Patient Testimonial (Herniated L4-L5 Disk)

I am a 32 year old woman who would be in great health if not for a recent back problem. I was diagnosed with a herniated L4-L5 disk, degenerative disk disease, and an annulus disk tear about 2.5 years ago. After managing the first two years through regular, sustained physical therapy and medicine, the situation deteriorated so much that I could hardly walk, sit, work, or function normally, and physical therapy was no longer helping. Unsatisfied with my prior doctor, who ultimately (and exasperatedly) told me that a traditional spinal fusion was the only other option besides living in pain, I searched extensively for another opinion from the best doctor I could find. I sought long and hard, and went to visit Dr. Choll Kim of the San Diego Spine Institute. I am incredibly glad that I found him, and that I am now under his care.

Dr. Kim’s resume is outstanding. He was trained at Harvard Medical School, did his residency at the Mayo Clinic, and is rated as one of the best orthopedic surgeons in the US & World News Report. Importantly, he also is a leader in the field of minimally-invasive, endoscopic surgery for spinal injuries. Minimally invasive surgery converts the barbaric and brutally invasive “old” technologies of back surgery to a version 2.0 which is much safer and makes healing much faster. The treatment is done through a tiny incision, using very advanced tools, so that your muscles and skin do not have to heal from being sliced through to reach the spine. This method reduces healing times and the rates of infection dramatically. Given the potential trauma of back surgery, I think it is incredibly important for a doctor to stay on the edge of technology, which Dr. Kim has admirably dedicated himself to.

At our first meeting Dr. Kim went through my medical history and was fully prepared, having ordered and viewed films of my back and having reviewed old MRIs. I was impressed by this, and his readiness to help me proactively, after having been given the runaround by other doctors that did not want to do anything until I was sitting in front of them. Dr. Kim confirmed that the treatment that would potentially “fix” my problem would be a spinal fusion. I wanted to avoid the spinal fusion, but knew I needed some sort of intervention to stop living in pain. Dr. Kim and I decided to try a new physical therapist and new medicine for 4-6 weeks. He gave me his cell phone number and let me know that I could call him any time. I went to a follow up meeting four weeks later, still in pain. Because I did not want a spinal fusion, Dr. Kim suggested a smaller surgery to “clean up” my disk. The less invasive surgery would not entirely fix my problem, but it should help reduce chronic pain. The surgery I eventually had was the Transforaminal Endoscopic Spinal Surgery (TESS), which is shown on his website.

I was impressed with Dr. Kim’s office throughout the surgery planning. Professional and organized, the office made sure that I was comfortable with all of the details of the procedure. My surgery was scheduled approximately 3 weeks after Dr. Kim and I decided together to proceed with the surgery. I was afraid, and have written detailed notes of my experience which I hope will benefit other patients considering a surgery.

Description of the Surgery Day

5 am arrival at Alvarado Hospital. I spent 2 hours with the pre-op prep nurses. I was nervous but the professionals in the hospital made me more comfortable; everyone was very kind.
About 15 minutes before the scheduled surgery, an anesthesiologist came to meet with me and explained the planned method of sedating me and relieving pain during the surgery.
One very important matter is that I was not given general anesthesia for the surgery. I believe many of the endoscopic surgeries are done without anesthesia. General anesthesia is one of the riskiest parts of surgery. It is not needed for this minimally invasive surgery, since the patient is not cut open. This was one of the more frightening things before the surgery, so I elaborate on my experience here to try to alleviate some of Dr. Kim’s patients’ fears.
I was wheeled into the operating room without pain medication or sedation. The doctors came in and explained everything again.
I was laid face down and made very comfortable. Dr. Kim personally made sure that I was surrounded by pillows and as comfortable as possible. He has a very kind approach that was really reassuring.
The anesthesiologist told me he was going to sedate me and moments later, through my IV, the anesthesiologist gave me something sedative. He then gave me a little bit of whatever they use for general anesthesia, something for nausea, and something that almost completely took away pain.
What they gave me helped tremendously! Suddenly I felt very relaxed – I literally thought, “oooh, that’s nice!” considering moments earlier I had been pretty upset. Once that took place, I think they started the surgery right away, but I don’t know when it started exactly. I did not worry about whether they were cutting me (or not). Although I was not asleep, I did not feel them make an incision to insert the endoscopic tools for the surgery, and was not aware of when the surgery started.
I did realize at some point that the surgery had begun because the doctor showed me my disk on a screen that he was looking at through the endoscopic tools.
I was aware of what was going on, but again, was no longer afraid.
The surgery required using a tool to wide a hole between my vertebrae. Specifically that means that at some point, they drilled my bone. It did not hurt. I did feel and hear a tapping sound
Overall, I was not panicked or upset or emotional at all during the surgery. I felt okay and did not worry, thanks to the medicine. The surgery took about 2 hours.
There were a few moments of pain, but not excruciating pain. I felt tingling in my toes at one point, and felt pain in a few isolated moments. I let Dr. Kim know when I felt pain or tingling, so that he knew he was touching various nerves. He uses the sensory information to help him through the surgery.
The surgery finished. I was wheeled out and given pain medications. A nurse spent the first 2 hours observing me. They had me get up and go to the bathroom. I was in pain after the surgery, but honestly, if you’re having surgery for back pain, the pain is probably not unlike what you have already experienced. I don’t think I ever got above a 6 (on the 1-10 scale) (with medicine).
On the ride home, my pain level was about a 6 on a scale of 1-10. I went home and slept, and took pain killers and muscle relaxers. I was able to walk around the house the same day. It felt like having a bad day with back pain. I wrote the first part of this summary the night of my surgery. My husband was amazed that I was able to do so. I could eat but was definitely “out of it” thanks to the painkillers and muscle relaxers.
I am resting, and expect to heal from here, with a scheduled return to work in one week.

