Older Adults who are Single Having Surgery Prolonged Due To Age

[Scared]

I recently had my return appt w/ Dr Gupta. Although there was a couple of other issues he discussed which stunned me, I was prepared to discuss having a support system in place. He kept questioning me about being single & w/o family. I emphasized hiring in-Home health aides. My neighbors tend to keep to themselves, are younger & work all day. I am lucky to just take my dog out for potty trips. But I also have a couple of old friends who are going to help me out but they don’t live near me. So has any single older (I’ 63) adults experienced having their fusion surgery prolonged due to their age? Isn’t this ageism? That’s how it feels to me.

[Tina_R]

I recently had my return appt w/ Dr Gupta. Although there was a couple of other issues he discussed which stunned me, I was prepared to discuss having a support system in place. He kept questioning me about being single & w/o family. I emphasized hiring in-Home health aides. My neighbors tend to keep to themselves, are younger & work all day. I am lucky to just take my dog out for potty trips. But I also have a couple of old friends who are going to help me out but they don’t live near me. So has any single older (I’ 63) adults experienced having their fusion surgery prolonged due to their age? Isn’t this ageism? That’s how it feels to me.

You could argue that it's none of the doctor's business what your arrangements are at home, but the hospitals always ask. Their occupational therapists try to have you make the most of your physical situation (what the house looks like) so I'm not surprised they want to see that you have human support nearby.

How close do your friends live - a few miles away, 30 miles away? Do you exchange texts with them a lot?
Do you live in an apartment with several neighbors who share walls or in a house with a few who are mostly always working?
Is your dog a heroic rescue dog like Lassie in case you need help?
You don't have to answer all this here but the answers make a difference.

My recovery may not be like everyone's but it has been rough. I need a cane to walk and I am at much greater risk of falling than before the operation. I would have been frightened to face this with no one else in the house. If you're not going to need a cane for long it may be entirely different. And you'll be in rehab for a couple of weeks, right?

Is it ageism? Hard to say, it's an acknowledgement that it's hard to face this alone and that is more likely with an aged population. Young people always seem to be surrounded by other people and they have technology to connect them. I wonder if the doctor would treat a young person the same way. Or an older man.

[Scared]

Due to the on-going deterioration of my spine this increased pain, resulted in inability to do social activities. I used to have several friends but after awhile they disappeared. I live in a townhome community. Lost my career/license/retirement resulting in disability. To maintain my sanity I use to garden (flowers)but had to give that up 2 yrs ago). Anyway the Scoliosis book by David Wilber’s has chapter about your emotional state post surgery & needing support. My friends live about 30-45 minutes from me. So this is what I’v got- It’s not like you’re a 6 yr old & walk up to someone on the street & ask “will you be my friend?” (smiley face). I do think its none of their business as it’s MY LIFE at stake. I told dr I would also be getting stairlift to access upstairs even though he didn’t even inquire about # of steps in my home. It’s been a long strange trip per the Grateful Dead & apparently not over.

[KathyInIowa]

I recently had my return appt w/ Dr Gupta. Although there was a couple of other issues he discussed which stunned me, I was prepared to discuss having a support system in place. He kept questioning me about being single & w/o family. I emphasized hiring in-Home health aides. My neighbors tend to keep to themselves, are younger & work all day. I am lucky to just take my dog out for potty trips. But I also have a couple of old friends who are going to help me out but they don’t live near me. So has any single older (I’ 63) adults experienced having their fusion surgery prolonged due to their age? Isn’t this ageism? That’s how it feels to me.

I was younger than you when I had my surgery 4 years ago (I was 55 at the time) and my fusion is considered "short" as my scoliosis is "adult onset" so my fusion is mostly lumbar (T11-sacrum). I was in good physical shape and all of that. I am married and my surgeon knew that I would be going home to a support system.

However, one thing that my husband and I STILL talk about is that l did not "come around" from being on drugs until about day 10 or 11 after surgery. The hospital tried to release me only 2-1/2 days after surgery and I was still very "out of it." Apparently when that discussion was happening the OT was in the room and when my husband said "I don't want to take her home like this" the OT said "she's not going anywhere." I only stayed 1 more day......

