Archive for July, 2011
A couple of you have asked how much NuVasive or Dr. Smith are paying me to say the things I have. I want to make one thing perfectly clear…..I AM NOT, I REPEAT, N O T GETTING PAID TO SAY THE THINGS I HAVE. Not NuVasive, not Dr. Smith, not Dr. Crovetti, not Dr. Sparling, none of them are paying me! All of these men and business are outstanding in their field and deserve the kind of words I’m extolling on them. In other words, they’ve earned it!!!
Until one has suffered agonizing back, leg or hip pain, you can’t begin to know what your life can be like without the continual drain on your energy just to deal with it. Often without relief. To be given a measure of relief from the agony is to be given a new lease on life, gives you plenty of food for thought, and makes one want to further the cause for the sake of others.
That being said, I would be remiss if I didn’t let you know that my rose colored glasses aren’t so thick that I can’t see they are human or that NuVasive is a “business”, BUT, they have risen to the level of genuinely caring for the patients who seek them out… amazing, I know. As is always the case in our existence, there’s an element of fallibility. However, for whatever reason, with these doctors and business they take everything into consideration, weigh the risks, and are willing to put themselves and their talents on the line in the name of medicine for the sake of their patients. And although they are fallible, they are closely married to the meaning of the phrase, “First, do no harm.”
It bothers me that our world has become so cynical about the very systems put in place to help us because of unscrupulous people who’ve damaged or manipulated their very purpose. I will never understand why it will be OK to help only certain people and not others having the same condition but different circumstances, as is the case with a growing number of insurance companies.
Recently I was asked to write a letter on behalf of those who will come after me and my surgery, to convince the insurance companies to reconsider their actions of exclusion for life-changing back and leg pain sufferers. They, the insurance companies, are calling it “stricter guidelines.” It seems their bottom line is so much more important than the health of the patient. AND, it’s appalling to note that they view anyone over a certain age or with certain conditions, not worthy of the treatment or care available to them simply because it costs too much in their eyes.
I’ve never had a romance with my insurance companies, although I must say, the last one I had was a Cadillac plan and I utilized it properly to my benefit. Actually it benefited them as well because since my surgeries, I am becoming a productive member of society and not continually using my plan. A plus indeed, that is until you know that our coverage drastically changed July 1st and I no longer have that great coverage. This new plan is one I’m not happy with at all, but it is the best we can have right now. We must pay, out of pocket, all expenses incurred on our own up to the maximum deductible amount before they will pay one cent. With a 5K deductible, you can see how this majorly, adversely effects every medical decision I will make hence forth. Even for the rest of my follow-up visits from my surgeries.
I wonder what the decision makers would feel like if one of their children or spouse were in need of the very procedures they are excluding? I wonder if they’d ever be able to walk into their loved ones hospital room and coldly say, “Well, my dear, the good news is, there is a life altering procedure that can be performed to rescue you from the agony of your pain and the throws of long-term care, but your policy doesn’t allow you this procedure because in a cost saving measure, the insurance company is disallowing your claim.”
There’s one thing I’ve learned for certain, that no matter how much money a person has, in times of medical need, there isn’t enough money in the world that can buy back your good health! We’re only on this earth for a very short time, and we need to “first do no harm.” It’s a real shame that some stockholders find it more appealing to have a few more gold coins in their coffers and pockets than to care for our fellow man.
Imagine what a world we could have if every man and woman exploited their personal talents for the sake of others without giving up their own dreams and desires. I guess in some respects I was just brought up with an entirely different rule book than that of a lot of others. Which may explain why I’ve been so unlucky in love. I keep holding others to the same set of standards I was raised with. I don’t think that’s too much to ask, even taking into consideration all the cultural differences. Most cultures have a code of ethics and conduct. If you live by nothing else, then live by the golden rule, “Do unto others, as you would have done to you.”
So in some small way, I hope this explains why I say the things I do about others. I don’t just have these thought about my doctors, although they’re the topic of this discussion, I hold others dear to me and with the highest regard even outside of the medical field. Like in education…. but that’s for a whole ‘nother post. Suffice it to say that there certainly are a lot of good doctors in this world. I write about what I know, and these are the doctors I know a little something about!
As always take care of you and yours and I’ll be posting again real soon,
P.S. To the person who asked if my doctor can fire me after saying all these things…. NO, you can’t fire someone you don’t pay! He can ask me not to come back to the office, but that’s about it!! These posts and my website were my idea long before I had my surgery or the successful outcomes!
I HAVE SOME GREAT NEWS!!! My son, Brian and his awesome girlfriend Ally got engaged on Friday evening! No date has been set because they want to do it the right way and have everyone there they want as well as have a place of their own. It’s awesome to know too they given it a great deal of thought and not just run off and done something without pre planning things. So, the long and short of it is that our family just grew by one!!! Welcome to our family Ally! You’re a terrific addition!
OK, so here’s the details about how Brian proposed! Of course in his “Brian way” it was grandios!! It seems he is friends with a lot of the right people in Vegas these days and even so far as the general manager of the movie theater they frequent. Through a friend at the Chamber of Commerce, Brian was able to have a special video made of two Lamborghini racing side by side down a road. Across the screen this guy imposed the words. On the road of life, I want you in the passenger seat next to me….. Alexandra Kay Damazio, will you marry me? At that point the lights to the theater were turned up and Brian got down on his knee and asked her to marry him and gave her the ring. A flawless 1+K diamond. She was so shocked!
Several of their friends were in the audience and Greg and I were just behind a wall until the trailer started. When it first came on, some were heckling it because they couldn’t figure out what movie this was for. Some didn’t pay attention to the words across the screen. Ally said that when she saw the two cars she started shaking because she knew what was about to happen… she started to cry and continued to shake! People in the audience started clapping and cheering but Brian had to shush them and shouted out, “NO, Wait! She hasn’t said yes yet!” Apparently Ally was crying so hard she couldn’t get the words out! She yelled out, “YES, I’ll marry you!” then jumped into his arms… later they both said it was everything they’d hoped for. On his part, we were able to be there and he was able to keep it from her so it would be a surprise. On Ally’s part, it WAS the surprise she wanted to have, and in just the right circumstances. Literally, the night before, several of her “movie going” friends got together and they were asking her if Brian had popped the question yet. She told them no, and they said he better get with it! When they saw what was happening they let out a yelp right along with Ally!
And so, Brian starts a new chapter in his life. Taking on a wife is a huge responsibility but one I think he can handle. He’s got a great head on his shoulders and thinks things through. I think they’ll do alright. On Ally’s part, she’s a strong independent young woman who is willing to work for what she wants. She’s not afraid of hard work and with Brian by her side she will shine really bright!
God Bless them both! They really deserve the good life for all they’ve been through in their young lives. I hope and pray their lives are blessed with big good times and small bad times. There has to be some bad times so they would be able to never forget what it takes to appreciate the good ones. They work really well together and I pray that continues as they start to build their life together.
Brian, my son, life is all about choices. I’ve told you that since you were very little. You’ve made a very good choice! (And besides, in the end, you got the cheerleader from your high school!) Ally’s a keeper and I’m glad you’re the one that gets her!
From the bottom of my heart, I love you both,
Always remember to take care of you and yours,
Well, it finally happened…. someone’s tired of hearing me talk about my surgeries and my doctor and in a negative way! So here goes…. here’s what I’ve got to say to them…
It’s been brought to my attention that I may sound like I’m sugar-coating everything I talk about while writing on my website. I was told there are plenty of other really good doctors in this world that perform just as many successful surgeries as Dr. Smith. I agree, there are a great many good doctors that regularly have successful outcomes like Dr. Smith. However, after seeing three doctors and being turned away from two, one of which said I was so deformed he wouldn’t touch me, it was Dr. Smith who took the chance with me.
