My 6 week check!

Well, I had my 6 week check-up yesterday (yes, I do know that I am over 7 weeks, but this is the NHS we're talking about) and it was all very uneventful and rather unexciting. I didn’t get to see my surgeon, but since he is some kind of Scarlet Pimpernel type creature who only seems to be available to you if you pay him large sums of money to visit him privately, I wasn’t surprised. What I was a bit surprised by though was the fact that I didn’t even see another member of the surgical team, or even one of the doctors that I had seen when I was in hospital. Ah well, I guess they can all look at the x-rays later, unencumbered by the troublesome patient!

Anyway, the registrar that I saw examined the x-rays that I had taken and checked that none of that my current hardware had come loose. Thankfully it hadn’t although new bone growth (from the bone grafts) couldn't yet be seen. He seemed pleased with my general progress and recovery from the operation, telling me that they did most of these ops on teenagers (tell me something I don’t know), and that it all got much harder once you were past the age of 17! I guess I’m just a couple of years past ideal then…

There were really only two other pieces of news – a vertical line drawn on my most recent x-ray shows that I am still not quite straight, although now my vertical line passes through my SI joint (see http://healthgate.partners.org/images/si55550402.jpg) rather than through the outside of my hip. To say this is a massive improvement is an understatement.

As to the matter of the second op, well that is still quite a possibility, but given that I am now over 7 weeks post op, there is no rush to make the decision. In fact, he actually said that it would be best that I should recover fully from this one first which I was pretty pleased to hear. The concern is that my thoracic curve will act as a lever on the point where my hardware ends causing me problems in the future. They will monitor it closely and I get to go back to see him (or even the Scarlet Pimpernel) in 3 months time. At least the surgery is much less invasive than what I have had done, so every cloud has a silver lining and if it does prove necessary, then better to do it now before I get even older!!!

I do have one last thing to say and that is a really big "Thank You!" for all the flowers - just as one bunch seems to fade and die then another pitches up on the doorstep to take it's place. I am really, really grateful - so THANK YOU!

7 weeks post op today…..

….gosh, is it really that long? 7 weeks is almost 2 months after all. In some ways it feels a lifetime ago that I came out of surgery and then other times it feels like just a couple of weeks. How it varies depends on how much the pain impacts on what has become my daily life – although the situation of having hubby as my skivvy as well as working full time is only temporary (however tempting it is to let him keep up the good work!)

It really is all contrasts at the moment. Days like today, when I am sore, I wonder if I will ever get back to the way I was – actually I sincerely hope that I will be a new improved version of the way I was – and that’s without the liposuction or leg extensions! But then again, there are days like yesterday, when I felt like I was ready to rejoin humanity and get back to my life (or at least do so very, very soon). There seems to be no in between. I think there are some very simple equations that explain it all:

Today = feeling dodgy + extras painkillers + sleep = Feel good tomorrow
Today = feel good + extra walking + do extra + sleep = Feel dodgy tomorrow

Simple eh!?

On a different note, I cannot believe how many hits this blog has had and I just hope that reading my experiences is a help to others who are going through or about to go through this same op. Having said that, aren’t you all just bored of all my ramblings by now??

One last thing, the www links page has been updated to include all the other links I have come across, rather than just those mentioned in the blog so far. I hope they are useful too!

I'm still waiting for *that* moment...

I have heard of many people who have cried when they first see their x-rays or when they first see their new straight back and ever since I was operated on, I have been waiting for it to happen to me. So far it hasn’t and I’m a bit disappointed….

I firstly expected to be overwhelmed when I first saw my x-rays but to be honest I just had a whole other set of emotions going on. To start with, I had been pretty ill that day and I was very uncomfortable and then when I saw the x-ray, well, yes I was impressed in a very wow kind of way, but also I was the teensiest bit disappointed that I wasn’t any straighter! Now don’t get me wrong, I wasn’t expecting 100% correction, but you see such amazing before and after x-rays on some of the forums, that you always hope a little bit that maybe you would be one of them.

A couple of days later, the physios brought me a full length mirror and I saw myself stood upright and straight for the first time. This will be it I thought – that moment(!), well, it wasn’t. Again, I went wow (actually I went WOW!!) but still no waterworks. Then there was the measuring moment when I found out I had grown two inches and then there are all those comments from people about how tall and straight I look – all awesome and wonderful but nothing to start me blubbing. In fact, apart from a couple of bad pain occasions the only time I’ve really cried is when I received some flowers that had been specially ordered in my favourite colour.

