An Ironman triathlete gets back in the race with help from Dr. John Hamilton and Inova Neurosciences.
Mark Fostek, 49, has been an athlete all his life. A former college baseball player, Mark took up running in his late thirties. In 2015, he discovered the triathlon, a sport that combines swimming, cycling and running – and he has never looked back.
Mark quickly progressed to Olympic distances, then set his eye on the Ironman: a grueling race that combines a 2.4-mile swim, a 112-mile bike ride and a full 26.2-mile marathon, all in 17 hours or less. Between 2016 and 2019, he completed four Half Ironman races – a distance of 70.3 miles in total – and celebrated the completion of his first full 140.6 mile Ironman in October 2017.
In late December 2018, Mark began to experience troubling symptoms. “I know my body pretty well, and when something doesn’t feel right, I tend to know what it is. After a bike ride one day, I felt something I had never felt before – tingling on my right thumb and forefinger,” Mark said. “It was similar to the sensation you get when you hit your funny bone, but it never went away. After the third day, I knew that this wasn’t normal.”
An IT professional by trade, Mark headed to his computer to research his symptoms. He concluded that nerves in his cervical spine – his neck – might be getting compressed or irritated. He consulted with several surgeons, but it wasn’t until he met with John Hamilton, MD, neurosurgeon and Co-Medical Director of Inova’s Spine Program at Inova Fairfax Hospital, that he found the right fit.
Inova’s Spine Program is part of Inova Neurosciences and is composed of highly regarded spine specialists, supported by a dedicated team. “To qualify as a provider within Inova’s Spine Program, you need to be an expert in spine. We have the most cutting-edge resources with respect to spine surgery. Anything that is offered, you can get it here,” Dr. Hamilton said. “When you look at number of cases, the outcomes and the patient satisfaction, I would rank it with any institution in the country with respect to spine.”
Dr. Hamilton reviewed Mark’s X-rays. It was clear that Mark had suffered considerable degeneration in two spinal discs in his neck, which were not improving with physical therapy or other conservative measures. The degeneration was causing cervical radiculopathy, which is the medical term for inflammation or irritation in the cervical spine’s nerves. That irritation was causing his symptoms. Mark and Dr. Hamilton talked about Mark’s alternatives, which included fusion, disc replacement and decompression.
“Our first meeting lasted more than half an hour, which was incredible. He understood what a big decision this was for me, and his calm demeanor put me at ease,” Mark said. “I knew that this was the person I wanted performing surgery on my cervical spine.”
Mark was most interested in a Mobi-C artificial disc replacement, which would maintain his neck’s flexibility. Spinal fusion surgery would also treat his symptoms, but it would involve fusing two or three of the bones in his neck into one long bone, reducing its ability to bend and flex. Mark wanted to avoid fusion, if possible, so that he could maintain the flexibility he needed to continue competing in races.
After two weeks of consideration, and lots of additional research, Mark decided to move forward with the surgery. The plan was for Dr. Hamilton to attempt a two-level Mobi-C disc replacement, which had recently been FDA approved to treat Mark’s condition. Mark hoped that Dr. Hamilton would be able to avoid a fusion on the lower level, but it would have to be a judgement call during surgery.
“I was really worried about it, but I left it in God’s hands. It was out of my control,” Mark said. “I had complete faith in Dr. Hamilton.”
On February 22, 2019, Mark had the surgery at Inova Fairfax Hospital. “I’ve had several surgeries over the years, and I was more than happy with everything at Inova Fairfax Hospital,” Mark said. “I was thoroughly impressed.”
When he awoke after surgery, Mark was delighted to learn that Dr. Hamilton had achieved the best-case scenario: a two-level Mobi-C disc replacement, with no spinal fusion. “It’s a delicate dance. Sometimes, the patient’s anatomy won’t allow us to place two artificial discs,” Dr. Hamilton said. “I was able to achieve the goal of replacing both discs, which was the outcome Mark wanted.”
“When I came out of surgery, I got the great news I had never dared to imagine: he was able to do the best-case scenario. I was thrilled,” Mark said. “I put my complete trust in him, and he delivered.”
Mark left the hospital on the day of surgery, wearing a rigid brace to protect his neck. Within three weeks, he was walking up to five miles a day, and Dr. Hamilton cleared him to resume training after three months. Mark got back to doing what he loved – training for the next big triathlon competition.
With his neck feeling good, Mark completed a Half Ironman in 2019 – just eight months after his surgery. He dedicated the race to Dr. Hamilton, and he gave Dr. Hamilton his finisher’s medal. Although Ironman races were cancelled across the country due to COVID-19, Mark was able to complete his second full-distance Ironman in November 2020 – the only Ironman to take place in North America in 2020.
Mark’s advice to other people having neck symptoms is to do your research, but don’t wait too long for surgery. “You only have one chance to do this right, so get someone who is highly regarded, with the best resources, the most talent, the best training – and without a doubt, that’s what I had with Inova and Dr. Hamilton.”
To learn more about Inova’s Spine Program at Inova Neurosciences, visit inovaspine.org.