Posts Tagged ‘The Better Way Back’
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:
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,
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,
email@example.com Twitter @KathleenMosko
WELL! There’s been some real buzz about my e-book, BACK SURGERY FOR 2012!
I so appreciate those of you who have purchased the read through Amazon Kindle. I condensed all the medical information about my first surgery into an easy read where it’s all in one place. That way my readers don’t have to sift through my memoir stuff to find out what they want!
For those of you who don’t know, you don’t have to own a Kindle to get the reader. There are FREE apps you can download for your PC, iPhone and many other electronic devices! Exciting, I know!
There’s also a lot that’s been going on in my life personally and I’m going to get back to sharing stuff with you… in the meantime, I’m still writing so it’s really hard to know how to spend the same 24 hours each day….
I got a vocal coach who, was very pleased with my singing and offered me to sing in one of his productions he produces here in Vegas when he feels I’m ready! I can’t wait, but there’s much work to be done! I’m also meeting with a songwriter who has put together a few different tunes for us to use as a basis for a couple of new songs I wrote lyrics to… GOSH! it’s exciting to be me right now! I know it wasn’t alway so but we do have to suffer through the hard times to enjoy the good ones. AND to know the difference! Right now, I’m just taking all that life has to offer!
This is just a quickie message to let you know, I’m coming back and a little about what’s happening… I’ll talk with you all soon, in the meantime, you know what to do…
Take care of you and yours,
firstname.lastname@example.org Twitter @KathleenMosko
WELL, HAVE I’VE BEEN BUSY!
Today I launched my book on Amazon for the e-book version on Kindle. I’ve been patiently waiting until all things were done just right but, today it all came together. My medical memoir is, “BACK SURGERY FOR 2012″ That’s what you will use to search it if you want otherwise, just use this link below….
A few things you may not know:
You can download a free version of a Kindle reader for your PC without buying a Kindle.
There is a free app for the iPhone but I’m not sure about the other types of cell phones like the Droid or Blackberry, etc.
I’m still Dr. Smith’s Patient Advocate and a Patient Ambassador for The Better Way Back
Amazon has a rating system for books with five stars being the best. If you are so inclined to buy the book and read it I sure would appreciate it if you’d take a few minutes and rate the publication as you see fit. The more five stars I get, the faster it will get to the best seller list! I so appreciate all my readers from around the world who have taken the time first to read my website and to leave comments. It has made me a more humble person and a much better writer!
So much “stuff” is going on in my head right now I somehow can’t remember everything I needed to share so forgive me if you see multiple posts over the next few days as I remeber and keep you up to date on the latest information!
Until I can spend a little more time with you all, you all know what to do… take care of you and yours and we’ll talk again soon!
Installment 9 part 2… Questions and Answers for those who have had or will have an XLIF, ACDF, Total hip replacement, or Chronic DVT’s
email@example.com Twitter @KathleenMosko
Well, I have about sixty questions on ACDF surgery so let’s get started! I’ll try to answer as many as I can on my own and I’ll find out the answers to the rest from Joe, Dr. Smith’s PA or Dr. Smith himself. That may take a while….
Q: WHEN WILL THE STERI STRIPS FALL OFF AND IS THAT THE ONLY THING HOLDING MY INCISION IN PLACE? A: No the incision is sewn from the inside, and the steri strips are used only to hold the wound closed so there’s less scarring. They will eventually wear off as you shower daily and go about your normal routine, Usually within three weeks.
Q: WHAT TYPE OF SURGICAL FUSION HARDWARE IS MY DOCTOR GOING TO USE IN ME? A: There are several different types of hardware depending on the circumstances of your injury available to your doctor to use inside your body. He may have a good idea about how to repair it before starting the surgery, but once in, may see additional or different hardware may fit more to your particular circumstance. Hardware such as cages, plates and rods are sometimes used to stabilize that area of the spine.
Q: HOW CAN I BUILD STRENGTH IN MY NECK? A: There are several exercises I did to help strengthen my outer neck muscles but, you may want to also do exercises that strengthen the inner muscles as well. Go to the earlier post I entered about doing exercises specifically for the ACDF procedure. Some of them are designed to use the inner muscles too but I found that talking or singing with good posture are a couple of really great ways to exercise the inner muscles. It amazed me at how many muscles I actually used to practice my singing for choir.