Until one walks in the shoes of someone who suffers from severe back and leg pain along with hip and shoulder and neck pain, one can’t even begin to place the value on what Dr. Smith did for me. When the dust settled claim-wise from my insurance company, I was appalled at the price the hospital took in comparison to the amount my doctor received. I really feel it was upside down. He is so underpaid for what he gives back to people!
So my thought has been two-fold, give back to others and help Dr. Smith get the word out in a positive manner. There are so many horror stories about botched back surgeries. So many so, that the insurance industry now wants to deny most back surgeries. Herein lies a HUGE problem… this comes on the eve of a VERY large number of successful minimally invasive back surgeries. The procedure is so new, that a lot of the insurance companies are still skeptical about it’s place in the industry and are looking at ways to restrict even the most successful minimally invasive procedures. It’s just absurd!
Some have suggested I have an ulterior motive for offering my time to Dr. Smith’s office to be an in-house patient advocate. And they’d be right. Yes, it is all about helping others make that final decision to change their life and free themselves from the hideous pain they suffer, but there’s more to it, some of which is self-serving.
It’s been eleven years since I’ve been in the workforce. Eleven wasted years of productivity, of my family’s lives being so different because I wasn’t able to contribute financially but rather only as a homemaker. And often shoddy work there at best. I’m in the “black” years, those that put me really unemployable because of my age, and yet too young to collect social security. But then there’s the issue of the economy. In a few years when I reach 65, will it even be available to me? And what about Medicare and Medicaid? What price will I be paying along with those benefits? Not to mention the fact there are so many people much younger than I unemployed and eager for gainful employment. What possible chance do I have if you really look at the BIG picture of the global economy?
The above questions will be decided for me by powers far out of my control. But I can in some small way take stock of my situation and realize I am now in a position to do something about it. Since I no longer spend my days preoccupied with the “white noise” of pain underlying everything I do, I’m able to concentrate on things of importance. Things like writing my memoirs and figuring out how to help others. I don’t get paid for what I do right now, but someday I may, and in the meantime, I’m gaining new insight to help expand the emerging developments in neurosurgery. Without patients to operate on, a surgeons skills are not used to the fullest.
I hold a pretty unique position in the fact that I’ve had three very debilitating conditions which have been corrected successfully. My willingness to discuss these conditions can bring hope to the tens of thousands still suffering from these conditions and who are unaware of what relief may be available to them. I’d like to think I can show my humanity to others, by sharing with them my experiences and what they can expect and hope to achieve through their personal surgery. As is always the case each patient will have a varied outcome for several reasons, but the most important is the level of commitment they dedicate themselves to the physical therapy for their recovery. A doctor is only one part of the equation in the healing process. It’s imperative each patient dedicates themselves in order to achieve maximum results.
That being said, it’s harder than you can ever imagine. These prospective patients will need help. I’ve been told a lot of people aren’t as strong willed as I am to face this type of a challenge. Or atleast they think they aren’t. They just need a boost of confidence to know they can handle the surgery and recovery which will make their healing go much easier. That confidence can translate into lesser time in a brace or on the sidelines until they gain their strength back. That’s where I come in. It’s my personal experiences rich in human frailties that can guide others to know they too can do what I did.
It’s been awkward finding a rhythm, getting back in the groove of going to an office and being somewhat creative for a purpose. I haven’t hit my stride yet, but I keep plugging away at it. I trust that one day, soon, things will start to click and feel I’m finally back in the groove. I may not be able to do the job I once did, but I’m certainly not ready to keep myself out of the game any longer. I was a family mediator by degree; an architect of lives. It was very rewarding work to see people so far apart on the simplest of issues come together through what I said, and how cool it was to craft their lives in such a way they became civil to one another and could deal with the negative issues that made them angry. To some degree, I understand how Dr. Smith feels when someone comes into his office downtrodden in a wheelchair and in a short time comes back walking upright with a smile on their face. It’s a gratifying feeling.
I don’t know that I’ll ever be able to mediate again, but I can be an architect of lives, helping others, coaching them to transform their own lives, to be productive, and active once again. We have but one life to live, we better give it our best shot!
So I can say to those who’ve called my intentions into question, yes, I am just slightly biased. Not just for Dr. Smith, but for the treatment and technology he used to transform my life. It can be that way for so many more. Especially if insurance companies don’t put more stringent guidelines on people, tying the doctors’ hands and limiting them to band aid treatments instead of fixable procedures. Also, these doctors, not just mine, need to have a larger cut of the pie. I was in the hospital 3 days, not weeks or months. My doctor got paid only one tenth the bill the hospital charged. It’s insidious to think they have to be willing to save lives and maintain their training and teaching just to get paid pittance in comparison to the amount the hospital raked in. I might add too, that the care I got at the hospital was less than stellar.
I might have been on morphine, but I still know what good hospital care is. The most outrageous act committed by a nurse who came into my room, put down a blood draw tray, walked over to the bathroom toilet, flushed it with her bare hands, then walked back over to me without washing or sanitizing her hands, and wanted to start feeling for a vein. I stopped her, asked her if she was going to wash her hands before she touched me, she looked at me and asked why. I said because you just flushed the toilet and didn’t wash. She got indignant with me, left the room and sent someone else in to do my blood draw. I understand that was only one nurse, but she does represent the hospital. Each of us represents where we work, as a part of the whole. Therefore, it’s no real stretch for me to assume that there may be more like her where she came from, in that very hospital. If she hasn’t got enough pride in her job, that by her attitude, she could cause more harm than good by her presence, she should not be there.
I was defensive when I was called out about my attitude towards my doctor and the procedures performed on me, but I hope you all can see a bigger picture now and have a deeper understanding about what is really in play here. If you don’t get it now after this explanation, you never will. Most will, some won’t and I really don’t feel like wasting my time on those who want to bring into question my motives. I simply want to get on with my life in a more meaningful, positive way than ever before.
As always, remember to take care of you and yours,
As the last of my emails are answered gathering physical addresses to send my postcard invitations, I’m reminded of just how much love there is in this world. My Facebook Peeps have been a Godsend in my healing.
I moved out to the Las Vegas area now five years ago and in that time I’ve started to rebuild a life for myself and my family. It hasn’t been the easiest thing I’ve ever had to do, but, it’s not the hardest. The living of each day helped distract me from the isolation and aloneness I’ve felt. And as I’ve watched Brian blossom into this amazing young man, I realize it was the right choice.
Since I could take the time to focus on myself for a change, I went full-bore forward to have my broken body repaired. I’m only now realizing what a feat I undertook. Yes, I know there were some pretty dark days, and my Facebook Peeps were there to help me through. I apologize to every one of you who had to listen to me complain while your lives were falling apart as well. You managed to put a smile on your face long enough to lift me up, to help me through a time equal to having to go underground with Brian at three years old and having no one to really lean on. I will be eternally grateful to you who reached out to me this time around. You have no idea what saving grace it was for me. There was also a dabbling of supporters from around the world who made the effort to make contact me in support of my efforts. My healing has been a collective effort of the positive love I’ve felt from each and every one of you. If you don’t think one voice counts, think again. YOURS DID!!
