Waiting for a date

[Kelsey's Mom]

I thought January 5th would never get here. Now that it has come and gone, surgery confirmed, tentatively set for spring to early summer, I'm trying my best to wait patiently for the date to actually be set.

Dr. Lenke, St. Louis, at Shriners. Other than that, we are still patiently waiting to find out.

In the meantime: Kelsey has been experiencing more pain. She actually mentioned that it feels like it is pinching (ribs/lumbar) which I don't know if is possible. The x-rays sure made it look possible. I don't know whether to call and ask for possible short term pain solutions. Does anybody have any suggestions?

Also, has anyone experienced any problems with back acne? Our info pack stressed the importance of her back being clear in order to have surgery. We are encouraged to contact a dermatologist if over the counter doesn't clear the acne. How clear does it need to be? She looks better, but not CLEAR. Will they discuss this in detail with us in pre-op? Will we have time to clear it after that? Or should I call and ask them about it now?

I know these don't seem to be the standard questions, but my main concern is that we will get a surgery date scheduled and then find out we can't do the surgery because she's not ready. Dr. Lenke was already booked for 26 weeks this year when we saw him (Jan 5), so I would be terrified to have to try to reschedule!

Should I just call the nurse and ask her all these questions? She said we could call about anything... except the surgery date.

[Kelsey's Mom]

Info I forgot

I forgot to put in the info we discovered at the Jan appointment:

Her curves have progressed from 58 Thoracic and Lumbar to 70L and 67T. Her fusion will be from T4 to L4.

[mbeckoff]

I would certainly call the nurse and ask her these questions . She did say that you could ask her anything. Is she able to sleep? If she is in pain enough that she is mentioning it, then I would most definitely call and let them know.

As to the back acne, again call and make them aware of it . They will tell you what to do about it

Good luck with everything

Melisssa

[pmsmom]

I would definitely see what you can do to clear up the back acne, if nothing else, for your peace of mind.

We discovered our dd's just a few weeks before her surgery. As her first surgery had been cancelled, we didn't want to have to cancel again. The surgeon did see her about a week or so before surgery and said that he was most concerned about the area immediately around the area where he would operate be clear.

There are certain things that can be done to get the acne cleared. Although my dd's cleared most of the way, it was not totally clear for surgery. We just prayed and hoped for the best.

Also, we did take her for a 2nd opinion to another surgeon about her acne. We asked him if he would operate on her back in its condition and he said yes. He said he'd operate on backs in worse condition. I'm glad we didn't go with that doc.

[Pooka1]

Also, we did take her for a 2nd opinion to another surgeon about her acne. We asked him if he would operate on her back in its condition and he said yes. He said he'd operate on backs in worse condition. I'm glad we didn't go with that doc.

The issue never came up with my girls. I am guessing both had acne on their back on the day of surgery but I don't know that. They both have acne now on their backs. The surgeon never commented and he saw their backs one day before for one kid and two days before for the other.

I have to wonder if there is a lick of evidence one way or the other about this. I presume the worry is infection. The question is... are the infections associated with surgery ever the same organism as in the acne bacteria. If not then there is zero connection between acne and post op infection rates.

[pmsmom]

The issue never came up with my girls. I am guessing both had acne on their back on the day of surgery but I don't know that. They both have acne now on their backs. The surgeon never commented and he saw their backs one day before for one kid and two days before for the other.

I have to wonder if there is a lick of evidence one way or the other about this. I presume the worry is infection. The question is... are the infections associated with surgery ever the same organism as in the acne bacteria. If not then there is zero connection between acne and post op infection rates.

Sharon, now that you mentioned it, I think it was the 2nd surgeon we saw about whether or not he thought Paula would be ok proceeding with surgery with the acne stated that it's a different case with adolescents vs. adults. With adolescents, it's more a case where it could be hormonal. With adults, there's more of a chance with it being bacterial.

Imho, I would still see what the surgeon says about the acne regardless of the person's age.

But then, you all know how I get.

[Pooka1]

Yes but even if it is hormonal in adolescents, it is still associated with bacteria. The acne spots are not aseptic (sterile) as far as I know. The hormones change the oil production and skin renewal rates I think which in turn present harbor for bacteria.

It seems likely the bacteria in adolescent acne is similar if not the same as that in adult acne but I don't know that. I don't know why it would be different if all acne bacteria are living in the same environment.

It is my understanding during surgery that they flood the patient with massive broadspectrum antibiotics. I think the post op complication rates are largely antibiotic resistant staff, NOT acne bacteria which would presumably be knocked out virtually instantly. But of course, again, I don't know that.

[pmsmom]

Yes but even if it is hormonal in adolescents, it is still associated with bacteria. The acne spots are not aseptic (sterile) as far as I know. The hormones change the oil production and skin renewal rates I think which in turn present harbor for bacteria.

It seems likely the bacteria in adolescent acne is similar if not the same as that in adult acne but I don't know that. I don't know why it would be different if all acne bacteria are living in the same environment.

It is my understanding during surgery that they flood the patient with massive broadspectrum antibiotics. I think the post op complication rates are largely antibiotic resistant staff, NOT acne bacteria which would presumably be knocked out virtually instantly. But of course, again, I don't know that.

All good points you make Sharon. You are right--the acne would have bacteria, whether a teen or an adult has it.

Dd did have antibiotics during surgery--remember all of her medication allergies? She was given ancef (sp?) during surgery via IV, but also had her back scrubbed prior to surgery.

In fact, after surgery, her back looked great--no acne.

But then as the weeks went by, the acne started to return--first in the places where she started to get feeling back. It still seems that way. She has no feeling in her back around the scar, and the acne seems very light in that area. Now it's mainly on her shoulders.

I'm so glad this board is here so we can bounce ideas off of each other.

[Kelsey's Mom]

x

Thanks to all for replying. I have yet to contact the nurse. I talked myself in and out of it this week, then couldn't find my contact info when I had finally decided to stop procrastinating. Now, I have all info in place and can call tomorrow.

Having battled my own acne in highschool, I realize that if we use a prescription med, she should clear rather quickly. So, I just guess I need to find out if that is what they would recommend.

K's rotation seems more pronounced and she actually winced when I hugged her yesterday, took my arm and moved it above her arm instead of under it to hug me. She hasn't been one to complain much about pain, so the new sensitivity concerns me.

Really want that surgery date.

My oldest daughter is moving away next week. She says she'll be home for the surgery. I told my husband I don't see how she can swing that at a new job, but he agrees that she should definitely come home.

(I know this post is kind of all over the board. This is the only place that I can talk about what is going on with her. It makes me feel good to know there are others out there who have already been through this or are dealing with similar situations. Thanks)