Praising the Lord! (L4-5 fusion)

[AnnOdom]

I had first posted here a few months ago, asking about the Medtronics CD Quadrant Sextant System, as that's what my DH's neurosurgeon was going to use to fuse one level~~~L4-5, which was bone on bone. Anyhow, after battling with WC for almost a year, from the onset of the severe pain and painful sensations in his left leg, he was admitted to the hospital on Nov 30th, exactly one year since these new symptoms had started. This was his 5th back surgery, BTW. He had surgery on Dec 1st, using the above mentioned system, and it took about 6 hrs, due to a lot of scar tissue that had to be removed from nerve roots. When he got back to his room, all the pre-op symptoms were gone! The bad thing is the anesthesiologist had ordered PCA with Dilaudid. I nearly had a fit as this drug is slowly broken down, and accumulates in the body. Plus, it caused Dan to to totally confused. Since he had Lortab ordered, I told the nurse to stop the PCA, and just give him the Lortab. In fact, I moved the pump and the hand control away from the bed so he couldn't get to it. Dan was able to dorsiflex the toes on his left foot, which he'd not been able to do since he developed foot drop, for which he had emergency decompression surgery in 1998. I had to light up the nurses in the wee hours on Friday morning because the day nurse hadn't told his replacement that Dan wasn't to have the PCA. He called me at the hotel and told me he was at home in Victoria (where we used to live) and then said, no, Nacogdoches (close to where we live). I threw on some clothes, got to the hospital, and called for the house supervisor. I had a pretty good head of steam built up. For one thing, he was still wearing the blood-stained gown he had worn to surgery on Wednesday, one soaked dressing wasn't changed for 24 hrs, when I brought it to the nurse's attention, and this had caused his temp to spike to 101.2! And, he hadn't had a bath. The supervisor was very nice, things got done, and we had a nice visit, as I'm a retired R.N., with most of my experience in the O.R. He got to go home Dec. 3rd, after getting his back brace, and I believe he was spiking a temp on the way home. Didn't have a thermometer, and it's 90 miles from our house to Shreveport, where he had his surgery. I confirmed the temp spike and had to "walk" the night supervisor through how to contact Dr. Ramos' P.A. as they were still in surgery. Maribeth called when they finished, and said she would call in an ABT the next morning~~~it was after 9 PM when she called. Had frustration with Dan's WC approving his RXs, including the ABT. The pharmacist sold me three, to get him through until Monday. Got them approved, was doing dressing changes, and that one incision was indeed looking on the verge of infection. Ya just don't leave a blood-soaked dressing on an incision for 24 hrs as blood is one of the mediums used to culture out bacteria! Anyhow, it was looking much better when he was seen the following Thursday, and the x-ray looked GREAT! Here was this normal space between L-L5, with the bone graft there, and the 2 rods and 4 screws. He just saw Dr. Ramos on Tuesday, and he said he's doing better than he had anticipated, this soon after surgery. In fact, he said he was doing extrordinarily well! He was able to slightly dorsiflex the toes on his left foot, and his left foot wasn't flopping when he walked. Of course, he'll be wearing this brace for a while longer and can't drive. As heavy as this brace is, now I know why God delayed the surgery until winter was almost here as Dan is very hot-natured, and he would have burned up in it, LOL! Pre-surgery, I had asked Maribeth how well Dr. Ramos' patients did following this procedure and she said he had over an 85% success rate. Of course, we all know that a lot of the outcome depends on following the doctor's orders, and having a good state of mind and looking for an excellent outcome Dr. Ramos wanted him to slowly decrease the Neurotin, then start on the Vicor and Valium, but he saw our pain management doc on Wed. and he wants Dan to continue the Neruotin as he said it'll help the nerves heal, and to instead start decreasing the Vicor and Valium. I'll tell y'all what, no matter what any doctor says, Valium is the BEST MUSCLE RELAXANT ever! In fact, that's what it was initially used for and the very first med given IV push when someone is having a seizure. Like a lot of good drugs, it got abused. I have neck problems and have been on Valium for a muscle relaxant for over 10 years, and for most of that time, only taking it twice a day. Now, at least I can take it 3 times a day, along with the Vicor for the constant cervicogenic headaches I have. Thank God for my recliner, a heating pad, and my laptop so I can be on-line, with my neck supported properly, and heat on it

