[Artificial Disc Replacement / Cervical] Thumoeides Prestige ST C6/C7

[thumoeides]

This is a long and probably over detailed description, but I found these reassuring to read before my surgery, so perhaps someone will benefit from my story.

Had surgery this morning at 7 am at Texas Health Presbyterian Hospital with Dr. Marlin. I didn't sleep at all the night before, but I was quite stressed and so didn't really feel tired.

The surgery went very well and the doctor is quite pleased. Unlike many here from what I can see my main problem was muscle atrophy. My left triceps, wrist extensor, and pectoral muscles were all atrophied and shrunken and weak. I did have some pain, but since January 15 when this all started my pain has improved quite a bit. I even had second thoughts about the surgery. But my muscles never improved.

Marlin checked my muscles before and after surgery, and the change is remarkable. Especially the triceps is much stronger.

I checked in this morning at 5:30 am. I was taken to a room to change into the silly open back hospital gown and entered in the computer (they have them on rolling carts), asked some questions, and had my neck cleaned. I was then wheeled to the pre-op staging area where I eventually met my doctor and my anesthetist as well as the two surgery nurses.

Every one who talked to me throughout the day always asked to look at my arm band with my name and birthdate, and asked me to state the information out loud. I was also asked several times where on my body the surgery was to be done, and what the procedure would be.

I was told by the anesthetist that the anesthesia would stay in my system only minutes after surgery. I was then given an intravenous anesthesia which knocked me right out.

I woke up in the anesthesia recovery area at about 11 am. I was quite groggy and needed to urinate. Randy, my recovery nurse, gave me a bottle, but I couldn't bring myself to pee in bed. He thought my elevated heart rate might be caused by the need to urinate. I was also very thirsty and he gave me ice chips.

My throat was (and still is) quite sore when I swallowed, but otherwise I felt little pain.

In about two hours I was wheeled to my room, which is in a newly built part of the hospital and quite nice. I was attached to an IV for potassium and leg stimulators to prevent blood clots. After a while a nurse unhooked me and let me go the the bathroom to pee, whew!

Dr Marlin has me in small collar, he says to remind me not to turn my head too far or make any sudden movements whilst I heal. The incision area does not feel painful at all, but swallowing has been painful all day. I was very thirsty and hungry, but I had missed lunch. Dinner was mashed potatoes and green beans and gravy with some ground beef. It tasted quite good.

I have since been visited by a nurse from respiratory therapy who gave me a device to measure deep breaths. I was told every two hours to breath deeply five times and then cough. This is to help prevent pneumonia.

Marlin requires a test to see how much remains in the bladder after urination, since especially some older men have trouble voiding as an effect of the anesthesia. I had no trouble once I was allowed to stand up.

I have been visited by a patient care technician to take pulse and BP several times. I have also been given IV antibiotics, which took only half an hour to go in, and a shot of morphine when the pain started to climb to a three. It is good advice to get ahead of the pain because it is harder to bring down than stop from increasing.

Marlin visited at about 7 pm (he works long hours) and once again was quite pleased with the outcome. He said the pain in my arm was from when he touched the nerve whilst removing the bits of herniated disc. He is keeping me at the hospital overnight for observation. I am to have an x-ray in the morning and then be discharged.

I can't say enough about how polite and professional everyone at this hospital is.

[thumoeides]

I have pain swallowing but I can talk fine. I have some off and on pain in my left arm at the triceps level, sometimes in the forearm and wrist. It is a sort of an ache. The triceps is sore to the touch and when I tighten it. Neck pain only when I rise up from lying down on my back--so I don't do it, but rather roll to the side and rise up. Slept on my side last night.

I have no shoulder or scapular pain which I was told was universal with ADR, so I am surprised. My surgeon told me to expect scapular pain due to his working on the bone.

I was sent home with antacid in case of sour stomach due to stress and a short steroid course for swelling as well as Norco for pain. Surgeon prescribed three 10 minute walks a day, which feel good. No driving allowed, lift nothing over half a gallon of milk in weight, wear a collar whenever going out of the house. Everything below the knees is off limits (but surely I could sit on the floor or squat?). I have a very careful surgeon.

