Chris' Neck &
Back Injury Page
This page is dedicated to my neck surgery and low back injury. It is a first-hand experience
of the research, successful, and unsuccessful methods and their results.

Specific things covered are a ProDisc-C review (Total Disk Replacement-TDR) and first
hand experience with the Pain Free - Egoscue book and clinic.

All information and images may be used by anyone. Clicking on images will enlarge them,
right clicking on them will give the option to save the image.

I encourage anyone suffering from similar injuries to spend some time on this page and
feel free to contact me to discuss anything that I did not put on this page.

PLEASE NOTE: I have not received any compensation for any kind of advertising. If it seems like I am
promoting something, its only because it worked for me and I'm hoping it can work for others.
This is a section specifically for pics and info on my neck injury and disk replacement using the Prodisc-C artificial disk
replacement. It was last updated:  
7 YEARS POST-OP - 3/18/2016.
Neck Injury
I am currently a Fire Captain and started in the fire/rescue
service in October of 1990.

In 1992 I was injured during a rescue, blowing out both
shoulders and neck. There was no MRI back then so I used
chiropractic primarily to resolve pain and manage the injury.
The first couple years after the surgery I would have flare-ups
that would be so severe, I would be paralyzed from the neck
down. During these extreme flare-ups, I could not even roll over
in bed and needed people to help feed me, cloth me, etc. until
the flare-up would subside after 3-5 days. Flare-ups occurred
every few weeks and varied in severity. After the first couple
years, I was able to successfully manage the injury with working
out and chiropractic and it brought me close to 80-95%
pre-injury with occasional flare-ups every month or two and low
in severity.

In March of 2009 I had a flare up that was so bad I went to the
ER. They took an MRI which showed rupturing of 2 cervical
disks with protrusion into the spinal column and causing
pressure on the spinal cord. It was diagnosed that I probably
had disk herniation since the injury but that many years of
activities and wearing a heavy helmet on the job deteriorated
my condition to the point of disk rupture.
Starting with the March flare up, my symptoms were...weakness in the right arm increasing and then progressing to the
left arm in May. Tingling and numbness in the right hand fingers. Trembling in the right hand steadily increasing and
progressing to the left hand in May. Trembling was especially noticeable in my right thumb over 50% of the time. Pain
in the neck and shoulders staying consistent. I did 6 weeks of physical therapy which diminished the tingling and
numbness and minimized neck pain, but did not resolve any other symptoms.

My pain level during the March flare up was a 10 out of 10. After PT I was able to relieve my pain to a 2 out of 10 on a
good day, 5 out of 10 on a bad day. I was not able to sleep without the assistance of medications due to the pain. I was
not able to do many activities or hobbies, including riding a motorcycle (because of the weight of the helmet), SCUBA
diving (due to the motion of the neck), and even photography (lifting the camera for prolonged periods my hands
would shake).

6 weeks prior to surgery I had an EMG (Electromyograph) test. It is a test that checks for abnormalities in nerve
conduction. It was found I had abnormal readings to the right side consistent with the findings of the MRI. That test
doesn't give any percentage or degree of abnormality, it only gives 'abnormal' or 'normal'.
I posted a pic of the MRI on the internet and requested any and all help. I received hundreds of replies (approximately
500) and many that pointed me in the direction of an artificial disk replacement vs. fusion. Based on those responses, I
did over 90 hours of research on reviews and alternatives for my condition. I created a graph of all of my possible
solutions and their outcomes. Based on my graph, I settled on having a 2 level artificial disc replacement.

I found 3 devices in use: Bryan, Prestige, and Prodisc-C. The Bryan was the most
controversial due to the disk material. The Prestige and Prodisc-C were essentially
identical in function, however the Prestige is all metal, uses more hardware, and is
more invasive with screws into the vertabrae. Due to those factors, I chose to go
with the Prodisc-C replacement.

I researched the history and possible complications with artificial disks. I found they have been in use in Europe for 14
years, in the US for 4 (at the time I wrote this on 3/29/10). There are approximately 17,000 patients with artificial disks.
The first US TDR was in 2003 and the patient has had no complications and still relieved of pre-op issues. The cervical
artificial disks are the most respected and most common. Complications from Thoracic and Lumbar disk replacements
are mostly due to surgical access, not so much the disk itself.

