People have been asking about how Kirk's doing. Most of his friends know that he has been struggling with neck and back problems and the associate pain for most of a decade. Kirk is keeping this page updated as he seeks some relief from the medical community.

Kirk began to suffer from chronic neck and back pain, starting to limit activities and growing worse over the course of the next few years.

Kirk's neck after C6-C7 fusion

After 4 years of increasing pain, Kirk underwent surgery for a anterior fusion of C6-C7. It was hoped that this would resolve the majority of the pain. It helped a little, but left Kirk in a daily pain cycle that was difficult to manage. Continued physical therapy and careful scheduling of activities helped, but life was not in any way normal.

With pain increasing and limitations on activity becoming more strict, Kirk sought out additional conservative treatments for pain. He redoubled physical therapy and underwent a series of epidural injections.

With the failure of conservative treatments, Kirk began looking at the possibility of another surgical intervention to return to a normal life.

After seeing more doctors than he can count, Kirk has been diagnosed with DDD (Degenerative Disc Disease), the failure of discs to maintain the normal spacing between the vertebrae. Combined with a moderate level of spinal arthritis, this has put increasing pressure on the nerve roots leaving the spine, especially at C5-C6, the space between the C5 and C6 vertebrae. This is one level above the previous fusion.

The Prestige Cervical ADR

The resulting pain is hard to describe. In the mornings, after a hot shower, the pain starts out dull and not too bad. As the day progresses, the pain develops into sharper and sharper stabs and spreads through both shoulders and down the left arm. If Kirk seems a little distant at times, it is because it is hard to concentrate on normal activities while dealing with the ebb and flow of the waves of pain.

After much deliberation, Kirk has scheduled a surgery on January 11, at Stenum Hospital in Bremen, Germany. Doctors in the US have recommended the Artificial Disc Replacement (ADR) surgery, but are unable to perform the surgery due to FDA restrictions. So, Kirk is leaving January 7 to stay 2+ weeks with the best spine surgeons in the world, Dr. Hans-Georg Zechel and Dr Karsten Ritter-Lang. Check out the Stenum Hospital Web Site for more details on the hospital and the surgeries they provide.

A combination Fusion and (Double) ADR

Fusion has been successfully used to reduce pain caused by spinal disc degeneration. However, when a fusion is done at one spinal level (joint), the level above and below the fusion are forced to do more work to accomplish everyday movements. When you start with a degenerative spine, it is widely believed that fusion accelerates the damage to adjacent levels. ADR has been successfully used for 20 years (in Europe) as an alternative to fusion. Rather than joining two vertebrae into one (fusion), ADR restores the normal vertebral spacing (taking pressure off the pinched nerves), while retaining the normal range of motion.

With both fusion and ADR, the pain reduction is about the same. Usually, it does not result in a pain free existence, but it often helps a great deal. With fusion, people often require further surgeries every 4 to 6 years. With ADR, the degenerative process is slowed. It is possible that future surgeries can be avoided altogether. With fusion, activities are limited for 6 months to accommodate the healing process. With ADR, healing is accomplished in 8 weeks.

Kirk is a prime example of how the US medical system has failed Americans. The FDA, in it's attempt to protect us, is keeping us from proven treatments with better long term outlooks. Would Americans be better without the FDA? For increasing numbers of Americans, sadly, yes.

The Spinal Kinetics Cervical ADR

Kirk's family physician hooked him up with a Peoria neurosurgeon doing FDA clinical trials on Artificial Disc Replacments (ADRs). This doctor recommended the Spinal Kinetics artificial disc for Kirk. So, Kirk is working on now exploring what it will take to get this disc replacement or if it is worth the effort. This newer disc replacement actually has "axial compression". In easy terms, it does everything else that the other artificial discs do, and it also acts like a shock absorber, more exactly mimicing the function of a healthy cervical disc. As it turns out, with a previous fusion, some shock aborbing capability is already lost, so having a little more "give" could be even more important. At last, the US medical system is trying to help with more advice, even though they can't actually do the surgery here at this time.

After a flurry of phone calls, Kirk got the answer. When the American manufacturer of the Spinal Kinetics ADR found out that Americans were getting this implant, they pulled the plug. Now, the only way to get a Spinal Kinetics ADR is if you are not American. If it's not the FDA, it's the sad state of the American Tort system as it affects malpractice and related lawsuits. It seems like the whole system is geared against the ability of Americans to get top quality health care.

At this stage, Kirk can't wait longer to get the help he needs. Even though the newer ADR is considered better, the older one is simpler, theoretically less subject to long term wear, and way better than the fusion alternative. If we think of the Spinal Kinetics ADR as a 100% solution, a 95% solution (Prestige ADR) is still a lot better than a 10% solution (fusion).

