Cook: It’s tough getting old: jelly doughnuts and herniated discs

Taken from the Chattanooga Times Free Press
October 22, 2017

By David Cook

Looking back, I should have seen it coming.

But I can’t look back right now. I can barely even turn around.

It started this spring. We moved houses, and I carried and stacked boxes like Tetris. The new house had water issues, so I was crawling around like a coal miner, digging French drains that seemed more like moats.

All the while, my lower back began to nag, these little sighs of pain.

Hush, I whispered. Have some more Advil.

On the ledger balance of lumbar health, I was overdrawn. Soon, I’d pay up.

“The bill always came,” wrote Hemingway.

It happened two weeks ago. We’d gone camping, and I arrived at the campground vertical, standing on my own two feet. I stoked the fire. Uncorked the wine. Inflated the air mattress. (“You camp lazy,” my daughter said.)

The next day, I was horizontal.

“Can’t walk,” I moaned.

It was excruciating, this fire-rope of back-and-leg pain. For days, I was completely bed-bound, unable to walk. One MRI later, the doctor delivered the news.

“You have a protruding disc,” she said.

Nestled between our vertebrae are discs, sort of like little spinal pillows. Under stress, these discs can swell outward, leaning heavily against the fiber of hypersensitive nerves in our spine. (Hence the leg and calf pain). Sometimes, the pillow breaks. The discs protrude. Bulge. Herniate.

“Like jelly out of a doughnut,” the doc continued.

I would hear this analogy a lot — a bulging disc is like jelly out of a doughnut — and, my friends, it’s simply not true. Jelly doughnuts are pleasant things, like rainbows and kittens. A more appropriate analogy? Lava out of a volcano. Tar out of the pits of hell.

Apparently, many of us 40-something men have jelly-doughnut back. Upon hearing of my woes, they came out of the woodwork. (Slowly, of course, while bending at the knees.)

“I dropped the soap in the shower,” one friend said. “Couldn’t walk for days.”

“I sneezed,” my best bud remembered. “Wasn’t the same for a year.”

I heard one story of a man who coughed. That’s it. Just a cough. And he couldn’t walk for three weeks.

“You have a herniated disc,” the doctor said. “You may need surgery.”

The word “herniated” is Greek for “getting old.” I wish I had some dramatic, manly story about my injury — power lifting at the gym, fighting off wolves — but the tipping point could have happened while licking a stamp. Or lacing up my therapeutic Rockports. Who knows.

It’s been excruciating. (It will soon heal, the doc promises.) The Bible says not to covet my neighbor’s ass, but what about his healthy spine? I was training for a half-marathon. Now, walking to the mailbox is victory.

The pain.



“Approach this with kindness,” one wise friend counseled. “Let your back become your teacher.”

Oh, it has.

This pain has increased my empathy for those who suffer from chronic pain. And I now understand how opioid addiction — just make the pain stop — can happen so easily, so innocently.

This pain has taught me the clear connection between immobility and depression.

This pain has reminded me that the body — our gloriously, wonderfully complex bodies — will one day wither and die. Injury is a dress rehearsal for death, teaching what I forget on my healthy days: that all things deteriorate and age.

This pain has taught me gratitude. For small things, like walking.

And big things. Like family and friends.

(Allow me some specific thank-yous: to my English Department colleagues, Dr. Stephen Dreskin and his amazing Tennessee Valley Pain Management staff, Donna Pearson, Dr. Matt Bernard, Dr. Jason Robertson, Debbie Hill, everyone at the Center for Sports Medicine and Orthopedics; most of all, the magnificent and incomparable Jean Rogers and Deeann Cain.)

And allow me a deep bow.

To those of you who are also suffering.

Because life hurts.

Look around. I see friends with cancer. Parkinson’s. Going through divorce. Addiction. Loneliness. One friend’s due for a spinal fusion. All of this makes herniated discs look like pancakes and syrup.

Know the only bipartisan issue in America? Pain management. We aren’t the body politic. We’re the body broken.

This injury has reminded me of our truest job: to love one another out of the pain.

I didn’t understand that so well when I was, you know, younger and less herniated.

Looking back, I should have seen it coming.

“Dad,” my son said a few months ago, looking over at me. “You have crumbs in your ear hair.”

“I have what?” I asked.

“Crumbs,” he repeated. “In your ear hair.”

At least it wasn’t jelly.

David Cook writes a Sunday column and can be reached at dcook@timesfreepress.com or 423-757-6329. Follow him on Facebook at DavidCookTFP.

Dr. Jason Rogers on ThisNThat

Dr. Mitchell on This n That

Dr. Mastey on “3 Plus You”

This Medical Practice is Doing All the Right Things for Patients

Andrea Hardaway, MBA LSSBB
Performance – Process – Projects

How embarrassing!
I sprained my ankle in 2015. It’s sort of an embarrassing story, really. Let’s just say, it starts with a group of MBA students gathering in a room… fast forwards to the largest game of tag EVER… and ends with me being, basically, carried out of the room and transported to the nearest emergency room.
Thankfully, my ankle was not broken. However, over the next year, I found myself falling down several times. My ankle had been so weakened by the initial sprain that it was continuing to give out (i.e. “roll”).

