My plan of posting updates immediately following my surgery did not happen very well. Before the surgery, I got wrapped up in helping Deborah through her recovery, then there was work, and my new life. But, I want to let you know what has been happening and how things are going.
First, I want to say that Deborah’s recovery from her traumatic encounter with a car has been good. She had to be non-weight bearing on her left knee for three months. That is thankfully past, and she is in physical therapy to regain lost strength and get full use of the knee again. That is also going well and Deborah is nearly back to full health. That is a real relief.
As for my surgery, there were some last minute issues that caused the date to be changed one last time. Again, the insurance balked at authorizing the full double fusion surgery. The MRI was not conclusive that I needed the L5-S1 work, in addition to the full front and back approaches. My surgeon, knowing better, made the agreement that he would do the front approach and assess the situation. This meant that I would have to endure two three hour procedures on different days, instead of one six hour version. At this point, I was so tired of the struggle, so unable to do anything about it, and so in pain that all I could say was, “Whatever.”
So, now February 9th would be the day for the first surgery. Deborah drove me to the hospital for a 5:30 am check in and a 7:30 am start time. I was more than ready. After getting checked in and prepped, the nurse attempted to start my IV. I said attempted. She went for the vein in my left wrist just below my thumb. She stuck the needle in and taped it up, after which she went about other business. I started to feel rather poorly, and Deborah asked if I was OK. I said, “That hurts. In fact, please get her over here and get this thing out of me!” I have never done well with IVs in my hand. I thought I would bite the bullet because I would have lots of needles in me before this was over. But, this just was not right. The nurse ran back after Deborah called her. Indeed, she found that the needle had completely missed the vein. Unfortunately, my blood pressure dropped and I went into a form of shock. This is one of those weird mentally triggered physical responses that is very real. I sure got their attention. What I really wanted was a drink of water, but of course, I could not have that. They wrapped me in cool towels and lowered my head. In about 15 minutes, I was back to normal. The nurse was mortified. A different nurse started a new IV, and all was well.
I met the surgeon who would deal with my abdomen and would move things to expose my spine to my primary surgeon. I met the doctor who would make sure I was properly asleep. I also met a medical technician who would monitor my nerve function during the procedure, making sure whatever the surgeon did, they would know in real time if any nerves might be impacted. She put electrodes all over me. This was something that helped make Deborah more comfortable.
Finally, I said good-bye to Deborah, and I was wheeled into the operating room. I waved to the medical tech at her station in the corner, met the rest of the nurses and other support. Laid out on a table was an extraordinary selection of bright and shiny hardware. In addition to the usual surgical tools, I identified what were clearly some power tools. I like power tools. The table they would move me onto was a rather complex contraption. I asked how they were going to get me on that. It looked difficult. They said, “Don’t worry – you will be asleep.” Ah, OK then. We will come back to this later.
The anesthesiologist put the gas hose on my nose. “Just oxygen,” he said. A second later, I said, “That is definitely not just oxygen.” He smiled down at me, and said, “You’re right.”
Three and a half hours later I woke in the recovery room feeling very uncomfortable, but not in pain. Deborah tells me that she was not there. I am certain she was. Soon after they rolled me into my room and showed me the button for extra morphine. Morphine – now, in case there is any doubt – works brilliantly. My stomach had an eight inch incision. My guts had been moved around like so much baggage, I had six screws and two plates installed on the front of my spine, and two new artificial disks placed where my old ones used to be years ago. I was catheterized, groggy, uncomfortable – but I was not feeling any pain. I was OK with that.
“Have any numbness?” Yes, my thumb is numb. It was, in fact, very numb. To me, even in my reduced mental state, it was because the poorly installed IV needle had hit a nerve. But, this caused no end of concern for the nurses. They called my surgeon. My internist was informed, and I received a call from him. Geez, it is my thumb. My surgery was in my lower back. The two are not connected. I just laughed and laughed when my MD called. He told me I was clearly doing fine. The thumb did bother me, though, and I talked about it.
I turned the TV on and watched the interesting colors flash on and off. There might have been some images and sounds, but I could not tell for sure. I think Deborah was there. Nurses might have come in and checked things. I pushed the morphine button and watched day turn to night and back to day again. I think my brother and his wife came to visit. I tried to eat a little of the full liquid diet food. It did not like it in my stomach. The nurses helped to clean me up. They gave me pills, changed my urine bag, and I pushed the morphine button. The “question” started – “Have you had a bowel movement?” No. If I had, I would have told you because I ain’t moving from this spot.
