my spine

Let’s just say, my day did not go as planned.

We showed up at the Rothman Institute in King of Prussia at 11:40 for my appointment at noon. After filling out a couple dozen forms, and handing the pretty young pregnant woman my insurance card, an hour long discussion with their billing department and our insurance carrier revealed that I’m not covered for all of this. Apparently, spine doctors hate our insurance and refuse to play in their network. It’s long and sordid, but the end result is we had to fork over $265 and will end up paying a few or more thousand when this is all stitched up. heh…stitched up, get it?

anyway….

After we decided to go ahead with the appointment, it was already one o’clock. A nice young man in blue hospital duds called me back to X-ray. Normally, I refuse X-rays with a righteousnes seen only in fundamentalist christians holding pro-life, pro-death penalty signs, but not anymore. I’ve had so many X-rays and MRIs lately that I’m positively glowing. The nice young man took four X-rays, placing me in different positions with the care a child uses to set her dolls up just so.

After this, I was sent out to the waiting room to sit and wait as all the people who came in after me got taken back to see their doctors. Our long, involved discussion with the money people had used up our appointment time, so I lost my place and had to go to the end of the line. With insult and injury, I read Oprah’s magazine for the first time in my life. They had all the issues on all the tables and every one had a picture of Oprah. No mistaking that very thick magazine for Vogue or Vanity Fair or Cosmo (do they still publish Cosmo?). I didn’t get the appeal, so after a bit, I dug around and found a very slim U.S. News from last month and flipped through that. Finally, a woman called me back.

After disrobing and donning the standard gown with the open back, I waited in the slightly too cold room, staring at the pictures of my spine. Finally, Brni realized I was missing and came back, then the woman came back. She spent a goodly amount of time arranging my spine on the light box on the wall. Apparently, there is a strict protocol for the actual hanging of X-Rays: full frontal (or backal?), side-view, side bent forward and side bent backward, and the sides must all face left.

She had me explain everything I’d already filled out on the 10 page questionaire (why do they make us fill them out if they don’t read them?), examined me, oohed and ahhed as I bent over and placed my hands flat on the floor by my feet, and left to go tell the doctor of my wondrous ability. Finally, the surgeon came in, tall and good looking with an open and friendly face. Okay, now’s my chance to tell him my desire for as minimally invasive a procedure as they can muster. But, this part of the day goes the way you’d expect from the way it began…downhill.

Apparently, I not only have bulging discs and stenosis, I have spondylosis as well. My spine is unstable. My spine is misaligned. My spine is out of whack. The bone labeled L4 is tipping over L5 in a way that is just not right. I saw it on the X-ray when nobody was with me. I saw it and thought, this isn’t going to go well, I wish I’d brought Oprah back with me. I need major surgery. I need a fusion, with bone from my pelvis and titanium rods to hold it all together. I need days in the hospital and weeks in a brace and then more weeks in therapy. No micro-surgery for me.

Before he left, the surgeon asked if I’d please show him my (now famous) forward-bend.

So, then it was more forms and waivers and reams of paper all explaining that with my signature I understood that they had explained all the things that could go wrong and that I would submit to this procedure despite their warnings. And I signed all the pieces of paper, correcting the typos as I went along, holding back the tears.

Later, in an attempt to feel in control, I opened my laptop to research this procedure and the doctor and the hospital and look what I found….a webcast of an operation similar to the one I’m going to get, at the same hospital and the guy talking is my surgeon! I watched the hour long video as they used drills, chisels, mallots, wrenches and other tools to fix a woman who’s back was far worse than mine. It was fascinating! And I can tell my surgeon is competent. So, if you all want to see and hear what is going to happen with my back, go here: http://www.nlm.nih.gov/medlineplus/surgeryvideos.html and select from the list, Lumbar Laminectomy and Transforaminal Lumbar Interbody Fusion (Thomas Jefferson University Hospital, Philadelphia, PA, 11/15/2006).