So what is with all this? I was starting to become afraid that it was just because I was the hard hearted type but it has just occurred to me that there is a probable (and logical) explanation. I soon get my review appointment in which they will tell me whether I am to go back under the knife and be changed again – I think I just don’t want to get too happy about the way things are right now until I know that this is the way they will stay.

In the meantime – I still have that top that I would never have worn before the surgery to go. Maybe that will do it!

On the up (or not)

Well, not, when it comes to getting out of bed this morning….

That sounds bad, but actually it is really good. So far, I have woken in the mornings, uncomfortable and stiff and although I know it will hurt, ready to get out of bed to try and get comfy somewhere else. Well, this morning, as I sipped my morning coffee, propped up on my pillows I didn’t want to move. I was warm, cosy and pretty much pain free. Wow!

In fact, this follows on from a pretty good day yesterday where we went out (nothing exciting only necessary shopping) and then when we got back I had a really nice shower. So far, sitting without leaning against something has been the hardest thing to do so the shower seat (which is just a board across the bath) has been hard work. Yesterday, the pleasure pain balance (pleasure of the shower versus the pain of sitting without support) finally came down firmly onto the pleasure side.

Yay! I am definitely improving!

Always a step back…

…before one forward of course!

Well, I’ve been expecting it, but it’s still a disappointment. Today I am pretty sore again and don’t feel like doing too much at all. I decided to do a quick update to my blog and then go back and slob out some more in front of the goggle box. Thanks goodness for the Commonwealth Games – saving me from repeats of daytime soaps and gawd knows what else. I don’t even really feel much like reading although I may get back to some later. I have had a pretty varied list of reading material that I have gone through over the last few weeks from Jeremy Clarkson, Bernard Cornwell, J.K. Rowling, Clive Cussler and Janet Evanovich through to Dean Koontz. Read into that what you will, it’s a pretty eclectic mix but doesn’t contain much in the way of classics! Also on my ‘to read’ shelf is some Bill Bryson, Stephen King, Tom Sharpe and Ben Elton along with a huge pile of Sudoku books (note to self, do not mention before Christmas/birthday that you like Sudoku – I had enough sudoku presents to drown in last year). BTW, psychiatric commentary on my choice of books will not be appreciated!

Enough of books, I’m off to my comfy chair! Suffice it to say that I am still better than I was a little while ago and in the way of these things I know I will be on the up again tomorrow. In the meantime, please all get out your violins…

6 weeks ago today….

Ah yes, it really is that long. Actually for a 6 week report I have to say I feel pretty good. At some point in the last week something changed. It was the day that hubby phoned me and asked how I was and I said “good!” For 2 days after I wasn’t good but the not good was different from before (ie more tired than painful) and then Sunday and Monday I had 2 good days in a row. In fact I feel pretty good today too. I still have a lot of pain but the nerve pain is finally under control and I have cut my major pain meds to half at night. What bugs me the most is the swelling – I feel like I have a large balloon filled with water under my skin – I wish it would go but I know it could take months. I can be patient I guess – yes, yes, really I can - there's no need to look so cynical…

I am still phased out by my reflection. Every time I look in the mirror it looks odd and I wonder how long it will take until I am used to it. I have been so crooked for so long that my brain just doesn’t want to believe it yet. I cannot believe that stripey jumpers (which I’ve always liked) now just look straight across – I think I shall have to get some knitted with diagonal stripes! Oh yes, and then there’s the thing that some of my friends are getting a crick in their neck talking to me – I guess I don’t look right unless you tip your head to one side.

I can now toddle around quite safely with only one crutch. I’m sure my physio won’t be very happy (uneven stresses and all that) but at least it makes carrying things easier. Still haven’t tried soup tho’…..

I think that’s all for this update – things are going well – looks like everyone who told me I would start to feel much better at 6 weeks were right.

Before and after...

Pre-op Aug 2005 & Post-op Feb 2006

What can say about this - it speaks volumes itself* so for once in my life I will shut up....