Q: CAN I STILL USE A PILLOW TO SLEEP WITH AFTER MY ACDF SURGERY? A: I personally don’t use a pillow but, there’s some modifications you may want to do for using a pillow to sleep. I was told that my pillow should be under my shoulders also, not just under my head. That way my head and my neck were on the same plane or slope so there’s no pressure on the repair. I had a 3 level fusion which included a plate. It was far more comfortable for me to give up my pillow than thinking I still had to somehow sleep with one. When I choose to sleep or lay on my side, I make sure my foam pillow is then under my head, making sure it is no higher than the depth from the end of my shoulder to my neck. Here’s another hint. Because I had a total hip replacement, I make sure I have another pillow handy if I lay on my side to put between my knees. This is something more people should do anyway even if you didn’t have a total hip replacement.
Q: IS IT NORMAL TO HAVE A LUMP UNDER MY SCAR? A: Though many people have a really nice scar that heals flat and eventually almost disaappears, some develop keloiding. This is when the repairing tissue generates too much tissue and forms a hard lump just under the wound. If there are no other indicators of a cyst, or tumor or a fluid pocket, then this should eventually reduce itself in most cases. Some don’t go away without further intervention such as plastic surgery or Vitamin E oil applied for several months directly to the wound where the lump is. I had to use the vitamin E oil and bought it in a higher concentration. There are two different concentrations, 10,000 IU of Vitamin E or 40,000 IU of Vitamin E. My scar flattened over a period of months of continuous daily use. I put it on right after I brushed my teeth so I wouldn’t forget. I’m happy to say my scar is flat and starting to turn back to normal skin color instead of purple. Rubbing out the scar with this oil will also loosen the scar tissue, making it much more supple.
Q: MY THROAT FEELS LIKE SOMEONE IS CHOKING ME… IS THIS NORMAL? A: This is something I struggled with for well over 9 months. It does eventually go away with the strengthening of your neck muscles. The harder you work those muscles, the more toned they become, the less they will spasm and constrict. KEEP AT IT…. I was still worried about it right up until singing at Christmas Eve Mass. It will still happen every now and then, but to be honest it’s only been twice since Christmas. Keep strengthening those neck muscles!
Q: HOW LONG DO THE MUSCLE SPASMS LAST AFTER AN ACDF PROCEDURE? A: That’s not possible for me to answer. I know how hard I worked on my neck muscles to get them back and strengthen them, but as it turned out, I’ve had plenty of times there were set-backs, the biggest was when, seven weeks after my ACDF, I had to have my total hip replacement. This brought on a whole different set of circumstances since they had to use another airway to perform that surgery as well.
Q: HOW LONG AFTER THE ACDF IS THERE AN INCREASE IN COMFORT? A: That depends largely on how much you are willing to do the exercises to strengthen all the muscles in your neck. Remember, you’ve probably had weak muscles for a very long time and it will take some time to strengthen them so they can hold your head up for you. All told I really started to feel much more comfortable after my fourth month mark. BEAR IN MIND, I HAD AN ADDITIONAL SURGERY AFTER MY ACDF! I would imagine if you are doing your exercises, you could expect to have a high level of comfort conservatively after the 2 month mark…
Q: IS THERE ANYTHING SPECIAL I NEED TO DO IF I AM FLYING ONCE I HAVE AN ACDF PROCEDURE? A: This is one of the most common questions I get asked all the time. Another one is, “going through an airport do you set off all the bells?” Short answer to that is, ‘no, but’….” I recently had to be at the local police station where they routinely screen everyone… nope, no bells and whistles! However, when I flew back east in August I just told the TSA people when I first got up to them I had medical metal in me, they sent me right to x-ray and I was through in no time at all! Quicker I think than most people who went through the regular check line!
Q: AFTER MY ACDF PROCEDURE, WHEN CAN I EXPECT MY VOICE TO RETURN TO NORMAL? A: There’s only a long answer for this one. Simply because there are certain factors way beyond your control. As Dr. Smith answered this question for me, he stated that, “There is a high number of people who recover completely after a period of recovery, there is a small percentage who have a rasp to their voice that will eventually go away, and there is a very small number of people who will never recover from the rasp. But for the most part, I can say, that most people will recover to their normal voice after recovery.” Such has been the case with me, though my recovery has been a lot more protracted because of the additional surgery, AND, I’ve committed to extensive neck exercises because of my singing.
