Change is slow and steady at the moment. I'm hopeful that it continues along this road.
Speaking of roads, I'm walking more and more of the streets around my home. Today I did 1 x 17 min walk and 2 x 20 min walk. 17 min gets me about 750m and 20 min about 1km. The walks are getting faster each couple of days and my stride is getting better as well. If I'm not careful and overstride a step I can feel some tightness in my sacrum and lower back - a good sign to keep taking it easy and to listen to my body. I think this is important as it will drive the speed, and ultimately the success, of the recovery rather than any arbitrary goals if speed, distance or time.
A few frustrations are kicking in. I'm sick of lying down for most of the day. I have the tv, PS3, kindle, iPhone all set up but I'm still annoyed. Managing this and my own expectations remains a challenge.
My wife has taken the last week off, it has been so great to hang out with her and to have someone to do all the little things. I'd have been screwed without her. But she goes back to work tomorrow. So my mum arrives at lunch time tomorrow to take over caring duties! Very thankful. With me being injured and my wife being 24 weeks pregnant, it will be so nice to have an extra set of hands around the house to take the pressure off.
Sunday 25 November 2012
Wednesday 21 November 2012
Day 13 PLIF recovery
Almost 2 weeks post surgery, and everything seems to be going really well. The numbness in my right leg is dissipating, which is a great relief. The pain in my back appears to be gone, and the same for the leg pain
I'm still surprised at my mobility. Currently doing 3 x 15 min walks a day. This is dictated by what I can do, rather than trying to stick to a time. Still problems sitting, and this is something I am avoiding. I can handle stairs ok and all personal ablutions.
I'm coming down off the meds, using less and less which is great. I'm wary of managing the pain, so still being proactive with them. Night times are fine, sleeping and easy 6-8 each night, not waking up in pain.
I'm scheduled to see the neurosurgeon on 12 December and will review the current status and discuss the way forward
Overall, I'm stoked. I'm looking forward to continuing the recovery as fast as my body allows.
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| Scar at 13 days |
I'm coming down off the meds, using less and less which is great. I'm wary of managing the pain, so still being proactive with them. Night times are fine, sleeping and easy 6-8 each night, not waking up in pain.
I'm scheduled to see the neurosurgeon on 12 December and will review the current status and discuss the way forward
Overall, I'm stoked. I'm looking forward to continuing the recovery as fast as my body allows.
Saturday 17 November 2012
Day 8 - Home time
What a turn around, I wasn't expecting to get home until Monday, then suddenly the ambulance guys turn up, and I'm on a medical plane at 1pm. Home by 2.30pm. So glad I flew, was able to lie down the whole way, ambulances at either end for door to door pick up and drop off. Couldn't imagine sitting for over 5 hours in a car, bending and twisting in and out a dozen times at rest stops. Well worth it.
Below are a few photos of the transport home
Below are a few photos of the transport home
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| My ride home Kingair 350 - takes 2 patients and about 6 nurses |
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| Getting winched on board |
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| I'm in the front bed, other stretcher in the background |
Thursday 15 November 2012
Day 7 PLIF Recovery
One week post surgery, and I've had my first disappointment. Nothing, medical, no increase in pain, just a failure of administration (a pretty pissy issue I admit). I was supposed to be home on Thursday or Friday. That's not the case unfortunately. The ambulance services patient transport service has been unable to get its shit together and arrange transport home.Frustrating really, made worse by poor customer service staff and no one taking responsibility or being accountable. There's plenty of compromise solutions that I can think of, jeez inefficiency pisses me off. I was really set on getting home, seeing my wife, being in my own house and really kicking off my rehabilitation.
Anyway, in the bigger picture its not a major issue. I'm in good care, can do some recovery here, there's no pressure on my wife to care for me.
I managed to walk a 400m return trip today - I needed coffee. Getting into and out of bed is getting easier. I'm moving faster and freer each day. What amazes me is the difference between my microdiscectomy in April 2011 and this fusion. At the same stage of recovery, I seem so much more ahead. Not exactly sure on why though. More pain killers? Prior knowledge helping? A better surgery? I don't know. I do know that my recovery is still going to take a long time, that I can't get ahead of myself, that I need to be diligent on my recovery and that I can't rush it.
Anyway, in the bigger picture its not a major issue. I'm in good care, can do some recovery here, there's no pressure on my wife to care for me.