I then contacted approximately a dozen individuals who had either a disk replacement or fusion. I made sure to talk to
people at different post-op stages; less than 1 year, 1-5 years, 5 years+. I talked to 6 people directly who had disk
replacement. The most convincing person was a triathelete who had fractured his vertabrae and had a multi-level disk
replacement. He was competing in a triathalon 4 months post-op. When I talked with him, he was 4 years post-op with
no issues and competing on a regular basis. I found that most people I talked to with a fusion greater than 5 years
post-op were having issues again. My research found that statistically there is a 25% increase in suffering a herniated
disk below or above a fusion for every 10 years of life. Being fairly young, this was a major consideration for me
choosing disk replacement.

I found less than a dozen "complaints" about disk replacement surgery. I followed up as much as I could on each
complaint. A couple of the complaints I was able to actually contact the individual and talk to them. I found ALL of the
complaints could not be isolated to the disk replacement itself. In most cases, there were other pre-existing conditions
that could have led to the "complaints". Example: 1 person posted a complaint of extreme pain and tingling in the arms
2 years post-op. What they did not say in the complaint is that they were also 300 lbs, diabetic, and had suffered a
significant fall and broke his collarbone as well as damaged his neck. Therefore, I determined that the "complaint"
could have had other sources. Another "complaint" stated weakness and numbness 5 years post-op. Again I followed
up and found the person failed to mention in the complaint that he was pain free up until he took a fall down a 30 step
flight of stairs and hit his head and neck on the way down. I could not find ANY complaints that could be isolated to
post-op effects from the artificial disk itself. Most complaints could be traced back to other health issues or due to
other parts of an injury that were not addressed.

I was told by one person that they had read that there is a 20 year lifespan given on the plastic used in the Pro-Disc C.
However, I could not find any information to support this. I found that currently 7 years is the longest someone has had
a Pro-Disc C and they have no complications. I also found that the plastic was rated for 50 years+. I did find that it is
the same plastic that is used in knee replacements. Knee replacements are rated for 15 years. However the impacts
and weight load on knee replacements accounts for the wear and tear on the plastic and it would be substantially
different in the neck. I was told by one doctor that with the lubrication in the body along with such little weight and
impact on the cervical disk, it would be extremely unusual for the plastic to wear down, but IF for some reason it did, it
would not be any greater than the height of average normal disk degeneration.
I looked up surgeons who perform TDR (total disk replacement) and found 16 in California. Dr. Mark Howard was one
of them. He was located minutes away in Monterey. He also happened to be the same surgeon who had done a lumbar
fusion on Ame many years ago. Because of being local as well as having done Ame's back, he was my first choice.
After meeting with him I went to 2 other doctors. They agreed with his opinions and also felt he was a good choice.
Although there were 16 surgeons I found, not all of them had extensive experience doing TDR's. Howard has done 17
in the cervical spine, which is among the highest out of the 16. With all of this, I chose him and I feel he did a great job
and am happy with my choice.

When choosing a TDR surgeon, It is important to note that there are basically 4 types of doctors:
1) Those who don't know about it.
2) Those who do know about it but have insufficient information to trust their judgment.
3) Those who practice it but it is not their specialty and can perform it fine, but they are clearly not fully up to date on it.
4) Those who are leaders with it.

Ask lots of questions and do your research and find out which category your surgeon fits into.
On June 30th, 2009 I had a multi-level cervical disk replacement surgery using the
Prodisc-C at C-5/6 and C-6/7. The surgery took approximately 2 hours and I spent
just about 48 hours in the hospital post-op.

The wound was sealed with dermabond during surgery and had a drain tube. The
tube was removed 24 hours post-op. The wound sealed itself less than 24 hours
after drain removal. I used steri-strips to keep the wound sealed and a waterproof
bandage over the steri-strips. I did not take a shower for 6 days per the surgeon.
Although the surgeon said I did not need any bandages after a week, I kept using
steri-strips to keep the scar from stretching from my neck motion. I covered it with a
waterproof bandage to protect it further from stretching and keep it clean of airborne
contaminants. I did this for 1 month, even though I didn't need to. I feel doing this
helped minimize my scar today.
I was able to walk to the car from the hospital and move freely at home sleeping normal, but with the assistance of
occasional meds. Pain was mostly due to muscle spasms between the shoulder blades and diminished with occasional
narcotic meds. It was at a 5 out of 10. I was told the pain between the shoulder blades was due to the nerves in the
neck being stretched when they pulled apart the vertabrae to make access. I was told this would diminish with time. In
my research, I never found someone who permanently had this pain, although some took as long as a few months to
go away.

