Nairek L5-S1 ALIF Fusion January 2009

[Nairek]

PART 1

Tuesday, January 20th, surgery day. I had maybe 1 ½ hours of sleep between being nervous and my dog Peanut howling and falling over in her crate. As an elderly dog, she has been suffering from dementia and gets confused very easily. I decided to sleep on the couch to comfort her so we could all get some sleep.

The alarm clock went off at 3:00 a.m. and both my husband and I woke up to take care of our girls (a Beagle and a Treeing Walker Coonhound). After they were fed and walked, I left a note for my friend on what I needed her to do to look after the girls for me. I already had my bag packed from the night before since we had to catch the first train out of Poughkeepsie at 4:15 a.m. to make it to Lenox Hill Hospital by 6:00 a.m.

As we got closer to NYC, the reality of the surgery began to finally hit me. I tried so hard to keep the water works from flowing but the truth was I was scared. My husband kept telling me that everything would be fine and that this is what we have waited years for. And even though I could have appealed my insurance company’s decision, I decided that I couldn’t wait any longer and moved forward with the fusion. He reassured me that I was not making the wrong decision. I’ll post about that in another thread.

We took the #6 Lexington Avenue Local and arrived at Lenox Hill Hospital by 6:08 a.m. and went up to the 10th floor and waited only 10 minutes before I was taken in to pre-op. Dr. Bitan’s staff must have had me pre-registered already which was awesome. In pre-op you have the usual change into a gown & give them a few “samples” for various tests and so they could type my blood in case I needed a transfusion. The nurses kept telling me to relax and all I kept thinking was how can I do that knowing I’m about to be sliced, diced, and julienned?

I first met with Dr. Rizzo the anesthesiologist. He explained to me exactly what he would be doing in the OR. That there wouldn’t be any surprises. He explained that he would be “hooking me up” to a machine that will monitor my nerves so that they can avoid the prospect of nerve damage during the surgery.

Dr. Hannon peeked in as well. This time he had a full beard going on which he didn’t have when we met with him on December 18th. When we met with him back then, both my husband and I were extremely impressed with how he explained what his part of the surgery would entail. He was very thorough and answered every question that we had. He is also a very funny person who really seems to enjoy what he does. When he popped in that morning, he was all smiles which was a huge comfort to me. At least he was in a good mood before the surgery.

Dr. Bitan then arrived and said that we needed to talk about a few things before the surgery began. Basically, he stated that since I couldn’t get approved for the ADR surgery, we didn’t have the opportunity to discuss the changes that had to be made with the fusion which he apologized for. He informed us that he would need to make two incisions in my back so that he could insert two screws to stabilize the hardware. I looked at him and said “Wow, I wasn’t expecting that. That really sucks. But if this is what you need to do for the best outcome, I trust your decision and let’s do it”.

Dr. Bitan also mentioned that he had a medical student who was interested in watching the surgery in the OR and he wanted my permission. My husband said “as long as it’s lookie and no touchie, we are comfortable with that”. Dr. Bitan confirmed the student was only to view the surgery, nothing else. So with that being said, we were OK with it. I joked with him why on earth would this student want to watch something so gross and he said I don’t know I tried talking him out of it as well.

I then joked with Dr. Bitan and asked him if he could do a tummy tuck while he was down there. He looked at me and said “Oh, you wouldn’t want me to do that. I’m not good at those. Ask Dr. Hannon”. So I did, he laughed. Hey, you can’t blame a gal for trying right?!

After all of the new consent forms were signed, it was time to go off to the OR. As they were rolling me down the hall, I kissed my husband goodbye and held back the tears. As they rolled me further down the hall in the wheelchair, there were several times that I thought of jumping out of that chair and running away from the OR. It reminded me of my wedding day in a way (Not that I wanted to run from the altar). The reality of what was coming hadn’t hit me until I entered the OR.

I was wheeled in at 7:40 a.m., 10 minutes later than when my surgery was scheduled to start. I remember Dr. Rizzo said something about giving me relaxing medication and then the lights went out.

I don’t remember going into the recovery room. They let my husband in to see me for two minutes and he noticed that I was wheeled in to recovery at 2:45 p.m. The entire time of my surgery, no one came out to tell my husband what was going on. As Dr. Bitan was leaving the OR, he was dialing my husband’s cell number to let him know that everything went well and that there weren’t any complications. By this time, my sister and brother in law arrived to keep my husband company which was great since he was all by himself. We were initially told that the surgery would be about 4 hours long. I was in surgery for close to 7 hours.