I managed to walk a 400m return trip today - I needed coffee. Getting into and out of bed is getting easier. I'm moving faster and freer each day. What amazes me is the difference between my microdiscectomy in April 2011 and this fusion. At the same stage of recovery, I seem so much more ahead. Not exactly sure on why though. More pain killers? Prior knowledge helping? A better surgery? I don't know. I do know that my recovery is still going to take a long time, that I can't get ahead of myself, that I need to be diligent on my recovery and that I can't rush it.
Day 6 - PLIF Recovery
Six days post surgery, and I'm heaps more mobile. Still in pain, but its manageable. I haven't had to have morphine again which is great.
I'm walking (very gingerly and cautious) about 200m, three times a day, after each meal. I have been able to shower, shave, brush my teeth. All with some difficulty, and very slowly so as to avoid upsetting the surgery. Restrictions include no bending, twisting, lifting (over 2kg). No physical activity, short of walking. This is to be reviewed at the 6 week mark, just before Christmas, and again at the 12 week point. With my bub due in 18 weeks, I'm really conscious of this timeline.
There's still phenomenal pain from the surgery (you can't exactly escape that) but even despite that I can tell the pain in my back is so much better. There's a little numbness in my right leg, but the excruciating pain I had in both legs is gone. The neurosurgeon explained that the numbness is likely to be a combination of residual nerve damage, inflammation/swelling from the surgery, and some trauma from the surgery. It should calm down again.
The staff at Royal North Shore Private has been great, very helpful for pain management, very encouraging for the recovery, very supportive - even passing on movie tips for wasting time while stuck in bed!!
I'm walking (very gingerly and cautious) about 200m, three times a day, after each meal. I have been able to shower, shave, brush my teeth. All with some difficulty, and very slowly so as to avoid upsetting the surgery. Restrictions include no bending, twisting, lifting (over 2kg). No physical activity, short of walking. This is to be reviewed at the 6 week mark, just before Christmas, and again at the 12 week point. With my bub due in 18 weeks, I'm really conscious of this timeline.
There's still phenomenal pain from the surgery (you can't exactly escape that) but even despite that I can tell the pain in my back is so much better. There's a little numbness in my right leg, but the excruciating pain I had in both legs is gone. The neurosurgeon explained that the numbness is likely to be a combination of residual nerve damage, inflammation/swelling from the surgery, and some trauma from the surgery. It should calm down again.
The staff at Royal North Shore Private has been great, very helpful for pain management, very encouraging for the recovery, very supportive - even passing on movie tips for wasting time while stuck in bed!!
Tuesday 13 November 2012
Day Four - PLIF recovery
Holy crap. Now I know what pain is. Didn't sleep at all Monday night. I couldn't shake off the pain until about 11am when the doc gave me another shot of morphine.I knew this day was coming, I had read about it, been told about it and was glad I was prepared for it, otherwise I would have gone out of my mind.
As all the major drugs worked their way out of my system the pain really went up a notch. It is so frustrating to be unable to fix it, unable to take the pain away. To wait and see if the drugs work. Even lying still was agony, I couldn't roll over, sit up, stand, eat or drink. I ended up watching movies to try and distract me but even that didn't work.
Once we agreed to try a shot of morphine, the pain became much more manageable. Tuesday night I was much more proactive in managing my own pain rather than have the nurses do it for me. We came up with a better pain management strategy, without morphine, and that seemed to work last night. Slept in 3 hour blocks from 10pm to 7am.
As far as recovery goes, its very early but the neurosurgeon is confident.With help from the in hospital physio team I've got a series of exercises to do while in bed. While they are such tiny exercises, I am doing the religiously as I am sure they'll help. They also help pass the time!! I am walking laps of the ward after each meal about, 200m.That and general stretching help the body stay active. I can feel the affect on my body of lying down so much. For example, my hip flexors are cramping up really bad. I'm trying to stretch them when ever I'm out of bed.
I'm appreciating small things. Like a shower, shave, deodorant, clean linen and clothes. They really help mentally as I feel fresher and more positive.
As all the major drugs worked their way out of my system the pain really went up a notch. It is so frustrating to be unable to fix it, unable to take the pain away. To wait and see if the drugs work. Even lying still was agony, I couldn't roll over, sit up, stand, eat or drink. I ended up watching movies to try and distract me but even that didn't work.
Once we agreed to try a shot of morphine, the pain became much more manageable. Tuesday night I was much more proactive in managing my own pain rather than have the nurses do it for me. We came up with a better pain management strategy, without morphine, and that seemed to work last night. Slept in 3 hour blocks from 10pm to 7am.
