Spine Class and Other Ramblings

One of the very great things about my clinic is they have a team  approach for my case.  The team includes neurosurgeons, anesthesiologists, internal medicine doctors, behavioral health, physician assistants and nurses.  They met together last Friday and all agreed that I was a candidate for surgery.  Yay me!

Another awesome thing is the spine class they have to educate you about pre-surgery, surgery & hospital stay, and recovery.  There is so much information to know but they managed to pack it into a 2 1/2 hour class.  It was awesome!  I might add I've never met so many people with scoliosis.  I met one person when I was about 25 and I didn't meet another for about 10 years.  Then in the last six months I met 9 more including the 7 in my class.  It's nice to know you're not the only one out there.

Anyhow, in my class I learned of all the pre-op "to-do's" like: labs, EKG, physical exam with Internal Medicine, psychological evaluation, and a blood draw.  So, I have to make 2 more trips to Seattle before surgery; one 30 days before and another 2 weeks before.

My surgery will be from the back. (Posterior approach)  This approach to scoliosis surgery is done through a long incision on the back of the spine (incision will go pretty much the entire length of my spine to be fused from T3-L3 )  After making the incision, the muscles are then stripped up off the spine and nerves severed to allow the surgeon access to the bony elements in the spine.  The spine is then instrumented (screws are inserted) and the rods are used to reduce the amount of the curvature.  Bone is then added (either my own bone if they have to remove some in stiff areas or cadaver bone), which in turn creates a reaction that results in the spine fusing together.  The fusion process usually takes about 3-6 months and can continue for up to 12 months.For those interested in what exactly the surgery entails here's a short animation.

It looks so easy and gentle on the animation but I've watched a clip from an actual surgery and it is anything but gentle.  This is a link to a video of a Spinal Fusion Surgery.  FYI:  It is kind of gross.  It won't play with the safety mode turned on YouTube.  

On the day after surgery, if all goes well,  I'll probably move out of the Critical Care Unit and into a regular room  Bonus: spinal fusion patients have priority for private rooms.  I don't want to be miserable and have to share a room.  Plus private rooms have a couch or chair for family to stay with you.  Physical therapists will come and work with me during my time in the hospital.  I'll be up and walking the day after surgery.  We'll also focus on stairs since my bedroom is upstairs at home.  I'll have a social worker that will coordinate my care, such as finding out what my home situation is so I can focus on skills I'll need at home (like stairs).

My surgeon said the majority of his patients come home in only 5 days.  Yikes!  I don't know that I'll be ready to travel after only 5 days!  Of course it is required that a caregiver is with me for 24 hours the first 7 days at least.  I'll have Joe there to monitor all my medications, and incision site, running errands, refilling medications, and transportation. He will also be encouraging me to eat as I'll be on a 3,000-3,500 calorie diet!  I generally like eat so I hope I have a good appetite.  I'll need help with most things for at least 6 weeks as I won't be allowed to drive, bend, twist, or lift.  Full recovery can be 6 months to a year.

At my class I was measured for my TLSO (back brace).  I'm not looking forward to wearing it for the 6 months following surgery but figure at least it will prevent me from breaking my hardware and doing something I shouldn't.  Here's of picture of just how lovely it will be.  ;-)
  

I met with my surgeon after the spine class.  He reviewed my bending x-rays I had done after my last appointment.  The lumbar area of my spine is very flexible and he feels he'll have a good amount of correction.  However, my thoracic region is stiff and he may only be able to get 50% correction (so down to about 30 degrees).  I'm hoping he's just under promising and and will over deliver.  Just to be sure I have started do a bunch of stretches and exercises to hopefully loosen up that area.  These three are my favorite ones that I've found. I can feel the stretch without causing me pain.

Upper back stretches
Stretch the upper back