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I'm scheduled for ACDF - And I'm Scared because of my size - can you help?

ray78640rray78640 Posts: 18
edited 06/11/2012 - 8:39 AM in Back Surgery and Neck Surgery
I am scheduled for cervical fusion(s).
C 6-7 for sure, possibly c3-4 & c5-6 (really don't understand this). History of intense pain on right arm neck and hand.
I weigh 290 lbs - I'm a big man. I have a little bit of sleep apnea. I'm so scared, I do not know what to ask or who to ask. I'm affraid of not being able to breathe afterward or being able to swallow afterward.
Surgeon says much more difficult due to my size.
Does anyone here have expereience with this?
Or have you heard/read about another large person going thru this?
I'm so glad i found you folks - I'm just so nervous that I don't even know what to ask now that I'm here.



  • I assume you have told your surgeon about the sleep apnea? I friend of mine had surgery recently and the surgeon seemed concerned about that and had her do some additional testing prior to going ahead with the anesthetic. I can't recall the details. It was a different surgery -- to repair a hernia, I believe.

    I've not had cervical surgery -- just two lumbars, so I'm afraid I can't add anything to the mix in that regard.

    I'm sure others will respond soon. Sometimes the board is a bit slower than other times. Come back and post with your other questions...someone is usually around at any given time!

    It is normal to be anxious about the unknown, such as a big surgery. And it sounds like you have a few additional things to wonder about....

    It is not unusual to be told that they might operate on more than one level once they get in and can actually see what is going on. Not everything shows up on the imaging. When I had a lumbar fusion, I was told a similar thing. I ended up just having the one level done.
  • SpineAZSpineAZ WiscPosts: 1,084
    Much of it depends on the size of your neck. Someone who weighs 290 but carries not much of that weight in the neck won't be much different than anyone else. The challenge may be in getting you sedated and making you comfortable after the surgery. They'll also want to make sure you are breathing well. They will likely place an oxygen monitor on your finger and that may stay for a day or two. That shows them how oxygenated your blood is so they can have you change your breathing or add oxygen as needed.

    I have had an ACDF. The surgery was relatively easy for me. I will say that I've heard some people experience more throat pain than I did. I had about 1 day of it and cepacol lozenges helped me. When they do an ACDF they move your trachea/windpipe to the side to get to the spine - thus many wake up with a sore throat and a little difficulty swallowing. Although you may not want to eat solid foods the first night you will be able to eat soft foods. I compared it to the type of diet someone would eat after a tonsillectomy.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • I won't be much help to you here, but here's my 2 cents on your post. Me, I'm average sized, but someone near and dear to me has put on a lot of weight due to an array of health complications. She had a long surgery last Nov which kept us in the hospital for over a week. She never had any difficulty with airway management. The did with her, like most surgical patients, have the little tape on pulse/ox monitor on her all the time. I slept in the room nights with her and never heard the O2 monitor beep or heard any sign of breathing distess.

    Obviously, and I know you've heard all this before, extra weight does complicate almost all areas of health and health related procedures. The fact is though, the majority of our population is overweight or obese. With this in mind, it stands to reason that surgical procedures will be up to date and prepared to handle heavy people.

    I wish you the best on your surgery. Double check with your doc and maybe get a second opinion on what you hear from him. The right doctors and staff will keep you fine.

  • SpineAZ & B52

    Thank you both so much for taking the time to reply.
    I've been reading lot's here and feel lucky that everyone here shares their experience's with the rest. There is no substitute for actual experience or as close as being with a loved one thru the entire ordeal.
    For what it's worth to all here, I am not obese, although very overweight. Prior to my symptoms I worked out regularly and all of a sudden just stopped. This was baffling to me and my family and I had no real reason to give. I had started experiencing some severe pain in shoulder and thought I was simply giving myself "a break". Shoulder pain lead to arm pain, then wrist, then hand, etc, etc. Before I realized I had a serious issue that took some time to diagnose, I had gained a lot of weight. My PCP had some test done, and i was diagnosed with arthritis in many places and i was sent to a rumotologist who basicly prescribed pain meds. I eventually went to an emergency room at local hospital as i thought I was going nuts one night with the painn from face to neck to shoulder blade and all of my arm and the numbness was just maddening. A CT Scan was performed and I was told I needed a Neurologist and an MRI "right away".
    This is probably so familiar to most (if anyone is actually still reading).
    I'm now under care of the surgeon that will perform the ACDF on 12/23. Looks like XMas in the hospital for me he says.