I slept most of the time in recovery and was in a lot of pain during that time. I was finally brought up to my room at 7:00 p.m. and just kind of lay there semi-conscious. After 30 minutes, I asked the nurse if my family was still waiting for me on the tenth floor. Sure enough, no one bothered to tell them that I was moved to my room. Thankfully I had an hour with them before visiting hours were over. The incision on my stomach had a “medicine ball” attached to it which infused pain medication just under the skin of the incision which helped a great deal with the pain. The two incisions on my back though were extremely painful which was made worse by the fact that I was laying on my back.

The first two nights, the hospital couldn’t control my pain. It was so bad that I was moaning and almost in tears for the first two days and nights. And while the surgery went well, this was the beginning of some very scary events which we were not prepared for.

I don’t recall if it was the first or second night I was there, but there were issues where my blood pressure and potassium levels were too low. This was complicated by the fact that my blood oxygen levels were not normal and I was suffering from a rapid heart rate. I was kept on oxygen for 3 ½ days and my heart rate remained tachycardic and at one point was beating over 150 bpm.

I had been on a dextrose based IV drip which was then changed to a potassium based drip. When that wasn’t enough to bring up my potassium level, I had 3 infusions of potassium back to back to bring my levels up. I couldn’t understand what was happening to me. The potassium burned through the IV line. I felt like my hand was on fire. The nurse told my family that there wasn’t anything that they can do to ease the pain and that I had to have the infusions. And while all of this was going on, they had to cut me back on the pain meds because now my blood pressure was dropping. I recall that at one point it was 94/53. I finally broke down that night as my husband was leaving. I kept apologizing to him and telling him I was scared and that I didn’t mean to scare him. He felt like he was abandoning me for leaving but he needed to go home to take care of our pets who are basically our children. It was such an emotional rollercoaster which neither of us could control.

The second night, things got even more insane. I was receiving morphine injections in my shoulders to help deal with the pain when my blood pressure allowed them to do so. The injections only helped me for 20-30 minutes at a time. The doctor had ordered an EKG since my heart rate was so erratic. I remember a doctor had come in and asked what the results of the EKG were and I told him I didn’t know since the tech just walked out without saying anything to me or my family.

I had finally fallen asleep again when another patient stated flipping out and went on a rampage at 3:00 a.m. The RN’s & NA’s had been very loud at night. This particular night it sounded like they were having a party outside of my room. Maybe this is what set this patient off. I couldn’t see what was happening since I had the curtains drawn closed in my room. This guy was yelling “call my wife” and “call the police. I know what you were doing in the empty room down the hall”. I was in such pain but I feared hitting the call bell for help because I knew the staff had their hands full with this patient. I also feared for my safety and I didn’t want to bring attention to me in case this guy was running through the ward.

Thankfully, after an hour, things settled down again and going forward, nights were much quieter there. I had called for more pain meds but was told I had to hang on and since they couldn’t get the right dosage to help me, they would have to call a pain management doctor to help me. I told them “YES! Please call the pain management doctor”. I was so annoyed that they didn’t do this sooner since I had my own doctor for this!

[Nairek]

PART 2

The morning of day three, Dr. Hoppenfeld came to see me. He commented on my noisy neighbor and when I told him what happened the night before, he was shocked. So he ordered me a regimen of pain meds to help control my pain as well as a sleeping pill so I could try and get some sleep at night. The same day they started with the colace and laxatives to help me along in “that” department. The gas pain was excruciating! My intestines were still pretty sleepy and I was beginning to suffer from distended bowels. If I was able to double over from the pain, I would have. It was that bad.

I believe it was the night of day four that I was taken down to radiology to have x-rays taken of my back. It was pretty painful to try & get on the table and to roll over onto my sides but the tech was a really strong man who helped me. I asked the tech if I could see the x-rays when he was done and he was kind enough to let me take a peek. It looked like there were six screws and two plates in my back. It was weird to look at the x-rays and think wow, that’s what I have inside of me now!

By day five I was cleared by physical therapy to go home. I was able to walk on my own with little assistance since day three and I was able to walk up and down two stairs. However, I was told that I couldn’t go home until I produced a “meaningful” bowel movement for them. I was like you have got to be kidding me right? I had been on a liquid diet for five days, so I didn’t think anything would ever happen!

That evening, things began happening and I was in a much better mood. Baby steps I guess but it was something to be happy about. The morning of the sixth day, I was told by Dr. Bitan’s PA that if I could handle solid food for breakfast and lunch, then I could go home that day. I was so excited, that I called my husband as soon as the PA left at 6:30 a.m. to let him know.

