JeffreyD 3 level lumbar/ Charite

[JeffreyD]

SURGERY DATE: February 25, 2005

AGE AT SURGERY DATE: 46

SURGEON: Dr. Willem Zeegers

SURGERY LOCATION/CLINIC: Munich Germany /Alpha Klinik

DEVICE(s), LEVEL(s): Charite / L5-S1, L4-5, L3-4

COST = $29,000 euros (including 6 weeks of post-op therapy and medical care)
AMOUNT BILLED: Same
INSURANCE ALLOWED:None
OUT OF POCKET: All
TRAVEL:
EXPLANATIONS? I chose to stay 6 weeks post-op (I had bone quality issues plus a 3 -level operation) as I felt the additional cost of hotel stay was worth the expense. I chose to have PT at the AK for those crucial first weeks, as it was so beneficial to me and it was personally monitored by Dr. Zeegers........plus by staying a bit longer than usual, the plane ride home (12 hours in Coach) was not bad at all!

ONSET OF LUMBAR PROBLEMS:
First back problems started in 1992, while playing racquetball. Prior to this, I never had so much as a backache. Shortly thereafter my back just “gave out” at work, with no apparent cause. It just started hurting and before I knew it, I was unable to stand. After 3 days in the hospital, I was diagnosed with DDD at multiple levels and given a series of epidural steroid injections, which, along with physical therapy, got me back on my feet after a few months. Over the years, a steady decline ensued, with more frequent episodes of having my back go out, each leaving me with a twisted and offset torso with extreme pain. Physical activities fell by the wayside one by one. By 2004, I was headed for being home-bound in a wheelchair if things didn’t improve, and there was no sign that things would.


PRIOR SPINE SURGERIES AND PROCEDURES:
Over 30 ESIs, 2 level IDET with Nucleoplasty, 2 years of Med-X therapy.

PRE-OP MEDS: Norco, Neurontin, Trazodone, Indomethecine, Skelaxin.

PRE-OP DIAGNOSTICS:
Three series of facet diagnostic injections (all negative), Sacroiliac diagnostic injections (negative), 2 discographies with sedation (3 years apart with differing conclusions); my third discography (no sedation) was done by Dr. Zeegers, and was absolutely conclusive for concordant discogenic pain, primarily at 3 levels.

PRE-OP NEUROPATHIES :
Extremely debilitating left side low back pain. Often unable to bear weight. Pain radiating into Butt. Left leg sciatic pain, with numbness in left bottom of foot, big toe, and front of shin.


PRE-OP CONDITION:
95% back pain, 5% leg pain. Ability to work in graphic arts field becoming more difficult every day. Can only sit or stand for a very limited time. Unable to walk more than 1/8 mile. Only lying down provides relief. I was only able to drive short distances due to pain. All plans, both professional and personal were coming to a slow painful halt. For instance, my wife and I had to completely cancel all of our long time plans for our 25th wedding anniversary in February 2005 (trip to Hawaii). I would have had a tough time just getting to the airport! We ended up going out to dinner which was painful enough. I lived in constant fear of moving the wrong way and having my back go out. My lumbar pain levels fluctuated from 7 to 10, but it was the loss of functionality that was the main problem. I could not stand straight, bend in any direction, or lift more than 1 lb. My wife had to help dress me every day. I hadn’t been able to put my own socks on for years.

