19 Year Old Male. Scoliosis Progressing.

[JDM555]

What a rough night. I got up like 30 mins ago. Very painful and have severe nausea. I throw up from ice chips or a sip of water. Surgery took until 6pm. Got some nausea and vallium medications. In a lot of pain. So thirsty. Dilaudud isnt helping much. So hard to type.

[jrnyc]

i think the best thing would be just to rest...
and not to try to type....
why not just take it easy....
it sounds very rough...
you need to try to gather your strength for the next procedure....

you are in my thoughts and prayers for healing and for the pain to subside....
i hope the meds are helping...

jess

[titaniumed]

John

I cant believe you are posting! Let them know about your pain and nausea....

Try to take it easy, you know the drill.
Ed

[rohrer01]

I agree with Ed. You don't have to be posting right now. I realize you want to blog everything, but maybe now isn't the time. You can post what happened when you feel better. I believe fentanyl is stronger than dilaudid. I know it's more potent than morphine. Maybe you can ask for the fentanyl instead, since you are just out of surgery not that long ago. I know fentanyl makes me a little nauseous, but then again so does extreme pain. There are meds that they can give you to keep you from throwing up, even if you are still nauseated. I would imagine throwing up wouldn't be easy on your back. Gosh, I hope you get over this episode soon! My heart goes out to you.

[Elisa]

Good to hear from you John. Take it easy!!

[Mojo's Mom]

Hi, John! We can hear from you when you are better in a couple of days, take it easy! So glad to hear from you on the second "other side", though. Everyone here is thinking about you and sending you positive energy for healing.

[mabeckoff]

What a rough night. I got up like 30 mins ago. Very painful and have severe nausea. I throw up from ice chips or a sip of water. Surgery took until 6pm. Got some nausea and vallium medications. In a lot of pain. So thirsty. Dilaudud isnt helping much. So hard to type.

I am sorry that you are not feeling well after surgery. Can they give you something besides Dilaudud? Are you feeling any better?

[JDM555]

Hey guys. Finally managed to use a laptop. The pain is pretty bad. Dilaudid didn't do much. I started on that and I had to keep pressing the self medication button thing for pain. I'm still in severe pain. I had to tell my surgeon, so he ended up changing it to fentanyl. Still in a lot of pain, don't even feel a difference. Then they gave me vallium in addition to my fentanyl, and didn't do a big difference besides making me extremely sleepy. In surgery though, they found out L1-L2 and L2-L3 weren't fused as we predicted. But the thing is L1-L2's bolts were solid and not loose at all. But what the surgeons found on top of the lack of fusion in L2-L3, was that both of the screws were super loose. Nice they were loose, they caused the the holes to kind of expand from the bolts grinding and moving around .

Interestingly enough, I got to see all my old hardware and screws that were removed. Checking them out, I saw that most screws were thin, while 2-4 were thicker than the rest . I'm guessing the second time Ivan Cheng opened me up, he had to add thicker screws in the L2-L3 levels because the first attempt wasn't successful, so after doing that, it didn't get fused, and these 6mm screws ending up causing any even bigger holes from sliding in and out, so now my surgeon said the largest screws he has are 8mm, and he doesn't think it'll be tight/light enough in these holes. So he says we might need to extend to L4 cause the L3 bolts are pretty much useless.

I really want to avoid that, because the whole positive idea/plan of the surgery was to stick to L3. I told him to try either adding bonegraft around the screws so it can fuse while in the hole or to basically do T9-L2 and then add implants/hardware on L3 by itself as if it was a regular XLIF proceed. Any tips or ideas? I really don't want to extend it down an extra level. That was my main problem.

[jrnyc]

i hear you John...
but you do have to weigh the pros and cons....
it still would not be like going to the sacrum with pelvic fixation.....
is it worth the chance of non fusion...again....?
has the surgeon ever tried doing what you are asking...adding bone graft stuff to try and hold
screws in that way....?
can he give you any odss of how well that might work?

i am so sorry that you are in such pain....
i kinda figured there wouldnt be much differenece between the meds...
i never got much off a fentynl patch....
i hope the pain eases a little bit...
doesn't sound like you can sleep much....?

thoughts and prayers stay with you...

jess

[mabeckoff]

john,

My thoughts and prayers are with you. That decision is a difficult one. Why don't you email Dr Bederman and get his opinion on what to do? I know that he will be glad to help you out in any way he can. Also, you can ask him what pain relief he uses right after surgery because I felt nothing after surgery. When is your next
surgery?