After 32 consecutive sleepless hours, a 4 hour layover in Paris, and the normal perils of trans Atlantic flight, Kirk arrived in Bremen, Germany (pronounced something like Braymen). Checking into the hotel down the street from the hospital, Kirk set up his internet phone, so any friends can try calling at 815-313-1905. Bremen is a busy port town in the north of Germany. Americans may know it, since it is printed clearly on the front of every bottle of Beck's Beer.

The Stenum (pronounced something like Schtaynoom) Hospital is in the beatiful German countryside, about 15 minutes outside of Bremen. It is an orthopaedic hospital only performing elective orthopaedic procedures. This place is like no US hospital. People are actually calm, nice, professional, and always positive. If you stand out front, you can see, through the second floor windows, directly into the two state of the art operating theatres.

As you pass through the doors, you will find a nice reception area adjacent to the international department. The international staff make you feel welcome and understood. Malte, Ilka, and Sue all speak very clear English and are just great people. Sue is from near Grand Rapids, Michigan, so Americans definitely feel welcome.

Tuesday was spent with the normal medical tests prior to surgery. Things like blood tests, an EKG, and interviews with doctors and staff filled the day. The last meeting is with the head of surgery, Dr Zechel. His name is hard to pronounce for Americans, but it works out something like Tsek-shel. Of course, he can always just be called Dr Z, like the Daimler guy on TV. Dr. Z was busy with surgeries, so his meeting was rescheduled for the next morning.

One very nice result of the meetings is the news that the Prestige artificial disc has been updated. It is now press fit between the vertebrae and no longer requires any screws. Simpler is looking better all the time.

In between meetings, Kirk hung out with Steve (from Wisconsin) and Connie (from Michigan) and their spouses. By spending time with people having similar problems, the surgical process is advanced and common issues can be explored with people that really understand from a personal perspective.

Before breaking for the day, Malte, the head of the international department sat down and hung out with the group. Topics ranged from patient experiences, patient histories, hospital history, socialized medicine and the state of the US medical system. The conversation was very supporting and very friendly, as one should expect from Stenum.

In the evening the growing crowd of Americans (and the token Canadian) met for dinner at the local restaurant. As it turns out, socialized medicine doesn't guarantee quality care, just ask the Canadian. So far, one each from Illinois, Michigan, Wisconsin, Missouri, and Manitoba. Two more to meet brings the total to 7 North Americans for surgery this Thursday.

Sister Dawn & Dr. Heinz

Kirk met with Dr. Z. Everything is a go for a C5-6 artificial disc. Consideration was given to one at C7-T1, but the idea was rejected because the disc looked good on the MRI. As a bonus, it looks like the old hardware from the fusion will come out and make a nice souvenir.

Kirk's sister Dawn arrived from Florida. A nice lunch at the Backenköhler, a short walk to the hospital, and Dawn is ready to stay the week and keep checking up on Kirk.

Check-In time was 5PM. Yes, at Stenum, you are checked into the hospital nearly a full day before your surgery so everything can be fully monitored and you can be properly prepared for the surgery.

With Lumbar Disk Replacements, only a local anesthesia is used, an epidural pain block. So, all the others having surgery the next day got the equivalent of Ex-Lax. With a Cervical Disk Replacement, Kirk gets general anesthesia, so he dodged the bullet on this one. Still, night before surgery made sleep light at btest.

Kirk's Neck after C5-6 ADR Surgery

Patience. When you get the last surgery of the day, you end up waiting a while. Then the time comes. The most painful part was the insertion of the first IV (which really wasn't too bad, thanks to Dr. Geller). The surgery took about an hour and a half. Next thing Kirk knew, he was in the Wakening Room, just adjacent to the surgical theatres. This room has 8 beds, tons of instrumentation, and 2 nurses continually monitoring everyone. Unlike the US, the window is open for some fresh air. This may be why they can boast of a 0% infection rate. In the US, you might call this an ICU. This would be the place to spend the night.

Kirk was doing pretty well for about 45 minutes until he had an allergic reaction to the morphine. Recent neck surgery and vomiting are a great way to spend the night. When finally realizing the cause and effect relationship between the medication and the nausea, Kirk decided to stop pushing the button for the rest of the night. This turned out to be the best plan, and the pain was surprizingly manageable without the morphine, especially with the adreneline of the first day.

After getting off the morphine pump much earlier than normal, Kirk was walking around and generally annoying the Americans. One other guy got off the pump very early as well, but the other 5 were still layed up in bed. Hans supervised the early walking and mobility came back to a reasonable level.