Q: CAN ACDF PROCEDURES BE DONE MINIMALLY? A: YES! When an ACDF is done through the front it is considered being done minimally. The doctor makes a small incision in the crease of your neck in front just to one side of the larnyx to access the spine. Everything is pulled out of the way to get to the spine but is then put gently back when the surgery’s complete. My particular procedure was a 3 level with a plate and my incision is only 3 inches long.
Q: WHAT TYPES OF SETBACK CAN OCCUR WITH AN ACDF PROCEDURE? A: While there are any number of complications which can occur with ANY surgery, specific ones directly affecting your neck could be excessive swelling, inability to speak for a while, or infection. That being said, there are a whole host of other complications not necessarily related to the procedure itself but rather to the condition of your body or the influences the anesthesia or other drugs may have on your particular body. There may even be some unknown factors that crop up once you have undergone the surgery that may not have anything to do with it.
Q: SOMEONE WANTED TO KNOW ABOUT THE “BLING” I ADDED TO MY NECK BRACE. A: As a crafter and cardmaker I found it quite fun to make the best of a not so good situation. I added some gemstones to my neck brace by going to my local craft store and getting some rhinestones that stick on and some ribbon cut to the shape of where the logo of the neck brace was. Dr. Smith was quite amused by my clever addition. It added a little something to the notion I had to wear it for 6 weeks. It brought a smile to many faces in checkout lines and when I was walking through casinos.
Q: WHEN WILL THE POPPING IN MY NECK STOP AFTER MY ACDF PROCEDURE? A: One can only speculate this answer. It was my experience to feel the popping as the plating settled into the bones for the better part of six or seven months. It was annoying as hell at first but evenutally as it got less frequent it didn’t bother me at all. It’s now been 11 months and I can’t even remember the last time it did it for me.
Q: IS IT NORMAL TO HAVE A RUNNY NOSE AND A FULLNESS IN THE FACE ON THE SIDE THAT WAS OPERATED ON? Gee, I thought it was just me that had the runny nose… but I guess it wasn’t that bothersome enough for me to even find out if that was considered a medical condition related to my ACDF. I do know however, that the right side of my face is STILL puffy a little since my ACDF surgery 11 months ago. And no, I haven’t gained any weight! LOL (I haven’t lost any either!)
Q: I HAD A BRIGHT RED RASH ON MY NECK AFTER MY ACDF PROCEUDRE, IS THIS SOOMETHING TO WORRY ABOUT? A: I had that too! I didn’t have it all over my neck but rather just at the wound site. Some common sense should prevail here. First touch it to see if it’s hot, if it is, call your doctor. Take your temperature, if you have a fever and the rash, call your doctor. I, on the other hand, just kept a watchful eye on it. I didn’t have a fever, or the wound area wasn’t hot. within three days it was completely gone. I have no explanation for it and didn’t see my doctor so I can’t tell you what it may be. If you are really worried about it, call your doctor, only he can really make the determination as to what it really is.
Q: I’M STILL HAVING HEADACHES 6 MONTHS AFTER MY ACDF PROCEDURE, IS THIS NORMAL? A: My headaches stopped immediately after I had my procedure. I say that with a slight reservation because I have experienced a few headaches in the last couple of months. I’m hoping to explain them away from some of the stress I’ve been under lately. I guess my best thought would be that if they are frequent, pounding, or dibilitating, then you should call the doctor at once!
Q: IS IT NORMAL TO HAVE VERTIGO POST-OP FROM AN ACDF? A: I can’t say for sure if it’s normal, but I am just now getting to the point that vertigo is not so frequent a visitor… it really wasn’t all that bad, just annoying at times but I’m noticing it less and less. I’m not sure if it’s a condition directly related to an ACDF, but I might be inclined to think it is since I never had it before my surgery.
Q: I’M HAVING A PROBLEM WITH SWOLLEN LYMPH NODES IN MY NECK IS THIS COMMON? A: Swollen lymph nodes is not common for any reason! I didn’t experience that at all when I had my surgery and so my thought is that you will probably want to talk to your doctor at your earliest opportunity. It’s probably nothing, but may be an indicator of a few other medical conditions he’ll need to address.
