Posts Tagged ‘pain in back’

kathleen@kathleenmosko.com      Twitter @KathleenMosko     www.aimisspine.com

HI Everyone!

I’m off to do grocery shopping but I just wanted to let everyone know, MY BOOK IS FREE ON KINDLE TODAY ONLY!!!  If you’ve been wanting to read it but didn’t want to spend the money, now’s your chance!

You don’t have to own a Kindle to read it. Amazon has a spot where you can download a limited version of Kindle for FREE.

SO THERE’S NO EXCUSE!!!   YOU SHOULD BE READING MY BOOK!

Stop back and let me know what you think of it and also, stop back on Amazon to leave a review. The more reviews I get the higher it goes on the charts…. the more people will read it and get help!

Here’s what one person who bought my book had to say:

Hello Kathleen
Your book was wonderful as it led me to Doctor Smith. I have surgery on Oct 23 with him. Without your book I would still be in the dark about how to get out of this pain. You are a miracle at amazon. I really enjoyed my appointment with Doctor Smith and you described him perfectly. Thank you again as without your great advise the doctor said I would be I’m a wheelchair and in bed the rest of my life. The 23rd cannot come soon enough. Thank you again I hope your book helps many others as it has helped me. May your God bless you. (name witheld)

So you see, it IS changing lives. One book and one patient at a time…. there’s only 9,999,999 more people to reach!!!

My next FREE ON KINDLE ONLY DAY WILL BE:  OCTOBER 27TH, 2012! But why wait??? If you or a loved one or friend is suffering in pain, GET THE BOOK NOW! NOW is not too soon, and you should never procrastinate! Think of all you friends and family who will be forever in you debt because you led them to relief!!! GET THE BOOK FOR THEM…. make it an early Christmas present!

WHATEVER YOU DO…. GET THE BOOK AND SHARE!!! The more people who have it the more people can be helped!

Off to do the grocery thing now but, I’ll be back! But in the meantime, you know what to do…. take care of you and yours,

hugs,

Love,

Kathleen

kathleen@kathleenmosko.com    Twitter    @KathleenMosko            www.aimisspine.com

Hi Everyone!

Today is the big day! I get to go to the AIMIS, AMERICAN INSTITUTE OF MINIMALLY INVASIVE SPINE SURGERY, facility for a hands-on tour. This is the most important post from my visit. I was invited to come to see just what kind of facility it is, what kind of work is done and how ordinary people can have world-class surgeons available to them. I need to get this post correct!

 Marios, who is the business and industry consultant for AIMIS, picked me up at my hotel in Limassol to make the drive to Nicosia where the institute is located. We had a most pleasant drive chatting the whole 45 minutes it took.

I got a chance to see much of the Cyprian countryside which is dotted with both orange groves and many wild olive trees. A plant similar to our Bouganvilla here in the states grows wild, dotting the landscape with different hues of pinks, purples and magenta’s. These are splashed all throughout the land, drawing your eye to their vibrant color as you look in awe at the ancient land.

The facility at first blush dosen’t look like an ordinary hospital. It looks more like the library of a learning institution, or the lobby of an art gallery. The most amazing thing is that this institution doesn’t smell like a hospital!

An arranged meet n greet yielded me more names to remember, but, as I got to know them as people, the names were easy, they are becoming my friends. Nikos was the only one I recognize from an encounter we had in the states almost 2 years ago. He also did my initial meet n greet when I first arrived. It sure was good to see him again. After a bit of chatting, Valerie and I were off for the grand tour of things and meetings with others throughout the day to hone in on specifics each one of us would need to know about the facility. There was picture taking in the front lobby and then off to the serious stuff.

 There are so many facts about the building and how it was built, and how it’s maintained, I can’t remember them all. I do know that it is considered a “green” hospital, utilizing as many natural assets where possible like geothermal heating and cooling. (too complicated to get into right now!) One interesting tidbit is that all the rooms are equipped with big windows that are reflective but also, the vertical blinds are on a sensor which, when it detects too much sun, will automatically turn the blinds so no direct sunlight enters the room, yet they are not completely closed. A unit which hangs from an arm above the bed is the rooms’ master control panel turning on lights, calling for help, internet Skyping, TV, and a few other things I know I’m forgetting.

The bathrooms were one of the things that blew me away. I can’t remember if they were made in Sweden or Switzerland but, they were all shipped in as “pods.” The walls snapped together and had NO SHARP CORNERS ANYWHERE!!!  Everything in that bathroom was so cool, but mostly the rounded edges are what caught my eye. Mainly because that was one of the things I was worried about when I was in the hospital in the US. I didn’t want to fall and least of all have an additional injury from a sharp corner. The rooms at the facility are either one or two person rooms and all are equipped with a chair/bed which one person accompanying the patient can stay with them while there. Their visitors’ meals are also part of the added service. They’ve thought of just about everything for ease and comfort to the patient and their guest.

I think back on my experience in the US and, although my son was allowed to stay with me, he’s not small and had a hard time curling up in a bench-chair with wood-rail arms. There were no comfortable chairs for him to sit those long hours waiting for me to come around from the surgery. I wish he’d have had the comforts of the AIMIS facility.

One of the things I was most concerned with during my stay at the hospital in Vegas was the fear of MRSA which I addressed at great length with Dr. Smith beforehand. I was OK with the isolation in a room at the end of the hall because I didn’t want exposure to what could potentially be life threatening. I was adamant about my concerns because my mother-in-law spent the better part of a year on her deathbed, with the family being called home for final goodbyes three times. All because one of the aids at the rehab facility she was in was not cautious enough to wear gloves while changing my mother-in-law’s bandages.

The AIMIS facility can state they have a 0% infection rate for any patient surgery! Let me repeat myself here, THE AIMIS FACILITY HAS A 0% INFECTION RATE FOR ANY PATIENT SURGERIES!!!  THIS IS AN AMAZING FEAT! If we only knew how much preparation goes on prior to a person having surgery at this facility, you would just shake your head and ask, “If they can do that at AIMIS, then why won’t they do that in the states?” That question is one which should be asked on a regular basis! If I ever need surgery again, I want to go there to have it done!!!

There are other considerations to having a surgery done at AIMIS as well, like:

*World leading US-based spine surgeons

*The most advanced techniques and procedures with proven track records

*US cutting-edge spine technologies

*Affordable care – Significant savings for the same surgery in the US – with the same surgeon! ( I will expand on this further a little later.)

*Top quality healthcare – from day one to post-operative treatment when you return home

*Minimal recovery time

*Combine healthcare with a holiday in one of Europe’s favorite holiday destinations waiting for your “fit to fly” orders

*World-class European hospitals – should your case need a different facility for certain circumstances a private hospital in Greece is available

*English-speaking support from day one

*Follow-up care in the US through the network of member, associate and referring doctors

*Concierge services for patient and family members

 
AIMIS is the world leader in spine surgery excellence utilizing the talents of the best minimally invasive spine surgeons in the world. It’s a collective effort for health-care beyond borders giving it a global reach. The surgeons who are the founding members have each done hundreds, some, thousands of spine surgeries encountering many unique circumstances which they can address. This elite group of surgeons vette any new surgeons coming on board in such a manner that, if even one is not comfortable with the skill level of that incoming doctor, they do not qualify for admittance. These are the best spine surgeons in the world, many of them US doctors.

They visit for at least 10 days once or twice a year to perform minimally invasive spine surgery at often a significant reduction in cost for the operation. Some as much as tens of thousands less.

These doctors apply the most innovative and newest surgical methods and techniques making the surgical experience far from the scary traditional way surgery has been done in the past.

AIMIS doctors are changing lives, making productive members of society, when often patients would have been a burden to family and social services for many years. Too, their lives may have been cut short and their quality of life would be diminished greatly if nothing or traditional methods of treatments were used. People gain whole lives back that can be productive and fulfilling in ways they themselves can’t yet imagine!

Since the minimally invasive techniques often have less complications, patients and their traveling companion can do some sightseeing in one of Europe’s top holiday destinations until they are released and are “fit to fly.”
 
One of the biggest draws about this facility is that, although you get fabulous surgeons and outstanding quality care, you are supported every step of the way with your recovery upon return to your home. There are AIMIS doctors practicing from all over the world who, are more than willing to aid in your complete recovery.

Let me take a moment to clarify that. These men are the BEST OF THE BEST, but, no matter how many near- miracles they perform on the operating table, you as a patient are responsible for your after-care. YOUR SUCCESS IS DIRECTLY RELATED TO WHAT YOU DO POST-OP. (for example, 3 weeks after surgery don’t think you can go back to lifting weights, even if you feel good, your fusion or surgery is not nearly healed at that point, NO MATTER how good you feel!) By that I mean YOU are the only one in complete control of how you feel 6 months or 6 years from the date of your surgery. I will add there may be mitigating circumstances to each person because of additional conditions that might be present or may arise. OK, I’ll get off my soapbox now! (You can refer to one of my earlier posts shortly after my surgery where I talk extensively about the healing process and my involvement in my recovery.)
A really cool service they provide for patients is the concierge, professionals with extensive experience in the medical tourism industry, they are fluent in English and can help guide you through every step of the way!

If I may, I’d like to quote something right from the AIMIS brochure:

“The most dependable and internationally acclaimed studies on medical travel*, as well as the American Medical Association Guidelines on Medical Travel stipulate that receiving safe and quality care is the primary consideration of all medical travel patients: and the availability of follow-up post operative care upon returning home is an additional critical aspect of the decision to travel abroad.

AIMIS directly addresses these concerns by offering our patients the opportunity to have their surgery performed by our world leading US based member surgeons at internationally accredited hospitals; and by providing post operative follow-up care through our network of AIMIS Spine surgeons located across the United States and the rest of the world.” 

*Deloitte 2008 report, “Medical Tourism: Consumers in Search of Value,” produced by Deloitte Center for Health Solutions.

Additionally there are other reasons why someone would consider the techniques of minimally invasive surgery such as:

small incisions – I have three, two-inch incisions on my side which has left me without the massive scarring I would have had with traditional surgery

little or no blood loss – the average person with a minimally invasive procedure is about three tablespoons

reduced trauma to the body – this means a quicker healing time, often months less than a traditional procedure

the preservation of the integrity of muscles and ligaments – minimally invasive procedures spread apart your muscles, not cut through them

less threat of permanent nerve damage from nerve root retraction

less post-operative pain and for a shorter span of time

fewer post-op complications

shorter hospital stays – hours instead of days

quicker recovery time

reduced risk of infections

faster return to daily activities

useful for the elderly – can be performed on even some 90 year olds in certain cases

useful in obesity – a cyclical effect of inactivity brings on obesity that can be stopped with surgery to allow the patient more mobility and therefore loose unwanted weight

is more cost effective

I can only attest to what I witnessed in Cyprus at the AIMIS facility but, I have to say, it’s everything I’m writing here, and much more.

An added bonus is the Cypriots themselves who are warm, genuine and welcoming to strangers. I had a little down-time after I got back to my hotel one evening at about 10pm. Feeling a little hungry, I’d remembered a McDonalds not far from the hotel. I set out with the knowledge my hosts shared about how safe Cyprus is. I was about to put that to the test. At 10pm an unescorted American woman walked down the street about a quarter mile to the McD’s. Not once did I feel my safety was compromised or that I was in any danger. I stopped in several shops along the way, looking for that one, eye-catching piece I just had to bring home with me as a souvenir. Though I didn’t have that experience, I did experience a wonderful walk on a breezy, warm night on one of Limassol’s main streets and felt completely relaxed. It was a wonderful adventure. Oh, and by the way, I got a McD burger, Greek style! It wasn’t that bad, but I didn’t finish it cause I guess after all I wasn’t as hungry as I thought.

I’d like to address the process a person goes through to get to the AIMIS facility. I think this is important for me to share mostly because many may think it quite confusing, and it’s not!

There are three initial steps in the beginning to determine if you are a candidate for surgery at AIMIS.

AIMIS offers FREE comprehensive MRI reviews.

