Fifa's Surgery 11/10/14 with Dr. Buchowski

[fifa]

Fifa

After I came home, I couldn’t post....and e-mails were down to just a few words because I was in survival mode where every minute was spent trying to get comfortable some how.
Remember that this immediate recovery period will pass in time....Things will get better soon.

Use your e-mail program to construct your posts. Simply create a new e-mail and type your post there. After you are finished with it, then open NSF and copy-paste it in. You can also write your posts and send them back to you in your e-mail program. You can copy-paste and alter them at a later time.

I will keep this short for now, your bum must be hurting since we can only sit for 3 minutes....(smiley face) it gets better....

What meds are you on and how many do you take? I was basically taking 75-100mg of Percoset for the first 6 weeks......Percoset 7.5/325 (The standard heavy duty issue)

Hang in there

Ed

Hi, Ed -

You've brought up an interesting point and one I've been meaning to mention. I'm not a big drug taker and really never have been. The ortho group here over the years has always prescribed heavy-duty Motrin and maybe a muscle relaxant (Flexeril) if you're lucky, in addition to weeks of physical therapy and the occasional steroid injection into the spine. I always found this irritating because I felt like if my ailment was such that all of the above plus surgery was necessary, one might believe a pain pill or two were in order. LOL. So, over the past 25+ years, I kind of got used to treating my pain conservatively with ice, massage, occasional heat, rest, and motrin. In fact, Motrin was worked so well for me over the years that I stopped buying and using Tylenol - found that it did really nothing to help backache, let alone headache or any other ache.

So, I was discharged from Barnes on November 15th, a Saturday (was admitted and had surgery on the 10th). Discharge meds include a Vivelle estrogen patch, a progesterone pill once daily (I'm peri-menopausal), Prilosec daily (I have a tendency toward acid reflux), calcium, Vitamin D, and a multivitamin, plus Oxycodone 5 mg one or two tablets every four hours as needed for pain, diazepam (Valium) muscle relaxant 5 mg one tab every six hours as needed for spasm, baclofen 10 mg three times per day for muscle spasm, and doccusate-senna one tab twice per day for constipation. I think that is the whole list.

When I was discharged on Saturday (which they didn't tell me until Saturday morning), my goals as written on the bedside board were to have pain of 2 out of 10 and be able to ambulate idependently up seven stairs (there are seven stairs leading to the main level of our floor). Up to this point, I had not had a bm and was on clear liquids only. I wasn't really passing any gas, either, and the Lactulose they were giving me through a straw was coming right back up as soon as I drank it down.

Basically, I think I just had too much med on board. I couldn't keep anything down, and in typical hospital fashion, they bring you your breakfast and they want to start drawing blood, doing vitals, etc., so breakfast gets nasty pretty fast. With me, they were trying to get me to sit in the bedside chair to eat breakfast. By the time I had log rolled over to the chair, I had little energy to try to eat anything, but I did drink everything they gave me.

So, I think I was over-medicated. I don't know how many IVs they had to replace because they kept blowing the line. So, that gets us up to discharge from Barnes on the 15th.

Oh, and before I forget, the discharge was something else indeed. Because my husband left Columbia headed to St. Louis before we knew we were going home for sure, he left in his tiny economical car as opposed to my RAV-4, which is much easier for me to get in and out of. I asked if there were some sort of medical transport available and was told there was, but that it was "prohibitively expensive." It took several question to the care coordinator before someone told me it would be approximately $2,000 to ride home in an ambulance versus sending my husband two hours back to Columbia to pick up the more appropriate vehicle, then two more hours for him to return to St. Louis to get me, then the two hour drive to get me home. I told them we had just signed paperwork saying we would pay $30,000 for bone morphogenic protein, so what's another two grand????? At this point, all I wanted was to get home and try to get some normal in my life.

more below.

[jrnyc]

hi fifa
i am thinking you may not be up to writing for now...
but am sending you a private message...

hope u feel a little better every day...
jess...and Sparky

[titaniumed]

Fifa, I see your posts are getting longer, which is a good sign.....