.... and yes they are both me

* Actually I will say a few somethings....... firstly, I wore the bra to make the two pictures as similar as possible - it hurt my scar so I took it straight off afterwards.........secondly the red splodge on my low left back is the chest drain site - I know, I know, it is nowhere near my chest but it is healing well now ........and finally the lumpy bit next to and below above mentioned chest drain site is an extension of the yikky swelling that extends into my preggo style belly. Nuff said!

Useful stuff for your home

I have found over the last few weeks that I have not made any lists and I am getting withdrawal symptoms…

Seriously, there are a couple of lists of things that I’ve found really helpful and maybe useful to someone else too. The first one (which I’ll tackle today) is what aids I’ve found really helpful around the house since I got home. Our house currently looks like an old folks home with all the bits and pieces of clinical looking equipment hanging around but would I have it any other way – gosh no! In the hospital someone from the Occupational Therapy department came to see me and assessed what I needed. For several nights hubby was going home with all kinds of aluminium and plastic items – what fun eh? Anyway, I have found some of this stuff really useful – nay vital and so if you can’t get stuff from OT (or whatever the system is where you live), then consider buying what you need.

• First and foremost is a ‘handy helper’. Most people think these are handy items for picking up stuff from the floor. Wrong! These little gadgets are an absolute lifesaver for everything from getting you dressed in the morning (more in my next posting) to sliding furniture closer to you – just get a strong one! http://www.benefitsnowshop.co.uk/shop/detail.asp?bid=AZDQ-543431&item=1256
• I have also found a toilet surround (http://www.benefitsnowshop.co.uk/shop/detail.asp?bid=AZDQ-543431&item=4160) to be incredibly helpful (if you are taller you may want a seat raiser too). This will help you stand up when you are done without bending or hurting anything.
• I cannot live without my bed leaver http://www.benefitsnowshop.co.uk/shop/detail/4377.htm This is great to help you turn in the night, lower yourself down onto the bed at night and a help to swing your feet to the ground while getting off the bed. You just need to be careful not to twist when using it but it has been a real lifesaver to me.
  

Some other stuff that I didn’t get from OT but has also been useful is:

• A sports water bottle is brilliant – you need water for tablets and don’t want to be lifting heavy jugs or running out to the kitchen all the time – also you can drink out of it while lying down.
• I have also found a tablet sorter useful since I have to take lots of stuff spaced through the day.
• I use an insulated mug with a lid for hot drinks. I don’t spill it on the way back from the kitchen and also you can hang onto it and a crutch at the same time without leaving a trail of coffee behind you….
• A large lightweight shawl – wrap it round you – cover your knees (see old folks home..) whatever – it’s really handy!

Finally, you may find more ideas here : http://www.scoliosislinks.com/PreparingforSurgery.htm

Anyway, think that’s about it for now – I feel much calmer for making a list….

Scars 'n' stuff

Well, I thought it was time to get a picture up here of my great scar - it doesn't show it all since it curves round both front and back, but you get the gist. This was taken at 4 weeks and a couple of days post op and the big white dressing is the one covering my chest drain site. Yeah, I know, my chest must be in a funny place, looks more like a high waisted drain site to me but I guess they had to make the hole somewhere! You can still get to see some of my preggo belly but I did try and suck it in a bit (hee hee!). The piccie also shows a bit of my thoracic rib hump – funnily enough I think that sticks out a bit more now - but it may just be 'cos I don't seem to have a lumbar one any more! You see, precisely where my dressing is in the photo, there used to be a big lump sticking out and now it’s gone. I actually keep wondering where it has gone and almost half expect it to pop out again suddenly in much the same way that Alien does in the first film! Anyway, if you are desperate to see a better picture of the new style rib hump you'll have to go look in the album - I just didn't think it was interesting enough to post here.



Another bit of news (that I think is really great) is that my nerve pain is settling a lot. Last night I actually took my evening dose of nerve painkillers 30 minutes late. Given that a week ago I was crawling up the walls for an hour before they were due and pondering on the various options of screaming, crying, throwing something or even contemplating amputation (from the neck down, of course), then this is a major step forward. When the painkillers wear down now, it is like a major dose of ‘restless legs’ – I can bear to be touched (phew!) and I am even contemplating jeans (if I can get them done up over the belly!). The one and only time I tried jeans since I came home, the feel of the fabric itself was enough for me to tell hubby to pull them off quick (and just not for the right reasons) and that was while the tablets were working! I won't be stopping taking them for a while (that's for sure) but at least things are starting to get much more manageable. Every day I feel a little better in some way, but this is a biggie....

