One more really big surgery

[jackieg412]

I am being prepped for a really big surgery. The car accident or last September broke my neck. It also caused the muscle transfer that I had to my scapula to pull apart.
The only solution is a scapulothorasic fusion. I need to have my shoulder brought up because it is depressed about 3 inches now.
The surgeon told me that this surgery will make my spine surgeries look like a walk in the park. It is that painful. I don't know if it is more painful then a broken neck.

[titaniumed]

Jackie, When is this surgery?

You have done some painful surgeries and are experienced at pain.

As dreadful as it is, have you addressed pain control since your not your average bear? Will this one be on Tylenol like when you did your neck? Will you have a PCA on the shoulder and if so, what will it contain? I would address all pain control and also what can you do or take for sleeping....(which is so hard)

(BTW, Yogi bear is 60 years old, it was in the news recently)

Surgeons can paint a rough pain scenario sometimes which sure does get your attention. Yes, its going to hurt, but your pretty tough....

I would imagine that the sleeping is going to be hard.

Ed

[jackieg412]

No I haven't gotten a date yet. I still have to meet the thoracic surgeon. I have his name and location. They are to call tomorrow to set an appointment. Of course I'll ask more questions.
There is talk about reducing the deformity in the ribs . None of it sounds good.
I have been in communication with pain management. I do think the plan includes ketamine infusions and upping the pain pump.
Also a plan for a erector spinae block.I had to look that up. This information came from Dr. Young.
He said he used this on a patient with the same surgery and they did well. We are developing a plan and the surgeon has to approve and anesthesia has to be on board.
Also the thought of no movement of the arm for 3 months.
The surgeon is trained at Harvard and Duke. He has only did this surgery a few times. The other option is a Dr in New York.

[titaniumed]

No I haven't gotten a date yet. I still have to meet the thoracic surgeon. I have his name and location. They are to call tomorrow to set an appointment. Of course I'll ask more questions.
There is talk about reducing the deformity in the ribs . None of it sounds good.
I have been in communication with pain management. I do think the plan includes ketamine infusions and upping the pain pump.
Also a plan for a erector spinae block.I had to look that up. This information came from Dr. Young.
He said he used this on a patient with the same surgery and they did well. We are developing a plan and the surgeon has to approve and anesthesia has to be on board.
Also the thought of no movement of the arm for 3 months.
The surgeon is trained at Harvard and Duke. He has only did this surgery a few times. The other option is a Dr in New York.

Many on the Brit forum years ago that had Costoplasty (rib hump reduction) are very happy with their results....For some reason, these procedures (Thoracoplasty) are not popular here in the states. Both Costoplasty and Thoracoplasty are the same rib removal procedure with different names.

From what I understand, they use Ketamine instead of Morphine in anesthesia. (Ketamine anesthesia) There is a new interest in this since there are benefits, one of them being the respiratory depression problems with morphine or opioid's. Ketamine increases respiratory and circulatory, it doesn't depress it. Chances are your not going to feel a thing....Its not the anesthesia you have to worry about, its the reduction or weaning period that hurts. Ask your doctors about this. Also, ask about the time period on the ES block. When this drops off, how will pain be controlled in the shoulder? Will they "infuse" Ketamine after in your recovery?

There is a scapulothorasic fusion video on You Tube with Dr Romeo....He does the narration.

Your going to have quite the collection of scars on your back. You could tattoo each procedure and date it with a directional arrow, that way you wont have to fill out all the medical data every time you see a new doctor. Every time I see a new doctor, I have to write a book. It takes about an hour. (smiley face)

It looks like you will be sleeping on your left side for awhile. I had to do that for around 15 months. It felt so good to be able to eventually sleep on my right side after my shoulder healed.

Its going to be good to finally get your should problems fixed after all these years....

Ed

[jackieg412]

Yes Ed a lot of scars for sure. Way too many. I was to get a call today to set appointment for thoracic surgeon. But they didn't call. I guess I will have to try tomorrow. This appointment is at Rush in Chicago. Always a hard trip for me.
I have seen the video from Dr. Romeo. He used to be at Rush and my pain doctor was the anesthesiologist on one of Dr Romeo's scapulothorasic surgeries. He is in New York now.
My Doctor at Rush is Dr Grant Garrigues. He has an impressive bio. He has been nice to me too.I
I will remain on ketamine during recovery is what I was told. When I had it last surgery the on!y thing I was checked for was mental awareness. For a few days it was ok.
I ha e many questions yet to be answered.
Not looking forward to the answers.

[jackieg412]

Actually the brace Dr Garrigues said he would use will hold the arm about waist high in front of me. He said for 6 weeks and then in a sling next to me for 6 weeks. Also he cautioned that I would have to be careful not to fall on that arm for the rest of my life because I could break my ribs. Interesting

[RitaR]

I’ve been through the 12-1/2hour full fusion surgery and it was no walk in the park. Be strong. Lean on your support staff set up. I wouldn’t have made it without my husband! Please keep us posted. Give someone our contact info.