It might have been the next day, or the same day, or the day after that, when my surgeon came to visit. He checked my bloated stomach and asked how I felt. I told him I did not feel much of anything. He told me that my L5 – S1 junction was much worse than he expected, and he repaired it as needed. He told me he would do the second surgery a day later. I cannot remember what I said, but whatever it was it caused him to say that we could wait, if that is what I wanted.
“NO! I want it as soon as possible!!”
My outburst likely could have been heard well down the hall. My surgeon smiled and made the plans.
Day moved into night again. The TV stayed on, for whatever reason. I tried to read. Nope. The page just made no sense. “Have you had a bowel movement?” No. OK. Just no.
It must have been the morning of the second surgery, Sunday February 11th, because Deborah was in my room at dawn. I guessed it was dawn, because it had been dark for a long while.
The preparation went smoothly this time. I would have a different medical technician monitoring my nerve response, and I would not have a second surgeon this time, Going into my back would be generally simpler. The hardware would be heavier, however. This time, because they would have to put all my weight on my stomach, I wanted to be asleep when they rolled me over and put me on the operating table. Yeek.
This time I do not remember waking in the recovery room. I just remember being back in my room, and being very uncomfortable. I was laying on the work my surgeon just did – another eight inch incision, with a drain coming out of it, six big screws, and two more plates. I was really liking the morphine.
Day turned into night. I could hear Deborah coming down the hall on her crutches. I liked that sound, because it would mean she would be there for a while. I heard that sound all night long, and thought I was dreaming. It turned out to be a printer mimicking the sound of crutches.
“Have you had a bowel movement?” No. Believe me, I will let you know.
My surgeon came by and checked his work. He removed the drain. At some point someone removed the catheter as well. Out came the urinal, because I was not moving from that spot. I used the morphine button.
I was started on oral narcotic painkillers in addition to the morphine. The first one, I think it was Percocet, resulted in really intense hallucinations. I did not care much, but Deborah was worried. So, I was switched to Norco. That worked fine.
I think my internist sent a friend from the ER to check on me. He might have been a nice guy, though I cannot be sure if he was even a guy. For all I could tell, he was a large rabbit. A friend came to visit. Similar deal. Hey, Dave! You sure do have big ears.
At some point a physical therapist came by and showed me how to get out of bed. I did it, but I did not want to do it. I used a walker and moved around the room a bit.
“Have you had a bowel movement?” No. “Well, you cannot leave until you have had a bowel movement.” Oh, good. Threatening me will surely scare the crap out of me, right? Not.
Another day passed and another visit from the physical therapist came. This time I got myself upright and walked down the hall with the aide of a walker. My surgeon came by again. He asked if I wanted to go home tomorrow. “Yes, please!” He said he wanted me to walk a lap of the floor, and then he would release me. Ah, a challenge. Good. He never said anything about my bowel movements. Unfortunately, that was, in fact, an issue. I had not had any solid food since the day before the surgery. I had no ability to make it happen. The nurses called my internist. We tried Milk of Magnesia – nothing. Late in the night, I was given something stronger, a lot stronger.
“Have you had a bowel movement?” Yes, right now! Help me get to the bathroom, or we are in for a fun clean up.
OK. That was messy, but it was out of the way – Now on to walking the floor. Being an ultrarunner has advantages in cases like this. The therapist came by and I told him what I needed to do. He was definitely skeptical. With my walker, I showed him how walking two days after major back surgery was done. He was not skeptical any longer when I raced a man with a new knee, and dusted a woman with a new hip.
I was going home! Less than six days total in the hospital, and that counts the day between surgeries.
It has to be said – I was sad when the morphine drip was removed. The pain started soon after. The ride home was intense. At least I had the Norco, and I downed several during the hour long ride.
The next two weeks are basically missing from my memory. Deborah was trying to get me food and help me in other ways, but she was still on crutches. She had a real challenge on her hands. A home nurse came by, measured my incisions, and took my temperature and blood pressure. She never came back. I did not need her. A home physical therapist came by twice. He showed me some exercises that were easy for me. I walked him to the door using my walker the first day. He was surprised I could do that. The second time was several days later. He brought some tennis balls for my walker. While I appreciated that, I had ditched the walker the first day I had seen him. He did not come back, either. The pain and discomfort were considerable, but bearable with the help of the painkillers.
|My back incision. No stitches - medical "super glue." |
The front was too ugly to show here.