5 Weeks Ago Today…

Are you getting a deja-vue feeling here… Seriously, so far I have improved a bit every day, but nothing has happened that I would shout from the rooftops about, but I do have some news.

My scar is healed very well (in fact without meaning to gross you out too much, my last scab came off today) although bits of it are still pretty pink and my chest drain site has finally had the all clear. I can take a shower just as soon as hubby gets home from work – I shall be making noises just like on the Herbal Essences shampoo ads I am sure (and it won’t have much to do with hubby beyond his help to actually get in the darn shower (which is over the bath))! My preggo belly is also much smaller – I still don’t have the tummy I had but I can at least see my feet past it now (hee hee!).

I can now hobble around with just one crutch (but I’m not much good at it – altho’ by comparison I am positively speedy with two) and all in all, I am starting to feel like moving around much more. I have gone from oohing and owwing at every move, to wincing at every move, to moving sometimes without wincing, to now moving mostly without wincing, oohing or owwing at all…except first thing in the mornings - but I used to get stiff and ooh and ow a bit then before the op so I guess I can’t complain too much. I would be lying if I said there wasn't still plenty of pain, but at least it seems much more manageable now. Something really odd, is that around my rib (or lack of it) often feels really tight – like someone has me wrapped in a band and is squeezing it inwards – odd but not vastly painful. Something else which isn’t painful at all is around the incision site. In fact, it’s mostly completely numb. Now I know from other people (and from past operations) that the skin around an incision goes numb but does eventually come back to life. Yep – I have just poked my appendix scar (which I also remember went numb) – I can definitely feel it now. Anyway, for most of my new (awesomely huge) scar, I have an area for around 2” each side which is numb.

The only other update news I have is that I tried halving my night time dose of painkillers and found it to be not a great idea. To be fair I was not in agony, but I was uncomfortable enough that I didn’t sleep much. Given that I know that sleep (for me) is a great healer I decided to give myself another week before trying again. Once I can get that dose cut down then I can hopefully start to decrease doses and get weaned off the ‘heavier’ stuff. Just as long as I can sleep I’ll be happy….

Eeer Ummm Errrr Ummm … Making Whoopee

Well, I know that I’m not really quite up to leaping off the top of the wardrobe and swinging from the chandelier just yet (and besides which, hubby is too tired to do anything in bed except snore at the moment after all this looking after me) but all the same, at some point this subject is going to have to be tackled. When, where, and more to the point – how? Well, yes, I know the how in terms of the birds and the bees and all that, but what position isn’t going to result in either me feeling like I am being killed (and therefore wanting to kill hubby) – how many things are just going to be impossible – OK, OK – how many extra things! Well, would you believe – help is at hand for this tricky little subject (and for all you dirty minded people out there – please ignore the use of the word hand).

There is a book (and a video) to help in exactly this kind of situation – apparently all the participants are clothed, so this is no naughty peep show, but instead is a proper medical approach to a difficult subject – not only for post surgery, but for anyone at all with back pain. Sadly the book and video are only available in the USA, but the rest of us can download the e-book of “Sex and Back Pain” for just $3. So far, over 300,000 copies of this book have been distributed, so it must be saying something sensible.

Anyway, you can check it all out at:
http://www.impaccusa.com/frameset.html
Just follow the link in the left hand frame (it's close to the bottom of the list); you can also get to it from the E-book link in the same list. From the E-book link you can view a sample page and table of contents too.

Ambush!! (Cat style)

The cats are trying a new tactic in their efforts to aid my nimble footwork. I just went into the hall to discover a veritable obstacle course of a large number of cat toys - I have no idea where they all came from but know that getting to the kitchen will involve lots of extra fun whilst I use my 'helping hand' like a hockey stick and bat them out of the way. I am sure that the cats will think this some exciting new game and will want to join in. Ah well, I guess I have to fill my days somehow...

Links to useful links

I decided today that this blog was getting a bit too unwieldy to people who were just looking for information so I have set up two new links.

The first links to a photobucket album which shows all my spine pictures. It keeps them all in one place and I can add to it easily as I get more. You can get to it by clicking here - Warped Woman's Photobucket Album or by clicking the first Link on the right hand side of this page.

