Unsung Hero: Albertson and Dr. Melamed

Unsung Hero: Albertson and Dr. Melamed

At the Daytona Supercross in March, privateer Jimmy Albertson sustained a number of injuries during a crash in qualifying, including a fracture of the manubrium and body of the sternum (posteriorly displaced by 1cm), fractured T5 through T7 vertebrae, compression of the T4 through T6, an epidural hematoma at T5 (epidural space is the outermost part of the spinal canal), bilateral patchy lung contusions, and a left metacarpal fracture.

Albertson underwent surgery on his sternum at Halifax Health in Daytona, Florida, before flying home to see a specialist in Oklahoma City regarding his vertebrae injuries. Albertson had developed a vertebrae injury referred to as kyphosis, which occurs when the vertebrae in the upper back become more wedge-shaped. Following meetings with a specialist in Oklahoma City, Albertson was refereed to Dr. Hooman M. Melamed of DISC Sports and Spine Center in California, with special thanks to Jeremy Malot of Red Bull.

Dr. Melamed, a highly regarded board certified orthopedic spine surgeon, received degrees from UCLA and University of Pittsburgh’s School of Medicine. He’s also appeared on The Doctors Show, Dr. Oz, and Fox and Friends.

Last week, we had the opportunity to speak with Dr. Melamed and Albertson about the dangers of the surgery, what Jimmy has planned for the future and much more.

If you wish to make a donation to Albertson via Road 2 Recovery, go here

Racer X: Doctor, I’d like to start with you. I’m not sure if dangerous is the correct term here, but I think the procedure you performed was very difficult and from what I understand not many doctors actually do it. Can you explain what was so difficult about this certain procedure?
Dr. Melamed: Well, I would say first that being dangerous is actually how I would categorize this operation because, as Jimmy knows, the degree of difficulty is extremely high. I would say at most maybe 10 percent of the spine surgeons in the world do this operation. What Jimmy had was a very, very significant angular deformity that we call kyphosis where the spine was kind of tilted forward at the area where he broke his back and he disrupted the ligaments, which was between the fourth and the fifth vertebrae. It was tilted forward and there was 35-40 degrees of angulation. Normally this angulation is supposed to be about maybe 10 degrees or so. Up there, when the spinal cord starts angulating more forward, the spinal cord starts getting draped and it starts getting kind of stretched out, which is not good. So, what was happening to Jimmy was that he was compensating in order to basically fight that stretching. He was hyper-extending his lower back and his neck a little bit. Yes, you could argue, if we just go put some rods and screws and use it and lock it in place, the overall alignment is okay but you have not restored the angular correction between the fourth and the fifth vertebrae. I had to go in there and remove the part of the fifth vertebrae and the disc between the fourth and fifth, and then collapse the forth and the fifth and then restore the angulation. You have to work around the spinal cord. This is a very dangerous operation.

Jimmy, when this first happened what did they initially tell you in the hospital? Was there a concern about your long-term ability to walk or anything like that?
Jimmy Albertson: Yeah, it’s just so tough because we were in the Halifax Hospital down in Daytona. We were down there for a week and for the first three days the possibility of paralysis was pretty high because I’d had a hematoma on my epidural tissue of my spine, which was pushing on it. They were very concerned about that. Once they found out that that was stable, they actually had me up and walking before my sternum surgery. It’s kind of frustrating because there’s just so many different … I’ve obviously dealt with a lot of people in the medical field, and there’s so many people you can tell that are like, “Okay, he’s stable so just let’s not worry about this guy. Let’s move on to the next.” I was there for six days with a sternum that was broken in two pieces, completely separated. Once I got the sternum put together I felt 100 percent better, and I could actually feel more of what was going on with my back.