Breakfast came and I was so happy to finally be able to eat solid food! I still didn’t have a huge appetite but did manage to eat a little bit and felt so much better. I went for a twenty minute walk after breakfast and was so tired and short of breath afterwards that I had to lay down for a while. Dr. Bitan’s PA came back to visit and we chatted for a little bit. I told him that breakfast seemed to go very well and he told me that he will more than likely discharge me after 2:00 p.m.

My husband arrived shortly after 11:30 a.m. and I told him the awesome news. When lunch arrived, I was shocked at how much was on my tray and how good it looked. I was even more shocked by how it tasted. I expected hospital food to be horrible but it was surprisingly tasty. Even my husband was like, wow, that’s a lot of food!

After lunch, my husband was helping me to get dressed when there was a knock on the door. It was Dr. Bitan and his PA coming for a visit. (Dr. Bitan visited with me every day except for the weekend. I expected a colleague of his to check in with me, not him. I was impressed by this.) He said he was glad to catch me before I left and that he was sorry for keeping me over the weekend but he didn’t feel comfortable sending me home on Friday like he had planned. I told him I understood with all of the crazy things I had happening to me. It was better to err on the side of caution. There was a lot of happiness in that room and I was glad that there was a noticeable difference in my pain. That’s another post though since I think I may have put most of you to sleep by now.

And now the new chapter of my life begins……….

[Justin]

Karin,

Thanks for your posts. They remind me of the emotional roller coaster my surgery was -- the good, the bad, and the unknown. I've heard great things about Dr. Bitan, and it seems that he is a class act surgeon.

I'm so glad that you're on your way to recovery. Remember to take things slow and keep us updated on your progress.

[treefrog]

Thanks so much for sharing everything, I think it is very helpful to prospective patients to know all the things that can happen. I am scared of the post-op pain, I have read so many stories of people whose pain wasn't controlled post-op. Oh well, at least it eventually ends up being controlled for most everyone (I don't want to say everyone, since you can never know for sure).

I am surprised at all the little details that you remember. When I am scared like that, I can't remember anything.

I hope that recovery goes well. Take care of yourself.

[Gil Denis]

Hi Karin
Thank you for sharing that, I am looking forward to being on the other side of getting better

Thanks

Gil

[Nairek]

Originally Posted by treefrog

Thanks so much for sharing everything, I think it is very helpful to prospective patients to know all the things that can happen. I am scared of the post-op pain, I have read so many stories of people whose pain wasn't controlled post-op. Oh well, at least it eventually ends up being controlled for most everyone (I don't want to say everyone, since you can never know for sure).

I am surprised at all the little details that you remember. When I am scared like that, I can't remember anything.

I hope that recovery goes well. Take care of yourself.

I'm surprised too as to how much I remember after the surgery. I think part of the reason why I remember so much is because I was stressed out & wanted to know exactly what was going on.

I was VERY afraid of the post-op pain as well. I don't think mine would have been so bad if I didn't have the complications that I had. As each day passed, the pain became more manageable.

I kept telling myself that my quality of life was severely affected by my back injury & that I had to do something about it. I finally decided to have the surgery as I was tired of being in more & more pain on a daily basis.

The way I looked at it, sure I would be in pain after the surgery. But, as time passed the pain would be lessened if not completely eliminated from my life. To me, it was worth that time of extreme discomfort for a chance to be free from the pain that I had from this injury.

I'm the type of person who likes to prove people wrong when they don't think I can do something. I used this strategy when it came to being scared of this surgery. I turned that fear into strength to fight for what I wanted. I'll admit that it wasn't an easy fight, but it was something that I felt that I had to do.

Gil, I wish you all the best on fighting to get to the other side. Once you are there, you will most certainly feel better! Please keep us updated!

[Terry Allen Blackburn]

WOW Karin:

I am so happy for you that your surgery is done and you are going to be on the other side. The recovery will seem like a roller coaster ride with ups and downs but, you are one tough lady and will get through it in style.

It sounds like you had an excellent surgeon and good care from him. The rest of the hospital sounds a little nuts but, par for course at some places.

You hang in there and let your family and friends take care of you and nurse you back to health.

Keep posting as well so we can be apprised over your continued progress.