10 days post-op, I was able to start driving. I took occasional Advil for the shoulder blade pain which was decreasing
daily. The shakes were essentially gone in both hands. There was no numbness or tingling in my fingers at all.
Weakness in my left arm was gone and diminished by over 50% in my right arm and slowly improving each day.

At 2 weeks post-op I started working out cardio and with very low weights/high reps. I was able to do photography
without any hand shaking. Although I did have some trembling in my right thumb on occasions.

8 weeks post-op, I am essentially pain-free. I took Advil once last week. I am going to PT 3 times a week and at my
3rd of 4 weeks. I spend about 4 hours each time at PT. I walk on the treadmill 1 mile at 15% grade for less than 30
minutes with my boots (3lbs), helmet (5lbs), and all my firefighting webgear (30lbs.).
I spend an additional hour doing a substantial weight lifting regime including sit-ups with my helmet on. I then do an
hour and half of PT with the therapist which includes ultra-sound, massage, electric stimulation, and heat and cold
packs. I have them ultra-sound my scar and
4 weeks post-op I began heavy massage on the scar tissue.

10 weeks post-op, I cannot tell if there is any weakness in either arm, occasional soreness in the shoulder blades the
day after PT, and once or twice a week I notice very very mild tremors still in the right hand thumb. It is minimal and
lasts a minute or two and only when I do certain tasks, like a mouse, remote control, or dial on the cell phone. It is
dramatically better than pre-op. I have a small half inch area of numbness above the surgery site that I only remember
is there when I shave over the area and notice it. I have almost full range of motion with limitations on ear to shoulder
and head backwards. X-rays taken show excellent motion and implant placement.

13 weeks post-op, I have full motion of my neck without pain. I feel what I can only call 'tension' when I reach the max
points for lateral twisting of my neck. I am able to lift full weights without noticing any weakness in either arm. I still have
the occasional minor tremble of the right hand thumb during specific tasks. I still have the numbness under the chin. I
have returned to work light duty and anticipate full duty next week. I had a substantial workout for 2 hours yesterday
followed by 3 hours of 'active' beach volleyball. I woke up a little sore that went away by the time I got out of bed and
went to take a shower. This week I completed 4 consecutive days of intense physical activity including volleyball,
pulling a hose line, throwing a ladder, cutting handline, and hiking 100' of hose and a pack up a 40 degree slope. I feel

15 weeks post-op. I have been at work full duty for over a week now. I am doing all physical activity at normal limits. I
got out and rode my motorcycle for the first time. I put over 100 miles on it over 2 days with no problems. The tremor in
my right thumb and a bit in my hand are more noticeable, but still only occassionally and when I do specific tasks. I am
guessing this is probably permanent from taking so long to have the surgery or could be related to my shoulder since
the original injury did involve both shoulders. This week's routine consisted of:
Wed-2 mile outdoor hike with full firefighting gear (40 lbs), helmet, and carrying a shovel in the am. 1 hour of weight
lifting. 3 hours of active volleyball.
Thurs-20 minutes on treadmill full grade then 10 minutes on the rowing machine, 10 minutes on the bicycle, then 45
minutes of weight training. Volleyball again for 3 hours in the evening.
Fri-a hose drill with full firefighting gear (40 lbs) that involved pulling 100 feet of charged hose up a hill, then carrying a
hosepack (40 lbs + 40 lbs gear = total 80 lbs) up the hill, then cutting 20 feet of line through brush. It took me 17
minutes to complete. 2 hours of volleyball in the evening.
Sat-20 minutes cardio on the bike and treadmill followed by 40 min of weight training. 2 hours volleyball.

I have been EXTREMELY active and pushing myself physically every day. I sit here writing this after 5 days on duty of
intense physical activity. I am sore! I am starting to feel my body from my regime. However...I feel every part of my body
EXCEPT my neck! Everyone around me can't believe I went through a major neck surgery. I dive for the ball or lift a
dumbell and can't help but think,
"The surgery was a huge success!"
I'm on duty for 8 more days (pulling overtime) and will probably consider taking some advil tomorrow :)~

6 months post-op. I have been back to full duty for a couple months now. I have done some heavy training as well as
been a victim in training where they yanked me around pretty good by my mask and helmet. I've had no issues. I
completed 8 more PT visits and have discontinued future PT needs. My scar is barely noticeable. I feel occasional very
mild 'tension' when I turn my head to its max ranges. The tension rates barely 0.5 out of 10 and is more of a reminder
than an issue. I have almost full range of motion. I push myself sometimes and wake up a bit sore, but it goes away by
mid-morning or with Advil. I find the worst cause of soreness or pain is sitting in partially upright chairs for long times,
like at a movie or play. I find myself stretching my neck side to side when this happens. It causes "discomfort" rated at
a 1 out of 10. All of the issues between my shoulder blades has resolved. My right hand still has very occasional
tremors. They are mildly annoying. I am assuming they are permanent. Again probably due to delay in surgery, from
the slightly bulging C-7 that was not addressed, or related to the shoulder. I still have the numb spot below my chin.
The surgeon finds it unusual, but I figure it was from the incision location. Each person's nerve routes are different and
it would be impossible to have prevented it. It is not nocticeable really and a small price to pay for the overall benefits
of the surgery.

