Neal Berko, 59, back to work — and working on his boat — after surgical treatment for herniated discs
Neal Berko of Newtown, Connecticut, has always led an active lifestyle. A former powerlifter and current boating enthusiast, Neal, age 59, enjoys going to the gym, working on his boat, and bowhunting. But when Neal sustained an injury that caused extreme pain and loss of function in his left leg that worsened over a few weeks, he started to worry that he might have to give up the hobbies he enjoys.
Neal, who is self-employed and designs, engineers, and sells piping, initially thought he injured a muscle while he was preparing for a field visit.
“I thought I had tweaked a muscle, but it got worse,” said Neal. “Within an hour, I was unable to walk correctly and had pain down my left leg.”
What Neal didn’t realize at the time was that he had herniated two discs. This condition affects the rubbery cushions (discs) that sit between the bones in the spine. A herniated disc occurs when the soft, jelly-like center of the disc leaks out through a tear in the disc’s tough exterior, sometimes causing irritation or damage to nearby nerves.
A herniated disc is a common injury that can cause pain, numbness, or weakness in the arm or leg. Some people don’t experience any symptoms. However, Neal had damaged the L4 and L5 discs in the lower part of his spine and this had caused a severe nerve injury.
Getting Worse, Not Better
The next day after the injury, Neal spent time on his boat getting it ready for the spring. But despite his efforts to ignore the pain, his leg was getting weaker by the hour. Just three days after the injury occurred, Neal had to hold onto the railing while going up and down the stairs at home. He started using a cane to help him walk. He couldn’t sleep or eat because of the pain and he started to lose weight.
“My leg strength was 2 out of 10,” said Neal. “It felt like my leg was melting away.”
At this point, Neal knew it was time to see a doctor. He scheduled an appointment with his primary care provider Robert Altbaum, MD at Western Connecticut Medical Group (WCMG) Internal Medicine Associates of Westport.
In most cases, a physical exam and medical history are sufficient enough to diagnose a herniated disc. Common early treatment includes over-the-counter pain medication and rest. If the pain does not resolve, the patient may require a cortisone injection to reduce swelling and inflammation. The patient may also require physical therapy to minimize the pain caused by the herniated disc.
Dr. Altbaum recommended this course of treatment for Neal. After a few weeks with no improvement, it was becoming clear that Neal might need surgical intervention.
“The pain was abysmal, and my left leg was starting to atrophy,” said Neal. “My leg was a blob. I had zero stability.”
Dr. Altbaum ordered a magnetic resonance imaging test (MRI), and referred Neal to Scott Sanderson, MD, a neurosurgeon at Neurological Associates of Southwestern Connecticut and Western Connecticut Health Network (WCHN). A small number of people with herniated discs require surgery. But when pain relievers, steroids, physical therapy, and rest don’t improve herniated disc symptoms, spine surgery is typically the next step.
“Dr. Altbaum suggested that I see Dr. Sanderson — and I always listen to Dr. Altbaum because he takes care of me and my family. So about three weeks after the injury occurred, I saw Dr. Sanderson,” said Neal.
Fixing the Problem
“When I first met with Dr. Sanderson, I came in with a cane and was in so much pain. I had zero reflexes in my knee and ankle, and I couldn’t hold up my leg,” said Neal. “I asked Dr. Sanderson to tell me the truth about what was going on with me, and he was gracious and patient.”
“When I met Neal, he could barely walk and was losing function in his leg day by day,” said Dr. Sanderson, who is an assistant clinical professor of neurosurgery at New York University Medical Center.
Dr. Sanderson reviewed Neal’s MRI results carefully and told him that he would need surgery to fix his herniated discs. He also told Neal that some of his nerves were crushed and had become permanently damaged, but assured him that he would adapt. Neal and Dr. Sanderson agreed that surgery was his best option under the circumstances.
“I put my faith in Dr. Sanderson,” said Neal.
Successful Spine Surgery
Dr. Sanderson performed a discectomy and spinous process clamp fusion to surgically treat Neal’s herniated discs. Dr. Sanderson first removed the herniated disc material that was pressing on the nerve roots and spinal cord. Then, through a minimally invasive technique, he fused clamps (hardware) to each side of the spine for spinal alignment and stability.
The first thing Neal noticed when he woke up after surgery was that his leg pain was gone. Neal said that the surgical team members — from the anesthesiologist to the surgical and recovery nurses — were pleasant and friendly. He said the best, most caring, and most helpful staff members he encountered were the nurses’ aides in the hospital.
Neal was discharged from Danbury Hospital two days after his surgery. Dr. Sanderson provided him a thorough discharge plan, which included for Neal to immediately start walking using a walker. Early mobility contributes to having a positive outcome after spine surgery.
The day after coming home from the hospital, Neal was able to work from his home office. Six weeks after, Dr. Sanderson said it was safe for Neal to go back to the gym and exercise his left leg in order to regain function. At first, Neal could only lift one five-pound plate with his leg. Over time, he regained most of the function and strength in his leg. Today, he can lift 45 pounds with his leg. Also over time, he gradually started walking longer distances in his house using his walker. He eventually started walking laps on a nearby track without his walker. He also gained back the weight he had lost prior to surgery.
“Sailing” into the Future
Neal understood that a full recovery would take 6 to 12 months. Now, 10 months later, he is back to the activities he loves including vigorous gym workouts. He credited his care team, his family’s support, and his own attitude for his outstanding outcome.
“You need to find the right surgeon to fix you and the right hospital to prepare you,” Neal said. “I feel fortunate that I got to Dr. Sanderson. I don’t think anyone else could fix me like he did.”
Neal’s mom, wife, and daughters helped him throughout his recovery.
“Of course without my family, things would have been much more difficult,” said Neal.
Neal said that pushing himself while still “following the rules” and a positive mindset were important to his recovery too.
This year, Neal is excited to get his boat back in the water. He really enjoys polishing and waxing his boat and crawling through the engine room.
“I was concerned that my life would change. But I have no pain and no restrictions. In fact, I’m more active than I was before the injury,” said Neal.