I hope you are eating.....I say this because on meds, eating can seem impossible. The body can barely keep up after major surgeries on a regular diet, this is why I say this....I only felt better after I addressed my nutritional needs.....I remember eating chicken soup. I think we are taught this in Kindergarten. (smiley face)

And I hope you are doing your walks......you know what I’m saying. I would go out and walk about 300 feet to my neighbors home, turn around and come back. I did this around every 2 hours......along with pacing in the house.

We were the same way with meds.....but for now, you have this careful medication balancing act you have to do and I know it sucks, but soon it will be over....

I found Zantac to work best for acid.....the regular strength, not the heavy duty stuff. Dry Granola is also good for this....I kept a box of it by my bed.

Ed

[fifa]

Hi, Jess, Sparky, and everyone else - hope you all had a Happy Thanksgiving. (smiley)

I'm feeling okay today, but just okay. I think I'm simply overmedicated and I'm hoping a few of you can answer that or at least share your experiences if you're willing. By the time I was admitted to Boone Hospital here in my home town on the afternoon of 17th (I was discharged from Barnes on the Saturday the 15th), I was an absolute mess. I couldn't eat or hold down any meds, couldn't hold down any liquids, had nearly zero urine output, was passing no gas, etc. My abdomen was so rock-hard that it had a bronze-ish sheen to it. My large-ish sweatpants wouldn't go over my waist. Went to the ER where it was pretty quickly determined that I had an ileus. Took four nurses to start an IV - they kept blowing (obviously dehydrated). Their treatment for an ileus was nothing by mouth, which means the other end had to be treated. Believe me, at this point, it was FINE BY ME!!! LOL They loaded a full bag of fluids and nothing happened. Let's just say that they admitted me, and in a few hours, we had success, then more success, etc. (relieved smiley face). So, as best as I can figure, since the surgeon at Barnes prefers a candidate be on a clear liquid diet the Sunday before surgery, I hadn't had anything to eat since Jello Sunday night November 9th until baiscally last night. Everything remotely solid that goes in doesn't take much before I feel over-full. Instead of a basic packet of instant oatmeal, now it is a couple of tablespoons before I'm done. I'm a little afraid to eat right now. I mean, I'm hungy, but i'm just tired of dealing with the stomach stuff. For Thanksgiviging last night, my best hubby made my favorite thing in the world...vegetable risotto. I got about a quarter cup of that down before I decided I was in trouble, so I used a Fleet's enema to make quick work of that.

Okay, all you folks who don't mind talking about your bowels and/or your mental state (mine have been one in the same lately, obviously - HA!!!)

I put the oxycontin away. My local doctor discharged me from Boone with something that makes people a little less crazy than the oxy "Nucynta." No idea what it is and I haven't looked it up yet. The back pain, while terrible, seems less so than the "muscle spasm" pain. Yes, I've got the famous board nailed to the butt feeling and the not being able to sit up unless supported somehow thing. I feel like I want to lean against things. So, I'm getting this Nucynta and a couple of muscle relaxers (diazepam/Valium) that we already knew I could tolerate.

Here's today's big problem - this started last night. I have a big bad case of the bed spins. Not just a little vertigo - this literally makes me feel like I'm on the Tilt O Whirl or something. It seems to happen most often when I look up and to the left. Hubby is convinced this is my withdrawing from the Oxycontin. I'm trying to stay hydrated and will try to eat a little bit of something today. My walking is pretty good -I'm not using the walker as much as I was and the log rolling is much easier. I've showered and washed all the black matted crap out of the back of my scalp. All in all, not a bad day so far. Nothing sounds good to eat. Everything, even my beloved Diet Dr. Depper, tastes like aspirin or some kind of medicine to me.

Any and all advice appreciated from any of you. Will try to respond to you individually as I'm able. I'm still sleeping quite a bit - when I can. Insomnia is becoming a problem now, too.
Thanks to all of you for your support. Hope you are all well!!