So, I can highly recommend Dr. Marco Ramos, in Shreveport, La! He'll be up front with you, and this is the second surgery he's done on Dan, with the first being in 2004. He saw this problem developing in 2008, by MRI, and wanted him to consider surgery then, but he was scheduled for an anterior cervical fusion at the VA Hospital in Houston and couldn't cancel that. He had a good outcome from that also The problem with WC is they use quacks to do Independent Medical Exams and that's what caused Dan's long wait for relief.
God bless all of you, and pray that those still having problems find some answers and get relief of their pain. I have a dear friend whose 47 yr old son is having all kinds of problems post lumber spine surgeries.

[mmglobal]

Ann... what great news! I'm so happy to hear about your husband's success. It's amazing when symptoms are immediately gone... recognizable just hours after the surgery.

It sounds like you are an excellent advocate. Everyone should have someone with your experience looking after them. Some of the 'oversights' seem pretty egregious, but it's great that you were on the ball and didn't let any of them go on long enough to do any serious damage.

Please keep us posted on his progress. I look forward to more good news here. Thanks again for the update. All the best,

Mark

PS... I hope you don't mind, I added "fusion L4-5" to the post title so readers will know what the thread is about.

[Maria]

Ann,
Spoken just like a true RN who knows her stuff!! So glad to hear your husband is doing so well post surgery and do hope he continues to recover well into 2011! Thanks so much for updating~ Hope your friend's son will find some relief as well in the near future. Maria

[dshobbies]

Ann,

Very glad to hear about your husband's success and glad you were able to care for him. However, from reading your post, though your doctor may be at the top of his game, it sounds like the hospital needs someone like you. Where would he be if you didn't have the knowledge you do have?

Having had bad hospital experiences myself, I know the dangers that go along with it. One two day hospital stay turned into five because of what the nursing staff did NOT do.

Dale

[AnnOdom]

Dale, sorry to hear about your bad experience at the hospital. We can thank the California Nurses' Association for the lower quality of care in our hospitals. A number of years ago, they came up with this formula to determine how many patients one nurse could care for. Well, it spread across the U.S. and is used in all hospitals. Well, not all patients are created equal as some require more care than your other patients, and someone always gets short-changed on the care. It's almost like you need someone staying with you to be your advocate any more. I think in Dan's case, it was more a case of laziness on the part of his nurse, and yes, there are lazy nurses out there, just do what they can to get by and collect their checks, because they're well aware of the nation-wide nursing shortage. Things to watch for is nurses using sterile technique when changing dressings, doing dressing checks at least every 2 hrs, just in case one incision is still oozing, as Dan's was, and had soaked that dressing. I should have caught that earlier as it would have been really bad had an infection gotten hold as he is diabetic. Trust me, both the night supervisor and the on-coming day supervisor spoke with me, and said they would be making a written report. Dan just happened to get a lazy male nurse, and the floor didn't even have that many patients, so no excuse.
BTW, Dr. Ramos was named one of the top surgeons in the U.S. in 2008! God was watching over Dan when he first went to see him in 2004, as we had no idea how good a surgeon or how bad, for that matter, he might be. But, a woman came into the waiting room while we were there, and I got to talking to her about Dr.Ramos, and she assured me that he was excellent. Sure made me feel better, and especially after meeting him as he's so thorough. Thank you all for your good wishes, and will keep y'all updated The biggie now is for him to loose weight, like about 50 lbs, as that will really make it easier on his back. He's always had a weight problem, until he was diagnosed with diabetes, started counting carbs, lost the weight and was doing great, until the holidays came around. It's been downhill since then as far as his weight goes. But, we'll gitter done, LOL!