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Thread: 1st Scoliosis Surgery at age 63

  1. #46
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    Quote Originally Posted by Scared View Post
    How do you wash your hair since you can’t bend over? I have problems now doing this at the sink Nancy
    In the shower.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  2. #47
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    Quote Originally Posted by Tina_R View Post
    Does anyone think Nancy should get a second opinion about having fusion? Is it possible something less invasive could be done about her pain? I realize that only fusion straightens the curve in an adult. Nancy's curve at 30 degrees isn't the worst although she has lost a lot of height.

    Dr. Gupta is probably an orthopedic surgeon. Would a neurosurgeon have a different opinion, a different approach?

    I'm not saying you shouldn't have fusion, Nancy, just that it might be good to get a second opinion. It might help you understand the big picture better. I say this now in retrospect of my own case.

    I think of orthopedic surgeons as understanding the structure of the skeleton and the neurosurgeons as maybe being able to deal more directly with nerves and pain. My surgeon is orthopedic and I just assumed that my pinched nerve problems would straighten themselves out once my structure was improved. It almost seemed like that wasn't the case at first and I got a second opinion from a neurologist to make sure my nerve problem was indeed corrected by the surgery.
    Hi Tina...

    It's a valid concern. I'm guessing if Nancy's problem could be resolved less invasively, Dr. Gupta would hopefully mention it. With that said, I think it's always a good idea to investigate the most minimal solution. Dr. Berven at UCSF has been investigating this issue for many years. Prior to my retirement, we had 15-20 adult scoliosis patients who were qualified for a full scoliosis fusion, but who opted for a smaller surgery. They had an average of 2-3 levels done (usually L4-S1 or L5-S1). I think there were 3 who ended up needing more surgery. The remainder were doing well. Those who did well may all need more surgery in the future, but as far as I know, there's no indication at this point, that they'll have more trouble.

    When I had my original scoliosis surgery in 1992, I was offered the option of fusing only my lumbar curve vs. fusing both curves. At that time, I was pretty certain that I wouldn't want two surgeries if the thoracic curve became a problem, so opted for the bigger surgery. I would absolutely make a different decision today.

    I doubt that a neurosurgeon would be more conservative. In my experience, neurosurgeons don't turn patients away.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  3. #48
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    Quote Originally Posted by LindaRacine View Post
    Hi Tina...

    It's a valid concern. I'm guessing if Nancy's problem could be resolved less invasively, Dr. Gupta would hopefully mention it. With that said, I think it's always a good idea to investigate the most minimal solution. Dr. Berven at UCSF has been investigating this issue for many years. Prior to my retirement, we had 15-20 adult scoliosis patients who were qualified for a full scoliosis fusion, but who opted for a smaller surgery. They had an average of 2-3 levels done (usually L4-S1 or L5-S1). I think there were 3 who ended up needing more surgery. The remainder were doing well. Those who did well may all need more surgery in the future, but as far as I know, there's no indication at this point, that they'll have more trouble.

    When I had my original scoliosis surgery in 1992, I was offered the option of fusing only my lumbar curve vs. fusing both curves. At that time, I was pretty certain that I wouldn't want two surgeries if the thoracic curve became a problem, so opted for the bigger surgery. I would absolutely make a different decision today.

    I doubt that a neurosurgeon would be more conservative. In my experience, neurosurgeons don't turn patients away.

    --Linda
    But would a neurosurgeon do the same type of surgery? Could her pain be solved by a more limited surgery that might clear the area around a nerve? Has the surgeon explained to her what exactly is causing her pain and why fusion will fix it? I guess I sound distrustful of his motives, and I shouldn't be. Her surgeon is highly regarded and I'm sure has plenty of work and doesn't need her case.

    But my husband has a saying, it comes from the Dilbert comic strip. If you're a porcupine, you think using quills are the solution to every problem.
    Last edited by Tina_R; 10-31-2019 at 10:40 PM.

