After Injury on the Ice: Now He Lives Life in the Fast Lane

Dr. Rita Roy: Hi everyone. My name is Dr. Rita Roy, CEO at the National Spine Health Foundation, and I’m your host for the Get Back to It podcast, where we tell real stories of healing and recovery. What does it mean to get back to it? It means overcoming a spine problem through treatments that work in order to return to the people and activities you love, whatever that looks like for you.

It means getting back to your life. We’re here to share the success stories of those who did just that, and some of these stories you’re not going to believe. At the get back to it podcast. Our goal is to tell stories of spinal champions who’ve been able to achieve a better quality of life through spinal health care.

In today’s episode, I’m excited to be joined by Henry Drury from Wesley Chapel, Florida. Henry has participated intensely in diverse athletics. The former two time national champion in figure skating saw his Olympic dreams shattered by a devastating spinal injury in his teenage years. After a decade long journey through physical and mental challenges, Henry has defied the odds.

This was accomplished with the help of his incredible surgeon, Dr. Richard Geyer of the Texas Back Institute. We are honored to have Dr. Geyer joining us today as an additional guest on the podcast. Now that he’s a professional race car driver in the Toyota GR Cup North America Championship, Henry is proof that life doesn’t have to end after a serious spine condition.

Now that you know what to expect, let’s get back to it and dive right into Henry’s story. Have

Henry Drury: like many people as a kid, I wanted to be a race car driver. Um, Unfortunately, it’s a very unrealistic goal. And I realized from very early on that it just wasn’t possible financially for my family. Um, which, you know, it was disappointing, but so, so it goes.

And I, I ended up falling into another sport. So I like to joke that I didn’t pick it up or pursue it, but sort of fell into it as my sister one day started, started figure skating and I did what any eight year old boy would do, which is flat out refused to try that because it’s a girl’s sport. and sat there in the cold for a year before eventually, eventually giving it a go, you know, and enjoyed it, so kept trying it and kept trying it and kept trying it and it sort of snowballs from there, and sort of took over my life.

So that was the career plan. That was the ultimate goal. you know, my sister and I won, won two national championships back home in Great Britain, and then, you know, we were working on, on our career roadmap, really, our, our future goals. And the ultimate, the obvious one was the 2018 and 2022 Winter Olympics.

So we made the difficult decision to move to the United States for access to, you know, better training, better facilities, better sports funding. everything you could find. So sort of really trying to get all the pieces in place so that we could pursue our goals and be as good as we can be.

Dr. Rita Roy: At such a young age, Henry was pushing his body to its limits. He was determined to achieve an Olympian status. Unfortunately, this dream came to a sudden end when Henry herniated two of his lumbar discs.

Henry Drury: Yeah. So, uh, having, having moved to the U S for, for access to all of this training, um, you know, we’re, we’re now pushing as hard as we possibly can. We’re doing eight hours a day and the next hurdle or the next thing we were working on is what’s called the press lift. So it’s a lift where, where you start facing each other and, you know, push my partner over my head, lock my arms, and she’s fully, fully overhead.

at the time I was 14, I probably weighed 80 pounds. I was not the best physical specimen to be lifting. But so as we, as we start to learn this and train this, we’re doing it off the ice and I’m starting to feel occasional Pain in my, in my lower back, a sharp stabbing pain. Um, but you know, as an athlete, you’re taught that when it hurts, you push through, that’s what you do.

You don’t complain about it. You get on with it. So push through and sort of ignored it. Um, I mean, I raised it to my coaches, but you know, you push through, it’s what you’re taught to do. So we keep working on it. We eventually get to the point where we’re putting it on the ice, which obviously brings in a whole new level of stability. As you’re doing it on, on blades, on an ice rink, rather than standing off at the side. So we’re trying this lift. We, we start, I push her up over my head, lock my arms, As soon as I do, there’s just instantly this, this sudden sharp pain in my, so, you know, I put her down, gently, I will admit, I didn’t drop her, but put her down and sort of tried to move around and, you know, feel your way through it, like anything, you push through, it’ll be gone in a few minutes, it’ll be, it’ll be fine.

But, um, the pain didn’t go away. and after after a few hours and then a few days, um, it was still there and still pretty overwhelming. So it kind of ground training to a halt and left me left me unable to get out of bed.

Dr. Rita Roy: This began a ten year journey as Henry embarked on this long journey towards recovery. Henry got an MRI soon after his injury. Two weeks later he was diagnosed with disc herniations. He then tried various modalities of treatment including three epidural injections, physical therapy, a discography, and stem cell treatment.

Henry Drury: So, yeah, like I say, after the first few days of sort of not being able to move, I realized it might be quite serious. I had an MRI and eventually, you know, You know, got my diagnosis. So I think that’s when it sort of started to set in that it was serious. I was told from the off that it was a minimum of a two year recovery, which in a four year Olympic cycle kind of, uh, kind of ends that dream pretty quickly.

So I went through your standard, your standard sort of approach to a disc bulge or herniation. So started out with, with epidural injections. I had three of those total, but started with the first one, which made a big difference for me. It brought my pain down from a nine or a 10 to a six or a seven. Um, I started the typical sort of physical therapy, stabilizer, muscle work and core work.