Q: WHAT IS THE COMPLETE HEALING TIME FOR AN ACDF PROCEDURE? A: Even with the complications I had due to the the additional surgery, I am still almost at 100% as of 1 year post-op though standard for any major surgery is at the 2 year benchmark. I did take additional time to do extra exercising and stretches. As I continue on my path, the tightness in my neck muscles and my throat have gotten considerably less. I’m convinced the more you use your neck and throat muscles the more healing goes on. This is one time in your life you don’t have to feel guilty for talking too much! LOL
Q: I HAVE SHOULDER PAIN AFTER MY ACDF WHAT CAN I DO? A: A few of you have asked me about this… I didn’t experience any shoulder pain after my ACDF so I’m not really sure how to answer this. I’ve been trying to pin down the answer through Dr. Smith’s PA, Joe. But first I have to catch him without a patient … :>) My best guess is if it’s bothering you to the point of major concern, make a special appointment with your doctor to let him assess the pain.
Q: CAN I BE LEFT ALONE AFTER MY ACDF SURGERY? A: For the first week you may want to have someone around to help you navigate your surroundings. After that I was more than capable to do all the necessary things for myself unassisted. Talk to your doctor as to what his recommendation is.
Q: HOW LONG DOES IT TAKE FOR AN ACDF PROCEDURE? A: The rule of thumb for surgeons to repair one level of the spine is one hour per level. That being said, Dr. Smith did all six levels of my XLIF surgery in 3 hrs and 20 mins. A record for sure! I don’t feel he skimped and only did a half assed job either. If you knew anything about my doctor, you’d know he is very complete when he goes in… he doesn’t want to go back in a second time if he doesn’t need to. My 3 level ACDF procedure took 1 hour and 47 minutes, so I guess you could say he does his work in about half the time of the standard.
Q: WILL I HAVE A METAL TASTE IN MY MOUTH AFTER I HAVE MY ACDF SURGERY? A: I have not had ANY odd tastes or had my taste buds affected by my ACDF surgery. Because the metal is surgical grade titanium or composite, I highly doubt you would experience anything like that. Some pieces used for repair, to my understanding, are made of polycarbon fiber or very strong plastic, so I know for sure in that case you wouldn’t have a metal taste. Sometimes old blood may have the taste of metal and, if you are experiencing some kind of issue with your scar, you may have that taste in your mouth but even that’s highly unlikely because of it’s location to your open throat.
Q: WHY AM I HAVING PAIN WALKING AFTER MY ACDF SURGERY? A: I’m not quite sure as I’m not a doctor, but if your spine is ok otherwise, you may look to the anesthesia for an answer. In some people, anesthesia is harder on the body than others and depending on how close to your surgery you were having the problem of walking, that may well be the culprit. Some people have a harder time getting rid of all the effects of surgery than others. If the problem persists, by all means, call your doctor! Only he can make a good enough assessment knowing as much about your condition as he does!
Q: CAN A PERSON HAVE A 3 LEVEL ACDF? A: YUP! I’m walking, talking, living proof that can happen! And I must say I’m not so worse the wear for it! Actually I feel fantastic about my healing. My health is back to feeling like I’m a 28 year old. I have only a few restriction even after all the work I did have done. One big restriction is that I’m not allowed to water ski. And although I was disappointed at first, on second blush, I have to say that at 58 years old, I probably shouldn’t be water skiing anyway! LOL It’s probably a small price to pay since I haven’t been water skiing for the last 15 years at any rate. I’ve got a lot of living to do and I can finally do it without pain! Why take any chances on a water skiing accident? REALLY!
Q: I NEED TO HAVE DENTAL WORK DONE, SHOULD I GET IT BEFORE MY ACDF OR CAN I WAIT UNTIL AFTER? A: As a matter of fact I was in the process of changing over all my silver fillings to resin just before my ACDF, and months after the surgery I had a final cleaning. They had a pillow to accommodate me for my neck and was able to complete the cleaning with no problem. BUT BE AWARE! IF YOU ARE HAVING DENTAL WORK DONE CHECK WITH YOUR SURGEON BEFORE YOU DO! TOTAL HIP IMPLANT PATIENTS MUST TAKE A LARGE DOSE OF ANTIBIOTICS AN HOUR BEFORE GOING IN FOR DENTAL WORK! THIS MAY ALSO APPLY TO AN IMPLANT YOU MAY HAVE! CHECK WITH YOUR DOCTOR ABOUT DENTAL WORK BEFORE YOU GO!