Be warned, it’s graphic. But it also gives me hope. Hope that when I ask them to video tape it for me they will say yes (really!) but more importantly, it gives me hope that I’ll get my life back.

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18 responses to “my spine

  • irishkerry

    That’s some procedure
    Bionic Linda, who can still bend over in spite of the bad back! Maybe we can sell tickets ๐Ÿ™‚ It’s good to hear you talk about this with hope.

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    • irishkerry

      Re: That’s some procedure
      A couple of other notes about the general, etc. Ask about the anaesthesia before hand. Some places will at least try to add something to the mix to reduce the nausea (doesn’t always work); others will be prepared to give you something for it when you come out. My experience has always been that I wake up already cocooned in nice, warmed blankets — surely the best part of hospital stays (and you can ask for them in your room, too).
      I know I’m a little weird this way, but I always feel safe in hospitals. Maybe it’s because there’s something about Being In The Hospital that allows me to let go and let other folks take care of me. It helps that I’ve generally been blessed with excellent, caring nurses and other caregivers.
      One other piece of advice — get some of those foam earplugs to help at night. I like to put them in, then put my headphones on; the combination does a great job at screening out the icky stuff and letting in the soothing stuff.
      *more hugs*

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      • lsaboe

        Re: That’s some procedure
        good idea abt the earplugs, etc. i’m also going to bring my eye mask–the one filled with dried lavender. i’m very light sensitive and can’t sleep if i can see lights.
        so, did you watch the webcast of the surgery? if so, you’re the only one i managed to entice.
        (hugs much appreciated)

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  • Anonymous

    visualize whirled peas
    Well, it certainly isn’t the winter vacation you’d hoped for…
    Sorry that you have to have surgery. As I was telling you, my father-in-law also had surgery on his cervical vertebrae at the Rothman, and he’s about 30 years older — around 86. He had almost lost the use of one of his hands (I forget which one) and was just about getting around with a walker. After surgery he got back the use of his hand and he walks fine.
    While it’s true that Nature will heal us, sometimes she needs some help, and there really are good doctors and dedicated health personnel out there.
    Maybe you can find a little bit of time each day between now and March 5 to do some quiet meditation with whatever music you like. Visualize the doctor and Nature working together to make your back well and strong again. (Nature’s there working with the surgeon in the video … she just doesn’t let herself get recorded…you know how we women are: we never think we look good in pictures ๐Ÿ™‚
    Here are some affirmations for you:
    –Your surgeon is competent and dedicated.
    –You are going to wake up from the anesthesia
    –You are going to elude mischievous complications
    –You are going to work hard at getting better (as if you’re a stranger to hard work or something!)
    –Your hard work will be rewarded with recovery.
    –Barbara will visit you and bring you vegetarian soup.
    Holding you in the Light.
    –liberata

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  • notzathros

    If you’re going to need blood, you can bank it ahead of time. In addition, I have a goodly bit of lovely O+ lying about – you’re welcome to as much of it as you’d like – though I’ve heard tell from other consumers that it’ll make you avoid diet soda and give you cravings for dry cereal in the middle of the night for a few weeks;)
    I agree that inpatient rehab is the way to go. Let talented professionals wait on you hand and foot for a few days. You deserve the best.

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  • otcyborg

    Better living through titanium-woohoo!
    Yeah, I was scheduled for minimally invasive surgery…woke up with 14 inch incisions. Best laid plans…feh. Turned out the joints were too FUBAR once the ortho got in. Now I have really boss scars to show off. Whatevah. Get the surgery that will WORK and make you BETTER!
    Just let me know and I’ll happily provide you with “The OTcyborg Guide to Surviving General Anesthesia and Rehab.”
    Yeah ,ortho surgegies are like major contruction aren’t they?
    While they are totally different surgeries, I can tell you that I have not one scintilla of regret about having mine. Being freed of years (my case-lifetime) chronic pain was a revelation. Where are you having the surgery? Where are you rehabbing? I LOVED Bryn Mawr Rehab. Molly still smiles and waves at it when we drive past “That’s the place where Mama got all better”
    You’ve survived class with Sabum Howard-rehab will be easy by comparison ๐Ÿ™‚ Paek Bul Jool Kul, baybee!

