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  • outpatient vs. inpatient ACDF?

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    Old 10-29-2009, 03:27 PM   #1
    binx
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    outpatient vs. inpatient ACDF?

    hi again ,

    i spoke with the scheduler at my NS office to discuss surgery preliminaries (we are looking either at 12/3/09 or 12/7/09--happy holidays, right?) and she reiterated what the NS said during our last appointment--that i have the option of scheduling an inpatient or outpatient ACDF procedure. she said most people choose inpatient if they don't have help at home which isn't the case for me. my husband and other family will be here to support me, for which i am grateful.

    admittedly, part of me would LOVE to avoid staying overnight in the hospital and begin my recovery in the comfort of my own home, but i am concerned about what we would do if a complication arose. we don't live that far from the hospital, but it's still kinda scary.

    i did get a couple of opinions about this when i briefly touched on it in an earlier post, but thought i'd troll more broadly. what is the general consensus with respect to this issue?

    thanking you all in advance,
    binx

     
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    Old 10-29-2009, 06:21 PM   #2
    sk84life
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    Re: outpatient vs. inpatient ACDF?

    Go home! Hospital beds are very uncomfortable. Almost all our one level ACDF (and even some 2 level C4 or below) go home between 6-8 pm and they do just fine. If your surgeon is at all concerned, he will admit you...for unusual pain or nausea (rare these days.)

     
    Old 10-29-2009, 06:34 PM   #3
    matt3507
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    Re: outpatient vs. inpatient ACDF?

    sk84life,
    I read your reply about unusual pain or nausea being "rare these days" for 1 level acdf's. I am just wondering why that is so. Is it a technology issue or experience or something else. I could use some encouragement. Thx! take care.

     
    Old 10-29-2009, 08:39 PM   #4
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    Re: outpatient vs. inpatient ACDF?

    I'm on the other side....allow yourself one night in the hospital. Then you can gauge your pain level and address anything else that concerns you. If you fare well you can go home as soon as you see your doctor the next day. I did a two night stay for my ACDF and am glad I did. A few times I wondered "should this feel this way?" and I had the nurses to help me feel more comfortable about what I was experiencing.
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    Old 10-30-2009, 01:37 PM   #5
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    Re: outpatient vs. inpatient ACDF?

    matt - well, a lot depends on how well prepared the patient is for surgery in the first place.....most are just so glad to finally be having something done that they have a positive attitude. Secondly, and I can only speak from my own experience (both as someone who has had ACDF x 2, and also work with neurosurgeons and ortho spine surgeons) that the anesthesia used today allows for many types of surgeries to go home the same day. Certainly the surgeons have also refined their techniques too., but these docs all have their own way of handling patients.....some still use hard collars, some soft collars, some not at all.

    Obviously, how severe the patient's cervical condition plays a role, but for the more 'routine' ACDF these patients do fine.
    Yes, you will read here and elsewhere about the more complicated events, horror stories, etc. But thousands are done nationwide every week that you never hear about. Quality of care - nursing, anesthesia, recovery room, post-op - does vary location to location.

    Only you and your doctor know your particular condition. If he is giving you the option, then only you can decide what is best for you. You might ask what percentage of people like you do go home the same day and do just fine.

     
    Old 10-31-2009, 12:17 AM   #6
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    Re: outpatient vs. inpatient ACDF?

    You almost get charged for a full day any way, why not go ahead and stay one night where there is better pain control in case you need it. There are probabilities everything is fine and you will feel more comfortable at home, but if you have a reaction to the anesthesia, or some other unforseen thing, at the hopsital they will be able to handle those situations right away and you won't have to deal with that stuff at home. I think rushing it they take the drains out too fast, and that could lead to swelling, or problems with the incision down the line. It's only one night! Unless you are having the minimally invasive kind, why not stay the night!

     
    Old 10-31-2009, 12:02 PM   #7
    binx
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    Re: outpatient vs. inpatient ACDF?

    thanks again for all of your input. as ever, i don't expect anyone to tell me what is right or wrong--i am really trying to gather as much information as possible to allow me to make the best decision for myself. you all know how hard it is to get more than one line, or even one word answers from doctors sometimes, so, it is incredibly helpful to get an idea of the bigger picture from everyone here, including the good and the bad.

    hi again, neckpatient: my NS described the procedure as a minimally invasive, one-level ACDF. in your opinion, does that make an outpatient procedure more reasonable?

    thanks again for sharing your wisdom.

    with healing thoughts,
    binx

     
    Old 11-02-2009, 07:00 PM   #8
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    Re: outpatient vs. inpatient ACDF?

    If you doctor uses those words to describe and is comfortable sending you home some hours later same day - then yes. Are you having surgery at one of the laser surgery centers or a non hospital surgical center? Otherwise you will be at a hospital and they will keep you if they feel you are not ready to go home! It will be ok Binx! Lots of people who really worry over their one levels, fix it and then come back and remark they can't believe they waited so long and worried so much. Caution is good so never feel bad about questions.

     
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