Need: question list at bottom of post for surgery discussion tomorrow, your experience or suggestions appreciated!
This is another epically long post because I cannot seem to shorten. Thank you, I type in tears, thank you for your consideration and bearing its longevity. And unfortunately, Thank you for your years of horrid pain that has made many of you specialists and experts that I need now.
Fyi about me at this point in life:
Tomorrow is the appointment with my neurosurgeon to decide on the surgery I will have. He has explained it would most likely be L5-S1 fusion. This will be my third surgery in 12 years on my spine with 2004 L4-5, hip bone used; 2014 L3-4 with bmp cadaver bone used. Previous surgeries were successful in that I returned to active normal life, managed minor ache and pains. I made lifestyle adjustment after 2nd, will further adjust lifestyle after this one. Have recently gone thru pt and epidural injections. Both pain management dr and therapist recommend fusion after seeing my treatment results. They both said they rarely make that diagnosis, but in my case say there is no question, and even believe I will have excellent outcome. I too mentally think I will as I have before and have confidence in my entire team and myself.
Neuro has said he will obviously know more when he gets in there, it will be first time in my back. I moved away from previous orthopedist. He said he would like to consider removing hardware that is in there. We told him some has been on second surgery and that ortho said the original l4-5 is really imbedded in bone. He said he will consider that, and ordered at ct scan to road map me. He will be listening to me, comparing recent mri and ct scans when deciding approach. In my opinion, I have a small frame so I like the idea of old stuff coming out and getting new/lighter pedicel screws. So we shall see. Also he will discuss what it means that one of my pedicel screws is inseparable from my iliac vein and artery. Lastly, I have genetic partial sacroilization bilaterally of l5-s1, so he will review what that means to this surgery.
I have listed my questions to cover below. Please, your advice and suggestion of what else I should ask would be appreciated. I do have pain journal and husband going with me as well to be sure I can hear and make best decisions.
Number 1 can we do this asap please! Quality of life. Not minimizing others needs, but my life is truly on hold. As u said when u saw me three months ago, not to walk. That I will damage nerves. U hoped epidurals would relieve and so did I. If they didn't that we would fusion. I'm emphatically begging mercy: please can we schedule as soon as humanly possible!?!
1. Do you use stitches or staples? My previous with staples good/stitches do not heal on my body.
2. Will you use same incision?
3. Will you remove any hardware?
4. What do you think outcome for back/leg..realize you have to get in there to really answer
5. Blood, do I need to donate. Drains.
6. Cadaver or my own bone, BMP?
7. Pt and pain management, will I need to change to your office ones or keep the one I've been working with?
8. What kind of pt do you think is best while waiting for surgery, or should I discontinue? Currently we do heat/tens/massage and some upper body. We discontinued lower body work for fear of further nerve destruction.
9 what hospital? How long have you used? Are private rooms common
10. What is average night stay in the hospital
11 do you give a brace to me in hospital or do I need to get
12 will I see you in hospital or a pa? Will therapy begin there?
13 how long is typical surgery
14 number of vertebra matter? Sacrilization of l5-s1? What is my numbering so I understand versus a normal spine?
15 my SI joint arthritis, will surgery help or how should I address? Pt?
16 my nephrocalcinosis that popped up on ct scan, I have appt with my general to discuss. Do you have advice or knowledge, is this common of other patients?
17 I see my general tomorrow to get yearly blood work. I'm on high blood pressure med and hypothyroid. She will do full blood work up. May I use that work up for you as well? Can you right same order so when I go for draw I can have result sent to both? Mobility is an issue so I am trying to make my life easier.
18 currently on tramadol extended release with hydrocodine for breakthrough. I don't always take the hydro and pain management dr had to talk me into it when I described pain after second epidural, before third. I'm on Celebrex and muscle relaxers too. Ice heat and tens is my biggest lifesaver. Canes and walker is keeping me from falling. What is your typical medication for post surgery and what can I expect...obviously this is subject to change..what is your usual protocol?
19in your experience: what is outcome for a 42 year old lil lady like myself having third back, (fifth if you count micros)? I'm extremely ocd, positive, hyper happy. I have been homemaker for last three years for various reasons(hubby travels, kids age, income, and pain was last consideration.) kids are older now and I have a plan for my next goal in life, to go back to school and go completely 180 from previous job (elementary librarian/media specialist) to become a certified phlebotomist. I have such a positive nature I would love to be the difference in a hospital. I want to work with children as I'm extremely good with them. I want to wear scrubs, see kids and their families and make one small positive in their hospital experience.i want to still support my family by not bringing work home. Do you think this surgery can help me achieve this next dream?
20 lastly, started therapy so I can get help when depression creeps in and I chat on a spinal forum where I'm surrounded by my kind. I share this with u so that u know I'm a whole body person right now. If I could have a personal trainer, I would! But as you said to absolutely not be physical except Aqua therapy and specialty bike, I'm waiting for surgery to possibly add one. Realistically, what is your experience with age/health of going back ever to the high level or mid level or low level exercise. Remember, I was a marathon runner. It has taken years to overcome the loss of running in my life.