runner's surgery blog, L4/5, 2008

[runner]

Hi Maria,

No, I haven't been on here in a while. Let me do a quickie update (sort of).

Had surgery for L5/S1 in August, 2011. So I am a little less than two years--Oh, my how time flies--from my ProDisc L surgery. Yes, I got the ADR. I was in a lot of pain before I got that surgery, fighting for the surgery I thought would put me back in the game.

I have just been busy recovering, taking care of kids, doing things...

The surgery went well, but because they went back in through the abdomen (anterior), they encountered vessels that were -kind of stuck to the vertebrae bones ("scarred in"). My vascular surgeon was taking my iliac vein off and when he got to the last millimeter, the vein tore. He told me after the surgery, for a vein it bled a lot. He was able to repair it and what not. (I did have the dacron sheet over the bones but it did not extend down to L5/S1 so that didn't help.)

Indeed, I lost 3,200 cc's of blood. They were able to return half of that to me, I used up the unit of blood I had donated and whatever was left in the cell saver. My potassium level was down after that, they gave me K-riders to help that. Additionally, I spent a long time in recovery and I kept asking for pain control and some (sorry to say) stupid nurse gave me Valium injections instead of addressing my pain. I had a 7 am surgery, which I think lasted around four hours, and didn't get up to my room until around 7-8 pm.

My pain skyrocketed after getting to my room and it was way out of control. My day nurse, whose shift had ended, attempted to address the issue. The problem was that the PCA did not have a basal rate. And the PCA rate was low. This poor nurse, who didn't have the autonomy a critical care RN has, went the extra mile for me. She got a hold of one of the doctors that worked with my surgeon and got a basal rate. I was in so much pain and the next day, my pain doctor came in and took over. I was never very comfortable but things were better.

I was weak after surgery and had difficulty moving. And the mistake I made, was having surgery near a holiday. I was in the hospital a couple days and they determined I needed to go to rehab. So they have an in-hospital rehab that my surgeon wanted me to go to, but the rehab doctor examined me and decided I was not sick enough, so he would not admit me (mainly because of my insurance).
I had nurses, who obviously wanted to clear the floor because of the holiday, suggesting very strongly that I needed to get out of the hospital and go to rehab. They got me off the PCA--thanks a lot--barely weaned off, it was a joke--and onto P.O. meds.
Unfortunately, they wore me down. And off I was shipped to rehab. So, I get to rehab, they don't have my medications, my roommate has the loudest grating voice possible and there is no P.T. available. Since I had very little in terms of pain meds, I was up and down to the bathroom and was using my walker quite effectively.

Walking that much at night, I got very adept at using the walker and willed myself to get stronger. Yes, they did not have any of my medications and this is right after major surgery. They gave me I think one 10 mg dose of oxy or percocet from another patient and promised they would have medication soon. That first night, I woke up in the middle of the night because I heard loud voices. My roommate and a couple other people (staff) were talking very loud and I thought I was in some kind of dream. Then she kept asking for pain medicine repeatedly...I was going nuts.

I was there two days and they still didn't have my medication; I felt like an inmate from One Flew Over the Cuckoo's Nest. There was no P.T. person to help me rehabilitate, only an occupational therapist; I was getting Tylenol for pain and no other meds. So I planned my escape because I was in a lot of pain, I was not sleeping well and I thought I would go crazy. LOL.

I have never liked SNFs. Well, I packed my bags, got dressed and when my husband came to visit, I told him I was leaving. He was like, "No, no you have to stay here you are too weak to go home," etc... I told him, "If you don't take me out of here, I am hitting the streets and walking home."
He got quite upset at me because he had been told that I could not take care of myself.
Luckily, a couple from my church came to visit, and the wife was an RN and I spoke to them and she convinced my husband to take me home (AMA).

At home, I camped out on the couch and when the holiday ended, I called my surgeon's office to tell them my situation. I had no discharge papers, no hospital bed orders, etc...I spoke to the surgery scheduler/administrator and she was upset how I was treated by the hospital. She chewed them out for treating the doctor's patients like that (I was not the only one) and got me an in-home PT visit, ordered a hospital bed.
And that was how that part of recovery ended.

Runner

[mmglobal]

Wow, that sounds like quite an ordeal... but how are you now?

Mark

[runner]

Hi, Mark,

I am getting to that...something else happened after the surgery.

