Can I travel alone for surgery in the UK?

[spinches]

I am scheduled for surgery by Nick Boeree on Aug 24 (2 level cervical ADR). I planned to travel to the UK alone as I do not have family to go with me. I have been feeling confident about being able to work with any potential challenges that solitary travel might present. I wasn't able to anticipate exactly what these might be, however. I have requested recommendations from staff at the Nuffield Hospital, but communication from them has been very sparse and not always informative. (Email response time from Boeree's staff has ranged from one to two weeks, and has sometimes simply stated that personnel who deal with these issues are not available due to vacations and illnesses). I have gone ahead and bought plane tickets, scheduled hotel rooms, etc., and have been relatively at peace about all of it.

Then a nurse emailed me this week for the first time and strongly recommended that I not attempt to travel to England unaccompanied to have the surgery. This really frightened me. I did email back, of course, asking her to tell me what specific difficulties she thought I might encounter post-surgically if I am without a traveling companion. I am awaiting her response, which presumably may reach me next week. Meanwhile, my confidence has been badly shaken.

I would appreciate hearing from other members who had overseas surgeries about what specific needs were met by traveling companions. For example, were there physical problems immediately after surgery that required the presence of a family member, to get attention from medical staff, for example. Certainly that has been an issue in local hospitals where I had previous surgeries, but I have been under the impression that post-operative care and service in American hospitals may not be as good as it is in many other countries. One problem I thought about is handling luggage on the return trip, but I assumed I would be hiring a driver who could also help me with getting luggage checked in at the Heathrow Airport. I haven't hired anyone yet, but it appears that this sort of service is available.

Any advice and support others can offer would be greatly appreciated.

Sandra

[Frances144]

I travelled down from Shetland to Aberdeen (14 hour boat trip or 1 hour flight).

Pre-op, as I was fairly mobile, I was fine and went by boat on my own as there was snow and no guarantee I could drive to the airport - over an hour away on the first flight so no gritters.

Post-op, and I have had back surgery twice, my partner has always come down to accompany me home and I must say I could not do it without him. I insist on it. The airplane staff are fantastic but they are used to the Shetland/Aberdeen hospital situation, ie lots of help, sympathy and wheelchairs but it is hard, very hard.

The second time home after my PLIF L5/S1, I cried all the way home, quite literally, mostly thinking "how the hell will I cope". I walked onto the plane last and was first off as I was not supposed to sit for any length of time. I was drugged up to my eyeballs on morphine and every painkiller I could legitimately take, both times.

There is no way on God's earth, I would do the return hospital run on my own. My OH was there to support, to hold things, to help despite having airport staff to man my wheelchair.

I felt so vulnerable and so low, mentally. It takes incredible strength both physically and mentally to get home with a long trip ahead. I had to look at things in stages, you know, like half way there, 1/4 of the way there, that house to the next village. That way I could get home in my head rather than think of the huge trip ahead.

If you can, get help. Heathrow when you are fit and well is a nightmare. Heathrow when you are not ambulant is also fairly bad. Heathrow when you are post-op would be my hell on earth imho.

[spinches]

Thank you for sharing your experience, Frances. I shall certainly take it into consideration, especially because you are familiar with Heathrow. Also, I do remember having emotional distress following one previous surgery, which was greatly intensified or even caused by the morphine I was receiving.

I have read a number of posts by people who had cervical ADR surgery, then went sight seeing a few days later. I have no intention of doing that, with or without a companion, but these reports of the recovery process led me to think I could handle this.

Thank you again for responding so quickly to my post. Sandra

[Frances144]

The major trouble with spinal surgery is you can't have a t-shirt printed or tattoo on your forehead saying "I've just had back surgery, please help me or leave me well alone!" and no one knows!

Best of luck, ask me questions if I can help. I am in the UK but miles away.

[spinches]

Maybe T shirts with that message would be a good project for the SPS!
Thanks again,

Sandra

[ajj1001]

you can request assistance at the airport ( do this before travelling, say you need wheelchair transfer and do there and back) and under legislation in this country it is compulsory that they provide it, combined with a driver that will sort out the luggage problem. the emotional support is much harder to know how you will cope. people I ask for assistance are generally helpful and the south coast is friendlier than the london area.

[spinches]

Thank you for responding to my post Alison. I'll contact Delta Airline and request more information about what they will do for me, and also call Heathrow Airport if I need to. I am looking at this trip in terms of how I CAN do it, not whether it is possible.

I agree, the emotional support is probably the need that is most difficult to meet when going through surgery alone. I am thinking that I might have more problems in that area immediately after surgery. I would hope that by the time the surgeon says I can leave the UK, I will be able to type emails and use my phone to talk to my friends.

[Katie]

I traveled to Brazil from Canada, a thirteen hour trip, and I had my husband with me on the trip down, plus two of my best friends on the way back who came down to give me support after surgery. We stayed an extra two weeks after I got out, three in total. But we did travel around to resorts, etc. in that time and I managed well. (I had an ADR in C5/6 and fusion in L4/5/S1 in the same surgery)

The most important step as everyone has mentioned, is to get wheelchair assistance both coming and going. They help bypass all the lines, hassles, etc. and are amazing with their sympathies once they understand what you are going through. And if you look really pathetic and ask, if there is room in first class, they may bump you up to the more comfortable seats at no charge...it has happened. It was full when we traveled or they would have.