    My greatest concerns are:
    Long ride home from hospital - 75 miles
    No Pain Releif
    Breathing Difficulty, at home, not monitored, while sleeping.
    Swallowing Difficulty
    Extensive recovery due to my weight.
    A failed fusion - or not being able to return to work and remaining on disability.

    My Goals Are:
    Positive attitude while recovering -
    Getting back to being as active possible
    as quickly possible -
    Losing all weight gained -

    My spinal history is minimal -
    L4-5 Lamenectomy with no releif of pain.
    Opted to work thru pain and learn to live with as opposed to another surgery/fusion.
    There is no injury that can be ruled as the cause for my herniations and bulges in my cervical area.

    My upcoming procedures are:
    Tomorrow 12/16 a CT Myloegram -
    Fri 12/18 a complete check by PCP, blood, EKG, chest XRay, etc to certify that I'm fit for ACDF.
    12/23 ACDF

    I am so grateful to be here in this forum.
    Please help with any and all info that can be shared.
    I plan to update and share all my experience right here and hopefully I can help someone else.


  • Good luck to you Ray. Wish I could help. As for your sleep concerns, do you use a sleep apap machine. Or something similar? What does your Doc. say about the breathing concerns?
    Ask your surgeon to be sure your concerns are answered.

    Best of Luck to you.

  • JanisD

    Thank You! I do not use a CPap or anything else.
    When my surgeon asked if I had sleep apnea i was not able to answer truthfully. I knew I snored. I had to ask my family - my wife and I have been married for a little over 30 years - she says that once in a while, I stop breathing and then make a weird sound and start again. She is a heavy sleeper so probably sleeps thru most of whatever it is I do.
    My oldest daughter-in-law lives with us and 3 of our grandchildren. My oldest son (her hubby) just came back from Afghanistan after being in Marine Corp for 8 years. Anyhow..she says she can hear me snoring and then it soundls like I stop and the kind of gasp for air and then calm right down and resume snoring after several minutes.
    I am making a list of questions to ask the surgeon and this is at the top of the list.
    I am so frightened, it's not even funny but I never thought I'd ever be as scared of anything, but I am.
    Thanks again for the good wishes.

  • I think you're going into it with a fairly positive outlook, considering. You will be monitored for O2 level just about all the time you're in hospital. As for the ride home..mine was about 80 miles and guess what? It SUCKED!! I swear, I could feel every pebble in the pavement. The good thing though, is that it's so wonderful to get home that it was worth the ride. Now, 5 or so weeks after my fusion surgery, it's no real pain at all to do 80 miles in the car. You'll do OK. If there are going to be breathing concerns when you are at home, they make and prescribe one for you on your dr's order, breathing/02 monitors for home use. Just be sure to ask the dr if you may need one.

    Aloha brudda
  • Had myleo CT today - feel like I should not be on computer, very sore and off balance, so will update later....

  • One thing - make sure you've got a garbage sack to sit on in the vehicle - you don't want your backside sticking like velcro to the seat as you try to get in and out!

    I remember my 40 minute ride home - I was gripping that OMG bar for dear life the whole way. Once I was home I was great though, if I remember right I didn't want to go upstairs to bed, I wanted to stay up for a while.
  • welcome to spine health ray78640, and i believe you are normal to be scared. i was too. the best advise i can give you is to take a written copy of your concerns and fears that you listed above, and talked with your surgeon about them. your surgeon should be able to help you resolve each issue. some, like the weight issue might take a while. i know its scarey to sign the release papers for the surgery and not know to what extent they are going to fix in the surgery. i had a acdf c3-c7 10 hour + surgery over 2 yrs ago and it was a long recovery process for me. everybody recovers a little differently, but the main thing to remember is to follow your surgeons recovery orders excatly, and that way you have done the best job you can do for recovery. i wish and pray you have a sucessful surgery and a speedy recovery. God Bless, kc
  • I weighed 340 when I had my ACDF last Feb. (I have since lost 70lbs of it.) I didnt have any problems during the surgery. The anesthesiologist seemed concerned pre-op and asked me if I was that weight when I had had my hysterectomy 5yrs previously. I told him I was about the same and no problems then.

