Patient Story - Spine
A Crucial Race He Had Prepared For — and a Finish He Hadn’t
This was no ordinary footrace. The 300-meter sprint was the final portion of the physical fitness exam required before Bill McGuigan graduated from the police academy. For the soon-to-be officer, it was all systems go.
Almost. Just twenty meters short of the finish line, Bill felt a searing pain rip down his right leg. The pain was sudden and overwhelming — and as he hobbled his way to the race’s end, so was the fear that his career as a police officer might be over before it even began.
An Incorrect Self-Diagnosis
Bill was all too familiar with the aches and pains of a strenuous, physically demanding lifestyle. He had spent eight years with security police in the U.S. Air Force and then survived the even more rigorous six-month training program for the police academy. He convinced both himself and the doctor that he had pulled his hamstring from over-exertion, and treated his injury with ice packs, ibuprofen and rest.
For three weeks or so, Bill limped along as his leg felt neither better nor worse. Then the pain became more severe, and when he began having trouble walking, Bill decided it was time for a return trip to the doctor. This time, he’d let the physician diagnose the injury.
An MRI Reveals the Real Problem — a Herniated Disc
Bill headed for the emergency department at the Swedish Issaquah campus, where his partner is an emergency medical technician. He described his symptoms to the physician, who suspected his back — not his hamstring — might be the culprit. She sent him to the next room for an MRI that, sure enough, revealed a ruptured disc in Bill’s lower back. She urged Bill to see a spine specialist and suggested Dr. Alexis Falicov, and he made an appointment for two days later.
During the next 48 hours, Bill’s condition became so painful that he could hardly walk into Dr. Falicov’s office. After arriving in a wheelchair, Dr. Falicov listened to Bill’s story, examined him, studied the results of his MRI and confirmed that the young police recruit did indeed have a ruptured or herniated disc in his back.
The Disc Strikes a Nerve — Literally
“The bones that form the spine in your back are cushioned by small, flexible discs,” explains Dr. Falicov. “Think of little sacks — about the size of two or three stacked silver dollars — that are filled with jelly. They keep the spine flexible and allow us to move our backs.
“When a disc is injured, the lining of the sack tears and some of the jelly spills out. When the jelly hits a nerve, it can irritate the nerve and cause pain.
“Human beings don’t come with blueprints and every human is different,” continues Dr. Falicov. “The same condition can cause completely different symptoms in different people. Pressure on a nerve can cause pain in one person, numbness in a second and weakness in a third. In Bill’s case, the jelly fragment was directly hitting his sciatic nerve and causing him almost unbearable pain in his leg. He was miserable.”
Two Options for Treatment: Feel Better Now or Later
Once he confirmed the diagnosis, Dr. Falicov talked with his patient about treatment options. “The reality is that most disc herniations heal by themselves,” he reports. “About 90 percent of the patients I treat require three things: pain control, education about how to protect their back, and time. They usually recover in somewhere between six weeks and three months.
“Bill was clearly in the 10 percent who needed more urgent care. I told him he would likely recover on his own after six months, or he could undergo surgery. While more traumatic, the surgery provides many benefits: a more complete recovery over the long term and — most important to Bill — a faster recovery.”
A Doctor’s Appointment at 2 p.m. — Surgery at 6 p.m.
Bill needed about thirty seconds to decide that surgery was the right choice for him. “I was in such pain,” he recalls, “that I told Dr. Falicov if he could operate right then and there, I’d turn over. That wasn’t an option, of course, but he looked at his watch, checked his schedule and asked, ‘What about 6:00 tonight?’"
A Simple Surgery Requires the Greatest Precision
Just a few hours later, Bill was in the operating suite and Dr. Falicov was expertly repairing his ruptured disc. “We did a minimally invasive microdiscectomy through a very small incision,” explains the surgeon. “The advantages of a small incision, of course, are less muscle pain and a faster recovery.
“The surgery itself is quite simple. We go in and remove the fragment of jelly-like material that has spilled from the disc. When we remove the substance that has been pressing on the nerve, the pain disappears. Then we look inside the torn portion and remove any other free fragments that might cause a problem.”
What about the tear in the disc? “The sack will actually reseal itself on its own,” replies the spine surgeon. “The body will heal it with scar tissue, and eventually provide a new lining that is not quite as strong as the original sack, but usually strong enough to prevent the disc from herniating again.”
On His Feet and Back Home the Following Day
When Bill woke up from the hour-long operation, his leg pain was completely gone. He was still a bit groggy from the medications and the surgical site on his back was sore, but only 15 hours after surgery, he walked out of the hospital — no wheelchair required — and headed for home.
Bill’s Back is Back
Less than a month later, Bill returned to the police force working half-days on light duty. Two months after that, he was full-time and full duty, living the demanding and rewarding life of a police officer. No activities were off limits. For Bill, that was the best news of all.
“I had worked so hard to be hired by a police department and I did my very best at the police academy. For a while, I thought my dream would be crushed,” recalls Bill. “How can you be a police officer with a bad back?”
Thanks to Swedish and Dr. Falicov, that’s one question Officer Bill McGuigan will likely never have to answer.