Patient Story: "I Felt Like a Cripple, and I Couldn't Accept That"

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Alfred Tosto

By Alfred Tosto
I know I’m a pretty complicated case – I had a liver transplant in 2008 after being diagnosed with cancer and I take a basketful of drugs every day, immunosuppressants, prednisone, a lot of meds. But I’m a project manager and I treat the meds like any another project. And I always took care of myself and stayed in shape.

When I started having lower back pain in 2011 I knew it wasn’t normal, and I sure didn’t want to be taking pain meds in addition to everything else I was taking, so I saw a doctor pretty quickly. That’s when I first met Dr. Elowitz – he operated on me twice, to remove some synovial cysts and do a lumbar fusion at L4-5. I felt great for years after that. I did physical therapy and strength training several times a week, and was back to my old self.

Then last year I spent a weekend in March helping my wife install an art exhibit, then we packed up a house we were selling, and between those two things I really overextended myself. I had some back pain after that, but I took some over-the-counter painkillers and felt a little better. But by May that year the pain was so bad I couldn’t even lift my golf clubs. We took a trip to California for Mother’s Day, and I couldn’t even walk through the airport, I had to use a wheelchair to get to our flight.

When I got home I went to see Dr. Elowitz again, and this time he saw new disc herniation, mild scoliosis, spinal stenosis, and arthritis. But this time he said he didn’t think surgery would help, and he referred me to Dr. Weinberg and Dr. Mehta for pain management. I had two epidurals, but the pain came back both times. I was on a time-release pain medication, but it just wasn’t helping. I couldn’t walk very far – I would have to stop and sit. I was working, and I could drive out to a job site, but I needed a cane to walk around once I got there.  Dr. Elowitz suggested I see a physiatrist, and referred me to Dr. Singh. Dr. Singh also tried epidurals, in a different location, but they just didn’t bring me much relief either.

I couldn’t sleep on my left side, I was depressed (and sleep-deprived), and I really thought it was all over for me, that this was what old age would be. I was turning 65 and I felt like a cripple. I walked with a cane, couldn’t swim or ride a bike, could barely walk up the path over a dune at Long Beach Island. And I couldn’t go in the water, because I was afraid a wave would knock me over. I’d been going in the ocean my whole life, so that really hurt. I just couldn't accept that.

The team at the Spine Center had a conference to talk about me – they even brought in Dr. Elowitz to help decide what to do next. At that point it had been six years since he’d operated on me, but he was still part of the team helping me. They suggested I go see Dr. Kaplitt, who is a neurosurgeon who specializes in pain and is an expert in implants that control pain.

At that point I was desperate and would have tried anything, so I had a consultation with Dr. Kaplitt and heard about the spinal cord implant. There was a five-day trial period before I had to decide if I wanted the permanent implant, and I decided to go for it.  I’d been so discouraged by the results of the last epidural, I was afraid I was developing a dependency on the pain meds, and I just wanted the pain to stop.

The trial period was amazing – it worked. The pain was 75 to 80 percent less than it had been, so I scheduled the permanent implant.  I had to stay overnight in the hospital, but that was a precaution due to the immunosuppressants I was taking for my liver. It was a really simple procedure.

Two months later, each day now is better than day before. I can sleep on either side (after a year of not sleeping on my left), I can sit, and I’m up to walking two or three blocks at a time. I’m just back from a trip to San Francisco, where the hills are ridiculous but I used a slalom-style zigzag when I walked. But I walked!

When things were at their worst, on a scale of 1 to 10 my pain was between 8 and 10 all the time. Now, if I do have pain, it’s spotty and mild, maybe a 2 or 3 if anything. But overall I feel cured, back in action. People even say my face looks different, but that’s because I’m not in pain any more. My whole attitude is different. I can hold my granddaughter, I can go on vacation, I can go on a walking tour. I’m free.

I never lost faith in the Weill Cornell Medicine team and they never gave up on me. I know I had complications that were difficult, but they are the top guys and their approach to patients is something special. Dr. Kaplitt’s nurse practitioner, Kristin Strybing, even worked with my physical therapist to guide him on what to do, and what to avoid, now that I have the implant.  It’s really teamwork.

You can tell when you go into the new Spine Center that there’s something important going on there. It’s all coordinated, and the whole team meets and talks about the patients. Everyone is consulted and it’s all right there – I didn’t have to go running around from one place to another to see all those doctors. They say you should get a second opinion – well, the second opinion was right there in house. I wasn’t being shuffled around, I was working with a team. I have faith in all of them.