    I had no complications from my ACDF other than sounding like Minnie Mouse for three months.

    I have sleep apnea and I brought my CPAP for use during recovery. I had to use it with some oxygen because my pulse rate kept dropping for some reason. Once I was more awake this was no longer an issue for me.

    I think you are right on speaking to your dr about your concern. He might want you to get a sleep study prior to surgery. Sounds like you should have one sometime anyway. I have had my CPAP for 11 yrs and am pretty faithful with it. Since the weight loss I dont need it as badly as before but I am so used to using it I figure until I am closer to my goal weight I will just keep on with it.

    I live about 70 miles from where I had surgery. Make sure you get something for pain prior to leaving for home and make sure you have a plastic bag or something similar in case you get sick to your stomach. Oh and at least a couple of pillows in the car too. Plan your route to take advantage of the smoothest roads possible. Honestly you will probably sleep most of the way home and remember very little.

    Im having two more levels done on Dec 30th so will have to go through this all again. Hope you do fine. Sounds like you have a great attitude about it and that is a great thing to have.


  • Thank you all for the words of advise, which are very much being taken into consideration.

    It is Sat night, nearly 1:00 am, so I'm aprox 79 hours from my scheduled ACDF.
    Is it normal to sometimes feels as if there are moments when it fells almost pain free and the mind start to wonder if surgery is really needed?
    The moment to pain flares up that thought is gone.
    Also, I am beginning to become more & more nervous.
    I keep reading about the CHOKING and LUMP In THROAT, etc...can anyone be more precise about this?
    Is there any advice on how to avoid the choking -
    I hate the thought of the whole sleep apnea thing and choking while asleep at the same time ~X(
  • The good part is, you'll be in the best place to have your issues managed while you have the surgery, and a few days afterwards. Hopefully, for the ride home, they will give you some sort of brace or collar to help you get your neck in a comfortable position. Right before you leave the hospital, ask them to load you up will all the pain meds you can handle. I had a 110 mile ride home from the hospital and I made it just fine on the drugs they gave me. Have you had your apnea evaluated and looked into getting a CPAP machine? I had apnea when I was heavy and used a machine till I had my gastric bypass surgery. Now, after having lost 85 pounds, I don't need it anymore.

    All the best to you.

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Reading my last post you'd think I was on lot's of pain meds or something...LOL.

    Linda - 85 lbs? Wow - congrats!!! Thank you so much for posting your comment - I will ask for all the meds I can handle.
    I have not been diagnosed with sleep apnea - nor do I use a CPAP - however, I am looking into getting one for my recovery just to be on safe side.
    Thank you so much!
  • SpineAZSpineAZ WiscPosts: 1,084
    I swear there is something that makes us feel better in the few weeks or days leading up to surgery. Every time that has happened to me as well. "hey, I feel good, do I need to do this". But then I have to look back that the last 6-12 months and realize how the pain has impacted me and when that nudge of reminder comes back I know surgery is the right choice.

    I'm facing a major lumbar spine surgery in February and there are days when I'm thinking "Well, today's okay, if everyday was like today I don't need the surgery". And then the next day I turn wrong, get a sharp pain and think "oh yeah, that's why I'm doing this".

    Totally normal to feel this way prior to surgery.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Please forgive my spelling and grahmar...Im on lots of meds =P~
  • Good to hear I'm not the only one.

    It's 1:00 am again....seems like the pain cycle seems to allow me to hit computer at same time.
    Weird huh?