Fifa

[jackieg412]

Hi. Fifa, as rough as that all sounds to me it is like the same journey. I remember just being able to eat a single bit of food at a time.like one grape or a single potato. I was thirsty all of the time. And then it was a single sip of something. Sitting was impossible and I paced back and forth a lot. It will improve. A lot of rest yet. Even if you can't sleep for long. The spinning , I would think is coming from the meds. My surgeon just gave me a 2 mg dose of diazepam , I could not keep it down . Medication can help, but it can also be a trial and error type of thing. For me it is mostly error.

[Susie*Bee]

Dear Fifa - I am so sorry you are going through all these problems. Some do and some don't -- and you just never know. The one thing to keep thinking of is that you will get through this. And I know you realize that. Just keep thinking it when it the going is rough. I'm one of the ones who had an ileus, and I can't remember if I already told you that or not. I went NPO, not even ice chips, for 5 days after surgery (not counting surgery day). I know it seems like you are without nutrition during that time but they are "feeding" you with the IV. (Sure doesn't take the place of a steak, does it!)

I also went through a time period where the room would spin around when I was lying down in bed, but it was at least a few months or more after my surgery and I wasn't on strong pain meds then... and also many, many times when I lay awake for hours during the night, wishing so much that I could just go to sleep. Sometimes those are med related, I think, as right now I'm having that same problem because my neurologist just added a different medication and if something awakens me at 4:00, or at least by 6:00, in the morning (a foot cramp, almost every night) I cannot fall back to sleep for the life of me. Up until I started this new med I could sleep in until 8:00 if I wanted to. Oh well. (sad face). The main thing to keep in mind is that these things will pass and you just need to be patient. It may be some sort of hold-over from your anesthesia also, or just the trauma of the surgery.

I'm praying that you'll turn the corner soon and get the rest you need, your digestive system back on track, that you'll be able to eat the foods you are craving, and that you'll be back on the smoother road of recovery very soon. I think you've just hit several bumps, the main one being that they did not take care of you well at Barnes and sent you home when they shouldn't have. Take care.

[PeggyS]

Dear Fifa,

Things will settle down for you; it's waiting for that to happen that's so darn hard! I just can't believe how soon you were sent home - esp without eating solids & having a BM. I did receive a denial of coverage for my hospital stay from Sat-Monday. We weren't informed, but the dr knew I wanted to go to rehab. That had to be appealed,too. My ins did agree to pay for BMP, after a couple of appeals. Hopefully yours will too! It's unclear how much was actually used.

I'm glad there are people on the forum who can help you through this. I'm offering prayers for your back to heal, your gut to settle down and the correct combination of meds.

Please update us, as you feel up to it. Take care, my friend!

[tae_tap]

Hey there FIFA! Glad to see your writing more, that is a good sign. Now on the topic of Nucynta, we have given this particular med to many of our post-op patients and have seen good results. But our patients are not fusion patients. From my understanding from the literature our med reps presented us with is that Nucynta reacts in the body like NSAIDS and aide in the reduction of inflamation while dealing with pain without the addictive nature. We have seen many pain doctors prescribing this med as well and have seen studies where after a certain amount of time it enhance sensitivity to pain (which is weird). It's only been out for post-op pain for about 2 1/2-3 years so there really are not many long term studies on it yet. But if it helps, great!

I understand the waking of the bowels. After my full fusion I did not get clear liquids (other than ice chips) till day 6. I was not on solids returning home and didn't feel like eating till almost a month out. It took a good three weeks before the constipation let up. Heck, this time was a lot less time under Anastasia and my system has finally woke up with the help of mag citrate. So even with less stress it took a week to want food and to wake things up.

It will get easier. I can't fathom being cut loose so fast and then ending up in Boone. Did you have an Ortho while at Boone or GP?

I am praying that things begin to ease up!
(((Hugs)))
Tamena

[fifa]

Fifa, I see your posts are getting longer, which is a good sign.....

I hope you are eating.....I say this because on meds, eating can seem impossible. The body can barely keep up after major surgeries on a regular diet, this is why I say this....I only felt better after I addressed my nutritional needs.....I remember eating chicken soup. I think we are taught this in Kindergarten. (smiley face)

And I hope you are doing your walks......you know what I’m saying. I would go out and walk about 300 feet to my neighbors home, turn around and come back. I did this around every 2 hours......along with pacing in the house.

