April 30, 2014… I was scared shitless. Seriously. I damn near turned around on my way into the hospital. Jon, my roommate, friend, and appointed patient advocate, was my point of strength. He reminded me I needed to to this. I knew without the surgery, my career in EMS was over. Permanently. This surgery was giving me the chance to continue to do what I love to do, provide not just BLS care to patients, but ALS-level care as well. My internship is on hold due to this damned problem with my back, and I WANT… I REALLY WANT… I HAVE TO GET… my paramedic. So… I registered and was escorted to pre-op.
Initially, they didn’t want Jon back there. Put bluntly, I wasn’t going back without him. And they knew it. A quick conversation with the pre-op charge nurse, and we were both back there. Changed into that beautiful hospital gown and booties. They decided to put those DVT preventing leg pumps on me, but didn’t use them in pre-op. 20-30 min went by and a nurse came over to start a line in my hand. Went on one helluva fishing expedition using a 20g catheter in what is one of the easiest veins in my hand to hit. Hell, I’ve hit it. One handed. Took her 5 minutes. Seriously. Ouch. Anesthesia came over, talked to me a bit, verified a few things, then disappeared for a minute, came back with what I think was midazolam and that took some of my fear away. I was still crying off and on. Even when they took me into the OR soon after, I was still upset. I know my surgeon saw I was. Not sure exactly what he said, but part of what he said was that I would be back in EMS soon. I expect him to hold to his word. I will do my part.
Next thing I knew, I was waking up in post-op. Wanting Jon there. We had gotten agreement from Kaiser he could be there as soon as I was brought back, intubated or not. He was brought back, but the nurse I had was really not nice to me or Jon. He even kept shoving my gurney at times, and then another nurse pushed Jon away at one point (Yeah, I remember this, even with all the drugs). I kept holding Jon’s hand. The nurse kept saying “Policy prevents Jon from being there, unless I was dying or a kid”. Turns out that isn’t true. Jon and I dealt with it later, and the charge nurse was less than happy that she was never even notified there was a problem while we and she were there. She was literally 20 feet away, and he never told her. Ass.
Soon enough, I was sent to my room, which was a two-bed room. My hospital roomie and I got along great. She had surgery right before me, same level, same surgeon. I loved her as a roomie. They got us both out of bed that night, but left us sitting for over an hour (orders were no more than 30 min – I didn’t know). We yacked and yacked. High as kites, talking and talking. I still had a lot of meds from anesthesia in my system. Good thing. They were using morphine for my pain… a whopping 4 mg every 2-4 hours. Didn’t really touch the pain. DUH. Really? Ironically, my roomie was getting dilaudid and her pain was well controlled. By morning, I had taken a walk (primarily to get the friggin’ urinary catheter removed – a requirement). Got that out… whew! It was actually a Godsend to not have to get up to use the bathroom that first night. But with one kidney, I wanted it out ASAP. I do not want to risk a urinary tract infection any longer than I need to. Neurosurgeon came around, as well as his PA, they immediately changed my meds, first to dilaudid, then adding percocet every 4 hours. Problem is… the nurses didn’t follow those orders. Even when the PA confronted them, they used the “Well, her pain seemed controlled.” Uh, no… when I say it is 8/10, it’s 8/10… That’s not controlled. For the most part from then on, it was controlled. With 2 notable execptions. One was at night, and the night nurse insisted on giving me a single percocet (Note: 2 were ordered every 4 hours round the clock), and make me wait at least 30 minutes before she would provide any further pain control. It was my roomie who came over and talked with me, rubbing my arm, and helping through 45 minutes of hell, until she went out using her walker, and told them I needed help. They finally came in and gave me IV dilaudid. Which got my pain under control. 2 hours later, I got another dose. Finally slept for 4 hours straight. Wow! I needed that! The PA even told us it isn’t the first time that they have had run-ins with these particular nurses. So why the HECK are they still there??? Now, to their credit, I had several nurses that really were fantastic. I thank them for their compassion, and their help.