Terry Newton

[SASSY178]

Nairek-
I am post op two weeks from a lami/discectomy and have many of your same issues so I' m thinking that they must be pretty "normal" as the body recovers from such trauma. Aren't those steri-strips such a pain when they catch on to something!!! The doctor told me they would fall off but I finally had my husband cut them down a little at a time and eventually peel them off. It is hard to tell pain from incisions and pain that was there beforehand. I also have that issue. I still hurt from the incision in my back but I also have other back pain at times. In addition, leg pain that was there before surgery comes and goes as well. I think that we are still early in the healing process and just have to give it time. Wishing you luck in your recovery!

Sarah

[Nairek]

I had my 6 week post op visit a week & a half ago. Sorry for the delay in the update. I've just got a lot going on along with an increase in discomfort when I sit for too long. I basically have good news/bad news.

The good news is that I had x-rays taken & they show that the cage is right where it should be. It would have been nice if I was able to see the x-rays that were taken but I guess for whatever reason, the doc just doesn't do that. I know, I should ask but I didn't. I just take the word of the doc.

I seem to be doing fairly well since the surgery. The doc seemed happy with my progress. So much so that he didn't prescribe physical therapy & said that I can go back to work whenever I want. Here's the problem though. The new pain that I have in my back since the surgery hasn't let up. As a matter of fact, it's more intense now. On top of that, when I sit or walk for too long, I get a burning feeling in my right foot & pain in my lower left buttock area. Now when I told my doc this, he dismissed it as something that will go away. It's probably still being caused by the muscles in my back being cut. I'm also still dealing with pain/discomfort in my abdomen if something touches it. I hope that goes away really soon. (It actually bothered me to wear jeans the other day. )

So I went from his office to my pain management doctor's office. I lucked out that I was able to see him that day. It saved me & my husband $60 in train fare

I explained to my PM doc that the Lidocaine patches he prescribed do nothing for the "new" pain. When I showed him again where the pain was, he tells me he's positive it's coming from my SI Joint. Sacroiliitis strikes again. The pain feels like I am being stabbed or like it's a nasty burn. It's gotten so bad that it hurts to sneeze, lift up my left arm, & believe it or not, even a chill will set it off. So it's back to NYC this Wednesday & we're going to try an SI Joint injection on the left side. I am praying that this works. Otherwise I swear I am going to have a nervous breakdown!

I then tell my PM doc about the weird burning feeling that I am getting in my right foot. Now before I had the fusion, that same foot was numb & tingly & all sorts of whacked out. After the surgery I was just dealing with the warm sensations. When I was in the hospital, they couldn't explain why I was having that reaction. My PM doc took a good look at both of my legs & feet & was really quiet. So I asked him if maybe he thought it was the nerves just trying to re-adjust. Dead silence. I'm thinking great, he doesn't know what it is either. So after another half a minute of silence, he says to me don't shave your legs for a few weeks. I just looked at him like dude, you have got to be freaking kidding me right? So I asked him why. He thinks that I may be suffering from Reflex Sympathetic Dystrophy. He said that it happens after surgery & he's not sure if this is something that I have or not but the hairy leg thing or lack there of is a symptom of it.

So right now I'm just kind of at a loss. I'm stressed out. Between the surgery, having to put a beloved pet to sleep, the after affects of this surgery, disability checks not coming in, & the possibility of having to move because "The Evil Empire" (aka my husband's job) is sending his job over to India, I'm afraid that I'm going to have that nervous breakdown that I spoke of before.

I know that I just need to chill out but that's easier said then done. I'm going to shut up now. I just needed to vent. Thank you in advance for understanding.

[Cindylou]

Nairek, I'm sorry that you are still suffering. I do believe it is still very early days for you yet, since surgery. That said, I know that is easier said than done. "Waiting" seems to be something we spiney's do alot of. I am so sorry for the loss of your beloved pet as well. And, are you saying you might have to relocate to India?? You do have a ton on your plate. Are you on an anti-depressant? I would highly recommend it if you aren't, or increase your dose (per doctor's instructions) if you are, temporarily. Hang in there. We are here for you.

Cindylou

[Terry Allen Blackburn]

WOW Karin. A lot on your plate right now. I hope that the symptoms disappear after awhile more of healing. Did they recommend Lyrica for the nerve pain? That sure was helpful too me in my first year of recovery. I hope things start looking up for you. It may be a good idea to discuss upping the dosage of the anti-depressant for awhile. make sure you discuss this with your Primary Care Physician so it does not cross react to other medications you may be on.

Hang in there.