Q: HOW LONG ARE YOU OFF WORK FROM AN ACDF PROCEDURE? A: Because I haven’t been able to hold a job for the last eleven years I didn’t concern myself with how long it would take before going back to work. I do know that my collar was on for a full 6 weeks after surgery, so my guess would be at least until the collar comes off, maybe for light duty. It was probably another 6 weeks before I was really able to reach and do several normal things for myself with any amount of certainty. A person should really check ahead of time with their doctor before making any definite plans for surgery or traveling as well.
Q: CAN I LIFT LUGGAGE AFTER MY ACDF PROCEDURE? Check with your doctor about pounds to be lifted, but once I was medically cleared, I was able to do a carryon to the plane and had no problem lifting it into the overhead or down from it at 5 months post-op.
Q: IS THERE REALLY NO PAIN AFTER THE ACDF PROCEDURE? A: The pain which brought me to the doctor in the first place was gone immediately after surgery, no tingling in my arms, no numbness in my fingers, no headaches, and no pain that felt like someone was stabbing me in the back with a butcher knife! Yes, there was a lot of discomfort with the after effects from the surgery because it’s such a difficult and delicate one, but once I got past all that, I can honestly say, I am pain free. I haven’t taken a pain killer for any pain associated directly with the ACDF since a few weeks post-op. If for any reason you are feeling continuing pain post-op you need to make an appointment with your doc immediately. There may be something else going on in there and you don’t want to let it go.
Q: HOW WILL MY ACDF SURGERY AFFECT ME AS A SWIMMER? A: Because I’ve been a swimmer all my life it was important to me to get back to the one exercise I love the most. Swimming. If it weren’t for the fact that I had the XLIF procedure, I would be able to more readily just twist my head out of the water to get a breath when doing the freestyle stroke. But because of the way Dr. Smith repaired my back I have to pamper it by not twisting it so much. So, when I take a breath doing freestyle strokes, I needed to learn how to roll my whole torso rather than just my head. That took some getting used to seeing as how it took me years to NOT do that! You swimmers will get a chuckle out of that one! I can still turn in a mile in 1 hour and 6 minutes at 58 years old so, I guess I’m not doing too bad!
Q: WHAT IS THE SUCCESS RATE OF THE ACDF? A: I don’t have exact numbers for it but I do know it’s one of the most common surgeries for cervical fusions. It’s one of the older minimally invasive techniques used and given all my research on this matter, I’ve ascertained that the median success rate is at 80-85%. Not bad for a surgical procedure! I must say here that Dr. Smith’s rate is higher. The circumstances for the other 15-20% are typical of most surgical procedures, such as complications unforeseen, re-injury, or non-specific conditions leading to re-operation. By in large though, this is one of the most highly successful operations for correcting herniated discs in the cervical area.
Q: SOMEONE WANTED TO KNOW ABOUT THE AIR BUBBLES AFTER SURGERY… A: I spoke with Joe, Dr. Smith’s PA about this. After really thinking about it, he didn’t know what anyone could be asking about “air bubbles” because they don’t inject air into the surgical site in order operate as in an arthoscopic procedure. He could not answer the question on any level for me nor can I share any anecdotal experience since it never occurred with my procedure. I and Joe would need far more information in order to address this.
Q: WHAT IS THE REASON FOR HAVING AN ACDF SURGERY AND HOW DO YOU KNOW WHEN YOU’RE READY FOR SURGERY? A: Typically, an ACDF surgery addresses the pain in your neck and shoulders caused by a few nagging conditions that are related to birth defects, overuse, misuse, aging, or injury. A lot of birth defects go unattended for a long while until the overuse, misuse or aging process happens. People in general have a tendency to put off or ignore signs that something is not right… they may go years before having even the initial evaluation to determine what’s wrong. This may be the worse thing you can do… because, as you age, it becomes more difficult, the procedure more risky because of other medical complications, such as high blood pressure, heart conditions or any number of other maladies. When I was in an exam with an orthopedic doctor years ago I asked him, “How will I know when I’m ready for surgery?” His answer was simple, “When the pain is so intense it consumes you.” I didn’t understand what he meant, but it didn’t take long before I realized what he was saying. YOU’LL KNOW, THE PAIN WILL TAKE OVER YOUR EVERY THOUGHT AND BREATH IN SUCH A WAY YOU CAN’T CONCENTRATE ON ANYTHING ELSE. THEN, IT IS TIME! AND YOU WON’T BE ABLE TO GET IT DONE FAST ENOUGH! Unfortunately, many wait until this point to have something done, suffering needlessly. A lot of the delay is due to the horror stories people have heard for years about back surgery. THERE IS A DIFFERENT WAY TO DO IT NOW, BUT NOT EVERYONE OR ALL DOCTORS, NOT EVEN INSURANCE COMPANIES KNOW ABOUT IT! The sooner you get it done, the better result can happen. If you let the condition go until you are in excruciating pain, several things may happen. There may be a “natural fusion” that occurs, there could be a “severe narrowing of the spine,” a “blown” disc which is really a bulging disc, fractures of the bone, complications from osteoporosis, or any of the many other things that could happen to the spine.