I would be remiss if I didn’t mention how incredibly important Amanda Scott, my doctor of physical therapy has been in my life. Her lasting legacy has been the effort she put forth to make sure I had ammunition to arm myself once I was no longer under her care. I haven’t seen her professionally in almost a month and, aside from the fact that I miss going to physical therapy and having them all a part of my day, is the fact that they gave so much to me in the way of knowledge. I understand I’m not like most of the patients that come through their doors who only do their physical therapy half-heartedly, but she still went beyond her measure to make sure I had enough different exercises, and understood what they were for, so I could continue with them after I left. AND AMANDA, IF YOU’RE READING THIS, I WANT YOU TO KNOW THAT I AM!!! Not a day goes by but what she’s been on my mind either by appreciating what she’s given to me or by the memories I made with all of them at MattSmith Physical Therapy.
I understand I hold a very unique postion with my trifecta experiences. I’m glad it’s turned out the way it has for me in such a positive light. First for me personally and secondly so that I can share with others what I’ve learned along the way.
When I come back to Warren, I want to celebrate not only my birthday with you, IN MY THREE INCH HEELS, but our friendships which have been the greatest gifts of all. I wish I had the means right now to pay for all of your meals and drinks as a token of appreciation for your friendships. It’s funny in a way because it’s my understanding there will be more people at my get-together than there will be attending our class reunion. I really feel the love. I do have some small thing special planned for all those who are coming to Alberini’s on the 16th. You’ll have to wait and see what it is! I promise to try not having any more “dark” days ahead and be as upbeat as I can be to lift you up now when you need me. Although we each know that we can’t predict the future so who knows what tomorrow will bring for each of us. I would like to say that all the dark, bad days are behind me, and us…
As my healing winds down, I’m faced with the incredible opportunity of getting on with my life. WHAT AN AMAZING PLACE TO BE!!! A place I never thought I could reach. And now I get to open doors I used to just dream about and think, “if only I were well enough to open that door!”
I’m talking about being a productive member of society, one willing to give back for the many blessings each one of you bestowed upon me through friendship. In a perfect world, I’d love to find an employer who would be willing to pay off my student loans. (they have those things now) But I really want to be doing what I’ve been doing in Dr. Smith’s office. I’m a patient advocate helping to answer any questions his patients may have before they have their surgery.
It’s powerful for them to see a patient who’s had the surgery they’re facing and to know that they too can be like me. ( it would be nice to be paid for it, but for now that’s ok) I really like helping people make the right, informed decisions. It’s an incredible position to be in to add that extra boost to someone so on the fence about taking that huge step to have corrective surgery. I am a walking, talking billboard for minimally invasive surgery! So we’ll see what happens in the next six months or so as I become a whole new person.
The metamorphosis has already begun, and I want to see how big and brightly colored a butterfly I can become! It’s an exciting time to be me! But I must never forget where I came from or the friends who helped get me here. That’s why I can hardly wait to see all of you once again. Some maybe for the last time, others, if you are open to visiting me out here in Vegas! Nonetheless, I will see you at Alberini’s Restaurant in Niles, Ohio on Tuesday, August 16th at 6pm.
Just remember to take care of you and yours,
Sorry it’s been 12 days but I’ve been a tad busy… I’ve been making final arrangements to go back to Ohio for my 40th class reunion! When I first met my doctor, Dr. William Smith, I told him he had a year to get me well enough to attend my reunion and I wanted to wear 3 inch heels. Well here it is almost time to go and he kept his word! I tried on my heels the other day and I’m good to go!!! A while back I took in my 2 1/2 inch heels to my physical therapy doctor who taught me how to walk in them again… I’m pretty excited to be able to fulfill another thing on my bucket list. And on Thursday I start my first dance class. I bought myself some lessons as incentive but couldn’t use them til now… I’ll let you know on Thursday how it goes!
Well, additional questions have come up as I’ve gone through my website. Important questions I feel qualified to continue to answer. The more questions asked, the more informed you will be in making your final decision to have your life changed. As with all surgery, there are complications beyond the control of the doctor or that could not be seen at the time of your surgery. Just remember one thing, your doctor is acutely aware of the risks involved, therefore, it’s in his best interest to make sure everything he does is in your best interest. I say this because some of the questions asked seem to want to lay blame on someone. Surgery has it’s risks. That’s why you should be as informed as possible going into it.
HOWEVER, the surgery is only one small part of the healing process. YOU are the one in control of the final outcome. If you are a smoker and the doctor asks you to quit, THEN QUIT. The only person you are hurting is yourself AND the doctor can only do so much. Smoking is one of the biggest roadblocks to recovery. It limits your blood flow and slows down the healing way more than you can imagine. If your doctor tells you to go to physical therapy, THEN GO. During your operation, no matter which one you’ve had, your body goes through a severe trauma. The muscles he had to cut through to get to the area to be fixed need help so they can function at full capacity once again. It isn’t going to be forever, but after your surgery, you need to know you must make every effort to help yourself. THE DOCTOR CAN’T DO IT FOR YOU! One more thing, in most cases, your condition deteriorated over a long period of time. YOU ARE NOT GOING TO HEAL OVERNIGHT.
I spoke with one woman who told me she was planning on going across country as soon as she had her surgery. When I informed her she would have at least 6 months in a back brace she told me she didn’t have that kind of time. Her husband had retired the week before and they had always planned that as soon as he no longer had to work they were going to tour the country. It truly is a great plan for those who want to do that type of thing. But the reason she was going to have the surgery done was because she couldn’t step up into their RV due to her pain. I tried to reassure her that she’d be able to do all she wanted after the surgery but just not RIGHT after the surgery. Your body needs time to heal, and sometimes the healing is slower than we expected or wanted.
I temper what I tell perspective surgical candidates about my experiences not because I don’t want to scare them or not tell them the whole truth. My circumstances were very unique, and I was far more willing than most to comply with ALL of the recovery process. Some people are not so diligent and I’m OK with that if they are. Again, the only person they’re hurting is themselves. As for me, I’d been in pain for so long, I wanted to do everything possible to insure I had a complete and successful recovery. I lost an entire decade of my life to several disabilities and I needed to get on with things as quickly as possible and by doing the recovery necessary I was able to do that.
For most people, recovery can be totally and completely successful if they are willing to put forth the effort, unless of course, there are mitigating circumstances or complications. When a person does, they feel better about themselves. I had to give up my job because of the severity of my pain and succumb to a sedentary life for an entire decade. Because I wasn’t able to move as well as I once did, I put on weight. That in turn put more stress on my conditions. Which made it more painful, which made it necessary for more over-the-counter pain relievers. Those in turn, have an effect on your kidneys and liver because you’re taking so many a day just to get through. That makes you depressed which then makes you want to eat more and be less active. It’s a vicious circle with no real way out. That is, until you come to surgical relief. So it really does become a no-brainer that surgery is the best option, unless you are so terrified of surgery it’s impossible to overcome that fear. I don’t make light of that but let me address it head on. Would you rather be on drugs that change your personality, don’t really take away the pain for good and often times leave you “hooked” on them and still be limited with your mobility? Or would you rather know that after a time spent with surgery and recovery you can be drug free, and free to be as mobile as you once were.
Right out of the gate I want to answer a question posed to me online. “What kind of doctor performs the ACDF and XLIF? My doctor is a NEUROSURGEON. More importantly he is a doctor affiliated with NuVasive, the company instrumental in the development of the minimally invasive spinal fusions. NuVasive trains orthopedic surgeons as well as neurosurgeons to perform the ACDF and XLIF along with other minimally invasive techniques. Depending on the type of condition you have will dictate what type of technique your doctor will use. If this procedure is something you’re wanting to explore further, go to the NuVasive website where they can connect you with a NuVasive surgeon in your region.
