boeree every so often, updating him on my status and condition, notifying him of pain episodes and following his recommendations. I started having pain a few months ago. Boeree suspected facet pain. And surely, it was! The facet block 4 months ago got rid of it 100% for a few days. It came back very slightly with muscle tension alongside the two main lower back muscles to the vertical sides of the spine. Bear in mind, it came back VERY SLIGHTLY.

And so, I decided i'd go to brazil for carnaval. I'll tell you this, i've NEVER had a more physically strenuous trip in my life. 5 days and I drank 4 liters of alcohol and walked 20km, whilst jumping and screaming and falling and what not. When I got back to miami, NO PAIN AT ALL. Well maybe a 1 or 2 out of 10, but definitely manageable! I was due for a facet block before the trip to get rid of it entirely, but the stupid Dr. Castellanos in Miami cancelled mid-procedure. YES. HE CANCELLED MID-PROCEDURE.

Mid-post rant:  This is him. Don't ever bother going to him. He makes you wait 3 months for an appointment, 3 hours in the waiting room, and then cancels MID-PROCEDURE because he has a meeting. He won't apologize or even offer to re-schedule. I decided to stay quiet and just leave.

Anyways, I went to brazil without my facet block and came back just fine. A week later I start getting the 1-2 level pain (more muscle tension than anything) and I decide to fly to honduras for another facet block. This was 5 days ago and I feel great! The main culprit for my pain: THE RESTAURANT. Don't work in a restaurant if you have back issues.

Other than that, i'm doing wonderfully. There's no limitations to what I can do, but I am a little worried about my facets long-term. Don't let this deter you from considering the M6 though, i'd get a 2nd M6 implant in a heart beat.

Please if you have ANY questions, do ask and I answer back in less than an hour. I am paying special attention to the blog this next week, so ASK AWAY! I get an email every time someone comments so i'll answer ASAP.

Also, congrats to all those that have gotten the M6. Can you please do me a favor and add a link to your blogs in the comments section? Thanks!

And for the grand finale, here are some pictures and new angles from my facet block!

Wise words from Mr. Boeree.

Hello everyone. I'm really really enjoying my time pain free! I'm a whole different person. What really makes me comfortable is the fact that my disc is fine, and since i've had it for over a year, I think it's safe to assume that the endplates are permanently fused with my bones. Couple this mentality with no pain, and you have a guy in a great mood! Except this time, i'm conscious of what it means to be pain free and the need to keep it that way (there's nothing worse than feeling pain free and then falling back).

So I got a reply from Mr. Boeree:


Thank you for keeping me posted.  I am delighted to hear that the facet joint injections have been so helpful.


I think it very worth while bearing in mind that there is an important difference between degenerative facets and painful and inflamed facets.  Essentially when we remove a degenerative and damaged disc this motion segment (that is to say one vertebra, its neighbour, together with the discs and the two facet joints and of course all the ligaments that connect them) will not have moved very much.  In addition, as the disc degenerates it tends to place rather more load on the facet joints.  This will almost invariably lead to a little bit of damage to those joints, and this applies essentially to every patient I think who has disc replacement surgery to a varying degree.  Once we remove the damaged disc and replace it with the M6 we tend to restore movement to this level.  Of course it takes time to regain movement in the motion segment but this does come as you build up your activity.  As you do so the facet joints are progressively having to move, where perhaps they have not done so to any great extent before.  This can cause a little bit of inflammation of the facet joints, just as if you were pushing and regaining movement in another stiff joint elsewhere. 

Generally I find, where we need to give facet joint injections, that this will often keep things under good control.  Occasionally you do need to repeat the injections and indeed your interventional radiologist, or whoever did the facet joint injections for you, will probably have said that it is not unusual to give a ‘booster’ set of injections at six weeks. 

Ultimately, if you find you are needing repeat injections every so often the interventional radiologist may want to consider radiofrequency denervations of the facet joints.

I hope all of this is helpful.


I wouldn't mind having these injections every once in a while. If it gets to the point where I have to burn the nerves (radiofrequency denervations) around the facets, so be it. But I think i'll give a shot to the PRP (platelet rich plasma) injections that my doctor in miami recommended as well as continue taking heavy doses of Glucosamine/Chondroitin and Omega 3's.

I'll let you guys know if anything happens. Meanwhile, take care of yourselves and have a happy holiday! I'm heading back home, closing down the restaurant for 1.5 weeks, and enjoying my pain-free back at the beach with my family.