The spinal doctor down there basically was like, “You should never do anything ever again really that could result in any sort of fall.” She had told me to see a specialist when I got back, but I never got a clear answer other than that. When we got back, we did a bunch of research in the OKC area, and I actually was going to go do a different doctor and he ended up turning my case down after he saw my MRI. So, I went to another doctor, he came into the room after shooting X-rays and looking at all my old MRI’s and stuff. His first question was, did you walk in here? I’m like, yeah. He just told me basically go home and we’ll schedule you a surgery in 10 days, and before that we don’t want you driving in a car, we don’t want you doing anything, because this is very dangerous. It was kind of just like, yeah, we’re going to make your spine stable. He really wouldn’t kind of answer any of the other questions on what Dr. Melamed was saying about the angle of my spine. Once I’d kind of done some more research and found out that he wasn’t going to even try to attempt to fix that kyphosis in my back, I knew it really wasn’t the right thing. I’d gotten to a point where I got really depressed about everything and pretty bummed out, like I was going to be screwed up for the rest of my life. And then actually Jeremy Malott from Red Bull, we had done some projects together and we became friends over the last couple years, he got a hold of me and mentioned about the DISC MD group. That’s where they send their athletes for that stuff. He actually got me in touch with Dr. Melamed and another doctor over there, Dr. Bray. After they reviewed all my stuff, Dr. Melamed, he gave me a call on his own, which is crazy. I felt like that was a huge honor just for him to pick up the phone and call me. Usually it’s just an assistant that will call you. He explained that, yes, I do need to have those vertebrae fused and rodded, but the surgery is much more complicated. He explained the realignment of the spine. He spent the time to make me feel comfortable. He did tell me this is a very dangerous surgery, but at the end of the day, when somebody trusts my professional ability in riding a dirt bike or whatever, I take that on as a challenge. Whenever he said that this is a dangerous procedure but I can do it, I put my trust in his practice and the work that he’s done and basically the portfolio he’s built of success.

I think Dr. Malemed could probably answer this better. What are some of the potential things that could go wrong in a surgery like this?
Dr. Melamed: The biggest thing is paralysis, permanent paralysis. Of course, there’s other risk of spine surgery with the rods and screws not being in the most ideal position. Unfortunately, any time anyone puts a screw, the screw may not be in the most ideal position. You may have to change it, although that’s rare. Of course, there’s risk of infection, bleeding, heart attack, stroke. Other things that go along with the surgery. But the biggest risk with this operation is obviously paralysis. You’re kind of working around the spinal cord. The spinal cord is not something you can really retract. It is very, very delicate. One little slip of your hand, one little thing and it’s game over.

Now if he were to not undergo the surgery, what would his long-term health look like as far as his back and his spine?
Dr. Melamed: Disaster. When the angulation is supposed to be about 10 degrees on average and now you’re going into 40 degrees, you’re going to have to make the 30 degrees up somewhere else. So, the rest of the spine starts compensating. Like I said, his lower back was arching. It’s amazing, the X-rays before surgery and the X-rays after surgery. So, he would have ended up with a lot of back problems, with a lot of neck problems, and he would always be in pain.

Albertson: It’s funny because as a motocrosser you grow up taking risks and that’s something that you accept every time you put your leg over the bike. Going into the surgery, riding is a part of who I am. I want to always be able to ride a motorcycle. I’m going to tone it down from here on out. I’m probably not going to race professionally again. I may do some motocross races, but definitely not supercross and tone it back. But at the end of the day I want to be living a life where I can be doing whatever I want to with my kids and everything like that. My main deal going into the surgery was, yeah, I need to be right. I don’t want to look back and not have the surgery and then all of a sudden I’m screwed for the rest of my life. I was pretty okay with that decision all the way up until really the morning and the night before the surgery. I had never had so much nervousness and anxiety in my entire life. I couldn’t quite pinpoint what it was. I’d never, ever been nervous about an operation or anything like that, and literally right before I went into the operating room I had to get injected with basically some medicine to calm me down. I knew it was the right decision, but I also knew how risky it was. It was just a scary thing altogether. Luckily Dr. Melamed did an amazing job and it all turned out great. I couldn’t be more thankful.

How often do you see these types of injuries and in what fields do you actually see them in?
Dr. Melamed: This kind of an operation that I did, a lot of it is motorcycle or car accidents, a bad fall, people go from working on a roof or something like that, but motorcycles are the number one cause. Horseback riding a little bit you see that. But then outside of that, you use this in people who have what we called congenital kyphosis. They were born like that.