9 months post-op. I have a bit of increase in pain. I have a couple factors recently that have set me back just a little.
My schedule has been hectic and so I haven't worked out in almost 3 months. Then, a few weeks ago I spent a few
days back to back wrenching on the engine heavily. I had to torque myself inside of one of the compartments and
found myself upside down and backwards and like a pretzel wrenching. The next day I felt pain between the shoulders
and nerve pinching in my right elbow. A few weeks later now, I still have it a little. It feels like it is coming from C7
though, the disc that was slightly herniated and was not repaired in the surgery. I have very mild pain between the
shoulder blades, but I think if I can get back on my workout plan and stop pushing myself it will resolve. We'll see how it
is on my final update in July.

July 1, 2010, 1 year post-op. Pain has relieved with working out. Feel back to normal with no issues. Slight nerve
pinching on very rare occasions coming from what feels like C7 area. Scar is essentially invisible.
at 1 month post-op, I began pinching and deep
massaging the scar tissue myself. It would cause it
to flare-up and become puffy and red. No matter
how angry it looked, I kept doing it on a daily basis
for 2 months post-op. I alternated using Mederma
and Neosporin on the scar for 3 months post-op.
The Mederma works, but makes the scar red and
swollen and that's why I alternate with the
Neosporin. It has been effective in reducing the size
of the scar. I had PT ultra-sound the scar for 10
minutes every time I went. I had them do that for 2
months. I believe the ultra-sound and aggressive
massaging are the direct result to having a
practically invisible scar.
5/15/09 pre-op
R Rotation 48 degrees
L Rotation 42 d
Flexion 55 d
Extension 48 d

8/5/09 post-op
R Rotation 44 degrees
L Rotation 40 d
Flexion 48 d
Extension 48 d

R Rot 45 d
L Rot 40 d
Flexion 65 d
Extension 55 d

R Rot 51 d
L Rot 44 d
Flexion 66 d
Extension 61 d

NOTE: from the numbers on some of the dates, it made it seem I wasn't much improved from pre-op, yet I was, so
therefore the numbers must have been recorded incorrectly.
+Using pre-injury status as 100%...
+Just after the injury I was at anywhere from 20-60% pre-injury (depending on severity of flare-ups).
+The last decade+ I was able to get to 80-95% pre-injury (depending on flare-ups).
+The last few years it changed to 70-90% pre-injury (depending on flare-ups).
+The flare-up of March 09 put me at 30-50% pre-injury.
+After the flare up and after PT, but before surgery, I was at 60-75% of pre-injury.
+13 weeks post-op, I rate myself at 85-90% pre-injury with no flare-ups. I am continuing to improve. My pain, when I do
have it, never exceeds 1-2 out of 10, depending on how hard I work out.
+6 months post-op, I rate myself about 95% on average dropping to 80-85% on a "bad day" (soreness, tremors,
discomfort). Even on a "bad day" I can perform all the activities I want and have no physical performance limitations.
Pain, or more "discomfort", is at worst a 1-2 out of 10 and maybe 1-2 times every 2 weeks.
I feel I am better after the surgery than I have ever been post-injury pre-surgery. I feel I am very very close to
pre-injury health. So far it has been a total success and there are no complications.
I have been completely satisfied with the Pro-Disc C replacement so far. Of the complications or issues I had
researched and expected prior to the surgery, I approximate less than 10% actually occurred and less than 5% I still

I feel the success of the surgery was due to...
1) I did my research and new my options.
2) I watched my diet prior to surgery avoiding inflammatory foods and continue to watch my diet after surgery.
3) I exercised before surgery making sure I went into surgery physically ready. This included neck exercises prescribed
to me by PT as well as cardio.
4) I took care of myself and the wound post-op, exceeding what the surgeon asked of me.
5) I became as physically active as soon as possible post-op, exercising both my whole body and my neck.
6) I used the Mederma and massage aggressively to reduce the scar.

