10 Weeks Post-op..Ann Marie

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Ann Marie (amtl1110@...) - August 2007 (10 weeks post-op)

(Warning – this is a very long document!)

Following is my 10 week post-op update. I'm piecing it together from

a series of postings, so I apologize if it is a bit choppy.

I had my posterior-only revision surgery on June 6th, 2007, with Dr.

Boachie at the Hospital for Special Surgery (HSS) in NYC. He removed

the bottom half of my old Harrington rod, removed two disks, inserted

cages in their place, inserted a wedge to restore lumbar lordosis,

recycled some of the old bone mass to perform some fusion and

inserted one pelvic screw on the right side. The surgery took about

4 ½ hours and they used one unit of my self-donated blood. I woke up

in the recovery room (PACU) and was relieved to not be in much pain

and to have a nurse right by my side. The surgery was early in the

morning and I spent the first night in the PACU. I don't remember

too much about being there. I was moved to a regular room the next

day. I was pleased about that because the PACU area in HSS has a

ward configuration with many patients separated by curtains. It was

very loud and bright. I had the semi-private room to myself the

first night, which was nice. My husband was able to stay with me for

a long time and the morphine pain pump did a great job at keeping me

comfortable.

Overall, the surgery was a success, but I did have a few

complications. I experienced a dural tear when they removed by old

hardware. Dr. Boachie was prepared for this possibility and they

patched it up during surgery. The main symptoms are spinal headaches

and general malaise. I had to stay flat on my back for 48 hours,

which was fine with me. I also experienced a " dropped foot " which is

a temporary partial paralysis/weakness in my left leg. It came from

the doctors needing to move the nerves at L4/L5 around a bit to

access the disks. I am still dealing with this at 10 weeks post-op,

but it seems to be getting a bit better, but VERY slowly. In

addition, my heart rate is normally very slow and my blood pressure

is normal/low. These are both good for surgery, but they got even

lower and took a long time to get back to my " normal " levels. This

left me extremely fatigued and they considered putting me back on

heart monitoring just to be cautious, but that did not end up being

necessary. They also decided to give me a transfusion of the other

unit of my pre-donated blood. My blood counts were good, but they

figured it might make me stronger. I did feel a bit better

afterwards. I had a reoccurrence of the spinal headaches due to the

dural tear at some point, so I had to lay flat for 24 hours again.

This collection of side effects delayed starting PT for a few days,

but it was no big deal. The first time I sat up I could only dangle

my legs. I was too dizzy and weak and the PT had no problem with me

laying back down and trying again the next day. I don't remember

exactly when I stood up for the first time, but it was probably

around day 5 or 6. My back pain was completely gone from the minute

I woke up from surgery. It was an amazing blessing! My incision

also healed amazingly fast and I had the dressing removed after just

a few days. I had no staples or stitches requiring removal. I was

very comfortable lying on my back, which I did not expect. Though

not intended, I ended up with a bit more correction to my original

lower curve so I'm now a whole inch taller! I now stand a whopping

5' 3 " ! I was transitioned to oral pain meds (percoset) around day 3

and I luckily adjusted to them fine. I experienced horrendous

spasms/Charlie horses in my right leg & buttocks. It made standing

up and sitting up in a chair extremely painful. It hampered by PT

progress for a few days. They finally prescribed some valium and

that did the trick and helped keep me calm.

They sent me home on day 10. I chose to go home in an ambulette

rather than in

my own car. I felt more secure that way. The driver was very

knowledgeable about how to make me comfortable and the ride was

absolutely fine. My husband rode in the front with the driver. The

driver got me into the house very easily via the wheel chair. It

would have been a bitch trying to do it ourselves if we went home by

car because my house was still under construction and I don't know

how my husband and I would have navigated the stairs with the walker.