The Impact of it all
I fell down 4 or 5 times. Of course, it had to be at the most embarrassing of circumstances (like down the stairs at home when visitors were there, on the sidewalk outside of work, and during my niece’s photoshoot before her send-off to her first prom). Oy!
Even worse than all of that… I was in pain most of the time (the kind of pain that wakes you up in the middle of the night)!
So, yeah, I wasn’t that fun to be around on quite a few days. I was kind of cranky (and cranky is not a good look for me…. AT ALL!)

“Fun”-nomenal care
Now comes the fun part… getting treated for the issue. (I know, I know… “fun” is kind of an odd way to explain medical care). Nonetheless….
Anyone who knows me (or frequents my posts), knows I am completely addicted to a great customer experience! So, I HAD to take this opportunity to tell you about my amazing experience as a patient!
My doctor (Dr. Wamack at the Center for Sports Medicine and Orthopaedics) provided service and care at a level that was nothing short of exceptional.
Dr. Wamack treated me for over a year. The entire time, I knew surgery was an option. However, he wanted to be absolutely and undoubtedly sure every other option had been explored… before choosing an invasive procedure.

The final prognosis and moment of terror!
I won’t get into all of my treatment details. However, after several months of non-invasive and consistent attention, my ankle started doing a lot better. My pain levels decreased significantly. I was able to do most everyday activities with very little trouble.
My ankle issues were no longer generalized, but could be targeted to a specific area and condition. So, Dr. Wamack recommended we try a cortisone injection.
I won’t lie… I was TERRIFIED! I’d heard horrible stories regarding the experience of getting a cortisone injection. I was FREAKING OUT! Dr. Wamack, however, remained calm.
He talked me through exactly what would happen and explained every way he would help make the experience as painless as possible.
He even went above and beyond. He had a Nurse come in to hold my hand and talk with me through the procedure. She was AMAZING! She kept me calm and talked to me the entire time.
Before I knew it… the injection was done. I’d barely felt anything. As a matter of fact, I’d gone from freaking out and being on the verge of tears to looking into the eyes of a stranger (the nurse) and laughing hysterically about random facts that would have (at any other time) seemed completely insignificant. However, in that moment, they were significant. They were the things that got my mind off of the thought of impending torture and turned my focus towards life beyond the injection.

So, what was it… really?
In thinking over my treatment at the Center for Sports Medicine and Orthopaedics, what was it that really made my overall experience one of excellence?


I mean, let’s be real, I didn’t enjoy having to schedule my days around doctor’s appointments. I didn’t enjoy knowing the exam or physical therapy would increase my pain level for the day. I mean, there was still a lot of waiting in the process (and no patient likes to wait).
However, even with those things that seem inherent to any healthcare experience, this Practice got so many things right along the way.
From a patient’s perspective, I could certainly boast about:

  • Their patient portal (which made everything amazingly easy – from scheduling, to follow-up instructions, to paperwork).
  • The transparent and highly effective communication between Dr. Wamack and the highly skilled Physical Therapist (Andy Gean)
  • The registration process that is streamlined to perfection!
  • The way they are completely transparent regarding wait time
  • The cleanliness of the waiting rooms, exam rooms, and even the bathrooms!
  • The hot coffee available to guests (yes, “guests”. I felt more like a welcomed guest than a patient)
  • The consistency of processes across multiple office locations
  • The fact that they ASKED for my patient feedback (live and via a really simple survey)

I could go on and on about some of the tactical improvements and strategic advances that were obvious at the Practice.
However, the biggest thing that contributed to my exceptional experience is the PEOPLE who represent the brand.

They TOTALLY get it!
I always say… patients do not experience teams or departments. They experience your entire system (your brand); one person and one process step at a time.
The Center for Sports Medicine and Orthopaedics totally gets it. I have not had a single negative encounter with anyone in the office. There is a standard of compassion that is exemplified by every staff person. It is NOT the type of standard that mutes individual personalities. Instead, it seems to be a standard that allows each team member to be their best self; to stay connected to the reason they chose to work in healthcare to begin with.

So, what’s the lesson for other healthcare organizations?
So, let’s be real… Healthcare is a tough industry! There are always so many moving parts. With all of the pressures to deliver high quality clinical care, there is more and more pressure to also deliver an exceptional patient experience.
The reality is, there is no perfect process for healthcare operations. There are best practices that can be employed, standard patient satisfaction measures that provide guidance on what to focus on, and tons of ideas to constantly make things better.
However, as long as there are imperfect people with unique needs and preferences, it will be impossible to offer the *perfect patient experience*.
Some healthcare organizations make it their mission to never receive any negative feedback from patients. However, in my opinion, this is a very flawed approach.
While nice comments and top-box scores are wonderful, the real goal should be to create an environment in which patients actively engage in your journey to excellence.
Center for Sports Medicine and Orthopaedics is deliberate in their quest to deliver an excellent patient-focused experience. As a patient, I could see many indicators of how much they were working on my behalf. Because my care experience felt more like a partnership (one where I had an equal level of equity), I found myself taking a vested interest in their improvement journey.
Partnerships need praise from it’s members. Even more importantly, partnerships need insight, ideas, honest feedback, trust, integrity, and a willingness to do the work to make it great.
As the patient in the partnership, the best thing I could do, was provide feedback that let them know how great they were doing and also point out things that would make the patient journey even more exceptional. You see, because of the culture, I felt confident that Center for Sports Medicine and Orthopaedics was hungry to continue providing value and identifying areas of opportunity.
I am happy to say, I was right! The leadership at the Practice were highly receptive to my feedback and recommendations. They humbly accepted praise of what was working well, while asking questions and taking relentless notes regarding potential opportunity. (Actively engaged leadership at it’s best!)