Jimmy, you had mentioned Jeremy from Red Bull kind of set this up. You said you saw two other specialists and one actually turned you down. What made you make the decision to go to doctor was the best one and how did you come to that decision?
Albertson: At the end of the day, what persuaded me the most was when Dr. Melamed took the time to call me on two different occasions to make sure I was comfortable and I knew all the details going into the surgery. He let me know that this is a big operation. This is something you really need to think about and you need to weigh out the pros and cons. He was so truthful about everything and you don’t get that a lot with doctors. After talking with him on the phone, like I said, I went there for a week for a while just feeling like crap and depressed and not really knowing what was going to happen to instantly feeling 100 percent better. It was almost like I had taken some form of drug after I talked to him.

Jimmy, I know you kind of said you weren’t exactly sure what your future in racing would be. Is that something you guys discussed between each other after the surgery, prior to the surgery, at any time?
Albertson: It definitely was discussed. I’ll let you go on with this, Dr. Melamed.

Dr. Melamed: The thing is that I’m not really worried about what I did in surgery. What I’m concerned about is the area that I did not do surgery, especially the level above the fusion with the rods and screws. That level actually becomes a weak point, and the level below. So those areas become a little bit of the weak point, but their areas become more susceptible to injury. My concern is that if, God forbid, another one of these happens, something worse can happen. But what are the chances of him riding and something bad happening? It’s very small, but if that small chance happens, something really bad is going to happen. I told him I don’t ever want to be the doctor to get a call about my own patient.

Albertson: Yeah. I think the big thing is with me, let’s just face it. Supercross is dangerous. It’s a lot more dangerous than outdoor motocross. I’m to the point in my life where I’m okay stepping away from racing full-time. When you’re riding and training every single day, your odds shoot so far up of something bad happening, especially when you’re talking about racing supercross which is way more dangerous. For me, after this injury I’ve just kind of told myself, I’m going to ride bikes for fun. It’s not going to be my primary form of income anymore. I’ll figure something else out to do. But what I do want to do in the future is ride my bike for fun, and that means I’m not having to push my limit every single time I get on the bike. I can ride within my comfort zone and know that my back is going to be strong. Obviously that’s how it is. When you put metal in somebody, just like with the rod that’s in my femur or whatever, your point of breaking goes to someplace else. It’s going to transfer, and I understand that, but the last thing that I wanted to do was have that draped over kyphosis and be living in pain for the rest of my life. That pain leads to pill addiction. It leads to just basically changing who you are as a person.

I think Jimmy brought up a good point. Doctor, do you see this in people that don’t undergo the surgery? Do you see a rise in opioid addiction and things of that nature?
Dr. Melamed: One hundred percent. No question. Opioid addiction, nobody just wakes up one day and says, I want to go get addicted to narcotics. What happens is you have some injury to your spine and of course the initial injury is painful, yes. Everybody needs narcotics for that. I have no problem with that. But then what happens is if you don’t treat it , well the pain is never going to go away, and if you do surgery and the surgery is the wrong way, that is still going to have pain also. And these people get on it because they’re hooked. The worst part in all of this is that the doctor—this is what makes me crazy, that drives me off the wall—the surgeon who botches the surgery doesn’t have the audacity to tell the patient, “Listen, it didn’t go as well. We have some issues, but I’m not the person to really fix it. I think it needs to be fixed.” I think if you tell patients that, patients have no problem. What patients get pissed off is they’re basically not told there is anything wrong and you’re going to have to live with this. Believe me, I’ve heard that so many times.

Albertson: Not only just a huge problem, and obviously it’s a problem in the country, but in our sport too. It is insane. I’ll just give you my take on it personally. I’ve had a lot of injuries in my life and I’ve never had to be on pain pills for really more than a couple weeks. This current injury that I’m in right now, I’ve been in pain since the injury happened on March 11 and we’re now over a month out from when the injury happened and I’ve been on pain medication basically this entire time. This is the longest I’ve ever been consistently on pain medicine. My whole thing is, gosh, when can I get off this stuff so I can get back to being my normal self? It’s just a slippery slope. I can definitely see why people go down it and they get hooked. It’s an easy way out.