And then obviously, you know, just doing everything you can and looking for every option you can. So whether it was acupuncture or massages or some random weird idea on the internet, it was kind of, well, I’ll try anything and you know, we’ll see what works. so slowly, slowly improve my pain through that.

I had two more injections, one of which was, was helpful. Another one wasn’t. wasn’t so helpful. but at the end of the day, it was only sort of masking the pain. So I ended up bouncing around trying a few different doctors and trying to really narrow down the cause of the pain. Uh, which led me to experience a discography, which if you’ve had one, not fun, but that confirms the, that my pain was discogenic, and coming from the tear or the herniation in my disc.

So then we looked into, into some new options. So, I was very lucky to have a radio frequency ablation treatment and an intradiscal stem cell treatment at the same time. So I was sort of told if it stops hurting in the first six weeks, it might be this one. If it stops, stops hurting after, you know, a few months, it’s probably the stem cells.

So I had both of those. and shockingly, I ended up pain free for, for almost a year. six, seven months, I was completely pain free. so, you know, for me, it was cool, great. Everything’s everything’s fixed. I can get back to my life now. but then one day around the six or seven month mark, um, the pain, the pain came back with a bit of a vengeance and I was sort of back at the start, back at square one, really.

Dr. Rita Roy: After trying almost everything in the book, Henry was at his wits end until he underwent a life changing encounter and treatment with Dr. Richard Geyer at the Texas Back Institute.

Henry Drury: Yeah, so, so sort of having exhausted all options really in, in my recovery, um, I knew that the, all that was left really were, were big, big invasive procedures, something like a fusion, something like a disk replacement. So I was a little hesitant to, to look into this. I was lucky enough to meet with, with Dr.

Gaia in Texas. And after a consultation, I decided to go, go forward with that. And Dr. Gaia performed, uh, an artificial disk replacement or a total disk replacement of my L4 L5 disk in late December of 2022. right between Christmas and New Year. And that was, that was my Christmas present for that year. six months later, I was able to, to return to competing, you know, for the first time in 10, eight, nine years.

Um, I was back competing back doing sports. And as a result, I’m now competing as a professional race car driver in the Toyota GR cup, North America series, uh, competing for PT auto sport. And even though I’m still living with, with chronic pain, um, able to, to train, to race, to do all these things that I’ve always dreamed of doing, you know, and, and keep pushing myself every day, which is sort of what I feel I’ve always been, been best at.

So yeah, I’m able to push myself, train and not worry about doing further damage to my spine. So now I’m really hoping to use the fact that I’m able to compete again and sort of my, my journey and my story to prove to anyone with a spinal injury like mine or kids or young adults who’ve suffered from similar injuries that An injury isn’t the end of a career or a life.

There is still, you know, light at the end of the tunnel. So yeah, I’m, I’m extremely lucky to be in the position that I’m in now. And I owe it all to Dr. Gaia.

Dr. Rita Roy: Wow, Henry, that is such an inspiring story. I think it’s You know, I, we’re, we’re talking here, but if people could see my face as you were telling your story, just, you know, mouth dropping moments that are just unbelievable and your, your story is just so inspiring. I’m, I’m curious, um, you were 14 when this whole journey started at such a young age and, um, and you went through all of these treatments and, and this journey to get you to where you are now.

Did, did that journey take you? take over pretty much most of those teenage years for you? you know, going from treatment center to treatment center and sort of bouncing between the different options that you experienced.

Henry Drury: Yeah. So, I mean, again, for the first sort of probably two, two and a half years, I didn’t, I mean, couldn’t really leave. My bedroom, I was still able to walk around, but you know, it was pretty intense pain. So, uh, basically most of my teenage years sort of went, went in the bin, really, you know, I, uh, I couldn’t go to, to standard high school.

I had to do homeschool and college wasn’t really an option. So, yeah, that whole sort of formative teenage years, uh, Yeah,

Dr. Rita Roy: think about that, you know, you went from being at peak performance with Olympic dreams and then seeing that Olympic dream get really get crushed. Um, it certainly had to have weighed on your, um, you know, on your, on your feelings about yourself and your future and some of the mental health aspects that come along with having a dream like that shattered and being at such a young age and being really frankly debilitated from the normal activities that people can normally do.

Can you talk to us a little bit about your your mental state and how that affected you?

Henry Drury: so I mean, the years sort of following my injury were kind of, uh, the most difficult thing I’ve ever experienced because, you know, I mean, every, every athlete has injuries and you know exactly what to expect, you know, whether, whether you’re a pro athlete or you’re super young and just getting into it, you know.

You have injuries at some point, you get used to the recovery, the rehab, the process, and the time it takes. not really prepared for the, the mental side of it. So for me, you know, like you said, I had this singular goal every minute of every hour of every day was dedicated to this, this goal. And then, you know, like that, it’s cool.

What, what

Dr. Rita Roy: Yeah.

Henry Drury: You know, I can’t train. I, so it all kind of just disappears and crumbles around you. And especially with something, uh, debilitating, you know, when you can’t really move around much or go out and your social life sort of crumbles as well. And obviously school is a massive part of that. So, yeah, I, I had a really, a really rough few years, which basically, like I said, just stuck in my room.

