Robert & Julie’s Journey
With his steely blue eyes, intense gaze and confident demeanor, it’s hard to imagine Robert Jackson a frazzled mess. But that is exactly what he was less than one year ago.
Chronic, debilitating, excruciating back and sciatica pain rendered him helpless, making him a shell of his former and current self.
“My life was a struggle,” Jackson says. “I could barely get through work. I would come home, eat dinner and lay down. I couldn’t help my wife or play with my kids. The pain was affecting my relationships with my family. I had no desire to do any of my hobbies like hunting, fishing, and hiking. I couldn’t do projects around the house. I was useless.”
For years Jackson suffered from sciatica pain. Then he had a wakeboard accident, fracturing his L4 and L5 vertebrae. Those fractures healed but after the accident he was left with much worse sciatica pain and new pain in his lower back, right leg and foot.
The harrowing pain haunted him all day and all night. Despite a heavy dose of narcotic pain medication, he would wake up every hour. In the morning, he never felt rested. The vicious cycle continued with no end in sight.
“I couldn’t be the person I knew I should be,” he says. “At 38 years old, I felt like my life was over.”
Jackson was so desperate he agreed, against his better judgment, to back fusion surgery. A red flag should have been that his surgeon didn’t understand the source or location of his pain.
“He kept asking me if I had pain on my left side,” recalls Jackson. “But I had pain on my right side! I should have known the surgery wouldn’t work.”
The back fusion surgery was a horrible experience. Jackson was in bed for six months and when he recovered, his pain was worse.
Unfortunately, Jackson is in a huge camp of patients who endure the trauma of a back surgery that was never needed or indicated. This is because their spine is not the root of the pain problem.
“Chronic back pain is a condition that affects millions of Americans,” explains Dr. Tim Tollestrup, peripheral nerve surgeon. “The traditional approach to chronic back pain - spine surgery or pain management - has a mixed record of success at best.”
Tollestrup believes that the problem stems from a fixed mindset that doesn’t allow for outside the box thinking.
“Spine surgeons, pain management doctors, neurologists and other specialists are essentially blind to the peripheral nervous system,” says Tollestrup. “Peripheral Nerve Anatomy is not something that is taught in medical school or at any other stage of their training.”
Physicians who treat patients with spine pain, believe that all back pain originates from the spine. They are essentially incapable of considering any other option.
But here is the rub. If the patient’s back pain is due to a serious injury to the peripheral nerves, no amount of physical therapy, spine surgery, or narcotics will ever give the patient pain relief.
Luckily for Jackson, fate intervened, providing him with an unlikely road to recovery.
Jackson’s wife Julie cut her leg on a broken mirror, severing two nerves.
Two doctors, an orthopedic surgeon and a neurologist, both said there was nothing they could do and to let the injury heal on its own.
Tollestrup didn’t agree, operating on Julie the same day he examined her. He repaired her lacerated nerves using cadaver nerve grafts so that she would have the chance to regain muscle function and skin sensation.
After watching Tollestrup help his wife, Jackson started chatting with him about his back problems.
Within a few minutes of listening, Tollestrup intuitively sensed the problem wasn’t coming from Jackson’s back.
“That conversation gave me hope,” says Jackson. “For the first time in forever, I thought maybe I can get my life back.”
Jackson came in to see Tollestrup in his office. Tollestrup spent an hour and a half learning his history and physically examining him. This was in direct contrast with Jackson’s neurosurgeon, who never touched him.
“The reason that Jackson did not get better with the spine surgery is that his low back and sciatica pain were due to peripheral nerve problems and not a problem with the spine,” explains Tollestrup.
Tollestrup is only one of a handful of surgeons in the world who perform peripheral nerve surgery with a focus on relieving chronic pain. He trained under Dr. Lee Dellon, a trailblazer who essentially invented this new field of surgery.
Learning how to do this surgery requires an additional year of training on top of all the other postgraduate surgical training required of new physicians. Dr. Dellon was only able to train one doctor per year and did so for a decade. Dr. Tollestrup was the second to last fellow he trained.
Most of the doctors who trained with Dellon have made cosmetic or reconstructive plastic surgery the focus of their practices. Dr. Tollestrup is one of only four in the U.S. who focus on relieving chronic pain through peripheral nerve surgery.
“We are essentially witnessing the dawn of a new field of surgery,” explains Tollestrup. “The problem is that it is very difficult to create and disseminate new knowledge in medicine. In 50 years, this type of surgery will be as accepted and commonplace as any other type of surgery that we are familiar with in 2017.”
In Jackson’s case, no one – not four doctors nor two physician assistants – ever considered that the problem might not be originating from his spine.
Jackson, like many other patients, had surgery on his spine for a problem identified on imaging that is not even anatomically capable of producing the type of clinical symptoms he was suffering from.
There is even a term for patients who undergo spine surgery without any improvement or even worsening of their pain. It’s called “Failed Back Surgery Syndrome.”
Better and Better
Jackson’s first surgery involved Tollestrup removing his piriformis muscle, basically a spare part in the buttocks that we don’t need, and decompressing nerves in his leg.
Jackson says he knew immediately the surgery was successful.
“I felt so good right after the surgery,” Jackson says. “And I just kept feeling better and better as the days passed. The surgery completely healed my sciatica and right-side leg and foot pain.”
Tollestrup then operated a second time, removing Jackson’s superior cluneal nerves which relieved his lower back pain.
These days Jackson is back to being the person, husband, and father he knows he can be.
“I am doing my hobbies, helping around the house and planning trips,” says Jackson. “Next month I am going hunting with my two oldest kids.”
But the biggest difference is in his everyday life.
“I come home from work and instead of laying down, I interact with my family,” he says. “I am happy.”
He is grateful to Tollestrup for giving him a second chance at what matters most.
“He changed my life,” says Jackson. “I was suicidal. The pain was wreaking havoc on my marriage. Now my relationship with Julie is super strong.”
Jackson is now an evangelist for Tollestrup, encouraging others to see if he can help them.
Yet even after sharing his success story, he senses reluctance to try a new approach.
“Your neurosurgeons may be well-respected in the field and doing what they think is best. But this is a new area of medicine that isn’t taught in medical school.”
Jackson encourages them to take a chance. Why not?
“What is an hour of your life to meet with Dr. Tollestrup,” he says. “He will not perform surgery unless he knows it will help.”
“Millions of people could benefit from a surgery that they have no idea exists,” Jackson adds. “I was hopeless. And look at me now.”