I say this because if I had been going home alone, there's no way I could have managed. I don't know what the hospital does with patients who haven't come out of the foggy-ness of the drugs but don't need the medical care from the hospitals - if they are going home alone. My surgery was performed from the front and back in the same day, so maybe I was on heavier drugs because of that?? I don't know. But it took me a long time to come around!

I still wonder what I said to Ed on the phone! LOL!

Kathy

[titaniumed]

I still wonder what I said to Ed on the phone! LOL!

Kathy, You were coming off anesthesia....Lights on, nobody at home.

I don't remember what you said.....You were in the hotel room across the street hanging close to TCSC for a few days (which is a good idea).

I don't remember anyone that came to visit me in the hospital. I heard all these stories, "I came down, you don't remember?" multiple docs commented in my hospital reports that I am a excellent historian....I wonder what era I was talking about? I have no idea.....I didn't feel a thing in ICU. Ketamine is a different planet.....Bad kitty. I have always known it as being cat tranquilizer.....

(Anyone who does K as a recreational drug is crazy....This is NOT a good idea. It dulls or reprograms the pain receptors in the brain....modifies your CNS. I don't know if I could be in pain, and don't feel it as much anymore? How would you know? I don't think there is any way of knowing.

On the ortho wing, that changed, and weaning is the hardest part.... I quit my meds cold turkey at 6 weeks. Couldn't take it anymore. I replaced meds with nutrients and it worked like a charm. Painful, yes, but it worked.

On the subject matter of this thread, I was asked how many steps I have in my home by my surgeon about 6 times over the years. I have 2 steps.(Into my pup tent) Just kidding..... I hired a CNA who was basically a gopher, and my surgeon sent all the nursing and PT staff out to my home every day for a few weeks. Its way cheaper than a rehab facility and I saved my insurance company a fortune. I basically ran out of the hospital after 10 days since I was tired of playing doctor and wanted to return to normal. Scoliosis surgeons do not want to hear about staircases, or things like parachuting next week. (smiley face) Better to say I will set up a bed on the first floor. My surgeon wanted me to hire the CNA. I only had her come for 2 hours in the morning. I spent about $1500 having her come out to the house. She came for a month.

Operating on someone does involve the recovery process. From the beginning to the end. If the end result isn't favorable, or an improvement, why operate?

Ed

[mabeckoff]

I was given K during one of my surgeries at UCI. Never again would I take it. I was out of it for 10 days. It is horrible. I ripped my central line out. I was hallucinating the entire time. I was lucky that my doctor was able to keep me there because there was no way I could leave.

[Scared]

For clarification purchases, Dr G told me that I would be fused T4-pelvic (A/P), 60-70 % reduction of pain. I had concerns re: My Cervical problems which he said didn’t require surgery. He did say I had improved significantly re: physical ability. Prior to return appt his Med asst told me it would be 5 days in hospital + 1-2 weeks on-campus Rehab (this is in St Louis). 1 of his requirements is I seek 2nd opionion re: Cervical (I have already made appt w/ Dr Steven Glassman Norton’s Leatherman Institute last week Feb. Maybe will have surgery there after all. My VERY frustrating appt w/ Dr G had to do w/ his repeated emphasis on RISKS of surgery (which I was already aware of) & his questioning me about being single. BTW I recorded appt on my phone which he knew about which I highly recommend. I discussed concerns re: increased use of pain meds, increased pain & increased lack of quality of life. From what I have seen on forum Ed appears to be the only other single “older” adult here. Plus I’m not as physically fit as Kathy. So the longer I wait the higher the risks & tougher the recovery-Right? I already have osteoarthritis, DDD all thru spine, knees, L arm & hand & probably looking at Cervical surgery ahead. I’d like to believe I have a right to fight for a 2nd chapter to my life by at least decreasing this horrible pain I live w/.

[titaniumed]

I was given K during one of my surgeries at UCI. Never again would I take it. I was out of it for 10 days. It is horrible. I ripped my central line out. I was hallucinating the entire time. I was lucky that my doctor was able to keep me there because there was no way I could leave.