The second link is all about information. I have put a lot of information in this blog with links to other useful sites, but I'm aware that it's not always easy to find what you want. I have now set up a page which contains nothing at all but these links. I have separated them into categories and they each have a simple heading (rather than just showing you the http:// address) so hopefully will be easy to navigate. You can get to it by clicking on WWW (Warped Woman's Wonderings) links page or by clicking the second Link on the right hand side of this page.

Let me know if you have any problem with any of the links not working and I will see what I can do to fix it.

So what is this nerve pain anyway?

There has been a lot of mention in both hubby’s entries and mine about this dratted nerve pain and I’m figuring that not everyone knows what it means. I know how I got it …and no I won’t simply be flippant and say – I got it from the surgery! I woke up from the anaesthetic and had no pain but heck I was wired up to all kind of intravenous stuff which kept me happy so there’s no surprise there.

Anyway, we’ll ignore the false sense of non pain from that and concentrate on what happened once they took my happy button away. I (obviously) had a lot of pain that I would label as post-operative. That is, all around my incision and my chest drain hurt – heck, they’d just slashed a large hole in me, what did I expect?

Nope all that was Ok, but what I didn’t expect was the nerve pain (see I may be rambling but I’m getting there). Once I was awake(ish) I found that I’d lost some feeling in my left thigh, groin and around my buttock. Its only surface sensation (and the same as lots of other areas in my feet and legs) so in itself is no real biggie. Around the edges of this area though really hurts – it’s the kind of pain that makes you skin hypersensitive and that goes right through you in the way that scraping your fingernails down a blackboard does*. You can’t touch it, the bedclothes are torture and any clothing feels like sandpaper or worse. It’s like super-bad sunburnt skin or like someone has taken a cheese grater to you and then sat you in a salt bath. It is seriously yuk and was the only thing that reduced me to tears in the hospital! Anyway, it’s been caused by stretching my spinal cord around and since it was already damaged/deformed it decided to complain at the rough treatment. The bad news is that it may take as long as a year to settle down – the good news is that there are specific drugs for nerve pain and once they’ve built up (takes about 2 weeks) – they work! Yep, thank goodness they really do (even if they do wear off a bit before the next dose is due. Grrr! )

Since I’m on the subject of pain, I thought I’d mention a couple of other things that might help you if you are trying to identify what type of pain you have. Muscle pain usually hurts more if you try and move, but may be fine if you stay still. Everyone has had a stiff neck after sleeping funny at some point in their lives – that’s normally muscle pain. Anti inflammatory painkillers are usually used to treat this. Muscle spasms are related but different. You get hit by a muscle spasm and you’re not going to move – in fact, you know that if you try and move the teeniest bit you will be screaming your way to the ceiling. You get one of these, you’ll know what it is – and tablets will work way too slowly (you try not breathing for 30 minutes while you wait for the tabs to kick in!) – I always use heat or massage (if you can stand it) for this. Lastly, there’s bone pain – this is relentless and hurts whatever you do – constant grinding tooth-achey feeling.

So that’s pain – and here’s a really useful page which explains the type of painkillers available and how and why they are used. If you suffer from regular pain, it’s worth looking at. Click here for a useful page on Pain Management


*For my younger readers, a blackboard was an archaic torture device used by teachers back in the Dark Ages when I was in school. Although many teachers of the time would have you believe this was nothing more than an early forerunner of the visual aid, it was in fact it was a device used to torture generations of small children. Fingernails were dragged down this board creating an excruciating noise which was used to punish actions such as talking in class or not paying attention. Interestingly, the item used for marking the board (called chalk) was another type of torture device and was used by hurling across the room to strike the offending child. Many teachers could rival the best fast bowlers in terms of both their speed and accuracy. Of course, all this would be termed as child abuse in this day and age – which may be why the white board was invented…

4 weeks ago today...

At exactly this time 4 weeks ago today I was asleep and my surgeon was just about to make his first incision. The time since has mostly passed in a blur – but I guess that might have something to do with the drugs…

Time now is passing a bit slower – partly because hubby has now gone back to work and I am on my own in the house – actually, that’s not strictly true as I have my 2 cats to try and trip me up so I’m not alone. They are trying to be helpful I think as by trying to stay upright whilst avoiding them means I am learning to balance better (umm I think)! Actually (very sweet this) – every time I do something that makes me wince or swear a bit my little baby boy jumps up on my lap and nuzzles at my face to make sure I’m OK. Little baby girl is not so considerate - she just jumps on all my sore bits in bed which shows something (dunno what, but something!) – probably that I have more boy appeal than girl (pleased to hear it really!)