To start the process, go to www.aimisspine.com  and click on the Free MRI review button (on the right of the homepage), then fill in the electronic forms and press “submit.” Upload the electronic MRI using the link sent to you. If your MRI is not in electronic form, they also provide the office address to send your MRI films by mail or courier. REMEMBER, it is vital to send the completed “Patient Information Form” along with it. The form can be downloaded from the website.

Once the MRI, either electronic version or the mail version has been received, it’s sent to the US based AIMIS board of surgeons for review. Within 5 working days, they will contact you by email with a summary of the US surgeons’ findings about your condition. Please make sure you send only the most current MRI (less than a year old). If your MRI is older, you may be asked to obtain a more current one.

If surgery is determined to be necessary, an estimate of the costs of your treatment with AIMIS will be sent to you. If the quotation is accepted, they will continue the registration process.

NOTE: I want you to understand completely about the costs…. SOME INSURANCE CARRIERS WILL ALLOW CERTAIN SURGERIES ABROAD!!! According to Nikos, here’s how it works.

“Insurance companies will usually cover patients if they have international coverage. In this case usually pre-approval is necessary and they will have to liaise with their insurance company. AIMIS will support the patient with everything that they may need in reference to reports and further information that is necessary.
Again though, we must emphasize that Insurance coverage is dependent on the plan that each individual person has.
Payment process also depends on the insurance policy as some insurance companies arrange for direct payments and other insurance companies ask for the patient to pay and then re-emberse them.”

So my thought is, keep all avenues of the process open, don’t give up until you know there is absolutely no other way to get this help!!!

There were a few more meetings for Val and I to have before we left after lunch. Meals are a very important part of the Cypriot way of life, so everyone met at the cafe to eat and interact. I love the “team” approach they all so willingly have and the camaraderie that’s so natural here.

Back in my hotel room, I had a few moments to relax and take stock in the day I had…. I’m absolutely blown away with the events of the day. I’ll write more about tomorrow later but, for now you know what to do,

take care of you and yours,

hugs,

Love,

Kathleen

kathleenmosko@gmail.com                           Twitter @Kathleen Mosko

Hi Everyone!

I’m really sorry it’s been so long. I’ve been dealing with some personal issues that have just derailed me. I did however want to recognize one of the most personally important days of my life, March 8th.

March 8th marks for me two years since I met Dr. Smith, who literally changed my life. Many people have a “hero” worship with their doctors when they cured them. I know he’s not a hero, but he’s more than that. I know he set out to change lives all those many years ago when he first started going to medical school, but I’m not sure he can comprehend what a difference he’s made in all the lives he’s touched, and in mine, simply because I’m still discovering all the ways he’s made a difference for me. I’m sure others feel the same. If I could wish one thing for him, it would be, for just one day, to be me and see himself through my eyes. Then he would know just how special he is to me.

Two years and one day prior to this Thursday,  I was still facing all the uncertainty of conventional back surgery. The kind that would give me a measure of relief, but would do damage to good muscle and tissue in order to relieve me of  far greater pains. Yes, I’d finally found an orthopedic doctor willing to take on my case, but with stern warnings he was limited as to how much he could help me. And, he shared he couldn’t get me completely out of pain. My spouse jumped at the chance and scheduled my surgery for me, allthewhile asking the surgeon how long it would be before I could do all my wifely duties.

In my heart of hearts, I’d always wanted a neurosurgeon to do my surgeries after reading all I did about my condition.  It was MY BODY, and I had to remind my spouse of that as I waited patiently for my appointment with Dr. William Smith, Neurosurgeon. THAT’S who I wanted to see. I wanted to hear it from his mouth what he thought he could do for me.  Little did I know WHO I was actually meeting that fortunate day.

Dr. William Smith has spent his life dedicated to helping others, to make their lives more fulfilling, more active, more whole. His dedication has been spent honing his skills, testing the outer edges of possibilities, learning, improvising, innovating, designing, crafting all the most modern technology possible to use as part of his arsenal in the operating room, where he is most comfortable. There nothing else matters, and everything matters. He understands full well he may hold that person’s whole future in his hands. He lives and breathes to “first do no harm” and to help mend the broken body before him the best way he knows how. His empathy for that broken life is unmatched by anything I’ve ever known. His calm demeanor, his calculated precision, and his compassion all culminate in a life saved from the ravages of  inexplicable pain. I know, I was one of those patients on that operating table he believed was worth saving.

To me, it was a ”no-brainer”  to volunteer at his office to speak with other patients going through the same doubts and fears. To know what Dr. Smith does not from a description but by experience has given me  depth of understanding. I want others to know how much talent and dedication he has, and how much I want everyone else who needs him to trust him enough to do what he can to make them whole as well, it’s that important. I can extend to others my experiences and put their minds at ease in a way I didn’t have access to before I had the surgeries.  In some small way I add to his ability to help others by showing them firsthand the results of his work, his sample on the shelf. But I know full well it all started March 8, 2010, a day I will always celebrate in a very personal way, knowing that was the day that changed my life forever.

Nothing I will ever do or become from that day forward could be attributed to anything else but the fortunate appointment I had with Dr. Smith. Without it my life would be a totally different one, and I’m guessing much less than the one I’ve got!  He’s afforded me a measure of dignity and self worth I’ve not felt my entire life and he’s done it in a discrete manner, which is greatly appreciated. He’s helped to heal my body, mind, and spirit giving me hope when I needed it most.

So there’s really nothing for you my reader to celebrate except maybe for the fact that without March 8th being totally significant to me, all of you wouldn’t be able to benefit from what I share on my website with you.

I will be back at writing soon, but in the meantime, remember to take care of you and yours,

hugs,

Love,

Kathleen

kathleenmosko@gmail.com              Twitter     @KathleenMosko

Hi Everyone!

Hard to believe it’s no longer January! GEESH! The older I get the faster the time goes! The holidays were a blurr since being sick right before Christmas and losing our family Therapy bunny, Skittles, 3 days after Christmas. His bonded mate, Candi, has been just as lost as I’ve been without him, and she and I have taken some time to get to know one another again without him around. It’s been painful to watch how lost she is, it’s sad, just very sad.

Anyway, I’ve had this to do for a while but I never realized how much had piled up for this post or how long it’d actually been. I must apologize and then I thought no, I had some living to do, as you all have, and this website in an extension, not an appendage of me and mine! LOL I have several irons in the fire, one very big one, and several small ones and a couple medium-sized ones so it’s no wonder time has just flown! I really do love being busy… although, I finally learned how to take time to stop and smell the roses… they’re wonderful to smell!

Well, I went back to October and looked at my analytics to see what questions you folks were seeking answers to. I can’t believe I let it go that long! Hmmmm. I’m gonna break it down for ya into the different surgeries, first the XLIF, then the total hip and lastly the ACDF. There’s a reason the ACDF will be that last one. It’s because I’m still having some issues with mine and I’ll be doing these topics in separate posts but want it close to this one so you can have the information all together, sorta… LOL I am always surprised at some of the questions, some are similar to ones already asked and answered in my other posts, but I’ll answer them again here just in case I put a little different twist on it that might be beneficial to you in a way I didn’t cover the last time.

SO HERE GOES – XLIF FIRST!

Q: ARE THERE ANY PROBLEMS WITH AN XLIF?    A: The short answer to that is, probably not. The XLIF can be explained that it’s the procedure used to get the doctor into the middle of your body with the least amount of damage to other tissue, muscles and maybe even organs. The XLIF is a procedure or technique designed to get access to the spine. What a doctor does once he’s in the middle of your body at the spine is different than that. There are several procedures available to your doctor to fix any number of problems once he gets in there and sees what’s really happening. I happen to have the good fortune of my doctor being the leading neurosurgeon in the US who not only sees your spine in 3D once he’s in there, it has been told to me he can actually envision in his mind what may be going on in the interior of the spine as well or 4D. Most doctors only need the 3D version for their work to be successful. There are few questions you may want to ask the physician doing your surgery. One, is he NuVasive trained? The reason I share this question is because NuVasive docs are trained on cadaver bodies in an intensive, extensive lab environment. They also are trained to use an advanced version of neuromapping, much like an EEG only MUCH more sophisticated. This is where wires are hooked up to your legs at critical spots and held into place with a plastic sleeve. While undergoing the operation, the doctor is trained to utilize this neuro aide so he can tell exactly what nerve is being touched, drastically reducing the chance of further nerve damage. A doctor who uses this pretty much knows exactly where he is in your spine. One other question you may want to ask is how many of these procedures has that doctor performed. I know that everyone has to start somewhere, but I was one of the last of my doctor’s first 1,000 patients. He’s now working on his second 1,000! In otherwords, he’s had plenty of experience before doing mine! That is not to say all other doctors are not as good as mine, yes, I am partial, but there are plenty of really great neurosurgeons who do excellent work.  Problems arising after an XLIF procedure are usually from some other complication such as drug interactions, body systems malfunctions, or some other unknown at the time of the surgery that manifests itself post-op. The choice of your physician is a determinant here as well. I personally wanted a neurosurgeon, hands down, no ifs, ands, or buts. That being said, I know there are many orthopaedic surgeons who have gone through the NuVasive training and are well qualified to do the XLIF procedure.

Q: WHEN IS A PERSON A GOOD CANDIDATE FOR THE XLIF PROCEDURE?   A: Any number of stars must be in alighment for you to be a candidate such as insurance carriers allowing the procedure, and your body systems all working as well as they can, but from a strictly medical point of view, the doctor makes the final determination about your condition from a series of tests, mostly, at the very least, an MRI. This allows him a peek inside your body and see as to what’s happening in there and what if anything he feels he is capable of doing to fix it. One look at MY MRI’s and my doctor looked back at me and said, “My God girl, you’re a mess!” (those were his exact words) He makes the determination from what he sees internally no just by you coming in with a few old x-rays and telling him you have a pain. He takes many things into consideration before suggesting minimally invasive surgery. Usually he and the insurance company want to see if more conservative non-invasive measures can correct the pain prior to using surgery as a last resort. Some choose not to go through surgery at all for whatever reason, some can’t because of other medical conditions, and still others who won’t give up smoking which pretty much takes back surgery off the table for them unless they quit. (Please referr to a couple of earlier posts about smoking and surgery for more details about this issue.) This is due to the very low success rate of bone fusion while smoking.

Q: HOW WILL I KNOW WHEN IT’S TIME FOR ME TO HAVE BACK SURGERY? A: The short answer to this is, WHEN THE PAIN IS SO ALL-CONSUMING YOU CAN’T THINK OF ANYTHING ELSE! When it taints your thoughts, your sleep, your intimacy, your social and work life, yeah, then it’s time to do something about it. Afterward, if you have the XLIF done, you’ll wonder why you waited so long to have it fixed! THESE ARE WORDS RIGHT FROM THE HORSES’ MOUTH! My circumstances were such that I couldn’t get fixed until I did but I did it as soon as I could! And, it wasn’t a moment too soon! HONESTLY!

Q: WHAT IS THE MORTALITY RATE FOR AN XLIF PROCEDURE?  A: In Dr. Smith’s practice, there has never been a death due to an XLIF procedure. That being said, there are certain unknowns which may adversely affect a successful outcome, such as complications of drug interactions, body systems malfunctions, or some other unknown determinant which causes death post-op. One in particular that comes to mind is MRSA infection. My particular doctor wants his patients in and out of the hospital as quickly as possible and often will perform the surgery on an outpatient basis, greatly reducing the risk of infection and possible other complications. I can only speak for him at this point, so I’m not sure what other doctor’s statistics are.

 Q: IS THERE DEEP TISSUE INJURY FROM AN XLIF? A: I wouldn’t classify it as injury, but there is a certain amount of pain or discomfort from the core muscles being pulled apart in order for the surgeon to get to the interior of the body. That being said, I shudder to think of the pain associated with the actual cutting through of all those muscles in order to get to the interior as is done in the waning traditional procedures. Since the “stretching” is far less destructive, I am perfectly happy to recover from that vs actually having my muscles being cut through!