Told to keep the incision site dry and change the dressing once a day starting tomorrow. Poor wife has to look at the wound and see if it is healing properly. On Wednesday I am to shower, get the incision wet and replace the dressing. On Thursday the sutures will be taken out by the surgeon.

[Justin]

thumoeides,

Congratulations! I'm so happy that you are on the other side of surgery, as I'm sure you are. Dr. Marlin sounds like a great surgeon. Thanks for the detailed account of your surgical experience...it will help many Spine Patients.

Please keep us posted as you recover.

[thumoeides]

Justine, thanks for your responses. I do hope to help others with these reports.

Day 3 after surgery

Throat pain much decreased, but some swelling persists as it is a little difficult to swallow.

Left arm pain also decreased, I notice it more when I take the three ten minute walks a day as prescribed by my doctor. The triceps is still sore to the touch, and sometimes the shoulder aches. I figure that may take weeks and even months to resolve itself as the nerve heals.

Bandage changed for the first time today. Slight swelling and redness, but nothing upsetting.

Energy level good. I think I'll report less often from now on unless something changes significantly for better or worse. I'll post next after I see the surgeon to have the sutures removed at the end of the week.

[thumoeides]

Day four recovery

No big changes from Day three, but I thought I'd add two things.

The throat soreness is mostly gone, but I still have to push a bit to swallow. I have allergies and so some post nasal drainage that is causing some coughing.

The night nurse at the hospital brought me Cepacol cough drops which really helped with the soreness. Now I am using Mucinex to thin the mucus and I think it is reducing the coughing.

The other thing is that only now do I feel my bowels have fully come back. I thought I could pee and poop and so I was good by Saturday, but I realize now things were slow and blocked. I would only partially evacuate. The night nurse had said at the hospital that the colon is the last thing to fully wake up from anesthesia.

[thumoeides]

Day seven recovery

First follow up doctor visit. He removed a suture, there was only one. Commented that the area under the tape on the bandage was redder than the incision.

He was two and a half hours late so only had a brief visit. He tested the muscles and strength is still returning. I am now allowed to drive and do household chores, but no physical therapy for at least two more weeks. While doing the three walks a day I should add four nods and four head shakes. I can drive, but very defensively, and no looking back over my shoulder.

I feel only occasional pain, like an ache, in the areas that were originally painful when moving the arm quite a bit, as in swinging it on a walk. The triceps is still sore to the touch and sore when extended. Doctor said all that is to be expected. The triceps is damaged and the nerves will undergo reinnervation over time. There is still pressure on the throat felt when swallowing. And there is some small neck soreness. All of this seems to diminish with each day.

The only odd thing is occasionally I feel muscle strains in my back and shoulder pain. I think that is muscular from slowly reestablishing proper posture.

I have a follow up doctor visit with x-ray in two weeks. I won't post again until then unless something changes significantly.

[thumoeides]

Three week recovery

Saw neurosurgeon yesterday. He is very happy with my progress. The x-rays look very good, the disc is placed anatomically in a line with spine tips.

He says my nerves are already at 90% or more recovery. Now I need to rebuild muscle size and strength. But he wants me to start very, very slowly. I can lift and move my arms. Do curls, triceps extensions and wall push ups. I'm not to get down on the floor for push ups, or do bench presses. I should build up to 10 lb weights. But don't push too fast. I asked him how I would know if I was pushing too fast. He mentioned another patient who called to say her knees hurt from all the walking. So I guess the guide is whether my muscles hurt or simply fail. But I was doing triceps extensions with ten pound weights prior to surgery. He also said that is all the weight one should need to lift for any sport.

He also said I can now go biking. I can walk longer distances than 15 minutes at a time. I no longer need to do the head movements. He said those were to inhibit scar tissue from forming on the nerves.

I still get transient pains in my neck, shoulder and arm. I can't associate them with any particular position, and they come and go unpredictably. The only thing I can somewhat connect to the pains is exertion, but I have been hardly exerting myself. My surgeon said some nerve filaments take longer to heal than others. I once had what I can only guess was a post viral syndrome neuropathy that left me with some numb spots and a finger that would not bend. But the nerves healed after about 18 months. So I will be patient.