R

[runner]

Recovery, Part II:

I did much better at home. The outpatient PT person showed me how to take care of myself at home, what not to do, went over my medications, and orders.
I got the hospital bed so I didn't have to go up and down the stairs in our house.

I was getting stronger by the day, but I still had a high heart rate (110-120 or so) and was wiped out.
So I was laying on the couch one day with my oldest daughter on one end and me on the other, watching Blue Planet, and I started feeling funny. It was about 25 days since my surgery and I started getting a fever.

I started watching my temperature because I did not have any cold symptoms, just a fever and feeling of being ill. When my temp went over 102 degrees, my daughter called my doctor's office and managed to get a message to the surgery RN. She called my daughter back and told us to go to the ER.
She told me to stop taking any medication, including pain medication, not to eat or drink, and go. So off to the hospital we went.

When we arrived at the hospital, it was busy, and we checked in and soon, I was triaged, a triage RN, takes your vitals and your complaint down. We went to a waiting room and I was able to lie down. By this time, I was in a fair amount of pain because I had not had anything for pain for a while. Nothing to drink either.
Eventually, I was taken back into the ER and they did blood cultures, and blood work and did a chest x-ray. Back to lying down and then finally, we went to a room. It probably was not that long but I was in pain. So it was a relief to get to lie down on a bed, ER bed as it was.

Once there, they hooked me up to an IV, gave me pain medication, and Zofran. The P.A. came in took down my history, my complaint and so forth. They ordered a CT and I did that. All this time, I was thinking this isn't so serious. Until they decided to admit me and the ER doctor came to talk to me. My surgeon decided I needed to stay in the hospital.
The ER doc told me they might have to open me up again as I might have a post-op infection. He told me that my WBC was elevated, my Lactate level was high (it was high normal) and some other labs were off. I had leukocytosis, which I didn't know at the time. Also a high CRP and sed rate.

Once back to the ortho floor, they started me on IV antibiotics, Vancomycin and other medications. All I could think about was how hard the surgery was, I could not go through another surgery. I was like, "No way."

This time, my nurses were great. My husband came to see me and I don't recall much else that night. It was weird being back in the hospital. I was in a private room, which struck me as funny. I was NPO after midnight that night.

Thank God, the next day's labs, my WBC was back to normal, so was my kidney function, my Creatinine, GFR, and Chloride. They discharged me that day, after getting another dose of antibiotic.
So I am leaving my room and I read my bulletin board and realize I was a rule out sepsis patient, that was my admitting diagnosis. I may be an RN, but I guess we can be dense too.

I feel like I dodged a bullet and I was never so glad to leave a hospital!
The blood cultures never grew out bacteria, but I knew it was an infection. I was just ever so happy not to go under a knife again.

So my recovery was difficult, and I was still in pain--but not as bad as before the surgery--and I kept saying, "Well, why am I not doing better,?" and my doctors would say, I had two major surgeries and it takes longer to come back/recover from two surgeries. However, I am happy to say, I started improving more the next summer, and at the one-year-mark and I just continued to make progress and was happily surprised. Eventually in 2012, my heart rate went back into the normal range and my stamina improved. And then my BP dropped out of hypertensive range.

Not only that, I was going to movies and concerts here and there and exercising. In September, 2012, my surgeon told me I was free to go and if anything ever came up, to give them a call, but I didn't need regular appointments anymore. First time that was happening since 2007.

I was planning to go back to school in 2013 and then back to work when I felt able to and you know how they say: If you want to make God laugh, tell him your plans, (Woody Allen).

New chapter in my life, cervical problems start for real, in Mid-October, 2012.

To be continued...

R

[jsewell]

Runner i have been reading your current stories and i have had similar experiences. We should get together and entertain each other with our stories. So i was a really obsessed runner, when i live in Ca it has always been trail running. all this came to a hault, not by my back but by a hip replacement. But at this point i would never be able to run with this back of mine after 9 back surgeries.
Are you albe to run at all? Do you live in the LA area?
Judy

[runner]

Hi Judy,

Yes, we should talk.
You have me hands down on the orthopaedic surgeries. I have only had two lumbar ones, two knee scopes and nose surgeries. Nothing on my feet, though I have had injuries there and plenty of running injuries.

I am sending you a PM.

Runner

[runner]

Having surgery next Wednesday (10th) and it is two-level fusion.
Will explain more next time.

R