Malte dropped by with all the old hardware from Kirk's neck. (Ask Kirk to show you the hardware sometime.) Going from 5 exposed pieces of metal to a single implant should help, in and of itself.

Eating Breakfast - 17 Hours After Surgery

Now its just a waiting game. Taking time to rest intermixed with normal daily tasks gives everything the oppurtunity to calm down. Pain is actually worse today as the mind caught up with the body's new configuration.

The girls all ended up at the Backenköhler for the Cabbage Festiival. Apparently, this happens every Saturday night for 2 or 3 months in the winter when hundreds (maybe thousands) of drunken German folk converge on this small country town in the name of cabbage. All day long, busloads of people arrived, many on foot pulling wagons of beer behind them. Horse drawn beer trucks completed the authentic German atmosphere, while all the patients watched from a safe distance, locked up in the hospital.

Another boring day in the neighborhood. Early excitement included Kirk's incision site opening up and starting to bleed out. When this began, a doctor was immediately called in and the incision was reclosed. They seem to be using fewer stitches to minimize scarring. So far, the scar is looking pretty cool.

Kirk was able to increase his daily sleep schedule from 2 hours up to 5 hours. Of course, this didn't prevent him from attending the hallway party at 4AM. There's nothing more pathetic than all the patients hanging out in the hallway in the middle of the night while nobody can sleep.

Hans with the Hands

A nice massage from Hans started the day out right. To the patients, he is known as "Hans with the hands". He is a totally cool massage therapist and a fun guy. The phsycial therapist came later and really was great. A little stretching and strengthening and recovery is doing well.

All the Americans got X-rayed today, and everything looked great. It's nice to hear the words "perfect placement" from the head surgeon.

Doctor Zechel and Malte dropped in to say goodbye. They are on there way to Saudi Arabia for a week of consultations and surgeries. Stenum hospital first began their international department to fill the need for Middle Eastern patients. It has been more recent that their services have been extended to North Americans.

The good news came early from Dr. Heinz, with the question: "Do you want to go to the hotel tomorrow?".

An Exit Sign on the Autobahn (Hotel Bound)

Kirk is finally out of the hospital! 5 Americans hopped in a bus and took a 30 minute drive to the Park Hotel. When Kirk is in his hotel room, he can be reached at 815-313-1905 (local Illinois number). Everyone spends a week in the hotel, adjusting to normal life, normal beds, normal foods, to insure that there is no need for any followup.

One guy ran into some minor complications and couldn't go to the hotel. His lower back surgery had caused him some abdominal pain, so within minutes, all the doctors were checking him out and giving him further tests. He is in very good hands. Latest word is that he had a small blood clot by the incision, and he's getting fixed up.

View from the Park Hotel (after Kyrill)

Since this was a quiet day, Kirk decided to go shopping for replacement luggage (thanks to Air France baggage handlers). Unbeknowst to all, a freak weather system was closing in with peak gusts measured at 118 mph in central Germany. Due to some technical detail, this storm wasn't classified as a hurricane, but the German weather service was calling it "Hurricane Kyrill". Despite the weather, all went well, and everyone made it back safe to the hotel in time for their appointments with Hans, the massage therapist.

The side story was pretty crazy. Since the hotel laundry service was going to cost maybe €50 to €100, Dawn practiced her German on the taxi driver, asking to go to a laundromat. It seemed a bit unclear to him, but he pressed on through the city streets. Noone was surprised when the destination turned out to be a store selling washing machines.

Boring.. but feeling better every day. Thanks to Peter, Sriraj, Jim, Keith, Scott, & Kevin for calling.

This time, laundry was more successful. Dawn went out and found one of the few laundromats in the city, while Kirk rested at the hotel.

A small group ate at an Italian restaurant. The menu was bilingual - German & Italian. At least German is kind of like English and Italian is kind of like Español. Somehow, it all worked out.

Bremen City Centrum

More Bremen Sights

Little Red Riding Hood

A quiet day, including a short walking trip to the City for the open air market and a Bratwurst.

The last American was released from the hospital today. It turns out that he had a small blood clot, and they were keeping him under close observation until that was resolved.

The group took him out for dinner where a very strange event took place. A group of marauding women went from restaurant to restaurant, with the ringleader dressed as Little Red Riding Hood and selling small beverages. It turns out this was a German bachelorette party.

7 Surgeries - 12 Artificial Discs

Sue and Hans organized a dinner for the group of 7 patients here together, at a nice Italian restaurant. This may be the last oppurtunity to see everyone before people start getting authorized to travel home over the next several days.