Q: DOES IT HELP TO HAVE THE XLIF DONE FIRST IF THERE ARE OTHER SURGERIES PROPOSED? A: That will strictly be up to your personal condition and how unstable one area is vs another. Often when a person, especially with a scoliotic condition, is faced with multiple surgeries to correct or improve the condition, the surgeon will take into consideration many factors such as, the area most unstable, lifestyle or activity level of a person’s work, or the acuteness of the pain. There are many others as well, one in particular is if the patient is a smoker. This is a very big issue for a surgeon when making a decision to perform surgery. (see earlier posts on this website for details about smoking) Another consideration upfront is your insurance carrier and what they will allow. If all things are equal and your surgeon is a go… in my particular case, my lower back posed the most immediate of problems, so the XLIF was my first surgery. I have known other surgeons to do a cervical correction first because the neck was more unstable than the lower back. I can’t address the reasoning for this or the particular condition of the patient; not enough information was shared.

Q: WILL A BACK FUSION LAST? A: The short answer is, YES!  HOWEVER! There is evidence that certain activities will aggravate the areas directly adjacent to the fusion causing arthritis or other conditions. A modification of certain activities should be discussed with your surgeon so it is perfectly clear to the patient which activities to avoid and the ones which can be resumed after recovery.

Q: HOW CAN I IMPROVE THE BOND OF MY FUSION? A: The time to do that is long before you need surgery. The higher your bone density the more successful your fusion may be. The number 1 thing a person can do for themselves is if they are a smoker; QUIT SMOKING!!! Exercise is the second. Those who do impact exercises, even the low impact, are in a better position to have a more successful outcome. If that’s not possible, as it was in my case, then doing passive exercises to strengthen the muscles and surrounding tissue of the painful area by doing water exercises is always a plus. Additionally, there is some indication that if you can slow or reverse osteoporosis it would help in the healing of your fusion. CAFFIENE has been linked to the onset of osteopenia (the precursor to osteoporosis) or osteoporosis itself. Some studies have shown that more than 300mg of caffeine, or more than one cup of coffee per day increases your chances for those onsets. Also noted is that fact that several non-coffee related foods are high in caffeine and may also be ingested throughout the course of one’s day adding additional caffeine to their intake. Mixed in with all of this is the lack of Vitamin D which is needed for the body to increase it’s metabolizing of calcium. When a person drinks coffee, it acts as a diuretic which also increases the amount of calcium expelled by the body. Caffeine also interferes with absorption of Vitamin D in the bones. So my take away from this is, eat more calcium and Vitamin D enriched foods, and drastically limit your intake of caffeine. And by the way, that means chocolate too! ALTHOUGH TEA HAS CAFFEINE, IT DOESN’T HAVE THE SAME EFFECT ON THE BODY AS COFFEE CAFFEINE DOES!   GO FIGURE!  (some of this information was taken from my search on the internet)

Q: HOW IS THE BONE HEALED IN AN XLIF SPINAL FUSION? A: Once the doctor implants graft material along with a “growth medium,” it should start to take hold right away. Graft material may come in the form of a non-bodily produced agent or, like mine, was the scrapings off my ribs to insert so it was my own body supplying the material. At about 6 weeks post-op a bone growth stimulator, a simple device designed to send electrical signals to the healing area to increase the rate of stimulation of growth. As one rep put it, If you took the time to have the surgery, and your doctor suggests a bone growth stimulator as part of your recovery, it’s just one more tool in his arsenal to help you heal quicker an more completely. My particular bone growth stimulator was provided to me by Biomet. (go to www.biomet.com to learn more about the science and  how it works. Aslo it gives you questions to ask your doctor about the device.) It’s a little device no bigger than a deck of cards with a case that attaches to your clothing or belt and attached to some wires with patches that have a sticky gel on them that stick to your skin where the doctor wants the healing, not where your scars are. All things being good, the total fusion takes about six months to complete. In the meantime, your body should be pampered somewhat. The surgeon will track your progress by a series of x-rays done at certain intervals of your healing to make sure the fusion is complete. Once the healing is complete, you should be able to resume most all of your old activities. I’m still learning what all I can do that I had to give up for so long.

Q: ONE PERSON ASKED ABOUT HAND PAIN POST-OP, AND ANOTHER ABOUT FOOT PAIN FROM AN XLIF… A: My take on this is that there are other underlying causes to those conditions which can only be addressed by your surgeon. If you haven’t made him or her aware of this condition, please do at your earliest chance. It may be something simple he can address to alleviate the discomfort.

Q: I HAVE PAIN IN MY LOW BACK AND BUTT AREA AFTER MY XLIF. A: This person doesn’t say how long after the surgery so I can only address it from my experience. I don’t recall having much butt pain at all but yes, there was some low back pain. Mainly this was due to a couple of things. First, my muscles were weak from non-use all those years prior to my surgery. Secondly, my back muscles were stretched and I had to allow time for them to work themselves back into place. As I increased my activity levels and my exercise regimine, my discomfort with my low back muscles became a thing of the past. So much so, sometimes I now have to really think hard how much pain I was really in.

Q: WHAT ARE THE NEGATIVES FOR AN XLIF PROCEDURE? A: I will only be able to address this as I know it from my experience with Dr. Smith. As far as I can assertain, there are none. Dr. Smith is very careful to screen his surgical candidates for the XLIF due to their other medical and physical conditions. I spoke directly with Joe, Dr. Smith’s PA to get his perspective about negatives. He shared with me that just on the merit of the condition of the patient and the quality of the procedure, one can expect to have recovery to a greater degree. There are no guarantees with any surgery and there are those cases where, inspite all the best efforts, some nerve damage is irreversable. Dr. Smith has an outstanding recovery rate, far higher than anyone, to my knowledge, performing the surgery to date! (other than Dr. Pimenta who pioneered and perfected the procedure)

Q: IS IT OK IF I PICK UP SOMETHING WEIGHING 10#? A: Depending on where you are in your healing process the answer is yes, and no! LOL For the first six months of my recovery of the XLIF, I was not allowed to pick up anything heavier than 5#. My son, Brian, jumped at the chance to get me a Coach purse, which I vehemently resisted, until Dr. Smith told me I would have to reduce the weight of my purse. Brian nagged me for two years prior to get me a Coach purse but I kept telling him no. After the Dr. Smith directive, he showed up one day with this 10″x8″x2″ purse. I have had more people ask me why I even bother with such a small purse, and it being a Coach purse and all, so then I have to stand there and explain to them it was Dr. Smith’s fault and what Brian did for me to acquire it! I don’t have a limitation now but Brian spent so much on it, I don’t have the heart to not use it. He’s told me it was ok if I didn’t but, it was such a fun gesture, I can’t put it away. It came in handy after my ACDF surgery anyway because I wasn’t allowed to lift anything but 5# or under then as well. Now it’s just a novelty! A gallon of milk or water weights approximately 8.5 pounds which, at the beginning of your healing will be too much to lift. For a while I suggest buying your milk in half gallons if you want to lift it yourself. And ladies, change the size of your purse!

Q: DID ANYONE LOSE WEIGHT AFTER THEIR XLIF? A: I can’t speak for anyone else, but for me the answer is a big fat YES!  I lost 29 pounds. My doctor of physical therapy told me it was due to muscle mass loss. BELIEVE ME, if I could have gained back the muscle mass without gaining back the weight I would have given up my eyeteeth for the trade! Once you are done with your slow pace and you go back to physical therapy, you should regain most of the weight back. I didn’t take it off all at once and it came back slowly as I increased my exercise program. I have hamstrings now that actually do what they’re supposed to so I’m ok with gaining back the muscle weight. NOW, if I could only lose the fat weight, I’d be in great shape! LOL

Q: I HAVE A LARGE LUMP UNDER MY XLIF SCAR AND THE AREA IS TWITCHING…  A: The lump can be one of several things, a cyst, sometimes caused by trapped fluid or blood, a growth of tisssue under the skin, or it could be the scar, which is what they call keloiding. A keloid is when scar tissue manufactures too much skin to repair itself. It’s more annoying than anything else, and it sometimes makes the scar wider than the original inciscion. If a keloid becomes unsightly, you can see a plastic surgeon to repair it. It isn’t however caused by anything your original surgeon did or didn’t do. It has to do with how your body repairs itself after a wound. In the other instances as cited above, each should warrant a visit to your surgeon to address them so he can assess what needs to be done to correct the lump, if anything. As for the twitching, although it is probably associated with the healing process of the wound itself, you may want to address it at the next regularly scheduled office visit unless you feel it’s so annoying it warrants its own visit.

Q: I HAVE SWEATING POST-OP OF MY XLIF… A: Your body has experienced an induced trauma with the XLIF surgery, although it was a good trauma in order to fix the pain. Some people react differently to that trauma and their metabolism is thrown way out of whack. I too, had the very opposite effect, I sat chilled to the bone though it was 110 degrees outside! (Remember, I live in Vegas!LOL) I would be sitting in sweatpants and a sweatshirt covered with a blanket while the rest of the household members were in shorts, T-shirts and the air conditioning was running! It was a bazzar time for me and my metabolism but it got better as I got further out post-op! I am now back to my “normal” if one could call it that… I can sit in a room in a pair of shorts and the heat doesn’t have to be blaring for me to be comfortable. It’s mostly part of the process. As your metabolism returns to a normal state, the sweats should reduce in occurance. IF for some reason you are having sweats with a fever, by all means seek medical help immediately. There may be an infection which needs addressed STAT! Take your temp and see if it’s normal or if you have a fever, then act accordingly.

WHEW! This concludes catching up with the questions concerning the XLIF PROCEDURE asked on this website as concerns and followups to the different posts. I will return shortly with a continuation of Installment 9 of Questions and Answers to address the ACDF procedure.

In the meantime, you know what to do, take care of you and yours,

hugs,

Love,

Kathleen

 

 

 

kathleenmosko@gmail.com                      Twitter    @KathleenMosko

Hi Everyone!

Since we’re on the subject of post-surgical stuff, I was thinking about my expectations. Also, I’ve listen to a lot of questions about what others’ expectations are for their post-op experience.

It didn’t hit me all at once. Call me naive. I guess I had this ah ha moment ‘long about two or three months into my recovery. I was sitting at Dr. Smith’s office and it hit me when the TV in the waiting room showed a commercial for a law firm handling Social Security Disability cases. I won’t have to file for SSI! That was certainly a light bulb moment!

I’ll tell ya why. All along the before thought I held deep in me was, I would get a wheelchair, get on SSI, and live what life I had left out and settle for whatever moresels life would hand me in the way of attention and companionship. I’d given up on life, on ever owning my own home again, of ever being out of pain, of possibly facing giving up driving, of ever not being co-dependent on another human being. What I felt I was facing was the rest of my life in a downward spiral. At some point I figured I would become bedridden and it’s not a far leap to the coffin after that. Yet, through all those thoughts, there was a burn deep within my soul. It was still that last flicker of hope. I was born an optimist, so how could I possibly not hold out even the slightest chance of hope.

I’ve shared with you in the past I never gave up hope on Brian, no matter how hopeless it seemed, and if that was within me then, then why should I be any less of a person to deserve that same power of hope? I honestly can’t tell you HOW I managed to muster the courage any other way except, I prayed. Mom always said, “Prayer is powerful, Kathie.” I prayed long, and hard and oh, so often for God to show me a sign, just like He did in the past with Brian. I asked Him to guide me in a direction of wellness to skilled hands who could rid me of my torture. And then, I gave my expectations to Him.

As I found my way, at first I had certain hopes, wishes really, because those hopes seemed so far removed from what I could possibly achieve. I’m talking about just being out of pain. My original thoughts surrounded the idea that the doctor, any doctor I could find, would take away even half the pain. It would eventually return but it would buy me time of some relief. That’s being in accordance with all the horror stories I’d heard about back surgeries over the years. I was open to at least that by the time I finally got to speak with doctors.