Let me address the surgery itself. Minimally invasive ACDF, XLIF or even the hip replacement I had done puts less stress on your body. I’ll explain in simple terms. Because of HOW your doctor gets to the area needed fixed, he is able to do this by no longer cutting into as many layers of muscles and tendons. In years past, a surgeon had only one method to reach the affected area, through all the layers of muscle and tendons. In doing so, they caused as much or more damage to your body just to reach that area. That’s why so often you’ve heard of someone’s brother’s, uncle’s, cousin who had back surgery and swears it was the worst thing they ever did. IT DOESN’T HAVE TO BE LIKE THAT ANYMORE. More and more doctors are being trained in the minimally invasive procedures giving rise to a very high number of success stories. Another very HUGE plus of the minimally invasive procedures is that a patient isn’t on the operating table near as long as the old method. The XLIF procedure I had done was three hours and twenty minutes. Normally, with any other doctor, it would’ve taken about an hour per level. Since I had six levels done, it should have taken at least six and that’s not including opening and closing. Dr. William Smith is exceptional and world renown. I am very blessed to have Dr. Smith as my doctor.
An added benefit of the minimally invasive procedures is, there is less blood loss. I had a patient speak with me about his pending operation. I told him that I was in the hospital three days and was amazed. But he was opting for the conventional procedure because he liked his doctor and the surgery would be closer to home. As it turned out, he spent five weeks in the hospital. During the first eight hour operation he started to “bleed out” and the doctor had to stop the operation. This was NOT an minimally invasive XLIF procedure. He closed him to let him recover from the blood loss. Three weeks later they went back in to finish the job they started. It was a long, painful, grueling process. One he said, he never wished anyone would have to go through. I feel really bad for him, but in the end, it came down to him choosing the wrong procedure for the wrong reason. He is getting better and more mobile every day. He did say that he was very frightened by the whole ordeal and wished he’d made a different decision. Hindsight is always 20/20.
Someone asked, “how strong is a lumbar fusion?” Well I’ve been told that if I was in a car accident, the other unfused portions of my back would break before my fusion would; taking into consideration you are more than six months out from the operation and all things went well. My doctor takes x-rays at different intervals of my healing post-op to see how well the fusion is “taking.” The x-rays will clearly give him a measure of what’s happening in my body. The more successful the fusion is the more solid the spine looks in the x-rays. Dr. Smith has always been pleased with my progress.
Another question was asked about the swelling of my legs post XLIF. I suppose it all depends on many circumstances. One, how active are you post-op? Activity and movement are important during the first phase of your recovery. I’m not talking about walking around the block, I’m talking about just doing the passive exercises prescribed to you while in bed, like moving your feet up and down and bringing your legs to a bent position while laying down and moving your legs from side to side. And then there’s always the trek to the bathroom. I’m glad I live on one floor so I could walk to the bathroom.
A family member was recovering from a hip replacement and had a portable potty brought to her bedside. She got no real exercise at all and she never did really recover from the surgery. I have to add she also refused to do any of the physical therapy exercises at home on her own. Keep remembering… your recovery success is up to you! No one else. Swelling can also happen when edema occurs, which is often treated with medication. As you become more active post-op, your swelling should subside, unless of course there are some other medical issues you need to deal with.
“There’s pain in my shoulder after my lumbar XLIF surgery.” Yes, there will be some pain in your shoulder on the side you were operated on. Remember, instead of the doctor cutting through all your muscles, his assistant “pulled” them aside so he could work on your affected area. By pulling all those muscles aside, they’re stretched from their attaching points, often farther away than you may think that they are attached. I’m grateful to my doctor for explaining that I would have that pain afterwards so it came as no real surprise when it did. It should subside within a couple of weeks post-op, at least mine did.
Yes, there will be pain the length of your leg for a short while. This too will subside as the nerves reconnect that your doctor had to work on. Actually he probably released the nerves from being pinched and you may have a feeling like someone is poking a needle into your skin in a hundred different places. That’s your nerve endings reconnecting. Each person will experience this a little differently and the length of time it takes for your nerves to regenerate will be different as well.
One of the coolest things about minimally invasive surgery is the fact that you have very small scars in comparison to conventional surgeries. I have three, two-inch scars on my right side. Dr. Smith also needed to go into the back, so I have a one-inch scar on my spine at waist level; which has almost disappeared. Prepare yourself to wear very loose, comfortable clothing for a few months until you can put a pair of pants or skirt on with a tighter waistband. The incisions are usually made right at the waistline. I have a propensity to keloid so I had to work on my side scars with some Vitamin E oil. I got the 40,000 IU’s, but for most people the 10,000IU’s should do the trick. (you can find this in most drug stores or health food places such as Whole Foods) When you rub it on your scar, push with some degree of pressure. You’re not looking to reopen your wound, but you are wanting to break up the scar tissue forming underneath where the doctor actually cut. Mine was flat and comfortable within a few months.
One parent was concerned about picking their child up after surgery. Whether it’s the XLIF or the ACDF or for that matter even the total hip, you should probably avoid doing any lifting until you’re cleared from your doctor to do so. Make arrangements for someone to do those kinds of activities until you are more able. One trick would be to sit in a chair or on the sofa and either have the child brought to you or to have the toddler climb up to you. Lifting in the first couple of months of any surgery should be avoided unless otherwise specified by your physician.
OK, so I’m four months post-op from my ACDF and I have a few bits of wisdom for those who have just had it or are thinking about it. Let me preface this by saying…I WOULD DO IT AGAIN IN A HEARTBEAT!!! The relief I got from the pain was immediate.
The surgical pain is a little bit different. One has to understand that within a little less than 8 weeks after I had my ACDF, I had to have a total hip replacement. This meant I had to have another airway put down my throat, allthewhile healing from the neck surgery. This posed some interesting problems for me healing from the ACDF. It was four days after my ACDF hard brace came off that I found out I’d have to have a total hip replacement.
The hard brace, I’m not gonna sugar-coat, was the most unpleasant thing I’d experienced so far. We have a natural tendency to twist our head in a certain direction of sound, or to look down when we drop something. With the hard brace I tried to do all that but my chin was caught making it immobile. Each time I did this my jaw had extra pressure on it from trying to look a certain way. My teeth hurt a lot from that pressure. I was uncomfortable most of the time. The only relief I got was if I went to lay down or at night because I was able to wear a soft brace if I was laying down. But I knew it was only for six weeks. My back brace was on for four months, originally being told I’d have to wear it for six months.
I don’t know if it was a combination of being in the brace for six weeks and having to have another airway put down my throat, but the healing of my neck has been slow for me even though it’s only been four months. I just feel I should be further along than I am. It’s felt like someone is choking me, not enough not to breathe, but still choking me. What it really is, is the muscles they stretched to get to the area of the spine to fuse, relaxing. The right side of my face is still slightly puffy, but I’ve never had my jaw go completely out of place afterwards. I did have some clicking, but my doctor of PT gave me some mouth exercises to help with that. A few weeks of doing those and my jaw felt much better.
Early-on after surgery, I did have some real muscle tightness but as I did my physical therapy exercises, that subsided. I had a lot of breathing and swallowing issues right after my ACDF but it was my own darn fault. You see, I refused to take the steroids the doctor prescribed while in the hospital. It wasn’t until he was out of town five days later that I realized I was in trouble and had to call his PA, Joe to have a script called in. Joe said they’d take a couple of days to kick in but I should be OK. They did and I was, but not before it gave me a real scare! A really stupid move on my part! Hindsight is always 20/20!
