Nairek L5-S1 ALIF Fusion January 2009

[Nairek]

PART 1

Tuesday, January 20th, surgery day. I had maybe 1 ½ hours of sleep between being nervous and my dog Peanut howling and falling over in her crate. As an elderly dog, she has been suffering from dementia and gets confused very easily. I decided to sleep on the couch to comfort her so we could all get some sleep.

The alarm clock went off at 3:00 a.m. and both my husband and I woke up to take care of our girls (a Beagle and a Treeing Walker Coonhound). After they were fed and walked, I left a note for my friend on what I needed her to do to look after the girls for me. I already had my bag packed from the night before since we had to catch the first train out of Poughkeepsie at 4:15 a.m. to make it to Lenox Hill Hospital by 6:00 a.m.

As we got closer to NYC, the reality of the surgery began to finally hit me. I tried so hard to keep the water works from flowing but the truth was I was scared. My husband kept telling me that everything would be fine and that this is what we have waited years for. And even though I could have appealed my insurance company’s decision, I decided that I couldn’t wait any longer and moved forward with the fusion. He reassured me that I was not making the wrong decision. I’ll post about that in another thread.

We took the #6 Lexington Avenue Local and arrived at Lenox Hill Hospital by 6:08 a.m. and went up to the 10th floor and waited only 10 minutes before I was taken in to pre-op. Dr. Bitan’s staff must have had me pre-registered already which was awesome. In pre-op you have the usual change into a gown & give them a few “samples” for various tests and so they could type my blood in case I needed a transfusion. The nurses kept telling me to relax and all I kept thinking was how can I do that knowing I’m about to be sliced, diced, and julienned?

I first met with Dr. Rizzo the anesthesiologist. He explained to me exactly what he would be doing in the OR. That there wouldn’t be any surprises. He explained that he would be “hooking me up” to a machine that will monitor my nerves so that they can avoid the prospect of nerve damage during the surgery.

Dr. Hannon peeked in as well. This time he had a full beard going on which he didn’t have when we met with him on December 18th. When we met with him back then, both my husband and I were extremely impressed with how he explained what his part of the surgery would entail. He was very thorough and answered every question that we had. He is also a very funny person who really seems to enjoy what he does. When he popped in that morning, he was all smiles which was a huge comfort to me. At least he was in a good mood before the surgery.

Dr. Bitan then arrived and said that we needed to talk about a few things before the surgery began. Basically, he stated that since I couldn’t get approved for the ADR surgery, we didn’t have the opportunity to discuss the changes that had to be made with the fusion which he apologized for. He informed us that he would need to make two incisions in my back so that he could insert two screws to stabilize the hardware. I looked at him and said “Wow, I wasn’t expecting that. That really sucks. But if this is what you need to do for the best outcome, I trust your decision and let’s do it”.

Dr. Bitan also mentioned that he had a medical student who was interested in watching the surgery in the OR and he wanted my permission. My husband said “as long as it’s lookie and no touchie, we are comfortable with that”. Dr. Bitan confirmed the student was only to view the surgery, nothing else. So with that being said, we were OK with it. I joked with him why on earth would this student want to watch something so gross and he said I don’t know I tried talking him out of it as well.

I then joked with Dr. Bitan and asked him if he could do a tummy tuck while he was down there. He looked at me and said “Oh, you wouldn’t want me to do that. I’m not good at those. Ask Dr. Hannon”. So I did, he laughed. Hey, you can’t blame a gal for trying right?!

After all of the new consent forms were signed, it was time to go off to the OR. As they were rolling me down the hall, I kissed my husband goodbye and held back the tears. As they rolled me further down the hall in the wheelchair, there were several times that I thought of jumping out of that chair and running away from the OR. It reminded me of my wedding day in a way (Not that I wanted to run from the altar). The reality of what was coming hadn’t hit me until I entered the OR.

I was wheeled in at 7:40 a.m., 10 minutes later than when my surgery was scheduled to start. I remember Dr. Rizzo said something about giving me relaxing medication and then the lights went out.

I don’t remember going into the recovery room. They let my husband in to see me for two minutes and he noticed that I was wheeled in to recovery at 2:45 p.m. The entire time of my surgery, no one came out to tell my husband what was going on. As Dr. Bitan was leaving the OR, he was dialing my husband’s cell number to let him know that everything went well and that there weren’t any complications. By this time, my sister and brother in law arrived to keep my husband company which was great since he was all by himself. We were initially told that the surgery would be about 4 hours long. I was in surgery for close to 7 hours.

I slept most of the time in recovery and was in a lot of pain during that time. I was finally brought up to my room at 7:00 p.m. and just kind of lay there semi-conscious. After 30 minutes, I asked the nurse if my family was still waiting for me on the tenth floor. Sure enough, no one bothered to tell them that I was moved to my room. Thankfully I had an hour with them before visiting hours were over. The incision on my stomach had a “medicine ball” attached to it which infused pain medication just under the skin of the incision which helped a great deal with the pain. The two incisions on my back though were extremely painful which was made worse by the fact that I was laying on my back.

The first two nights, the hospital couldn’t control my pain. It was so bad that I was moaning and almost in tears for the first two days and nights. And while the surgery went well, this was the beginning of some very scary events which we were not prepared for.

I don’t recall if it was the first or second night I was there, but there were issues where my blood pressure and potassium levels were too low. This was complicated by the fact that my blood oxygen levels were not normal and I was suffering from a rapid heart rate. I was kept on oxygen for 3 ½ days and my heart rate remained tachycardic and at one point was beating over 150 bpm.

I had been on a dextrose based IV drip which was then changed to a potassium based drip. When that wasn’t enough to bring up my potassium level, I had 3 infusions of potassium back to back to bring my levels up. I couldn’t understand what was happening to me. The potassium burned through the IV line. I felt like my hand was on fire. The nurse told my family that there wasn’t anything that they can do to ease the pain and that I had to have the infusions. And while all of this was going on, they had to cut me back on the pain meds because now my blood pressure was dropping. I recall that at one point it was 94/53. I finally broke down that night as my husband was leaving. I kept apologizing to him and telling him I was scared and that I didn’t mean to scare him. He felt like he was abandoning me for leaving but he needed to go home to take care of our pets who are basically our children. It was such an emotional rollercoaster which neither of us could control.

The second night, things got even more insane. I was receiving morphine injections in my shoulders to help deal with the pain when my blood pressure allowed them to do so. The injections only helped me for 20-30 minutes at a time. The doctor had ordered an EKG since my heart rate was so erratic. I remember a doctor had come in and asked what the results of the EKG were and I told him I didn’t know since the tech just walked out without saying anything to me or my family.

I had finally fallen asleep again when another patient stated flipping out and went on a rampage at 3:00 a.m. The RN’s & NA’s had been very loud at night. This particular night it sounded like they were having a party outside of my room. Maybe this is what set this patient off. I couldn’t see what was happening since I had the curtains drawn closed in my room. This guy was yelling “call my wife” and “call the police. I know what you were doing in the empty room down the hall”. I was in such pain but I feared hitting the call bell for help because I knew the staff had their hands full with this patient. I also feared for my safety and I didn’t want to bring attention to me in case this guy was running through the ward.

Thankfully, after an hour, things settled down again and going forward, nights were much quieter there. I had called for more pain meds but was told I had to hang on and since they couldn’t get the right dosage to help me, they would have to call a pain management doctor to help me. I told them “YES! Please call the pain management doctor”. I was so annoyed that they didn’t do this sooner since I had my own doctor for this!