When I went to the first doctor and he shared I was so deformed he wouldn’t touch me, my heart sunk. That, for me, was one of the lowest points of my life. To know it had gone so long without treatment, that it was now beyond treatment was truly a devastating blow. When he offered up a colleague as an alternative, my hopes flickered a little. It would take a lot for me to come out of that funk. For another week until his office visit, I waffled back and forth between doing nothing and accepting my fate as it were, or giving it another shot. I always knew in the back of my mind I wanted a neurosurgeon to do my operations if it could be done, but the first doctor didn’t give me much to go on in the hope department!

Since I saw the second surgeon, an orthopod, he gave me a smile as he delivered what he thought was good news to me; I thought that’s all I could hope to achieve. He could reduce my pain by about 50% and I would have 3 major surgeries tearing up my flesh and rendering my muscles pretty much useless. I can see why so many people swore if they had to do their back surgery over again, they wouldn’t.

BUT, March 8, 2010 is my day of mercy and redemption! The day emblazoned in my brain. From his very first words, I knew Dr. William Smith was going to be very special to me. Succinct and charismatic in demeanor, he knew intuitively and listened intently to my story of pain. One he’d heard so often he could recite it just by looking at how a person was walking and standing. My expectations rose considerably as I floated out of his exam room. It would take me days to digest what all was said, and I did hang on his every word simply because I was alone, no one else  came with me to the exam. The only thing that kept resonating in my brain, pinging back and forth like a tennis ball, was the words, “I can take away your pain, do it in a minimally invasive manner and have you back to life activities in a matter of months.” It was almost beyond comprehension.

As the days past waiting for my surgical date, I had to pack and move and be host to out of town visitors. But I’d catch myself when the pain became so overwhelming, thinking of how it just might be to do that very task WITHOUT THE PAIN. As hard as I tried, I just didn’t have a single experience in my recollective past I could relate that thought to. So I simply endured, edging ever closer to my goal, one I pledged to God I would not take for granted should He so grace me with a full recovery. This website fulfills one part of that pledge.

My expectations grew thinking of all the endless possibilities, first little ones, then the “what ifs.” You know the ones you’ve dare not dream. Instead of dreaming about not being in pain, what if you were to dream about being able to sit through an entire movie pain free at a movie theater. ( I tried it at home first) Then, “what if” I could go to the mall and just window shop, or better yet, go to the Fashion Show Mall and walk ALL FOUR FLOORS with no pain! Or linger in a store just to check out everything that caught my eye because I didn’t have to leave because of the pain. And “what if” I could go with my guests to the Hoover Dam and walk around with them, climbing all the steps and walking across the bridge, and feel no pain. “What if” I could finally go back to work and be a productive member of society? WOW! The possibilities were endless… my expectations soared. I’ve eventually been able to do all my “what ifs.” The greatest of these has been being able to physically kneel in church and thank God for all His many blessings.

Early on though, I realized those were somewhat distant goals. Things I could eventually achieve. My condition didn’t happen overnight, and it was going to take some time to undo it. I had no clue how much healing was involved or how long it would take. I simply dedicated my every ounce of being to becoming well again. I had to, I had HOPE, and God was on my side and He wouldn’t let me down if only I would put forth the effort and do my part.

I”ve said it before, Dr. Smith is not a god, but an “instrument” of God given special gifts to share with the world. His time and talents are so rare and unique and it hasn’t been wasted on him. I know several people in my close circle of acquaintances and family that have the IQ of genius, but have done nothing with it, wasting their lives in mediocrity. Such a shame, and frustrating for me to know how hard I’ve struggled to gain each bit of me through endless trial and error, working hard to grasp every ounce of knowledge I come by.  With a reading disorder and being ADHD, one would think I couldn’t focus long enough to write one paragraph, let alone undertaking the task to write three books. And a lot of people have sold me short because of it. (They are now getting quite a surprise!)

As my surgical date approached, my expectations grew. I would need those thoughts to get me through to the other side of my journey. Those expectations weren’t lost, but rather utilized as a way to motivate me to keep at the physical therapy, to do the things necessary for myself to achieve my ultimate goals.

I’ve talked with several people who have a wide range of expectations post-surgery and for their recovery. Some with as narrow a focus as just getting out of a wheelchair and maybe going to a movie. Others envisioned a two or three week recovery. One that would put them back to all their daily tasks within six weeks, and were angry when they weren’t, however pain free they may be. I keep emphasizing how critically important it is to engage in as much formal physical therapy as possible to return your body to a state of new normalcy, free from pain with muscles strong enough to support your repair. But that takes time!

Some are very lucky to have the experience as one gentleman did after his surgery that within two or three weeks was completely pain free from the pre-op pain AND the post-op pain. Another was angry at Dr. Smith that he still had a twinge in his side from the surgical site, although Smith got them out of a wheelchair and was walking upright without the severe pain that put him there. If there’s one thing I’ve noticed about Dr. Smith, it’s that he loves smiles. Especially when they erase the furrows of pain on a person’s face. NO, there are no guarantees when he performs the surgeries, but this is a world renown surgeon who doesn’t do something first, unless he sees it needs done and then, thinks it will alleviate the condition that sent you to him in the first place. Again, HE LOVES SMILES! And he has a very long list of admirers.

But your expectations for your “after surgery” recovery should be balanced with certain expectations of the amount of effort you personally put into it. The old adage, “You can lead a horse to water but you can’t make him drink,” comes to mind in this instance. Dr. Smith(minimally invasive procedure)+personal dedication with a positive mental attitude+motivation=a healed body as pain free as possible! This is a great formula, one you are expected to be an integral part of. Your doctor is only one part of your healing, and your expectations should be the focus of your recovery as a participant. He can’t do the physical therapy for you! YOU are the only one who can fulfill those expectation! But remember… it doesn’t happen overnight, and it takes concentrated effort on your part!

I made a pact with Dr. Smith on March 8th. I pledged to him I would do everything he asked of me, and I wouldn’t complain no matter how difficult it was to do. If he would keep his word to me, then I would keep my word to him. He smiled. I think he knew how serious I was and how important it was for me to make that pact with him. He agreed and it’s kept me going through the tough times all the way to now, as I become a productive member of society, ready to give back.

Just remember to keep your expectations within what you know you are willing to put forth the effort for. Don’t make them so unrealistic they become unattainable. No one wins then. YOU ARE A WINNER, YOU CAN DO THIS, YOU CAN BE PAIN FREE!

And on that, I will just remind you all to take care of you and yours,

hugs,

love,

Kathleen

 

kathleenmosko@gmail.com              Twitter     @kathleenmosko

Hi Everyone!

I bet you thought you were going to get out of the torture of hearing more about my surgeries! NOPE! I’ve got something to say about the flip side of the issue of the
“injury pain,” I need to tell you about the “surgical pain” from my XLIF.

BUT I FIRST HAVE TO ADDRESS A VERY IMPORTANT FACT…

MY CASE WAS MORE SEVERE THAN MOST AND IT WAS UNIQUE IN MANY WAYS…

PLEASE BEAR THIS IN MIND AS I DISCUSS THIS SIDE OF THE ISSUE!

OK, I’ll tell you straight on, it felt like Dr. Smith had operated on the wrong part of my body… by that I mean, immediately upon waking up in my hospital room, I didn’t have the pain I had in my back like right before I went in to surgery. I did however have some really overactive nerve endings that were jumping all over the place, and mostly in my legs afterwards. I’m gonna take you through this slowly so you’re informed, but not scared out of your mind should you be looking to have this done. I’m gonna explain the “whys” of the surgical pain for ya.

Before surgery my pain level on a scale from 1 to 10 was a 60… it was all consuming. And so was this. PLEASE KEEP REMEMBERING MINE WAS AN EXRAORDINARY CASE!

AND I’D DO IT ALL AGAIN FOR THE RESULTS I’VE GOTTEN BECAUSE OF IT!

Dr. Smith had just performed a one of a kind surgery on me with no cages, no rods and no plates but he did SIX FULL LEVELS of fusion. I have 36 setting pins and one screw and that’s it!

Here’s a little of the physiology of the repair.

The XLIF procedure is thus:Dr. Smith made three 2 inch incisions on my right side and one 1 inch incision in the small of my back. ( often times the doctor doesn’t need any other access except the three incisions on the side, but for as extensive a repair that I needed, and to have the best access to where he needed to be, he went in through the back too.) In order to do all the repair needing done, he was able to reach it all with only those four small openings. Scrapings of my own bone were taken from my left ribs to place in a bone growth medium and implanted in my vertebrae for the fusion. I could feel the pain in my left side post-op, but it didn’t last but about six weeks.

The pain at the incisions was minimal, more annoying than anything else, itching mostly as they healed, and because of where they were… right at my waistband. But loose fitting clothing took care of that. There were only steri-strips, all the stitches were internal. The incision in the middle of my back was non-existent in the greater scheme of things. I kept forgetting it was there!

When Joe Delappi, Dr. Smith’s PA, pulled back the muscles so Dr. Smith could work, he was stretching them, the outer ones as well as the core muscles. ( see earlier posts for the explanation detailing the XLIF procedure itself)

OK so, we’ve got the incision pain, the stretched muscles pain (this pain was in my right shoulder as the core muscles are attached higher on the body and also the stretched muscle pain in my right side more towards the outside at my waist,)and all SIX levels of nerve endings he released that were being pinched, AND, the sciatic nerve! Dr. Smith told me he had no clue how much feeling would come back, but he was pretty sure I’d have way more than what I had before the surgery. Dr. Smith’s a conservative kinda guy and doesn’t promise you the universe, but in the back of his mind, knows he can probably deliver the moon, the stars and the little brass ring you’ve been holding out hope to grab. 

He also knows that reaching for that brass ring depends solely on what happens AFTER SURGEY! He’s not God, but rather an instrument of God, and with his talents he is able to give you relief from your pain and suffering, but the rest of your recovery and how far you get towards grabbing that little brass ring, is mostly in your hands. By that I mean, your determination to be the driver of your recovery by participating wholeheartedly in your physical therapy from the moment you set your feet on the floor for the first time after surgery, rest squarely in your hands.

It was maybe six or eight hours after my surgery that I ended up out of bed, first to go potty, then to use the walker and walk the hallway. I got to be really good friends with the morphine pump button while I was there. I just kept pushing it until it worked. If I could’ve walked the hallway that night, I’d have been released to go home the next day… barring any other complications. And there were none. HOWEVER, I had some real issues with the nerve endings jumping all the time. I ended up staying until the morning of the third day, but Joe was ready to throw me out the evening of the second! LOL

I’ve been trying to think of a way to explain the pain using a common element that most all of you have experienced so you can fully understand what I’m talking about. I’m a visionary for the most part and if I can envision something, it helps me get through an event. I try to relate a present experience with one I may have had in the past, or some thing that I learned before that can help me understand what’s going on. The more you know the less frightening an event can be.

Have you ever seen a misty rain on glass. You know how the droplets are so tiny that they just adhere to the window but as a few seconds pass, the droplets become heavier,( this is where Dr. Smith would have released my pinched nerves) which makes them start to slide down the glass? Imagine the small tiny droplets of mist as the damaged nerves that the doctor just released. Using that image, allow the flow of each of those droplets to be continuously connected from the top, and as it gains more weight from the next connection, you see the droplet get bigger as it travels. Now, note that it’s not just one droplet that’s doing this but thousands, maybe tens of thousands of droplets that are doing this all at the same time. YOU’VE GOT A LOT OF ACTIVITY GOING ON ALL AT THE SAME TIME! And in reality, the activity feels like a pin prick, which in itself isn’t too bad until you realize that, oh, I don’t know, at least a gazillion of em are all doing it at once! That’s a LOT of pricking! LOL

Yeah, that’s what it was like for me. It wasn’t that I couldn’t withstand it, it was just that I had so much damage to all of those levels and they all needed fixed at one time. And they all started to heal at the same time. It was like an electrical explosion in my legs. LOL I guess I never realized just how numb my legs were till I started getting the feeling back in em! ( kinda like sitting waaay too long on the toilet engrossed with some bathroom reading material! hahaha I know you know THAT feeling!)

NOTE: not all people experience this or this level of endurance. As a matter of fact, few do. Most experience a much lesser, or almost none of the pain I did. Remember mine was SIX levels, most patients only need from between one to three levels. Often only one! That puts them back on their feet and into life in a matter of weeks, far quicker than what I experienced!