Most importantly, I paid very close attention to my body and what it was telling me, never pushing myself beyond limits.

I thank everyone who replied to my postings and gave me support and feedback. Feel free to pass on my information
to anyone who may be able to use this info. If you know anyone who would like to talk to me about my research and
findings, feel free to pass on this page.
1-18-12, 2.5 years post-op. The last couple months I started getting some pain in my lower right of my neck and very
occasional spasms in the front of the neck. I went back to Dr. Howard where follow up X-rays were taken. There were
some startling findings. Because my head positioning was still poor (from many years of guarding the original injury),
the right side of my C7 vertabrae was becoming arthritic where it comes in contact with T1 (shown by the lower left
green arrow in the pics), probably causing nerve irritation and the origin of my neck pain. Furthermore, and what was
more shocking, was that my body is apparently spontaneously trying to fuse over the lower TDR at C6 to C7 on the
front only. The TDR at C5 to C6 was normal. A layer of bone can be seen in the X-rays starting to form over the front
(indicated by the right side green arrow). Looking into this further, Heterotopic Ossification can be a random
occurrence in post-operative TDR patients. My research pre-op did not turn up any of these findings and now doing
research, the earliest reports showing this as an issue are 2 reports dating 2006 and 2007, the rest all from 2010 on.
The studies are controversial. Some show rates as high as 49% showing post-TDR HO, others less than 10%. The
methods and numbers tested are questionable for forming a long term hypothesis. HO has been recorded in cervical
fusions as well, so choosing fusion vs. TDR does not necessarily reduce chances for HO.

In my case, the HO is extremely minor and has not restricted movement of the TDR (as you can see by the gap in the
TDR), nor restricted my range of motion. Further, even if it is successful in fusing, it is low enough in my neck that it will
not affect my movement long term. C5/C6 is showing no HO and if it has not started by now, most likely will not as long
as I keep motion in my neck. If I become sedentary, there is the possibility it could start. To go in surgically and remove
this is an option left only if it progresses to severe pain or restrictions and any surgery will become very risky.

Even with this new information and seeing potential for a worst case scenario of successful fusion of C6/C7, it has not
changed my opinion of undergoing the procedure. This falls in line with what was consistent in all the studies I found...

92% of patients with HO said they would not change their decision and still happier with the results than
undergoing a fusion or nothing at all. I would be included in the 92%.
Any surgery holds inherent risks. The chance of any kind of surgery bringing you 100% success to a pre-injury status
is very slim. Each person needs to evaluate the worst case scenario of any surgery and compare it to how you will be if
you have no surgery. Even if both of my TDR's fuse (which is highly unlikely), I will still be better off than if I had no
surgery and still be better off than if I had fusion. I still recommend a TDR over a fusion as the results long term with a
TDR are still better than proven results from a fusion. HOWEVER, finding relief with non-surgical techniques should
still be the #1 choice and I would suggest scrolling down this page to read up on what I found with my low back injury.

1) Select the right surgeon.
2) Get multiple opinions on your MRI and Xrays.
3) Go into surgery as healthy as possible, stay healthy post-op at least 6 months.
4) Massage the site as soon as possible to reduce the scar.
5) Use ultrasound, electro, and massage therapies.
6) Select the right Physical Therapist.
7) Keep mobile.
8) Follow up post-op at least 1 year, 2 years, and 3 years to make sure everything is okay.
6 Months post-op                        2.5 years post-op
Low Back Injury
This is a section specifically for pics and info related to my low back injury and my results with the Egoscue methods.
It was last updated:  
On 9/6/11 I was doing a training exercise involving being in full firefighting gear with an air pack on. The training
involved going through a maze-like confidence course, breaching walls, entanglement, and profiling through confined
spaces. On day two as I was nearing the half-way point of the final confidence course, I removed one side of my pack
and began to profile through a stud wall. My pack got caught and as I began to yank it through, my knee slipped and
my lower body tweaked heavily. I felt an immediate sharp pain in my low back. But being me, I continued to push
through, blowing it off as just another minor strain/sprain that comes with the job. I continued through the training,
sliding down a tube, breaching a wall, going through an entanglement prop, breaching another wall, then moving to
breach a third wall. Upon breaching the third wall and entering the second entanglement (the very last part of the
entire evolution), my low back seized and locked up. I stopped the training and attempted to stretch it out, but it
continued to stay locked up and I could not complete the training. I continued to work for another month, taking it easy
and hoping to get better. But I didn't. It gradually got worse and eventually, a month later, I saw a doctor who took me
off full duty.