OK, I’ve been working on this post for weeks now…. I can’t tell you what it’s like to get the good answers when I’m chasing down Joe the PA or trying to get a few seconds of Dr. Smith’s time to answer these questions. I have more on the ACDF QUESTIONS AND ANSWERS but I thought I better get something posted or I’m gonna lose you all….
I’ve been dealing with some “personal issues” lately and that’s why you haven’t seen me on so much… I haven’t forgotten you and I’m hoping to get back to my more frequent posts, but right now I’ve had to take care of some really important things. I do hope you understand and hang in there with me. If you have any pressing questions you can always contact me by email at firstname.lastname@example.org This segment is not done, I just felt you needed this post as soon as possible… I’ll be back soon.. I promise!
In the meantime, remember to take care of you and yours….
Installment 9 of Q & A for those who had or will have an ACDF, XLIF or total hip replacement and I’ve added a new one DVT! OR HOW MUCH DO YOU LOVE ME? LOL part one…
email@example.com Twitter @KathleenMosko
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,
firstname.lastname@example.org Twitter @KathleenMosko
I thought I’d share one whole day of activities with you. I don’t have anyone to follow me around with a camera and take a video of everything I do, and quite frankly you wouldn’t get the color commentary the way I can express it in words. So you can just suffer a whole day with me in writing….
It’s 4:30am, my usual time to get awake. My body never adjusted to Pacific Time so I just let it do it’s thing. East Coast Time isn’t a bad thing anyway. I get to watch the sunrise through my patio doors and often I’m not disappointed by the beauty of an early morning sunrise coming up over the mountains. Having been confined for all those years to lay flat, and all the recuperation time, I cherish every streak of light in the sky, every bird that chirps and flies by or lites on my tree to sing to me. I am well, I am alive!
I didn’t think twice about rolling on my side and standing without a boost or delay to get motivated to stand to get out of bed, I had to go to the bathroom. I didn’t need to hold onto the wall for support, nor did I feel like I had to turn on a light to make sure I didn’t fall. I wasn’t wobbly at all. When I sat on the commode, I didn’t think about holding on to anything on the way down, nor did I on the way back up. My motions are second nature to me now. Reaching to brush my hair and wash my face isn’t even the slightest of issues, I did it without needing to plant my feet in a stance to accommodate the possibility it might be too painful to stand long enough to do that. Brushing my teeth is a specific no- brainer, I just brush my teeth! No elbows on the edge of the sink to support my weight because the pain is so excruciating I don’t want to brush them.
On my way to the kitchen, I pass by the bedroom, a place Irarely am now. I close the door and smile knowing until tonight I won’t really need to lay down. The bunny wanted to be played with so I reached down, I didn’t have to sit down, to pick her up and walk into the kitchen to make breakfast. I didn’t need two hands to reach from one object or wall to the next item to stabilize my gait, I was too busy holding and talking to the bunny. I reached into her hutch to give her her morning greens and never stopped to straighten myself back up before continuing. I just stood up!
The eggs are on the bottom shelf now, more room for tall things on the top shelf. It’s OK, I can reach them without using the open refridgerator door for support. I also bent over a little farther to put away the bag of bunny greens in the drawer.
Ah, the smell of a fresh cooked breakfast, that’s a good thing now that I can stand long enough at the sink and stove to prepare myself a simple meal. The stool I used for 11 years is gone, it’s been getting in my way, and besides I don’t feel the need to sit when I cook or do dishes anymore. Breakfast with the bunny done, I head back to my room to change. I smile when I pull my leg up to put it through the opening of my undies standing up in the middle of the room. That’s something I couldn’t do not long ago, nor did I ever think I’d be able to! I didn’t have to lean against anything nor did I have to sit, or did I almost fall over from lack of balance. I just did it!