As far as recovery goes, its very early but the neurosurgeon is confident.With help from the in hospital physio team I've got a series of exercises to do while in bed. While they are such tiny exercises, I am doing the religiously as I am sure they'll help. They also help pass the time!! I am walking laps of the ward after each meal about, 200m.That and general stretching help the body stay active. I can feel the affect on my body of lying down so much. For example, my hip flexors are cramping up really bad. I'm trying to stretch them when ever I'm out of bed.
I'm appreciating small things. Like a shower, shave, deodorant, clean linen and clothes. They really help mentally as I feel fresher and more positive.
Monday 12 November 2012
Day Three
Check out the X-rays below. See, told you, I wasn't lying.
The screws are so long apparently because they adhere to the engineering principle of cantilever. Still, they match the scar nicely. It also shows why the recovery is such a challenge and has to be done so carefully.
Meds are tailing off, which makes it a hard balancing act. Walked a full lap of the ward today, spoke with discharge officer about hitching a ride home. Also got basic plans off the physio for recovery. Will post them later. Still finding it hard to type - concentration and focus are hard to master on the pain
Saturday 10 November 2012
Day Two
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| Massive Morphine syringe - and Eva Green in the background!! |
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| Scar on day 2 |
Finally able to type today. Morphine drip gone, just on oral pain killers. Been up walking twice, only about 10m though!! Catheter out to this morning. Any guys reading this, you'll feel my pain.
How is the pain - hard to describe. There's obviously massive pain around the incision, but the pain in my back is gone and so is the numbness that was in my legs. Obviously you want this to be the case, that the current trauma isn't just overtaking all the pain. Its to early to tell if its a complete success, there's still so much that can go wrong.
Eating ok, drinking ok, and getting around ok.Still needs a month or 2 off!! Good thing its cricket season!!
Day One - What a day
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| Draining the wound |
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| Out of my mind?? |
Nausea, pain, nausea, agony, drugs, nausea. Nothing like waking up in ICU, stubbornly eating a a hospital made mcmuffin (it was machappy day after all) only to throw up on yourself.
Transferred from ICU to neuro ward about 1pm. Team here are great. Struggled with a fever overnight. Anything to keep the temperature down!! It doesn't help when the fire systems are being tested all day and the air conditioner is off!!
Thursday 8 November 2012
The night before PLIF surgery
Travelled to Sydney ok Hospital admin went ok. I've got my own room, so can't complain,
Nervous
Met neurosurgeon, discussed risks, outcomes, recovery, strategy for the operation. Going to be using the InterFuse system.http://www.vti-spine.com/interfuse.html The animation here shows how its done. (I really need to figure out how I embed videos that aren't on youtube!). Found good studies on this method, the one the maker has on there website is 97% successful fusions, at six months, from104 patients.The question remains though with fusions, will this take my pain away?
Anxious
Met anaesthetist. All sorted for the day to. That must be a cool job to knock people out eveyday.
Worried
I've been bumped down from early morning to the afternoon. A couple of brain tumour patients are ahead of me. I know I'm in pain, but seriously, they can go first.
From surgery to ICU overnight to keep an eye on everything, then out to the normal ward. All going to plan, a few days there, and then into the rehab section.
Second guessing myself? No. I'm in pain, have been for a decade, I'm over it. Lets focus on the recovery. I have a great support network around me - from wife, family, friends, co-workers, to surgeon, sports doc, physio, rehab. I will be drawing on this as much as I can. Thank you everyone
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| Out the front of RNSH |
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| View from room |
Met neurosurgeon, discussed risks, outcomes, recovery, strategy for the operation. Going to be using the InterFuse system.http://www.vti-spine.com/interfuse.html The animation here shows how its done. (I really need to figure out how I embed videos that aren't on youtube!). Found good studies on this method, the one the maker has on there website is 97% successful fusions, at six months, from104 patients.The question remains though with fusions, will this take my pain away?
Anxious
Met anaesthetist. All sorted for the day to. That must be a cool job to knock people out eveyday.
Worried
I've been bumped down from early morning to the afternoon. A couple of brain tumour patients are ahead of me. I know I'm in pain, but seriously, they can go first.
From surgery to ICU overnight to keep an eye on everything, then out to the normal ward. All going to plan, a few days there, and then into the rehab section.
Second guessing myself? No. I'm in pain, have been for a decade, I'm over it. Lets focus on the recovery. I have a great support network around me - from wife, family, friends, co-workers, to surgeon, sports doc, physio, rehab. I will be drawing on this as much as I can. Thank you everyone
Sunday 4 November 2012
L5-S1 Posterior Fusion - facts
Only 5 days out now.