I didn’t have any face pain after my ACDF, except right afterwards, but that subsided quickly. It was from them pulling those muscles aside to get to the vertebra. It was really weird for a while because when I tapped on my neck it sounded so hollow. All the muscles and inner-workings; voice box, esophagus, etc were so far over and they needed time to work their way back. It took almost a month for the tapping to not sound so hollow! Before my ACDF my arms were constantly going numb and my right fingers were numb as well. As soon as the ACDF was done, the numbness went away.
Right before surgery I asked Dr. Smith if I’d be able to sing again. He answered, “Most people recover nicely getting their voice back and have no problems. A small percent end up with a rasp in their voice for a good while and an even smaller percent will have the rasp permanently.” Well, that didn’t really answer my question, but then again, it did. What he was telling me was what I could hope to expect, but that each person’s recovery is different and he wasn’t going to predict anything.
He did advise me that I shouldn’t put a strain on my voice until I was like at least four months out to allow everything to work back into place and then I could start to do singing warm ups and vocalizing a little. I’ve started the warm ups and the vocalizing and I’m here to tell you it still feels like there’s a lump in my throat. I’m wondering if I should get my throat stretched. The more I use my throat and neck muscles for talking and singing the less I feel like someone’s choking me, it’s still there, but less and less as the days go by. I imagine that by the six month mark I should have my voice back completely with no discomfort in my neck at all. Just in time for rehearsals for Christmas Choir. Now my singing voice will be a different story. I don’t know how far up the scale I’ll be able to go, but from the preliminary exercises….well, let’s just say, I’m very hopeful! The more I get control of the muscles the better the sound is. I’m starting to do some things I didn’t do before so I’m treading on mighty uncharted territory. More along the lines of contemporary singing rather than the opera type that I was trained to sing. That’s OK, I like a good adventure!
I’ve had some unique experiences because of me having an XLIF and a total hip. I am glad however that I didn’t have the total hip any sooner. If I had, I don’t think it would’ve rendered the same positive results. By that I mean, my back had to pretty much completely heal before Dr. Michael Crovetti, the hip surgeon, would know how to set my hip so I didn’t have to wear orthotics any longer. He did the final “tweaking” so to speak to my structure. Even though Dr. Smith had stabilized and straightened my back to a degree, my shoulders were still visible crooked. One was higher than the other. It wasn’t until Dr. Crovetti replaced my hip that I now stand with both shoulders even.
I had a picture taken at the NuVasive Cheetah Ball in San Diego with Bill Walton and Nate “Rock” Quarry. Standing between the two of them made it really obvious how crooked I still was, but that was before the hip surgery. I’d love to have another picture taken between the two of them again just so I can hang them side by side to show the comparison. With each surgery I’ve become a better person! Physically and mentally. If anyone is facing the same dilemma, to them I say, have the back done first, wait and heal completely from that and then have the hip done. You won’t regret it. I’D DO IT AGAIN IN A HEARTBEAT!!!
So as I close for now, I hope this has opened your eyes to some of my experiences. Do your research and make sure you fully understand what it will take to heal. And whatever you do, remember that your doctor can only do so much, it’s up to you to do the rest! Choosing a minimally invasive procedure is a step in the right direction… enjoy your journey.
As always remember to take care of you and yours,
Geesh! I’m awfully sorry it’s been 2 1/2 weeks since I last wrote! I’ve been a tad busy with a few personal things, (Greg having surgery and some painful dental work done) but I’ve been reading your questions…
I decided to dedicate a whole entry to this website about all the questions that keep popping up about the different surgeries I’ve had. It’s my hope that I can put some of your fears to rest, answer some questions and shake a finger at some who’ve thought it’s all on the doctor to make you feel better!
I’ve dissected the questions into the three main categories of :
Cervical Spondylosis/ACDF procedure/cervical fusion
Total hip replacement/hip arthroplasty
XLIF procedure/spinal fusion
In doing this I trust it will clear up some unsettling feelings you may have about any of the above procedures. If you are a neck/back/leg pain sufferer, then you know PAIN! You also know it will take some healing to get to a point of no pain. Please bear with me as I address these issues you’ve asked about.
Bear in mind also that what I share with you is MY experience, what I’VE been taught and MY understanding of the procedures performed on ME. In no way does this constitute a medical opinion or negate the advice of your personal doctor or surgeon in any way. My only intention with what I share is to INFORM you of the experiences I’ve had.
As we all know, no two people are alike and neither are any two surgeries. AND we also know there are risks involved with any surgery. You are best advised by your personal physician and surgeon about what outcome(s) you can hope to achieve. It is in your best interest to be as informed as you possibly can be, before making any decisions, weighing your options against your own personal judgements, or belief system.
Make no mistake, surgery is an invasion on your body that requires time and effort to heal. Every effort will be made by your physician and surgeon to help you in any way they can, HOWEVER you, as a participant in the healing process, with a vested interest in getting better, must assume responsibility beyond the scope of what any one physician or surgeon can do.
I will be blunt, forthright, and honest about all of my healing and experiences… about what I’ve learned from other experts (mostly in the realm of physical therapy) along the way. Because I’ve developed a very close relationship with my caretakers, I’ve gleaned a great deal of understanding about my body, it’s healing, and what I can hope to achieve from it in the near future and in the months and years to come.
Herein lies some of the questions in answer form I’ve been seeing because of this website.
CERVICAL SPONDYLOSIS/ACDF procedure/CERVICAL FUSION
Cervical spondylosis is agony. Because of where the pain occurs, it can render you almost immobile. It taints most upper body movement with any number of pains manifested at either the slightest of motion, or the broadest of reaches for something you may need to pick up. The pain can range from a dull relentless ache, to a searing pain that cuts through you like a knife, stabbing you in the back. A head turn or tilt, a spontaneous reach for something falling before it breaks, or sometimes even a deep breath requested by your doctor to listen to your lungs; all of these actions can put your mind into a blithering state of semi-consciousness while you readjust yourself to find a more comfortable position to be in less pain. Notice I said less pain here, not out of pain. For the most part the pain is an ever-constant reminder that you are limited to your movements and at any given moment you will be stopped dead in your tracks until you can find some measure of relief. Until that point, you are not able to concentrate on even the smallest of tasks before you.
Chemical pain relievers often do little to mask the symptoms or give you a state of comfort. Relief sometimes comes in the form of going horizontal for a period of time. Sometimes, long periods of time. Which plays on your self esteem in different ways. First, it renders you unable to perform even the most ordinary of tasks. And secondly, it takes you out of the game of life for sometimes unprecedented amounts of time.
I share all of this with you for two reasons. One, I regret not having that inordinate amount of time I spent laying flat on my back for ten years for some small measure of relief to do the things I either needed to or wanted to do. By doing so I missed out on a good amount of life, of which I’ll never get back. It dictates to you how you live your life, not allowing you to choose how you want to live.
The other reason is to help the people living with or who are around the pain sufferer who may not fully understand what’s happening to someone when they’re experiencing such pain. NO, they CAN’T move or do the thing you asked of them. NO, they CAN’T go with you to be an active participant in activities which require movement far beyond their present capabilities! Don’t make them feel any worse about not being able to participate than they already do. NO means NO! A little empathy goes a long way here. They’re NOT over-exaggerating their inability to move. They are NOT just looking for sympathy. NO, they CAN’T just work through the pain to accomplish whatever’s requested of them.
The pain they have in their neck, shoulders or arms and the numbness and tingling they may be experiencing in either one or both sides can render a person much weaker in their ability to do even the smallest of everyday tasks such as opening a jar, picking something up or even holding something for any length of time. The condition is REAL.