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    • lsaboe

      yes, i’d love a copy of your “guide” as i’m really a virgin when it comes to all this…
      the surgery will be at Jefferson, downtown. after that, i’ll probably go home (god i hope it’s home!) as the only thing i’m allowed to do for 6 wks is walk–no bending no twisting, not even allowed to sit for more than 20 minutes…no nuthin until the bone graph heals. apparently, until the graph heals, there’s a possibility of the titanium rods breaking (scary shit).
      after that it’ll probably be weeks and weeks of physical therapy at the Rothman Institute in K of P.

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      • otcyborg

        Immoral support
        In no special order…
        I was allowed to wear headphones during the surgery to block out any unconcious absorbtion of the noises. Ask if this is OK. I think it helped me alot. Pick music you are willing to never hear again though. My body still vibrates like a jackhammer when I hear Jean_michel Jarre’s “Oxygene”
        You will likely be sick as a dog when you wake up from general (puking). Alas, this is normal. This is mitigated by being happy and grateful to be alive. It is also normal to be really cold-ask for blankets. The recovery room nurses are very, very used to this, and would rather you speak up about your needs. You know that “I don’t want to be a bother” thing-let it go.
        The first 2 days after surgery SUCK! The good part comes later. Meds are your friend. Drug-seek like Robert Downey Jr! There is no good reason to not have good pain management. These drugs were designed for when you have had your bones sawed apart and screws hammered into you. Use them! No brave soldiering. If you are having pain, bitch until you aren’t. It’s diva time.
        Hydrate, hydrate hydrate! It helps your body clear the anesthesia. You will need to aggressively hydrate for weeks. It helps the nausea.
        When you are on the clear liquid portion of your journey, have hard candies available-they are a clear liquid and you will probably have a sore throat. Now that I think of it-you may need someone to bring you some veggie friendly clear liquids since the hospital will try to give you Jell-o and beef broth. Doubt they have miso.
        For bed mobility issues, make friends with the biggest scariest looking dude who’s a nursing assistant. They are the ones who know what they are doing as far as moving your immobilized ass. Avoid skinny nurses.
        Bring your own hygeine products from home. They are remarkably humanizing and help get the hospital stank off you.. Bring a long handled something to scratch with. Not being able to bend and having itchy legs (another side effect of anesthesia) is maddening. They can give you Benadryl for that.
        Once allowed to eat-think fiber. General is uber-constipating. I won’t share anymore.
        Always get the pain meds BEFORE doing any sort of activity like the first time you stand up. The PT stood me up the very next day-I thought he was on crack. It took 45 minutes. The next day it only took 5 and I took 3 steps.
        Visiting hours are only an excuse to kick out annoying people. They really won’t care how long good supportive people are there.
        If offered the chance to go to inpatient rehab DO IT! no matter how much you want to go home. PT and OT can help you learn how to do a lot within your current restrictions, it is safer, and you can keep getting the good drugs. No Loki’s underfoot either.
        Titanium is good strong stuff. One a bone graft takes, it’s solid. They just have to scare the shit out of you so you behave.
        Mentally, you will be pretty stupid for about 6 weeks. Your whole bodily integrity has been fucked with. Don’t fight it. Embrace it.
        Remember, you gave birth to Jesse without anesthesia. You must be pretty butch.
        More as I think of it. Call me, write back with questions…etc

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      • lsaboe

        Re: Immoral support
        this is great stuff!!! i think i’m gonna print it out.
        thanks!

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  • notzathros

    When’s the big day? Please let me know what I can do to help. Maybe give Juliet a chat if you’re worried. She was scared to death about the hip surgery and lived in agony for years while putting it off. Now she doesn’t know why she waited so long. She got her life back. Now it’s your turn.