I have read about the hallucinations and the K hole effect. I didn't hallucinate or dream, but I was a hose puller (NG Tube) and they tied my arms down. That was what woke me (my mind) up, I yelled out loud, "What happened?" Referring to the surgeries....I was out for 4 days. There was no pain at all in ICU, none at all. My surgeon prepped me on all of this.

Some friends told me that they came down and saw me standing by the bed with all the hoses hoses hooked up next to all the fancy equipment. The ICU nurse told them that Ed likes to stand. Funny because I don't remember this. I guess I was standing there just about all day. I guess sleeping is hard even if you cant feel it. ??? I do not remember standing up for the first time. By the time I was on the ortho wing, I was already a pro at standing. When the mind returned to normal, then I realized how tall I was standing.

Ed

[mabeckoff]

I have read about the hallucinations and the K hole effect. I didn't hallucinate or dream, but I was a hose puller (NG Tube) and they tied my arms down. That was what woke me (my mind) up, I yelled out loud, "What happened?" Referring to the surgeries....I was out for 4 days. There was no pain at all in ICU, none at all. My surgeon prepped me on all of this.

Some friends told me that they came down and saw me standing by the bed with all the hoses hoses hooked up next to all the fancy equipment. The ICU nurse told them that Ed likes to stand. Funny because I don't remember this. I guess I was standing there just about all day. I guess sleeping is hard even if you cant feel it. ??? I do not remember standing up for the first time. By the time I was on the ortho wing, I was already a pro at standing. When the mind returned to normal, then I realized how tall I was standing.

Ed

When I was given it, I was not told about it. I found out later that it was a new program at UCI. They gave it to help the pain. I would rather have pain.

[Scared]

I have read about the hallucinations and the K hole effect. I didn't hallucinate or dream, but I was a hose puller (NG Tube) and they tied my arms down. That was what woke me (my mind) up, I yelled out loud, "What happened?" Referring to the surgeries....I was out for 4 days. There was no pain at all in ICU, none at all. My surgeon prepped me on all of this.

Some friends told me that they came down and saw me standing by the bed with all the hoses hoses hooked up next to all the fancy equipment. The ICU nurse told them that Ed likes to stand. Funny because I don't remember this. I guess I was standing there just about all day. I guess sleeping is hard even if you cant feel it. ??? I do not remember standing up for the first time. By the time I was on the ortho wing, I was already a pro at standing. When the mind returned to normal, then I realized how tall I was standing.

Ed

Ed I thought you had posted or responded to an earlier thread about the benefits of Ketamine for surgery? You had provided the YouTube re: Dr Joshi which I thought would be great for anesthesia? Am I wrong about this? I questioned Dr G about using Ketamine even though I knew it was probably up to the anesthesiologist & he confirmed my thinking. Do you still think it’s worth using Ketamine?

[LindaRacine]

For the record, I am also single, and actually older than Ed. After my 2011 revision surgery, I spent one post-hospital night with a friend, but was too uncomfortable to stay there. I went home, and essentially took care of myself for the remainder of my recovery. I had neighbors who were willing to chauffeur me when needed, and used the local disabled bus service when necessary. I had groceries delivered, and friends and neighbor delivered snacks and meals.

[titaniumed]

For clarification purchases, Dr G told me that I would be fused T4-pelvic (A/P), 60-70 % reduction of pain. I had concerns re: My Cervical problems which he said didn’t require surgery. He did say I had improved significantly re: physical ability. Prior to return appt his Med asst told me it would be 5 days in hospital + 1-2 weeks on-campus Rehab (this is in St Louis). 1 of his requirements is I seek 2nd opionion re: Cervical (I have already made appt w/ Dr Steven Glassman Norton’s Leatherman Institute last week Feb. Maybe will have surgery there after all. My VERY frustrating appt w/ Dr G had to do w/ his repeated emphasis on RISKS of surgery (which I was already aware of) & his questioning me about being single. BTW I recorded appt on my phone which he knew about which I highly recommend. I discussed concerns re: increased use of pain meds, increased pain & increased lack of quality of life. From what I have seen on forum Ed appears to be the only other single “older” adult here. Plus I’m not as physically fit as Kathy. So the longer I wait the higher the risks & tougher the recovery-Right? I already have osteoarthritis, DDD all thru spine, knees, L arm & hand & probably looking at Cervical surgery ahead. I’d like to believe I have a right to fight for a 2nd chapter to my life by at least decreasing this horrible pain I live w/.

