ONS Returns Firefighter to Active Duty

Amherst firefighter, Nick Chirekos, drove to Greenwich for ONS care. firefighter, Nick Chirekos

For nearly 3 years, Amherst, MA, firefighter, Nick Chirekos, 30, sought treatment for his lower back pain with local practitioners but could not find lasting relief.  As the scope of the pain increased and radiated down Nick’s left leg, his quality of life took a turn for the worse too.  The pain inhibited his day to day movements. It  eventually eliminated his ability to work out and rock climb, two of his favorite activities. More importantly, Nick’s back problem threatened to ruin the career he loved because he found it impossible to perform his duties as a firefighter and paramedic.

“I eventually got to the point where I had decided I was a liability to my fellow firefighters,” Nick said of his decision to leave the squad in October, 2018.

It was at that point that Nick knew he had to turn to ONS.

Nick trusted ONS to get him better.

“I just didn’t feel comfortable that my local doctors could really fix my condition,” said Nick. “I grew up in Larchmont and had only heard good things about the doctors at ONS. I made the appointment with Dr. Apostolides and made the nearly 3 hour drive  to Greenwich .”

Nick knew immediately that he had made the right decision. “Right off the bat, it was a day and night difference from the care I had been receiving. From making the appointments to the nurses and staff, and of course, Dr. Apostolides, I had complete confidence that ONS was the right place to be.”

After reviewing Nick’s MRI and discussing the non-invasive options that had failed, Dr. Apostolides diagnosed two problems with Nick’s lumbar spine. The first was spinal stenosis, a narrowing of the canal where the nerves live, that can cause back pain, leg pain, and difficulty walking distances. The second was a left sided L4-5 disc herniation that was compressing the left L5 nerve root and causing left leg sciatica. Dr. Apostolides recommended a bilateral laminectomy (making a window in the bone) to enlarge the spinal canal and make more room for the nerves, and a left L4-5 microdiscectomy (to remove the disc herniation and relieve the pressure on the left L5 nerve root).  Nick scheduled the surgery for January 2019.

In January, 2019, Dr. Apostolides performed the procedure with precision at the Stamford ASC, the ONS ambulatory surgery center. Nick was impressed with the environment and level of care he received throughout his experience at the ASC.

“The facility was immaculate, and the staff was fantastic from the beginning to end,” he said.  He was up and walking just 2 hours after waking from the procedure. and t the pain shooting up and down his leg – which he described as “the most uncomfortable pain” – had vanished.

A life and career recovered.Nick Chirekos and family

Nick began his recovery at home on the same day as the 3-hour procedure, walking a little bit each day, feeling better and better.  He began physical therapy near his home 10 days post-op to strengthen his core and back muscles. ONS made it easy for Nick to recover close to home. Dr. Apostolides and Nick’s physical therapist had regular contact to discuss the progress of his rehabilitation and Nick was able to have most of his post-op appointments with Dr. Apostolides by phone.

By the following August, Nick had returned to full duty status and the activities he had been doing before his back became an issue.  One year later,, he was in great shape for  a new sort of heavy lifting:  Twin baby boys named, Patrick and Henry.

“Dr. Apostolides, the nurses and all the other staff at ONS 100 percent saved my career,” Nick said.  “It was totally a team effort and I am incredibly grateful!”

Non-Surgical Options for Back Pain

Roughly 80 percent of adults experience back pain at some point in their lifetime and most instances can be managed without surgery. In this live webinar,  ONS physiatrist, Dr. Alex Levchenko will discuss common causes of low back pain and treatment options including physical therapy, medications and injections. Q & A at the end of the presentation.  Click here to access Microsoft Teams Live. NOTE: IOS users may need to download the free Microsoft Teams app to access the program.

Condition Your Back for Winter


Back pain following a few hours of shoveling snow is all too common.  In a recent article that appeared in the Fairfield and Westchester  town sites of the Daily Voice, interventional sports and spine specialist, Dr. Alex Levchenko, advised readers to make sure their back muscles were in working order well before the first mounds of snow fall.