Didn’t do any schoolwork. Didn’t have a social

Dr. Rita Roy: so hard. That’s just Yeah, that’s so hard. And, we’re, we’re going to talk about this as we get along here, but I’m curious about, you know, your decision making along that treatment journey, that there were lots of attempts at treating your pain and your injury, um, before you got to see Dr.

Guyer. And, um, I’d love to invite Dr. Guyer to talk with us, about, um, you know, when, when Henry appeared on, Your doorstep at your practice there in Texas. what, what were your, what were your feelings, Dr. Guyer, when you first met this handsome young man who’s been through a lot and now is finally seeking your care?

Dr. Rick Guyer: Well, first of all, I want to say, Henry, I’m so happy that you’re here. You are where you are today because the biggest joy for me is to see a patient get back to their life But I remember when I first met Henry, I was impressed with number one his maturity his intelligence The fact that he really had researched everything really really well the fact that he had been through all the conventional treatments, even some unconventional that not necessarily proven like stem cells and things like that for his degenerative disc.

But this is not an uncommon story. We see a lot of, uh, individuals in their teenage years that have either injuries or they just develop low back pain and they just suffer through it. And. You know, the conventional wisdom is that, well, don’t do anything with them. And we shouldn’t do anything as a teenager, but once they mature, they’ve been sort of poo pooed and well, just live with it.

But Henry had higher aspirations. And, you know, as we heard his story of becoming an Olympic champion and then wanting to get back into racing. So I was impressed, but I was a little concerned because Henry’s young. He’s in his twenties. And we, at that time, we’ve been doing the artificial is just about 20 years.

But subsequently, we have now published a paper and I published this last, um, I think it was May or June, and it showed our follow up up to 21 years and a revision rate of less than 1%. So it makes me feel much more secure in recommending this for younger patients. And the, the disk are tested to last 40 years.

In the laboratory, but we’re seeing little or nowhere at 20 years and compared to hips and knees. If you had a hip or knee that was 20 years old, you’re looking at a 10 to 15 percent revision rate. So the good news for Henry is that he has less than a 1 percent chance of this needing to be revised. And hopefully this will last him for as long as he’s active.

And um, You know, when we don’t have a crystal ball and I can’t, you know, predict what it’s going to be in 40 years, but I think part of the problem is that, uh, the way the total hips and total needs were devised is a similar way is what we tested the materials for the artificial disc in that we expect everybody to walk 10, 000 steps a day, but nobody flex and extends her spine 10, 000 steps a day.

So the bottom line is that Henry is not alone. There’s many individuals out. there, a lot of them get fusions, which is a shame because results from the disc replacement are so good and really is a natural solution to let a patient, you know, live their dreams. as he has done.

Dr. Rita Roy: amazing, Dr. Geyer, and I know that you have been one of the foremost thought leaders and inventors, really, in developing the technology around artificial disc replacement. And I’m so happy that we have this time today with this incredible patient success story to talk about this technology to help the public understand really what that technology can do, that it’s not experimental.

As you say, it’s been around for a long, long time. And Um, you know, Henry, you had done your own research to compare the different treatment options. People look at, you know, a fusion versus a disc replacement, and it’s, you know, people are confused about fusing, which means no motion, or saving the motion, and which one is better, and why shouldn’t everybody have one, and why should you have one, and, and one or the other operation.

Um, you know, Dr. Geyer, you talked about comparing the disc replacement. to an artificial hip or knee. And, and why is it that the public has such great adoption of a total knee replacement or total hip replacement, but there’s still confusion about what a total disc replacement is.

Dr. Rick Guyer: You know, Rita, it really baffles me too. And it’s frustrating because when I first went into practice, I realized then that fusions only led to more operations as a patient got older. In fact, I was checking my email today and one of my original papers on the, um, deleterious effects of fusions on the adjacent levels.

I published in 1995. We thought about this forever. And unfortunately, it’s much more complicated that because there was a stigma in the scientific literature, and even in the academic world, that you can’t operate for back pain. If you operate for back pain, they’ll never get better. And a lot of this came from Oh, the workman’s complinature, people injured on the job, and just a poor understanding of where the pain generators were coming from.

As science progressed, we developed, and you know, now we know where they are. And then, another complicated issue is that, uh, during the, uh, development of the artificial disc in the U. S. in the early 2000s, there was a lot of competition between the companies. And one of the companies went before Medicare saying that you need to give this a non coverage decision because people over 65 are not candidates for artificial discs, which is true for the vast majority of those patients.

But because the non coverage decision, the insurance companies didn’t recognize it. And that’s why they say it’s still experimental. It’s less and less, but this March will be 25 years since we did our first one here at TBI. 25 years, not experimental. There’s been over a thousand articles published on lumbar disc replacement and it is a safe operation and it’s a durable

Dr. Rita Roy: Wow. Wow.

Dr. Rick Guyer: Unfortunately, these, uh, the stigma about operating for back pain still exists with the insurance companies and even to some surgeons, it’s a to a certain extent.

Dr. Rita Roy: that’s one of the things that we work so hard to do here at the National Spine Health Foundation, is to get the honest, accurate, unbiased information out to the public about the variety of treatment options that exist. And I think Dr. Guyer, you and I have talked before about this idea that, you know, we Finding the right operation for the right patient for the right condition.