Candi, the bunny, wanted to play again. I got on the floor and laid on my tummy to coax her out of her hiding place to spend a little one on one time with her. NEVER before in the last 11 years did I ever attempt that particular move, getting on the floor, ESPECIALLY if no one was around! It’s become second nature to me if I want to let Candi know I’ll play with her. If I lay very still she’ll come out and jump on my back and run up and down the length of my body. It’s like an all over body massage, with no therapeutic benefit because she’s only four pounds! I don’t mind, it’s one of our ways to bond. Time to get up, roll to my side, tuck my good leg under my torso, use my elbow to lift, plant my other foot on the ground, and voila, I’m up off the floor, without needing someone to lift me up, or a chair or object next to me, or struggle to get up.
It’s laundry time! Bending from the waist is not possible since the XLIF, but bending to pick up the clothes isn’t something I have to think about either. I simply reach down bending at my hips, pick up the clothes, and in they go. Push a few buttons and on to the next task.
Pain? NOPE, not even as much as a twinge. I love the new me. Hmmm, a cup of coffee, and a check of my emails. Sitting is an activity relegated for purpose these days; at my desk to write at the computer, watch a little TV to get the news; not something I have to do to get my focus back. Most times I don’t use my hands any longer to boost myself out of a seat, I have the strength in my legs and back muscles and there’s no pain so I don’t have to compensate for it. I get out of the seat typically just using my legs, back and abdominal muscles. Those are the ones that were so compromised before because of the injury and all the pain! NOT ANY MORE!
Noticing our bottled water supply was getting very low in the fridge, I picked up two of the flats of water using my leg and arm muscles and, sitting in a chair loaded the fridge with the water. With little effort, the job was done! Pain? NOPE, not even a twinge! I think I’ll do a couple of things today, clean up the patio and back yard, and take in a swim! Cleaning the back yard was something I’ve been itching to do for a while now, like two years since we moved here! I want to plant some rose bushes and some annuals! Yes, it’s spring in Vegas already! Cool and warm enough to work outside! That’s the beauty of Vegas!
I decided to start with some general cleanup and raking, bending over to pick up the plastic bags and candy wrappers, newspaper and debris that blows into our yard when the wind kicks up. We’ve had plenty of that. Started moving some of the rocks the guys had to dig up and remove from the dirt where they buried Skittles. Up righted the artificial Christmas tree that’s in a planter, weighed it down with those big rocks. I think some went as much as 10 or 12 pounds! I moved the others in a more pleasing arrangement and dug up a sapling I’ve had my eye on since last year! I’ve been waiting to get a shovel in my hands to dig it up and plant it elsewhere. I emptied the compost bin and spread the compost around with a rake. I only got half the yard done because I had to stop to BBQ lunch! Pulling weeds makes me hungry!
BBQ’d chicken satay and broccoli and cauliflower, a great lunch! It kinda looks like rain and I was gonna go back out to do the rest of the yard but there’s always tomorrow for that. I want to watch Dr. Oz and then head to the pool. Pain? NOPE, not yet! (don’t think there’ll be any! LOL) I did a lot of raking since this tree we have in our yard not only drops its leaves, it has seed pods much like the cigar trees back east! (I think those are actually poplar trees back east) Anyway, this tree makes a real mess in the fall! Oh, I even cut back the rose bushes too! It’s looking pretty spiffy I think!
Well, off to watch Dr. Oz, then to the pool! Be back shortly!
OK, so Dr. Oz got me heading in the right direction. (this is a topic for a whole ‘nother post!) It’s so warm out, almost 70 degrees, that I decided to wear my suit and cover to the pool instead of clothes, I packed em and dressed after my shower. An hour and a half of upper and lower body exercises in the water (I will post a list of the water exercises in a different post a little later) and then a quarter mile of swimming! Any pain? NOPE, still none!
Home to cook my spouse some dinner and a light meal for me. Then an hour more of TV and finishing up this post. Dinner is a no-brainer for me anymore since no matter what I choose to cook, I can more than tolerate whatever action or body motion it requires, like chopping up onions at the sink or dicing peppers, or rolling out dough! All of those things I hesitated to do before my surgery! Dropping something on the floor and picking it up is also a no-brainer! I used to have to kick it over to where I could lean up against something to bend over to pick up or I used my toes to pick it up. Now, I just bend over, and pick it up!
