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Wheely Grateful

Outdoorsman Survives, Thrives to Ride another Day

Arthur Holmes, or Rick, as most people know him in Idyllwild, California, is an outdoor enthusiast. He loves hiking and has ridden mountain bikes and motorcycles for nearly four decades. However, an accident in 2008 threatened to end Holmes’ favorite pastimes.

“I was on a downhill trail I hadn’t ridden before, when I fell over my handlebars and landed on my head. My neck seized up and I heard a crunch,” says Holmes. Miraculously, he rode home. His wife, Susie, sent him to the local chiropractor’s office. An X-ray revealed the sobering news — he had broken his neck. The chiropractor told him to go to the hospital immediately.

It would be the first time Holmes met Board Certified Neurosurgeon Alfred Shen, MD, at Eisenhower Medical Center. “He looked at me and smiled, and kind of shook his head with a ‘you don’t know how lucky you are’ look on his face.”
 
Holmes’ injury required immediate surgery. Dr. Shen performed odontoid screw fixation surgery, which involves placing a screw into the vertebral body. The screw crosses the fracture line into the broken bone segment to keep it from moving freely. Holmes’ wife Susie assisted him through a fairly long recovery process, and it wasn’t long before he was able to walk, hike and ride his bikes again.

In less than a year following his neck surgery, Holmes’ wife Susie was diagnosed with a brain tumor. “That was the second time I saw Dr. Shen,” explains Holmes. “We went right to Eisenhower and he was waiting for us in her room. It hadn’t been even a year since I broke my neck. Susie had taken care of me for a year and then I took care of her for a year. I thank God for that.”

Four years later, Holmes began experiencing back pain. “I tried rest and physical therapy, but the pain got worse,” says Holmes. “I took care of my back and did stretches, but I still had trouble. When I finally went to see Dr. Shen, I was taking 600 milligrams of ibuprofen, three times a day.”

Dr. Shen determined that Holmes’ issues were different than his previous injury. “Mr. Holmes’ problems had more to do with his lifestyle, and years of wear and tear,” explains Dr. Shen. Holmes had two problems — a lumbar spondylolisthesis, or slippage of one vertebral body over another, and spinal stenosis due to the spondylolisthesis.

Offering Holmes conservative measures to ease his pain, Dr. Shen explained that it would only be a temporary solution. Holmes opted for surgery in March 2013.

Dr. Shen performed a laminectomy, or decompression, on Holmes to relieve the pressure on the nerves in his back. “As active as he was, I knew the spondylolisthesis would get worse over time. In addition to the decompression, we did a fusion,” says Dr. Shen. “We scraped out the disc and prepared the end plates of the vertebral bodies.” Dr. Shen then inserted bone-filled implants inside the disc space. Holmes’ own bone was utilized in this case, acting as
seeds for new bone to grow and fuse. In addition, screws and rods were inserted to stabilize the vertebral body. The entire surgery took about six hours.

“I felt relief as soon as I woke up from the procedure,” says Holmes. “During my recovery from surgery, I wore my brace. In December, Dr. Shen said I could ease back into things.” For Holmes, who will be 69 years old in April, easing back into things means using his chain saw, riding his motorcycle and hanging out with his constant companion, a Labrador/Akita mix named Charlie. But, he knows his limits. “I’m a lot smarter now. There is a little voice in my head that says I need to hold back a little if I want to keep riding. As I get older, my new motto is ‘learn
to ride another day.’”
 
His neurosurgeon appreciates Holmes’ way of thinking. “Rick is one of those patients you love to have in your practice,” says Dr. Shen. “He was compliant, realistic and aware that his lifestyle would cause some aches and pains. I’m just glad that he can get back to his activities and that he has no more pain. Hopefully, it will be many years before he needs me again.”