There are some people for whom a fusion is the right operation, but there are other people for whom the disc replacement is a better option. And, um, when it came to Henry’s, uh, case, was there any doubt in your mind about which direction to go for his treatment?

Dr. Rick Guyer: No, you know, if I was writing the textbook about the ideal patient, I would use Henry as my example. I mean, really, he is the ideal kind of patient. He, you know, very bright, very stable, very goal oriented. His quality of life has been affected by, you know, not being able to do even the simplest things that he wanted to do.

And he was motivated to get well and had single level disease. and normal, you know, bone stock, all the good things that we needed for a successful result. And the only thing Henry had to do after surgery is just to pick up his rehab and and keep on pushing on. And uh, thank goodness he’s had a great result.

And really, one of the highlights was my seeing him at the former one race in Austin,

Dr. Rita Roy: All right!

Dr. Rick Guyer: was with his team there and we met and we took lots of pictures. So it really, it warms my heart to see him back doing what he’s doing. And, you know, I hear about a lot of patients tell me that they’re doing, you know, the things they want to do, but I rarely see them in their own environment.

So it was really a

Dr. Rita Roy: That is awesome. I’d love to get some of those pictures or get one of those pictures and we’d love to share that.

Dr. Rick Guyer: I’ll be glad to send you a

Dr. Rita Roy: you. Thank you. What a, what a great moment. Let’s talk about race car driving and back problems. Um, Henry, how do you think the view of your profession now as a professional race car driver, um, views a driver who has had a back surgery?

Henry Drury: It’s a challenging one, and this is something that I spoke to Dr. Gaia about at the, at the Formula One race. In that, at the end of the day, we are, we’re athletes, and we’re hired athletes. We’re hired to perform and paid, you know, under the assumption that we will be, you know, 100 percent fit and perform to our best.

So there is a lot of stigma around it in, in the, you know, there is probably 20 to 25 people in. Just in my immediate racing paddock, people who race at the same weekend, who’ve all had an artificial disc replacement, no one will admit it. No one will talk about it. Because they don’t want to be seen as, you know, damaged goods or, or as a, as a risk.

you know, on

Dr. Rita Roy: their value. It might decrease their value as a performer. Oh my goodness.

Henry Drury: Precisely. So it’s, it’s massive and it’s, you know, disk bulges and herniations, as far as I’m aware, are quite common in car crashes. So it’s sort of a bit of an occupational hazard, but no one will, will admit to it or talk about it. So it’s a, it’s a big priority for me and, and, you know, Being open about it, you know, it’s, it’s not exactly a secret that I had, uh, had an injury and I’m not, and then I’ve had the surgery and I’m proud of that.

I want to show that, you know, I can perform just as well as, as anybody else. I mean, uh, the, the only, what sort of the one flare up I’ve had since. Since my operation happened during a race weekend, and it was the best race weekend I’ve ever, I’ve ever had. So, you know, if anything I can do to prove that, you know, after an operation or with back pain of any kind, you can still perform, you know, then that’s, that’s great.

That’s the ultimate goal, really.

Dr. Rita Roy: That’s Geyer, I’d love to hear your comment on this as well. You know, So, before having the treatment, patients are often impaired. They’re maybe not fully disabled, but they are doing their job, or they’re doing their work, or they’re going through their life with impairment. So that after a successful procedure, they’re actually better than before.

They’re better than ever, maybe, in their ability to perform. Do you see that to be the case?

Dr. Rick Guyer: Rita, that’s a great question. And that we know that it takes about, between 6 and 12 weeks for the bone to bond to the artificial disc. And that’s why we limit patients, um, for the first 12 weeks. After that, though, we take all restrictions off, with the exception, with the simple analogy. Basically, I tell the patients, and Henry will like this, keep your foot off the gas pedal for 3 months.

After 3 months, you can accelerate, but you don’t floor it. Because it’s very important that they have a very, very strong core. And one comment that Henry made that’s sort of paradoxical, for example, if I operate on somebody in the armed forces, you know, a serviceman, and if you do a fusion, they’re out. If you do an artificial disc, they can still stay in.

Dr. Rita Roy: goodness! Yeah.

Dr. Rick Guyer: it, it’s very interesting, and that’s why I found it surprising when Henry and I discussed this in Austin. Uh, it, it’s amazing, because really, the artificial disc, is not a stigma. And with the safety devices they have in the cars today. And, you know, while I’m not 100 percent sure of all the safety devices Henry has in his cars, I know in Formula One, they are totally strapped in.

And even though they experienced G’s of up to six or seven, it’s a very, very safe, you know, structure that they’re, or a very safe area. that they’re driving at that time. So it’s, it’s interesting, but I think that as time goes on, we’ll see it utilized more and more. And hopefully even the stigma in Henry’s field won’t be the same and it will be

Dr. Rita Roy: Well, and I think just demonstrating success, you know, through your performance, Henry, can help erase that stigma. What’s interesting is that, you know, people, um, think of these, you know, there are catastrophic, there are catastrophic accidents or injuries that can happen, but a back condition isn’t one of those.