Today, a group of 6 managed to navigate the EuroRail system to go to Oldenburg, about a 40 minute ride on a very nice train. It's too bad the US is so spread out. Travel by rail is quite reasonable. For some reason, Oldenburg escaped most of the bombing during "The War", as they call it. The Medieval charm meshes well with the modern shopping in the city center devoid of autos, but full of people.

Kirk's neck is doing pretty well, getting slowly better each day. The train ride wasn't as much of a problem as it might have been a few weeks prior, and the walking wasn't bad either. Each day is different, but it seems like there is some hope that the surgery had a significant positive effect.

Oldenburg Sights

The Park Hotel at Sunset

The first two Americans left today. Another got cleared for leaving tomorrow, and one has to stay on a few more days for some leg pain.

Sister Dawn flew home to Florida. Kirk is very thankful that she had the time to go all the way to Germany to help him out. Dawn missed her flight in Munich. She is getting the grand tour of JFK, La Guardia, and Miami airports to get home.

Dr. Z and Malte returned from Saudi Arabia for the meetings with the patients. Kirk noticed that, on the X-Ray, the ADR looked a little different than the Prestige disc. After looking more closely at the reports, Kirk discovered that he had been one of the first Americans to receive the Spinal Kinetics disc. Kirk was simply overjoyed. He got the newest best ADR, and it looked very good on the X-Rays.

The meeting with Drs. Heinz and Zechel went well. Kirk was released to travel home. Dr. Z was leaving for India to do 30 or so surgeries for kids that wouldn't otherwise be able to afford them.

Dr. Hans-Georg Zechel & Kirk		Licht, Liebe, Leben - Light, Love, Life

The flight home went well. The short layover in Paris was quite dramatic, but successful.

Kirk is back in the store, doing office work. Johan stopped by and is going to help Kirk with a collar he can use when he is able to jump. This was suggested by Dr. Heinz and will be designed to limit overextension of Kirk's neck during a strange opening. It's still more than 2 months before Kirk is cleared for normal activities, so time will tell.

Two months have passed and the continual improvement has been quite dramatic. It's hard to assign a number, but around 50% of the pain has vanished. Before surgery, it was a struggle to make it to mid day. Now, late in the day, stiffness and pain still creep in, much later, and much less than before surgery. Before surgery, medications could not significantly help the pain. Now, in the evenings when some moderate pain sets in, medication can usually alleviate it, to a reasonable degree.

What a difference! Life has returned to a manageable state. Several people have commented that Kirk looks somehow different, somehow alive again. Kirk continues to recomend ADR as a far superior alternative to fusion. Kirk thanks the fine people at Stenum Hospital for giving him back a life.

Johan stopped by today to measure Kirk for a support collar. Johan is an incredible guy who builds artificial limbs and support devices for all sorts of people. He is also a budding skydiver who is destined to be a very talented member of the skydiving community. Within the next month or so, Kirk will have the technology to prevent overextension of his neck, even in a violent parachute malfunction. Chances are, Kirk will never need to rely on the collar for help, but if he does, he will be forever grateful to Johan.

Today, the owner of Skydive Chicago stopped by to visit Kirk. He had to go out of town on business and he didn't have a pilot for the the fast approaching weekend. Kirk had flown extensively for Skydive Chicago over the past 5 years, but in recent times, he had been physically unable to fly for more than an hour or two, perhaps 4 or 5 loads, due to the extreme pain. Despite painful memories of last year, Kirk agreed to fly for the weekend.

Saturday arrived with a hundred of people wanting to jump. Kirk hopped in the DeHavilland Twin Otter at 8AM and managed to fly 30 loads to 13,000 feet, allowing more than 600 jumps to be made. After the last landing, Kirk watched the beautiful sunset, very sore and stiff, but knowing that he was able to do something that was simply unthinkable, just a few short months ago. Kirk will never be 20 years old again, but this day proved that pain had returned to a more manageable level.

Life is now more possible, thanks again to the fine people at Stenum.

Kirk is back doing more things including household tasks. Today's job was changing the tire on the lawnmower. After being fairly inactive for a while, Kirk overdid it a little bit and seems to have injured his lower back. At this point, the lower back pain is worse than the remaining neck pain. This has just motivated Kirk to work on getting in better shape and increasing the level of activity, being a little more careful doing heavier or awkward lifting.

After procastinating for some time, Kirk decided to start a diet. Weight can have a big effect on back strain, and this is a factor that can be controlled (with more effort for some than others). The Nutrisystem diet has been good in that you get to eat enough to not be hungry.

