L4-5 & L5-S1 Chartie Stenum - kc0iet

[New-disc]

K,

Sounds like things are going well.

Thank you for the update!!

I've checked in on this site almost every day to see
how you are doing.

Walking that far is great news!! Take it slow......

Please keep us all posted as you heal.

Todd

[mmglobal]

I spoke to KC a few days ago. It's tough to listen to the descriptions of the limitations imposed by the DVT and the impact that will have on the rest of her life. However, it's wonderful to listen to descriptions of walking longer distances than ever possible without crutches, canes, wheelchairs... and without the RSD-like symptoms that occurred whenever she tried to do this before the surgery. It's been a tough road for KC and I hope that after a few months, it will all seem to be VERY worthwhile.

You may already know that I was able to observe her surgeries. It was planned to be anterior and posterior surgeries on the same day. The surgery started with the anterior procedure to remove both prostheses and replace them with synthes synfix cages. These anterior cages are similar to the STALIF cages that provide big-footprint fusion cages PLUS screw fixation to make them even more stable and rigid than the more traditional style cages.

One thing of note is that the surgeon was somewhat surprised to discover a significant amount of tissue behind the prosthesis, seeming to indicate that inadequate preparation of the disc space was performed in the original ADR surgery. A typical ADR surgery may go very quickly if there is not very much tedious work to do to prepare the site for the prosthesis and to adequately decompress behind the disc if there are osteophytes, calcified remnants of disc herniations, scar tissue, etc.. Inadequate preparation (simply not following the recommended procedure) substantially increases the risk of less than optimum outcomes. That's why the procedures exist.

After the anterior procedure was complete, it was decided that it would be prudent give KC an opportunity to recover some from the first surgery before proceeding with the posterior surgery. The risk of complications from 2 shorter surgeries is far less than the risk of complications from one longer surgery. (I have always wondered about the combined cervical/lumbar surgeries they do in one OR session at Stenum. I know no other facility that will do that. Interestingly enough, my client for my next trip overseas is an MD who needs both cervical and lumbar surgeries. When I started a discussion about the options, she just cut me off... "absolutely medically inappropriate!")

10 days after KC's anterior surgery, they went in posteriorly to explant the existing fusion hardware at L4-5 and implant new hardware at both L4-5 and L5-S1. We had never been able to understand why the revision surgery at Stenum only included L4-5 because there were clearly structural problems emanating from L5-S1 before the revision. There were more surprise findings upon exposing the fusion site at L4-5. Not only was there no fusion mass present, but there was no evidence of any effort to create one. I suppose it’s possible that morselized bone was implanted and was completely resorbed, but the surgeon noted that apparently no effort was made to decorticate the bone before laying down the graft as is typically done during a fusion. It may be the case that the 2006 Stenum fusion procedure did not include an attempt to create a fusion mass. I don’t know the reason for this because in a typical posterior fusion, the hardware needs to function as a load bearing device until bony fusion occurs. After the fusion occurs, the hardware is redundant. Without bony fusion, the pedicle screws will continue to bear the load and the system will be more at-risk for future problems. I’ve never seen another fusion procedure with no attempt to promote bony fusion. I still don’t understand.

In any case, KC is progressing, albeit slowly. I hope to hear more good news soon!

All the best,

Mark

[Cindylou]

Thank-you for that detailed explanation of the surgery and reversal Mark. Boy, KC has been through the ringer. I hope this latest revision holds the key to your recovery KC so you can begin to get back to the task of living your life! My very best to you.

[wilsonrob]

KC,

Remember me. I was in Stenum when you had your fusion revision. I was the one that had the substantial DVT in 9 ? places of my iliac / femoral vein. It was a very difficult time. But I have had great improvements. I still wear a knee high stocking and get some swelling but it is greatly improved. I spoke to Mark and it is fine if you get my number from him and call me to discuss. Some of the things that seemed to help are:

* healthy diet
* lots of water
* try some pycnogenol bark tablets
* lots of walking - I know it hurts
* of course I believe in lots of prayer which I will be doing for you

[kc0iet]

It has been sooooo long since I have been on the forums that I forgot where all of them are!

Anyway, I just wanted to say hello and give you an overdue update.

It has been two years since I was in the hospital for my last pair (the 6th and 7th) major spine surgeries! I am doing really well. I still have a lot of health issues and am now hopelessly addicted to Fentanyl but rarely take any other pain meds and have NOT used my wheelchair since I got home from the hospital (July 2009). Thanks to the DVT's between surgeries in 09, I will always have to take Coumadin and keeping the levels where they need to be is a challenge...

But - I am about to take on another huge challenge. I'm not sure if I am ready, but I got in to Law School! I will be moving half way across the country, alone, and embarking on the most challenging academic pursuit of my life! Your prayers and positive mojo would be appreciated. I have been working towards this goal ever since I have been unable to work. I am both excited and scared ****less! Without further complications or delays, I will be 50 when I take the Bar Exam!

PS - Mark, did you change your email address? I've tried many times to email you. My prayers continue to be with you

[Maria]

Hey Kc..
I remember when I was thinking about going to law school and how old I'd be when taking bar exams (back then I was nearing 40y.o.) and a friend said "you're going to be that age anyway".. so true!

Such exciting progress you've made and while medicated! I stopped taking Neurontin last August and have finally felt like I can think again tho the last few years on it seemed to really make my mind sluggish. Probably just wasn't bothering to try to think!

I don't know any docs in the area that you're relocating to however you're probably going to want to try to locate a good Pain Management doc to prescribe for you vs. a GP. When I relocated I tried to get a 3 month supplie of meds as it took me a while to find someone to prescribe for me (when I moved out of state).

Good luck w/everything and please keep us updated!

[dshobbies]

Wow KC,

I'm jealous. I was about 40 when I thought of going to law school and I'm sorry I didn't - and I would have taken the bar exam before 45.

So to you I say - good for you!!!! Gutsy move but after what you've been through, a walk in the park, which is difficult enough.

And of course, glad you're doing well enough to even consider it, let alone actually do it. I'm quite impressed. I know you'll be inundated with studies but please, please, keep us posted. Success stories give so many so much hope, even after initial bad outcomes - Please

Dale