And so the good news is that there are treatments that get you back. So, you know, if you blow out a disc, that’s okay, there’s, there’s a treatment for it. Just like you rebuild the car and the car gets out there and performs, you can rebuild the back and get out there and perform as a driver. And um, I think you’re stepping forward here to be so honest and courageous about your treatment, Henry, is what needs to happen in public messaging around these treatments so that, um, you know, we can change the dialogue and we can change that discussion.

Henry Drury: Yeah, and it’s, hopefully it’s something that, multiplies as other people choose to, to share their story. I mean, this was sort of the first question I had for Dr. Geyer when, when I first met him and asked about the disc. Is, you know, I was, felt sort of trapped into this road where the only option was a fusion.

Which I knew would mean more surgeries down the line, it would mean loss of range of motion. Now in my mind, it didn’t mean a return to competition. And so my first question was, well, okay, you know, I’ve seen all these success stories, but can you show me any athletes with success stories? Any athletes who’ve had this and are still competing at the highest level?

And the way I remember it, Dr. Geyer basically said, yes. But I can’t tell you their names. They’ve, they’ve had it, and they’re doing really well, but they won’t talk publicly about it. You know, so there’s, you know, people in this sport, people in that sport, you know, whether it’s hockey or running or golf, whatever it is, you know, there’s people with the surgery competing at the highest level, but so few will, will admit to it and talk about it.

So hopefully, you know, that’s slowly starting to change as there’s, there’s more published research on, on the ADR and as it’s, it’s put out there more and becomes less. Experimental.

Dr. Rita Roy: Well, Henry, you, you know, as Dr. Geyer points out, you are so articulate, so bright, so intelligent, so knowledgeable. Um, it’s, it’s such a pleasure talking with you, um, about this because of so much of this self education. That you’ve done. And we say it’s so important for people to be their own best advocate for themselves.

And so much of what we try to do here with our work, like telling this story is to encourage other people to inform themselves, right? And where do you go to get good information that’s unbiased, that’s accurate, that’s truthful, when we certainly ask people to come check out SpineHealth. org for that, um, and also to talk to experts, um, experts like Dr.

Geyer. I’d love to know how you found Dr. Geyer. What was your journey to finding Dr. Geyer? You’d been through treatments with lots of different healthcare providers over many years. Um, can you talk to us a little bit about that journey of finding the right surgeon for you?

Henry Drury: Yeah, so, so as you say, it’s very difficult to find, truthful and accurate information and so I would often just go to the doctors that I was seeing and ask where I could learn more about it. But, you know, it’s, it’s very easy to end up in a back corner of Facebook with a random person who says that, you know, their specific diet or sticking a H2 pencil into the side of their leg.

cured their back pain. So, you know, it’s very easy to go down a rabbit hole and find random information. I, I saw a spine logo on the side of a race car, um, and discovered a doctor called Dr. Robert Mason. Um, In learning about him, I learned that he’d had an artificial disc replacement himself, um, in his, his cervical spine.

Um, but he, uh, he was actively racing in a race called the Daytona 24 hours here in Florida. So I went, okay, you’re a patient, you’ve had this, this surgery and you’re, you’re still driving race cars. So I reached out to him and basically asked for advice and sort of tried to learn everything I could about it from him.

and he, he’s a surgeon himself operating out of the, the Mason Spine Institute in Florida. And he, he recommended Dr. Geyer and sort of gave me all the information I needed to start thinking about the surgery. You know, at the time, this was still the big, scary, invasive procedure that I was trying to put off because it was the be all end all, you know, so yeah, he gave me lots of information and referred me to Dr.

Geyer and I sort of, uh, Went from there and it was the consultation really, which gave me the confidence to go from all the consultation with Dr Guy, which let me go from this is this big, scary surgery that I’m going to learn about, but maybe have in a few years to actually, um, I feel really confident about this and I can really see this, this helping me and, you know, potentially, not curing, but, but helping with my condition.

Dr. Rita Roy: Wow, that’s amazing. And there it is, that peer to peer support. Talking to someone who’d been through it, getting, you know, getting your, your insight from another patient, and learning from their success. And that’s what we’re all about here. That’s, uh, that’s amazing. And again, so grateful that you’re stepping forward to do this for the many others.

Um, Dr. Geyer, uh, how, how incredible that your patients are out there and, and helping others as Henry is doing today. Dr. Geyer, I wanted to talk with you a little bit about, um, You know, Henry’s journey that he had exhausted all of these what we call non operative treatments and and maybe some that are that actually are potentially experimental like stem cell therapy.

Dr. Garrett, what do you say to patients who are trying to avoid surgery or who think that surgery is the last resort? Should surgery really be the last resort or should it be something that people consider more early in the journey?

Dr. Rick Guyer: it, it does differ. But for example, in Henry’s case, he had problems for years and years. And although the FDA criteria said that, You must have pain for a minimum of six months. I rarely operate on a patient with six months of back pain. Most of my patients are very typical, like Henry. They’ve had problems for years and years.

They may have had a previous discectomy, you know, four or five years ago. And often it’s the younger person in their late teens may have had a problem, had an early discectomy and then in their mid twenties or late twenties begin to have problems. So generally it is rare to operate on somebody at six months. You can do it, but I will say that the majority of the patients usually have problems for years. They usually will get over the acute episodes and they manage until they finally realized that, you know, their life has been so

Dr. Rita Roy: Yeah.

