3

I awoke to Dr. Clavel's unmistakably powerful voice resonating at my bedside. "Joshua. How are you feeling?" I complimented him on a job well done and vice versa, and then he said the magic words. Time to pack my things and hit the streets of Barcelona. Either the nurses were sick of seeing my bare feet up and down the halls, or he could tell that I couldn't wait to test out my mechanical spine. In any case, I jumped at the chance to venture back out into the world. Actually, I gave a single fist pump and a grin...but I thought very seriously about jumping with joy. His team of merry maidens went right to work getting me cleared for takeoff. The little check valve was pulled out of my arm, I got a fresh waterproof bandage on my scalpel wound, and I had my first shower since the operation. Two full days is just about the longest that this Pisces can go without a good soak. Brut claims effectiveness for up to 24 hours, and I found out that a reapplication does not buy you any extra time. My beautiful bride collected our effects and we boarded the waiting taxi to descend the mountain and return to the heart of the city for the duration of our stay in Spain. My dad was in the UK on a business trip so he flew over for an evening visit. He was expecting to see me weak and weary in a hospital bed and gown, so I was happy to meet him at the hotel in Josh clothes. Not long after he arrived, a physical therapist showed up with her motorcycle helmet in hand. I love this town. I was feeling loose and limber after being contorted by the two-wheeling body mechanic, so Sarah and I took my Dad down to the sea for some tapas and paella at an outdoor cafe by the beach. We've eaten at a different place every time we've gone out and have yet to find something that wasn't delicious. Frankie would love it here...pizza on every menu. Sarah has been trying them all out for you bud. By the end of the day, I was feeling pretty sore but happy as a clam. One day at a time. No more, no less. Hasta mañana!

Dr. Clavel's masterpiece.

Day 2

Buenos dias amigos! My first full day with my new disc has been better than I could have hoped for. First I have to finish up some details from yesterday. I was wheeled down to a basement floor and passed through a window onto another stretcher. I chatted with Dr. Clavel and his anesthetist for a bit before it was time to go under. Next thing I know, I was waking up in an ice cold recovery room, with a bedside heater blowing warm air under my blankets via a hose similar to that of a vacuum cleaner. That hot air was my favorite thing in the whole world for whatever length of time I was in that room. Memory is a little hazy on that part. The pain wasn't nearly as bad as I had expected, especially considering all the warnings the staff had given me. After about an hour or so back in our private room(which is more like a mini apartment than a hospital room), a nurse came in to change the pain meds on the IV, but the first bag was still full. At some point during bed transfers, the IV hose got kinked underneath the bandage where it enters my forearm. No worries at all, I was very relieved to know that the pain was tolerable without morphine. They must be used to a lot of whiny Americans here, hence all the talk about surgery pain. The incision in my belly is sore and my spine is pretty tender from the disc install, but it's just a big ol piece of birthday cake compared to that stabbing pain I was used to. I guess I didn't realize how bad it had gotten. When I first met with Dr. Clavel earlier in the week, he asked if I was on any medications. I explained that my doctor at home had had me on just about every pain killer under the sun at one time or another over the course of about 2 years, through what was basically a trial and error process to see what worked for me, and that I had gotten sick of all the nasty side effects and weaned myself off all the prescriptions a few months prior to coming to Spain. This was when