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    • lsaboe

      the big day is March 5th and i’m scared shitless. i have *never* had surgery or been under general anesthesia and i’m absolutely positive that i will not wake up once they put me to sleep. on the off chance i do wake up, i know i’ll be felled by an embolism or some other ridiculously rare complication, and if i survive even the rarest of catastrophes, i will, without doubt, be paralyzed and STILL in pain.
      my only shred of silver (as in lining) to this whole thing is the plan to design an intriguing and somewhat twisted tattoo to enhance my scars.
      ogod, do i need whatever support (immoral or otherwise) you all are willing to give.
      (seriously, thanks!)

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  • c_bob

    Let us know if there is anything we can do to help. (Considering how close we are!), especially after the surgery but before as well.
    I know this is a dramatic step, but if it can allow you live your life more fully then it sounds worth the risk and difficulties.
    I know I speak for the both of us.
    C.

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  • earlofgrey

    I have been and will be cheering/praying/hoping/magic dancing for you.

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  • uneedak1u

    You WILL get your life back, I promise. I had an anterior cervical diskectomy and fusion in April ’04, and while it sucks mightily that I needed to have it done in the first place, especially at 35, I have not for a single day regretted it.
    Like you, I have bulging and ruptured discs (5 bulging [C3-4, C4-5, C5-6, T9-10 and L4-5] and 1 ruptured [L5-S1] at the beginning of this process). After a year’s worth of conservative treatment, including epidural steroid shots, physical therapy and myriad stretching and chiropractic, I was told that I really needed to be able to use my left arm, which just wasn’t going to happen without surgery. I scheduled it, but put it off for several months due to work scheduling constraints.
    I had the surgery at the end of April ’04. They removed my degenerating disk at C4-5 and inserted cadaver bone (they didn’t want to do a graft from my hip due to my other arthritis issues) and fused the whole thing together with a titanium plate. I was also told to be prepared that I may need to switch it to a 2- or 3-level fusion later if the disks at C3-4 and/or C5-6 continue to degenerate.
    I was in a hard collar for 4 weeks, then a soft collar for another 4 weeks, and had roughly 12 weeks of physical therapy.
    I won’t lie to you: it’s not pleasant to go through, and if you’re anywhere near as impatient as me, you’ll find yourself frustrated at the snail’s pace your recovery can take. But to me, it was infinitely more tolerable than trying to live my life on Vicodin, which I did for about 6 months before the surgery.
    I’ve had a lot of surgeries for various reasons, and this one scared the crap out of me, but I’m so, so glad that I did it. Even when I have some residual tightness in the tendons and ligaments around the area of the surgery, it’s NOTHING compared to the pain I had before.
    And Rothman is excellent. I got a second opinion there, which concurred with my first one.
    FYI, my uncle had a diskectomy and fusion at L4-5 the same week I had my surgery. He was up walking the next day, and was home in I think 3 days. And he’s doing beautifully – much like me, he says he doesn’t know why he waited so long.
    So, there you have it. It’s something I weighed very, very carefully, and didn’t want to do, and thought I’d end up regretting, but it was one of the best decisions I ever made.
    Good luck, and if you want to talk more about it, even if it’s just to blow off some steam, you know where to find me.

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    • lsaboe

      wow. this is so helpful to hear. i’ve NEVER had surgery, general anesthesia or anything, so this is a very scary proposition for me to even ponder. but…i’ve exhausted all other avenues, medical as well as alternative with a few quacks thrown in for good measure. i simply have no choice. i need to be able to stand up, walk and sit, which right now, i can’t do without the help of narcotics, and then i can only stand for about 10 minutes before my feet go numb. it’s no way to live.
      and thanks for the offer to talk…i may take you up on it.

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  • zjman

    *peace, love, and strength*
    correcting the typos as I went along
    Here, I thought I was the only one who did that!

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  • westlinwind

    *ponders detailed instructions and drawings to ink on her back for the surgeons*
    Love you, Lady.

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  • brni

    remember… get the tattoo AFTER the surgery, not before.
    and it’s not their fault that people in new mexico don’t know how to spell “albequerque”.
    *very big hugs*

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