Finally, to the patients out there
Let’s do our part to help make our experience the best it can be. Instead of thinking of ourselves as only being a patient who receives a service, let’s take the perspective of being a partner in the delivery of our care.
Here are some things you can do to help make the partnership a success:

  • If you get registration paperwork ahead of time, fill it out.
  • If you’re running late for an appointment, call.
  • If you don’t understand something the doctor says, ask them to clarify.
  • If you’re uncomfortable, let someone know.
  • If you have concerns, share them.
  • If you receive a survey, fill it out.
  • If you see something going right, let them know.
  • If a staff person smiles at you, smile back.

Every patient is a person and every person has a story. Thank you for taking the time to read my story. 🙂

1st Annual Baseball Symposium


Moms’ Soccer Clinic with Dr. Jason Robertson


Lower Extremity Functional Movement & Return-To-Activity Testing


What will Functional Movement and/or Return-To-Activity consist of?
During testing, a Physical Therapist will assess your balance, functional movement (whole body), and jumping ability (when appropriate). These activities will be assessed using the Functional Movement Screen, Y-Balance Test and Hop Testing. Hop Tests will only be administered with your doctors approval and if your activity includes jumping.


What is the purpose of these tests?
We are assessing how your whole body moves after injury. These important movement patterns often change after injury and may leave you at risk – even if pain has subsided. Ensuring you are able to perform the basic movement patterns is an important step in the rehab process and ensuring future wellness.

How is risk level calculated?
CSMO utilizes a research-supported algorithm called Move2Perform that considers your scores from Functional Movement Screen, Y-Balance Test, Hop Testing, age, gender, sport/activity and activity intensity level.


Will my doctor be notified of my results?
Yes. You and your doctor will receive the results and use them to identify potential risk of (re)injury and create a custom plan for minimizing future risks.

Will I have follow-up testing?
Follow-up testing may be recommended based on your initial performance and your physician’s preference. Typically, a repeat test will be performed 4-6 weeks after initial assessment. A Physical Therapist will provide corrective exercises to perform independently if appropriate.


If my score indicates I am at higher injury risk, can my score be improved?
Yes. Test results will place you in one of four injury-risk categories: optimal, slight deficit, moderate deficit or significant deficit category. Corrective exercises will be provided to improve your score if you score in the moderate or significant deficit categories. Research shows that individuals in the moderate or significant deficit category are 6x more likely to sustain a non-contact injury during sport/activity causing lost time from sport or requiring medical attention. Improving your movement score will help reduce your injury risk.

What should I wear?
Athletic clothing and athletic shoes.

How long will the visit last?
Your visit will last approximately 1 hour. We recommend that you arrive a few minutes early to your first appointment.

How to schedule?
Your doctor will notify Physical Therapy that you need to be scheduled and we will call you within 2 business days to schedule an appointment.

How is this visit billed?
This will be billed as a Physical Therapy visit. If you have used the maximal number of visits on your insurance, you can self-pay $75 per visit (this is due at time of visit).

Testing Locations

Hixson PT Office
2051B Hamill Rd
N. Park Plaza, Suite 1000-A
Hixson, TN, 37343
Physician Office Building directly behind Memorial Hixson Hospital
(With Chattanooga Heart Institute) 1st Floor
Phone: 423-624-2696 Ext 7734

Cleveland PT Office
2400 N. Ocoee St.
Cleveland, TN 37311
Phone: 423-624-2696 Ext 7316

CSMO is a Proud Sponsor of the Best of Preps


The Chattanooga Time Free Press is proud to present its annual Best of Preps event, Thursday, June 9 at the Chattanooga Convention Center.

Celebrating the best high school athletes in the greater Chattanooga area, the awards dinner and program offer students and their families an opportunity to publicly acknowledge the athletes’ accomplishments and enjoy an appearance by Kansas City Chiefs star, and former University of Tennessee standout, Eric Berry.

Visit bestofprepschatt.com for more information!

Nash Honored for Caring Spirit


CHI Memorial Foundation recently presented John Nash, M.D. with a Caring Spirit Award.

Dr. Nash’s grateful patient shared, “He took care of me immediately, radiating empathy and care.”

More information about CHI Memorial Foundation’s Caring Spirit Award is available at http://www.memorial.org/caring-spirit.