Kirk after his first jump in 11 months

Kirk got part of the day off from work and took time to assemble his new parachute container. This container contains some new technology that makes it very soft and padded around the shoulders. In addition, some of the flaps have been updated to make the opening sequence more consistent. This makes the openings softer and more directionally stable (on heading). Packing the parachute was a bit painful. It was nice to finish the job and take a rest. Now, with a parachute ready to jump, there was no longer any excuse to stay on the ground.

10 Jun 2007

With light steady winds, Kirk climbed aboard the airplane for a jump. At 5,000 feet, Kirk put on his neck brace, just to help if things got wierd on opening. The jump was very uneventful. The new container was noticeably more comfortable and the opening was feather soft. After an 11 month layoff, the timing on landing was less than perfect, and Kirk was a little upset that he tripped and fell on his butt, but that really didn't matter in the end. Back in the air, it felt good...

Good news on the diet. Amazingly, Kirk lost his first 10 pounds. Too bad there's quite a few pounds left to go.

Kirk has been quiet for quite some time, but he hasn't stopped the healing and learning process. With the help of Nutrisystem, Kirk has now lost 35 pounds (15+ Kilos). With a little more effort, he hopes to lose another 10 or 20 pounds (maybe 10 more Kilos). This has helped the ease of day to day activities. People with back problems should really take care of how much weight they carry from day to day. Weight loss should not be discounted as an important element of health and healing.

The summer season has kept Kirk quite busy and tired, and limited the amount of effort he could expend on seeking further solutions to back issues. The ability to be upright 8, 10, even 12 hours without excrusciating pain kept him going from day to day. This has been in stark contrast to the 2, 3, or maybe 4 hours of functionality per day before the surgery.

Despite all this, Kirk has managed to make a dozen jumps, more or less, including 2 jumps from a DC-9 Jet. It's nice to be "back in the air" in a significant way.

So now, Kirk had some spare time and effort to expend the effort to take it to the next level (for him). Everything comes in small steps and stages, and Kirk was ready to move forward.

Kirk went to visit Jonathon Bender, a physical therapist. His office is 45 miles away, but Dr. Laich recommended him, and distance has never been a big obstacle for Kirk. Quality of care is much more imporant. Kirk is no stranger to physical therapists. Kirk has known many physical therapists over the last 10 years. This guy seemed different.

Jonathon said things like - We are going to go slow, and identify things that are helping you, hurting you, or aggravating your issues. Each time, we will learn something, and use the knowledge to improve your treatment. How refreshing! This guy understands the complexities of back problems, and the aftermath of surgeries. He is using a very scientific method, to identify strategies that can improve the "quality of life". He is not a surgeon, so he can't identify issues that can be resolved with surgery. That's just fine. The surgeons have already done that. This guy can help resolve muscular issues and things that the surgeons can't do.

Jonathon identified quite a list of issues, including some confusing and conflicting indications of what is going on with Kirk. In the end, he focused on muscular tightness in the thorasic spine area, and gave Kirk posture exercises to try to stretch out muscles that are clearly way too tight.

At last, someone is listening and trying to address specific issues in a very methodical way. So far, this guy is really cool.

Kirk has learned a lot from physical therapy. Despite treatment by several therapists over a 10 year span, Kirk has learned a number of very helpful things. Aside from the specific exercises to strengthen certain muscle groups, it seems that the most valuable lesson is relearning how to do basic moves. That is, when simply reaching to pick something up, you have a number of choices on which muscle groups to use. Kirk did not realize that years of pain had trained him to "guard" his spine by using muscles, that, at times aggravated the pain. With proper instruction, and building on the confidence of success, Jonathon was able to retrain Kirk in a number of basic motions. This sort of retraining is very important and should be a part of any rehabilitation process. Kirk is happy that he finally was able to get good advice on these issues.

After a lot of soul searching, Kirk and Jonathon decided to take a break from physical therapy. Gains had been significant, but, for some time, simply stagnant. At this time, the chance of further gains were less attractive than the pain from doing the work.

After taking some time off, Kirk has recently restarted therapy at home. While some activities still aggravate pain, Kirk has been relatively active and has essentially maintained the gains from the last year's effort.

Weight loss is staying stable at a little over 40 pounds. This helps a lot.

Work has kept Kirk quite busy, but he has managed to do some light construction projects, expanding his parachute service facility. With the weather warming up, Kirk is planning to do some jumps, as time permits. This may take a little warming up, but it is now quite reasonable to consider. It is hard to even remember that, before surgery, the pain made these activities, simply, unthinkable.