Dr. Rick Guyer: and their quality of life has not been what they want. That then they start to look for other options after exhausting the usual conservative treatments that we

Dr. Rita Roy: Yeah. And I think one thing for Henry’s case in particular that was challenging is that he was so young, uh, when this condition first struck at age 14, maybe not even through puberty yet, um, still having lots of bone growth. Maybe there were some, you know, some of the, um, the, the growth plates had not, you know, not fully completed their growth.

So, you know, it’s a, it’s a challenge. A gentle, um, area there when you’ve got really a pediatric patient who’s going through managing a very painful and debilitating condition, Dr. Geyer, what, what, uh, uh, what recommendations do you have to young people?

Dr. Rick Guyer: For the adolescents that I see, or even the late teenagers, we do everything we can to avoid doing surgery on them. Although the FDA criteria says the youngest age we can operate is 18, I have rarely done an 18 year old. I have done some. These were really miserable kids. So miserable they couldn’t go to school.

Very stable psychologically, good family support system, not taking drugs. It’s pretty rare, but we always, we try to carry them as long as we can. And, you know, sometimes it’s hard. I explain it to the parents and to the patient. And I also look for the maturity. For example, Henry was young. He was in his early 20s when we did a surgery.

but he had a maturity beyond his years. And for the few young teenagers that I’ve done, you know, in their 18 or 19, uh, these again have been very, very mature, uh, patients that we have the frank discussion, say, look, you’re very young. This is the device that we’ve been using for X number of years. We know it’s tested and last 40 years, but you know, you’re 18.

Dr. Rita Roy: yeah,

Dr. Rick Guyer: So we don’t know. But as time goes on, we get more, we are having more and more confidence in the device itself. And as I said, we’re almost 25 years using the device. So, you know, I have less angst about putting in a patient in their 20s than I used to. but now with the data, I feel very good

Dr. Rita Roy: confident. Um, Dr. Geyer, I’d like to talk just for a few minutes here about degenerative disc disease, and what that condition is, and just dive into a little bit some of these non operative treatment options that, that are out there, and how a patient should arrive at a decision.

on an artificial disc. So what is the disease? What is the discography that Henry talked about? Can you talk to us a little bit about that?

Dr. Rick Guyer: Well, the disc is made up of a ring we call the annulus and inside is the nucleus and the nucleus is, is made up of a sugar protein molecule and Because it also contains water, it gives a little bit of the shock absorption to the disc, but in no way when you walk around does your disc go up and down.

It doesn’t. You know, you’re taller in the morning and you lose a little height throughout the day as each disc, uh, lose a little bit of water. What happens is, uh, there’s genetics involved and also the environment. So sometimes patients have a horrible family history and they just inherited from mom and dad and they may get early degenerative disc disease where the nucleus begins to dry out.

the rings begin to tear and they may get a herniation because the rings tear and then the jelly or the dried out jelly will come back and pinch a nerve. In other cases, they may just get back pain and that’s what we call degenerative disc disease. It’s, It’s a disease, not per se, but it’s a condition.

Everybody will get it after the age of 40. 40 to 50 percent of people will have at least one or two discs that are degenerative. A family history, you may have much more. And with the family history, it’s not unusual that we’ll see an adolescent that has degenerative disc disease. But the first treatment is always conservative treatment.

It’s anti inflammatories. It’s going to therapy to learn the proper exercises and to work on the core. As I said earlier, the core muscles, which are your trunk muscles, are your dynamic stabilizers for the spine. The static, uh, support for the spine is really the disc. and the vertebral bodies. So that’s the hard part of the spine.

But then the soft part, which are dynamic stabilized, are the muscles and the ligaments. And then injections, but not excessive injections. I mean, sometimes patients have had 20 or 30 injections. That’s inappropriate. You know, a couple injections, sometimes a facet injections or medial branch box with what we call a denervation or facet, uh, rhizotomy can be helpful.

Chiropractic, Helps a lot of patients to, uh, active exercise is really, really key and it’s only when they fail this and then they may have one or two levels that look abnormal, uh, if it’s a clear cut history that you can get by discussion with the patient. the typical pattern, like, you know, what kind of things you can’t do and you can do.

Uh, when did your pain occur? And then the examination with painful range of motion, but normal neurologic examination. If one level is present, for example, in Henry, you may consider discography, especially if you want to be certain of the diagnosis. There’s something called a nocia scan that is, uh, it’s an MRI spectroscopy that picks up the chemicals of denervate of degeneration.

And that’s helpful, but not in many insurances pay for it now. So discography used to make a more clear diagnosis for the patient and also for myself as a surgeon. And then if they have normal bone density. For example, uh, the amount of calcium in their bones and they have normal facet joints, then they’re an ideal candidate for the disc replacement

over a fusion.

Our goal here at TBI and the Center for Disc Replacement, we look for reasons not to do an artificial disc, not the other way around. We don’t look for reasons to do a fusion and not an artificial

Dr. Rita Roy: That’s so interesting. Thank you so much for sharing that, that information so clearly. understanding the anatomy of the spine is helpful so that you understand where that disk is, what its purpose is, and how it can be compromised, leading to, um, pain as an indicator that something is, is, is wrong in there.

