AMD and Me
What It Was Like to Undergo Arthroscopic Microdiscectomy Surgery
Post Operation Updates

"How long have I had a bad back?" I asked my wife, Ronna.

"Are you kidding? Since before we got married," she answered, "And that’s 17 years."

It didn’t help the pain much, but I think the realization of how long this back stuff had been going on, helped me decide to "go for it." Back surgery. "Enough is enough," I repeated to myself.

That and the fact that I couldn’t stand, walk or even sit. The pain running down my thigh, through my knee and into my ankle was absolutely excruciating on that Sunday, May 11, 1997. I literally could not get out of bed. A doctor with a bad back once told me that the only time you should consider back surgery, is when the pain is so bad you crawl into a hospital and beg them to cut you open. I was there.

In my mind, I ran through all the things I had tried to lick the back and leg pain: Physical therapy, stretching, chiropractic, acupuncture, massage, Rolfing, Alexander Technique, epidural steroid injections, muscle relaxants, pain pills, Yoga… none had worked long term. My first MRI, taken about five years ago, showed a ruptured disk at the typical L5-S1 location. Then a second MRI taken in May, 1996 showed more rupturing at L5-S1, and a new rupture in the disk above at L4-L5. During the past 12 months, about 50% of my waking hours were in pain. And it seemed whether I exercised or not—it didn’t matter—I’d get hit with bouts of back and leg pain.

Saturday, May 10, 1997, I knew I had really overdone it. But my son’s Annual Mayfair School Carnival was held, and I had to set up the sound system and help organize the event. Fortified with three Darvoset pain tablets, I attempted to make a go of it.

"You look terrible," my friend Vanita said. "What’s wrong?"

"Back. Leg pain. The usual," I muttered. But by mid-afternoon I left the Mayfair early and was back in bed trying to get some relief from the unrelenting ache.

The prior Wednesday, I had been to my orthopedic surgeon’s office and we talked about "alternative" surgical techniques. He poo-pooed Arthroscopic Microdiscectomy (AMD) as an "experimental" technique that did not have much of a following here in the San Francisco Bay area. Nevertheless, I had investigated AMD by doing research on the Internet, and was impressed with the facts and presentation of Dr. Anthony Yeung’s World Wide Web site. My logic went like this: I figured I could always have the "Gold Standard" major back surgery if an alternative approach failed. It was logical to me, but not to my orthopedic surgeon. But I decided his reluctance to embrace this technique had more to do with his livelihood than science. To do AMD you have to be re-trained, big time. And that takes time and costs a doctor money. I could now see why he always recommended "regular" back surgery. That’s how he makes his living.

I emailed various questions to Dr. Yeung, and the following morning his email reply was on my computer…straight answers to my many questions. After several more exchanges of email, we both decided I was a good candidate for AMD.

I called his office in Phoenix, and spoke to Vernida, one of his capable assistants, only to learn that the first available surgery appointment would be in late June, over a month away. I knew it would be tough, but I was willing to wait.

On Tuesday, May 13, I got an email message stating that Dr. Yeung had rearranged his surgery schedule and he could perform his AMD procedure on me on Thursday, May 15. I immediately called Dr. Yeung’s office and confirmed that I would be in Phoenix—somehow! It was ironic that Dr. Yeung’s practice was based in Phoenix, too. Because I still have two sisters, a brother-in-law, a niece and both parents living in metro-Phoenix. I lived in Arizona for 29 years, graduating from the University of Arizona, and working in my family’s advertising agency business for 23 years before moving to San Francisco. Plus, I still have many business ties to the state, being the President of KUSK-Television in Prescott, Arizona.

But how would I fly to Phoenix? Sitting was even more painful than standing. I decided I would simply buy three airline tickets and lay down across an entire row of seats for the trip.

On Wednesday, I was driven to the airport by my wife, lying down during the entire trip in the back of our minivan. Sitting in the wheel chair was very difficult for the trip to the gate. I laid down across seats in the gate area waiting for my flight to be called.

On board, the flight attendants could see my pain and let me lie down through the entire trip, even during take off and landing.