Here is a wild thought as to help while you are just out of surgery....is there anyone on the board who would be able to visit spinches while she is there, for moral support? I know there have been a few of us on the board who have successfully gone out of country for surgery on their own and lived to tell the tale. I think anything is possible.....most of us are pretty darn strong, considering what we have had to cope with so far. I'm not sure I could have coped with Brazil on my own, with little English spoken there, but who knows. Having my friends there was priceless, I do remember that.

To be really encouraging though....my cervical surgery was a non-event compared to the lumbar I had at the same time. It just didn't compare. Other than a very sore throat and numbness/soreness on the side where my incision was, it wasn't bad at all. Maybe it's like hitting your thumb with a hammer after you stub your toe though...you are so busy thinking of the thing that hurts more to notice the other When are you planning on going??

[spinches]

Thank you Katie, for your response. That is wonderful, that you had such strong support from loved ones during your surgery, and that you were able to enjoy some time with them even afterwards.

Surgery is scheduled for Aug 24 with Nick Boeree. It will probably be a 2-level ADR at C 5-7, but Mr Boeree wasn't sure if the 2-level will be necessary.

The ADR surgeons I consulted here in Oregon consider one-level ADR to be "an outpatient procedure." That means they do it in a surgery center in about an hour to an hour and a half, and the patient is sent home with a friend or family member as soon as they are sufficiently awake to be put in a vehicle. The first local ADR surgeon I consulted told me that self-employed people like myself, who need and want to get back to work, often return to work with his approval as early as one week after the surgery. The second local ADR surgeon told me that he also does cervical ADR's in a surgery center. He told me that if I paid out-of-pocket the surgery center would cost me about $15,000 USD whereas the hospital would cost more like $27,500 USD for the same service. Even so, I was not totally convinced that a surgery center is a safe setting for a major neck surgery. One of the European surgeons (Bertagnoli?) states on his website that ADR should not be done as an outpatient procedure. That was part of the reason why I decided to do the surgery in another country, especially if it will be 2 levels. I could get hospitalization in England or Germany for as long as I need it at a total cost that is probably less than what I would pay for a 2-level surgery in a surgery center here in the U.S.

So, what I concluded from these conversations with surgeons, and from several of the experiences described by SPS members, is that the recovery from surgery would not be terribly difficult. I have been focusing on how to deal with whatever challenges I might face traveling alone, and telling myself I can do this.

When I was considering going to Germany, one of the doctor's websites or medical tourism websites said I should fly business class on the return trip. This made sense to me, as plane travel is so uncomfortable now even when one is totally well. I consulted a travel agent at AAA and learned that I couldn't really split the trip into coach class on the way and business on the way back, so I got business class tickets round trip. They cost close to $3000 USD, and that is a large part of the reason why I decided not to take a friend along. If I had been thinking about it, I would have deferred the surgery at least a month rather than flying during tourist season, but my mind wasn't focused on that issue when Mr Boeree offered the August 24 surgery date.

I really haven't been concerned about getting through this, until the nurse at Nuffield Hospital got so concerned and sent such a discouraging email to me. About a month ago, I told Mr Boeree's PA that I would be traveling alone, and she did not say anything negative about that. This is an example of the communication problems with this hospital; they seem to not be geared up to respond to the needs of international patients who are making travel plans. I kind of like it that they function more like a medical institution than a commercial one, but there clearly are disadvantages for the international spine patient.

Thank you so much for all the support you have given me.

[Katie]

Sandra, I didn't mean to 'rub it in' about having friends go along with me....I'm so sorry if it came across that way. I was just rambling (as I often do as the old gang here can attest) and was trying to get to the point that the cervical ADR surgery should be less to worry about than if you were having lumbar ADR/fusion, just from my experience. And that either way, you will hopefully be strong enough to go it alone. What I also meant to add was that if I could have gotten first class ($7000 just for me), my friends/hubby would have been ok with sitting in the cheap seats....true allies indeed!

If it is financially possible, would that be an option for you....bring one along as moral support, but accept that both of you won't be comfortable while flying? You could make it more enticing by offering them your high end seat for half of the trip maybe??

I would be extremely leery about this, either part:

they do it in a surgery center in about an hour to an hour and a half, and the patient is sent home with a friend or family member as soon as they are sufficiently awake to be put in a vehicle. The first local ADR surgeon I consulted told me that self-employed people like myself, who need and want to get back to work, often return to work with his approval as early as one week after the surgery.

I was told not to turn/twist my neck for six weeks, if not more (my memory is getting a bit fuzzy). This from one of the top International doctors. That is a far cry from going back to work in one week. How many ADR surgeries have these doctors done, may I ask? Personally, I think you are wise to look elsewhere.