Being on my own is interesting – we have one of these long thin houses where the kitchen is out the back and must be at least 3 miles from the lounge (I know, I know I’ve been told a million times not to exaggerate) – at least that’s what it feels like when I try to get there with my crutches. Oh yes, and how do you carry coffee and toast while using crutches – answer – you don’t, you use your wheelchair and balance things on your lap. I’m finding ways round stuff whilst still only doing the minimum that I have to. Hubby is still trying to do everything and getting exhausted in the process – I can’t wait until I am fit enough to help him out a bit.

Anyway, finishing the rambling update – moving is getting easier. Nerve pain is under control until the painkillers wear off so I only get a couple of spells of an hour or so grimacing each day. Post operative pain is still sore but no longer agony. My left leg is marginally improved but that suits me fine – any improvement is good and its early days yet. My scar is looking good and it’s less than a week before I finally (hopefully) get my dressing off and can shower (yippee). So, all in all, I think I feel quite positive today!

I’m full of advice me

This is just a bunch of random mumblings that occurred to me when I was in hospital – its odd stuff, but if you’re getting surgery you may want to know it!

• Anything you try and do after surgery hurts more than you think it will, takes longer to complete and generally exhausts you. Well, I’m sure you wouldn’t think that washing could take an hour and make you feel like you’ve run a marathon – but it does!
• Learn hospital routines – when they get you up and when lunch comes etc. Hey, when you know how long ‘til the next exciting thing to happen, the day will go faster (well that’s what I found anyway!).
• Take all the drugs they offer you – don’t be brave. The best thing you can do for yourself is get moving as soon as you are allowed – you can’t do this is you are in agony.
• Take an interest in your drugs – why you are getting what you are getting and when. This will help when you get home as you will already be in a routine.
• If you have a chest drain and you need to turn, try not to roll on top of it. It will hurt (oh boy will it!). Be brave when they take it out – and don’t worry too much about that either as it’s all over pretty fast!
• Drink lots – you don’t want an infection down there to add to all your other woes – besides which, it will help keep your blood pressure stable (yes really!)
• Eat as soon as you can, your body needs calories to heal.
• When you wake up from your operation you will be all puffy and feel like the Michelin man – this will pass in a few days but makes you look and feel pretty weird.
• Wet wipes are nice when you are stuck in bed – yes, I know there are bed baths but still….

Thinks that’s all the odd stuff I wanted to tell you apart from the fact that if you want a Chippendale in hospital with you, take your own – none of the male nurses quite hit the mark there!

Snap, Crackle and….

…Pop! My upper spine is making some very odd noises – not exactly snapping and crackling, but its been doing quite a bit of gentle popping – I’m not worried, as I’ve been told it’s quite common…and it doesn’t hurt. It is kinda odd tho’ and I can only assume its things adjusting to, and settling into their new position. I’d like to think I’m stretching out some more only that makes me sound like I’m not happy with growing only 2 inches – I know I always dreamed of being 5 ft, but I don’t wish to sound too grasping!

I’m glad my upper back doesn’t hurt – the rest of it screams loud enough to make up for it though. I’m just wondering where my magical 3 weeks is. I have been told that at 3 weeks everything starts to get better but at 3 weeks 5 days I’m not getting to feel that. To be fair at 3 weeks 3 days I managed to move a few times without wincing so maybe I am getting there! Seriously each day is an improvement on the last and something gets easier – at least the pain stops me from getting too active and dislodging all my hardware!

One last bit of news, I went to see the nurse again about my chest drain site. It is looking much better with all traces of infection nearly gone (thank goodness). I still got a new dressing and a no shower instruction and have to go back next Tuesday. All being well, I shall climb into the shower next Wednesday morning and you won’t see me until Thursday….
(Yes, I have noticed that this is a bath but you get the idea!)

So what happens on surgery day?