I still have a slight sensation of pressure on my throat when I swallow, like a finger pressing against the esophagus. But there is no pain, and it improves gradually.

The incision is now a raised lump about two inches long. The surgeon said there are sutures in there which will dissolve and some remaining inflammation. He recommended aloe lotion to help prevent a visible scar. He said he does not recommend any of the treatments marketed for preventing scars. The saleswomen at the health food store said vitamin E also helps.

Energy level is good, but it will suddenly give out and I need a nap.

I am to see the neurosurgeon again in three weeks for a six week check up.

One side note. I have a tooth which has broken off. It seems it was weakened after a root canal 18 months ago. I'm looking at an implant. My surgeon says to postpone oral surgery if I can to give my neck time to heel. Oral bleeding puts bacteria in the system which can aggravate remaining inflammation from the surgery. But of course a broken tooth can become infected as well. So the surgeon says wait if you can, but have the tooth extracted if you must. But I should take antibiotics prior to any work being done. I can take 4 500 mgm. capsules of Amoxicillin prophylactically 1-2 hours prior to any invasive procedure such as dental work. Three months post surgery that will no longer be necessary.

Just to contrast different medical judgments: I saw my GP last week for my yearly physical and he said he expects I will have full recovery and be able to go running again. He argues that most of the stress from running is absorbed by the knees, hips and lower back, not the neck. He does say however no powerlifting.

I will report again in three weeks unless something changes.

[KBear]

Glad to hear you are doing so good, that's awesome!

[thumoeides]

Six week recovery

Saw neurosurgeon yesterday. He is very happy with my progress. He remarked on how much more quickly recovery occurs with arthroplasty than with fusion.

I still get transient and sometimes lingering pains in my shoulder, arm and hand, and I still feel pressure on my esophagus. But both of these seem to be very slowly improving. They all come and go and I cannot pin them down to any particular posture.

Tthe neurosurgeon felt my scar, which has decreased in size remarkably over time, and said he could still feel some sutures which have yet to dissolve. I have been putting aloe lotion on it every day to decrease its size and hardness.

Week before last I travelled to Daytona Beach Florida to grade AP government exams for one week with several hundred other government teachers from around the country. We grade the essay portions of the AP government exams. There is a big convention center with tables and we sit in groups of ten for eight hours a day grading on average about three hundred exams a day per person.

I was pretty much pain free despite sitting with my head bowed forward for long periods. One day I had some pain which grew to a 3 by the end of the day, but I took some Advil, and a martini, and it did not return. Evening walks on the beach were good as was swimming.

By the way, my artificial disc did not set off the metal detectors at the airport either coming or going. TSA did however confiscate my pocket knife I forgot in my laptop bag.

I am to continue walks and now go to the gym for some machine weights to strengthen my pectoral muscle. But still nothing over ten pounds. The important thing is good posture. Bike riding and walking improve posture. Swimming is also good. If I try anything new I should not do it every day but wait to see how I feel the next day. I should listen to my body for warning signs. I asked what signs but he said everyone is different.

Talking about possible future problems and how to avoid them--since I have degeneration and impingement at the level above the replaced disc--my neurosurgeon then said he thought I brought this on myself. I was surprised because I remembered asking him before the surgery whether anything I did caused this and he said no. I mentioned this and he claimed I never asked him directly before. He said I ignored the warning signs--pain and tightness--as described in my natural history. He mentioned a previous patient he saw that day who began going to the gym for no reason and now is miserable.

He made it clear that he thought weight lifting and running are bad and lead to injuries. Why risk injury unless it is necessary for professional sports? Professional athletes are always risking injury and often are injured. Light weights are just as good for health as heavy weights, and may be even better since in some sports heavy weights lead to increased injuries.

For anyone still reading this far I have a question. Has your surgeon told you this was your fault?

[KBear]

I am amazed at how well you are doing at 6 weeks out! As far as surgeons blaming you, in my case no, but it was clearly caused by a car wreck.