When Severe Pain Moved In, Orthopedic Surgeon Made the Call to RSC
Stephen Gabriel, M.D., remembers the shoulder discomfort coming “out of the blue” on a Wednesday back in February 2016. The pain gravitated to his neck and then escalated. By day three, he recalls, he couldn’t lift his arm.
When you’re an orthopedic surgeon, this is an especially troubling development. “I could probably gut it out through the pain, “says Dr. Gabriel, a general orthopedic surgeon at KSB Hospital in Dixon. “However, the loss of motor function was the biggest issue.”
A call to his friend and professional colleague, Rockford Spine Center Surgeon Fred Sweet, M.D., was the first step. They began with an MRI and knew immediately that surgery was the solution.
“Dr. Gabriel’s deltoid function had deteriorated quickly and he was unable to lift his arm to put on a surgical mask,” recalls Dr. Sweet. “I recommended a C4-C5 anterior cervical discectomy and fusion (ACDF).”
This procedure removes a herniated or degenerative disc in the neck. Surgeons typically make an incision in the throat area to reach the front of the spine and make the repair.
“It might have gotten better without doing the surgery but it might not have,” says Dr. Gabriel. “We needed to do it. I woke up from the surgery and the pain was gone.”
Today, six months later, his strength has returned to nearly 95 percent, he says, and he continues to do physical therapy.
“The progress was very quick and each day was a bit better,” says. Dr. Gabriel. “It was very surprising how quickly I was able to get back to work. I paced myself and was right back into it.”
Dr. Gabriel has been a colleague of Dr. Sweet’s for many years and guesses he’s referred more than 300 patients to him during that time. That relationship brought him peace of mind when he was facing surgery.
“Dr. Sweet is a professional and I really trust him,” says Dr. Gabriel. “I was very confident when I called him and did not hesitate to follow his recommendations.”
While some patients are often reluctant to visit a surgeon, Dr. Sweet says surgery is often the last thing he’s considering when working with a patient.
“I try first to understand who they are, how their condition or disease affects them and what the best way is to help them,” he says. “I explain their options and sometimes surgery is one of them. Careful selection is the key to good results.”
Dr. Sweet completed the surgery on a Tuesday and Dr. Gabriel was back at work that Thursday, seeing patients, and doing surgery on Friday.
“I was back at it very quickly and it was very fortunate that I didn’t need a more significant procedure,” he says. “I was also lucky to have the motor deficit affect my shoulder and not my hand. I saw patients three days later and was back in the OR as a surgeon, not a patient.”
Joe Altenhoff was no stranger to the pain. And, he’ll tell you, he’d even become used to it.
Active and in good physical shape, he’d altered his lifestyle in an effort to cope with the nagging irritation in his back that had lasted more than a decade. However, for the owner and principal at Arc Design, an engineering firm in Rockford, there finally came a time when he reached his limit.
“I lived with the pain for a long time,” says Altenhoff. “But when the pain escalated and my leg started to go numb, that’s when I knew I had to do something.”
That something turned into a lot of things. He’d tried chiropractic treatments, anti-inflammatories, along with a number of other therapies and exercises. Nothing worked.
A visit to spine surgeon Christopher Sliva, M.D., at Rockford Spine Center, led to the imposing-sounding diagnosis of isthmic spondylolisthesis, more commonly understood as a slipped vertebrae.
“Joe’s symptoms had progressively worsened,” says Dr. Sliva. “He was dealing with buttock, thigh and calf pain with numbness and paraesthesia, or a ‘pins and needles’ sensation.”
More importantly, Dr. Sliva understood the impact the pain was having on Altenhoff’s life.
“The pain was really disabling to Joe,” Dr. Sliva says. “He had to modify his lifestyle quite substantially and he wanted something more definitive to be done about it.”
After exhausting a number of non-surgical options, it was clear that surgery was the solution. He and Dr. Sliva discussed the procedure and worked together to develop a plan.
“We empower our patients so they can choose their course of treatment and surgery is typically our last resort,” emphasizes Dr. Sliva. “We look at conservative treatment options and how pain is affecting a patient’s quality of life. Only about 10 percent of our patients end up needing surgery.”
Altenhoff is an engineer, a problem-solver by nature, and he was very involved in the process. He and Dr. Sliva looked at the scans and the models of the spine to understand what was wrong.
“I was thinking about alternative ways to fix it,” he recalls. “However, I knew it was complicated and that it wasn’t going to go away and would most likely get worse. I had a lot of confidence in Dr. Sliva going into the surgery and I knew it had to get done.”
Working with Dr. Sliva and his team, Altenhoff was diligent in preparing for the procedure, known as a transforaminal lumbar fusion. The procedure involves removing a disc from between two vertebrae and then fusing the vertebrae to together. For the patient, the results can be remarkable.
“I woke up and instantly knew it was better,” remembers Altenhoff. “I could feel it right away and it was amazing. That was a start of a phenomenal recovery.”
A day after the procedure, he was doing occupational and physical therapy to jump start the recovery. Today, six months after the surgery, Altenhoff has resumed his active lifestyle. He’s made a few modifications but “nothing too radical,” as he puts it.
And, of course, the pain is no more.
“Having pain for so long, you take it for granted,” he says. “I’m grateful for Dr. Sliva and his team and so happy that the nuisance of having that daily pain is gone.”