I initially had sharp pain in the low back and upper hips. It radiated through to the front of my upper quads and nerve
pinching was felt down the left leg, into the knee, and ended at the ankle. Eventually the pain turned to stiffness and
overall discomfort and the nerve pinching randomly went down the left leg, then the right, and back to the left. Muscle
spasm and aching covered my entire low back and radiated up into my mid-back and could be felt in my ribs.

X-rays and a MRI were done. There was absolutely nothing wrong in either and it was determined I had a moderate,
possibly severe, low back soft-tissue injury that probably included a tear. This was good and bad news. The good
news is that I would not need any surgical intervention. The bad news is that recovering from a soft-tissue injury in the
low back can be a long and painful process.

I started with standard Physical Therapy using basic stretches and strengthening. I did many sessions and was able to
have some resolution of the leg pain, but seemed to hit a wall with full recovery. Then did pool therapy using core
strengthening with same results. I started Egoscue techniques and have done several sessions with good results. I
finally received two surgical injections into the vertabrae and seemed to break through the final barrier in resolving the
injury. Each treatment method and what part they played in my recovery are detailed further, below the Egoscue info.
1-19-12. First meet with Oscar at the Monterey Clinic office. I gave him my history and then walked onto the mat for
evaluation. He had me stand normally and pointed out my misalignment.

I then proceeded to do some of his exercises.
and immediately noticed not just a difference in
how I felt, but clearly from the pictures below you
can see some re-alignment.

The order of the exercises became very apparent.
I would finish a sequence and he would check my
alignment. Some exercises made me improve, some
made it worse. Further, some improvements were
cancelled by other moves. Example: I did one exercise
and it increased propulsion and I was pushing off
the balls of my feet more and striking on my heel less.
But then I did the next exercise and lost that propulsion
but gained heightened posture. Oscar reversed the order and I had both propulsion and heightened posture.

So it is very important to note that just following the exercises in the book may not solve your issues. It
may take you either experimenting with different sequences or going and seeing someone familiar with
Egoscue exercises to diagnose you individually.

Below are pictures conducted before and after the exercises. The dots have been graphed and level
horizontal and vertical lines overlaid.  (clicking on images enlarges them)
I'm just going to start very simply with I am NOT a book reader. I read online articles, magazine articles, newspapers,
etc., but a full book? Nope, just not me.

My mom had given me a book about a year ago. It's called Pain Free from Pete Egoscue.
She said someone told her about it and she read it and started doing the exercises and
it made a huge difference.

Seeing how I had an injury that could be re-occurring if not rehabilitated correctly, I picked
up the book and started reading it.

As a non-book reader, I was instantly given hope when on the second page of the
introduction, it basically says, "If you aren't into reading the book straight through, then
just read the first 3 chapters then skip to the chapter regarding where you are having
pain and read it. Then read the other chapters when you get around to it". I'm
para-phrasing of course, but it made the thickness of the book seem manageable and
wanted to pass that on to other non-book readers.

I started reading the book and became quite intrigued. It made a lot of sense. I got into
it quite a bit and was reading a bit each day. I finally got to the exercises and they seemed simple enough. I started
doing them and noticed a change in the way I was walking and standing.

Although I was feeling better, it was the news of my neck HO in combination with my back injury that drove me to
consider going to see Pete Egoscue, knowing he had a clinic. I punched in Egoscue Clinic into the internet and found
the website I was amazed that they apparently had a number of clinics and entered in my zip. Not
only did I find there was an actual clinic in San Jose, but they operated a satellite clinic right here in Monterey! I made
the call and met up with Oscar Gonzales. He stated that the Pain-Free methodolgy has taken off so well, Pete Egoscue
only teaches the teachers and multiple clinics have opened up. Oscar reported there are many professionals who
have taken on the Pain-Free experience and his clientele include doctors and surgeons, other physical therapists, and
even some high profile stars.

