THE LONG AND WINDING ROAD

‘A journey of a thousand miles must begin with a single step’. - Lao Tzu

After struggling for years with lower back pain, things have finally become too much to bear. It’s been a long old haul getting this far. The usual lengthy wait for initial consultations with a rheumatologist, then four following months of daily physiotherapy to try and adjust and strengthen everything, X rays, EOS scans, bone density scan, an MRI, eventually with referral to a surgeon in one of the best back clinics in France. A process that thus far has taken a year, which I understand by many standards is reasonably speedy. I am thankful to the French medical system which although under pressure, seems to be less so than the UK.

Diagnosis: three herniated discs, spondylolisthesis between L4-L5, and stenosis of the spine. In lay terms, three discs are bulging, a lumbar vertebra has slipped out of alignment with the others and that, along with arthritis and bone nodules in the spine, is pinching the spinal cord. It causes huge pain in my back and across my pelvis, with tingling and numbness in my left leg.

Big day a couple of weeks ago. I found out that my bones are indeed suitable to have surgery as, despite having the back of a wizened, excessively post-menopausal, 90 year old hag, I have a skeleton that is as strong as a 25 year old male wrestler. It’s good news as it means my bones will be strong enough to support the screws and rods, essentially the back scaffolding, until the bone graft ‘takes’ and fuses the two vertebrae together. Thankfully that’s a positive from the robust gardening exercise and much-loved Pilates which has mercifully helped and not hindered me.

The final scans, pre-op meeting with the surgeon and seeing the anaesthetist are all done now too.

It was very cold and extremely dark at 05h00 on that midwinter morning a few weeks ago. The sky though, was clear and the stars shone brightly, as bleary-eyed, Simon and I stumbled into the car and headed up the frosty drive.

On this particular morning I had yet another scan booked, a CAT scan this time, plus the pre-op appointment with the surgeon. Downside of these are that they are in Bordeaux, some 2 hours away without even considering the rush hour traffic. My scan is booked for 08h00, with the requirement to be there 15 minutes beforehand.

Predictably the inner Rocade, the notoriously congested city ring road, was heaving with traffic at 07h00 as everyone made their way to work or school. As we arrived, albeit a few minutes late, the staff looked as somnambulant as we felt.

Being called straight in, the scan done in a trice, my results were almost immediately in hand. Thankfully the surgeon is in the same building as the scanner, but it was far too early for our appointment so we headed off and found breakfast, returning later.

France is different to the UK. As individuals, we are each responsible for looking after and bringing our own records to each rendezvous.

My French is way from perfect but it’s certainly reasonable. I do try very hard and I am able to converse with most French people perfectly acceptably. Secretary number one at the outpost appeared to be finding the day tough. Unfortunately, the requirement for still wearing masks in medical buildings complicates our linguistic difficulties in a couple of ways. No-one realises how much you rely on watching facial and lip movements or how much a mask muffles a voice when one needs it to be crystal clear and concisely spoken.

Today, this manifested itself in a grumpy Mademoiselle rolling her eyes at me, not once but twice. A double eye roll no less. Something of an achievement.

Now if there is something I find difficult, nigh on inflammatory, it is the more-than-occasionally-encountered, medically-employed-French-female’s belief, that an eye roll is a helpful and positive reaction to my quite clearly saying in acceptable and comprehensible French that I did not understand and could she please repeat herself? After the second optic gymnastics, it was all I could do in my pre-meeting-surgeon state of heightened anxiety not to either walk out or burst into tears. I did neither but whinged to Simon relentlessly thereafter.

Onward to the inner sanctum and the surgeon’s real secretary. Maybe it had already been a trying, early morning start in theatre, as by 10h00 he was already running an hour an a half late. Having come all this way, we had no alternative but to sit it out, as I sweatily clutched my growing bundle of documents.

Upon being called finally into his spacious and ultra swish consulting room, I saw piles of beautifully presented parcels lined up along his expansive window sill. They were not all gift wrapped but definitely heavily favouring expensive whiskies with the odd extremely chic designer wrapping on show. Most likely gratefully gifted from thankful and appreciative patients before me.

It struck me again how young he is.

We started in French but I was far too stressed to make a good job of it for very long. I really needed to understand every single word he said to me. After the almost obligatory test to see if I was going to ask before he offered to speak English, he reverted to English anyway, presumably sensing my nerves. Inwardly I sighed with relief.

Not only was he running late but seemed stressed.

Especially when he took my unruly bundle of scans, results and associated medical ephemera, with a definite sense of theatre, tipped them all unceremoniously into a heap, and started sorting it into piles, tut-tutting, scrupulously, efficiently and pedantically labelling each one as he went. Then I understood the reason he was running so late. I was not the only individual he had seen that day whose paperwork had required a thorough spring clean.

Patience almost expired, he explained that a surgeon has to be ruthlessly exact and organised, with everything at his fingertips in readiness. This included my documents which must never again look like they did when I walked in. I felt like a stupid child for the second time that morning.

On then to the matter in hand.

If it were only as simple as requiring a spinal fusion. It turns out that my spine is in a worse state than I originally thought, confirmed by that morning’s scan. The new decision that was sprung upon me was whether he fused L4-L5 which is currently causing the sciatic pain, or newly diagnosed L5-S1 which would help more with the back pain. Both places are looking dodgy. The back pain appears more intense for me so I would have preferred that to be done, although in reality, it’s hard to determine where back and leg pains separate.

He decided to call in his colleague and have a pow wow. It was all in French of course so I was hugely relieved to understand everything. Definitely helped by the fact they were not wearing masks and were speaking clearly to each other, in recognisable French without the curious twang of south western dialect we are accustomed to back in ‘la France profonde’ away from the city.

Decision made.

Despite the accelerated pain from the back coming from L5-S1, the L4-L5 situation is more severe and unstable, so should be done. Some two or three years down the line, it may then be necessary to fuse L5-S1.

Bugger.

It’s not what I wanted to hear but it is reality. I can only be guided by the experts, in this case two of them.

Surgery date was confirmed and I left the meeting feeling even more anxious.

As we left, secretary to the inner sanctum was efficiency personified, easy to understand and in the merest jiffy had booked my pre-op meeting with the anaesthetist. Bundling my now immaculate dossier into a labelled and shiny bag, she saw us on our way and out into the blizzard outside.

It’s still a long road ahead.