Saturday, August 20, 2011

This is Spinal Surgery

Six years ago, I had a lot of back pain, the result, I assume, of two decades, give or take, of standing in trading pits. I went through a series of MRIs and found out I was a mess: stenosis, arthritis, cord compression, and a few more bits. I had surgery scheduled, but knew enough guys back in Chicago who went under the knife to cure back pain. It never worked. So I cancelled.

With much doubt, I started seeing a chiropractor, and the back pain disappeared. In its place arose a new set of symptoms: leg numbness, pain, a constant sense of having pins and needles. I have a high pain threshold, equal to that of a dairy farmer a friend said (high praise) so I bore with it, but when my knees started buckling and I suffered an occasional fall down the two steps to the computer room (invariably while holding a full cup of coffee), I knew I needed to revisit the ol' MRI machine to see what was causing my 48 year old body to pose as an 80 year old's. (I wrote about that two posts ago, I believe).

With the results in, I saw a neurosurgeon on Tuesday. He was alarmed at the progression (or is it regression?). My spine was so pinched, like an indented pool noodle, that he feared a fall would cause some serious damage. I needed surgery and this time I was up for it. This wasn't for pain, this was about functionality. Not that I love to walk, but I do like having the option. The surgeon left to call the operating room as to their schedule, and Karen and I were shocked to find upon his return that two days later, on Thursday morning, I was going to be cut.

On one hand it was a comfort to not have time to think about it. On the other hand, it would've been nice to have some time to think about it. Didn't matter though, the wheels were now in motion.

With the market behaving with the same lack of control as my legs, I thought about how much this might cost me. What could a little spinal surgery come to - $30,000, $40,000, $50,000? I had no idea and was afraid to call my insurance company, even though I assumed I wouldn't have to pay the full boat. I assumed they'd try to tell me not to have the procedure. The hospital, Bassett in Cooperstown, was very helpful, filling me in on their conversation with Allied Benefits and, it turns out I have a cap on cost. I did call Allied, but got the feeling they were just spitting back what I told them Bassett had told me. I nervously await the bill.

The surgery was moved from 11 AM to 9 AM, which was good since I couldn't eat after midnight. We checked in and, in the waiting room, which had floor-to-ceiling black and white baseball shots which I'll have to investigate further (there was a nice one of Maury Wills backhanding a grounder), Karen and I went through the paperwork.

"What's PACU?" she asked the woman at the desk.

"Oh, that's the recovery room."

It was clear Karen wasn't going to get what she wanted, which was what the acronym stood for. It became a running gag: everyone she asked told her "Oh, that's the recovery room."

I've found that having friends as doctors makes the hospital experience more relaxing. I never would have thought that in the past. Down on the operating floor, we talked to my anesthesiologist, who was the first person to give me the lowdown on some of the risks.

"You're going to be prone for five hours and, though we are very careful, you may develop pressure sores from the weight distribution. Chin, knees, hip bones. Sometimes there's pressure on the eyes that could lead to blindness, but that's never happened here."

There was more: a breathing tube, which when removed would leave me with a temporary throat problem (I have a Vito Corleone thing going on still) and a catheter, which I dreaded. I was told the tube would come out before I was awake, but the catheter would remain. It wouldn't hurt, I was assured. It would feel weird, like having an earthworm pulled from my penis.

This was scary stuff. "Could I back out now?" I asked, with no real intention of doing so.

"You wouldn't be the first."

The surgeon came in, and reiterated my problem. The spinal cord is supposed to be an oval looking downward, but mine looks like a three-cornered hat. The Tea Party strikes again! I was to undergo a laminotomy (still don't know), a discectomy (removal of a disc) and a cage fusion (either an exotic wrestling match or a newly built metal and bone support).

By this time I wasn't very nervous. Having had a colonoscopy a long time back helped. Before that delight, I was told I wouldn't remember anything. That was hard for me to intellectualize, but having undergone the experience I know it to be true.

Finally the moment came and I was wheeled into the OR. I remember the lights, and some people milling about, and then it was about 3:30, I was in PACU (Peri-operative Acute Care Unit, we eventually found out), and it was all over. Some people visited me to check me out and fit me with a new plastic brace/corset. Reports were that I was very cooperative.

The worst was over, and I wasn't even aware of how it played out, but the recovery was going to prove problematic. Not physically, I could already feel my legs were better. I had the worst roommate imaginable: a cantankerous, complaining, snoring evil Oz behind the curtain that divided the room. All night long his machines were buzzing. He couldn't figure out why, but I could here that he wasn't interested in how to fix it. The nurses told him how to avoid having his IV tangled but he insisted he had faulty equipment. Even when no staff was present, he would complain out loud. I had no problems with anyone and if they arrived a little late on my behalf I was fine with it. Cranky Neighbor bitched on my behalf. Thank God for earplugs.

The night went reasonably well despite the black cloud to my right, and I learned something important about myself. I can't pee lying down. You're given a jug to use, which was some relief accident wise, but I need to get up and that would prove a chore. Two strong guys were brought in to help me up and I made it to the bathroom, a heroic achievement. It was a struggle to get from lying down to sitting up. As the night wore on, I was able to leave bed with only a little help.

All signs pointed to a lunchtime discharge. I was feeling fine, though sore, as if someone had sliced their way through my back muscles. My wound was draining into a white hockey puck device that was connected through a tube into my back. This too, upon removal, would feel weird like the evil earthworm of the catheter.

Karen and Nate came to visit. Nate was worried, on edge a bit, but soon, with no real sense of my comfort, hopped into bed with me and started watching TV. "You're not dying, are you?" When he saw my puck, he asked, "Is your blood brown?"was very sweet and comforting.

Karen, who was as wonderful as I would expect, had put in a lot of hours the night before and came back as soon as Joey got off to work. She took Nate for pizza in the cafeteria, and it was only a matter of time before I was released, leaving my nemesis behind the veil cursing and screaming at his lazy, good for nothing wife who couldn't do anything right. At least that was his take on her; I was glad to leave.

I slept on the couch last night, finding my down to the floor and bathroom. It's truly amazing that I had back surgery two days ago, and have already improved dramatically, enough that I'm sitting at the kitchen writing this. No pain, all gain.

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