[Spinal Fusion / Lumbar] L4/L5 MIS TLIF for DDD

[Scott]

Hey everyone. This site was very helpful in preparing me to make a decision on my surgery. I live in Lancaster PA and saw a highly regarded local doctor who wanted to do an ALIF. I got a second opinion from a highly recommended surgeon in Annapolis, MD who does Minimally Invasive Surgery and he recommended the MIS TILF as my best option. He said that ALIF was also a good option, but felt that the risks were higher than MIS TLIF. He did not feel that I was a good candidate for XLIF due to the position of my L4/L5 and the potential for nerve damage.

So after 6 months of surgical investitation I have my surgery scheduled with Dr. Timothy Burke on Friday Jan 28 in Annapolis MD. This is about a 2 hour drive from my home, but I felt that the pros outweighed the cons. Luckily both Dr. Burke and Anne Arundel hospital are participating in my insurance. I have a lot of prep work to get done over the next few days (physical, pre surgical class at the hospital, wade through insurance red tape, etc), but I am happy to have a plan to move forward. I will update everyone throughout my journey.

Scott

[Justin]

Hey Scott,

Congratulations on making a decision in regard to what type of surgery / choice of surgeon! That's a huge step. Spine surgery is a life-changing event and it's not merely a physical change. Good luck and please keep us posted.

When is your surgery by the way?

[Cindylou]

Oh, hey Scott, I see now you started a new thread on this. (I responded to your other post) January 28th....right around the corner! I am so happy for you, and yes, definitely keep us posted on your journey. This is a huge decision as you move forward, and I wish you only the best. Cindylou

[jeanie]

Almost time! It's quite an experience, so keep us posted on your event. I'm one month out and doing pretty well, but I have been so glad to get support to understand how slow recovery is. The SPF members will be there for you!

[Scott]

Well, it is two days prior to surgery. My insurance company finally approved the procedure yesterday. They only pre-approved me for a one night stay in the hospital. My doctors will then need to justify each additional night stay as we go along. The doctors office did not seem surprised by this. Has anyone else had similar experiences? I had the pre-op physical this week with blood work and an EKG.

My surgery is at 7:30am on Friday, so I have to be at the hospital at 5:30am. It is a 2+ hr drive from home, so I think that we will get a hotel in Annapolis MD the evening before.

I'll post when I am stable enought to do so.

Scott

[jeanie]

My HMO authorized 4 days in the hospital. My MD told me I could go home on day 3, but my husband declined to take me home because he saw how much care I really needed. Three times a day physical therapy came in got me out of bed starting on day one, and that was essential to teach me the mechanics of how to get up, walk, climb stairs, sit, without aggravating the surgery. I think if you firmly tell them you're not ready to leave, they're not going to kick you out of the hospital.
Scott, I feel better than I have in years even though I'm still very debilitated because of the surgery. I hope you have the same reaction I have had so far. My thoughts are with you.

[Hooch]

Good luck Scott, you'll be back home before u know it.

[Scott]

I am home and doing great. Here are some blog posts about my revocovery.

Scott: Update 2/8


The last several days have been busy. Mainly because, not only are we keeping track of all of Scott's meds, etc., but also because he has gotten much stronger and wants to move around more. Unfortunately with the snow on the ground, walking outside isn't happening.


The past few days Scott has walked around the house, using his walker, restlessly moving from room to room. I can tell he's feeling stronger and much less pain. He has reduced the frequency of the pain meds he is taking, though he is still on a long-acting twice a day med, as well as a short-acting one. If the doctor discontinues the long-acting one, I'm not sure how that will impact his pain level, especially in light of how much he has been moving around. We'll cross that bridge, as they say...


I had to remind Scott many times not to leave the walker behind, because it was getting in his way and he would leave it and walk without it if he was going a short distance. It really is a pain to have to use it all the time, and he may not need it 24 hours a day--maybe he could just use a cane now, but I'm not sure. We didn't get really good instruction and physical therapy isn't supposed to begin until 4-6 weeks post-op. We see the surgeon's PA this week, so we'll ask about that when we see her.