Also, I'd like to publicly thank Mr. Nick Boeree for all the help he's given me personally. He always takes the time to reply to my emails, questions, and concerns without hesitation. His diagnosis of the facets being the problem was spot on, all through merely a phone consultation. He's a great doctor and a great person, and although I hope I never have to see him again, I wouldn't mind sharing a drink with him someday.

Cheers.

THIS is pain relief.

Wow. This is what it felt like from month 3-6 post-op. Pristine, strong, pain-free! My facets have finally calmed down.

There's one very important thing to note about this, that because only my facets were treated, the surgical site is absolutely pain free. The disc is doing a great job. What i'm wondering is why the facets started flaring up. Is it disc related? This didn't start happening until after the 6th month post-op. I hadn't had any sort of heavy activity for years until I started this restaurant. And the disc IS supposed to prevent facet degeneration by having constrained motion.

So i'm left wondering, what caused this? I don't want to jump to any conclusions yet.. but I will ask Boeree his opinion.

I'll let you know what he has to say.

Cheers everyone! Now lets hope I stay pain-less!

Got my Facet Injections!

I got my facet injections today! I had levels L4/5 and L5/S1 done. Initially I was only getting L4/5 done but mid through the procedure the doctor decided to do L5/S1 free of charge. I figured I don't want to go through another round of injections in case L5/S1 was the culprit.

I'll be keeping a pain diary and i'll post an update in 2 weeks. Wish me luck!

Feeling fine.

So I went to see the sports medicine doctor. He wanted to use ultrasound to see my facets but the machine got scrambled signals because of the disc. We're gonna have to see another doctor that specializes in the spine to check them out. My appointment isn't until November 21st.

My spine has settled down, pain is down, and i'm feeling a lot better despite the increased work load.

So, everything's fine right now but I do want to get those injections.

Good luck to everyone!

Grow Up

It appears some of Mr. Boeree's competitors are checking out this blog closely. I've gotten some very unprofessional comments these past few days on behalf of 'anonymous' posters that say my surgery was a failure. Nice job guys!

Latest Phone Consultation with Mr. Boeree

I talked to Mr. Boeree a few days ago. He called me from his home right after dinner. As always, extremely polite and generous with his busy schedule.

I told him what was going on. I also asked him about my disc. He said the disc is in perfect condition and is still placed the way it should be. He said it might be my facets giving me issues. I immediately thought, oh no, degenerative facets. He said no, it's just that they might be pissed off with the new movements stemming from the disc and that this might be upsetting the muscles which tighten after they sense issues. He recommended facet joint injections at the L4/5 level.

Here's his follow-up email:


Just to recap with regards to the possible injections with your radiologist.  These would be image guided facet joint injections at L4/5.  I would normally use a combination of local anaesthetic and Depo steroid but I will of course leave the final decision about this with your radiologist.  I think it would be helpful to keep a pain diary for a week or two before you have the injections done and continuing in the weeks subsequent to this.  Be prepared for the fact that the injections may not have any affect for a week or two although you may potentially get quite good transient relief for a few hours following the injection of local anaesthetic into the joints.  This is of course is useful diagnostically in terms of establishing whether or not the facet joints at L4/5 are contributing to your symptoms

Self-explanatory I think! He said this is the first step in determining where the issue stems from, and that, if it works, will resolve the issue quickly.

It makes sense that it might be the facets. It's where I feel the pain being. And it makes sense that the muscles tighten as a result of this.

I have an appointment tomorrow October 18th with a sports medicine doctor in Miami. Lets see what he has to say!

Retlouping!

Fellow reader recommended Retlouping. It works wonders people! Except I did it with my legs UP against the wall instead of on the floor. It hurts like hell when you're doing it.. but it increases flexibility instantly. Good way to 'nerve floss'!

EDIT: I was laying on my bed with my legs up against the wall.

EDIT 2: I went to the gym today and tried it with the legs on the floor. Works equally as well!

Stretching, Electric Thingymagig, Anti-inflammatories, Less Stress

Alright. I think I found the solution to my tightness problems. I started seeing Dr. James Piccolino here in Miami, he's a chiro that specializes in soft tissue. We started doing a lot of stretching, and something called 'nerve flossing' which mobilizes the nerves. I asked Mr. Boeree about it and he found the term very interesting, although he calls it 'nerve mobilization'. Other than that, I used my Tru-Wave TENS electronic stimulator which seemed to calm my spasms down a bit. I also took a small dose anti-inflammatory. BUT MOST IMPORTANTLY, the restaurant is running smoothly and I have people doing all the jobs like they should.

Things are going fine today. Back is feeling relaxed. I'll be seeing Dr. Piccolino a few more times, he does wonders with stretches. I also have a phone consultation with Boeree soon. I'll keep you posted on that!