I know that many people who are awaiting spinal surgery will never have had any kind of operation before and this being a big one; it’s going to be pretty scary. While I was in hospital and starting to recover, a lady came in for a knee op – she was terrified and mostly because she had no idea what was going to happen. She wasn’t afraid of the operation particularly, or even of the recovery – just the unknown of what would actually happen on surgery day. Funnily enough this has been mentioned to me before so I thought I’d tell you what went on in my hospital and even though different hospitals will vary, at least you’ll have some idea. I hope it’s a help anyway.

Here in the UK, you are usually called in the day before your op – given a bed and a locker and you get to sit there and be visited by a succession of nurses who check your blood pressure and temperature and ask you lots of questions about your general health. They organise some armbands for you with your name and address on (just in case you forget who you are) and give you extra bands for any important allergies. Depending on when your surgery is the following day, they will put a "Nil by Mouth" sign up to show that you are not allowed to eat (its for about 12 hours before surgery). Late in the day they should be able to give you a time for your surgery – mine was set for 11.30 am although this may be delayed or brought forward slightly depending on how the cases before yours go. On this day you may also see the anaesthetist and your surgeon. They both want to check up to make sure you are OK and to explain procedures – if you have questions, they will be happy to answer them. I didn’t actually see the anaesthetist until the morning of my op but only because it just varies a bit from place to place.

On the morning of the op, you will normally be asked to shower and make sure you have no make-up, nail varnish, hair spray or deodorant on – a nurse will come round with another whole bunch of questions about that. You will have to remove any jewellery – although normally they will put tape over wedding rings and you can carry on wearing them. You will have to put on a very fetching hospital gown which does up down the back and gapes to show your assets – don’t worry though – they will mostly be covered by the fetching paper knickers that you also get to wear! After that, they put on some smashing stockings too – they are very tight but prevent DVT so are well worth having. All in all, with your knickers, gown and stockings you suddenly become some high fashion icon (not!)

If you are very nervous, you may get a mild sedative to keep you calm before the operation – no-one wants you to be upset, nervous or frightened by anything that is going to happen to you today. The next thing to happen is that a porter will take you to the operating theatre area – they are very experienced at dealing with nervous patients and keep up a constant chatter to take you mind off things! Their job is to take you into the anaesthetist’s little room. The anaesthetist will have a couple of assistants and often there is music playing – they are very calm and say nice things to you to keep you happy. Your surgeon may pop in to say hello and then the anaesthetist will ask for your arm so he can give you a ‘sharp scratch’ as they insert the anaesthetic. They may ask you to count backwards from 10 – you are lucky if you can get to 8 before you are asleep – yes it really is that fast! Everything else is done while you are asleep and dreaming of happy things and so you really have nothing else to worry about ……..

Some piccies for you...

Aha, I have finally decided to get round to posting some nice piccies for you. They're not the greatest images as the pre-op and post-op were taken held in front of the bedside light in the hospital rather than pinned on one of those fancy lit-up boards but you should be able to get the idea. With any luck I will get better pictures at my follow up appointment and then you might even get colour?


These x-rays clearly show the progression between Oct 2003 and my pre-op (2 weeks before my surgery). We have worked this out to be about 10 degrees which is an eeek amount - take that forward year by year and you'll see what I mean! The apex of my bottom curve has got very sharp in the intervening 2 years.

You can see my nice shiny metalwork (actually I have no idea if it's shiny, although I do know it's colour coded) in the last x-ray. You can also see the upper curve that they didn't do and to all of you who think it's not very straight, the picture below shows just how far off vertical I used to be and where I am now. Any more straightening and my paralysis risk would have gone through the roof - it's amazing what they've done - eh?

Nuts!!

Just got back from the surgery after getting my chest drain dressing changed (again). There was much over-enthusiastic tightening of the stitches in the hospital when my chest drain came out and when it was time for the stitches to come out they didn’t want to (come out that is). The nurse had a go and gave up – she called sister and she had a poke and pull too. After a few minutes she gave up and called the doctor who fiddled with scissors, scalpel and the like. At this point I am glad I can’t

• a) feel too much in this area and
• b) see what is going on.

Finally there is a muted yippee from behind me followed by a more muted swear word – umm, nurse, can we have some steri- strips in here please? So that was that, the dressing was changed 3 days later and now it has been changed again today but today it looks a bit infected so it was re-dressed and more steri-strips applied. As I said – nuts!