Something is amiss. Dr. Guyer, you have mentioned several times during this conversation, the importance of core strength. Henry, you have been a lifetime athlete. I think that your core strength is something that you developed as a, as a figure skater and has stayed with you throughout your life. Um, you know, A lot of patients think that when we talk about core strength, we’re talking about a six pack ab.

That’s not what we’re talking about. We’re talking about, as Dr. Guyer mentioned, those deep muscles that run along your spine, deep inside your body that stabilize your spine. And being able to get into those muscles takes different kinds of exercise than what Maybe most kids think about like crunches, sit ups, or, you know, developing that superficial layer, a beautiful musculature.

But what’s happening behind that and deep inside of that is so important to your spine health. Um, and so important to that, uh, wellness journey. I hear surgeons say to me, you know, as a surgeon, we can do our part. We can do the operation. We’ll do it masterfully. We’ll do it perfectly. the patient has to do their part.

And the patient part is that recovery part, which includes core strengthening to make sure that whatever surgery happened is going to be optimized with all the other things that you do to take care of your, your health, your nutrition, your exercise, your physical therapy. Um, Henry, I just want you to share with us a little bit about your recovery journey here as we, as we.

Get, get to the tail end of this conversation. Your recovery after your surgery.

Henry Drury: Yeah, I mean, to start, you’re absolutely right. So going into physical therapy, whether it was a 14 or later in my recovery journey at 18 or 19, you know, core strength has always been a massive part of training for skating and racing. So every time I go into physical therapy, it’s cool core strengthening.

Easy. Got this covered. Whatever. And then I get there, and they kick my ass. So it’s, it’s, like you said, you know, it’s not the obvious, you know, crunches and the six pack stuff that you’d normally see, you know, in a gym or whatever. It’s the deep stabiliser muscles. So I’d always go in with this attitude of, cool, easy, no stress.

And then I walk out sore. but yes, I mean, following my operation, it was a, in total, I think a six month recovery. period. Um, I’m not the most patient of people. It’s, it’s not my strong suit, but uh, this is probably the one time that I was so terrified of getting it wrong that, uh, that I stuck strictly to that, uh, um, that three months and then slowly build up to it as Dr.

Geyer was saying. So, um, Yeah, I think I started, you start physical therapy pretty much immediately after, after the procedure, and then within the first few weeks sort of start to ramp it up slowly. And that was, it’s, it was very helpful for me because it’s sort of some of the very little physical activity you can do.

So if anything, it’s, it’s welcome. Um, even if it’s only a couple of times a day, but it’s welcome in that it gets you moving and allows you to do things. But it was also very strange for me in having to learn to do things that I’d put off for so long. So, coming to the end of my, my recovery period, you know, my physical therapist was, you know, having me run. And I haven’t run since I was 14 years old, just because it’s, you know, it’s impact and I built up this connection in my head of, cool, running means that it hurts. And then even as my back sort of stabilized a little, I just knew that it wasn’t particularly healthy and there were alternatives available.

So, you know, he’s trying to teach me to run again. And I’m sort of trying to push past this mental block in my head of, of, you know, now I can’t do this, or, or bending at the spine. You know, I’ve spent 10 years squatting instead of bending to, to pick things up. And so having a physical therapist go, cool.

bend over and touch your toes. And there’s, there’s such a mental block. And it was really, really strange for me in trying to teach myself to do things that I’ve avoided for, for such a massive part of my life.

Dr. Rita Roy: incredible. But by the way, you should still continue to bend your knees when you lift something heavy. But that, that’s amazing, just that, that the self talk, right, that you had to accommodate for and now you don’t have those limitations and those, uh, you’ve got to, you’ve got to get over those mental blocks.

That’s, that’s incredible. Thank you for sharing that. That’s amazing. Um, Henry, at what point after your surgery did you realize you didn’t have pain anymore?

Henry Drury: I want to say it was, uh, three or four months in and I always sort of described it as, uh, a realization because I think living with, living with pain for so long, you sort of, especially when it’s constant, you sort of learn to tune it out

Dr. Rita Roy: Oh, right. Mm

Henry Drury: or not entirely tune it out, but you, you become used to it, you know?

So it wasn’t a, um, I didn’t wake up and go, Oh, awesome. I’m pain free. I think I was about three, three months into the recovery and I’m sort of walking around doing things. And suddenly in my head, I’m like, Wait, my back doesn’t hurt. Why doesn’t my back hurt? What’s happening? So it was sort of a realization or a bit of a shock, you know?

So it was very much a, um, an instantaneous like, what’s going on? Why, why isn’t it

Dr. Rita Roy: Did it give you confidence to then do some of those things in physical therapy? Like, oh, maybe that’s not going to hurt if I go on a little jog, right? Like,

Henry Drury: did. Yeah. And I mean, as Dr. Go was saying, you know, you, you build up to it. So, you know, we built into things very slowly, but, you know, bending without pain was, was really unusual. And it, it let me go, okay, I can, you know, try a bit harder. I can bend a bit further. And then I would start running for very short distances, but it’s okay.

