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Originally Posted by spineally challenged on November 03, 2003
SURGERY DATE: 11.7.03
AGE AT SURGERY DATE: 41
SURGEON: Dr Zeegers
SURGERY LOCATION/CLINIC: Alpha klinik - Munich, Germany
DEVICE(s), LEVEL(s): Charite III, L5/S1 , L4/3
COST =
AMOUNT BILLED:
Surgery including all tests, hospital stay, and compulsory corset: £16063.70
Physio: £348.85
Massage: £276.06
Extra £76.99 for extra tests following some post op complications. Hotel: £1985.56
INSURANCE ALLOWED: None
OUT OF POCKET: All of it - £19206.16
TRAVEL: £455 includes flights and travel insurance
EXPLANATIONS?
ONSET OF LUMBAR PROBLEMS, DATE OF INJURY, CAUSE, ETC...:
In 1986 I suffered an acute attack of low back pain, which took a month to recover from. 3 months later I was working in a bent-over position when my back started to ache. By the evening I had severe pain in my back and left leg and my spine had taken on a ‘skewed’ appearance.
The following year consisted of long periods of intractable leg pain (left leg) which culminated in me being referred to an Orthopaedic surgeon. A CT scan showed that the L4/5 disc was degenerate and associated with a degree of spinal stenosis. In July 1988 I was operated on at 3 levels L3/4, L4/5 and L5/S1 to decompress the nerve roots and relieve the stenosis.
Following surgery my recovery was slow. My leg pain returned and could only be relieved by lying down. Standing or walking remained very painful for 12 months following surgery. My lumbar mobility and strength remained poor particularly in flexion.
Gradually from early 1990 the acute vulnerability of my back decreased. I started to work again as a cabinetmaker. I continued to be troubled but in the main the attacks of leg and back pain became less acute and could be ‘worked through’ by adjusting my work to suit my level of disability.
Towards the end of 1994 things took a turn for the worse. I repeatedly suffered acute episodes of disabling back pain, which could only be eased by bed rest. Following one particularly bad episode I was in acute pain for 6 months spending much of my time in bed where I got some relief. During this period I could no longer work and I was forced to abandon my business as a self employed Cabinet Maker. Even household chores became difficult & often impossible.
Following an MRI in 1995 I was placed on the surgical list for a spinal fusion at L4/5 and L5/S1. Following discussion with the surgeon I decided not to proceed with fusion but to follow a course of rehabilitative physiotherapy. This combined with drastically reducing my level of physical activity resulted in lessening the frequency of the acute episodes and I now found myself with chronic back pain/discomfort, occasional acute flair ups and a severely restricted lifestyle. The acute episodes were now characterised by crippling back pain and only mild infrequent leg symptoms.
To achieve this fragile level of ‘stability’ in my back I had had to make many life changes. Along with avoiding all strenuous physical activities I had to avoid sitting for any length of time. Sitting resulted in immediate discomfort and frequently prolonged sitting was followed by an acute episode of back pain, which usually saw me bedridden for up to 4 weeks. I tended to lie down whenever possible which was fine in familiar company but very embarrassing and quite frankly impossible in many formal situations. I now work from home as a web designer and have designed a computer workstation, which enables me to work lying down.
My work, home, family and social life were all affected by my physical limitations.
Whilst for the most part my pre-surgery symptoms were not crippling my life was necessarily severely restricted in order to keep my back as pain free as possible. For many years I battled against my symptoms pushing my back to its limits and beyond so that I repeatedly ended up in acute disabling pain. I learnt with time that by avoiding certain activities principally anything strenuously physical and prolonged sitting that I could in the main keep my pain levels tolerable. However the limits this placed on my life were in my mind unacceptable.
PRIOR SPINE SURGERIES AND PROCEDURES:
Decompression / Laminectomy: In July 1988 I was operated on at 3 levels L3/4, L4/5 and L5/S1 to decompress the nerve roots and relieve stenosis.
PRE-OP MEDICATIONS:
PRE-OP DIAGNOSTICS:
Discogram - 4 levels. L5/S1 and L4/3 were extremely symptomatic. To everyone’s surprise L5/4 although the most degenerated level was found to not be a pain generator. L3/2 was used as the control level. This procedure was done with no sedation and was extremely unpleasant but it is the definitive test and the extreme pain was only short lived..
MRI and X-Rays
PRE-OP NEUROPATHIES:
Slight numbness/tingling predominately in left leg.