[Pooka1]

I really want to avoid that, because the whole positive idea/plan of the surgery was to stick to L3. I told him to try either adding bonegraft around the screws so it can fuse while in the hole or to basically do T9-L2 and then add implants/hardware on L3 by itself as if it was a regular XLIF proceed. Any tips or ideas? I really don't want to extend it down an extra level. That was my main problem.

I love your thinking here. I think you are on the right track to relentlessly pursue staying above L3. L3 seems to be a critical level in terms of whether or not an extension distally will ever be required per what I have been told and what I read. I am not in your shoes but I would accept some risk with less tried procedures in order to stay above L3 as you are mentioning here.

Good luck. Good job.

[jrnyc]

has it been tried before?
is your surgeon willing to go ahead with such a procedure?
if it didn't work, what would the consequences be to you?
is it worth the risk?
would you have to live with whatever the outcome would be?

jess

[rohrer01]

I don't know about filling the holes with bone graft to make a tighter fit. They need to be tight right now so they can be used to correct your curve and imbalance. It would take some time for the bone graft to turn to bone around the screw, meanwhile the screw would be wiggling aroung and probably pushing the bone graft out and into an area you don't want. I know it's bad news, and talking to your doctor is always a good idea, but sometimes they know best and you don't want to have to go through this again. I know you are afraid of extending to T4 as there is a good chance of wearing out the bottom two disks and eventually having them fused. But a surgery in who knows how many years for the last bit of lumbar vs. having to have the whole thing done again and each time the screw holes get bigger and bigger? It's a tough choice. Too bad there isn't some other way to anchor the rods at L3 without having to go to L4. Maybe Linda would know. I hope she chimes in here. I understand what you are saying about going from T9 to L2 and just doing like a TLIF between L2 and L3, but can they get good correction that way since your curve really does look like it extends beyond L3 on the x-ray. If they did this and needed extention later on, they would be stuck with what you'll have at L2/3. IF he does it this way would he fill up those large holes with bone graft, or would it heal and fill in by itself? Can they up your fentanyl for a while? There are some other really good painkillers out there. They gave my daughter something during labor and I can't remember what it was, sorry... If the fentanyl isn't cutting it, though, I would either ask for an increase or a change to something else. I hope you find a solution that both you and your doctor are happy with that will work.

[Pooka1]

They gave my daughter something during labor and I can't remember what it was, sorry...

Stadol? I got a hit of that during labor.

It was the only drug because, unfortunately, they mistakenly had me down as wanting natural childbirth (NOT!) and then it was too late for an epidural. They resisted giving me the stadol for a while I think because they had me mislabeled on the chart. I think the error came from my attendance at a birth class which, unbeknownst to me when I signed up, was a natural childbirth class. DOH! Still pretty bitter.

[Pooka1]

http://en.wikipedia.org/wiki/Butorphanol

Place in therapy

The most common indication for butorphanol is management of migraine using the intranasal spray formulation. It may also be used parenterally for management of moderate-to-severe pain, as a supplement for balanced general anesthesia, and management of pain during labor. Butorphanol is more effective in reducing pain in women than in men.[2]

In veterinary use, butorphanol ("Torbugesic") is widely used as a sedative and analgesic in dogs, cats and horses. For sedation, it may be combined with tranquilizers such as alpha-2 agonists (medetomidine (Domitor)), benzodiazepines, or phenothiazines (acepromazine) in dogs, cats and exotic animals. It is frequently combined with xylazine or detomidine (Domosedan etc.) in horses[3].

Interesting that they use it in horses. My labor always conjures up notions of the movie, "They shoot Horses, Don't they?" :-) Well they at least give them stadol!!! I had to beg. Repeatedly. Jerks.