The program is not cheap. It is called an "8 step program" and is about $1495 for 3 months. This cost includes 1
session per week for the first 4 weeks and then follow up sessions that range from once to twice per two weeks,
depending on an individual's response to treatment. There are forms to help get this filed with insurance, but it is a
50/50 chance of getting insurance to finance it. However, if you consider that once you conclude the 8 step program,
you will have everything you need to stay healthy the rest of your life, I suppose this is relatively a small price to pay.
The red grid represents before and green after the exercises. Anywhere you can't see black indicates my lines are
overlaying level lines. In the composite overlay, the black lines are white. You can see some key changes:

PINK ARROW - shows how my center moved closer to center position.
BLUE ARROW - shows how my hands came out slightly in response to my upper back being more upright.
WHITE ARROWS - show significant change in my stance and the green arrows are much more in line with vertical.
Some of the exercises I performed
PINK ARROW - shows my head becoming more upright and aligned, putting the curvature back into my lower cervical
spine (also alleviating some neck pain from the C7 nerve issue).
BLUE ARROW - shows my my hips staying in place, but rotating slightly forward, putting the curvature back into my
lumbar spine (also alleviating some pain in my hips, low back, and knees from my recent low back injury).
WHITE ARROWS - shows increased alignment of my legs, sending the knees forward slightly and I noticed my knees
were not locked backwards as tightly.
SPECIAL NOTE: Ame went with me on my visit to get another opinion and Oscar was kind enough to evaluate her and
have her do some exercises. Ame does step class every morning and also practices yoga almost daily. She did show
misalignment in her knees and hips and after she did some exercises (different than mine as her misalignment was
different), we were able to visibly see some changes in her stance and hips as well, although they were more minor
than mine.

I have been given my list of exercises to do and am planning on starting them this week. We will see how they go and I
will post my results.
4-5-12. We have gone in on a family plan with Oscar at Egoscue in Monterey. We have paid for 16 visits divided
among my mom, myself, and Ame. We all went in for our first sessions together. Oscar went through the exercises and
developed menus for each of us.

5-3-12. Ame and I have been practicing our menus. I have been doing mine between 5-7 times a week, a couple times
a week twice a day. It is best to do the exercises after any workout and walking for 15-30 minutes afterwards locks in
the menu's results. I am noticing huge posture and walking differences, Ame's results are more mild, but she practices
yoga regularly which I guess makes her less off-whack than I am.

6-1-12. We referred a friend to Oscar who has seen him a couple times now for back pain. She is reporting good
results. Ame and I are practicing regularly with a new menu. I am still seeing good results, but not as significant with the
newest menu. I am walking and moving good with improved posture, but my low back pain has not resolved any. Ame
is seeing more stabilization in her results rather than new results.

7-1-12. Ame and I received new menus from Oscar. Ame is not seeing any benefit from her menu and hasn't been
practicing much. My new menu is better than the previous after some tweaking by Oscar. I am practicing my menu still
5-7 times a week once a day. I have noticed some stabilization in my posture, but it is not as great as from my first
menu. I believe the Egoscue is working for my overall stance and posture, but it is still not relieving my low back pain.
This week I received a steroid injection for my low back at L5/S1. It has relieved a lot of the pain. I still have many visits
with Oscar left, but my early impression is the Egoscue is very effective for my overall health, but has not been able to
alleviate the original low back injury. It should also be noted that I have had 28 visits to physical therapy and 9 visits of
pool therapy as well as a series of prednisone, all of which has been unsuccessful in helping my low back. So the fact
that the Egoscue has not helped may not be as much an indicator of Egoscue techniques as it is more likely I have a
very stubborn injury.

8-10-12. Ame and I received have seen Oscar twice now and received new menus. I am still seeing body stabilization,
as well as it is helping loosen my back from my heavy workouts. Ame is not seeing so positive results. However, she is
intermittent in her practicing. I am not always getting to do a full regiment, however I am using individual items off the
menu during my stretches after working out. I get home and end up doing about 3/4 of the menu before I get tired from
my day. Overall, every time I do any of the exercises, I feel better.

9-28-12. I have been doing my full menu now pretty much daily. I returned to work and did some good workouts as well
as my full menu. I saw Oscar today and we took pics of how I was doing.
After finally getting approval for physical therapy two months post-injury, I attended 6 sessions at twice per week for
three weeks. The physical therapist I was seeing seemed average in their experience and had me doing standard tests
to help diagnose the injury. The exercises the therapist had me do seemed to increase my pain. After the first three
weeks were complete with seemingly no positive results, I aggressively petitioned to have the physical therapist
switched. I switched over to Kurt Burgchardt with Monterey Orthopedic and Spine Associates. He was the one who had
rehabbed my neck post-op. The first thing I found out is that some of the exercises I was doing at the previous PT,
were most likely exacerbating my injury! Kurt put me on a regime for core strengthening and stretching. After the first
day of doing them, I already started feeling better, but was very sore and achy that night!

