ACDF is not a four-letter word

ACDF is not a four-letter word

On Monday, September 18th, I will have anterior cervical discectomy and fusion (ACDF) surgery (https://en.wikipedia.org/wiki/Anterior_cervical_discectomy_and_fusion) to repair degenerative disc disease at three vertebral levels, C4 through C7. This was not a frivolous decision. I consulted with three well-respected surgeons in my area – two orthopedic surgeons and one neurosurgeon – who concurred that the muscle weakness and atrophy resulting from the injury could be permanent and the progression can only ceased by performing the surgery. It has been determined that alternative treatments such as physical therapy and injection will not be able to stop the progression of the muscle weakness and atrophy. Fortunately, I have not experienced much pain as a result of the degenerative disc disease. In many ways, having little pain makes the decision to pursue surgery more difficult because right now my quality of life is not affected much. However, I am an active person and want to have no restrictions on my physical activity. I also know that my recovery from surgery will only get harder as I get older. Life provides no guarantees, so I have decided to proceed with the surgery.

I have told many people about my decision to have the surgery and their initial reaction is one of fear, concern, and pity. The thought of having elective major surgery is difficult for most people to comprehend. In the past, it was hard for me to wrap my head around it, as well. About 10 years ago, I was diagnosed with a partially torn right rotator cuff. I was scheduled to have surgery to repair the injury, but ultimately called it off out of fear. I reasoned that it wouldn’t make sense to volunteer to have surgery for something that might be corrected through another means of treatment. Ultimately, the pain and inflammation subsided and I went on with my life. However, my throwing shoulder has never been the same. It still hurts when I throw a baseball. I often regret that I did not bite the bullet and have the injury repaired at the time.

Now, I am in a much different place in my life and the circumstances surrounding this injury are admittedly a bit different. I have a much better grasp on my emotions. My decision-making skills have improved significantly with a great deal of guidance and practice. For instance, I only consulted one surgeon when I was diagnosed with the rotator cuff injury. I impulsively agreed with the doctor’s assessment and scheduled the surgery without seeking a second opinion. Then, I canceled the surgery without speaking to the recommending surgeon again and slinked away from the whole process. Not only have I secured three separate opinions for my neck injury, but I also consulted with my neurologist, my physical therapist, and close friends to secure information from many different perspectives. I have been able to assess the information in an objective way. My decision to pursue surgery was well-reasoned and was made from a position of confidence and strength. ACDF surgery has an extremely high success rate, I was told. Recovery from ACDF surgery is pretty reasonable and future repair is almost never required, I was told. I would be able to resume unrestricted physical activities after about a year, I was told. All of this made sense to me when I decided to proceed with the surgery. I believe my decision is aligned with my priorities and values. I feel really good about my choice to have the surgery.

It might sound weird and even naive, but I am a little bit excited to have the surgery. I am eager to know if my decision is the right one. I want to see if I’m up for the challenges associated with going under for a two and a half hour surgery and the challenges associated with recovery. I want to my repair my arm, so I can use it normally again. I want to be able to show my kids that it’s possible to decide to do something scary when the facts are on your side. I know there is always risk with having surgery, particularly when it involves manipulation of the spinal cord and moving the trachea to do the procedure. Nevertheless, I have determined that the benefits of surgery outweigh the risks. I’m looking forward to coming out the other side and sharing my experience.