I’m finding my biggest drawback for any of my activities is sitting at my computer! I really don’t have all that comfortable chair and my work space is very limited. I wish my computer battery hadn’t died on me so I could keep recharging it and then take my computer to different areas of the house, or out on the patio. Instead, until I get a new computer, I’m going to be forever connected to a wall plug. I know, I shouldn’t complain, some people don’t even have a computer! ’nuff said! LOL
As I sat in my recliner watching TV, Candi, our bunny and I snuggled under the throw-cover. She is getting used to not having Skittles around and I’m doing way more with her because she’ll let me. Picking her up or getting her out of her cage has become a common act, I don’t even think about how I’m going to lean and get her out or up. Good balance and no pain, that’s what it took! And I’ve got both. After the show it was back to her little den and I to brush my teeth (without pain) and then bed.
I’m really loving my freedom from pain, and to think of other things besides it. As I undress for bed, I look in a mirror, no I really look at my scars. For however small they are, and for as much relief they provided, I almost wish I could show them off! Not that I ever would! That would mean a bikini and yeah, I don’t see THAT happening ever in my future! LOL I’d swim naked before I’d swim in a bikini! Naked swimming would mean I would be in some secluded place by myself or with one other person… just sayin…. it’s a lot different than wearing a bikini to the beach or pool! Nonetheless, I’m still not bothered by the scars. I’m wearing them like a badge of honor! They are a constant reminder of where I was, and makes me appreciate where I am today! Any pain as I lay down to sleep? NOPE! It’s just another ordinary day! It was an AWESOME day!
I’m now 21 months post-op for my XLIF surgery, 11 months post-op for my ACDF surgery, and 9 months post-op for my total hip replacement. I don’t take ANY medication for pain at all. If my muscles are a little stiff, I have the skills now with the exercises (the ones I already posted for you) to work through the stiffness and I’m good to go! NOPE, no pain! I’m a very lucky person…
I hope someday everyone can feel as good as I do! But in the meantime, you all know what to do….. take care of you and yours and I’ll be back with some really good stuff very soon.
email@example.com Twitter @KathleenMosko
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,
firstname.lastname@example.org Twitter @kathleenmosko
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.
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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.
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!
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AND I’D DO IT ALL AGAIN FOR THE RESULTS I’VE ACHIEVED BECAUSE OF IT!
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I thought I’d engage my readership in this post…. here’s the deal….
I have two trains of thoughts about the issue of injury pain vs surgical pain…. I can give you the short, more “clinical” view of these two issues, or, I can give you the long, personal journey version which may include as many as three posts to get to it all.
I started writing the long, personal version and then I had the thought that maybe some of you may only be interested in the shorter, “clinical” version. So, I’m throwing it out there to you…
YOU HAVE A CHANCE TO VOTE
SHORT, “CLINICAL” VIEW OF THE TWO ISSUES?
THE LONG, MORE PERSONAL VERSION OF THE TWO ISSUES?
HERE’S WHERE THEY WILL DIFFER…
IF I do the short version, I will do a little research, (all online stuff, which you can obviously do for yourself) and I’ll limit my comments to just what I’ve experienced in a clinical sense according to what that research exposes.
IF I do the long version, you’re gonna have to get a cup or two of coffee and suffer through maybe as many as three different posts as I give you my background as to how I came about to have the pain, how it affected me and how I dealt with it until I was surgically fixed and what the effects of each have been in accordance with each procedure.
I’LL KEEP VOTING OPEN UNTIL MIDNIGHT SUNDAY, JANUARY 15, 2012 WHEN, AT THAT TIME I WILL COUNT UP ALL THOSE WHO COMMENTED ON THIS WEBSITE POST. THIS IS THE ONLY PORTAL I’LL TAKE VOTES ON.
YOUR COMMENTS ARE INPERATIVE FOR ME TO KEEP SCORE ON THIS…. AND I’LL HAVE A SCORECARD BY MY COMPUTER TO ADD A MARK FOR YOUR VOTE.
On Monday, the 16th, I’ll start my research if it is the short version vote that wins or if it’s the long version, I will post the first installment by Monday evening…
So make a comment, let me know what you think… what type of writing do you want to see me doing on this very important subject?
VOTE BY ENTERING A COMMENT!
This should be fun for me, I hope it’s fun for you!
in the meantime, take care of you and yours!