PRE-OP CONDITION:
Leg pain 5%, Back pain 95%. For pain levels, ability to work and function, disability status, etc see ONSET OF LUMBAR PROBLEMS, DATE OF INJURY, CAUSE, ETC above
TIME POST-OP AT ORIGINAL POST HERE: 16 weeks
DESCRIBE YOUR SURGICAL EXPERIENCE:
The Klinik and Dr Zeegers were both excellent. Dr Zeegers was confident and compassionate and the nursing staff were all kind and professional. The vast majority of the staff spoke excellent English.
Thursday 10th : Arrived at Klinik at 12.00 midday for pre-op tests and surgical consult..
X-Rays, MRI, Flexibility test, Discogram, test for back muscle strength ( found to be 70% below norm.). We saw Dr Zeegers for the final consult at about 9 PM and it was decided to proceed with ADR surgery on 2 levels the following morning at 9 AM.
After this emotionally and physically exhausting 9-hour day at the Klinik we returned to our hotel to await the morning..
Friday 11th : Arrived at the klinik 8.45. I said goodbye to my wife at 9.15 AM and the operation started at about 10.00 AM. I was returned to the recovery room about 3 PM after a 5 hour op.. I had lost 2+ litres of blood during the operation when a small blood vessel was torn and needed a transfusion. The blood loss + anaesthetic left me extremely weak – Dr Zeegers asked me to try and stand in recovery and while this was physically possible I almost passed out and was hurriedly returned to a recumbent position. I was finally returned to my room at about 8 PM. The rest of that evening I slept on and off but also found the energy to phone friends and relatives and was surprisingly chirpy… I had no extra pain relief that night other than what had been administered directly postoperatively.
Saturday 12th: I woke feeling OK’ish – my back was slightly sore and I seemed to have no leg pain. The incision (20cms) was sore – particularly when coughing/sneezing but was manageable. With the assistance of the nurse I made it to the toilet but almost passed out and had to once again hurriedly retreat to my bed. Following medication my dizziness subsided and by the afternoon I was walking up and down the corridor and chatting with my fellow patients. Thin broth soup for supper only water to drink..
Sunday 13th : The medication (Novocain drops) seemed to be controlling my post op symptoms. I walked outside the Klinik for the first time (wearing my corset) and managed about quarter of a mile. Weak broth for dinner followed by mashed potatoes and veg. but still only water to drink. My blood pressure was still low. I had very little back and leg pain.
Monday 14th : Walked up to the next floor for X-rays which confirmed that the positioning of the discs was excellent. In the afternoon walked about half a mile outside the Klinik. Very little pain – the medication seemed to help with the other post op symptoms: dizziness, shivering, sweating.. I had my first real solid food today.
Tuesday 15th : Following an ultrasound test for deep vein thrombosis and news that my blood analysis and pressure were satisfactory I was given the all clear and told I could return back to the hotel. I was given an appointment to see Dr Zeegers on Thursday. In the afternoon I started gyrotronics treatment (only 5 days following surgery). This was a real shock to the system and in retrospect I think it would have been better to start Thursday or Friday. I walked to the Klinik and back for the therapy session a total of about half a mile..
I was released from hospital with only paracetomol and codeine pills. While in hospital I had been on Novocain drops. This sudden drop in medication proved too great and that evening I really crashed – shivering, sweating, feeling nauseous etc. The night was very rough – myself and my wife were both very scared as some of the symptoms were consistent with an infection. I managed about one hour’s sleep..
Wednesday 16th : Following my terrible night we rang the Klinik first thing in the morning and spent most of the day back at the klinik feeling extremely unwell while a battery of tests were performed to rule out infection. In the end my condition was stabilised by reintroducing the drugs I had been on whilst in hospital along with anti-nausea drops. We finally got back to the hotel about 4 PM and by the evening I was sufficiently recovered to take a short walk to the local shops followed by a reasonable nights sleep. In retrospect I feel the terrible previous 24 hours could have been avoided – had I been released with the same drugs I was on whilst in hospital then I would not have crashed.
Thursday 17th : I felt much better today and we managed a walk to the local park where we sat on a bench and watched the world go by. My appetite was much better though still not normal. I resumed gyrotronics again walking there and back and the experience was much better than on Tuesday. After gyrotronics I rested for the remainder of the day and had a reasonable nights sleep although I was woken up very early by severe leg nerve pain which strangely went away when I got up the next morning.
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