Diane's surgery blog

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It's 10:30am, Wednesday morning in Bogen. Diane's surgery will happen this afternoon. It'll be a 2-level ProDisc. We've been in Germany since last Thursday. I'm sorry that we weren't posting more... it's been VERY busy here and internet availabilty and the time to post were never aligned.

I'll do my best to keep everyone up to date over the next few weeks. Our room in KKH Bogen is very nice and has high speed wired interned. We are paying the extra 85 Euro for a private room, plus another 45 Euro for a bed and meals for me, as I'll be staying with Diane until she gets out of the hospital.

I'll fill in the blanks as best I can. I'm going to post things out of sync. so there will be a lack of continuity, you'll have to look for the filled out 'placeholders' if you want to get the full story. Much more to come...

All the best..

Mark

[mmglobal]

Those of you who have been following Diane's story will remember that she did great after the July discectomy for about 2.5 months, then started having symptoms on the other side. By early November, we knew that the disc was too severely compromised, but it took her quite a while to come to grips with having more surgery. If she did nothing, she did not hurt very much. However, she learned that the threshold was quite low and a quite innocuous activity level generated substantial symptoms. It was hard to watch her progress as a spine patient. There is such a huge difference between someone who's new to this and someone who's suffered for years with chronic pain, but watching her discover what it's like has been quite difficult for me.

The role reversal we are doing is pretty amazing. As I went through this as a patient, I was discovering it all for the first time. Now that I've been through the surgical ordeal remotely with hundreds of clients and have been through it, up close and personal with about 50; I see things from a different perspective. Diane watched me through years of disability and everything that goes along with it, and she's watched what I do from afar... getting to know many of my clients very well. So now that she's learning first-hand what it's like to head down this road, we are both surprised by what we are discovering. I thought I understood caregiver issues better than I really do. She's learning things from the patient's perspective that give her a more thorough understanding as well.

As we approach this, I find it shocking that we consider her to be a 'newbie'. She's so far removed from the difficult cases and in such better shape than many of us who've had years of suffering with chronic pain. How horrible is it that being unable to work or function normally for almost a full year now, makes her a newbie? How horrible is it that a year of suffering and disability only qualifies her as 'not that bad'? It's an amazing perspective that we get when we live in the world of spine patients.

In November and December, Diane could not get used to the idea of coming for surgery. I had a trip to Pro-Spine with a client in late January and I thought she'd go then, but she was still having the typical doubts about surgery. When her pain would subside for a day or two, she'd think that she'd get away without surgery... then a simple walk on the beach would flare her up and she'd know that she'd be there sooner rather than later. With the severe collapse at L5-S1, it seems unlikely that she'll just be OK, and sooner, rather than later would seem to give her a better chance for a good outcome... before other elements of her spine degenerate further. (See other discussion about "auto adjacent segment disease.")

By late-January, she was ready to go. We ultimately decided on the late March date that was offered by Pro-Spine. We've both been to Munich, Straubing, and Bogen many times, so preparations were easy. Fast-forward to the night before we leave and there was such a poignant moment... Diane says it's OK to share. Tuesday night before we left, Diane asked Susan (our daughter) to take some pictures of her with Zoey (our grandaughter) so she'd have some pictures of them together to take on the trip. I knew that the pictures were for Zoey... not for Diane. It really brought home the depth of feelings that so many have at this stage.



More later... gotta run... surgery starting now... wish us luck!

Mark

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It's over... Diane is in recovery room now. All went well. Details later.

[sahuaro]

Mark :
(I hope it's okay to post on here--if not, please delete)

I am so glad the surgery went well. Please give Diane a hug for me.
And thank you for those eloquent posts.

Barbara

[mmglobal]

Taking a quick minute to add more detail. 2-level ProDisc done this afternoon. Surgery went as well as it can possibly go. Large anterior herniation at L5-S1 was somewhat inflamed. Very substantial defect in posterior annulus and PLL, dura visible through hole. Surgery confirmed what we only learned yesterday on discography... very severely compromised annulus at L4-5. Large circumferential tear... disc bulge/protrusion still contained by intact PLL, but this disc was severely compromised and based on discography, was painful. There are so many serious issues surrounding what we discovered about L4-5... I hope to write a substantial account of it... and we'll introduce a new term... auto-adjacent level degeneration.... Coming soon to a forum near you.

