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Spinal rap: A brief look at my surgical recovery (so far) – Part 1

On April 15 I had an operation to decompress my spinal cord and to have the C5 disc in my neck replaced with a new titanium disc. I ended up in hospital for 67 days. Here’s the back story (no pun intended). 

For the past 18 years I have lived with a compressed spinal cord. Although I had the condition since 2003, it wasn’t diagnosed until an MRI scan in 2007. The scan showed that the C5 disc in my neck was completely herniated and that the disc was pressing directly onto my spinal cord causing hundreds of electric shocks every single day. I was prescribed daily amitriptyline which significantly reduced the number of shocks I felt. I was also prescribed heavy duty painkillers (dihydrocodeine) but I soon realised that work was the best analgesic in the world. Instead of taking up to four doses of dihydrocodeine every day, I worked (and worked). I rarely took more than four doses of dihydrocodeine a year let alone a day. I was also given details of an operation I could have but just the very thought of it scared me – especially because of the risk of being left paralysed from the neck or chest down. I was told to come back if I changed my mind about having an operation. 

I am not 100% sure what caused the complete herniation of the disc in my neck but I suspect it was a minor traffic collision I was involved in at the beginning of November 2003. I was sitting on the front seat on the top floor of a double decker bus when a taxi crashed into the right-hand side of the bus and I was propelled forward onto the bus’s front window where my head hit the glass window, smashed the glasses I was wearing, and left me concussed. I was highly stressed that day because I was on my way to have a CT scan to look at swollen lumps in my throat for suspected Hodgkin’s or non-Hodgkin’s lymphoma. Later that week I had a lymphadenectomy and the biopsy showed that I didn’t have cancer but was diagnosed with toxoplasma lymphadenitis. It was after this operation that I began to get the constant daily electric shocks (over 100 a day) every time I moved my neck. I assumed that the constant electric shocks were as a result of my operation but I was later told that the shocks were being caused by a compressed spinal cord and that my lymphadenectomy was not the cause.

Over the next decade or so, the pain caused the constant compression of my spinal cord got progressively worse. Walking became increasingly difficult but I used excessive work as the strategy to suppress the increasing physical pain. In short, work became the perfect distractor task. When I was 100% cognitively engaged (e.g., giving a paper or teaching, writing or editing papers, etc.) I was in no pain whatsoever. I returned to the workaholic tendencies that I had before I had children. One of my consultants also described me as having “unspent youthfulness” which masked my medical condition for years. 

The lifestyle I was leading in the years leading up to my operation probably didn’t help. I was travelling excessively averaging 20-25 overseas trips a year for conferences, consultancy, and research meetings. Walking became increasingly difficult as I was unable to lift my right foot properly. During 2019, I had a number of really bad falls abroad (tripping over because my right foot wouldn’t lift) including three in Abu Dhabi and a couple in Auckland which left me with horrendous bursitis on both of my elbows

During the lockdown period, my health deteriorated badly. I was not globe-trotting anymore and I was housebound for over a year. My working life (and social life) became increasingly sedentary. I was doing everything from home including all my teaching. I had not stepped foot in my university office since the end of February 2020 (and still haven’t).

In August 2020, I saw one of my consultants and told him that my health condition had got significantly worse and that I now wanted the operation. However, because my surgery was classed as ‘elective’ as opposed to ‘urgent’ a date for surgery never came as the Nottingham hospitals were full of very ill COVID-19 patients. At one point during the pandemic, Nottingham was the UK city with the most COVID-19 infections. By February 2020 I could hardly walk and was becoming increasingly immobile. I rang my consultant’s secretary every week asking if I could have an appointment. I finally got one at the end of March 2021 and after seeing how bad my mobility was, I got an operation date very quickly. Thursday April 15, 2021. I was told by my consultant who was performing the surgery that he expected my to be back home the next day if the surgery was successful.

I have to be honest and say that the operation still scared me. Although there was a small chance of dying, that didn’t worry me. It was the thought of waking up paralysed which dominated my thoughts for over a week prior to the operation. Loss of limb use. Loss of job and livelihood Loss of identity. Loss of salary. There are many risks with any operation but spinal surgery carries many extra risks. I was told that some of the consequences could be eating and drinking difficulties and voice loss (as they would be carrying out the surgical procedure through the front of my neck and having to decompress my spinal cord by going via my trachea and oesophagus). I told my consultant that I would rather be dead than paralysed from the chest or neck down.