I think both of you can probably speak to this. It not only is just the initial pain, but it’s the depression and all the other stuff that comes with it when you’re on this medication for that long, right?
Albertson: Oh yeah. A lot of times there’s a very blurred line in-between depression and pain. I think a lot of times you’ll be like … I found myself when I was in that bad spot in-between trying to figure out what we were doing with my back, I found myself asking the question, am I taking pain medication because I truly really hurt and need it? Because I can take pain. I’ve taken pain my whole entire life. Or am I taking it just to numb my mind of what’s actually going on? And that’s when it starts to get scary.

Doctor, what do you see as far as a recovery process? Obviously Jimmy’s recovery is not over. How long of a timetable do you see and what are some of the steps he still has to go through?
Dr. Melamed: I met Jimmy last week, last Tuesday, so eight days ago and he had about almost a month had gone by that he was basically in this unstable spine with this bad posture dealing with it. Yeah, that’s very painful and of course if he doesn’t get treated and if he would have ended up with the wrong surgery, guess what? He would have ended up doubling up on the narcotics. Next thing you know a year from now, Jimmy would have been a full-blown addict basically. As I talked to him, once you get the surgery within about a week or so to 10 days you start slowly tapering the medications off. The pain is going to slowly get better. It’s a process basically. I told him by three months, assuming everything is healed well, by three months I want to say Jimmy you are good to go, buddy. You’re loose. I will cut you loose and lift all restrictions on you. So it’s not as long as people think it is, the process. We will start him on therapy I told him in about eight weeks or six weeks he can start doing on a stationary bike and start maybe by eight weeks start gentle weight-lifting.

Albertson: That’s what I’m hoping for. What’s cool about Dr. Melamed, I’ve been to so many doctors where I’ll have a broken collarbone and they’ll be like, yeah, that’s six months until it’s going to be better. It’s like, what are we basing this off of? A freaking 80-year-old woman who sits on the couch and smokes cigarettes? We’re talking about high-end athletes. We work on our health 24/7. We eat the right things. We have bloodwork drawn so we know we’re not imbalanced anywhere. Taking care of our bodies is what we do. I know that Dr. Melamed doesn’t look at that scale the same. You’ve got to treat the patient, not the injury.

Dr. Melamed: I make sure their nutrition is optimized, make sure what they’re eating, their diet, what they’re doing, all that stuff I make sure is all optimized. It’s not just the surgery I’m doing. As Jimmy said, you’re treating a person, not just some bone there and putting rods and screws. You’re treating a human being.

Jimmy's done with supercross, but we still might see him at some motocross races in the future.
Jimmy's done with supercross, but we still might see him at some motocross races in the future. Jeff Kardas

Jimmy, I know you were a little hesitant maybe initially to get some help from Road 2 Recovery, but what have they provided you through this time? I know they’re a big help to everyone in the industry.
Albertson: Yeah. I was really hesitant at first because I’ve done well for myself in my career and I really didn’t feel the need. Obviously the first three days in the hospital were like, oh my gosh, possible paralysis, I don’t know how long I’m going to be here, if I’m going to need a medical flight home, stuff like that. So once we kind of got to the point where I was getting around fine at home, and I didn’t think I was going to have to have any surgery, I was like, I really don’t need this help. I talked to Anita [Button] and Mike Young up there and I kind of came to the conclusion like, look, if any money’s been raised let’s just put it back into Road 2 Recovery and put it towards the people who need it because I’m going to be fine. My whole thing was I might need help if say if I would have went to Dr. Melamed and my insurance wouldn’t have covered it, but I knew that’s the surgery that I needed. Then yes, I would have needed help with that. Luckily everybody at the office there at DISC MD group, everybody was so awesome about handling everything and handling my insurance stuff that it ended up working out great. But what was cool with the Road 2 Recovery guys was, yeah, we might not be needing what we thought we might need out of them, but just the simple things like flying Georgia [Jimmy’s wife] and I out there and then flying me back first class after surgery. It was still miserable being even in first class, but to where they tried to make this as easy and comfortable on me as possible. I tell you what, I’m the type of person that if it’s my own money I’ll spend whatever it is to make it right, but there were certain instances where it didn’t matter. I wouldn’t have had the money to go completely out-of-pocket on a massive surgery. So I think just them always being there in our corner the whole time was just huge. I couldn’t thank Mike and Anita enough over there for everything they did.