Yesterday (Monday) we went to the mall and walked for a bit, picking up a few things we wanted along the way. 2 hours was a long time to be out and Scott was really played out by the time we were done. I was figuring we'd only be there for an hour but he wants to push it and that's probably because he likes being out of the house so much. It would be better if the weather and road conditions were nicer and we could walk outside for shorter spurts more often, so he wouldn't feel like he had to push himself. If anyone has any ideas where we could walk indoors as an alternative to the mall, which is just huge, I'd appreciate the feedback.


Again we encountered a few people that were just unbelievably rude to Scott with his walker. The most glaring instance, and the one that just made me lose my temper, was as I was helping Scott to the car at the curb as we were leaving the mall. An older woman stepped up onto the curb and didn't see Scott because he was behind the pillar but walked into him but then stood there waiting for him to go around her. With his walker. She finally went around him, shaking her head as she walked to the door and that's when I lost it. I'm afraid I had to yell after her something to the effect that one day she'd be using a walker and she'd see what it was like. I'm not exactly proud of losing my temper, but I am amazed that people are so rude to those that have walkers, wheelchairs, etc. It's almost like they think they've brought them along to get some sort of special accommodations. Ah, well, I'm off my soapbox now. I know that I certainly see the world very differently due to this.


The activity of the past couple days really had an impact and Scott woke up with a much higher level of pain this morning. So I gave him a max dose of his short-acting med to make him comfortable again and put him back in bed. I'm going to have to make sure he takes it easy today. I think he may be trying to do too much at once and "cheating" a bit by not wearing his brace as often as he should. I think he's using the walker as he's supposed to again, but I'll keep an eye on that too. He has really amazed all of us with how quickly he has been able to get stronger and do things he wasn't able to do when he first came home. I think, though, that maybe he's pushing it a bit too far. It's a delicate balance. You need to move to get stronger and heal. If you do too much, you cause yourself a setback. Somewhere in the middle is just right.


I'll try to update again after our visit to Annapolis with the surgeon's PA on Friday.

Scott: Update 2/4



The past two days have had their milestones for Scott's recovery.


Thursday was full of improvements. We were finally able to get Scott into the shower which made him feel much more human. Prior to that it was mainly "spot cleaning." LOL. Fresh pajamas and sheets afterward were followed by a long nap, of course. He ate better overall yesterday and seemed more lucid throughout the day. By the end of the day, I noted that he had taken less of his medications, spreading them out a bit. He was more sore and uncomfortable by bedtime but we gave him the maximum dosage of the pain meds at that time so he could sleep comfortably and he slept through the night. Sleeping through the night is good on one hand but on the other, it caused him to wake up hurting. He rebounded fairly well from that with just regular doses of his medications, however.


He rebounded so well this morning, that he was able to go with me to a doctor appointment and then to two grocery stores! I was shocked at how well he did. He walked through SKH with the walker first. We were probably there about 30 minutes. Only one or two people were rude and cut him off because they couldn't be bothered to wait for him to walk so slowly in front of him. (You see the world much differently when it is you or someone you love who is using a walker/cane/wheelchair, etc.) After SKH, I asked him if he wanted to go home, but he wanted to go to another store, so we went to the next store and there he used the motorized cart. As bad a driver as I am, I would have been knocking over displays; he had the hang of it right away. Another 30 minutes and then we came home. The trip tired him out and after I put everything away, I made lunch and then gave him meds and helped him get upstairs so he could take a nap.




He complained about his lack of stamina, which I am sure is frustrating for him. I am sure he is going to be "feeling it" this evening in all of his muscles too, but I am glad that he is making the effort to exercise when he feels good and being cautious not to overdo it. (The motorized cart was probably a good decision in the second store.) He finds it difficult to get comfortable anywhere in our family room to sit and watch TV for any length of time. We've been trying to make an effort to remedy this but so we haven't found a good solution.


I promised a picture of the incisions. As I said, they aren't gory, and this is from a distance and a smallish pic so you can get an idea of the size of the incisions without feeling nauseous. ;-) They really are small for what was done through them. Pretty amazing. This was taken Thursday. They look even better today. The bruising and surrounding redness has disappeared a little just a day later.