  4. #49
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    MRI findings

    Tina, Here's Dr. G's report 12/17: degenerative scoliosis w/ coronal imbalance 8cm R, positive imbalance of 14cm, flat lumbar, fused L2-3, curvature at that time was 13 degrees in thoracic. I did see a scoliosis dr. in Lexington prior to Dr. G but he did not recommend surgery. Dr. G said I would eventually require surgery. Due to my rapid deterioration of my spine per my symptoms plus increased pain I obtained new MRI 3/19.
    MRI 3/19 Findings:
    Significant Rward scoliotic curvature of thoracic centered in lower part; Mild-Mod DDD changes thru out w/ disc space, height loss, Endplate Osteophyte (bone spurs) formations; Bony remodeling + Height Loss along Lward vertebrae of Lower Th; Disc bulges T2/6, T7/8, T11/12 L1; Articular Facet Disease; T10-12/L1 appears to be the worse with mild-moderate facet disease (esp T11/12 Canal narrowing where there is contact on spinal cord).
    Lumbar: Acute Endplate changes L4/5 (Endplate Remodeling/Fracturing);+ Schmorl's Nodes(herniation of disc), Rotary Lward curvature; SacralCysts; Aticular Facet Dis.; Scar tissue w/in Ligments; Several layers of Canal & Forminal Stenosis; L2/3 fused; Degree of curvature in Lumbar was not identified
    Well I did my best (hope I wasn't repetitive)- forgot also have Osteoarthritis - I identified Cervical problems in earlier response to Ed. Appreciate your concerns but I have faith w/ Dr. Gupta. Will not really know for sure what's going to happen until I see him 1/15/20.

  5. #50
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    Quote Originally Posted by Scared View Post
    Tina, Here's Dr. G's report 12/17: degenerative scoliosis w/ coronal imbalance 8cm R, positive imbalance of 14cm, flat lumbar, fused L2-3, curvature at that time was 13 degrees in thoracic. I did see a scoliosis dr. in Lexington prior to Dr. G but he did not recommend surgery. Dr. G said I would eventually require surgery. Due to my rapid deterioration of my spine per my symptoms plus increased pain I obtained new MRI 3/19.
    MRI 3/19 Findings:
    Significant Rward scoliotic curvature of thoracic centered in lower part; Mild-Mod DDD changes thru out w/ disc space, height loss, Endplate Osteophyte (bone spurs) formations; Bony remodeling + Height Loss along Lward vertebrae of Lower Th; Disc bulges T2/6, T7/8, T11/12 L1; Articular Facet Disease; T10-12/L1 appears to be the worse with mild-moderate facet disease (esp T11/12 Canal narrowing where there is contact on spinal cord).
    Lumbar: Acute Endplate changes L4/5 (Endplate Remodeling/Fracturing);+ Schmorl's Nodes(herniation of disc), Rotary Lward curvature; SacralCysts; Aticular Facet Dis.; Scar tissue w/in Ligments; Several layers of Canal & Forminal Stenosis; L2/3 fused; Degree of curvature in Lumbar was not identified
    Well I did my best (hope I wasn't repetitive)- forgot also have Osteoarthritis - I identified Cervical problems in earlier response to Ed. Appreciate your concerns but I have faith w/ Dr. Gupta. Will not really know for sure what's going to happen until I see him 1/15/20.
    Don't mind me, Nancy. I'm thinking of my own case. I had an opportunity for a second opinion and then never followed up on it. The second opinion was with a doctor who did minimally invasive surgery. He was recommended by my insurance company, the surgeon I ended up going with for my fusion was not recommended.

    Obviously my insurance company was pulling a fast one because minimally invasive surgery is much less expensive. And Dr. "Minimally Invasive" seemed dubious for a number of reasons. But I wondered if I should have at least listened to what this doctor had to say. A second opinion never hurts. I seem to make emotional decisions about this.

    That said, fusion has not been perfect but it probably was the right thing to do for me.

    Your MRI report is complicated, but so are the reports of most of us at our age.
    Last edited by Tina_R; 11-03-2019 at 12:35 AM.

