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January 22, 2013

News on life after the L5-S1 slice and dice

Posted in: healthcare

I had the very necessary surgery on Friday, January 18, 2013, so here’s where I am after the bilateral discectomy now that I’m a few days post-op.

The good news is that the surgery was successful; 95% of the herniation was removed, the not-so-great news is that the surgeon found that the disc was so calcified that it had to have been herniated for at least a year (!)  – I don’t remember having any back pain like that a year ago. The acute attack I experienced that put me on this path was in August 2012. Anyway, so instead of slicing away all of the herniated disc tissue, he had to chisel more than half of it out. He actually used the word “chisel” when describing it to Kate, so I imagine myself as a slab of meat on the table being chopped away on.
The fact that the herniation was there much longer means nerves may be permanently damaged. We won’t know how much for several months. I am doing OK; the major shooting pains caused by the herniation is gone.

The chop shop

My surgery arrival time was 10:15 AM. Kate and I were taken to the pre-op room, where we waited for the usual — prepping, IV insertion (in on first try!). TV was programmed on “E”, so we were stuck watching Joan Rivers and Kelly Osbourne blathering on about fashion on the Golden Globes for a while. The nurse attending to me talked about people she’s seen come in who are addicted to plastic surgery…hmm.

NOTE:  All of the staff at the hospital treated us so well, recognizing Kate as my spouse. It’s worth mentioning because you can’t take that for granted everywhere. North Carolina actually has had a law on the books allowing a patient to designate health care proxy for some time; this predates President Obama’s executive order to medical facilities to treat same-sex partners as spouses if it receives federal funds.

I was in the operating room at 1PM and my wife Kate reports that I was out of surgery around 4PM. This was supposed to be a 90-minute operation, but there was a complication once the surgeon got cut me open and took a look at the spine.

The photo at left was taken just after I was wheeled from recovery to the room that I stayed in overnight. I was still very groggy, but even then, I could feel immediate relief in my left leg, which was very numb and constantly had shooting pains that felt like electrical charges going down it. Both feet are completely numb, tops and bottoms. The bottom remained numb, I expected that since I have neuropathy that predates the herniation, I did have great relief on the tops of my feet, but it’s not a guarantee that all effects are resolved right away, if at all.

More below the fold.

Saturday

Didn’t sleep much overnight because the nurses were in every 30 minutes to an hour to check vitals. I was able to get up twice to go to the bathroom on my own, though it required the nurse to unhook me from all of the machines and walk my IV rack into the bathroom for me. Getting in and out of bed was a big production and it hurt like hell, but I could do it.

I hadn’t eaten since 6:30 PM on Thursday but was not really that hungry post-op. I had a little bit of chicken soup and saltines before I passed out in the room on Friday to keep my blood sugar stable, but didn’t have a meal until the AM. Some egg whites, bacon and toast. I was actually feeling pretty good, albeit sore (pain level around 6.5 out of 10), and was ready for discharge by 11AM, after getting dressed and walking around the ward for about 2 minutes. I was surprised that while I was slow, my limp was now completely gone!

I got my paperwork and instructions (no shower for 2 days; no bending, twisting, lifting more than 5 lbs for the next six weeks; how to roll out of bed like a log, some PT exercises), and was taken down to the car, carefully loaded into the Subaru, and Kate drove me home.

I had a meal, then walked around the house several times to the point of fatigue, and took my pain meds and went to bed early (around 6PM). Woke up with a fever of 101. Took some Tylenol and it went down.

Sunday

Was up several times during the night, but was up around 8 AM. Completed a walk around my cul-de-sac (actually the entire block)! It was a nice day here in Durham — in the 60s — so I took advantage of it for my PT. I’m beat, but this is what my very sore post-op back needs to heal. I’m supposed to walk at least 5 minutes, two to three times a day to keep that scarring down.

The best part of the walk was being able to feel my left leg again; my ankle and feet are still numb, but this is still a huge improvement. After that I needed a nap big time. I posted the pic at right on Facebook and received a ton of support from my peeps.

Fever

I was exhausted from the walk, and got into my jammies for a nap. At some point I felt really cold, actually to the point of my teeth chattering. I knew that wasn’t good, so I got up and took my temp. It was 101.5. A half hour later it was 102.5. That told me it was time to call the doctor. He suggested the obvious — take Tylenol every few hours to get it down, and see if it stays down. It’s unlikely at this point to be infection of the incision (too soon), but a reaction to the anesthesia (though I’m having no respiratory effects, something unusual for me). It’s just watch and wait.

It was a pretty miserable night, fighting it every 2-3 hours or so, getting up while half dazed and checking my temp and taking pain meds and/or Tylenol. I had to get up because I needed to walk around anyway for my back, but it meant very little sleep.

By the next AM the fever broke. The doctor said if this keeps up to come in. He said if it’s infection, you’ll see a fever around day 5 or so.

Monday

Still very sore, and ran a fever this night as well, though it was easily controlled with less doses of Tylenol. I saw my incision site in the mirror for the first time; it is really hideous, bruised and all, but it’s healing ok at the present time. Kate has been a blessing and is patient as a saint. She has to help me dress, put on socks, clean and dress the wound, etc. I will  have a hard time getting up from a seated position and getting into/out of bed for a while; that’s to be expected. I rode in the car to go to the drug store again to get more tegaderm bandages, and walk around. As you might imagine, the outings/walks are tiring, but it’s good for the back to keep moving.

I managed to stay up all day without a nap and didn’t use any pain meds between 4AM and 5PM when I went to bed. I tend to have a high pain threshold since I already live with the chronic pain of rheumatoid arthritis and fibromyalgia, so it’s easy to step down off of sledgehammer meds.

To feel useful, I folded and put away some laundry, being careful not to twist or bend — Kate got me one of those grip and grab devices to pick up things off of the floor or above my head, so it’s a godsend.

The annoying issue aside from the fever is the fact that today the numbness in my left leg returned. It was completely gone right after surgery. My guess is there’s swelling inside from the operation itself that is pressing on the nerve again, but it should go down in time. Messing around there as much as he did, it’s not surprising there is a lot of inflammation and bruising. This is apparently normal, so I was only disappointed, not panicked. I’m still optimistic about recovery though; I knew in advance it would take months to know what “full recovery” will look like.

I expect to get out again for additional walks this week, and to take it easy. After all, if I don’t take the time to heal, there is a much greater chance of re-herniation and a trip by to the operating room, something I definitely want to avoid.

Will be back to more blogging as I can. As you might imagine, my concentration level isn’t what it could be, lol. I am, however, on social media when I’m not passed out or walking. :)


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