An Ordinary Life After Breaking my L1 Bone

It took many years for me to achieve an ordinary and pain free life after breaking my L1 bone. I had broken my back after falling two stories from the roof of a building in London. In hospital just days after the fall, the surgeon and spinal specialist Dr Arun Ranganathan asked me to make a choice, to undergo spinal surgery or stay bed bound and let the injury heal naturally. It was a difficult decision, but one thing I remember clearly was when Dr Ranganathan said a broken back would affect me for the rest of my life.

Years later, I’m pleased to have defied the odds and report that breaking my L1 bone has had almost no bearing on my life. There are just a few minor considerations like sleeping on a hard mattress causes pain and I avoid high impact exercise such as running. Cosmetically, I have significant scarring on my back and I gained weight. But for the most part I am healthy and I feel grateful for my full recovery.

There was a time when I was not so grateful. After breaking my L1 bone I opted for spinal surgery. Four metal pins were inserted around my broken L1 bone to stabilise the area, which allowed me to walk and move whilst the secured bone healed. Regaining muscle strength after the operation was painful at first, but learning to walk and move normally again was a swift process and I was fully mobile within a month. The real pain was the nerve pain.

Breaking my L1 Bone
I broke my L1 bone, which is part of the thoracic spine

I had never experienced nerve pain before so I was completely clueless about what it was when it began. The pain would start in the late afternoon on the right side of my body in my hip and leg and would grow gradually stronger until it was unbearable. As the weeks passed, the onset of pain would start earlier in the day until eventually it became constant chronic nerve pain. It is hard to describe what it felt like. Nerve pain really gets underneath your skin and into the bones. It felt like metal poles stabbing me repeatedly. But the worse thing about the pain was not understanding why it was happening to me. Neither the doctors or the physiotherapists explained what nerve pain was and every time I complained of it I was shut down and told it was pain caused by poor posture and not walking correctly.

The only thing that relieved the pain was lying down and I came to realise it was movement (standing, walking, sitting) that triggered the pain. After an initial period of depression I decided to do something about it. I began researching solutions online, which led me to see a chiropractor. This was unwittingly a poor choice. The chiropractor, despite the fresh surgical scars on my back, began performing manipulations and using an activator gun, in the hope of stopping the pain. However it only bought on new lower back pain and negated all the physiotherapy I had previously done.

On the physiotherapists advice I started regular exercise. Whilst it did not eliminate the pain it was helpful in relieving the severity of it. At first I did my own workouts in the gym using the cross trainer and rowing machines. As I gained in strength I then started doing yoga and pilates classes.

The next solution I looked for was in medication. My local GP had previously trialled two common nerve pain medications with me: Lyrica and Gabapentin. Both are anti-epileptic drugs that work by interfering with the nerve impulses that cause pain. I trialled both for several weeks with little result. Then a doctor at the hospital introduced me to Tramadol, which was a real life saver and enabled me to manage a normal life. Tramadol is a man-made opiate designed to provide short term pain relief. Because it also causes hallucinations and a feeling of relaxation, it has now become a popular drug on the black market, which makes it more difficult to obtain a prescription for. I first tried Tramadol after an afternoon visit to the hospital, by which time the pain in my leg was particularly severe and I was having difficulty walking. The pain relief was not instant however I had an overwhelming feeling of wellbeing. I began taking Tramadol just in the morning and it made me feel positive and energetic and also reduced the pain. On Tramadol I felt I could do anything and I was able to work long hours, do extra curricular activities, survive on little sleep, and it reduced my appetite so I also lost weight. The best thing about Tramadol was its anti-anxiety properties and for the entire time I took the medication I never felt anxious or stressed. It was like being on top of the world. I slowly started increasing my dose so I was taking it twice a day, and I experimented with both immediate and slow release capsules.

Breaking my L1 Bone
Tramdol immediate release capsules are recognisable by their yellow and green colour

Unfortunately overtime, my dependency on Tramadol started to become less glamorous. Tramadol makes you constipated, which could sometimes be painful. It also causes extreme drowsiness when mixed with alcohol, so I found it difficult to socialise with my friends at the pub or even enjoy a glass of wine with dinner. Mornings became a nightmare because when I woke up the previous days’ Tramadol had worn off and I would be feeling the comedown and very depressed until the new dose started to kick in. The last straw came in 2014, when Tramadol was classified as a controlled Schedule 3 drug in the UK, meaning I was no longer able to have a repeat prescription and each month it became an ordeal to queue up at the GP for a new prescription. I started to resent being dependent on Tramadol and wanted a change.

The change came when I reconnected with Dr Ranganathan at Whitechapel Hospital. He had learnt of my chronic pain and was determined to fix it. I underwent x-rays and tests but nothing out of the ordinary was found. He concluded the pain was likely linked to the positioning of the metal pins in my back on the right side, and they could be impinging on some of the nerves when I moved. The alternative diagnosis was that a piece of small bone could have become imbedded in the nerves, in which case nothing could be done.

Hoping it was the former assessment, two years after my accident I underwent surgery to remove two of the pins from the right side of my spine. The operation was quick, with small slits made parallel to the original scar in order to quickly retrieve the pieces. I took two weeks off work to recover.

The surgery was a success and the severity of the nerve pain had decreased, although there were some twinges of it. My back was a little tender and weak however I was able to move around without much pain or difficulty. The greatest challenge was recovering from the Tramadol addiction. I went against the doctors advice and stopped taking the medicine cold turkey. For the first two weeks the main physical problems were nausea and diarrhoea. I also felt extremely tired and lethargic but I was unable to sleep. I tried to combat these symptoms by taking vitamin B, C and L-Tyrosine as well as taking frequent walks and hot showers. I felt quite fragile for several weeks but overtime, slowly but surely, I started to feel like myself again. Many people were surprised I was able to stop taking Tramadol so quickly and kept asking me if I had really stopped. However I was never really tempted as I had already made my mind up to stop it. I still have some medicine left and in the past two years I have only taken it once when I had a bad tooth ache.

Throughout the whole process I gained a lot of weight. Prior to breaking my back I had been a slim size 10. When I started taking Tramadol I went down to size 8. At that time I was also doing a lot of exercise in the gym. After my final surgery, the combination of quitting Tramadol, taking L-Tyrosine and being too depressed to exercise saw my weight balloon to a size 12. Ever since it has been a struggle to get back to my former size 10.

After making a full recovery the most important thing for me is to maintain good health by keeping fit and eating well. Because of the trauma of breaking my L1 bone it is especially critical that I maintain a strong core and good posture, which is only possible through exercise, otherwise I will experience back pain. I do a combination of yoga, aerobics and swimming three times a week, and I also enjoy walking. If you asked me what is the secret to surviving a broken back, I would say it is a combination of self-motivation and exercise. Now, sticking to a healthy diet is the next challenge…

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