Wednesday, June 10, 2015

Fighting Back, Part One: Overview of the Surgery and the Pre-Op Period

I intended to write, both on the blog and for myself, during my recovery downtime but that hasn't materialized.  Part of the issue is that sitting is hard on the back and so I'm in bed much of the time and only using my tablet instead of my laptop -- I'm a slow enough typer normally, let alone on a smaller touchscreen!  Still, I want to have more of a record of this recovery and also want to share it for anyone who might be looking for firsthand accounts of spinal fusion, I'll compromise with a throwback to my beloved bulletpoint style posts that may take a bit to complete but hopefully will cover the surgery and the early weeks of the recovery.

Since a single post was becoming unwieldy, I'm going to split this up a bit.  I'll add in links to the other parts once they are complete but here's a bit of rambling on the procedure and the pre-op timeframe...

Note: These posts are all just my personal experience and recommendations and thoughts should be taken as such.

The Procedure (copying myself from Facebook)
  • This will make more sense in combination with the links below (obviously generalized so may include irrelevant pieces or miss important ones) -- My surgeon did a posterior (i.e. from the back) laminectomy with fusion (much bigger endeavor than w/o), the term "PLIF" is often used for Posterior Lumbar Interbody Fusion.  The doc used pedicle screws and rods plus a bone graft of “locally harvested” material taken from the earlier in the surgery.  It was complicated since I had a previous surgery at the same level from the front (anterior, ALIF) using two cages plus bone morphogenetic protein (supposed to encourage bone growth).  We believe the area never fully fused leaving instability that caused pain.  The underlying reason is basically unknown…they’ve referenced “degenerative disc disease” (read: bone broke down and no one knows why) and also “failed back surgery syndrome” which pretty much means what it says! 
  • Here's a short animated video shows a procedure much like mine; 
  • This page has lots of words but more info than most;
  • This page provides an overview of fusion (as one person said in an online discussion about a procedure akin to mine “[t]hink of it as fusion being the primary surgery with laminectomy just a part of the process”;
  • One more link with a bit of detail on the screws 
  • Background: Many years ago, I waited much too long to speak up about pelvic in I was put in a cab and dispatched to the doc after passing out at work.  By then the pain was bad and no longer confined itself to my period and when I finally did seek help it felt pretty urgent.  Despite both the doc and I "knowing" it was endo, they ran through tests for a number of other possibilities first since endo is a surgical diagnosis.  Finally, we were ready for what I "knew" was the procedure that could diagnose and even help treat the pain.  The date was set...until I showed up to the pre-op with a "little" congestion and found out it was walking pneumonia!  That meant a heart-wrenching delay and means I freak out a bit about pre-op issues.  
    • Before this surgery, I needed a clearance from my general practitioner and a bunch of tests.  I was worried but I "passed."  
    • The week before surgery I felt kind of weak and had cold symptoms.  It isn't the right response, but I didn't say a word and figured I was fine as long as I didn't have congestion or a fever on the big day.  As a kid I'd get strep throat without the slightest temp rise and my norm is closer to 97.6, a degree below average...still I felt like I might have one about 5 days out (I refused to check).  So I held my breath when the nurse took my temp in pre-op and my heart stopped when she voiced the read-out "One hundred even."  Thankfully, and perhaps b/c they didn't know it was more equivalent to a 101 in someone else, they still allowed me to go ahead.
  • One of the many reasons I like my surgeon is that when he stopped by my pre-op bed (side note: it was in a little bay with a real door and this odd toilet that folded into the wall!) he gave me a hug and told me he'd pray for me.  It seems standard for the surgeon to check-in, but this truly made me feel like he cared.  Despite not being a religious person, I truly do appreciate prayers and I also appreciate any sort of thoughts/energy/wishes that people put out there.  I will admit, as another aside, I told people that for the day of the prayers/wishes/vibes/energy should all be directed towards the doc to guide his "part" would come after.
  • I'd had surgeries before and knew I couldn't wear my contacts.  The staff seemed a bit befuddled by me refusing to just send my glasses with my husband.  I knew I'd be in recovery for an hour or so before I saw my family when I was moved to a room.  I couldn't imagine the added anxiety that not being able to see would bring.  I pushed and, despite insisting patients couldn't take anything with them, they eventually agreed to have my glasses travel alongside me.  Absolutely worth the push (though truly surprised that I seemed to be the only person who made the request)!

Click for Fighting Back, Part Two: In-Patient Recovery.

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