That pain was at times really overwhelming, but, as my son so poignantly put it, “Just think Mom, once all this pain is gone, it’s all going to be gone forever!” THAT’S what I clung onto as the days passed and the meds sometimes didn’t do the trick. It became my silent mantra. I had a great many tricks I’d devised to overcome the sensation I was being poked by a million needles all at the same time.

First, I chose to welcome that feeling rather than complain about it. I knew that it was all part of the healing that was going on and in the end I would come out of this a changed person, and I have. To endure that kind of pain is only doable with a postivie mental attitude that you’ll get beyond it. That was my second trick. Just keep on thinking this is just a temporary condition at this point, and once done, there’ll be no more pain and no more need for strong medication.

 You look for subtle changes in the way you feel, you study your body every minute you’re awake, and you pray that you sleep long enough to feel like the change comes over that respite. There was no night or day for me at the beginning, no meaningful time for me except when it was time for another pain med. I lived and slept according to the pain med schedule. Thankfully Brian called Joe to ask him if there was something else I could take because there was such “bleed through” pain (this is the pain that comes in spite of you being given a strong narcotic at a high dose)  and it was almost unbearable.

I will tell you that Joe was AWESOME when he gave Brian the right advice to augment my meds with a particular addition which gave me the relief I was looking for. I’m not going to tell you what that was because I don’t want you trying it without your doctors’ advice. It worked for me but may be highly dangerous or ineffective for you so you’ll need to check with your doctor. I can’t tell you though, how much I appreciated the added meds. JOE ROCKS!

But, that too brought on more constipation, so I had to up my stool softener to a laxative. I didn’t care. I got the relief I was looking for. Now bear in  mind also the level of pain I’m discussing here, knowing in past posts I’ve shared with you that I didn’t take ANY prescription drugs for 10 years with the injury pain, so you have some idea of what level of high tolerance I have for pain.

I also kept in mind that I must keep moving. If it were up to my spouse, I’d probably still be in a walker. He encouraged me to just do nothing, and to take more pain pills, which spurred me on to do more, maybe a little too much more because there were days the activities I did rendered me incapable to do much else but sleep or lay flat for the next day or so. Stupid, I know, but I was in a hurry to get my life back. You know the one Dr. Smith alluded to… the one where I could wear three inch high heels! LOL And he even gave me a bonus, 2 1/8 inches back in height!

Some of the tricks I incorporated into my daily routine in the beginning was to use ice blankets on my legs  to numb the nerve endings so the pain wouldn’t be so horrendous. I had four of them, two in use while the other two were freezing. I can only liken it to something my mother told me when we were discussing her neuropathy from diabetes. She said one of her doctors told her that as the neuropathy spread, it would be like she was in a torture chamber with no relief. He said often times patients want so much medication they would rather OD than go through it. She looked at me and said, “He was right, it’s worse than torture.” And on top of it she had muscle spasms in the bottoms of her feet that were excruciating!

I only had a small taste of what my dear mother suffered with for the last ten years of her life. That feeling in my legs only lasted for a few weeks and it was ever-decreasing as the nerves reconnected. My empathy for her is boundless. Recently, I found out they have an experimental surgery to alleviate that neuropathy in diabetic patients. I wish she’d lived long enough to get that relief and walk.

I used to envision a bunch of wires flailing around like a garden hose at full blast that someone let go, all at the same time. As the water got turned off, those wires would calm down and just behave themselves. Intense, yes, but nothing like what my mom suffered through. There was no end to her suffering. She only took  6 extra strength Tylenol a day, and, if my brother forgot to leave em out for her, she didn’t even get those. A few times mom would call me to come over and bring her some Tylenol because my brother had been gone all day and she was in terrible pain. Since all I had was Tylenol too, and not any good stuff, I took what I had to her to give her some relief.

Like I said, as the days wore on, the pain lessened and what was unique that I noticed, was that the more I moved, the less it hurt later that day… so I kept moving! At first I was only able to walk from the bedroom to the kitchen, but then it was outside to the driveway, then down the driveway, then to the next driveway, then the first light pole, then the second and so on!

I can remember it wasn’t time yet for my next round of meds and I was hurting really, really bad. It was about 2:30am and Brian had just gone to sleep. He’s such a dear son, and when I called him he got up without complaint and asked me what I thought I needed. I wanted to walk, not just in the house, but outside. I’d noticed that if I walked up and down the driveway which was on an incline, after about twenty times of doing that, the pain subsided. I was later to find out once I got into formal physical therapy with Dr. Amanda Scott, I was actually doing exactly what I should be doing to alleviate the pain! She explained that when a muscle hurts or cramps, you want to do an exercise that uses the opposing muscle to facilitate relief. WHO KNEW!? LOL All I knew was that  it didn’t hurt so bad afterwards and I was able to make it to my next set of meds. By walking the incline I was actually using the opposing muscles to make the pain subside.

Let’s talk about medication. TAKE IT DAMN IT! If you’re worried about getting hooked on the stuff, you won’t! It’s that simple. BUT, your body was put through a major trauma; one of massive proportions! Don’t try to be a hero, I’M NOT JUST TALKING TO YOU GUYS OUT THERE! Your body is a marvelous organ capable of so much healing and corrective and compensating activity. But you gotta help it. Especially when the trauma you put it through was deliberate!

Time is such an ambiguous element in our lives and we often really don’t understand it or appreciate it. I’m putting this explanation here because you really need to understand that when you are in the process of healing you loose all sense of time, you often feel like you’re moving in slow motion and your healing can’t happen fast enough. I’m often asked, “How long before I can get back to my normal life?” Well, first that’s very subjective, depending on so many factors. (if there were any complications, your level of pain, your level of tolerance for pain, your injury and what you had done, how willing you are to participate in your recovery and how much physical therapy you’re willing to do.)

During your recovery phase, you lose the sense of time; AND, you’re often in a very big hurry and rush your healing. DON’T DO THAT! You are not going to be like that forever! And, you need the meds to heal long enough for you to do the PROPER healing!  You are not going to be on those meds forever, and they’re strong for a reason… they are aiding your body’s natural ability to heal itself.

I am allergic to codeine so it took out a whole class of drugs for Dr. Smith to prescribe to me as pain killers. I was on dilaudid which is 20X’s stronger than morphine it was told to me. First Brian, then I, had to go through this whole ID process each time I got a script for it because it’s what they consider a “class A” drug. Only so many pills are given and you have to verify your purpose for it’s consumption each time you pick it up and you have to show your picture ID and all that jazz. Dr. Smith anticipated me being on it for at least a year. I had figured out the rate of consumption of the pills, how long it would take me to wean myself off of them and it was going to take me like7 more months… and like a few hundred pills. by my fourth month post-op I was feeling so good and doing so much physical activity I really didn’t feel I needed em. So without his knowledge, I started to wean myself off em.

I started that in earnest the last part of August. I went to see Dr. Sparling, my primary care physician and we had a long heart to heart talk about the drugs.  I told him the numbers I’d figured out and how long it was going to take for me to get off  them. I also said I wasn’t willing to wait that long. I had my surgery on May 28,2010, and late August put me at three months. I also knew the longer I was on them, the harder it would be to get off. I WAS AT THREE MONTHS POST-OP! In healing terms, that a short period of time to not need any medication, ESPECIALLY WITH WHAT I HAD DONE, but I thought it was more a hindrance at that point rather than a help. I wanted to do more physical therapy and I needed to know what to work on in reality, not what was masked by the drugs.

The conversation led to Dr. Sparling giving me a couple of options, he said I could go to one of the drug rehab programs they have for recovering drug addicts, I could just keep stepping it down like I was, OR, I could break myself off it cold turkey. Well, the first option was definitely out of the question. This was a condition I had to deal with without other people who became junkies by choice. And I didn’t consider myself a junkie because I took it just like Dr. Smith ordered and I can honestly say I never deviated and took more at one time or closer together or anything different than what was on the script! NOT ONCE! I knew the only person I would be hurting was myself and I also needed to set a good example for Brian. Besides, I really was to the point at three months that I didn’t really need em much.

Dr. Sparling described for me what would happen to my body if I decided to get off them cold turkey, and he said it wasn’t going to be nice. He defined for me what it was I would experience and how I would probably feel. He reached out to me with a lifeline saying he’d help me through it as much as he could. I guess there’s a drug you can take that helps with some of the side effects but I chose not to ask for that either. In my mind, cold turkey meant just that, COLD TURKEY! In Dr. Sparling’s office, after weighing all my options, I told him I wouldn’t be going to a drug rehab program, and I didn’t want any additional drugs, so the only thing left for me to do was to go with a modified program. He and I decided when, after cutting the pills in half, then in quarters, I should just stop taking them. He asked me to call in and just let one of the girls know to tell him. He also said it would take about two weeks once that was in place so I should call about two weeks later to let him know through the girls how things were for me.

All along, because of the pain, I’d developed high blood pressure. Dr. Sparling was concerned about that so he had me monitor it at those blood pressure stations like at WalMart. He gave me a number to shoot for and told me to call him if the number got beyond a certain point. I felt I had all my bases covered. And, I had an appointment with Dr. Smith mixed in that timeframe, so if I needed to address something drastic I could talk about it with him. I felt enveloped with security knowing I could have a successful outcome because my doctors cared so much about me. It really was the first time in my life I felt like someone was watching out for me and my wellbeing. I felt informed and confident because I armed myself with enough information, eventhough I’d never gone through something like this before, I understood what would happen. The unknown wasn’t that bad because of it… WELL, ALMOST!

When actors portray a junkie on TV with the jitters and the shakes and the cold sweats, and the scratching of your skin because it itches like something’s crawling on it… YES, IT’S THAT, TIMES A HUNDRED! I remember going into the kitchen antsier than all get out, my skin was crawling soooo bad. Even my head itched. I looked out the kitchen window several times, and looked back at Brian and my spouse sitting at the table. I started wringing my hands together and then scratching my head. Brian came over to me and gave me a hug, told me it’d be ok and it won’t be long before all of it was just a memory.

Greg remained seated where he said, “Just take another pill, there’s better quality of life through more powerful drugs!” And then he laughed. Brian and I just looked at each other. I didn’t need enticed to go back to where I was, I needed to get clean! I occupied myself by going for walks to the bookstore around the corner from my house. I tried to concentrate on shows on PBS that seemed interesting at the time but my attention quickly faded. I did laundry, I washed dishes, I cooked, I played mahjong on the computer incessantly. I played with the bunnies like never before! I tried to find stuff that was mindless that wouldn’t tax my thinking power as the drug got out of my system. Knowing what to expect was a great tool for me. I was able to follow my progress, knowing what Dr. Sparling had explained to me. No wonder he was voted a top family physician 9 years running!

I honestly feel I had the best of the best taking care of me! Dr. Roland Sparling, and world renown neurosurgeon, Dr. William Smith… a power-packed combination! A song comes to mind from The Sound of Music, I think it’s called “Something Good.” There’s a line in it that goes something like, “So somewhere in my youth or childhood, I must have done something good!” I must have, to deseve these two and eventually three men, Dr. Michael Crovetti, for my hip, and I have to add in there too, Dr. Amanda Scott, doctor of Physical Therapy. Without this incredible team, who knows where I’d be today. But, I am going to give myself credit too. When I first embarked on this journey, I told Dr. Smith if he was willing to take my case, I promised him I’d do EVERYTHING, EXACTLY how he wanted me to, no matter what. I wouldn’t complain, and I’d see to it I didn’t deviate one bit. I KEPT MY WORD TO HIM! And he kept his.

October 1, 2010 was the day I stopped taking any pain killers for my back whatsoever. That was 16 months ago, and four  months and two days post-op to be completely off them. I still had to take my BP meds and the stool softener for a while but most everthing was stopped. Bear in mind now that 10 months after the XLIF I had 3 levels of my neck fused together with an ACDF procedure on March 16, 2011 and seven weeks and five days later, on May 9, 2011 I had a total hip replacement done. I was on pain killers for only three weeks for the ACDF and two and a half weeks for the total hip…. just sayin…

Although Dr. Smith had originally said I’d be in my back brace for six months, I was able to get out of it during my October visit as well. Out of my back brace in four months! My fusion had taken hold so rapidly I didn’t need it from what he saw on the x-rays! I was exhilerated! My spirits soared. And the first place I wanted to go alone with my new set of wings was to the Cathedral… me and God had some talkin to do!