I have a hospital bed set up on the first floor and it is great! I

originally had long rails the whole length of the bed, but traded

them in for the short rails just at the top. These keep me from

falling out of the bed, but enable me to sit up at the edge of the

bed on my own if I need to. I was very cautious and made sure that

someone was nearby when I got up, went to the bathroom etc., but I

got stronger and more independent each day. In addition to the back

brace, I wear a leg brace for the dropped foot. It is very helpful in

making sure I don't trip over this weaker foot, but again, I have to

be careful. I have a commode that can be either sit at the bedside or

fit over the regular toilet. After the 2nd night, I chose to leave it

in the bathroom. I did not pass my bowels before leaving the

hospital. When I finally did (2 weeks after surgery) I had a rough

time of it. Sorry for the graphic details, but I had to un-impact

myself since all of the milk of magnesia, suppositories, peri-colace,

fruit, etc., seemed to have no effect. When the time finally came, I

just had to get through it. Anyway, I briefly had to deal with some

minor hemorrhoids and made sure to eat tons of fruit, bran, colace &

milk of magnesia. On the bright side, I sure felt better afterwards

and think my pain levels actually went down a bit! Speaking of pain

meds, I started out take 2 Oxicodone every 4 hours and 1 valium every

6 hours. I am now down to 1 tablet about 5 or 6 times per day and I

haven't needed the valium for a few weeks. I had a visiting nurse

for 2 sessions. That's all my insurance would authorize. Considering

my incision was healing nicely and my blood pressure had stabilized,

I agreed that I did not need additional skilled nursing visits any

longer. I had 5 in-home PT visits. I eventually climbed my stairs

which enabled me to go take a shower using my walker. Ahhh!!! I am

blessed to have lots of help at home so I can focus on healing. Early

on, I slept pretty well, but sometimes I just couldn't get

comfortable. I watched a lot of TV and dozed off regularly. My

appetite was good, but I kept my meals light and easy to digest. I

got a Netflix subscription but early on had a hard time staying awake

during an entire movie. I didn't mind - those cat naps felt great.

My four week post-op visit to Dr. Boachie was very good. I was very

relieved to know it all looked " clinically " good. What I was probably

even happier about was the fact that I was comfortable during the 35

minute car ride into Manhattan and was able to sit in the

waiting room for a number of hours without any discomfort. My husband

and I even went out to a restaurant for an early dinner and I was

able to sit in the chair and enjoy the meal. I did take my pain meds

just prior, so I'm sure that helped. By the time I got home, I laid

down and pretty much slept until morning. The day took a lot out of

me, but for my first time out of the house in 4 weeks, I was pretty

pleased. I had to find a pain management doctor since Dr. Boachie

won't prescribe meds after the 4 week check up.

I had to wait a week or two to start out-patient rehab due to a

waiting list. After a lot of research, I decided to go to Burke

Rehabilitation Hospital in White Plains, NY. One of their

specialties is spinal rehab and they are also equipped to work on the

dropped foot. I do 3 on-land sessions per week and 2 in-water

sessions. The initial plan was for 8 weeks of PT and it looks like I

will have 8 more weeks. I do PT exercises at home on my non-therapy

days. This includes the use of an electronic stimulator on my left

calf to try to help the dropped foot.

My emotional state early on was fragile. I was quick to cry and

experienced mood swings. I also had a hard time focusing and my

memory was terrible. As soon as I was able to lower the dose of

narcotics a slight bit, I felt MUCH better. I still have my

emotional moments, but they are few and far between.

This is a terribly long post, so I will fast forward to today. I am

10 weeks post-op and am feeling pretty good. I am on a pretty low

regiment of Oxicodone and my pain is minimal. I mostly just get

stiff and, actually, walking around probably does as much as the pain

meds do to help me feel better. I am still wearing the back brace

(but not to sleep) and leg brace and I walk with a cane. I am

allowed to climb the stairs alone, but I only do so if someone is

home in the house. I can shower by myself, but still use the walker

for support in the walk-in shower. I can drive myself to therapy and

I have a handicapped parking permit which is awesome! I am bit more

emotional again the last few days. My care taker is on vacation this

week and then she heads home to Germany at the end of the month. I

miss her already. Besides the great care she took of me, her

friendship and companionship prevented me from falling into

depression. I'm working through this and hoping that my new-found

independence (i.e. driving, etc.) will help me adjust to a new

routine and ward off the depression. I think what is also

contributing to my moodiness is the phase of recovery I am in. At 10

weeks, I've made steady progress, but I still have a long way to go.

The milestones come a little more slowly and I am getting impatient

and bored. I also get frustrated that I wake up full of ambition,

goals and ideas, but by lunch time my energy has faded and I feel

disinterested. This is all normal stuff and I know I'll be fine, but

it's still annoying. I'm starting to do all the back-to-school

preparation for my daughters, so that is starting to put a bit of a

spring in my step again. I think that is a good sign that I will get

though this funky emotional stage I'm experiencing.

My next appointment with Dr. Boachie is not until October 8th when I

will be 17 weeks post-op. At that point he will X-ray me and advise

me about when I can return to work part-time. It seems like a long

time from now, but I know it will be here before I know it. For now,

I'm working hard on my PT, enjoying precious time with my family and

trying to stay positive.

Thanks to everyone for the support and warm wishes to all!!!!

Ann Marie