As I promised, following is my day-to-day journal detailing not only my experience with a Spinal Cord Stimulator (SCS) implant surgery but I've adding (hopefully) helpful suggestions about things I’m glad I did or things I WISH I had done. Look for the !!!. Sorry if it is too long but I do so hope it is useful for you guys!
Surgery was Friday, 8/3. Arrived at the hospital at 7:30 am and checked into preop. Since I hadn't had eaten or drunk anything for hours, despite dehydration, the nurse used a very small amount of lidocaine and !!! the lidocaine made it really easy to establish the IV. Ask for it if your nurse has trouble getting a vein. Met with Medtronic rep who was great answering questions and then the surgeon who also detailed what I could expect. At that point, I showed the surgeon where I wanted the pocket for the stimulator to be placed. !!! My hub had marked it in green ink-we worked it out the night before! Then the nurse let a bag of antibiotics drip while I waited to be called back.
They took me into surgery and placed me on my tummy with comfortable arm rests and a head rest, sort of like a massage table. The surgical team all introduced themselves and my Medtronic guy named Mike instructed the surgeon about lead placement (I had a Medtronic 5-6-5 paddle lead and an adaptive stimulator put in.) !!! Ask your rep about turning on the stimulator. Mine recommended that I not turn it on for several days or until swelling went down and I felt more comfortable.
Next, they put me in twilight sleep – I couldn’t remember anything from that point until the brought me “up.” They placed the paddle by doing a partial laminectomy (removed a small piece of bone around T8-10) and brought me back awake so I could help then with exact placement. When testing was complete they put me back under. By testing I mean that they temporarily connected the stimulator to the electrode paddle and kept asking me where and when I could feel stimulation until the exact placement was determined. So where was I? Oh yes, I was placed back into twilight sleep and the pocket for the stimulator was put in (I SWEAR you can’t see it and barely feel it) and the “tunneling” for the wire leads was completed. !!!My stim pocket was on my left butt cheek just to the side of my sacral dimple and down a bit in a little fatty area. I sleep on my right so I didn’t want it on my right side. Procedure took over 2 hours with an extra hour in recovery.
Now, back to my room and until the numbing wore off completely (for me about 6 hours after surgery) I felt just fine. I felt so good that I couldn’t imagine what the big deal was all about. Then the numbness wore off and my pain went from a 2-3 to about a 20 out of 10. I am a woman who has had 2 children by natural birth with no more than an aspirin. I was fearless in the face of a L4-L5 fusion and this was by far the worst pain I have ever felt. It seemed like the pain was manageable until I had either muscle spasms or gas pains – not sure which. When the spasms hit, I could barely breathe. The spasms came and went for about 6 hours. When the spasms weren't seizing, the pain was about a 12 but a 20 out of 10 when they spasmed.
One other thing that I wasn’t prepared for was that my neck was sore from being on stomach with face turned to right for 2 hours AND my arms were sore because they were placed up over my head on both sides. The soreness did wear out pretty quickly. Also, had those little nose clips placed on for oxygenreally drie
d my nasal passages out. !!!Be sure and take chapstick for after surgery comfort. Your lips will be dry!
!!PLEASE, PLEASE, PLEASE make sure that you go into this surgery with relatively empty intestines. NO constipation in advance. I didn’t think of that. After surgery and before all the awful pain started, I ate a huge dinner despite the fact that the doc ordered a liquid meal. I pleaded with my nurse to let me move to a soft diet and I ate meat loaf, green beans, fruit, cheesecake, roll – well you get the picture. 45 minutes later the most excruciating back and rib cage pain spasm started. The kind that I begged for morphine. (That’s NOT me) I have no way of knowing if it was the gas or the spasms from surgery but after valium for the spasms and meds for gas and pain meds it finally resided. But it was 6 hours of hell. The “I want to die” kind of hell. !!Don’t be shy about asking for medication when the pain starts. Don’t be stupid and try to breathe through it like I did. If you are at the stage of getting a spinal chord implant then you are opiate tolerant. !!!MORPHINE will be your friend. Don’t be afraid to ask for the drugs you need!!!!!! You probably won’t need it long but while you do, ASK FOR IT. Some docs use a pain pump but mine didn’t. Find out in advance what your doctor’s protocol is.