  6. #51
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    Quote Originally Posted by Scared View Post
    Tina, Here's Dr. G's report 12/17: degenerative scoliosis w/ coronal imbalance 8cm R, positive imbalance of 14cm, flat lumbar, fused L2-3, curvature at that time was 13 degrees in thoracic. I did see a scoliosis dr. in Lexington prior to Dr. G but he did not recommend surgery. Dr. G said I would eventually require surgery. Due to my rapid deterioration of my spine per my symptoms plus increased pain I obtained new MRI 3/19.
    MRI 3/19 Findings:
    Significant Rward scoliotic curvature of thoracic centered in lower part; Mild-Mod DDD changes thru out w/ disc space, height loss, Endplate Osteophyte (bone spurs) formations; Bony remodeling + Height Loss along Lward vertebrae of Lower Th; Disc bulges T2/6, T7/8, T11/12 L1; Articular Facet Disease; T10-12/L1 appears to be the worse with mild-moderate facet disease (esp T11/12 Canal narrowing where there is contact on spinal cord).
    Lumbar: Acute Endplate changes L4/5 (Endplate Remodeling/Fracturing);+ Schmorl's Nodes(herniation of disc), Rotary Lward curvature; SacralCysts; Aticular Facet Dis.; Scar tissue w/in Ligments; Several layers of Canal & Forminal Stenosis; L2/3 fused; Degree of curvature in Lumbar was not identified
    Well I did my best (hope I wasn't repetitive)- forgot also have Osteoarthritis - I identified Cervical problems in earlier response to Ed. Appreciate your concerns but I have faith w/ Dr. Gupta. Will not really know for sure what's going to happen until I see him 1/15/20.
    Nancy... Don't be too freaked out by the MRI report. If you looked at a bunch of MRI reports for people in your age group, they actually would be relatively similar to your report. Degenerative changes of the spine are far more the norm than the unusual.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  7. #52
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    Quote Originally Posted by Tina_R View Post
    Obviously my insurance company was pulling a fast one because minimally invasive surgery is much less expensive. And Dr. "minimally Invasive" seemed dubious for a number of reasons. But I wondered if I should have at least listened to what this doctor had to say. A second opinion never hurts. I seem to make emotional decisions about this.
    Hi Tina...

    I'm not sure, but I don't think that minimally invasive spine surgeries are less expensive than open spine surgeries. The minimally invasive implants are probably a bit more expensive than standard implants, and the procedures may actually take more time, so the OR cost may be higher as well. I think the hospital stay may be shorter for minimally invasive procedures, but the per night rate isn't nearly as expensive as implant prices.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  8. #53
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    Thanks for Info

    Tina & Linda -Appreciate your thoughts & info. Of course I was/am freaked out by the MRI report. I looked up every word on that document. I already knew my spine was/is a mess (WE know our bodies move than any medical professional). I always go into a dr appt with knowledge so I can have an educated discussion w/ the dr. This year I feel “cornered” because I can’t live w/ the pain & inability to do just about anything! Plus at age 63 it’s now or never (older adult outcomes & recovery harder). My neurologist told me in May, I had a maximum of 1-1/2 years until the severe problems w/in Cervical will affect my brain + other problems. I just have to go forward basically 1 day at a time. Don’t want to (have surgeries- 2) but have to. But still will have to wait until I get Dr G’s blessing. I am experiencing problems just getting to my 2 PT appt s each week + accidentally burned my outer thigh about 6 weeks ago w/ hand held massager (has heat element on handle- was using on legs because they hurt so much). Haven’t been able to get to pool rx due to the 2nd degree burn. So very frustrated that I’m not as physically fit as I need to be.

  9. #54
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    Shower???

    Quote Originally Posted by LindaRacine View Post
    In the shower.
    I understand that I’ll have to use a shower chair BUT how in the world after you are in shower, pull shower chair (facing facet) pulled up enough so you don’t “bend” to reach facet??? I am a bath person (have been using a bath Matt for fear of falling) for years. I guess now I need those bath bars installed in bath/shower. Just another financial problem for me. I was hoping you would give me more “details” but I guess I was wrong.

  10. #55
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    Quote Originally Posted by Scared View Post
    I understand that I’ll have to use a shower chair BUT how in the world after you are in shower, pull shower chair (facing facet) pulled up enough so you don’t “bend” to reach facet??? I am a bath person (have been using a bath Matt for fear of falling) for years. I guess now I need those bath bars installed in bath/shower. Just another financial problem for me. I was hoping you would give me more “details” but I guess I was wrong.
    I used a shower stool, with a handheld shower head, after both of my surgeries. If you put the stool in front of the controls, the handheld shower head can be held at the necessary height.

    You'll need to ask Dr. Gupta, but I'm guessing that if you'll be fused to the sacrum, they will not want you in a bathtub for the first 3-6 months. I never regained the ability to sit in a bathtub. I also can't sit on the floor with my legs out in front of me.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  11. #56
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    Quote Originally Posted by LindaRacine View Post
    I used a shower stool, with a handheld shower head, after both of my surgeries. If you put the stool in front of the controls, the handheld shower head can be held at the necessary height.