I had the “stab in the back” kind of pain and the numbness and tingling in my hands and arms, plus spasms in my neck, along with the inability to stand at the stove or sink for any length of time because of the reach I had while doing so, not to mention the angle I needed to bend for dishes. My head also tilted to one side or another when I was upright, it was a real effort to hold my head up straight. (it looked like I was holding a phone on my shoulder without using my hands) And then there was the numbness in my arms and fingers and the constant tingling and shooting pain between my shoulder blades. Oh, and did I mention all the sleepless nights I had or the ones where I could only get two or three hours at a time? (sometimes I took “night naps” [1 hr or less of sleep at a time] because of the pain) The headaches were excruciating, often debilitating. AGAIN, the best relief I found was going horizontal for more hours than I care to account for.
Over the counter medicine did little to relieve what was wrong with me and my doctors from Ohio didn’t believe I could be in that much pain and still be functional. Some thought I just wanted the scripts for the pills to sell. And as I told Dr. Smith, “I’m an ‘if it’s broke, fix it’ kinda gal,” but I should’ve added, “And if it ain’t broke, don’t touch it!” But I think that went without saying. It had little to do with the pills, I hate taking any kind of em, but I needed some kind of relief but never got until I met Dr. Smith.
I was overjoyed when Dr. Smith validated my pain as he pointed it out to me when he looked at my MRI. “I see your problem right here!” pointing at three vertebrae that were squished together. The pain was real, not in my head; just imagined! I smiled with satisfaction when I heard his comment, “My gosh girl, you’re a mess!” His next words were even more welcome when he said to me, “I can give you a measure of relief from all the pain you’ve been experiencing through a surgical procedure called ACDF.” He didn’t promise me the sun, the moon and the stars, but he did promise me he could relieve my pain. That was music to my ears.
What is ACDF? It’s an acronym for Anterior Cervical Discectomy and Fusion. I’ll leave the “technical” explanation for your doctor to explain. There are many “variations” of the procedure, enhancing your chances for a complete and successful recovery. (different conditions need different applications to address specific issues unique to your own body or condition.) The ACDF is a procedure where the surgeon goes into the spinal column at your neck through the front, either one side or the other of the voice box and the esophagus. The surgery is actually performed this way so the surgeon can best locate and isolate the involved vertebrae with less damage to connective tissue and tendons making motion possible in the first place. This leads to a quicker healing process. It is said that a successful ACDF procedure can give the pain sufferer immediate relief from all the excruciating symptoms right after surgery. THAT is a very accurate statement!
HOWEVER, there’s the pain from the surgical wound and procedure. Believe me, I never thought this was going to be a walk in the park pain free. But I have had some twists of fate so to speak with my healing I wasn’t exactly prepared for. IT HAD NOTHING TO DO WITH WHAT THE DOCTOR DID! It was a specific set of circumstances no one could have anticipated. A couple of things I brought on myself and I’m still kicking myself for having done them. Life is all about choices.
For one thing, I guess I didn’t realize they were going to have to pull my voice box and all my neck muscles out of the way to get to where the doctor needed. That being said, it would’ve been ok for the average person. But, I am a singer, (see earlier posts for in-depth explanations about being able to sing after ten years) and after just getting my voice back and the breath to hold the notes, I didn’t realize it would affect my singing like it has. In defense of Dr. Smith, I also have to admit, I had to have another major surgery just weeks after my ACDF which didn’t give my neck near enough time needed to heal the way it should have or could have. Because of that additional surgery, and because they had to use yet another airway down my throat, well let’s just say, the healing in my neck was set back, is slow going, and I’ll have no way of knowing what the eventual outcome will be about my singing for a few more months.
I had some additional complications most people don’t have because my throat started to close from the swelling due in part because I was too stubborn and didn’t want to take the steroids prescribed by Dr. Smith. He graciously honored my wishes even though the nurses kept asking me if I’d reconsider. It wasn’t until 5 days after surgery that I conceded and called his office, at which time his PA, Joe, called in a script for me to take. By then I could hardly swallow food or saliva and breathing was a scary event. I prayed the steroids would kick in quickly. It was my own stupidity and poor judgement that led to extra suffering and worry. The pills quickly did their job, but I was just that much further behind by then.
It was hard for me to find a comfortable spot to lay. I was in a soft neck brace at night and a hard one the entire time I was up. That hard one was soooo uncomfortable but I made Dr. Smith a promise to do EXACTLY what he asked of me. So for six VERY uncomfortable weeks I suffered through the hard brace, all-the-while walking and doing everything he assigned me to do. To make the whole experience a little easier to take, I decorated my neck brace with some fake rhinestones where the ugly logo of the brace manufacturer was. It was my signature and my way of keeping a little control of my situation. The added bling caught Dr. Smith’s eye and he laughed with enjoyment at me embracing the temporary state I was in.
On my first visit back after my surgery I was given a script for PT. But Joe said if I didn’t want to do it I didn’t have to. Well, that PT turned out to be my saving grace. My doctor of PT, Amanda Scott, from Mattsmith Physical Therapy knew how much singing meant to me. She also knew I was going to do everything asked of me so she was willing to go the extra mile and find me plenty of neck exercises to strengthen my muscles. It also helped with the muscle spasms in my neck and shoulders. I can’t say enough good about Amanda, she’s awesome at what she does! She’s one of my heroes! And so are her exercises. For as much as I don’t like doing the exercises, like she’s said many times, they will give me a measure of relief until my muscles are strong enough to do the job on their own. In strengthening my muscles, which have been either not used properly for ten years, or been stretched beyond their normal capacity, or damaged in some way by the invasion of the surgical procedure itself, I will bring them back to their proper function so there’ll be no pain when I call upon them to use.
There was a LOT of stiffness in my neck, even now, four months post op, I find myself getting up with a stiff neck or at the very least, tight muscles, although it is getting better the more I do my exercises. And I found that the more I did my exercises, the better I was breathing because I was forced to breath correctly while being that active. (If anyone is interested in a list of those exercises, leave me a request in my comment box. On a subsequent post I’ll then post them for all of you to use. There are a LOT!!) I was amazed at how many different exercises Amanda came up with for me to use. And don’t beat yourself up if you forget a few and do only certain ones. The body has an uncanny way of acclimating quickly to repetitive motion so I was told not to do all of them every day each time I did exercise. By switching things up it keeps your muscles guessing, much like when you do different activities in daily life. If they don’t know what muscles you are going to call upon, they will all stay in shape if you work them alternately.
Another hard lesson I had to learn was to talk. Not that I couldn’t after surgery, it’s just that I didn’t. Greg is a silent person and only speaks when necessary. Brian and his girlfriend are often not at home for great lengths of time which renders me silent for a huge portion of my days. So, I discovered my voice was quite raspy for a long time. It discouraged me thinking I’d never be able to sing again, if I wasn’t going to be able to speak. Dr. Smith even mentioned the change in my voice. It was very disappointing to me. It wasn’t until my nephew called me one night out of the blue and were on the phone for the better part of almost three hours. In the morning my throat was very painful, but it was a good kind of hurt. You know the kind of hurt when you use muscles you haven’t in a long time…. that kind of hurt. As it’s turned out, I now go to the store or Walmart and will speak with anyone who’ll talk to me just so I can strengthen my vocal chords.
Oh, I still do my neck exercises and stretches but I know that I have to use my vocal chords too. I’m now allowed to do some vocal warmup exercises and as my chords get stronger, the more in control I am of the sound they make and if they’re on pitch or not. The tongue and jaw exercises have been especially interesting… I told Dr. Smith I have the strongest mouth in Las Vegas…. and that’s saying something! He laughed, and agreed!
