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Anterior Cervical Discectomy & Fusion (ACDF) or, My Big Bike Crash and Surgical Adventure

Anterior Cervical Discectomy & Fusion (ACDF)  or, My Big Bike Crash and Surgical Adventure

On July 26 I had a nasty cycling crash. I’m fond of telling people that cycling is a low-impact sport, unless you impact the ground, which I did that day. My cycling buddy Bob McGlashan were riding the Lake Casitas loop from Summerland, down the coast to Ventura (there’s a nice bike path next to the 101 freeway) and up the road paralleling highway 33 north. We had a howling tailwind and were flying at over 20mph on a modest upgrade. Well, at the big left turn to the lake, a car was coming the other way at high speed, so I timed my left turn to be after he flew past me, but at the last minute he hit the brakes and turned right. I had to veer right around him a little, which would have been fine, but as his car passed in front of me there was a pothole I had to swerve right to miss, sending me straight into the curb, which I hit at around 20mph, flipping me right into a dirt/rock field. I slammed my head, shoulder and hip really hard, the same side as my total hip replacement from 2013. There’s a dent in my helmet from a rock, so it did its job, but I could barely walk. As we were too far from home for a call to my wife, and no Ubers anywhere near us, I tried riding and there was almost no pain at all, so we rode the two hours back to the car. But by the time I got home I couldn’t walk from my car to the house without assistance, so I went to the Cottage Hospital ER and got an X-Ray and then a CT scan. There were two small pelvic fractures, one on the inferior ramps of the pelvic bone (not a problem) but the other one is on the acetabulum of the hip where the ball of the joint presses up against the socket (mine is titanium and plastic), so every time I put weight on the leg it hurt like hell.

I also pinched a nerve in my neck, which two days later was unbearably painful. I couldn’t sleep without strong painkillers. Another cycling partner of mine, Dr. Walter Burnham, happens to be a world-class orthopedic surgeon specializing in the spine, so he did an MRI on my neck and found some pretty severe degeneration of C-5, 6, and 7—not from the crash but from…”life” (he said, when I asked). So that led to the ACDF surgery, which Walt did on September 6, two days before my 65th birthday.

I would have done it earlier, but Medicare coverage started for me on September 1 so I had to wait in order to have the surgery fully covered. Yes, I have health insurances, with Blue Shield, and a fairly expensive plan at that, but even so it was going to cost me over $10,000, so it was worth waiting a couple of weeks. I could rant for pages more about our messed up healthcare system, but I won’t as at the moment I am grateful for the near miraculous performance of Dr. Walt and his team, along with everyone else who took care of me along the way. (i.e., it’s the system that’s messed up, not the people.)

I did notice how careful everyone is now with opioid painkillers, which saved me from being miserable for weeks. When the ER docs wrote a script for a codeine painkiller, unbeknownst to me the law now requires that any opioid prescription must include a prescription for Naloxone, the inhaler that saves your life if you overdose. The codeine (Tylenol 3) was $1.57 for 12 pills. The Naloxone was $75. My wife Jennifer picked up the order for me. I called the ER to complain about the price differential. The woman explained the law to me. I told her I understood, but asked “the instructions say to take 1 every 4 hours. What moron would take all 12 at once?” She replied: “you’d be surprised.” Alas, that’s the world we live in now.