First few days after surgery

The surgery took place on a Tuesday. I spent 3-4 days mostly sleeping. I was in pain but again, not excruciating. I pretty much stopped taking painkillers and muscle relaxers 3 days after the surgery. After 4 days, I basically just felt like my back was out.
By Saturday I was okay enough to go to the grocery store by myself, but I could not lift anything more than 2 pounds.

Sunday I had a dinner party. It was probably unwise because by the end of the night I needed a painkiller and was having muscle spasms, but I had a good time. No one would have guessed I’d had surgery a few days earlier!

One really amazing thing – Dr. Kim and his team were in contact with my husband and I during these days. My husband sent Dr. Kim a text to let him know I was okay. I had muscle spasms on Monday but did not realize that was what they were, so we called the office and someone got back to me right away. Dr. Kim actually called me once to check on me. I was so impressed by the kindness of this person who is so extraordinarily busy, yet caring. His entire team wraps up the patients in holistic care.

One week later

I returned to work the Monday following my Tuesday surgery, but did not go into the office. I needed a nap midday. I was okay to work but realistically I could not have sat for 8 hours in a day. By the end of the work week (spent working from home) I had a lot of swelling and was in pain again. I was in pain when I sat for longer than an hour. By the weekend, I essentially slept and rested all weekend to recuperate from the swelling I caused myself by sitting for work all week. I would recommend taking 2 weeks off work if you have to sit or do any heavy lifting at all. Actually, I’d just recommend at least 2 weeks off for “simple” surgeries like mine, and of course more if you have a more complicated surgery.

Almost 3 weeks later

I avoid sitting but can do so for limited periods without pain (driving, eating dinner, etc.) Otherwise I feel great. I went out with friends to a Japanese-style karaoke saloon on Friday night, and to dinner and out for dancing with friends on Saturday night. On Sunday morning, I marveled at how amazing I feel, and how YOUNG I feel. It is almost like I forgot how vibrant life feels during the chronic pain I suffered through. I feel so much energy. I think that I repressed acknowledgement of how much pain I was in for so long that I got used to seeing life in shades of gray. I am only 3 weeks out, and know I am still healing from the surgery, but I am already so glad that this chapter of pain in my life is ending. It is all uphill from here. Dr. Kim told me I’d be back in pilates and hiking in about 3 more weeks. I started PT last week. My range of motion is limited, but I am already out of pain.

I am very grateful to Dr. Kim because of the respect and care with which he treats his patients. Never rushed, never callous, and truly acting in his patients’ best interests. A few key things I appreciated include:

Being given the doctor’s cell phone number. This is remarkable!
The feeling of being truly cared for
The best modern technology, applied.

I am incredibly grateful that I went to Dr. Kim and that I am under his care. As one side note, I want to let Dr. Kim’s patients’ know that I offered to write this for them and that there was never a request to do so. I really think the world of Dr. Kim and assure his future patients that he will act in his patients’ best interests. Dr. Kim did not “sell” me on surgery, which had been a concern of mine about doctors in general. In fact, Dr. Kim gave me every other option, and led me away from a more intense surgery.
I hope this information is useful for you if you are making a similar decision, and wish you the absolute best with your healing and your health.