The article, It’s Time to Train for Shoveling Snow, Says ONS by John Haffety, Dr. Levchenko warned that all too often, people who are inactive throughout the year underestimate the physical challenge involved in clearing snow.  Even someone in good shape can strain their back from the rotation of lifting and tossing snow onto a pile.

“You should take the time to strengthen your core and back muscles just as you should before starting any strenuous activity,” he said. “You wouldn’t walk into a gym and try to lift 100 pounds if you haven’t lifted weights before. You would build up your strength. It’s the same thing with shoveling snow.”

Dr. Levchenko said the number of patients he sees with back pain increases after every large snowfall. “People tend to think of shoveling snow as a nuisance when it is really an intense form of exercise.”

When large snowfalls do occur, he recommended getting ahead of the accumulations. Start by shoveling smaller amounts every few hours rather than waiting for it to pile up and freeze.

Before tackling the job, it’s important to warm up your muscles. Once outside, maintaining proper posture and body mechanics will minimize stress to the weaker back muscles. Dr. Levchenko recommends avoiding rounding the lower back. Instead, shovellers should keep a straight back and lean forward with a slight bend in their knees.

It’s also important to use your core, hips and hamstrings to provide strength and stability rather than relying on your back and shoulder muscles to do the heavy lifting. Using ergonomically designed “push” shovels can also help ease lower back strain.

Dr. Levchenko advises people with pre-existing back conditions to avoid shoveling altogether. “It’s better to pay someone else to do it and save yourself from all the ways the increased back pain will impact your life,” he said.

Upcoming Free Seminars by ONS at Greenwich Hospital

Mark your calendars for these upcoming seminars by
ONS physicians!

Low Back Pain and Spine Disorders

Neurosurgeon Scott Simon, MD

Tuesday, February 7, 6:00 p.m. – 7:00 p.m.
Greenwich Hospital, Noble Conference Center

Join neurosurgeon, Scott Simon, MD as he dispels myths about what works and what doesn’t work to treat low back pain. He will talk about prevention of low back injury, the importance of proper diagnostics and review “what’s new” in treatments.

Dr. Simon specializes in the treatment of spinal disorders. He is one of a few physicians nationwide who is trained in both neurological surgery and orthopedic techniques to treat scoliosis in adolescents and adults and is an expert in minimally invasive spine surgery. Dr. Simon graduated from UMDNJ – New Jersey Medical School. He performed his residency at The University of Pennsylvania and did Fellowship training in spine surgery and scoliosis at The Schriners Hospital for Children, in Philadelphia.

To register, call 203-863-4277 or 888-305-9253.

Or register online.


Joint Replacement Educational Seminar

Wednesday, March, 28, 11:00 a.m. to 12:30 p.m.
Greenwich Library Cole Auditorium
101 West Putnam Avenue, Greenwich

Speakers: Joint replacement specialists Frank Ennis, MD and Brian Kavanagh, MD

Many people suffer from severe pain caused by arthritis, a fracture or other conditions that make common activities such as walking, putting on shoes or getting in and out of a car, extremely difficult. Today, over 600,000 hip and knee replacement surgeries are performed each year in the United States. Deciding if- and when- it’s time to consider joint replacement surgery are important decisions.

Greenwich Hospital will host a Joint Replacement Educational Seminar at the Greenwich Library led by orthopedic experts Dr. Frank Ennis and Dr. Brian Kavanagh that will provide answers to many commonly asked questions, including how to know if you need a hip or knee replacement, the best way to prepare for surgery, and what to expect from the recovery and rehabilitation process. The surgeons will also discuss what’s new in the field of joint replacement and how materials and techniques have improved over the years.

Registration is required. To register, call 203-863-4277 or 888-305-9253. The Joint Replacement Educational Seminar will also be made available in an online video on the hospital website, www.greenhosp.org and at www.onsmd.i9e.co after April 11.