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Thread: Pre-op appt. - some good news

  1. #1
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    Pre-op appt. - some good news

    The pre-op appt. for S was today. Here are some salient points:

    1. Lumbar curves straightens completely on bending therefore compensatory.

    2. Fusion will be T4-T12 or T4-L1 with the decision to be made on the table.

    3. Risser is 3-4, NOT 0. After I picked my jaw off the floor and mopped up the drool, I asked how that could be when I was told her Risser was 0 in September. The surgeon said it happens. So this almost completely obviates the risk for crankshaft and was the best news we received. He added that the risk of crankshaft would be low for S even at the lower Risser. I didn't pursue it because I didn't care at that point.

    4. He rarely does self-donated blood because the overall risk of that is higher than disease transmittance using blood bank blood in terms of how they have to handle the blood. That obviously isn't a full explanation but I accepted it. There is a 30% chance of needing blood bank blood in surgery of this type/duration. I asked if we should station her identical twin will in the lobby in case of needing an emergency donation. He said no. I'm not sure he realized I wasn't kidding. But I realize they wouldn't do that for any number of reasons, least of which they aren't going to simply take my word that the girls are identical though they do look alike.

    5. Bone taken from spine and bone bank. None taken from the hip. VERY GOOD NEWS!

    So overall, it was very good news. I am very relieved. Both S and W came out of there very happy and wanting to get to school as soon as possible. They made it back at lunch time. Could be worse.

    When I dropped them off and signed them intoschool, I happened to see the homebound coordinator in the office. She said they qualify for certain things if a doctor says they will be out at least four weeks. Now based on the material I have, I am not convinced he will write that note. If we get close to four weeks out and need a note, I'll get it then.

    Also, middle schools in this county no longer have the teacher as tutor program. I was sorry to hear that because their favorite teacher from last year emailed me and volunteered to be the teacher-tutor. I mentioned this to the homebound coordinator who said that the teacher likely isn't aware that the county doesn't offer that any more.

    I can go in and pick up her assignments. Or maybe her twin can since they are in the same classes (except elective). The homebound coordinator mentioned something about English and Math assignments (as opposed to science and social studies I presume) that had to be done a certain way but I didn't catch it. I'll email her for clarification. I think science at is as important as Math and English. Call me a crazy scientist.

    S will be about 5' 9" after the surgery, gaining about 2 inches on the table. They grow up so fast!

    Afterwards, any further growth will be in the legs, if any.

  2. #2
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    I think the appt went very well. How great that there will be little (or no) fusion in the lumbar region. Nicole also went from 0 to 5 risser very quickly. It all sounds great to me. Good luck with everything.
    Melissa
    From Bucks County, Pa., USA

    Mom to Matthew,19, Jessica, 17, and Nicole, 14
    Nicole had surgery with Dr. Dormans on 9/12/07 at Children's Hospital of Phila. She is fused T-2 - L-3

  3. #3
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    Quote Originally Posted by Pooka1
    4. He rarely does self-donated blood because the overall risk of that is higher than disease transmittance using blood bank blood in terms of how they have to handle the blood. That obviously isn't a full explanation but I accepted it. There is a 30% chance of needing blood bank blood in surgery of this type/duration. I asked if we should station her identical twin will in the lobby in case of needing an emergency donation. He said no. ...
    I've never heard of any risk cited for autologous donation, but a pre-op TWO days before surgery (not typical *either* - I did MINE a *month* before ... as do most people) makes it a moot point: It's far too late for autologous *anyway* since it must be done no earlier than 30 days prior and no less than 10 days prior.

    And of course it would do no good to have a donor "on call": It takes 3 days to screeen donated blood.

    30% chance of needing blood? Wow. Never heard that one either. Hanson told me it was rare these days (I didn't need mine, BTW).