Thanks for the good thoughts and prayers for continued progress and recovery. It's slow and every day has its frustrations but thankfully God has graced us with some extra patience (ok, He gave me the supply that I was lacking, ok?). We're so thankful to have friends and family to support us. Your cards, calls and emails may seem small but they really make a difference.


Scott: Update 2/2


Sorry my updates from the hospital took on the form of Facebook updates. At the last minute, I decided not to take the laptop and it was harder than I thought to post updates to Blogger from my phone. Plus, I was just so completely exhausted, putting more than a few lines of thought together was impossible. Facebook was about the best I could do for the time being. I tried to send out a few emails to those of you not on FB. It was difficult to stay mentally organized.

We are home now and it has been tougher than we could have imagined. All of it. Really it started before Scott even had the surgery. Despite his best efforts and lots of stool softeners the week before the surgery, Scott got unbelievably constipated in the hospital. He was in pretty bad distress and didn't go much before we left the hospital and was really uncomfortable. The hospital released him anyway, which was both good and bad. I wish they had taken the constipation more seriously and he had been more cooperative in letting them deal with it. (He refused to drink certain things that would alleviate it due to the taste.) Still, I was glad to be home and to have Scott in his own surroundings.

Despite insane amounts of stool softeners and laxatives since the day of surgery, Scott was still really hurting on Tuesday. I realized that we needed to resolve the situation that day or we were going to be making a trip to the ER and what they would do to resolve it would be rather traumatic and awful. So, with much prayer and determination, I was a mean nurse and today Scott is feeling much better. (You don't want to know the details.) The best part is that now, instead of focusing on that discomfort, he can focus on his back and he's moving around much better, despite the pain. Hooray!

He has four really tiny incisions. I'll post a picture sometime after I change the dressing. They're not gory. They are all stitched up and even have some scabbing on them now. You wouldn't even believe that they could do what they did to him (inserting the hardware, removing part of the disc, inserting the spacer, placing the bone graft, etc.) through those tiny incisions! A CT scan confirmed that the hardware is placed properly.

This morning I noticed that Scott is eating very little and seems a bit weak, so I'm trying to get him to eat small meals more frequently. It seems to be helping. He was actually a bit more "active" (meaning he sat up in a chair and talked with his mom for a while this afternoon and read the newspaper instead of dozing in bed). His spirits have improved as well. He's about to take an afternoon nap.

I have to say what an absolute blessing all the help we have had has been. My dad came and stayed with the kids on Thursday and Friday nights. My mother-in-law has been her since Saturday. We have had two wonderful meals from friends and more are scheduled to come. (Thank you, Michelle Simon for coordinating this! Michelle has let me know that there are still some dates available, so if you are interested in helping, you can contact her; I can give you her info if you need it.)

The meals seem like such a small thing but they are huge when you are managing a list of 8 medications given on all different schedules, dressing changes, taking Scott's temp to monitor for infection, taking his anti-embolism stockings off for an hour twice a day and remembering to put them back on, making follow-up appointments, helping Scott in and out of bed, making sure he is walking enough, eating enough, drinking enough, etc., etc. Not to mention caring for the kids' needs and giving them attention--thank you Joann--I don't know what I'd have done without you the last couple of days! Oh, and did I mention one of our trees fell last night? LOL. It's only real life, right? So, not having to cook for the time being is such a blessing for which we are truly grateful!

Please feel free to call, send Scott cards, or email. I'm sure he would love to hear from you. At this point, he's not ready for visitors. He can't stay awake for very long at a time yet. Even small activities are still very exhausting. Still, I've seen a lot of progress, even in the past two days and I'm hopeful for his continued, slow but steady progress.

[Cindylou]

Great updates Scott, whoever was posting for you. Wife? Sounds like you are in great hands for support and hands-on help and it also sounds like you are making some good progress. It's still a big surgery, so slow and steady wins the race here. I hope you will continue to provide more updates along the way as we do care. My best to you in your recovery phase, Cindylou

[Hooch]

Naughty boy, not drinking your milk of magnesia! The first few weeks are pretty rough, but glad all went well.