I have to say that I did have some really bad pain in my neck and shoulders after my surgery leaving me in doubt that I did the right thing. But as time has worn on, I’ve come to realize the necessity of continued PT, even at home when no one is looking, and the allowance of time to pass. I had some pretty intense shoulder pain immediately following the surgery. It’s my understanding that a bone graft is used in order to fill in the fusion in some cases. If that’s the case then I’m sure they took the graft from my shoulder blade which would explain the added pain. As with the XLIF, a bone graft was used in order for the fusion to be a complete success.
In that procedure they took my bone graft from one of my ribs. It was painful at first, and I was uncomfortable most of the time when I sat, or moved a certain way, but as time passed, the pain disappeared. So too has the pain in my shoulder, a combination of passing time and of me doing some intense upper body strengthening I imagine. As for my incision, I had an infection in my throat after my hip surgery which swelled it once again. Dr. Smith was out of the country, but Joe was there to see me and get some antibiotics working quickly. I keloid (thick scarring tissue) so I wasn’t sure if the lump at the incision was swelling or just scar tissue. At any rate, Amanda and Bobby, my PT tech, kept rubbing 40,000 IU of vitamin E oil on my incision on the advice of Dr. Smith to aid in the reduction of scar tissue and the healing of the actual wound.
I knew the brace was only for six weeks even if it was hard for me to wear. My back brace was on for four months! I figured I could do six weeks with this one. I know the only one I hurt is me if I don’t do what Dr. Smith, or for that matter, any of my other doctors ask of me.
As far as I’m aware of the longevity of the success of the ACDF procedure, taking the proper care, I would imagine it will last me the rest of my lifetime. I don’t plan on being a UFC fighter and I’ve given up the hope of getting back to water skiing, so barring an unforeseen accident of some sort, there’s no reason for me to think this procedure needs to be revised.
It’s been my understanding from a patient perspective, there are certain mitigating conditions that directly affect a successful outcome of the ACDF surgery. One of the biggest issues is if the patient is a smoker due to circulation problems. Healing comes slowly, or in some cases, not at all, when people are smokers. Some other factors may be heart conditions or diabetes. In some rare instances, outside conditions can create an environment where the bone grafts may not “take.” In that case, it would be within the doctors’ judgment to make that determination and appropriate action. It was scary for me as the days and weeks passed and my healing was so slow due to the added stress on my body from having an additional surgery so close to my ACDF. I literally felt like the fusion was not taking properly or not at all. When Dr. Smith looked at my follow-up x-rays and said with almost a smile in his voice, “Your procedure is completely fused, it looks really well and I’m very pleased with what I see.” Whew!” I was beginning to think the things I felt in my neck and shoulders were still going to be a part of my everyday life. Ah, not so! I just needed to strengthen them, and his visit gave me a renewed sense of purpose for my exercising.
As with all healing, a doctor can only do so much, he’s not God. After he preforms the skills necessary to correct what’s wrong, it is up to us as patients to do our part, to make good the rest of the healing if not to please the doctor, to make us not look like a slacker. We are in charge of our own destiny. If we don’t put in the work, then don’t blame the doctor if there’s not a successful outcome. Yes, before you get all upset, there are those circumstances sometimes far beyond your’s or the doctor’s control and something bad may happen or the surgery just isn’t successful for one reason or another. In those instances, it may have been any number of reasons for which we should not second guess unless we know every minute detail of the case. And each case is uniquely different than the next.
As far as the pricetag of the ACDF procedure, it is mostly contingent on several factors. One, your insurance carrier and coverage, how much work your doctor has to do once he gets in there to stablize everything, what type of and how many pieces of hardware used, your area of the country for the pricing standard(reasonable and customary) for this type of operation, and the biggest price differential is how much the facility you are being cared for at charges you and your insurance company. I will leave this last issue for another post, as it is a HUGE pet peeve of mine.
As I’ve gone through this little discussion, I trust I’ve answered all the questions posed to me over the course of the last two month’s worth of posts for my ACDF procedure. As with any medically invasive procedure, there are risks as well as benefits. My benefits far outweighed any risk I may have had because the pain was so debilitating. IF someone were to outright ask me if I’d do it again…. the answer is a resounding, Y E S!! I WOULD DO THE ACDF PROCEDURE OVER AGAIN! The biggest reason is that I’ve gotten past concentrating on pain and started concentrating on living. The hideous pain stole ten years of my life, and I’ve got a lotta living to get in now. LOOK OUT WORLD!
My next topic is my TOTAL HIP REPLACEMENT/ HIP ARTHOPLASTY
Only a few questions have been asked about this procedure so I’ll make my statements brief. A major portion of my healing from my hip replacement has been covered in prior post entries. If you would like to know more, please either refer back to those posts or leave a note in my comment box and I’ll gladly address any issues you’d like to discuss.
The number one question about hip replacement is: When do I know it’s time to get my hip replacement? The short answer is, when you’re ready. But I know the underlying thoughts that make people hesitate and downplay their pain and condition if they go solely on that answer. The bigger questions are a little more complicated than that. Ergo, what happened to me, I’ll explain.
For about a year, I’d been having trouble with my right hip. It kept popping out of it’s socket, I actually could feel it either pop out or work it’s way back in. When it popped out, it was excruciating and my only recourse for the pain was sitting or laying flat on my back. I really regret not knowing “when” to address this issue with a doctor because it took me out of the busiest time in my son’s life, when he really still wanted me to go with him and do things with him. I just wasn’t able to go and do those things. And now that time is lost forever. We have a unique bond ( see earlier posts) and it was exciting to know I’d raised him to be a respectful young man who wanted his mother to share in his experiences with him. I knew it wasn’t going to last, there was a small window of opportunity this would occur in his life with me and I was missing out on a LOT of it.
When I did go, I took some over the counter pain reliever and attended the functions he asked me to go to. A movie at the theater, a frozen yogurt run late at night, a Best Buy run to get yet another piece of electronic equipment, or just wander through the aisles of Walmart late at night because neither of us could sleep. I did do some of it, but mostly I was in pain. He was acutely aware of my condition and often took it into consideration while planning an outing for us. He was always respectful in the fact that he never rushed me or slammed me for not being able to go the quicker pace he would’ve like to have gone.
But as time wore on, I found myself horizontal more and more for all the reasons of my health. And it was heartbreaking. I WAS MISSING OUT ON LIFE. Time was passing me by and as I watched from my chair or my bed and realized just how much time I’d given in to my pain. It was time to act.
Not only because of the pain did I feel the urgency to get my hip done, but because our insurance was drastically changing. We had a Cadillac policy with all the bells and whistles, but in less than a few short months, I would no longer have such good coverage.
Originally, when I first went to Dr. Smith we addressed my lower back and cervical issues. I knew what was going to happen with those. But after my spine was straightened, I found my hip was popping out more and more. It put me down for lengths of time, rendering me unable to do my “back rehab” the way I was supposed to. It was so frustrating for me. Dr. Smith and I discussed it and he sent me to a doctor of orthopaedics that he highly respected, Dr. Michael Crovetti.
Dr. Crovetti is a powerhouse, young, sensitive, energetic and a genius when it comes to fixing hips. I was out of my hard neck brace only four days when I saw him in his office. There he took one look at my x-rays on the lightbox and said, “Yup, I see what’s wrong,” pointing at the deformity along the bone line. That was the good news, he knew what the problem was. The bad news was, “You’re gonna need a hip replacement soon.” I broke into tears. I felt so bad for him, it’s the first time I’ve ever cried in a doctors’ office. But it was the final blow. In less than two months I wouldn’t have the great insurance, and I wasn’t yet healed from my neck surgery. He looked at me and said almost apologetically, “I’m not trying to force you into anything you’re not ready to do, I’m just saying, to be out of pain, you’re gonna need a total hip replacement soon.”