As the day of the operation approached, I again used work to block out my fears and negative thoughts. On April 15, my partner dropped me off at the hospital at 7am in the morning. Before my operation I had talks with the anaesthetist and one of the surgical team. I then had to sign the consent form which included a very long list of all the things that could go wrong. However, the weeks prior to my operation were surviving not living. I felt I was in the last chance saloon.

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

On the fly: Travel tips for excessive travellers

In a previous blog on ‘binge flying’, I noted that as part of my job I do a lot of travel. In the past 12 months as part of my job I’ve been lucky enough to go to China, Macau, Hong Kong, Japan, Argentina, New Zealand (twice), United Arab Emirates, Denmark, Finland, Norway (twice), Spain (twice), Portugal, Belgium, Malta (twice), Bulgaria, and Ireland. For me, travelling has become an occupational necessity.

However, I have tried to turn my experiences into something more positive and have written a number of short articles providing tips about travelling abroad for outlets such as the British Medical Journal and the PsyPAG Quarterly as well as publishing a short paper on ‘addiction’ to flying (see ‘Further Reading’ below). This blog uses material from my previously published articles cited below to provide some tips on making travel a little less stressful. While this blog is aimed at other academics, most of the tips are generic and apply to anyone travelling abroad.

Before you travel

  • Scan important documents electronically: Rather than photocopying all your important travel information (e.g. passports, insurance documents, etc.), scan all of them electronically and then e-mail them to yourself. You will be able to retrieve them from anywhere at any time if things go wrong.
  • Check your plastic: Before your trip, check all your credit cards for wear and tear as you could be stuck in a foreign country without access to cash machines or the ability to buy anything. Also, think about getting credit cards that include air miles, lounge access and upgrades (e.g. Amex cards).
  • Don’t get currency at the airport: Pre-ordering your currency will almost certainly be cheaper than the exchange rate at the airport currency bureaus. Make sure you get some low denomination notes and coinage for tips, taxis, etc. However, if the country you are travelling to has a strong currency, it might be better to exchange large amounts of money there rather than in the UK.
  • Treat yourself to a ‘Priority Pass’ and get premium lounge access: I’m very fortunate that on long-haul flights I travel business class which gives me access to the premium lounges before my flights. However, on most of my European trips I fly economy but I still like to use the business lounges. For this, I buy an annual ‘Priority Pass’ which gets me into 100s of lounges around the world. There are various levels of membership to suit your needs and they are good value for money.
  • Check your insurance: Has the university paid for you or do you need to get it yourself? There is nothing worse than losing your luggage and then discovering that you weren’t properly insured.
  • Check the weather forecast: There’s nothing worse than turning up in a country with the wrong type of clothes. Check the medium range weather forecast so that you know whether you will need that coat or jumper!
  • Know what you will need to pack: In addition to all the academic things you might require (laptop, memory stick, reading material), don’t forget the necessities in addition to passport, tickets and currency (e.g. adaptors, toiletries, medical supplies). Crease-free clothing can also be a help as not every hotel will have an in-room iron and ironing board. Also, pack some plastic carrier bags for your dirty laundry.
  • Check if the hotel has (preferably free) Wi-Fi: There’s nothing worse than turning up to a hotel and finding you have to pay for Wi-Fi access or worse still that there’s no Wi-Fi at all.
  • Travel as lightly as possible preferably hand luggage only: Take as little luggage as you can as you will always come back with far more than you went with (e.g. papers, conference programmes, conference freebies, leaflets etc.). For one or two night trips, take all your items on as hand luggage. This can often save a lot of waiting at the baggage carousel. To avoid bulk in your luggage, decant shampoos, etc. into smaller bottles so that you carry only that which is necessary on your trip. Miniaturise as much as possible including toiletries.
  • Get easily identifiable luggage: If you have to take non-hand luggage, tie a brightly coloured ribbon or something unique to your luggage so that you will easily spot it on the baggage carousel. Others are less likely to pick up your bag by mistake and may save you time.
  • Make sure that people know when and where you are going: Given all the things that can possibly happen abroad, make sure you let both family and the university (supervisor, head of department, etc.) know where you are going to be.
  • Charge up your laptops and mobile telephones: Make sure all your electronic items are charged up. Keep your chargers in your hand luggage as you may be able to charge up at the airport and/or the plane itself.
  • Check-in online: By checking-in online, you will be able to print your boarding pass and select your seat before you even get to the airport. If you have hand luggage only, this will save valuable time – especially if you are stuck in traffic on the airport bus or your train is delayed.