    You'll need to ask Dr. Gupta, but I'm guessing that if you'll be fused to the sacrum, they will not want you in a bathtub for the first 3-6 months. I never regained the ability to sit in a bathtub. I also can't sit on the floor with my legs out in front of me.
    Thanks Linda

  12. #57
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    I have always preferred to shower and wash my hair at the same time with the overhead stream of water.

    Since my surgery I have had to change things. By trial and error you work out a routine.

    I couldn't stand for long, too weak and had poor balance. So I got a portable chair for the shower. And I couldn't reach my feet so I got a basin to fill with liquid body wash and soak them in. When my chair is close enough I can (barely) reach the lower faucets to turn them on and adjust the temperature.

    I, too, have a hand held shower head. It has a hose which is attached to the overhead built-in shower head. I sit and soak my feet and soap as much of my body as I can reach, then rinse with the shower head in my hand.

    Then I overturn the basin with my feet, grab the basin, stand up (using a grab bar on the side of the tub), place the basin on the seat, kick the seat back a bit with one foot to get it out of the way, and I have room to finish up with a conventional shower (I have hooked the shower head above me by now). I stand and reach those places I couldn't reach while seated, but I'm not standing for long.

    I drop soap and sponges all the time, so I have extras around the tub. They are conveniently located on wall mounts.

    In the beginning I needed help in the shower because I was weak and clumsy. You should have help at first, too. Even today when I don't need somebody by my side to help me shower I feel better that someone is in the house.

    It might be worth it to have a plumber alter your bathroom, or just somebody handy that you know. It doesn't necessarily require drilling into porcelain fixtures or wall tiles for these adjustments.

    Just after you're home from surgery you will only be allowed to sponge bathe for a while to protect the surgery site. Then you will be allowed to shower but must keep the scar covered with a kind of cape so it doesn't get wet. I forget for how long all that lasts, maybe ten days. I remember not being able to wash my hair for a long time and I was miserable, but it ends.

    They should give you directions from the hospital. Ask the occupational therapist for help.
    Last edited by Tina_R; 11-04-2019 at 10:10 AM.

  13. #58
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    Quote Originally Posted by Tina_R View Post

    Just after you're home from surgery you will only be allowed to sponge bathe for a while to protect the surgery site. Then you will be allowed to shower but must keep the scar covered with a kind of cape so it doesn't get wet. I forget for how long all that lasts, maybe ten days. I remember not being able to wash my hair for a long time and I was miserable, but it ends.
    Just an FYI... this varies by surgeon. For my second set of surgeries, I was allowed to shower as soon as I went home. For my surgeon, it depends on the type of closure and how the wound looks.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  14. #59
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    Quote Originally Posted by titaniumed View Post

    I have neck herniations at C5-6, C6-7 in my neck with no scoliosis. This has nothing to do with scoliosis or my fusion mass, and more about degeneration.....You know you have it when your thumb, index and middle finger go numb. Neck disorders are identifiable by hand and arm pain and numbness. Ring and pinky symptoms are the next 2 levels lower. C8-T1

    You should be communicating with your surgeon. The best way to do this is to e-mail his nurse, assistant, or (PA) Physician Assistant. Ask for an e-mail address and only ask one or two questions at a time. Questions are easy and answers are difficult if not impossible. Do not write a book, these people are busy.

    Ed
    Ed, do you still have numbness in your fingers and have they tried to fix it?

    Concerning communication with my surgeon and his office, I asked for an email address so I could send an attachment, a directive from another doctor. I was told "We have a firewall". I could snail mail or fax it. I guess they don't trust patients at that hospital when it comes to email, I can't believe they don't use email at all. It's an odd place in some ways.

  15. #60
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    Quote Originally Posted by Tina_R View Post
    Ed, do you still have numbness in your fingers and have they tried to fix it?

    Concerning communication with my surgeon and his office, I asked for an email address so I could send an attachment, a directive from another doctor. I was told "We have a firewall". I could snail mail or fax it. I guess they don't trust patients at that hospital when it comes to email, I can't believe they don't use email at all. It's an odd place in some ways.
    Tina, Every once in a while they will tingle and I am going to wait on the neck. I probably will never have my neck done unless it gets intense. My surgeon and I talked about a 2 level ACDF. From the front only.

    I also get the strange electrical zaps in my legs every once in a blue moon....Its no biggie.

    I did score some Diclofenac in Colombia, 100Mg 16 capsules, $3.50 US I use this for my neck if it flares up. This is cheap.

    Fax? That's incredible. I threw mine out around 20 years ago.

    Ed
    49 yr old male, now 60, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

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