Terry Newton

[phylly]

Karin,
I wholeheartedly agree with Cindylou and Terry. Cocktails of drugs are very helpful during the recovery especially with the symptoms you are having. Being in less pain can help you heal faster and different drugs can effect the different symptoms you are having. Feeling like you are going to have a nervous breakdown is not good. We know that you are venting but you must be stressed by all you are going through and 6 weeks is not that long after having surgery. BTW I think that your doctor should show you your x-rays. That was the first thing my doctor did at the 2 week visit. He wanted me to see the bone, the pins, and screws etc and how they were placed. While your nerves are healing lyrica or nuerontin can help. An antidepressant may help with the stress and your pain meds should help with the pain. I am not sure what you are on right now? Maybe you can call your Drs. instead of a long train ride into the city. Sitting still for long periods of time is not that great, walking would be more helpful but if you are having pain from walking too then maybe shorter walks will do. I was prescribed a muscle relaxer before surgery to help with muscle spasms and I have used it after the surgery when i feel tightness in my muscles. I also think when you feel really stressed you should try to relax and maybe visualize something peaceful and relaxing. Take deep breaths and try to think of things you love to do that are fun. Try to stay in that peaceful pain free place. I know this is harder said than done but it may help. I know when I am stressed all my muscles tighten up and make everything worse than it really is. Is there someone you can talk to? Any family member who can be your confidant. I know that your husband must also be stressed thinking his job is going overseas. What a bummer. We are all here for you too so vent away. I am sending good thoughts your way.
Phylly

[Nairek]

Originally Posted by Terry Allen Blackburn

WOW Karin. A lot on your plate right now. I hope that the symptoms disappear after awhile more of healing. Did they recommend Lyrica for the nerve pain? That sure was helpful too me in my first year of recovery. I hope things start looking up for you. It may be a good idea to discuss upping the dosage of the anti-depressant for awhile. make sure you discuss this with your Primary Care Physician so it does not cross react to other medications you may be on.

Hang in there.

Terry Newton

Terry,

Indeed, I have a lot going on. Of course my life is always full of some kind of drama. Kinda sad that it almost seems normal to me.

I have to go for an SI Joint injection on Wednesday. Hopefully it helps with some of the issues I'm having. When I go back for an office visit with my PM doc, I'll ask him about the Lyrica. I was taking 25mg once per day before bed up until 2 weeks before the surgery. I wasn't able to function on it if I took it during the day hence why I'm a tad hesitant to go back on it again.

We'll see what happens. I'm just taking it 1 day at a time for now.

Karin

[Nairek]

Originally Posted by Cindylou

Nairek, I'm sorry that you are still suffering. I do believe it is still very early days for you yet, since surgery. That said, I know that is easier said than done. "Waiting" seems to be something we spiney's do alot of. I am so sorry for the loss of your beloved pet as well. And, are you saying you might have to relocate to India?? You do have a ton on your plate. Are you on an anti-depressant? I would highly recommend it if you aren't, or increase your dose (per doctor's instructions) if you are, temporarily. Hang in there. We are here for you.

Cindylou

Hi Cindylou,

How are you feeling since your SI Joint fusion? Hopefully better. I know that it's still the early days since the surgery. I'm a NY'er & we're not known for being very patient when it comes to waiting Even my OS told me that it will take time. I work 2 jobs & I just want to make sure that I don't lose them. Well the 1 job is very understanding, the other 1 is understanding but my supervisor is a real witch. Besides, daytime tv is just garbage & I can actually feel braincells dying when I watch it.

Thank you for your condolences on the loss of my dog. I had Peanut for close to 10 years. She was a rescue who turned out to be a sick little girl. I've been told by many people that I gave her the best life possible & that not many people would have taken care of her or kept her like I did. I was blessed that my vet gave her a sedative that enabled her to pass away while she was sleeping. It was the hardest thing I've ever had to do but I know it was the best thing to do as her quality of life was suffering. It's been tough on all of us, including her siblings.

My husband's job will eventually move to India or China or somewhere else over that way but without him. If we move, it will be to Florida. We were there a few weeks ago & of course fell in love with the climate & palm trees all over again. This happens every time we go down there. We have to get in touch with a Realtor down there & fly back down there to look at houses. Then we have to hope that we can sell ours. The market tanked up here so it's a stressful situation for us both.

I'm not currently on anti-depressants. I was on them years ago & hated the way they made me feel. I gained a lot of weight when I was on them as well. I've been doing fairly well without being on them. I just tell myself that eventually things will get better. Probably not the best thing for me but it's worked so far.