    It's quite strange he can't read the x-rays and interpret whether to take T4 *before* on the table. An experienced surgeon CAN. My surgeon and I discussed this exact topic the morning before surgery (he had studied my films and felt T4 was involved), but then again, all he does is spinal deformity surgery ...
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op 53, Post-op < 20
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
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  4. #4
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    Pam,

    Are you saying that it is rare to need blood or to not need blood. Dr. Dormans used cell saver and said that Nicole would need two units of blood during recovery. That is exactly what she needed. Also, I have heard of surgeons saying they weren't sure whether they would fuse L2 or L3, for example, until they actually went in there.

    Yes, it would be too late to donate her own blood at this point.
    Melissa
    From Bucks County, Pa., USA

    Mom to Matthew,19, Jessica, 17, and Nicole, 14
    Nicole had surgery with Dr. Dormans on 9/12/07 at Children's Hospital of Phila. She is fused T-2 - L-3

  5. #5
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    Edit to remove my post. It's not worth the effort.
    Last edited by Carmell; 03-24-2008 at 04:37 PM.
    Carmell
    mom to Kara, idiopathic scoliosis, Blake 19, GERD and Braydon 14, VACTERL, GERD, DGE, VEPTR #137, thoracic insufficiency, rib anomalies, congenital scoliosis, missing coccyx, fatty filum/TC, anal stenosis, horseshoe kidney, dbl ureter in left kidney, ureterocele, kidney reflux, neurogenic bladder, bilateral hip dysplasia, right leg/foot dyplasia, tibial torsion, clubfoot with 8 toes, pes cavus, single umblilical artery, etc. http://carmellb-ivil.tripod.com/myfamily/

  6. #6
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    Quote Originally Posted by MATJESNIC
    Pam,

    Are you saying that it is rare to need blood or to not need blood. Dr. Dormans used cell saver and said that Nicole would need two units of blood during recovery. That is exactly what she needed. Also, I have heard of surgeons saying they weren't sure whether they would fuse L2 or L3, for example, until they actually went in there.

    Yes, it would be too late to donate her own blood at this point.
    Tut tut tut. Don't argue with the "expert!"

    Of course her experience is the absolute correct and average and ALWAYS relevant to EVERY OTHER PATIENT ON THE ENTIRE PLANET blah blah blah.

    Her surgeon fooled her into thinking he knew which exact levels he was to fuse so that becomes the "gold standard." I can easily imagine her bugging the crap out of him to commit before surgery because she thinks that's the way it has to be.

    She does the pre-op a month ahead, well EVERYBODY better DAMN WELL do it that way because ONLY her surgeon can be correct on this. Every other surgeon is an idiot. And if they aren't well then they aren't a pediatric scoliosis expert. That's her "logic."

    And if she is unaware of something well if can't POSSIBLY be correct. More "logic."

    Pam, GO AWAY. Far away.

    Man, if it weren't for all the other great people, I would be so gone. I am spoiled on being able to killfile idiots.

    sharon

  7. #7
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    Quote Originally Posted by txmarinemom
    I've never heard of any risk cited for autologous donation, but a pre-op TWO days before surgery (not typical *either* - I did MINE a *month* before ... as do most people) makes it a moot point: It's far too late for autologous *anyway* since it must be done no earlier than 30 days prior and no less than 10 days prior.

    And of course it would do no good to have a donor "on call": It takes 3 days to screeen donated blood.

    30% chance of needing blood? Wow. Never heard that one either. Hanson told me it was rare these days (I didn't need mine, BTW).

    It's quite strange he can't read the x-rays and interpret whether to take T4 *before* on the table. An experienced surgeon CAN. My surgeon and I discussed this exact topic the morning before surgery (he had studied my films and felt T4 was involved), but then again, all he does is spinal deformity surgery ...

    GO AWAY

    .....


    ....

