02 July 2019
Mr Paras Jethwa, a consultant general and laparoscopic surgeon at Spire Gatwick Park, is also a cycling phenomenon. He clocks up around 7,000 miles a year cycling to and from hospital, enjoying rides around Surrey and Sussex countryside after work, and taking part in endurance races across the UK and Europe.
Since this passion took hold when he was in his 20s, Paras, aged 50, has achieved at least 30 triathlons, several Iron Mans, and countless 100-mile bike rides.
But all that stopped when he suddenly developed back pain in February last year.
'I was on a short break in Paris with my son when I started having pain in my bottom. I can’t recall anything which happened specifically, but we had to drive home early as I suddenly couldn’t walk the length of a room without being in terrible pain.'
Within a few days, he had excruciating pain in his left leg. A MRI scan showed he had a prolapsed disc which was pinching the nerves - a prolapsed or slipped disc is when the soft cushion of tissue between the discs in the spine pushes out. He took a week off work to allow it to settle down.
'I knew round 50-75% of prolapsed discs can get better by themselves so I was hoping I would be in that group.'
When he returned to work, he could only do ward rounds by holding onto a wheelchair for support and had to sit down to perform operations. He was taking pain killers and muscle relaxants at night just to get some sleep and says he felt very low.
He contacted fellow Spire Gatwick Park consultant and neurosurgeon Mr Giles Critchley who was Paras’ senior house office in 1994 when they were both at St George’s Hospital, Tooting. 'I had bumped into him a couple of times at Spire Gatwick Park, so I phoned him and said 'help me'.'
Mr Critchley referred Paras for a local steroid nerve injection which relieved the pain for a while enabling him to start swimming and going to the gym.
'I was determined to get better. Although I was fit from cycling, I realised I had ignored my core muscles which support the spine, so I started focussing on those.'
However, the pain returned leading to a second steroid nerve injection, but this time it had little effect. Paras was now in constant pain and had limited mobility and developed some weakness in his ankle.
'We are an active family and I normally take the kids (aged 16 and 14) cycling or playing frisbee or football but when the back pain occurred my son said 'you’ve stopped being a dad'. I remember taking my children to Reigate Common to ride our bikes and I just couldn’t do it.'
Paras was put on the urgent list and had a microdiscectomy on May 25 last year, performed by Mr Critchley.
'By the time of the operation, I had not slept for a few days because of the pain. My big fear was that this was going to stay like this for ever but when I woke up after the operation I had no pain at all and could stand up straight, which is something I hadn’t been able to do for a few months.'
Paras had a phased return to work, challenging himself to walk 15,000 steps a day to improve his fitness levels, and continued exercising his core muscles in the gym.
Six weeks after the operation, he went for his first bike ride, a gentle 10 km, and since then nothing has held him back. By that September, he was part of a 20-strong team of surgeons taking part in a gruelling seven-day bike ride from Southampton to Edinburgh, which was featured on The One Show.
'It was my first big ride since the operation. We were cycling 100 miles a day and it was fantastic!'
Paras has been firmly back on the saddle ever since with no return of the back pain. He can comfortably cycle to the top of Box Hill (the former Olympic route) in just seven minutes and this summer will be taking part in one of Surrey’s newest sporting events, Ride Reigate (100 km on July 7). A month later he will be at Ride London (100 miles on August 3-4) and then in September, Paras will be attempting the cycling mecca, Mont Ventoux in France - not once but three times, choosing three separate routes to reach the summit.
While back pain may have temporarily halted his cycling ambitions, it has changed him as a person and as a consultant he says, 'it is shattering and very humbling to go through something like this. I now have much more empathy for patients, and it certainly made me realise what is important in life.'
What the surgeon says:
Mr Giles Critchley, consultant neurosurgeon: 'Most people have back pain at some point in their life, but it usually settles by itself within a few months. Around five per cent of people with back pain will have what is often called a slipped or prolapsed disc*, which presses on the nerves causing sciatica – pain radiating from the lower back into the buttocks and down the leg.
For most people it will settle with time and the usual advice is to take over the counter pain killers and anti-inflammatories, and keep as mobile as you can. If it doesn’t settle within a few weeks your GP can prescribe stronger painkillers and may refer you to a physiotherapist. In more severe cases, a steroid injection will be administered which will take away the pain and allow the area to calm down to enable healing.
We try to avoid surgery wherever possible but if the pain makes it difficult to work, enjoy everyday activities or sports, or is causing weakness, then that can be the next step. In Paras’ case, he was bent double, with the pressure on the nerves causing a dropped foot which meant surgery was necessary.
A microdiscectomy is minimally invasive surgery in which a small portion of the disc is removed to relieve pressure on the nerve. It has a high success rate often with good relief of the leg pain in 80-90% of patients. With help from physiotherapy you are often back to normal activities within three months.'
*Rarely disc prolapses can cause severe back pain and the disc can affect bladder and bowel movements and cause numbness in the bottom and in the legs. In these circumstances immediate medical help and surgery may be needed.
If you wish to seek advice or book a consultation with Mr Critchley, please call on 01293 778 906 to find out more.