Farmer's Delight

He came to my clinic smiling and with a spring in his step. He extended his hand out to shake mine. As he sat down, this 86 year old farmer said  “I have worked in farms all my life, walked miles every day in my 250 acre farm. I have picked up sheep, sheared them and milked cows”. This gentleman did not look his age. He was tall and well built. A gentle paunch. Stubble on his face. Hands far from being manicured with cuts and dirt under the nails. He had decent clothes but worn out shoes.

He said, “I struggle to walk even hundred to 200 yards in my farm.“ His eyes had a glimpse of dismay and sadness. “I get numbness in my legs and my ankles become weak. I get pains down the legs until I can’t move any more.” He looks up at me and said “but if I sit for sometime, I am able to walk again.”

His MRI showed what I expected to see, severe narrowing of his canal in the lumber region of his spine. This is called lumbar canal stenosis. I could not see any spinal fluid at that level. This indicated very severe narrowing. I knew of a very effective procedure that I could do to relieve his symptoms, but I was worried.

At the back of my mind, I was concerned whether he would withstand surgery at that age. As we get older, the reserves of the organs of our body, like the heart and the lungs, reduce. Surgical procedures, being a stressful condition on the body, can strain these vital organs, and they can potentially fail. The question was whether they were strong enough to withstand that stress.

I explained his condition and the options available which included managing it with symptomatic treatment and the option of surgery. I also explained my concerns. I stated that if he chose surgery, I would take the anaesthetist’s opinion to see if his body would cope with the surgery. He thought for a moment and chose the surgical option. “It is not only part of my job but also my passion, I don’t think I could cope not being able to walk.”

To my delight, the anaesthetist cleared him with flying colours.

His surgery went very smoothly. I saw him post-op in the recovery room as he was waking up from anaesthesia. The first thing he said was “I don’t have leg pain. My legs feel free.”

I smiled and said we will meet in the morning… even after decades of spine surgery I still prefer to confirm the results of the operation the next morning, after all the anaesthetic drugs have effectively been thrown out of the body, and my patients have walked or stood long enough to confirm result of the surgery.

In the morning ward rounds with the nurse and my junior doctors, I opened his room door and met a very cheerful man sitting proudly in a chair. He got up immediately and walk towards me “you have changed my life. I have no pain and my weakness has improved. Thank you so much.”

No matter how many times you have heard those words, they never fail to give you an endorphin surge. With a gentle smile I replied “I am just doing my job”