Of course, all this means that I still can’t take a shower (eew – 3 weeks now!) so I’m guessing before long any visitors will only contact me by phone……..

I have to tell you about my insides....yes really!

I hate to do this when you may have a sandwich in your hands (if you have, put it down, crumbs are bad for your keyboard!). Anyway, all prospective surgery people need to know this stuff so I will try and be gentle.

Anaesthetics mess up your toilet habits big time. In fact they stop you dead – add to that the fact that morphine slows your bowel down to a snails pace and you get a recipe for disaster and lots of money for laxative makers! I went 8 days before I went if you see what I mean and I needed help for that. My advice is this – the sooner they offer you something you can take orally to help you go then take it! Like many people before me, my experience in hospital was pretty unpleasant and at 3 weeks post op I am still sluggish – mind, I’m still enjoying a certain amount of morphine so I guess that doesn’t help – helps with the pain tho’ (mmmm, morphine….)

I will have more advice soon, but nothing else on a subject that I feel I have to be tactful about ……..

So what did they actually do to me?

I’m sure there will be those of you who really don’t want to know what my surgery entailed, but I think it’s quite amazing what’s been done so I thought I’d share. I shall try not to be too gruesome about this but if you are really squeamish, don’t read it…

Before my op I thought I would look like the glamorous magician’s assistant who had an accident during the ‘lets saw the lady in half trick’ but that turned out not to be the case. My incision looks more like an accident on the helter skelter as it spirals around me from almost my navel, up past my ribcage and around up towards my shoulder blade. In these days of keyhole surgery, the surgeon must have rolled up his sleeves and said ‘let’s have some fun boys…’

Anyway, having wedged me on my side and made his incision, it was time to get all my nasty obstructive innards out the way of my spine. Given the problems with my intestines after the op, I guess they just pushed them all to one side of me and then found when they tried to put them back that they wouldn’t quite fit in the same way! The next trick was to remove my bottom rib and pass it to the guy in the corner to grind it up to use for bone graft material. I personally have a mental image of him putting it in a plastic bag and hitting it with a rolling pin in the way that you would bash up digestive biscuits for a cheesecake base but I don’t suppose it’s really like that (hee hee!). Once the rib was out of the way they cut through the diaphragm and then do something like stick a pin in your lung so it collapses (it’s still attached to you so doesn’t fly off round the room like a popped balloon thank goodness). So all the preparation work done to give them access they get going on your spine.

The first thing they do is take out your discs – I don’t know how, but it probably involves a hammer and chisel. Once they’ve done that you have a wibbly wobbly spine which is much more flexible – from here it’s onto big boy’s toys, a nice big drill and a really expensive meccano set! They first twist each vertebra to get rid of your rotation and then drill into the bony bit of each vertebra and insert a screw with a hole in the end. Then a rod is treaded through the screws and these are then tightened up which pulls the spine into alignment with the rod. Then comes your rib which is squeezed into where your discs used to be (this may or may not involve a piping bag). This will (in time) grow, attaching each vertebra to the one next to it making a solid column. For the technical among you, this covered the area T10 to L5. Slight hiccup when L4/L5 didn’t quite hold up so a cage was inserted (see http://www.spineuniverse.com/displayarticle.php/article1523.html for more info on cages)– this involved more drilling and screwing – men eh – can’t get enough of all this DIY!

Well, it was time to put me back together – insert chest drain (push tube in until it hits solid surface (eek!)) – find extra bit of stuff – “what’s this, shall we put it in or leave it out?” and then it was time to turn me over onto my front and get ready to slice me open from the back to sort out T3 to T10 but….something happened and after 6.5 hours already on the table they decided to go home for tea. The good news was that I got a much much better correction than expected from what they had actually done so I have to wait until my 6 weeks check-up before they decide whether or not to do the rest. Kind of odd if they do, but there will be no nasty lung stuff involved with a second op if I need it so it’ll be a bit easier…

So, that’s it…the technical stuff is this: USS II instrumentation (http://www.synthes.com/html/USS_II.4688.0.html) used T10 to L5. This stabilises my spine around broken vertebrae at T12, original spina bifida lesion at T12/L1 and split spinal cord T11 to L3. Cage used at L4/L5 to correct saggital imbalance caused by de-rotation of spine during operation.