I made it to Phoenix, where my brother-in-law, Steve, picked me up at the airport and took me directly to Dr. Yeung’s office for an examination.

Dr. Yeung was everything I hoped he would be; bright, personable, caring and extremely creative. Pioneering his AMD technique is more than just science, I thought. It has a large measure of "art" involved. Medical creativity.

"What do you think?" I asked my brother-in-law.

"I think you’re in good hands," he replied.

"Me, too," I said.

Dr. Yeung also introduced me to a young doctor from Syracuse, New York, Arnold Criscitiello, who would be helping Dr. Yeung during the surgery and learning the difficult procedure so that patients in Upstate New York can take advantage of this new technique.

During the examination, we decided it would be helpful to have a new MRI done, since my last MRI was over a year old. With some string pulling, an appointment was made at a Phoenix lab for the next morning at 8:30, with my surgery scheduled for 1:00 pm.

By 11:30 I was at St. Luke’s Hospital, fresh MRI’s in hand, ready for the procedure. But my MRI shots showed a disturbing new problem. One of my discs, at L5-S1, had calcified… hardened, and before the surgery, Dr. Yeung said he doubted he could remove this calcified disk. He asked if I still wanted to go forward with the surgery.

I said, "Do your best. I want to go for it."

In the operating room, they helped me turn over onto my stomach, situating pillows under my shoulders and head. I was as comfortable as I could be in this situation, but quickly the euphoria of the anesthesia had captivated my whole body. I could hear, see, move, speak--but as the needles and scopes were inserted into my lower back area, there was no pain. The anesthesia also produced some vivid visual effects. As I looked at the operating room, it appeared as an impressionistic painting with points of intense color like a Monet painting.

After working on the L4-5 disk, Dr. Yeung went to the other side of my back and went after the second, tougher, calcified disk at L5-S1. This time I felt a bit more of a sensation with the needles, but it was not of long duration or that painful. Upon completion, the staff turned me over and held up two viles of yucky-looking brown material. "Here’s your disks," they said. I asked if I could keep the viles, but no, they had to go to pathology for testing. Dr. Yeung also said that he was not able to remove the calcified disk. But I figured if it had calcified, maybe it would not rupture any more and just sit there. Perhaps my sciatic nerve would learn to "work around" the calcified disk. I didn’t have any scientific evidence to back up my thoughts, but in my euphoric state, everything was beautiful.

It seemed like only minutes, but after two and a half hours of surgery, I was being wheeled into the recovery room at St. Luke’s feeling very good.

About an hour later, I was sitting in a wheel chair being moved down to the front door of the hospital. I stepped into my brother-in-law’s van, this time sitting in the front seat. Pain? Very slight. Ninety percent of my sciatica leg pain was gone.

As I walked into Steve’s home I felt a little surge of discomfort in my right leg, but I proceded to lay down on an inflatable sleeping bag pad that I had been using to sleep on.

After some family conversation, I decided to call it a day, and fell into a deep sleep. I slept from about 6 pm till morning.

The first indication of the success of the operation came at about 5:00 am on Friday, May 16. I pushed myself up from the inflatable pad on the floor, got up and walked to the bathroom, 100 percent pain free! No leg ache; no ankle soreness; no calf pain. NO PAIN! What an amazing procedure, I thought! I still had some numbness in my foot, but my foot has been numb for at least five years. And I’d take numbness over pain any day of the week.

Later that morning, I called Dr. Yeung’s office and reported my progress. "There's no pain, and I'm not taking any pain pills, not even ibuprofen," I told him. Dr. Yeung urged me to take it easy and stressed that it would be about two weeks before we really know the success of the procedure. I also sent email to many of my "connected" friends telling them that I was alive and well and pain free!

On Saturday, May 17 I flew back to my home in San Francisco, this time sitting in just one airline seat! Air travel had always been one of the most difficult feats for me with a bad back, but this trip was very enjoyable!

I am writing this on Saturday, May 24, 1997. This past week I’ve had a couple of days of soreness, but Dr. Yeung removed a large volume of disk material, and that takes time to heal. But today I awoke 100% pain free, again. My foot is less numb than last week and I am working hard at not "overdoing it" as I often tend to do.