On the plane itself

  • Go vegetarian: If you want to maximise sleep time on long-haul flights, pre-order the vegetarian option as these are usually served first.
  • Take food and water on board with you: If you are flying on a budget airline, buy a ‘meal deal’ at the airport (or make your own sandwiches) as the food on board will be more expensive. Buy a bottle of mineral water at the airport as you cannot get liquids through baggage checks and on-board drinks may by pricey.
  • Book an aisle seat: On long-haul flights, always book or ask for an aisle seat if you’re not in business class. This means you will be able to get up and move round at your convenience rather than have to keep asking people to move.
  • Eat and drink alcohol in moderation: It is very tempting to drink free alcohol and eat anything that’s placed in front of you on long trips. However, you should try and limit yourself as you could suffer both dehydration and indigestion.
  • Beware the in-flight entertainment: The in-flight entertainment service may not be to your liking so take some interesting reading and/or a few DVDs (and play them on your laptop). DVDs and a Netflix account are also useful if you are in a hotel that has no English language television stations!
  • Wear headphones: If you want a peaceful stress-free journey without talking to anyone next to you on the plane, wear mp3 player headphones (even if you are not actually listening to anything). If you are going to actually use headphones, then invest in noise-cancelling ones as they will be better for the journey (and better than the ones provided by the airline itself).
  • Bring your own eye mask and ear plugs: If you are on an overnight long-haul economy flight, bring your own ear plugs and eye mask as the plane may not supply them and even if they do, they may not be of good quality. An inflatable neck pillow can also be very comfortable. Wet-wipes can also be useful in helping you feel refreshed after a few hours of sleep.

At your destination

  • Find the local university: If you are short of money, try to find out where the local universities are in a city. The canteen is likely to sell cheap meals and the students will tell you about the most economical places around.
  • Avoid internet roaming charges: As soon as you are in the country of your visit, turn off your data roaming on your tablet computer (e.g. iPad) or smart phone (e.g. iPhone) to avoid charges for things like emails and web browsing. In European countries there’s free roaming at the moment but that will change after Brexit!
  • Make use of the hotel facilities: If your hotel gives free access to its facilities (e.g. business centre, gym, swimming pool), then take full advantage and use them. Use the business centre to email if the hotel charges in-room Wi-Fi access.
  • Adjust to the local time as soon as possible: On the plane, change your watch to the local time and try to stay up and go to bed at your ‘normal’ time. If you get home in the daytime, resist the urge to have a nap as you will feel much worse for it later. Medical supplements such as melatonin may also help overcome jet-lag.
  • Ask where your room is in the hotel: If you don’t ask where your hotel room is located you might end up being right next to the lift or in an outward facing room where you hear all the noisy traffic. Alternatively, take some ear plugs with you, just in case.
  • Know a few words of the native language: Learning even a few basic words of the country’s language will help you in most situations.

On getting back

  • Have convenience food to hand: Make sure you have something easy to prepare for eating (e.g. a ready meal in the freezer) for when you come back as you may get back late when no shops are open.
  • Get in touch with your new contacts: When you are back home, email your new contacts along with anything you promised to send (like the paper you gave at the conference) to help facilitate new working relationships.

Dr. Mark Griffiths, Distinguished Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Griffiths, M.D. (2003).  Tips on…Business travel abroad, British Medical Journal, 327, S38.

Griffiths, M.D. (2012). Tips on…Conference travel abroad. Psy-PAG Quarterly, 83, 4-6.

Griffiths, M.D. (2017). A brief critique of ‘flying addiction’. Global Journal of Addiction and Rehabilitation Medicine, 3(1), 555602.