We were the same way with meds.....but for now, you have this careful medication balancing act you have to do and I know it sucks, but soon it will be over....

I found Zantac to work best for acid.....the regular strength, not the heavy duty stuff. Dry Granola is also good for this....I kept a box of it by my bed.

Ed

Hi, Ed. The problem is that nothing sounds good. Most things taste like melted plastic or perhaps a chewed-up aspirin. I am drinking though, but none of that tastes good, either. So far, the thing that tastes the best has been Bob Evans heat and eat mashed potatoes. That started today...about an hour ago.. I just haven't been able to keep anything in me for very long. Took awhile to get all the lactulose, suppositories, enemas, stool softeners, etc. out of my system.

I've been trying to walk, but hadn't been doing as much as I should because I've been kind of weak. Yesterday, during a moment of sheer willpower, I walked downstairs with my two-legged and four-legged boys. Can't tell you how nice that was. Puppo doesn't seem to understand where I've been but won't leave my side since I've been home. So, that's 14 stairs to the lower level and 14 back up to the main. It was plenty. LOL

Hope you're well. Thanks for your encouragement and support. I'll post more as I get stronger.

Fifa

[green m&m]

I had severe abdominal pain in hospital and at home until maybe day 3 back home.

My abdominal pain was beyond the bloated pain was a very inflamed 'angry' pain. It felt food poisoning like pain and not just constipation related.

Eventually I came up with a theory (this may have been induced by hallucination from pain meds) that my body was over loaded with mast cells from the opiates... and my bowel was inflamed from all the mast cell/histamine reaction.

I wanted to take something for the itching anyway so I made my boyfriend go out and get me benedryl tablets, took 50mg to bed that night and woke up next morning with significantly less pain. Bowel function returned to near normal next day.

Most likely a coincidence, but over abundance of mast cells can cause problems in our body. So worth trying if your intestinal pain feels inflammatory and/or you have skin itching. I'd try before bed though as it can make you drowsy.

It took me a while for my taste buds to return to normal. For a while, everything tasted salty, even steamed veggies that were not seasoned in any way. Still salt sensitive which I guess is a good thing.

I had lots of soups -- only the liquid the first week back. I tried and wanted to eat solids but my body wanted nothing to do with it. Soup and smoothies kept me going. Also prune juice.

[LindaRacine]

Hi Fifa...

Sounds like you're pretty much of a mess at the moment. I'm sorry that it's so difficult. I suspect that you were discharged from the hospital too soon, and now it seems like you're like a pinball. Do you have a primary care doctor, or even better, a pain doctor, who can take over your care?

I think it's a good sign that you're hungry. When you eat, eat slowly over a long period of time. Hopefully, that will cut down at least a little on that bloated feeling. By the way, risotto can be constipating in some people. Try fresh fruit. For some reason, that was pretty much the only thing that appealed to me after my first spine surgeries.

I had never heard of Nucynta, so I looked it up. One of the first things i read was "You should not use Nucynta if you have severe breathing problems, or a bowel obstruction called paralytic ileus."

Hang in there. This will all get worked out. I hope it's sooner rather than later.

Regards,
Linda

[fifa]

Hi. Fifa, as rough as that all sounds to me it is like the same journey. I remember just being able to eat a single bit of food at a time.like one grape or a single potato. I was thirsty all of the time. And then it was a single sip of something. Sitting was impossible and I paced back and forth a lot. It will improve. A lot of rest yet. Even if you can't sleep for long. The spinning , I would think is coming from the meds. My surgeon just gave me a 2 mg dose of diazepam , I could not keep it down . Medication can help, but it can also be a trial and error type of thing. For me it is mostly error.