[titaniumed]

Yes Ed a lot of scars for sure. Way too many. I was to get a call today to set appointment for thoracic surgeon. But they didn't call. I guess I will have to try tomorrow. This appointment is at Rush in Chicago. Always a hard trip for me.
I have seen the video from Dr. Romeo. He used to be at Rush and my pain doctor was the anesthesiologist on one of Dr Romeo's scapulothorasic surgeries. He is in New York now.
My Doctor at Rush is Dr Grant Garrigues. He has an impressive bio. He has been nice to me too.I
I will remain on ketamine during recovery is what I was told. When I had it last surgery the on!y thing I was checked for was mental awareness. For a few days it was ok.
I ha e many questions yet to be answered.
Not looking forward to the answers.

Yeah....One of the nurses was pushing me mentally after a week. That I do remember! I was in the twilight zone with a lot of fog......and lost a full week of memory.

I had no PCA. Probably because my arm and shoulder were broke??? and NPO, (No food by mouth) fed by IV with monitored injections every 4 hours. I do remember it was a major effort finding and getting a hold of the nurse call button....Of course someone would move it all the time, and they rotated nurses like crazy. You lose memory and switch nurses all the time, how are you supposed to get phone numbers? (smiley face)

I guess your going to have to sleep in a recliner chair....which is no fun. Lots of pillows, foam blocks might not be a bad thing to have.

Jackie, are you alone? You know I did my surgeries alone. I left the door open on the house and all my neighbors were coming over often. Since I skipped rehab, Dr M ordered the nurse and PT people out to my home, they came everyday. I would hear "Ed, are you awake?" I would reply, "I never went to sleep".

You know I do have a person that has my username and password that will post here should something happen to me. You know, you have to think about these things....

Ed

[titaniumed]

Actually the brace Dr Garrigues said he would use will hold the arm about waist high in front of me. He said for 6 weeks and then in a sling next to me for 6 weeks. Also he cautioned that I would have to be careful not to fall on that arm for the rest of my life because I could break my ribs. Interesting

In the video, they fuse the scapula to the ribs with the wires. (I can throw the link up if you want) I can see how you can break your ribs, all that will be fused together.

Ask about the autograft. Will they get it from your lowest rib.....??

Ed

[jackieg412]

Yes I am alone. I do have 5 adult children in the area and 1 grandchild old enough to help. I don't know how rehab skill work but I spoke to the Secretary to the shoulder doctor and she said it is hard to qualify for rehab with an upper extremity. We will see because of the fused spine and recent broken neck and keeping your balance.
It was real hard the night after the broken cervical i had to keep telling help to someone came. I doubt it was too loud but I couldn't move to find a call light. Rush does not believe in keeping a catheter in place so if you had to go to the bathroom I had to get someone's attention. Then I had to use diapers because I couldn't be lifted. Not a good night. And I was in ICU.
I have seen the video of Dr Romeo. I was actually referred to him and the doctor I chose at the University of Chicago.
The doctor at the University of Chicago also does this surgery but all of my other doctors are at Rush. With the implanted pump someone needs to care for it.
If a doctor does this surgery twice a year it is alot. There are a few locations where it is taken care of.

[jackieg412]

The auto craft will be from my hip. A good thing is in all of the other surgeries I never had that done. I can't tell you how hard it is to be fixed though the back of the cervical. The anterior approach is easy. The screws up there are irritating. It is skin over screws. I have someone I work with that keeps wanting to run across them. I don't understand doing that and I have told her very firmly not to do that.

[jackieg412]

Thanks Rita. I know the long spinal fusions are difficult my first was 14 hours and I made it. But then I had pain medication too.
It has been determined that most of the regular used pain meds I cannot have. So recovering from a broken neck on Tylenol was beyond difficult. But I made it.
With this scapulothorasic surgery to have the surgeon say the spine surgeries were a walk in the park next to this surgery , one can just imagine what that may mean.

[titaniumed]

The auto craft will be from my hip. A good thing is in all of the other surgeries I never had that done. I can't tell you how hard it is to be fixed though the back of the cervical. The anterior approach is easy. The screws up there are irritating. It is skin over screws. I have someone I work with that keeps wanting to run across them. I don't understand doing that and I have told her very firmly not to do that.

That's good to have 5 adult kids. Prepping the inner circle is important, I'm sure your kids are trained at spine recovery. And soon, extreme shoulder recovery. Any of them need a job? They are probably pretty good at it right now.....(smiley face)

This shoulder brace is going to be a challenge getting comfortable. You know this....

Sometimes we have to go through these extreme surgeries, and its hard to keep it together sometimes....Even though things will get tough again, you know your going to get through it, it will pass....

I would ask about the autograft from the hip. Some scoliosis patients complain of pain when they dig for bone down there.....

Do you have any neck x-rays you could post? Would love to see those....

I am going down to South America this winter for 4 months. I want to avoid the winter storms and related pains and see how that goes.

Ed

[jackieg412]

I do have copies of my xrays and will attempt to put them here. At Rush, when they take xrays the Dr walks in and hands you a copy. Maybe later today. When I pulled the rod out that X-Ray is very interesting.
I did get my appointment with the thoracic surgeon. It is next Wednesday.
Yes the adult children are used to this. No one could prepare them for that accident. At first it didn't look like it would turn out as well as it did.
I wish I was going south too!

[jackieg412]

broken neck photos thw one with the side by side photo shows the first surgery and then the rods pulledout