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  • Surgery done I'm HOME

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    Old 01-14-2013, 08:34 PM   #31
    pebblebeach3
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    Re: Surgery done I'm HOME

    QUOTE:

    Also, from my research morphine & dilaudid are measured in milligrams(mgs), fentanyl in micrograms(mcg).


    GMAK:

    In a recent post you stated that dilaudid/morphine is measured in milligrams (mgs.). Not sure that this is correct.

    I belkeve that the Medtronic system that I have implanted in my system is called Synchromed II. When I went into a site under that name for Medtronic it discussed the specifications for the implant. There are two different sizes to the units. One is 20 and the other is 40 which is the unit I got. I guess it holds more of a resorvoir of medication.

    But the specification that also was listed as to the medications said "mL" which from what I looked up means "MILILITRES."

    So I think the way is measured is different from MG's. I am not sure if you calculate it how much of a difference there is between a "MG" and a "ML" but I assume that there is a difference in the measurement.


    Also you questioned the PROCEDURE itself. My pain management doctor told me that this procedure is done under "local" compared to a "general" anesthesia. Whether you can be put out or not, I am afraid that I do not have the answer on that one.

    I do remember at first lying on my stomach and I was able to hear what was going on and talking to someone. It was an extremely uncomfortable position for me so every so often I would have to adjust my neck very slightly. And even the little movement I made was to much. They told me (nicely) to keep still. And they would also ask how I was doing which I was able to tell them the problem that I was having.

    Then yes they did have to flip me so that the device itself could be placed in the abdominal region itself. I believe I was still awake for this part of the proecedure, but for reason I don't remember as much for this part fo the surgery. Not sure why though.

    But also, and I cant remember which part of the surgery this was done, but they asked me to wiggle my toes. I remember doing this several times during the procedure.

    I have heard some surgeries other than this where being awake during part of it is needed by the patient. Like Medtronic also makes a device implanted in the brain for Parkinson patents called Deep Brain Stimulatio. It is uded to help control tremors. And this requires some response from the patient during the surgery itself.

    I have to admit I dif feel things. I dont know if you ever went thru an EMG. That I was able to feel at certain point and to me at least that was painful. For some reason it felt the same way to me during the implant. I was not screaming in pain so dont get me wrong, but I was certainly aware of it.

    Every so often I do remember them (anesthesiologists) were injecting me with more medication, not sure what they were injeting though.

    If you are concerned about this I would suggest you ask the doctor as to whether being awake during the surgery is ALWAYS done or if there are options etc.

     
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    Old 01-15-2013, 01:18 AM   #32
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    Re: Surgery done I'm HOME

    Thanks so much for telling me about the anesthesia & surgery. I think im getting queazy in my old age! Im sorry I sound so weak, i know that i will have to face it like anything else i have to do to help control pain. Also, thank you for the medication help i was mistaken. I should have said mg/ml or mg per ml vs mcg/ml or micrograms per ml. Thanks for your kind patience with me! My family members are pushing me to go back to the dr that recommended the pump. I have lots of concerns, i havent had surgery since 1992 & facing an OR seems harder than before & im not sure why. Im so glad that the trial, implant is over for you & your on the road to recovery! Hope you have many low pain days or no pain days would be awesome!

     
    Old 01-15-2013, 06:20 AM   #33
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    Re: Surgery done I'm HOME

    Gmak:

    Facing surgery is scarey, it is overwhelming and should not be taken lightly.

    You said that your family is pushing you to go back to the doctor and have the pump done. I am sure that they are wishing the best for you and for what's in your best interest. They don't want to see you in pain. They have your best interest at heart.

    But please remember that the decision is yours completely. You are the one that has to make the decision that is in your best interest. It is your body that would be subjected to surgery and you must deal with the pain. You really need to feel in your heart that the surgery is what you want and is something that is right for you.

    People can give you their opinions but you have to do soul searching for yourself. For me I think the pump is the right answer.

    And yes being scared of surgery is normal. Even though its been a long time since youve been in surgery you need to prepare yourself physically for the challenge of surgery but you have to prepare yourself mentally and spiritually as well when entering such a big challenge. I believe, and not sure if you agree or not, but there is a big connection between mind-body-spirit. When they work together the better the chance of success.