Hi, Jackie -

It seems in retrospect now that the bed spins were probably most likely related to being dehydrated. I pushed as much fluid as I could, and it took two days, but I'm happy to report that it has gone away (knock wood). The feeling is hard to explain, but it is as if I were tied to a spit that got turned very quickly - that rolling down a hill feeling if you ever did that when you were a kid. It happened so fast that it was instant sick-making... all I could think about was I have to get prone now. I counted up the days, and it was something like 19 days with maybe a bowl of Jello, some ice chips, two frozen sherbet cups, and very little else except sips of water with meds. A lot of what I took in came back up because of the ileus. Anyway, in doing some reading about dehydration, I think this was the problem.

I've started to eat again, but it seems like only very small amounts are working best. I'm trying to eat lots of veggies and fruit so not to tax my gut so much. The very best thing I've found so far is tea with sugar and soy milk (I don't drink regular milk). I think several cups of that turned me around. Oh, and I drank a cup or two of prune juice, and even though I love the stuff, probably won't do any more large quantities of that. The acid of fruit juice has been hard for my bits to handle. LOL

Thanks for writing - I certainly would appreciate any and all advice! Thanks!

Fifa

[PeggyS]

Hi Fifa!

Just checking in to let you know, I think about you everyday & I'm sending prayers for steady recovery.
Love your sense of humor: bowels & mental state being one in the same! I can certainly identify!
I'm impressed: a whole flight of stairs - good for you!

Take care!

[jrnyc]

Fifa....i read the same thing Linda Racine mentioned...
that Nuycenta should not be taken if an ileus is present...
perhaps you should double check it with the doc who
prescribed it....????

as others have written, i am so so sorry you are suffering
so and i hope things calm down and quiet down every way
possible, for your poor body to rest, heal, and get some
nutrition....i am sure not being able to eat food is contributing
to feeling weak....and i think Linda is right to say you were
discharged too soon....
a referral to a pain doctor....by your surgeon or GP...might
help, as Linda also mentioned....
there should be a doctor just concentrating on trying to get
you relatively comfortable, if there is such a thing right now, in
terms of the pain you are dealing with...while having the knowledge
of how meds will impact your gastrointestinal tract.

thoughts and prayers...
and a hug and a woof....
jess...and Sparky

[fifa]

Hi, Leah -

This made me laugh out loud! I read this several days ago at work, but I didn't have a chance to respond. That. Is. HILARIOUS!

Thanks to you and a couple of others, I asked the physician assistant about getting the pain meds before we leave the hospital, and she assured me that they would take care of that. So, thank you! I'm also going to ask for a shot or something for the ride home. It will be the one time I can relax while someone else is driving. LOL

I hope you and everyone else will share their funny stories with me. The humor really helps!

Take care - hope you are doing great!
Fifa

Hi, Leah -

I just had to post this while I was thinking about it - had you in mind when it happened on several (more like NUMEROUS) occasions. One day, I'll make a list of them and post them here, just for laughs.

Anyway, I wanted you to know that I had my phone with me and texted several people. Took some pictures, too. I was SO out of it (like two oxycontin every four hours whether I needed them or not) that I had no idea what day it was, what time of day it was, etc. Long story short, I texted a LOT of my buddies at apparently all hours of the day and night. They are all quite amused by this, but I was appalled to find out that I had done this. LOL I texted my cousin around 4:00 a.m. one morning asking her if she would mind stopping by to feed the fish. Uh, we don't have any fish. No idea what I was thinking about or what I was actually trying to say. Anyway, they were all actually very happy to hear from me and didn't care what time of the day it way. Again, I'll put a list together soon just for our own amusement. I texted my husband so many things that he couldn't understand...so many misspelled words, incomplete thoughts.

Oh, and the best part? Well, to me, anyway. You'd have to know us to understand out completely warped sense of humor, but my husband had been sneaking around taking pictures of me in the weirdest positions. You don't know how many pics I have now of me playing Battleship on Wii but having fallen asleep with the remote in my hand, still pointed at the television.

Maybe hubs and I are just weird, and maybe it is because I'm starting to feel a little better, but this stuff is making laugh (when there's been little to laugh about lately).

Hope you are doing well - was thinking of you and thought I would say hi. (smiley)