Using the exercises Kurt had given me, I began an intense daily regiment that included between 2-5 hours every day. I
would start with stretches and light exercises in the morning, a walk if I had time, then a full workout using the more
aggressive exercises in the afternoon, finished with a walk in the evening. Some days the afternoon therapy included
ultrasound of the area, electric stimulation therapy, and aggressive massage. I would follow up with ice at home in the

PT at Kurt's reduced my symptoms significantly. I no longer had pain radiating down the legs. It was isolating to an
area in the low back around L5 and S1. But I still couldn't seem to get past the stiffness in the mornings, aches
throughout the day, and pain in the low back.

After a couple months at Kurt's, we switched to a new method to try and get me over the hump. I did 6 visits at the
Monterey Sports Center's pool therapy program. I was given core strengthening and stretching exercises in the warm
water pool. Like the PT, it was helpful, but still did not seem to get me past the final hump towards complete wellness.

Drug therapy included Ibuprofen, a round of Prednisone, and very occasional Naproxen in conjunction with the PT and
pool therapy. One thing that should be noted is the drug therapy with the physical rehab gave me some significant
nights of insomnia.

I could not tell what was working better, the drugs or the rehab. I'm sure it was a combination.

Near the end of my sessions with Kurt, he tried an
Iontophoresis patch. The patch was highly successful and shed
new light on the origin of the injury.
Iontophoresis patch defined:
 a technique used to deliver a medicine or other chemical through the skin. It is basically an injection without the
 needle by using a positively charged electrical current to push a negatively charged drug into the body.

On 6-29-12 I received the first of two injections. Injection #1 was a flouroscopic guided caudal left facet injection.
Injection #2 was one week later and a flouroscopic L S-1 block. Summarizing, it was an x-ray guided injection into the
vertabrae of steroidal/pain medication. The idea was to try and diagnose the location and issue. They used half the
dosage so it would wear off quickly and I could tell which shot worked. Even though they were half dose, they did a lot
more than diagnose. Both shots were effective and eliminated pain and tension for days. I then started working out
and realized I was suddenly on a solid road to recovery. They offered to repeat the shots at full dosage, but I refused
seeing how weeks had gone by and I was healing very rapidly. 4 weeks post-injection, I was using the stair-master at
level 4/10 for at least 20 minutes with a 50lb pack and 10lb ankle weights and having no issues!
Egoscue Pain Free
Injury Summary
Treatments and Recovery
The green grid represents the end of the visit on 1-19-12. The purple represents how I walked into Oscar's today.

PINK ARROWS - show the lifting and aligning of my hips and torso. The exercises seem to lengthen my upper body
allowing my hips to be straight and my chest to be more upright.
BLUE ARROW - shows my head and neck in vertical alignment. I have had less neck pain and fewer nerve pinches
from the straighter position.
WHITE ARROWS - shows my legs rotating outwards. A key point is notice the outward position of the feet. I do believe
that camera angle was not 100% and makes it look like my legs are off-center. However, you will see my torso is right
on center and the picture you can see the wall edge curves at the bottom, thus throwing off the lower alignment.
The green grid represents the end of the visit on 1-19-12. The purple represents how I walked into Oscar's today.

BLUE ARROW - shows my my hips staying now horizontally aligned front to back. The curvature in the lumbar has
lessened, but with the hips aligned, the curvature is more correct and you can see it translating down into the legs
where my knees don't naturally lock (
3-20-13: There are no updates on my HO. My condition is still good, with full function and seemingly no restrictions,
therefore I have not felt I needed to follow up on the HO. I will only post a future update if there is a change in my

3-18-2016: I continue to do excellent. Every once in awhile if I sit with poor posture too long at the computer or go too
hard on certain exercises in my workouts, I get a neck pinch. But I believe the pinch is coming from the C7 disc which
was not part of the surgery rather than the TDRs. I don't know this for sure, but if I give myself a break it goes away
completely. Sometimes it may require some advil or I will get a neck massage and it goes away. On a couple of rare
occasions I had an upper back adjustment by the Chiropractor and that helped. But the worst it gets is maybe a 2 or 3
out of 10 on the pain scale, lasts maybe a couple days, and occurs approximately 3 or 4 times per year. Again it is
highly dependent on how much I overdo an activity. I have not gotten any X-ray to see how the HO has been doing, but
I haven't seen an immediate need as I am doing so well with great range of motion. I may do one in the near future just
to check and see how it is doing, but I don't foresee the HO has significantly taken hold and I don't think it is impacting
my outcome. Overall, I am still WAYYYYY better off and happier with my decision of a TDR.
Injury Summary & Updates