I finally had a chance to get to know my pain up close and personal. I learned what made it worse and what made it better, instead of trying to cover it up. I simply did more of the things that made it better and less of the things that made it worse. Even all of the twitches and spasms all up and down my entire back seemed to serve a purpose. If I paid attention to the spasms, they seemed to know more about what they were doing than I did, so I let them move my body however they wanted to, rather than resisting them to the point that they would turn into painful knots in my muscles. I watched a grin form on Dr. Clavel's face as he then explained that he had the same philosophy about pain meds and that he tries to implement it as hospital policy whenever possible. This is definitely the right doc for me. Muy inteligente. For my first meal after surgery they brought me a creamy zucchini soup which was much tastier than it sounds, a fruit cup, and a bottle of water. I slept off and on through the night as the nurses came in periodically to check on me and change IV bags. Sarah has been a real trooper and seems to be pretty comfortable in her transformer sofa/bed. She also has the best hair in all the land. The entire staff here is absolutely wonderful. There is a very helpful translator on hand to assist with the language barrier but for the most part I can talk to everyone with the little bit of Spanish that I remember from high school and hand signals, plus each nurse knows about as much English as I know Spanish. Un poco Ingles y un poco Espanol. Bueno. Before we checked in to the hospital, we had a couple days to tour Barcelona...what a magnificent city. Full of history, culture, art, romance, adventure, and delicious eats.  It's been a lot of fun talking to people from all over the world, especially when we each speak a different native language and we all communicate via the same broken Spanish as common ground. For breakfast today they brought in a cup of steaming hot milk, a packet of instant espresso, a packet of sugar, and two little packs of dry cookie wafers. I couldn't decide which part of that I was hungry for so I just dumped everything in the milk and made some coffee flavored sugary hot cookie soup. Delicioso. Sorry for jumping all around different stories and times, I'm just typing whatever comes to mind. It's now Thursday night and I'm still having a good day. A physiotherapist came in this afternoon and showed me some very helpful and simple exercises to keep the body strong while I'm in bed. I was also cleared to get out of bed and walk. The moment of truth. There was a little bit of extra pain when I stood up, mostly at the incision, but there are no words to describe how incredible it felt to go vertical onto a sturdy spine again. When I had the weak old ruptured disc, I relied solely on my core muscles to hold my torso up to keep weight off of the painful joint in my spine. This resulted in a great set of abs, but made it difficult to be upright for any length of time. I can already tell that I'll be on much better terms with gravity once again. I ventured out of the room and took my IV bag for a walk. A nurse pointed at my bare feet, shook her head and index finger and said "No...no, no, no." I held out my hands and wiggled my fingers to represent toes, meaning that I was much more stable and confident without shoes. Another nurse smiled genuinely and said "muy bien" and took her co-worker by the arm. After wandering around the halls a bit, I was wheeled down to the x-ray lab to get some pictures of my new parts. I just had a visit from Dr. Clavel, and he showed me the images. He was beyond pleased with the progress I'm making and his placement of the disc between my vertebrae. Picture perfect. He joked that if he didn't have to explain it to his wife, he would have my x-ray framed so he could hang it up at home as his masterpiece. Day 2 has been great, but I'm itching to bust out of this hospital.