I regained feeling in my thumb after about a week, maybe a little longer. When I was looking at my incisions in the mirror, I noticed I had significant bruises on my legs and back. I am not certain now if they gently placed me on the operating table, or threw me there. I was very asleep, so they could have done just about anything. I kind of like the idea that they played a game of throw the patient while they waited for the surgeon to get ready. I enjoy amusing people.
By the third week, I was walking a mile down the street. Slow, deliberate steps, but I was moving. My bowels where moving just fine too, thank you, though getting on the toilet was a new adventure in pain. I was able to start eating somewhere other than bed. I was starting to sleep through the night. I started to go to work, which surprised everyone. This required dropping the narcotics, because I need to think clearly and make quick decisions.
Every day I felt the changes. Some numbness in my left leg decreased and is now gone. Years ago, I lost feeling in the front of my thighs. You could have put a cigar out on them, and I would not have known. I fully expected that those guys were gone forever, and my surgeon expected so as well. But, right away I found that sensation had fully returned.
I was up to about 3 miles of fairly hard walking, but still careful, by about 2 months post surgery. I have to admit to getting a little frustrated at that time, because I could not run. I had to let the bone set to ensure a proper fusion. Even a little pounding or a too aggressive twist could ruin that. Running at that point just was not safe. So, to ensure I did not attempt it, I stopped the long walks. Not the best thing, but the safer thing. I know myself. It was the best thing at the time.
It has now been four months since the surgeries. My doctors promised me 80% pain relief, and that I likely would not regain the lost function in my legs. There might have even been other damage caused by the surgery itself. That is the way these things go. But, with big, giant smiles on their faces, my surgeon and my internist both have said that I have scored the rare 100% success. Not only has my surgeon taken my pain away, I have regained all lost function and sensation. All nerves have returned to normal. I am told that just does not happen. I knew I had a world class surgeon, but this is beyond dreams.
With the OK of my surgeon, I have started light running. At three and a half months post-surgery, I wrote this note –
“Three and a half months ago, my medical team performed two major surgeries on my back in an attempt to give me my life back. They said we are doing this so that you will not have pain anymore. We are doing this so that you can run again.
Today that promise was kept.
Today I ran.
It was a mile. I panted and coughed just like I am beginning again - I am. It was a long mile. I took it slow and savored it like a long ago forgotten favorite song. It was a short mile. I wanted more, but I have to learn to run again. It was the best mile. When it was done, I cried a little, for I had no pain.
Today I ran.
And even better, tomorrow I will run again.”
Just this week, I wrote this –
“Tied my running shoes with my feet on the floor today. First time in years. Ah, the little things....”
I have a long way to go. My body will continue to heal and adjust to the new hardware for about 8 more months. I need to remain careful to not do anything that will damage my surgeon’s good work. Once healed, I will be able to return to a fully normal life, a life without pain. I am like a novice runner again. One mile, two miles, a little more are the goals now. Each time I go out, it gets better. Easy, though. I still must take it easy and not push too hard. But, I know I am going to get back where I want to be. I will get there through hard work and making sure I let my back finish healing. I owe this to my surgeon, who did what he needed to do to make me run again, at no small risk of not getting paid for one of the surgeries. I owe it to my internist, for helping me in the first place. He listened when so many doctors did not. I owe it to Deborah, for living with me through this, for fighting when the fight left me, and for supporting me through this and through the ordeal that can be my dreams. I owe it to me, for simply enduring and continuing to live my dreams.
When my surgeon first saw me after the first surgery, he told me it is a wonder to him how I could have done the running and walking that I had been doing with what I had going on in there. I smiled and said it was just pain..... He looked a little stunned and said, "That could not have been just pain." I did not disagree.
To celebrate my return to running and my fantastic return to life without pain, I have registered for the 2014 Napa Valley Marathon, my favorite marathon. It is my deep hope that I can continue in this vein toward Death Valley in August 2014 for my long planned self supported solo crossing. Friends at my current job, and from my old one are clamoring to help out. It will hurt to say that my goal is to do it without help. But, they sure will be welcome to come out and urge me on. That would be more help than anything else could ever be.
I feel so good. It is really hard to believe. The expression of being reborn is overused, but, in fact, that is how I feel.