    It's like the first surgery that I went thru where they put Harrington Rods into my lumbar spine. I didn't know what to do. Yes the decision was mine. At the time I was seeing a neurologist for another health issue and when he heard about the surgery he didnt try to tell me what to do. He did address his concerns such as risks of putting a foreign substance into your body. Risk of infection for instance. All the risks he stated were risks, I knew that. But I knew that I either went thru the surgery and truly believed that I would be fine or if I didn't I probably would never walk normally again in my life.

    And I saw a neurosurgeon for another opinion on the same surgery. He too felt the surgery had risks. But in his case he did NOT feel the surgery were warranted. He felt go back to work but didnt really supply any solution or alternative to the treatment. While I respected his opinion it was what was right for me.

    So do some soul searching and see if this is truly what you believe will give you answers and is what you want to go thru. Only you can answer that question.

    And if the answer is yes, then will be the time to prepare yourself mentally for facing the OR.

    I have to psych myself up for the challenge. I have to get to that positive attitude that everything will be fine and I will get thru it. And if there is a challenge presented then I have to be ready to face that too.

    Like I hate going in for MRI's I go for the closed because I feel that they give better resolution to the films. I always start to panic when I know an MRI is coming up. The thought of going into the machine really puts me into panic mode. So I have to think positive and calm down. When going into the machine I close my eyes. I start to think of calming things. Like I love the California coastline. I think of being there and that relaxes me when I start to go into the machine and while I lie there. And this helps me mentally.

    Whatever worsk for you is what is important.

    Hope this makes sense and that you arrive at an answer on whether the pump is the answer for you. Good luck

     
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    Old 01-15-2013, 06:52 AM   #34
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    Re: Sugery done I'm HOME

    Were you on pain meds before? Did they have to titer you down from them so that you didn't suffer from W/D?

     
    Old 01-15-2013, 06:59 AM   #35
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    Re: Surgery done I'm HOME

    Furrymom:

    The most recent meds that I have been on was Hydrocodone 7.5-750 mg. The prescription that was given said I could take 1 1/2 tablets 4 times a day. But I never took the maximum. I usually took maybe 3 to 4 talbes a day.

    And I was on Tizanidine 2 mg 3 times a day. (muscle relaxant).

    No I didnt have to get off the medications prior to the surgery and there were no issues as to withdrawal.

     
    Old 01-15-2013, 08:35 PM   #36
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    Re: Surgery done I'm HOME

    Pebble,

    How ru doing now that it has been a few days?

     
    Old 01-15-2013, 09:03 PM   #37
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    Re: Surgery done I'm HOME

    I'm doing pretty good. I think I would say I am getting 80% relief from pain in my mid/low back.

    I still have leg issues; peripheral neuropathy which to my understanding the pump won't help. I also get SOME mid back pain. And my upper/neck area is still giving me issues.

    I think the trial I had better results. BUT I am still happy with what the permanent implant is doing.

    I see my pain managment doctor on 1/16/13 for follow up and hopefully removing the banages.

    I think I definetly see a difference in how I feel between the Intrathecal Pain Pump vs. The Spinal Cord Stimulator. I think the Pain Pump is working a lot better for me than did the Stimulator.

    So for now I am saying it is a SUCCESS!!!!!

     
    Old 01-16-2013, 11:58 AM   #38
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    Re: Surgery done I'm HOME

    Hi all. I just had a follow up appointment with the pain doctor that implanted the pump. They changed the dressing and have to go back next week. I still have the staples in and they should be removed next week. I am still somewhat swollen where the implant is.

    So there are still restrictions on twisting; bending and lifting. I still can't shower. I've been using a cloth towel to try to clean up the best I can. I will have to manage till then. Can't wait to hop into a shower again.

    I do have a "remote" control with an antennae. First of all the system is program by the doctors office which delivers 0.48 Dilaudid and 0.48 mL of Bupivacaine for the entire day. The remote does allow me to increase and give myself extra medication if I need. It will allow me to give myself a "bolus" of 0.100 ml of both medications 3 X's per day. But I am limited to doing so every 8 hours. I can't give myself medication before that time period. The system won't allow it. So there are some constraints on how much I can give myself and how often. But that is ok. This way I can't overmedicate by accident.

    He briefly looked at the MRI of the cervical area. Didn't like what he saw and wasn't sure if there was too much that could be done. But need to discuss further what can be done from a pain management standpoint rather then a surgical point of view.

    I see my neurosurgeon on 1/23/12 in the morning and my pain doctor the same day in the very late afternoon. So I will be busy and will see what the neurosurgeon says. I think one think NEW in the MRI report is that it says severe loss of disc height and bone spurs. I don't recall that being in the prior studies. What was there was the focal cord atrophy and myelomalcia.