Nowdays I have a hard time remembering what that pain felt like. I got feeling back in both my legs, and even in the top of my foot. I mean, I know it from my memory, but to conjur it up in my mind, well, it’s just not inscribed in my thoughts any longer. The white noise of pain, that boombox that never shut off in my head as I did my daily tasks was no longer occupying a place in my brain. I had room to think of other things, my thinking was much clearer, I didn’t lose focus as often. I’m still ADHD and have to keep myself on task, but for the most part I now spend my days filling my head and my heart with wonderful daydreams. Mom always said, “Your days are made better by your daydreams!” So now I get to daydream a LOT!

I hope this explanation of my surgical pain doesn’t scare anyone into not taking the chance to be out of pain. Just remember Brian’s words, “Once this pain is gone Mom, it’s gonna all be gone forever!”

PLEASE KEEP IN MIND, MY CASE WAS VERY UNIQUE AND PROBABLY WON’T EVEN LIKEN ITSELF TO ANY PROBLEM YOU ARE FACING NOW.

MAKE THAT CALL TO FIND A NUVASIVE PHYSICIAN IN YOUR AREA TO GET YOUR LIFE BACK TOO.

info@thebetterwayback.org   or call 1-800-745-7099

NO, NuVasive, nor anyone else pays me to say the things I’ve said… I am speaking on my own.

On that note, I’ll leave you to think about your decision to be pain free. And in the meantime, make sure you take care of you and yours.

hugs,

Love,

Kathleen

PS: This particular post has been especially draining on me to write because I’ve had to revisit all the subject matter. But, if it helps just one person make that decision to be pain free, then it was worth the effort to relive it again!

kathleenmosko@gmail.com                         Twitter @kathleenmosko

AND I’D DO IT ALL AGAIN FOR THE RESULTS I’VE ACHIEVED BECAUSE OF IT!

kathleenmosko@gmail.com              Twitter     @kathleenmosko

Hi Everyone!

I normally get up around 3:30 am and the first thing I do is feed my baby bunny, Candi. Now that Skittles is gone she needs some additional loving and reassurances that her routine, the one she had when Skittles was alive will still be in tact. So I keep to my schedule. The second thing I do is check my emails before I go to my website to read and allow all the comments that you post overnight.

I was delayed this morning because I awoke to a very disturbing email. Not that the author of the email sent anything bad, it was the content of his email that just flat out has PISSED ME OFF!

Remember a couple of posts ago when I told you all about the insurance company that denied one of Dr. Smith’s patients the opportunity to have this life-changing minimally invasive surgery? WELL, IT’S HAPPENED AGAIN! AND WITH A DIFFERENT PATIENT AND DIFFERENT INSURANCE COMPANY!

So, as usual, before I go off half-cocked, I did some additional research… yes, I know, maybe it’s overkill but it’s the latest information and it’s definitely cutting edge stuff… pardon the pun… I found the perfect explanation in a video offered by NuVasive, the corporation that manufactured the hardware that’s in my body.

I searched other companies, giving them a fair opportunity to post their stuff  here, anything that was even remotely updated… the best I could find was a few things from 2007… if it’s out there, it’s well hidden… so not that I’m trying to be partial, it’s just that THIS information was the most up to date I could find!

Click on this web link below and watch this video about the insurance companies and the developments and technology of minimally invasive procedures. 

PLEASE WATCH THE WHOLE THING!

SHARE IT WITH ANYONE YOU KNOW!

THE NEXT PERSON NEEDING A MINIMALLY INVASIVE PROCEDURE MAY BE YOU OR SOMEONE YOU LOVE!

http://www.nuvasive.com/about-us/health-care-advocacy/

ALSO……

While I was reading the denial letter the patient shared with me from the insurance company, I read a passage from it that made the hair on the back of my neck stand on end!

It was in reference to the patient and the guidelines he must follow in order to have surgery a consideration.  I am quoting the text directly………:

 Surgery is allowed only when….”The individual is a non-smoker, or in the absence of progressive neurological compromise, will refrain from smoking for at least 6 weeks prior to planned surgery… ” What happens to you if you’re in a car accident and need emergency surgery… just asking…?

THIS IS BECOMING THE STANDARD MANDATE FOR THOSE WHO NEED SURGERY ACCORDING TO INSURANCE COMPANY POLICIES.  STOP SMOKING NOW! Don’t wait until you need surgery in an emergency and there’s no time for you to stop first. Insurance companies are looking to deny surgeries… and back surgery for a smoker is almost a given failure!

The writing is on the wall folks… between insurance companies flat out denying procedures that are life-changing with minimally invasive procedure to disallowing anyone who is a smoker access to surgery all together, changes HAVE TO BE MADE and in our favor! You have to remember, if it weren’t for us, the people who buy the insurance in the first place, there would be no need for insurance companies!

HERE’S A QUESTION FOR YOU…   WHEN DID INSURANCE COMPANIES START TO RUN THE GOVERNMENT AND WALL STREET? OH, THAT’S RIGHT, RIGHT AFTER BIG PHARMA DECIDED WE SHOULD ALL BE ON SOME KIND OF DRUG SO THEY CAN BUMP UP THEIR BOTTOM LINE TO THEIR SHAREHOLDERS AND INSURANCE COMPANIES CAN BROADEN THEIR PROFIT MARGINS IN LIEU OF ALLOWING INDIVIDUALS  TO HAVE MINIMALLY INVASIVE PROCEDURES.

 

PISSED??? YOU BET I AM… AND SO SHOULD EVERYONE ELSE BE!

The more people who know and understand this the more enlightened we’ll be when we go to the voting booths to cast our ballots for those we chose to represent us! Big Pharma and insurance companies pay a lot of money to lobbyists to make sure votes go a certain way in their favor… and wait a minute…. how do they get their paychecks too? On the backs of every working man and woman who struggle to have food on their table, a roof over their head, and health care good enough to cover catastrophic health issues, least they be denied coverage and die before a resolution is met.

GET MAD, MAKE YOUR VOTE COUNT, CALL YOUR INSURANCE CARRIER AND KNOW YOUR COVERAGE BEFORE YOU NEED IT! MAKE IT A PRIORITY TO DO WHAT’S RIGHT FOR EVERYONE WHO NEEDS IT, FOR IT ONE DAY MAY BE YOU!!! FIND OUT WHAT YOU CAN DO NOW, AS ONE PERSON, OR A GROUP OF FRIENDS OR A CONGREGATION FROM CHURCH OR WORK… HELP RAISE AWARENESS FOR THESE IMPORTANT ISSUES! PLEASE, DO YOUR PART!

And as always, remember to take care of you and yours,

Hugs,

Love,

Kathleen

kathleenmosko@gmail.com              Twitter     @kathleenmosko

Hi Everyone!

I thought I’d start the year off right by clearing up several issues that keep arising in the comment section.

Let me first preface this by saying: I ABSOLUTELY LOVE HEARING FROM YOU! I APPRECIATE THE EFFORT YOU MAKE TO COMMENT AND GIVE ME POSITIVE FEEDBACK TO KNOW HOW I’M DOING! THIS IS WHAT KEEPS ME GOING! Thank you for all your compliments about my writing style, I smile each time I read such a wonderful compliment! One of my writing professors just passed away in July this past year and I’m sure she’s in heaven smiling too each time it’s posted!

That being said, here’s some things you may need to understand to fully appreciate this website.

AS LONG AS YOU ARE CITING ME, GIVING ME CREDIT FOR THE WRITING… YOU’RE MORE THAN WELCOME TO POST OR USE MY WRITING IN THINGS WHICH ARE APPROPRIATE TO DO SO.

I WOULD VERY MUCH LIKE FOR THIS WEBSITE TO GO VIRAL SOON SO POEPLE FROM ALL WALKS OF LIFE CAN BENEFIT FROM THE USEFUL INFORMATION!

IF ANY OF MY READERS ARE IN THE MEDIA, OR HAVE FAMILY OR FRIENDS IN THE MEDIA, PLEASE, BY ALL MEANS, SHARE THIS WEBSITE WITH THEM AND LET THEM KNOW WHAT THE INSURANCE COMPANIES ARE UP TO AND HOW NEW TECHNOLOGY IS GROWING BY LEAPS AND BOUNDS IN THE FIELD OF NEUROSURGERY! THE POSSIBILITIES ARE ENDLESS TO POSSIBLY HELP TENS OF THOUSANDS OF PEOPLE ALL OVER THE WORLD FROM SUFFERING FROM BACK AND LEG PAIN! PLEASE PASS THIS ALONG!

I am writing this website as cliff notes for an upcoming memoir I’m doing so not all the gaps are filled in… You’ll just have to buy my book to get all the “juicy” stuff! LOL

I am ONE writer doing all the posting, I do not have help with my writing. I AM NOT LOOKING FOR GUEST WRITERS AT THIS TIME!

This is a closed website without anyone’s help for writing as it is MY story to tell. I understand that many of you want more information and to be a part of my website. However, I will only be entering posts which pertain directly with my life experiences as they pertain to my healing processes.

At some point I may open up an additional website with a forum later this year, but for now, know that this is only as an additional thought, and not to expand my present website.

It’s been hard for me to get all the writing done I have in my que waiting, so for me to be a part of any discussion group would take up every last minute I have. I am healed enough to finally get back on the merry-go-round of life and do some exciting new things. I need time during each day to do them. As I hone my writing skills, I’m getting better and quicker at saying precisely what I want to convey so I have extra time for me to do other things and not neglect this website!

I haven’t looked for any other discussion forums pertaining to these particular issues, but I’m sure they’re out there if you just keep looking!

Someone asked me where I get my information from… PERSONAL EXPERIENCE mostly, the rest was either told to me by my expert doctors, my prior education, or I did a little research online… but very little online because you don’t really know what you’re getting there!

Sorry to the person who wants me to swap solutions to your web problems. First I haven’t the time to delve into it and secondly, I’m the last person you want to be asking for internet solutions…. I’m not savvy at IT stuff at all!

One person keeps posting that I bookmarked my website to increase the volume of traffic of my website… NOPE! I don’t bookmark anything because I have no idea how to do that! Others who have decided my website was worthy of others taking a look at it are the ones who are bookmarking it… Sorry…

Also someone keeps asking me if my titles to my posts should more reflect my post content to drive a higher volume of traffic… to that I say… worry less about your traffic and more about the quality of your content and the traffic will take care of itself. I have not done anything creatively IT-wise to increase my traffic flow so for me, I know the numbers I’m seeing in my analytics are “real.” By that I mean it’s pure data without any bells or whistles. OTHERS HAVE BEEN DRIVING MY NUMBERS NOT ME. Which gives me a much better view of the validity of my writings! “nuff said!

I do not have a hyperlink and I do not have a newsletter…. I am a lone writer barely able to make the posts I do… I’ll be going back to volunteering from a Christmas break so I may have even less time to post…

I do not know how to prevent spam as that is an IT question, but know that however my IT person has set up my website, I can filter it out.

I READ EVERY COMMENT THAT COMES TO MY WEBSITE, I KNOW HOW MANY OF YOU ARE RETURNING VISITORS! I DO NOT APPRECIATE THE ONES WHO HAVE NOT TAKEN THE TIME TO WRITE SOMETHING OF VALUE, BUT RATHER MORE LIKE A COMMERCIAL FOR THEIR OWN AGENDA… KNOW THAT I CAN SCREEN THAT STUFF OUT AND I DO!

As of right now I do not have a Facebook website link… My personal Facebook is just that,  for my family and close friends. As I grow in followers I will have a fan page set up for Facebook in the future, but as of now, I have none.