For those that don't know what surgery I'm about to have I'll spell out a few of the basics in this post.
Animated video of what the operation does:
http://www.spine-health.com/video/posterior-lumbar-interbody-fusion-plif-video
The big choice seems to be anterior (through the front) or posterior (from the back) fusion or disc replacement. There are advantages and disadvantage for each - whether its access to the disc, less moving of the spinal cord. Anterior vs Posterior has the added risk of injury to the bowel, ureter and for men - the lovely topic of retrograde ejaculation (no more babies!!)
Risks for PLIF fusion:
The chance of it working according to medical journals is >70%.
A lot of journals focus on things like the pedicle screws loosening, or the adjecent disc disease (where the problem moves up a level).
The basic philosophy I am using to accept the treatment is:
For those that don't know what surgery I'm about to have I'll spell out a few of the basics in this post.
Animated video of what the operation does:
http://www.spine-health.com/video/posterior-lumbar-interbody-fusion-plif-video
The big choice seems to be anterior (through the front) or posterior (from the back) fusion or disc replacement. There are advantages and disadvantage for each - whether its access to the disc, less moving of the spinal cord. Anterior vs Posterior has the added risk of injury to the bowel, ureter and for men - the lovely topic of retrograde ejaculation (no more babies!!)
Risks for PLIF fusion:
- Non-union
- Damage to the spinal cord or nerve roots
- Infection
- Bleeding
- Continued pain
- Adjacent disc disease
- Injury to the vertebral artery
- Blood clots
- Stroke
- Paralysis
- Bowel or bladder incontinence
- Death
The chance of it working according to medical journals is >70%.
A lot of journals focus on things like the pedicle screws loosening, or the adjecent disc disease (where the problem moves up a level).
The basic philosophy I am using to accept the treatment is:
- Ongoing conservative treatment - tried this for over 10 years.
- Discectomy and S1 nerve root decompression - the least invasive surgery.
- L5/S1 fusion - permanent, last resort.
- Life long maintenance of my condition - I will always be conscious of my back, I'll always be doing things to keep it healthy and functioning well.
Thursday 1 November 2012
Why so keen to get it done?
I must admit, there's a ulterior motive for why i am so keen to have major surgery.
I want to maximise my recovery before 20 March when my wife is due with our first bub!!
We are both super excited about our little bub!!
So with regards to the surgery, every day delayed is a day less of recovery. I have been in pain for a decade, managed it every way I can, had one small surgery on it already. So I know I need this oen now to take the pain away, there just aren't really any other options that I have left. So if I need it, then lets do it ASAP.
To the neurosurgeons credit, he has resisted me pushing a little bit. We have tried more cortisone injections
Its been three months since the really big relapse and despite a lot of treatment during this time, it isn't going away. The pain is there, so I need to do something.
On the upside, I will hyper-focused on the recovery. I will do everything I can to be able to help my wife in February/March and to be able to look after my bub when he arrives. I think I will actually have to watch carefully that I don't overdo it!!
I want to maximise my recovery before 20 March when my wife is due with our first bub!!
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| Waving |
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| Blowing bubbles? |
We are both super excited about our little bub!!
So with regards to the surgery, every day delayed is a day less of recovery. I have been in pain for a decade, managed it every way I can, had one small surgery on it already. So I know I need this oen now to take the pain away, there just aren't really any other options that I have left. So if I need it, then lets do it ASAP.
To the neurosurgeons credit, he has resisted me pushing a little bit. We have tried more cortisone injections
Its been three months since the really big relapse and despite a lot of treatment during this time, it isn't going away. The pain is there, so I need to do something.
On the upside, I will hyper-focused on the recovery. I will do everything I can to be able to help my wife in February/March and to be able to look after my bub when he arrives. I think I will actually have to watch carefully that I don't overdo it!!
Surgery delayed by a week!!
So.... I was all excited about the surgery finally coming around this Friday.
Only - NO.
I have had to have it rescheduled. I was so devastated about this. It felt like I'd been kicked in the nuts!! To be honest, I felt almost felt sick when I was told on the phone.
Only by a week, so its now on for Friday 09 November 2012.
Only - NO.
I have had to have it rescheduled. I was so devastated about this. It felt like I'd been kicked in the nuts!! To be honest, I felt almost felt sick when I was told on the phone.
Only by a week, so its now on for Friday 09 November 2012.
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