Here is a link to the little video I shot of the sample M6 disc yesterday so you can see it in action:

http://www.youtube.com/watch?v=S1UUGDpKuwA 

Now seems like a good time to provide some background details for anyone out there who doesn't know my story. I'm a motorcycle mechanic/tinkerer/thinker/mountain biker/surfer/swimmer/stand up paddleboarder/hiker/tree climber/adventurer/snowboarder/longboarder/runner/wakeboarder/all-around fun loving dude from York, Pennsylvania. I've always been passionate about enjoying life, but I never truly saw the significance of this passion until it was taken from me. On the morning of September 10, 2010, I was road testing a Harley Davidson that I had just repaired at the shop where I work. It was a warm, sunny, clear morning. The kind of morning where you can just imagine birds chirping and that perfect shade of bright blue in the sky. I approached a red signal light at an intersection on one of my usual test routes. As I was clicking down through the gears, the light went green and I rolled back onto the throttle. As I grabbed second gear and rolled through the intersection, the driver of a Ford Thunderbird coming the opposite direction made a hasty decision to jump across my lane and beat the oncoming traffic. It would've worked out great...that V8 had plenty of punch to move the little car in a hurry, but somehow she failed to see me at the front of the pack. I was launched into the air with the full force of all 8 of those pumping pistons. T-boned by a T-bird. I vividly remember hearing a loud crunch, and then silence as I realized I was airborne. Time warped to a crawl as I flew through the air, touched down on tarmac, and slid down the road in my greasy jeans behind the sparks flying off the motorcycle. Poor bike, I thought. I found myself laying in the gravel on the side of the road. I tapped the asphalt the way motorcycle racers do to be sure they've stopped sliding before attempting to stand up. I looked around and saw that the cars behind me had stopped in their tracks and a few kind souls were running over to help me. One man in particular was a volunteer fire fighter who carefully helped me to my feet and sat me down in his truck as he radioed for assistance. Someone had tracked down the girl who blindsided me and was trying to calm her down. She kept saying "I didn't even see him!" As the adrenaline wore off and medics arrived, I noticed a very strange burning pain in my left foot and leg. I had never been hit by a car before so I assumed it was a normal thing to feel. I was loaded into an ambulance and taken to the hospital. They found bruising and contusions all over my leg so we attributed the strange pain to the leg impact. My helmet was scuffed but not broken and my brain didn't seem to be too rattled. I refused the pain meds they wanted me to take and, being the optimist that I am, I left the hospital with crutches and a smile. When I got back to the shop, I modified the gear shifter on my own motorcycle so that I could change gears by pushing down on my leg with my hand, instead of pulling up with my toes as that seemed to aggravate the burning pain. Luckily I had installed an old sidecar on my motorbike so I could haul mountain bikes and surfboards, this meant that I didn't need to hold the motorcycle up with my throbbing leg...so I rode home in my white socks. And so began a seemingly endless affair with doctors, chiropractors, lawyers, insurance adjusters, judges, surgeons, physical therapists, pain management specialists, etc. I did the chiropractic adjustments, the epidural injections, the intense physical therapy workouts, the anti inflammatory drugs, the pain killing drugs, the nerve pain drugs, a back brace, an inversion table, even a microdiscetomy/hemilaminectomy/foraminotomy surgery. Nothing offered lasting relief from the stabbing pain in my low back and the burning pain and electric feeling in my left leg. The MRI reports said that my L5/S1 disc had ruptured and become dessicated(dried out). I started drinking a gallon of water every day to try to rehydrate the disc. I stopped drinking beer and started juicing fruits and veggies and eating healthy natural food because my body felt a little bit less like a living hell when it was running on good clean fuel. These healthy changes caused the extra pounds I had been carrying around to drop off rapidly, and the weight stayed off. This was when I noticed that the less weight I had riding around on my painful spine, the better I felt. So I committed to staying trim and healthy, in spite of my inability to get out and do all the things I love to do outside. I started seeing a precise correlation between wet cold weather and my most painful days. I knew this had to do with the barometric pressure, and not the dampness itself as most people believe, because I remembered learning that the reason the leaves on trees get all light and floaty before a storm is because a low pressure system is moving in and the pressure in the veins of the leaves is temporarily higher than the atmospheric pressure. What's true for leaves is also true for you and me. On a nice sunny day with high pressure, our internal pressure feels lower...so we are relaxed and loose and happy. When a low pressure system moves in, if there is any sort of inflammation or pinched nerves in the body it flares up and hurts more. If extremely low pressure feels bad...then extremely high pressure should feel good, right? So I pulled on my wetsuit and jumped into my parents in law's pond in the middle of winter and dove as deep as I could go. I found peace at the bottom of that frigid murky water with the bluegills and old tires. Some people think I'm a little nuts for doing the things I've done in my quest for pain relief, but I'm of the opinion that I'd be nuts if I didn't change the things that I have the power to control. You learn a lot about the human body, the mind, and the health care system when you go through an ordeal such as mine. The most important thing to know is that no one on this planet cares as much about your wellbeing as you yourself. If you don't get out there and find your own answers, they will never come. No one will do it for you. There is a long line of people out there just waiting to make money off of your suffering or gullibility, and you must be very careful where you place your trust. That brings us to where I am now. Laying in a hospital bed in Barcelona with a shiny new state of the art spine prothesis implanted in my back by one of the best neurosurgeons in the world. So now you know a little bit about the past, and a little bit about the now...stay tuned to see how the future unfolds. That reminds me, here is one of my all time favorite poems, Desiderata. That which is to be desired.