I have to keep telling myself that it’s only been 10 days since my surgery. Imagine what I’d be feeling like 10 days after regular back surgery!

Everyone who sees me marvels at the speed of my recovery and I’ve told countless people about my experience.

If you have long-term sciatica and you’ve tried getting relief from physical therapy and it hasn’t worked, I strongly think you should consider Dr. Yeung’s procdure.

I’ll post updates to my story in the coming months. Meanwhile, here’s to no pain!

 --Bill Sauro


September, 1997 Update

It's been three and a half months since my AMD surgery, and I'm still feeling so much better than before the surgery.  However, the fact that one of my ruptured disks had hardened, and that Dr. Yeung was not able to remove the fragments, has limited my recovery.  I still have occassional leg and foot pain... but it is manageable.

I also have a loss of strength in my foot and have trouble raising my right big toe.  My San Francisco orthopaedic surgeon is watching this carefully to make sure it does not worsen.  I've had a thorough neurological test (with needles and electric shocks down your leg... "I confess!  I will tell you the military secrets!") and that provided a baseline of my neurological condition.  I will be having another of those lovely tests next month to see if there is any change.

Otherwise, I'm able to walk around our beautiful City and can play baseball with my son again.

I just wish I had had AMD a year or so earlier... before the disks had hardened so much.

December, 1997 Update

Things just keep getting better! The numbness in my foot is much improved.  I can lift the big toe higher and I have a much greater level of feeling in the ankle, foot and toes.  And there is no more pain anywhere.

I'm still "stiff" in the mornings.  And I still take a great deal of care in the way I move... turning on my side to get out of bed, not bending over from the waist to pick up my shoes, etc.  But these are things that I'd thoroughly mastered as a result of my years of back aches, anyway.  If I'm careless I can end up with a bit of pain around the lower back area for a day or two.

It's not perfect back there... but it's still such an improvement over where I was in May of this year, it's absolutely spectacular!

May, 1998 Update

As I approach my one-year anniversary of my AMD, it's hard to remember how horrible the pain had been, or that I had so much trouble walking.  For example I remember that I had to use a wheel chair in Disney World during our visit there in 1996.

My foot numbness has stabilized... not getting better or worse.  I  have to watch my footing carefully, making sure I don't turn my ankle on uneven payment or stones, but big deal!  I can walk as far as I desire, and here in San Francisco, that's a critically important ability!

My wife remarked that since the surgery, I have not ever complained of a "back spasm" of any kind.  I've had some stiffness, as I said earlier, but not one incident of "pulling out" my back.  In the past decade, I used to have one of those about monthly!

But the most dramatic result is the lack of pain.  None.  Zero.  Nada.

So it's full "go" and full speed ahead with any activities I desire.  Thanks again, Dr. Yeung.

May, 1999 Update

I can't believe it has no been TWO years since my surgery.  I'm afraid this report will be totally boring.  No change.  No pain.  No problems.  I have not had an episode of back spasms or pain since the AMD was done.  Not one pull, twinge, ache or problem.  I routinely carry heavy stuff around, watching my posture but I feel I can do anything.

Again, I recommend AMD to anyone who is a candidate after Dr. Yeung has analyzed your MRIs.

May, 2000 Update

Three years!  Amazing!  Although the old spine has definitely continued on a path of deterioration.  In August of last year (1999) I had a full blown back spasm blow-out... the first since my surgery in 1997.  I was crippled up for about a week.  I had that crooked-spine look for the first time in ages where you stand in front of a mirror and your body looks like the Leaning Tower of Pisa!  I had a new MRI done and sent the results to Dr. Yeung.  He found a whole new disk rupture... this time at L3-4!  The good news was that the MRI showed the surgery performed at L4-5 was holding up nicely, but good old L5-S1 was still a calcified mess of gunk, probably the reason for my pain flair-up.  Dr. Yeung told me he had new techniques and tools for getting rid of the problem at L5-S1 and could of course clean up L3-4 quite easily.  I toyed with the idea of having another surgery, but the pain subsided, and I'm fine again now.  If the problems had continued for more than 3 weeks, I would have jumped on a plane again and had Dr. Yeung do his magic one more time.  And that's still a possibility.  But I'm able to do the things I want to do in my lifestyle without problems.  Walking long distances... climbing stairs dozens of times a day... playing catch with my son.  I can't ski or ice skate... but I wasn't very good at those sports anyway!  So what's the long term outlook... I honestly don't know.  But as long as I can do the things I like to do physically, I'll wait to have Procedure No. 2 until I really have to!