Outside of the really crappy spam, for the most part, you all have been very supportive of my writings.. it’s mostly been very positive feedback and for that I’m very grateful! I appreciate you taking the time out of your day to read my posts…and comment!  THANK YOU MUCHLY! :>))

SOME “I” “T” KINDA STUFF YOU MIGHT NOT KNOW – I had a very long talk with my IT guy who says the following:

If your readers are having a hard time loading the website, in any given browser, it may be that they need to update to the latest version of that browser in order to view the pics or even just the posts.

They may be using a browser that’s not powerful enough or is outdated and cannot handle my RSS feed. In that case they may need to change their browser OR THEY MAY NEED TO CHANGE THEIR SECURITY SETTINGS IN ORDER TO VIEW MY WEBSITE! Internet Explorer comes to mind as I speak of these things… they are notoriously outdated in many ways!

Also slow to load would signal a sign that your browser is not updated or powerful enough to handle my website. Update or change the browser… I guess the theme here is to have the right browser for RSS feeds or for just loading!

If you are not from an English speaking nation, that’s awesome, but if you don’t turn your English traslator on, I have no way of knowing what comment you want to convey and am compelled to delete your entry…

I have had several requests for people who want me to email them… I have sent several personal emails out and all have been tagged undeliverable because of bad addresses… which leads me to believe they are just spam! So here’s the deal…. if you want to have a private back and forth with me you must email me at my gmail address.

kathleenmosko@gmail.com OR you can Twitter me @kathleenmosko  Although, I am not real certain about Tweeting yet, if I receive one, my IT guy said I should see it on my iPhone so I can return it!

One last thing before I go…. I know the word “guys” is used as a collective term, but, know that first, I’m a lady, and secondly, there’s only one of me! LOL I’m just trying to add a little humor here…

I will, when I can, or if it’s an issue I just can’t keep my mouth shut about, answer back to some of you, but for the most part it will be hit or miss as the awesome volume of your comments have increased exponentially and my time at the computer has been lessened. I’ll attempt to find some kind of balance in the near future, but bear with me until then!

As always, thank you so much for visiting my website, and remember to take care of you and your…

hugs,

love,

Kathleen

PS: for the person who said it’s a shame I don’t have a DONATE button because surely you’d donate to the upkeep of this website… I took your advice and added a donate button, but I’ve yet to see you donate anything to my paypal account! LOL  If I get too busy finding a job or working as a volunteer, this website may have to go by the wayside if it’s not augmented! Just sayin….. :>)

kathleenmosko@gmail.com              Twitter     @kathleenmosko

Hi Everyone!

Back on December 14th I asked you to help re-post my website to make it go viral…. this is why….

THIS IS PROBABLY THE MOST IMPORTANT POST I WILL EVER MAKE! PLEASE READ!

Recently, Dr. Smith sent a patient to speak with me after seeing her in the exam room. I’m at the other end of the office and the entire walk back to where I stay, she was crying. Partly in pain, partly out of relief in the knowledge that she found someone who could take her excruciating pain away! I certainly know that feeling!

As we sat I gave her a few tissues and time to collect herself and calm down. I walked every mile she was walking only she didn’t know it yet. I quietly asked her to explain to me what Dr. Smith had told her. She gathered her thoughts and through her tears she shared her pain and what Dr. Smith said he could do for her. I asked her if she understood all that he explained. But she shook her head no. Then she said, “well, partially.” I was so right there in that moment with her. I remember when Dr. Smith said he could “fix” me and as soon as those words came out of his mouth, none after really mattered. But I didn’t have anyone with me just like she didn’t, so I slowly explained as much as she needed that I could explain all over again and this time she was writing things in her notebook. 

She was forthcoming about her pain and how her life was so adversely affected by it. It was heartbreaking to hear that someone else had to suffer the same way I did. Lucky for her it wasn’t as long as I had, but, nonetheless, still as debilitating!  She didn’t want to book a surgical date yet until she talked to her husband back home in another state. She and her husband run a bed and breakfast and her daily participation in the running of such a place is tremendous. You could say she’s chief cook, bottle washer, laundress, wood chopper, fireplace keeper, snowmobile guide, you name it, and on any given day, she may be called upon to pick up the slack.

I shared with her a little of my history about my back and how I got to Dr. Smith. Because Dr. Smith DOESN’T PAY ME, nor does NuVasive, I’m free to say whatever I need to without any restrictions. I volunteer to speak with patients and it was MY idea not his… he never asked me to do this for him! As I shared what I thought would be useful to her, you could see a calm come over her as though for the first time she was talking to someone who knew her pain. OF COURSE I DID!  Unless someone is willing to come forthand share their story, their doctor, in my case, Dr. Smith, would be the only person, and perhaps Joe who would know just how bad things were for me, and for the lady sitting across from me.  Everything about the environment I want to be soothing, so I pull my chair around from behind the desk to  show I have nothing to conceal from the patients. It’s a mediation technique I find very valuable.

By the time our visit was up she was clearly more in control of her emotions and at ease with what I explained. I always offer my personal business card I had made up as a writer, to give them an opportunity to call on me for further questions and concerns. All of the patients I talk to are welcome to contact me as a liaision for the office.

Days later I got an email from her saying her insurance company would not allow the minimally invasive procedure but rather would only allow the traditional much more complicated, more involved surgery.

WARNING: THIS PART IS VERY GRAPHIC! IF YOU HAVE A WEAK STOMACH DO NOT CONTINUE READING THIS PART… LOOK FOR THE NEXT SET OF ALL CAPITAL LETTERS TO CONTINUE THIS POST!

I need to make you understand the difference between a minimally invasive procedure vs a traditional procedure.

A traditional procedure should be one of last resort IN MY OPINION! Yes, it does hold it’s place for those few who can’t be operated on by the minimally invasive technique, who, by the way, are few and far between!

With a minimally invasive technique, to enter the body for spinal surgey is through the side. After you are put under, the surgical team turns you on your side. Usually three 2″ incisions are made, and the muscles are separated witht he aid of a PA who retracts the muscles rather than the surgeon cutting through them. There is minimal  blood loss ( three tablespoons or less) and the way muscles are retracted vs being cut through are the major differences. A more whole view of the spine is seen since the surgeon is performing it to visually see bothfront and back of the vertebra. In Dr. Smith’s case, he is one of those rare individuals who can operate in 3D but he visualizes in 4D. How’s that? Well, not only can he use everything in the operating room to see clearly what is the problem, he has the uncanny ability to visualize in his mind what the “inside” of the vertebra look like as well. In doing so, he gets a more complete assessment of what needs to be done. Granted, not all surgeons possess that 4D skill, but with the minimally invasive procedure, going in through the side, a surgeon can see enough of the “bigger” picture to properly use the remedies at his disposal to do a more complete job.

During a traditional procedure, major muscles are cut through,  often from the front of the body, which in and of itself poses certain risks, and protracted recovery, those are muscles you use for most of your daily activity, not just for ramped up or sports activities, organs must be pulled completely out of the body and set aside so the procedure can take place. Because the access is to the front, it limits the surgeons perspective to only that angle. Unless of course he can move you to a better angle. There is more time in the surgery itself, more risks involved, more blood loss, a lengthier hospital stay, more exposure to health risks in the hospital, and the recovery time is waaaay longer and the rehab MUCH more involved and protracted!

OK, YOU CAN START READING AGAIN!

Some insurance companies, like the one the patient he sent me,  would rather pay for a longer stay, more complications, more drugs, more rehab, more everything, than to allow a minimally invasive procedure.

Now, let me explain why. Insurance companies hire doctors to review cases. Often they are NOT well versed on the latest techniques, innovative procedures or the risk vs successes. This being said, some insurance companies have an appeal process which allows a surgical candidates’ doctor to have what they call a “peer to peer review” where the doctor who ordered the procedure has to contact the insurance doctor and defend his reasoning for the procedure, his credentials, schooling and anything else the insurance doctor thinks he should know before he allows the newer, more innovative procedure.

Unfortuantely, after our patients’ “peer to peer review” Dr. Smithwas unable to convince this, this, this, <Grrr> doctor, that the XLIF would really be the right procedure for her. Shooting me an email in panic, she asked me to call her. She’s terrified to have the more protracted surgery, for all the above reasons I listed! AND I DON’T BLAME HER! Especially knowing what I know from personal experience.

Dr. Smith’s experience, his education, his involvement in everything neuro should convince even the most staunch skeptic. He has an impecable record, is world renown, teaches the newest techniques all over the world, and has been instrumental in refining the procedure to the point that what he did for me a year and a half ago is obsolete! I don’t know exactly what he learned by doing what he did to me, I do know it was very unique, but I’m glad to have been the recipeintof such forward thinking from him. His abilities are incredible, and from what I’ve seen, is at the top of his “game” so to speak. He KNOWS without a doubt what he does in that operating room is hold the future of ever person he operates on. HE CARES MUCH MORE ABOUT US THAN WE WILL EVER KNOW!

In one of my recent posts I tell about how during a conversation at the office with Joe, Dr. Smith’s PA I learned that, even after I was put out, Dr. Smith warned Joe not to retract my neck muscles too far because I was a singer. My heart lept with joy when I heard he’d taken that step to care so much about my future. He had not only my life in his hands but my happiness and he cared enough to insure that stayed in tact! WOW! No one has EVER cared that much about me. And he cares for each one of his patients like that!

As part of what Dr. Smith and I have come up with to better serve his patients, he allows me the latitude to write letters of advocacy on patients’ behalf. He further had to defend his credentials, his experience level and his schooling to this, this, this, <Grrrr> doctor and along with his defense, I gave him a three page letter explaining from a patient perspective who’s already gone through it successfully, to be included with his papers on her behalf.

I’ve not been in the office since I wrote that letter and am not sure where the case stands at this moment. As soon as I know something, I will let you all know.

I’m appalled that Dr. Smith has to defend his credentials to this level in order to allow his patients the best treatment available because some out of touch doctor who has not kept up with innovation decides the fate of someone in such a manner. HERE’S THE CATCH…. THIS COULD BE YOU OR ONE OF YOUR LOVED ONES!

HERE’S MY CALL TO ACTION FOR ALL OF YOU!

Get ahold of your hospitalization policy, go over it with a fine tooth comb. If you don’t understand it, call them and MAKE them explain to you what the procedure would be should you need innovative minimally invasive surgery. Find out what their policy is about allowing it not just for back surgery, but for other types of surgery as well. ALL OF MY SURGERIES WERE DONE MINIMALLY INVASIVE!  MY XLIF, MY CERVICAL ACDF, AND MY TOTAL HIP WERE ALL DONE THAT WAY!

DO YOUR HOMEWORK BEFORE YOU NEED IT!

If enough people start a dialogue with the insurance companies, they will have to at the very least start a reviewing of their procedures and policies.

As a member of The Better Way Back Patient Ambassador team, I was asked to write a letter to an insurance company out of Florida which was denying about 99% of all back surgeries because they were only allowing the tradional, expensive and often unsuccessful back surgeries with little success. So, their theory was… we just won’t cover any! After that was brough to the attention of  The Better Way Back Team, they ramped up a letter writing campaign from all the members of the Ambassador Team about our individual success stories. They could no longer ignore the information before them enmass.

A couple of months later I was happy to get the email stating that particular insurance company has reversed their decision to change their policy and is now looking at back surgeries on a case by case basis. It’s not the best case senario, but it definitely is a win for all the patients who may potentially be in need of back surgeries who are stuck with that company as their insurance carrier!

On the 27th of December I got a call from one of Dr. Smith’s patients I’d seen. I was at home, not in the office.  He was calling to thank me for talking to him the way I did in the office. He was scared out of his mind. A few years ago he’d had traditional back surgery from a supposed highly skilled doctor here in Vegas. He shared with me he never really was out of pain and the doctor told him he would have to live with the condition because there was nothing more he could do for him. (so sad). 

This patient shared with me his inner-most fear of the same thing happening if Dr. Smith operated on him, but he was in so much pain again he didn’t really have a choice but to trust Dr. Smith and allow him the chance to maybe make things different for him. It’s a hard sell to someone who’s already gone through the process once to convince them they’re in a much better place. 