That’s when I explained to him about the insurance. His look softened and he said, “Ah, I understand.” Then in a very upbeat tone he suggested,”Well then let’s just book you in at the first open date. I’ll let you talk to my scheduler.” I cried through the entire registration process. The insurance company was giving me no choice. (you can read about my hip replacement in more detail by scrolling back to some of my earlier posts.)
I’ve shared this all with you because you see there are circumstances, some far beyond your control and others you do have control over that help you form your decisions. So, the short answer of “WHEN YOU’RE READY,” though really lame, is really the best answer anyone can give you. The questions you need to ask yourself is, HOW MUCH MORE PAIN CAN I TOLERATE?, HOW MUCH MORE LIFE AM I WILLING TO MISS OUT ON? These should be the questions you ask yourself to answer your own question, “when should I get a hip replacement?”
Dr. Crovetti is an amazing doctor who understands not only the mechanics of your problem but brings to the operating table the reason each of his patients has for going through the surgery to get back in the game. As a former athlete sidelined because of a sports injury, he is VERY much aware of the sacrifices his patients have already made because of their condition. He truly wants you back in the game as soon as medically possible, to live your fullest life. I am in awe of his work. I was up and walking 3 hours after surgery and off the walker and no cane assistance in four weeks. And yes, I did ALL the rehab he prescribed for me, and then some! I WOULD DO IT ALL AGAIN IF I HAD TO… HE’S THAT GOOD!
As with all surgeries, there is a time for healing which includes getting your muscles moving again. There were days I didn’t feel like doing my walking but I did it anyway. I gave myself a break by not going as far but I still did it….. and I kept at it. I walked through the post-op pain, and kept moving. A professor of mine once said that the body was designed to keep moving and the worst thing you can do, even for arthritis, is to stop moving! Dr. Crovetti ascribes to this philosophy. KEEP YOUR BODY MOVING!! Take your pain meds as prescribed, you’re not gonna get hooked on em, but you do need em for the short period of time you’re in the process of rehabilitation.
LISTEN TO YOUR BODY, it will tell you what it needs. At the very least, don’t give up walking or going up and down steps. My house doesn’t have steps, so I go to the mall and walk around from one end to the other and I use the steps not the elevator or escalator. There are leg lifts that can be done but each doctor sets your hip a certain way. Check with your doctor about which motions you are limited to.
Dr. Crovetti made sure I would be able to cross my leg, man style, so I could tie my own tennis shoes or paint my own toe nails. (he has a wife and two daughters, he understands these things) I won’t be allowed to thrust my leg back to a full backward extension, but I honestly can’t remember a time in my recent past that I’ve needed that motion and said, “Darn, I can’t do that!” LOL
Dr. Crovetti put in a ceramic hip which has yet to fail in clinical trials so he could not give me a specific end date for my hardware. He told me I could go back to water skiing if I wanted to, however Dr. Smith has already nixed that idea since he’s done all the other repair work. In 1978 my mother had her right hip replaced and was told that within ten years she’d have to have it replaced. She had the “old style” but never did need to have it redone.
I’ve talked to several people who’ve had bilateral hip replacements, even having it done at the same time…. I’m not so sure I’d do that unless of course I was faced with the same dilemma I was with time constraints and all. If my other hip goes out at any time, I wouldn’t hesitate to have it done as well. I’m pretty much all surgeried out but if something should come up of necessity, I wouldn’t hesitate to have my other hip done either.
Especially if I could have it done at the Coronado Surgical Center. This surgical center is in the same building as Dr. Crovetti’s office. His operating rooms are designed specifically for orthopaedic surgeries. A lot of thought went in to the design of the center to give his patients the optimal chance for a good recovery and minimal “hospital” style experience. My room was one of the six suites there at the center with many comforts of home. There was seating for several people and even a recliner! Kathy, the patient concierge, was there to help make my stay as comfortable as possible and addressing any issue before it became a problem. I was served meals from an Italian restaurant next door and had someone just feet away if I needed help. I couldn’t have asked for a better place to recover.
Dr. Crovetti does his surgeries on Monday and by Wednesday of that week you’re outta there! His on-campus staff of physical therapists works with you the entire time making sure you have the skills necessary to function on your own at home. AND, the beauty of the Coronado Surgical Center is that it’s about 20% cheaper to have it done there! It truly was an amazing experience, and since I had to have it done, I’m so glad I had it done there!
Although technology is growing by leaps and bounds and is crossing over in a huge way with the sciences, I don’t know of any study or project underway at this time addressing the issue of hip tissue being able to regenerate itself. That being said, I did see an article recently saying that a wounded soldier back from Afghanistan was given treatments over a two year period that helped him regenerate tissue in his leg that had been torn off because of an IED explosion. The article stated he was even showing signs of regenerating muscle tissue. The work is VERY promising for many reasons including bone regeneration!
So to recap a little in this discussion, about hip replacement, YES, I would have it done again! I trust Dr. Michael Crovetti’s judgement to do the right procedure and do it to the best of his ability. He is a doctor’s doctor, meaning, one that other doctors would trust to have him do their surgeries. As for the Coronado Surgical Center…. it’s an amazing place to have surgery! As for the procedure itself, I’m pleased with my progress even though it’s only been a little less than 8 weeks out. Last weekend I was picking weeds out of my flowerbeds! I feel amazing and I know it can only get better!
My last topic for this post’s discussion is the XLIF procedure
The question posed was open ended… it read “How soon after XLIF….?” So, since I’ve already covered ad nauseum the details of my XLIF surgery in earlier posts, I’ll refer you back to them and take a lighthearted approach to this unfinished question, David Letterman Top Ten style.
HOW SOON AFTER XLIF…..
10. …should I be able to walk to the bathroom and get up from the toilet? And the answer is….. within the first few hours after surgery!
9. …should I be able to have a BM? And the answer is…. as soon as you start eating fruits and veggies to make you go!
8. …will I be off this walker? And the answer is… usually within the six weeks after surgery if you become stable enough in your stride and you gain muscle strength back in your legs.
7. …can I get out of my back brace? And the answer is…. within four to six months, but only your doctor will be able to judge how strong you are to have it removed.
6. …can I drive? And the answer is… when the doctor tells you it’s safe, he wields a lot of power over you to keep others safe, remember you’ll still be on some very strong pain meds.
5. …can I return to normal daily activities? And the answer is… as soon as you feel you’re able to do the normal things you once did within the limitations your doctor has set for you.
4. …am I able to start physical therapy after surgery? And the answer is… at about six weeks your doctor will allow you to start the rehab process, keeping in mind that you should’ve been doing the passive physical therapies in bed and sitting up within hours and days of your surgery.
3. …can I expect the tingling and residual surgical pain to subside? And the answer is… you should start to notice a huge difference at about the four to five week mark.
2. … can I find my motivation to do the ordinary things I used to enjoy? And the answer is… use little techniques to help your motivation by making a calendar of all your benchmarks like the doctor’s two week follow-up visit, six weeks till you’re driving, six months until your brace is off, etc. Mark off as each day passes, you’ll be amazed at how quickly the time goes.
1. … can I have sex? And the answer is…. ASK YOUR DOCTOR!
I want to thank all the many visitors from around the world who’ve taken the time to read my words. It is my hope that you can learn from me and it is my prayer that you have a happy and healthy future. If in some small way I’ve contributed to your success, please drop me a line and let me know how I did and how I can improve my website so others can benefit from our discussions.
As always take care of you and yours and reach out and touch someones life, you may be just the person they are looking for.