  8. #8
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    Quote Originally Posted by MATJESNIC
    I think the appt went very well. How great that there will be little (or no) fusion in the lumbar region. Nicole also went from 0 to 5 risser very quickly. It all sounds great to me. Good luck with everything.
    Thanks so much, Melissa. I appreciate the kind words. I felt like celebrating after the appointment. We are all very confident.

    sharon

  9. #9
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    Quote Originally Posted by Carmell
    Sharon,

    I'm glad your appt went well. Sounds like everything is ready to go. We'll be sending our best wishes for a successful surgery and a smooth and uneventful recovery starting Wednesday.
    Thanks so much for that, Carmell. We are going in with high hopes.

    sharon


    Quote Originally Posted by Carmell
    And, pre-op the day before or day of surgery even is not unheard of. You sound shocked. Another note about how different every surgeon, and every hospital, is. Different isn't good or bad, just different.
    Why shouldn't she be shocked...she's the "EXPERT!"

  10. #10
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    Hey Pooka1, I'm so glad to hear that the pre-op appointment went well! It's nice to hear some good news before the big day. Good luck on Wednesday, and best wishes for a speedy recovery!

    I just want to comment on the whole "Pam go away" thing, because I think that Pam had absolutely NO intentions of making you feel hurt or upset. I know that Pam is a huge help to a lot of people on this forum. Sorry, just had to add my 2 cents...
    Last edited by beach_chikie; 03-24-2008 at 03:24 PM.
    [[hailey]]

    16 years old
    Had spinal fusion surgery on Jan. 30th, 2008 with Dr. Howard King at St. Luke's Children's Hospital in Boise
    Pre surgery: 52 Lumbar curve and 25 Thoracic curve


  11. #11
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    Sharon,

    You and Pam can certainly have different views, but I sincerely wish you would not bring personalities into it - it adds nothing to the forum - and everyone else seems able to refrain from doing this.

    I'm not looking to argue or get into any sort of war of words - REALLY - it's just that when you post things like "go away" and other sarcastic remarks it comes off sounding a bit childish and I'm sure you don't want to appear that way.

    I truly wish your daughter a quick and smooth recovery.
    mariaf305@yahoo.com
    Mom to David, age 17, braced June 2000 to March 2004
    Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

    https://www.facebook.com/groups/ScoliosisTethering/

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  12. #12
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    Quote Originally Posted by beach_chikie
    Hey Pooka1, I'm so glad to hear that the pre-op appointment went well! It's nice to hear some good news before the big day. Good luck on Wednesday, and best wishes for a speedy recovery!
    Thanks so much. We have high hopes for a speedy recovery.

    Quote Originally Posted by beach_chikie
    I just want to comment on the whole "Pam go away" thing, because I think that Pam had absolutely NO intentions of making you feel hurt or upset. I know that Pam is a HUGE help to a lot of people on this forum. Sorry, just had to add my 2 cents...
    In 15 years of reading newsgroups, I have killfiled exactly three people in all that time. There's your perspective.

    If this was a newsgroup, I would have killfiled her by now. I think of her as "Number Four."

  13. #13
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    Carmell and Melissa, re: transfusion, I didn't clarify "for thoracic fusions".

    Braydon's and Nicole were more involved, if I'm not mistaken(?).
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op 53, Post-op < 20
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
    EMAIL ME

  14. #14
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    Hi Sharon,
    I am glad you got the news you wanted to hear today.

    Please remember that people post here to learn, share opinions, and offer insight..........what good would a forum be if everyone just posted "that's great" all of the time - nobody would bother to post.........obviously support is important too, but most of us come here to learn and hear of others experiences too.

    Best of luck with the surgery!
    -Cara
    Cara, Mom to Nathan
    Diagnosed 24 deg. in July 2007, progressed to 38 deg. by August 2007
    Boston Back Brace 8/07 12/07
    VBS 12/10/07 Boston Children's Hospital
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    11 Degrees now!! (2012)

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  15. #15
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    Quote Originally Posted by mariaf
    I truly wish your daughter a quick and smooth recovery.
    Thanks, Maria.

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