This doesn’t hurt. So I can go a bit further and a bit further and a bit further. And that’s continued, you know, even, even into today where I’m training full time. you know, it sort of still surprises me when something doesn’t hurt. So the fact that I’m able to push myself to a new limit, and then have confidence to find another limit the next day, and then another the next day, has been, has been massive.

And that’s instrumental in being able to

Dr. Rita Roy: Bravo. That is awesome. It’s absolutely awesome. So excited for you. Um, the last thing I want to ask you about is when you made the appointment and you went in to meet Dr. Geyer, you know, one of the things we tell people is that when you meet a surgeon who, you know, you think is going to do a procedure for you, it’s a, it’s, it’s a lifetime relationship that you’re creating with that, with that surgeon.

can you share with us what that encounter was like and how did you know that Dr. Geyer was the right surgeon for you? So,

Henry Drury: going into this, I was still very much of the mindset that I want to learn about this surgery, but it’s still a big, scary surgery. So, you know, I just want to learn about it. And then in future, I’ll look at this as an option. and as I’m sure many people have experienced, you know, some doctors, you feel like you’re really rushed through.

An appointment, you know, they come in, they look at the screen, they tell you something for a few minutes. Cool. See ya, see ya never. Um, the thing that really, really surprised me with Dr. Gayo was how much time he took in talking through all the options. Why I should have the operation, why I shouldn’t have the operation.

You know, it wasn’t, I wasn’t being sales pitched on, on having a surgery. It was, you know, he took so much time and was so thorough in explaining my condition and the options available. For And one thing that I really liked, and to go back to what Dr Guy was saying about things you can’t do, is that The operation was never pitched as a cure,

Dr. Rita Roy: um,

Henry Drury: so a patient, you’re always, especially with a long term injury, you’d love to be told, cool, this is the magic cure, do this, you’ll be fixed forever.

But it’s not realistic, and the way Dr. Gaia pitched it to me was pick ten things that you enjoy doing. Five of those things you will be able to do either without pain or with significantly less pain than, than now. So yeah, I think it was, it was mostly just the time and the detail and the commitment. You know, he spent so much time educating me and giving me all the options.

So that was the key thing for me.

Dr. Rita Roy: and, and you had comfort and confidence that this was, this was the person for you, that’s amazing.

Henry Drury: Exactly. And to be able to walk out of that and go from cool, this is a big scary surgery I’m going to learn about but not have, to okay, I actually feel really confident in this, I’d like to move forward and have this operation.

Dr. Rita Roy: Yeah. That’s incredible. Congratulations on that encounter and look at you now. Dr. Geyer, we have a term for people like you. We call you healthcare heroes, uh, because you put the best of medical science into practice every day for patients. fantastic outcomes for your patients to get back to their lives, to maybe even be better than they were before.

And, uh, I know from my perspective, having been a patient, I am so grateful and I have such admiration and, uh, And, and reverie for people like you who find joy in creating these patient success stories. And um, we’re thrilled that Henry found you, that he’s sharing his success story. And I’m so grateful to you for joining us today on this podcast, uh, to share your expert insight and your wisdom.

Are there, are there any things that, uh, you’d like to share with us in closing, Dr. Geyer?

Dr. Rick Guyer: Rita, you know what? This is what I love to do. I love taking care of patients and you know, as I said earlier, I love seeing Henry get back to his life. And to me, the motion preservation disc replacement is the very best operation that I do and that I have done in my career. And it’s something that I dreamed of when I first did my first fusion.

I said, this is not normal. This is not right. But, um, to me, my reward is getting patients back to the life and doing something that restores normal motion rather than taking it away. Because as an orthopedic surgeon, we’re trying to return function and doing a fusion of someone’s spine is not returning their functions, making them better.

In many cases, that’s the best we can do. But in still many other cases, artificial disc is the best option.

Dr. Rita Roy: Henry, any, any closing thoughts from you?

Henry Drury: just to, just to repeat, you know, what, what I’ve said from the start, which You know, I just hope that through, through people going out and proving that with this operation, you know, there is, there is still hope in a way. And, uh, when you’re in sort of the lowest point of an injury like this, it can feel like, you know, your life is over and this is kind of it.

But, you know, there are other people struggling with the same thing. There are recovery options. There is still, you know, light at the end of the tunnel in a way. So, you know, I hope that people, Yeah.

Dr. Rita Roy: Thank you, Henry, for saying that. You just gave me a really awesome soundbite I’m going to be able to use for marketing purposes of our podcast. Henry, it was such a pleasure to meet you. Sharing the story with our community will no doubt teach others to never let a spine injury stop them from chasing their dreams. Dr. Guyer, it was also such a pleasure and honor to have you on the show today.

While it is great to listen to our spinal champions, it is also amazing to hear from the healthcare heroes such as you who helped them become spinal champions. Thank you both so much for being with us today. At the National Spine Health Foundation, something we believe in most is providing hope for recovery through sharing stories of success and expertise.

It isn’t always easy to find someone to relate to, even though 100 million adults suffer from neck or low back pain each year. To hear more stories of Spinal Champion recovery and access educational materials about spine health, visit us at SpineHealth. org. If you’re interested in supporting our show financially, you can contribute at the link provided.

Thank you for listening.