My PA pointed out I had done more walking than ANY of their patients EVER had. Really? Wow! I walked maybe 100 steps. She felt strongly my pain was from overdoing it. OK. I’m game to admit that. To me, 100 steps isn’t overdoing it (Especially after walking 3 miles the day before), but after a back fusion… maybe it is. I stayed in bed on day 2 most of the day, getting out only when PT wanted me out, or I had to use the bathroom. I used a walker everytime I got out of bed. Sucked, but I had to. Those first walks SUCKED. REALLY SUCKED. Pain like you can’t imagine, unless you’ve had this done before. But I did them.
Correction of my spine wasn’t quite what I had hoped I would get. But the nerve monitoring they do during surgery guides where they do the fusion. When they correct into toward what is a normal position and the nerves react by freaking out, they stop. I respect that. I have my own bone, donor bone, bony putty, and BMP, along with an Infuse implant in the intervertbral space, along with pedicle screws and rods holding L4/L5 together. What does it look like on x-ray?
Lateral (side) view
AP (Front/back) view
On Friday, I was offered the chance to leave. Initially, I was hesitant to, due to pain. But Jon and I talked, and we figured we could manage everything at home just as well, if not better, than I was getting at the hospital. So,I decided to check out (With the blessing of my neurosurgeon and his PA). I did ask for some oral dilaudid for breakthrough pain, which the PA did order. Thankfully!
While waiting for the pharmacy to get my discharge medications ready (Can you believe it too 3 hours???), I ended up with another bout of uncontrolled pain. I texted Jon, telling him how bad it was. He called me, and I could hardly talk, I hurt so much. This time, it took a call from Jon to the nurse’s station after I waited almost an hour for pain relief. Not sure what he said, but it shook them into action. They came in almost immediately at that point. I insisted on the dilaudid FIRST, then the percocet to cover after the dilaudid would wear off. They did it, no problem. Just before they pulled my IV, they pushed another 0.8mg of dilaudid (Topped me off for the ride home – THANK YOU!).
We got home, and although my first night was rough, it was better being home, knowing I could take my own meds ON SCHEDULE. I have had a few breakthroughs in pain, but all were managed quickly. My Iceman has been a Godsend (I strongly recommend it!). Came home using a walker, and was also given a cane. That was a rough thing to admit to need and use, but I needed it. Hell, I couldn’t even get up from sitting or lying down without assistance the first 2 days.The bruising on my back was horrendous. But I bruise easily. It is resolving. Got to shower after 5 days post-op. OMG… that felt SOOOOO good! My hair was one giant mess of ickiness. And I know even with body wipes, I still stunk. That shower still feels great!
So, where am I right now? Today is 10 days post-op.
It took several days, but I have graduated from using the walker. I am using a cane intermittently right now, but not inside the house most of the time. Outside, on uneven surfaces, in public… yeah. But even that is less and less. I sleep a lot. My body needs it. I only get 4 hours at the most, due to meds, but my body is using it.
I am still on full strength percocet. Using the dilaudid very intermittently (Like 5 out the whole 20 prescribed to me). Sucks. I have a normal high tolerance for pain. Wish I had been able to taper down already, but I’ve had more than a few people remind me the level of surgery I have had. Still taking valium to keep muscle spasms down, but I have been tapering off during the day. Seems to be helping with the lingering dizziness I have off and on. I’m walking more and more. Even walked a bit through Walmart earlier today. Prior to that, I was using their electric cart. Trying to walk more and more. Tomorrow… I want to walk to the mailbox and back (Not a short walk, and not on an even surface.). Won’t do it without someone with me, though. Or maybe a walk at a local park. I still am limited to no more than 10 pounds of lifting ANYTHING. I’ve been good about it.
I managed to wear blue jeans today! I know it doesn’t sound big, but it was for me.
I still need someone with me off and on during the day for minor things. I can’t do laundry, dishes, anything involving bending, lifting, or twisting. At least not until the 30th… I’m being a model patient. Really! This surgery is my ONLY chance at getting back to what I want… no… need to do. It keeps me sane. I miss it terribly right now. More than you can imagine. Well, I know some of you can who have had to leave EMS due to their backs.
I want to thank ALL my friends on the Spondylolisthesis group on Facebook for your support. Without you, I would have NEVER have survived without losing my mind. THANK YOU! THANK YOU!
And thank you to all my family, friends, and even some of my staff who have come to help. I don’t know how to repay you for your help, your ongoing help, and even just encouragement. I love you all.
Until my next update.