The good news is that Diane has been resting comfortably since the surgery. Medication level is VERY low compared to what I'm used to seeing. She rolls over without wincing too much. She's been sleeping most of the time, inspite of the low med levels. Both feet are warm and strong... not complaining of new leg pain or numbness (which can still come on in the days following the surgery). Recently, she's complaining of hip pain, which is also common and not something I'm concerned about.

It's still way early... but all signs are positive. Thanks for all your support... she'll be glad to see your posts.

All the best,

Mark

PS... I went to Giovanni's and got her a pizza, but she was asleep, so I gave it to the nurses!

[dshobbies]

I'm so relieved to hear that Diane is out of surgery and not in too much pain. Please tell her my thoughts are with both of you and I wish her the best.

Dale

[Cheryl]

Glad to hear it went well!!! Thinking of you both.

[mmglobal]

For the "Friends and Family" reading this; in the online patient community, we discuss many details that may seem to be too personal. However, for the spine patient that is about to go through the same thing... reading about all the various scenarios can be VERY helpful.
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We are both breathing a big sigh of relief. Things are going very well. Diane's surgery ended late yesterday afternoon... it's just after noon now... less than 24 hours out. She had some nausea in the recovery room that was nicely handled in 2 ways. An anti-emetic was effective, AND since her pain levels were lower than average, they were able to reduce the opiates that were probably causing the nausea. They stepped it down by 2/3 and she still had very low levels of post-op pain and slept comfortably most of the night. When she would wake up, she would use phrases like, "I can't get comfortable", or "yes, I have a little back pain." She could roll over without distress. She NEVER took opiates on a daily basis, so the pain meds were way more effective for her... unlike me... I had 3 years on large doses of opiates... so the amount of medication that they gave her, would have been like an aspirin to me. She's the opposite of that. The (relatively) small flow of opiates was like an elephant tranquilizer to her.

The down-side of this was some lower blood pressure readings that had me a bit nervous... by the 3 or 4 in the morning, it had stabilized with more appropriate readings and I finally got a nap at 6:30. When I went to check on her at 8, things were still good and we talked about moving her to the ortho ward instead of the unit she was on. (She was not in the ICU, but was an a ward adjacent to the ICU. Telemetry? Step-down unit? All the beds have full monitors that are tied into the station.)

They moved her to the regular ward at about 9am and she continued to rest comfortably. She made me promise that I wouldn't let her stay down too long, so I wouldn't accept her, "I want to sleep some more", and I insisted that she get up and move around. We put the brace on her and called the nurse for help. (Always... for the first time up, or if the patient is unsteady at all... have the staff help.) I was so pleased that she could sit up just like she could roll over. Yes, there is some back pain and some incision pain, but she sat up... sat there for a while... walked across the room and back... sat on the bedside and ate a bowl of soup (after the nurse verified that she has bowel sounds).

We talked about what she is feeling now and the great news is that she has no hip or leg pain at all. (These were her dominant complaints, pre-op.) She had some LBP when laying down, but when she got up and moved around, it went away and she was left with only incision pain. She is still on the pump... AND... she's been in bed for a couple of days, so we can be faked out regarding pain levels, but this is all so very encouraging.

It snowed enough on Monday night, Tuesday, and much of Wednesday (yesterday), so there was still some snow on the ground last night. It's all gone now. It's been a bit of a gray morning, but the sun is coming out now. Diane is back to sleeping, listening to my iPod with a peaceful look on her face. We are so much more relaxed now... the days leading up to the surgery were tough.... even with our extensive experience with spine surgery, Munich, Straubing, Bogen, friendship with Dr. Bertagnoli... there were so many stressors that most people have, but were absent for us... it was still amazingly stressful.

It's still early... we are not out of the woods yet... but only good news so far!

All the best... love to everyone...

Mark