He had another issue to contend with, his insurance coverage was changing at the end of the year, it was already the 15th of December and he needed to get his surgery pronto. His current insurance company would pay for it, the new one would not. Dr. Smith scheduled the procedure on the 21st of December and six days later I was getting a thank you call from this patient and I could hear the smile in his voice.

MINIMALLY INVASIVE PROCEDURES MAKE A HUGE DIFFERENCE!!!

I tried to lay out what happened to me, my attitude towards my recovery and involvement in the decision-making process and what I’ve done to insure my recovery with him and he stated he appreciated my candor with him about what I did in order to cope. I shared and gave him hope and courage. He was also grateful knowing someone wasn’t paying me to say this stuff which makes the position I hold in Dr. Smith’s office just that much more important… Dr. Smith has no idea what I’m saying to his patients… but, I have to admit, whatever they tell him on subsequent visits must be convincing enough, cause he hasn’t thrown me out yet! LOL

So, again, I ask that you start the dialogue with your insurance carrier before you have a need for it… Get in touch with The Better Way Back Coordinator, Ms. Julia Saba at 858-909-1800, toll free 1-800-745-7099. The Better Way Back, 7475 Lusk Blvd. San Diego, CA 92121 info@thebetterwayback.org   Ask what you can do to help further the cause, get involved because it may someday make a difference whether you or someone you love gets a back injury fixed or not!

PLEASE MAKE THE COMITMENT TO PASS ALONG THIS INFORMATION AROUND THE WORLD! NOT JUST IN THE USA. 10 MILLION BACK AND LEG PAIN SUFFERERS AROUND THE WORLD NEED US ALL TO DO OUR PART!

I am one of the lucky ones who got an end to my pain… help others get there too!

As always, take care of you and yours!

hugs,

love,

Kathleen

Hi Everyone!

So many times we wish we had a laundry list of do’s and possible don’ts ahead of our experiences… well today you’re in luck! I was looking through my hard drive and found some writings you may have a need for… let me know if these things are the least bit helpful. I wish I’d have known them before my surgery…. maybe you do too! :>))

  TIPS BEFORE SURGERY

 Do your own research, browse the internet, ask questions, be informed, knowledge is powerful, empower yourself to make the right decisions for you 

Block out all the horror stories you are going to hear about someone’s brother’s uncle who had back surgery and now he’s in a wheelchair, that isn’t you, and you didn’t have his antiquated procedure

Make a list of all your concerns and take it with you each time you go to your doctor, he’s not a mind reader, and often he’s rushed and you can get flustered getting through his exam

Keep a log of any calls you make to insurance providers, doctors’ offices, appliance suppliers and what was said, this helps in the event something comes into question, you can’t remember everything on pain meds.

Have a family meeting or with your caretaker to explain your fears and concerns before and after surgery, they will be your ally when you can’t communicate the way you want while on your meds.

Arrange to have someone with you for at least the first week, knowing you’re not alone is invaluable.

ASK for help, people aren’t mind readers, but will most likely help if you let them know you need it

Enlist someone in your circle of friends to be your sounding board, not to get their opinion, but rather to just listen to hear what’s on your mind out loud, you’d be surprised that some things just don’t sound realistic once they’re said, like telling off your doctor, he really is on your side, he’s staked his reputation on it

Get ice blankets or make them up ahead to have ready when you get home from the hospital, improvise if you must, to wrap your legs in it while your nerve endings are reconnecting and your skin is so sensitive in hyperdrive. Make them by freezing a couple of folded bath or beach towels that were damp, to use put a Chux pad under them so you don’t get wet as they get warm.

Have a network of family or friends or in-home health care professionals to help you through it, and ask them for help

Before surgery, shop around for a good physical therapy place, they can be key to your healing, AND DON’T SKIP Physical Therapy, the stronger your muscles are the more support they’ll be for your spine

Have fresh food in your fridge before you come home from the hospital, it’s an exhausting trip home and have a plan for foods, either frozen, prepackaged or fresh, it’s a little work but pays big dividends when you most need it

Ahead of time, prepare several activities you can do while you heal to break the boredom; maybe choose a book you intended to read but never had that much down time, or learn to crochet or knit, line up your favorite music to listen to or do a mundane activity such as rewriting your address book so all of them are updated, polish your nails, guys indulge yourself to buy a couple of special magazines about cars or fishing or fitness you stand at the magazine rack and read without buying while your wife shops

Have plenty of water on hand before surgery and have some chilled for when you get home.

Purchase items that will help you reach so you can maintain some of your independence.

Use sugar free flavor packets for water so you’ll drink more, just don’t use the whole packet.

Pay attention to your posture; correcting it each time you find yourself not straight up and down.

Get a long shoe horn. 

TIPS FOR AFTER SURGERY 

Listen to your body and let your body dictate your healing 

ASK for help, people aren’t mind readers, but will most likely help if you let them know you need it 

Start a notebook to keep track of your meds, figure out when they should be taken and how they should be spaced to give you optimum benefits, ask your pharmacist; make columns for date, time to take, med you took, and a checkoff column or time taken column…this will help if you are asleep or forget to take your meds when it’s time. 

TAKE PAIN MEDS, AS PRESCRIBED, THEY’RE ONLY FOR A WHILE Don’t try to be a martyr and let your pain meds go longer than the time allotted, you do more harm than good to your body… it’s been through a major trauma with surgery and you need the pain meds so your muscles won’t constrict and go into spasm… 

Be kind to yourself, if you can’t do it today, tomorrow is another day, right now the healing is all about you, treat yourself to make mistakes and not be so rushed to heal 

Talk to your doctor about laxatives and take them if needed, they’re only for a while 

Keep moving, WALK, it’s the best way to gain back your strength at the beginning 

Eat a little bit every three hours, make sure it’s protein and fruit, mostly apples, stay away from heavy carbs 

Follow your doctor’s prescribed course of healing, he’s aware of what you need for the progression of your healing 

Reestablish your old routine of hygiene, the quicker the better 

DRINK PLENTY OF WATER, not only is it necessary for you to eliminate, but it will help flush out all the meds from your system and keep all your systems balanced 

Make sure you keep in touch with your general practitioner to keep him informed, he’s there to pick up the slack between the times you see your surgeon, address any concerns with him you haven’t with your surgeon, they’re on your side, help them help you 

As you heal, make plans to do something special you haven’t been able to do in a long time, start gaining control of things that for so long were not in your control 

Reach out to someone else in need of hearing your experience, you’ll have made a friend for life 

This bears repeating again, have a family meeting or with your caretaker to explain your fears and concerns before and after surgery, they will be your ally when you can’t communicate the way you want while on your meds. 

This one needs to be repeated as well, have someone with you for at least the first week, knowing you’re not alone is invaluable.

Plan a couple of short outings with help as soon as you’re up to it to break the monotony of being indoors. 

Use sugar free flavor packets for water so you’ll drink more, just don’t use the whole packet.

Pay attention to your posture; correcting it each time you find yourself not straight up and down.

 Make a calendar on a piece of notebook paper with just the numbers for six months, circle your doctor visits scheduled, your two week, eight week, three month, and six month benchmarks, cross off each day as soon as it happens, at the beginning. put only half an X (/) to show you got through half that day already.

 Use short term goals to reach for, like loosing 5 pounds in a month or being able to walk to the corner by the end of the second week.

Plan your shower and lay out all necessary items ahead; wash cloth, razor, & body lotion for afterwards.

Sit squarely on things, making sure what you sit upon has no chance of collapsing.

Ladies, desensitize your skin so you can shave your legs by rubbing the area to be shaved vigorously just before touching the affected area with the razor. It’ll be much less painful.

Use your shower seat, men especially listen to this, don’t be stubborn, it’s only for a while, ladies place a clean wash cloth on it before you sit down.

Sit at the edge of your bed and stand up, then sit down as often as you can from now on. That motion will strengthen your back and your legs as well as your lower abdominal muscles.

ADVICE FOR SURGICAL PATIENTS

Be assertive, not aggressive with your physical therapy, the more you do without overdoing it, the more you’ll be able to do

Your Physical Therapist can teach you invaluable lessons how to deal with your new body for later

Learn from your Physical Therapist how to balance properly so it lessens the incident of falling

If you had bad eating habits and know it, now is a good time to change them, eat healthier

Weight loss is always a plus, but most of all, the less you weigh, the easier it is on your back

Improvise using aids to help you reach for things, and at the beginning, if it drops, leave it for someone else to pick up

Be very careful how you sit upon things like stools, until your fusing process is complete, you may want to avoid them all together, make sure what you sit upon is stable

Pay attention to your posture, correct it as soon as you feel it change, it’s a great habit to get into

In order to get through the first weeks of surgical pain I created a chart for myself out of notebook paper and hung it on the wall. It was a nondescript calendar of the following six months worth of days after surgery. You can use a regular calendar too. On it I placed my 2wk, 6wk, and 2 month checkups, then I put on there goals I wanted to achieve by a certain day, even if it took me longer I left that goal showing but then when I finally accomplished it, I put it on the calendar too. I continually set myself goals to reach, but attainable so I wouldn’t get discouraged. Finally I put at the end of the six months a goal I felt was doable but I had to work to achieve. That goal was me long after the six months came and went. And it didn’t matter to me because I knew I was getting closer and that’s what drove me to keep going.

As those goals were met and the days past, and as my achievements were accomplished, I crossed off those days… some days the pain got the best of me. On those days I took it sometimes minute by minute. I would set my goal for the noon mark so I could cross off half a day by drawing half an X across that day. Little by little I became so busy with my rehab and PT I’d forget to mark the days off and it’d be two or three days before I remembered to even look at my calendar. I always kept that end goal in mind. My achievements were small and incremental but always forward moving. In looking back, it simply amazes me what I’ve accomplished in such a short period of time. 

Find nonfat comfort foods that are healthy, filling, and that will be nutritious;

nonfat yogurt,

nonfat milk,

salad greens with canned mandarin orange sections and sliced almonds,

apples

sugar free applesauce sprinkled with cinnamon and chopped walnuts,

100% juices in moderation,

sugar free popsicles or other flavored iced treats,

28 almonds,

14 walnuts,

20 pecans as servings sizes provides important Omega-3′s for snacks,

Starbucks has Lite versions of their drinks that are only 100 calories,

chicken and turkey are high in protein, make sure you are eating lots of that, your body requires more now that you’re going through the healing process.

 Use lotion all over your body, it will stop the itching from dry skin.

 Eat small meals every three hours, use only one meal replacement bar in a day such as Cliff bars, they’re good, but not better than real food.

 Though each person is different, make a new bucket list of all the things you had to give up that you’ll now be able to do, it gives you personal motivation to stay on course with your Physical Therapy.

 Make a calendar on a piece of notebook paper with just the numbers for six months, circle your doctor visits scheduled, your two week, eight week, three month, and six month benchmarks, cross off each day as soon as it happens, at the beginning. put only half an X (/) to show you got through half that day already.

Do little things that make you feel good about yourself, meditate, pray, clean out that nasty junk drawer in the kitchen, reorganize your file cabinet, spend extra time with your pets, feed the birds in the yard, they’re fascinating to watch.

Try new activities as you feel better but remember to not overextend yourself, especially in the beginning, it will come soon enough.

Learn to be kind to yourself, pamper yourself a little, no one else will if you don’t.

Get in and out of the car by 1^st sitting down with both feet on the ground, then bringing both legs in together… those with SUV’s may require you to 1^st bend one knee back and place your foot into the vehicle before sliding your bottom onto the seat. Then lift your other leg into the vehicle.

When opening a sliding glass door, plant your stance at least shoulder width apart before using a pulling motion to open or close the door, use your body weight to the the work.

You can tell I had way too much time on my hands shortly after surgery… and this is by no means a comprehensive list, just some of the things I experienced while I was healing…

I’ll get back to substantive writing soon, I promise, but for now if you can use this information for your own surgery or to advise someone else about theirs’, use this information to make someone’s life a little easier…in the meantime remember to take care of you and yours!

hugs,

Love,

Kathleen