TIME POST-OP AT ORIGINAL POST HERE: 12 weeks

DESCRIBE YOUR SURGICAL EXPERIENCE:
I spent the pre-op day meeting the different specialists and having various test. Each specialist I met (internist, physical therapist, anesthesiologist, etc.) was interested in knowing me as a person, not just a patient. The same was true of Dr. Zeegers; he spent a ton of time with my wife and I, and was undeterred in his quest of accurately diagnosing my back problems. The level of medical care at the Alpha Klinik was world-class in every aspect.
My surgery began at 7:30am. I remember waking up with Dr. Zeegers talking to me about the surgery, and showing me pictures of the surgery. He was very confident that the placement was perfect, and was very concerned with how I felt, etc. I remember being aware that my back felt different; I had none of my usual back pain at all. I thought this was great, but knew that only time would tell. It was a very difficult surgery (over 6-1/2 hours), as the level of degeneration was extremely severe. I lost 2 units of blood during surgery, and required a transfusion. I was weak right after surgery, and could not walk to my room. I was wheeled to my room on the gurney, and helped to bed. Due to the blood loss, my blood pressure was dangerously low, and my hemoglobin count was low as well.. My eyes were swollen almost completely shut. A doctor who was a blood specialist appeared, and monitored my progress hourly until I was out of trouble. Dr. Zeegers came to my room that evening for a long visit with my wife and I. He explained the surgery in detail step-by-step, and sat next to me with his hand on my arm and answered all of our concerns and questions. The next day, Dr. Zeegers came by to look in on me. I was still very weak, and he ordered 2 more units of blood, which really got me over the hump health-wise. By the next day, I was much better. I was able to evaluate my condition; moving around was painful. My left leg was nerve-pain city. I had areas of numbness in my inner thigh. My back was more sore than painful. Very sore! I was able to go to the bathroom to do my business (number 2) with a little help (still had an IV) on day 3. I had my 2 drain tubes removed that day as well (over quick, only slightly painful in a weird way)....they had very little drainage. As my weakness subsided, my pain became more noticeable. Dr. Blome came in and advised me to begin pain control (I had stopped all pain meds) as it would help me to recover. We both agreed on a plan of me taking the meds I brought from home, and he wrote prescriptions for the same meds should I run out while in Munich. After having my first bowel movement (man, that was a happy day!), I was brought wonderful, gourmet meals for the remainder of my 6 day stay at the AK. I began very light Gyrotonic therapy on day 4, which helped my mobility greatly. By day 6, I was walking on my own for the most part. The many previous years of back problems had made my legs and back very atrophied and unstable, so it took a little while to regain muscle strength, but I did make rapid progress after the first week. Beginning week 2, Dr. Zeegers added a strength training program in addition to Gyrotonic therapy. This was not easy, but really gave me huge boost in improvement. By week four, I was able to get around fairly well, and made steady strides toward recovery. The left leg nerve pain was horrendous throughout this time period..........sleep was in short 1 or 2 hour portions.

RATE FUNCTIONALITY / SATISFACTION AT INTERVALS BELOW:

FUNCTIONALITY:
1. Very poor: much worse... disabled after surgery.
2. Poor: worse after surgery.
3. Neutral: No improvement, or improvements offset by new problems.
4. Fair, some improvement, limitations are still serious.
5. Good, substantial improvement, some limitations.
6. Excellent: no limitations.

SATISFACTION:
1. Very sorry I had the surgery.
2. Somewhat sorry I had the surgery.
3. Too soon to tell, or I'm ambivalent about the surgery.
4. I'm somewhat glad I did my surgery.
5. I'm very glad I did my surgery.

Don't forget the detail update section below!

DATE UPDATED: _________ FUNCTIONALITY: 5 SATISFACTION: 5 [6 WEEKS POST-OP]

DATE UPDATED: _________ FUNCTIONALITY: 5 SATISFACTION: 5 [3 MONTHS POST-OP]

DATE UPDATED: _________ FUNCTIONALITY:5 SATISFACTION: 5 [6 MONTHS POST-OP]

DATE UPDATED: 2-25-06 FUNCTIONALITY: 5 SATISFACTION: 5 [1 YEAR POST-OP]

DATE UPDATED: 2-25-07 FUNCTIONALITY: 4 SATISFACTION: 5 [2 YEARS POST-OP]

DATE UPDATED: 2-25-08 FUNCTIONALITY: 3 SATISFACTION: 4 [3 YEARS POST-OP]

6 WEEKS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ECT... (discuss surgery induced symptoms [leg pain?]):
Ready to fly home. I have significant left leg surgery induced pain; enough to keep me awake at night. I can only sleep about 1 or 2 hours at a time. My functionality is improving steadily. I can walk for a few miles (with rests), whereas prior to surgery, I could only walk about 4 yards!

3 MONTHS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]):Pain levels are dimishing, functionality is improving rapidly. I’m dressing myself, walking a few miles each day, doing light weight training at the gym, driving for as long as 45 minutes at a time, riding a stationary bike 3 times per week, etc. I am still in Gyrotonic therapy here in SoCal, finding that it helps immensely in regaining mobility and strength. During the last couple of weeks, my leg nerve pain has been just sliding away............I now sleep through the night with no problem. I’m taking Norco 4 or 5 times per day, 90 mg of Neurontin per day, and an occasional Skelaxin if needed. I also take 30mg of Trazodone each night.


3 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]):
I am experiencing chronic, very severe pain and horrendous nerve symptoms in my legs and low back. I can’t walk very much (or sit or stand very long for that matter). I’m still working, but life is difficult. No clear diagnostic cause has been found, though I have been presented with a possible cause due to L3/4 level scoliosis and rotation.

[mmglobal]

Jeff, I have 3 clients getting "tilted Charite' revisions" this summer. I can't discuss specifics online, but these cases may be relevant to you. We'll talk soon... all the best,

Mark