    Time will tell what to do. In the meantime I am still taking the hydrocodone and tizanidine so hopefully that will take off some of the edge from the neck pain.

    I just don't want to overdo it on pain meds. Now I am on Hydrocodone; Dilaudid; Bupivacaine and Tizanidine.

    I prefer going conservative on pain medications.

    More later.

     
    Old 01-17-2013, 08:40 AM   #39
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    Re: Surgery done I'm HOME

    Hi pebble! Hope this finds you recovering well & i surely want to know what NS says about your disc, neck, thoracic. Im praying for deanh surgery this afternoon & thought i would remind you. I think he has been so good to us on backboard!

     
    Old 01-17-2013, 09:07 AM   #40
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    Re: Surgery done I'm HOME

    GmaK

    I must be having a senior moment. What is deanh having done? If he is having surgery then yes of course we all have to stick together and pray for him as well.

    You are all family and we need to support each other in any way possible.

    Please refresh my memory on what he said or where his post is so I can see it.

    As to the neck I am not sure what can be done. My pain doctor yesterday looked at my MRI films and he had concerns about what he saw. Didn't sound like much could be done from his point of view. Not sure though what could be done from pain management point of view.

    As to my neuro surgoen he is aware of many things that already showed up previously on the films He was afraid to touch me last year. I think there MAY have been new things showing up on film but not sure. I have to compare the reports to sew if there are any changes between the 2 reports.



    I think the PUMP is working fairly well. I am alowed to give myself some extra medication 0.1 ml every 8 hours. I have slight low back discomfort so gave extra shot of morphine/bipuvacaine. My neck/upper back is giving me issues though. And that is what I want to address with the neurosurgeon. See what he says. But I doubt that he is going to recommend surgery because of the risks of surgery and my health risks. But its a matter of how to control the pain if no surgery.

    Will report back after appointment next Wednesday.

     
    Old 01-17-2013, 02:23 PM   #41
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    Re: Surgery done I'm HOME

    Hi pebble, Deanh to have Scs battery changed this afternoon. I wish your pump could help the neck pain also. I guess we have to see what neuro says. The old "screaming inside" pain, is it gone or controlled better because now one out of two places relieved? Thanks pebble.

     
    Old 01-17-2013, 08:30 PM   #42
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    Re: Surgery done I'm HOME

    Gmak:

    As to my mid-low back I would say that I have 80% relief from the pain that I had. I can go from having NO pain in the area at all to some pain On a pain scale of 0 to 10 I would say the worst I get in the mid-low back is maybe a 3 I guess. That's not to bad compared to the way it was.

    I can give myself a "bolus" when I see the need. I can give myself 0.1 mL 1 time very 8 hours or 3 times in total per day. So I am dealing with it very well.

    As to the upper thoracic/cervical area that area still is giving me troubel from mild to moderate/severe pain. I am not sure what I would put the pain level when it is at its worst. At least a 5 I guess maybe a little bit higher.

    I am concerned about the neck and what can be done to it. I really doubt that the surgeon (neuro) will recommend surgery when I see him on Wednesday. He has expressed his concerns to me several times over the past 2 or more years as to what the problems are and why he feels he CAN"T do surgery on me. So I am not sure what he will recommend at this point in time.

    I need to clarify as to what can be done from a pain management end for the pain in the neck. I still take Hydrocodone and Tizanidine which I guess is giving me some neck relief.

    But what concerns me is while the pain may be under control, that won't stop the progression of the problem. If the myelomalacia continues even at a slow rate; and the focal cord atrophy continues and continual problems with bone spurs and loss of disc height then what will the long term effect be on me. I have lost or have damage to the nerves causing weakness in my arms. That can not be repaired. So how do you stop further damage? That's what concerns me a great deal.

     
    Old 01-18-2013, 08:33 AM   #43
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    Re: Surgery done I'm HOME

    Pebble, Of course it concerns you greatly! Its very hard to just basically "stand by & watch" when the nerve symptoms progress or when the MRI shows progressive problems, or for me it is anyway. When all the drs said to me "no surgery"I cried & pleaded with 2 of the neurosurgeons to do surgery, but the answer was no. So no matter what my MRI shows or the increasing nerve symptoms, even if the pain treated, i really want to be able to tell the dr & get it stopped, but instead it just progresses daily, i take maximum dosage of lyrica, live with numb hands & feet, roof of mouth & teeth,etc, so i understand how it feels! It is hard, frightening, worrisome basically bites! Im sorry this is happening to you! I care & hope that the neurosurgeon can do something for you that will slow it somehow.