    Well - I had my CT/Myelo (sp) - that was so intense!
    I'm sure most of you are familiar with the procedure.
    Facedown on hard table that tilts, after some local numbing medicine a needle placed into spinal canal or cord(?) at low back...hips began to hurt, doc says that meant we were close...lol.
    Next was the really hard part...my pain is from neck up into face, shoulder, shoulder blades and all of the arm. Some braces were clamped onto this table and I was slid forward until my shoulders were touching these braces. I was told that the weight limit was 300 lbs and asked not to be nervous.
    The table was tilted and I was turned upside down. My shoulders felt like they were about to ignite in flames, the pain was so intense and I was certain I would be falling off of table because I thought the braces would fail.It was brief but so painful.
    I was kept in their 'recovery room' for 2 hours afterward. I made it through with just a slight headache afterward but the aggrevation to my nerve pain was about all I could handle...glad it's over.
    Not even sure what the films show. I have them with me and I'm supposed to take to surgery on Wed 12/23.

    I also went to my PCP for cardiac clearance, bloodwork, EKG, etc. I was surprised with an abnormal result on EKG but told that it was still OK to proceed.

    I'm now in wait mode - nervous - wondering what I should be doing to prepare???
    I'm about 52 hours away from my arrival time.
    I feel like -> :SS @) :SS
  • I'm so glad you found us. It seems from reading this thread that you're getting the support that you need to get through your ACDF. I've had a 3-level over a year ago and I still remember how difficult the wait was and how scary the whole experience was.

    I found that the anticipation was worse than the surgery. However, I happen to know that fact won't help you because I'm two weeks away from a lumbar surgery and already asked for some Xanax from my surgeon to help me out because I'm freakin'.

    But you'll be on the other side before you know it and posting back here about your experience. You'll come back as an official "spiney".

    You haven't mentioned - are you going to be wearing a collar? And if so, will hit be a hard or soft one? I'm just curious because I've found that people's recoveries are a bit different depending on if and what collar you're wearing - not better or worse, just different. I had a hard collar for four weeks and although it's difficult to get used to, I felt very safe having to wear it. It seemed like my neck was very vulnerable with out it (could only take it off to shower), so I was glad I had it.

    Take care, Ray. It's all going to work out fine. And if you're home and find you need something that you didn't get before surgery, just have wifey run out and get it for you.

    Also, think about what you'd like to have for mental stimulation during recovery. So many people think about the physical things they need, but forget that after a week or so, recovery becomes very boring and you'll need something to keep your mind busy. I had a Netflix account so I could watch movies, my computer, and my personal life-saver, my Nintendo DS with a ton of games.

    Anyway, I'm truly wishing you the best for your surgery and look forward to your first post-op reply, letting us know that you're ok and on to a successful recovery.

    Take care, Ray.
  • Cath -

    I too am so glad I found you folks. The preparing and wondering and worrying have been very strainful.
    But now I'm about 14 hours away from operation and have decided to turn off the worry for now and leave it the other powers that be hands.
    I'm glad you mentioned mental stimulation.
    I'm working on that now.
    I had a Lamenectomy at L4-5 in 1997 but still have no experience with a neck surgery.

    I will come back and post with updates post-op.

    Thank for all the encouragement!

    PEACE and Happy Holidays
  • Hello,
    ;My doctor told me today, my problem was not being at risk with my blood issue for having cervical surgery. I do not think they will want to do my surgery because I had gastric bypass 3 years ago, have problems swallowing already. I am confused. Gastric bypass slows down the healing process, nutrition is so important.
    I am waiting on my MRI before we discuss my options. Have Back surgery first!
  • I like your attitude Ray!
  • hey ray, im havin acdf c5c6 fusion on oct 27, 2016.  I too have sleep apnea n am sorta spooked.  Ive lost weight, exercised, and am trying to trim a few pounds b4 surgery.  any tips.  katie
  • hey errybody, Im scared and need encouragement, testimonies, n hard truths to help me.  Im havin acdf c5c6 oct. 27, 2017 and weigh about 219, I have been put to sleep sucessfuly a bunch of times at a higher weight (250) with no problems.  sorta worried that my throat will swell and I will have breathing problems post surgery.  Takin my cpap to the hospital.  Any tips anyone?
  • LizLiz Posts: 7,832
    Hello Kathy

    This is an old discussion created by a member no longer on the forum so I am closing it.

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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
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