October, 2000 Update

Still truckin' along!  No major pain issues since May.  The morning stiffness continues, but I'm sure it's as much age as anything!  (I'll be 54 next month!)  Hundreds of people have emailed me in the last three years, and for most people I recommend a second opinion on their situation from Dr. Yeung or a surgeon who is adept at AMD.  Hope this has been helpful!

April 2003 Update

How… I forgot I even had a back problem.  I just got an email from another successful patient of Dr. Yeung indicating that the link to www.sauro.com/nopain.htm was not working.  In reconnecting the link, I realized I had not updated this file in two-and-a-half years!  I'm doing very well, but I've made some major changes in my life.  November 5, 2002 I had a minor heart attack and had angioplasty and a stent installed in my heart by another very capable surgeon, Dr. Brian Strunk of Marin Cardiology.  My old philosophy was I'll eat what I like an not exercise, and if I get a signal, I'll change my ways.  Well I got the signal!  On heart attack day I weighed 192 pounds.  Today I tipped the scales at 149.5 and I feel great.  I go to a local gym and exercise regularly and yesterday my wife and a group of friends did a brisk 5-mile walk along the shores of Richardson Bay in Tiburon.  Beautiful!  Warmest regards…

September, 2004 Update

Life is good.  I rarely have any back pain of any kind.  Some morning stiffness until I get that cup of coffee ingested, but yesterday I carried an 80-pound Sony TV set from my son’s room, up two flights of stairs to the back of my car by myself.  That included the lift of the TV from a low table.  No back issues of any kind. And my surgery was “old school” as my son would say.  Imagine the results I could have had with today’s amazing improvements!

February, 2006 Update

Still seems really weird seeing “2006”, even though the year is two months old.  It’s been almost nine years since my surgery, and I’m still pain free.  I never had one of the those, “my back hurts so much I can’t move” episodes since the Microdiscectomy, and that’s pretty amazing.  Sure I get an occasional ache and pain, but I don’t consciously avoid picking up heavy things, I lug huge suitcases up three flights of stairs when my daughter heads back to college and so forth.  I am very blessed!

May, 2007 Update

At 60 years of age now, the old body has a pretty good share of aches and pains.  But that killing pain in the lower back and leg is not one of them.  Still no major spasms or back incidents after nearly 10 years.

June, 2009 Update

Has it been two years since I last updated this page?  Amazing how you don’t think of something when it is no longer a pain!  Still happy to say I’m in great, pain-free shape.  Gained a few pounds with the “good life” here in San Francisco (with 130 restaurants within 1/3 of a mile of our downtown condo!) but I’m walking at least 10,000 steps a day and no longer even have a car!  I can’t even remember the last time I had ANY back discomfort.  Hope your results are as good!

September, 2011 Update

Seems like two years is the length of my updates because nothing much bad has happened.  No major back incidents… stiff and a bit grumpy in the morning, but that’s because I’m eligible for Medicare in November!  Yikes, I can’t be that old!

November, 2013 Update

Just celebrated birthday No. 67 with a fun week-long visit to one of my favorite cities… Chicago.  Now if they could just adjust the weather a bit, it would be perfect!  Nothing to report in the way of back problems.  I just lugged a 90-pound old-school cathode-ray TV set out of an armoire, carrying it out the garage with no back issues.  Dr. Yeung reports that he has many more innovative procedures that might help my back be perfect, but I’m able to do everything I want… walk at least 10,000 steps a day, carry heavy items, garden, cook, do handyman jobs… so I don’t feel the need for anything further.  But thanks Dr. Yeung for allowing me to be one of your pioneer patients!

Sincerely,
WHS

 williamsauro@yahoo.com

 Dr. Yeung's website: www.sciatica.com