About 2 weeks ago (June 8th) I had my first formal visit with the spine surgeon, along with a medical resident on the surgical team. The conversation was sobering. They admitted that it could be possible to improve my quality of life with another spinal fusion surgery. But, they said, the procedure would be a true challenge for them and the risks would be great for me. There are many factors to consider before surgery even begins, but first… what would they do in the actual surgery?
Step 1: Make an incision on my (most likely) right side, across the ribs and under the arm.
Step 2: Crack a rib or two open (to make room for their instruments and maybe…hands…ugh).
Step 3: In that opening through my rib cage, they would then go in and move my organs to one side in order to get to the spine underneath. This would also mean moving my right lung over. Ouch.
Step 4: Plastic surgeon would then work on finding and removing as much scar tissue as possible. I have lots of useless scar tissue from previous surgeries. Scar tissue is brittle and only good for internal healing. It’s not at all helpful for surgeons.
Step 5: Once scar tissue is removed/reduced as much as possible down my spine, they will patch me up and close the wound.
Step 6: They’d begin a major incision down my spine, from the back this time.
Step 7: They’d identify two areas of my spinal column that do not yet appear fused. (This contradicts what a previous doctor told me. I thought my whole spine was fused but it’s not.)
Step 8: Surgeons would manipulate my spine so the angle of curvature is lessened at those two unfused points. Here’s an example drawing:
Step 9: Once my spine is significantly less curved, they would place a couple long metal rods parallel to my spine. The rods would then be anchored to my bone with hardware. Once done, the rods would extend from about the base of my neck to the beginning of my lumbar spine.
Step 10: Sew me up!
And now, here are some complications/issues to think about:
I have osteoporosis (low bone density). And the rods would need to be screwed/bolted straight into bone. What happens if the bone is not that solid? Doctors say it is an added challenge, but not impossible to work with.
I’m way underweight. How can I possibly recover well from such a traumatic surgery? Doctors agree on this. But there may be hope…through my veins. There’s a way to “feed” someone through the blood. It’s called Total Parenteral Nutrition, except in my case, it wouldn’t be TOTAL. I’d still eat as usual, but get extra calories through an IV bag. This treatment has it’s own set of risks, which I’m not sure about completely yet. But I will meet with a surgeon to discuss this possibility later.
I’m so underweight, there’s no padding on my back. So I’m concerned the wound itself will not heal properly. The surgeon said the skin IS thin, and suggested that a plastic surgeon would most likely be called in (not just to remove scar tissue) to evaluate skin health and discuss best ways to ease wound healing. I may need skin grafts (like patches) to lay over the wound. Or maybe balloon expanders under my skin before surgery. Ugh. I’ll know more when I see a plastic surgeon.
Other complications: Reduced lung function, paralysis, nerve damage, nerve pain, and… you guessed it… death. Oh, and of course the many unknown, unforeseen things life might throw me when I wake up. I also found about a condition that sometimes develops after spinal fusions, which is that stomach emptying slows down. Great. Just great. The surgery I’m having to straighten my back out and alleviate stomach issues may in fact CAUSE stomach issues. Still… it has been my gut feeling (pun intended) that my stomach is bad because of my back. If my back is fixed, I do believe my stomach will get better.
I also had an endoscopy recently, to continue investigating that sharp right abdominal pain I’ve been having. The results of the test were that I have gastritis, severe esophagitis, and a hiatal hernia. That explains the pain. I suspected a hernia, so at least I have an answer now. The doctor also took a biopsy of the tissue to evaluate for any growths or whatnot. I see the GI doctor in a few weeks. For now, she prescribed a different anti-spasm medication for the ab pain. The hernia, I’m sure, adds another complication to the spinal surgery. If I’ve got a piece of stomach sticking through my ab/diaphragm, and then surgeons start scooting my organs all over the place, I don’t need my stomach ripping or something. I’ll bring this up to them when I see them again.
Ah… lots to take in and think about. And I HAVE been thinking. But that’s for another post.