    Last edited by gmak; 01-18-2013 at 09:19 AM. Reason: wording

     
    Old 01-18-2013, 09:35 AM   #44
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    Re: Surgery done I'm HOME

    Gmak:

    I was sorting thru some old medical records the past few days. I have MRI reports that go back to 1989.

    While I didn't take time right now to review the old records I did quickly glance at a few here and there.

    One of the things that has recently been appearing in my Cervical MRI was that there is "focal cord atrophy" from C4-6 (I think). For some reason in the OLDER reports, I MAY have seen the same terminology in reports from years ago. So it started to make me think has this issue been going on a lot longer then I thought or remembered?

    When I am up to it I want to really sit down and compare the records over the years.

    I have records as I said that go back to 1989. I heve MRI's of the cervical spine; thoracic spine and lumbar spine. There are issues everyone from what I've seen and remember.

    It may take me a while to really go thru it all since there are so many reports to read. I have probably [approximately] 32 MRI/CT reports on file read and review.

    I do have several films and reports as well that are myelograms. Plus some of the earlier MRI's were done with contrast/Gadolinium.

    The contrast has to be stopped at one point because I am living with kidney disease and the contrast would have a negative impact on the kidney.

    It would be interesting to see how things have progressed over the years.

    I am not sure what the answer is anymore.

    I know my neurosugeon who I've been using 7 years or so I guess is concerned about surgery on me. First he has told me repeatedly to do surgery on me would be "a surgeon's" nightmare. He said the only way to get to the cervical area that is the issue would be to go thru the sternum. And if it is nightmare of a surgery for the surgeon then what would the surgery be like for ME?

    But his concerns also about surgery is because I have diabetes so the healing process from what I understand is an issue. Longer time in healing is one issue. But the fact that I was born with1 kidney and have Kidney disease of the 1 that I do have concerned him as well.

    I did ask my nephrologist [kidney doctor] about risks of doing surgery on me becasue of the kidney disease. A while ago he told me that the risk would be "low." At least that is his opinion.

    But there are risks with ANY surgery, even those that the doctors call "routine surgeries."

    But the question is for the surgery on my neck what would be involved in the surgety? What is the procedure called? And at what point do you have to question the BENEFITS vs the RISKS? When the risks outweigh the benefits then what do you do?

    So many considerations. But I don't have the answers

    I have some decent hospitals listed on my plan. But would I like a little more freedom to go to others for opinions that are not on my plan? I would love the option. While I do have out of network benefits, it does come at a financial cost. There is a much bigger out of pocket expense initially for me. And right now I can't do it financially.

    So I might have to live with what I do have as far as reasoable options.But then I am also faced with the fact that with some of the doctors on my plan many of them won't see me. They don't want to touch me surgically and they know that up front. So they won't waste their time or mine to see me, even if its to discuss what my options are. So my field of treating doctors sometimes become even more reduced because doors are being closed in my face.

    How many times have you been told yoru case is a complicated case? Sometimes it feels like such a lonely place in that I am battling the medical community to get some answers. It feels like a full time job in that I am trying to stay alive and improve the quality of life at the same time.

    In any case. I'm sure I will have more to report next weeks.

    I see the neurosurgeon in the morning then my pain mgmt doctor in the aftermmon. I expect to have the staples taken out then too. Then finally I can get back into the shower. I hate sponge bathing since I can't get the surgical areas wet.

    Enjoy the weekend everyone. And let it be a pain free day as much as possible.

     
    Old 01-18-2013, 10:23 AM   #45
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    Re: Surgery done I'm HOME

    Hi pebble, Im sorry, i have had that complicated case comment too many times! Truly i understand when not one medical dr has ever seen nor will touch an arachnoiditis patient such as myself. The pool of drs i have found with research is one dr, still practicing in alabama, im in texas, but he is a pm/anes not a neorosurgeon so the research continues to try to find a dr that can help in some way. I remember all the serious problems & diagnosis, surgeries that you have had & its complicated beyond compare i realize. I was just saying i have found no answers so far so i sit & watch the nerve damage progress. I hope there is a dr that can help you other than the severe sounding sternum entry surgery,

     
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