Saturday, the doc said I could go home unless the spasms were still awful which makes me think that muscle spasms are common so maybe it wasn’t the gas but……….who knows? I hate hospitals and I was ready to go. The doctor removed the dressings on my back and on my lower back, which really surprised me. He said they looked great and there wasn’t anything else I needed to do to care for them. Since I had an hour drive home I asked !!!my husband to bring along an ice pack and a sheet of inch thick foam that was big enough that I could double over for comfort. I think you can get it in the sewing department at Walmart (batting for quilting) or as an inexpensive bed topper. BELIEVE ME IT IS WORTH IT! This is not an original suggestion but one that I got from another spiney, Chagland (sp?) Use some of it as a back padding for the car or chair. The other part, cut into two 18” X 24” sheets and roll them up along the 24” side so the finished tube is 18” long and a couple of inches thick. Secure with twine or rubber bands. These are used to put on either side of your swollen spine to allow ice packs to be place on your back without pushing on the hurting part. Any leftover foam can be used to help pressure points.
!!!Another suggestion is an old-fashioned bed arm-back pillow available at Target, Walmart, etc. Also great for reading at night and for company so it isn’t a lame investment.
What does the back look like??? Very, very bruised. Deeply bruised around incision but the entire spine down to the stimulator will be swollen. For me, not so bruised around pouch for stimulator. Guess that’s the good part about having a little (OKAY, A LOT) of extra girl padding in that area. I am taking a few pictures of my back 2 days post-surgery so if anyone wants me to send one via email, pm me your email address and I’ll be glad to.
Sleeping at night – between valium and ambien, no problem for me but I stayed on my right side (pocket is on the left) so I did ok. What I haven’t been able to do at all is sleep on my back and I don’t have a chair lounger so that’s out. I get up once at night and take a round of pain meds and that gets me through pretty well. But this morning I got a call at 10 am from my pastor who unwittingly woke me up after nearly 9 hours of NO pain meds and I nearly scared him to death! He asked if he could say a prayer for me and I said “OK but you better make it quick!”
Sunday, still too out of it to post anything. FINALLY took care of the intestinal issue. FINALLY! Yes, there is a God. !!!Don’t overdose yourself on prunes and vegetable based laxatives. Please. Drink more water but resist the extreme. I stayed in the bathroom all day. And I am now using Metamucil daily and eating prunes in an attempt to regain a more natural schedule.
Monday – Chagland mentioned tylenol and ibuprofen being helpful. I agree!! Also changed out my patch today so that should help. !!!Ask your doc if you have to remove your patch for surgery. Mine didn't make me. Anyway, I figured by now I’d be up and about but not so much. I did get an OK to get a shower. !!!Since I was on meds and my husband had to go in and run our business, I was by myself. To be on the safe side I took a “sits” bath with water below my pouch incision so I could shave the old legs while sitting and wash those down south important parts. Then I popped into the shower with water hitting tummy area and got my hair washed with head leaning forward and avoided water hitting back. Doc said it could get a little wet but no soaking. There is something about getting clean, isn’t there?? Another thing is that I am changing out my sleep shirt daily to make sure I keep the back as germ free as possible.
So far my impression is that this has been a harder procedure than I had counted on. Part of it is my age – 60. Probably alot of it! I am just not as resilient as I was at 40. Thank goodness that I followed the advice of some of the other members here as well as my Medtronic people and have arranged housekeeping help for the next 6 weeks. I still hope to go back to work next week. We’ll see. I hope by tomorrow (Tuesday) I’ll be up to doing some telecommuting. I was able to put some dishes in dishwashter (taadaa) but that's about it. I really don't want to push myself and end up messing this up.
I’m sure I’ve missed something that I can add later. Sorry this is so long but I do believe that “for-warned is for-armed. More tomorrow. Kathy