Go placidly amid the noise and haste, and remember what peace there may be in silence. As far as possible without surrender be on good terms with all persons. Speak your truth quietly and clearly; and listen to others, even the dull and ignorant; they too have their story. Avoid loud and aggressive persons, they are vexations to the spirit. If you compare yourself with others, you may become vain and bitter; for always there will be greater and lesser persons than yourself. Enjoy your achievements as well as your plans. Keep interested in your career, however humble; it is a real possession in the changing fortunes of time. Exercise caution in your business affairs; for the world is full of trickery. But let this not blind you to what virtue there is; many persons strive for high ideals; and everywhere life is full of heroism. Be yourself. Especially, do not feign affection. Neither be cynical about love; for in the face of all aridity and disenchantment it is as perennial as the grass. Take kindly the counsel of the years, gracefully surrendering the things of youth. Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with imaginings. Many fears are born of fatigue and loneliness. Beyond a wholesome discipline, be gentle with yourself. You are a child of the universe, no less than the trees and the stars; you have a right to be here. And whether or not it is clear to you, no doubt the universe is unfolding as it should. Therefore be at peace with God, whatever you conceive Him to be, and whatever your labors and aspirations, in the noisy confusion of life keep peace with your soul. With all its sham, drudgery and broken dreams, it is still a beautiful world. Be cheerful. Strive to be happy.

Surgery Day

Hello all. I expected to be able to send iMessages using wifi but we are having some technical difficulties with the iphone. So I'll try this instead. Hopefully this reaches everyone who wanted to know how the operation goes. If you know anyone else who knows me and would like to hear more about this experience, please share this with them. Thanks! The boring details are for anyone searching the internet to learn more about artificial intervertebral disc replacement surgery, in particular the M6 disc. As this is a relatively new procedure, there is a limited amount of information available to people who are at their wits end with chronic severe back pain and/or nerve impingement resulting from damage to discs, the squishy things that occupy the space between the vertebrae of the spine.

I will provide my background story in a later posting. For now, here's the important stuff. I am laying in a bed in my room at a hospital in Barcelona, Spain. Any minute now, nurses will come and take me to an operating room where Dr. Pablo Clavel, a world renowned neurosurgeon, will make an incision near my belly button to access my spine and remove what remains of my ruptured, dessicated, black L5/S1 disc. The space between the vertebrae will then be spread open to its original height and the beautiful shiny new artificial disc will be hammered into place. Earlier today, I got to play with a working model of an M6 installed between two transparent vertebrae. What an impressive little device. I'll try to post a video later. The clear vertebrae allows you to see how the spiked keels on the top and bottom endplates will bite into the bone to secure it in place. I imagine this will be the source of the post surgical pain that the staff keeps telling me about. They said the worst of it should be gone in 24 hours. I'm no stranger to pain, so I'm not too concerned about that part. Smooth seas do not make skillful sailors. Severe pain helps me achieve a very calming meditative state, which in turn helps me "turn off" the pain from within, and sometimes it even takes me to an entirely opposite place altogether. But that's a story for another day. I know a lot of people at home are worried about me, but please know that today is a very good day and there is nothing to fear. The past two and a half years have been challenging for me. I have been called a quiet fighter and a bit of a hermit during tough times...meaning that only one other person has had to witness how bad this has been, and she is laying on a sofa bed right by my side. Everybody seems to compare me to someone they know who has back trouble, but I must say that there is something very different about a disc that has slowly degenerated over time due to age, and one that was still big and cushy that was suddenly burst upon a violent impact. Much more material to smash into the surrounding nerves. Today is the day that I will be liberated from this burden. So don't worry, be happy. If there's anything you can learn from me it's that we all have the potential ability to confront any challenge and conquer it with a big grin. Put faith in yourself and the people around you, and there is nothing you can't do. A strong person doesn't put people down, he lifts them up. If you're going through tough times in your own life, just take a step back and look at the big picture. Look as far into the future as you must to be able to see the part of your life where the problem no longer exists, and steer your ship in that direction. Identify the root cause of the problem and repair or eliminate it. Simply treating or masking the symptoms of an issue in any aspect of life is ultimately a waste of time. Time is a gift that should not be wasted. We have the ability to exist not just in one single moment as an object in history, but as the captain of a miraculous ship that is steadily accelerating into the future. You get to decide where it's going. As long as you don't make too many waves that send other ships off course, you can take that ship anywhere you please. When you realize this, you can achieve total freedom. A free mind, a strong healthy body, and an adventurous spirit are the tools of the trade. Remove the ego from any situation and you can see all problems for what they truly are: opportunities for positive change. Once I wake up as a new mechanical man, I will work on getting the news out to everyone who wanted to be updated. I'll apologize now in case I miss anyone. Thank you all for all of the faith, support, and love. I love, support, and have faith in each and every one of you. "knock-knock, hola!" My chariot awaits.