Nancy, I went through all of that....being single, and hearing about the risks and complications. Its a hard thing to absorb, what kind of body posture do you emit when somebody tells you and asteroid is going to hit your home? These weren't the most pleasant of discussions. What can I say? You hear this stuff and you feel like running like Forrest Gump. Run across the US. This was a discussion meeting, not a set a date meeting. You just don't go in and set a date on the first meeting. You have to build on a relationship and like and trust your surgeon, and that takes time. My surgeon didn't have the classic bedside manners that many might be looking for, but I wasn't looking for that, I wanted a expert technically oriented type of surgeon that could pull it off, regardless of if he came to visit me or hold my hand or mental massage or whatever. Its not about that. Surgeons are surgeons. They have a lot on their plate.

They have to talk about all of this because you will sign releases stating that you were informed about complications releasing the surgeons and the hospital should something happen. They cannot cover all complications because there are too many of them. Linda has posted extensive lists here on this subject matter. You can go blind, that's just one of them. If interested, I hope a search works. Searching here can take some effort.

If you want surgery, you have to really want it, and want it BAD. You cant paint a picture of impending doom, with asking "How am I going to do this? and "How am I going to do that?" Nobody knows, and its not what they want to hear. They want to hear, "I CAN DO THIS" its a total commitment from you to yourself and your surgeon. I can do this no matter what happens. This is extremely important or you will never get that green light out of any surgeon. We have to fight, and they want fighters. Nobody knows their destiny, we all have to figure out these things when they hit us.

I mentioned Leatherman a few months back since its in state. Its going to be a whole lot easier this way. Do not doubt their expertise....they have a long history in the scoliosis arena. Once again, its going to be best to go in blind and only answer their questions. You are technically hiring them, but they don't need the work. Don't offer a set of circumstances that raises any doubt as to not being able to do this...You will have to tell them things they want to hear. Its like getting a date. You don't start out with "Your place, or mine". Ha ha....I will admit, I have done that with varied success.

All your questions about recovery will be answered after you set a date. I set a 3 month window. Your inner circle, who will come over, who will food shop, who will walk Fido, who will wash the windows, mow the lawn, pull the weeds, fix the floor, none of these sorts of questions they want to hear, don't bring any of this stuff up.

You have to have neighbors that can help. If you go and talk to them and tell them you are doing extensive spine surgeries, you will be surprised who will offer help. You will need help shopping since you wont be able to drive. I would start working on this now. I had all my neighbors coming over everyday out of compassion, and it was great seeing them. One neighbor she brought over a very SPICY chicken soup that almost killed me. Ha ha That took a few Zantac pills to get that straightened out. You can have food delivered. Have a trial run delivered so you get this all worked out before surgery. Another 6 pack of Ensure please. That stuff is expensive....Get your inner circle trained.

If your doing surgery, get your finances sorted. Do not spend any money on anything. Chances are you wont need it. I didn't buy anything. I bought a foam topper 2 weeks after I got home. Had my CNA get it for me. $80.

One thing about recovery, its hard to spend money and I saved a lot of money in my recovery. If you stay at home, how do you spend money? I don't go nuts online and stay off Amazon. Each year I spend about $10 with Jeff Bezos. (smiley face)

There are a few solos here.....the independent mindset. We live alone for various reasons, but we always figure everything out on our own. There is nobody to talk to about feelings, or in recovery, pain. You eventually figure out all of this scoliosis related pain stuff, why and what causes pain and what should I do? Stress and diet play a strong part. We keep our meds on standby, but should we take them? Is this the answer? Many of the times it isn't. But I take an NSAID and go to bed and wait for a result. I have to feel the result. If not, why continue? NSAID s and meds in general are tough on kidneys and the liver and produce kidney stones, been there, done that. So, I am quite reserved and very careful about this. Certain types of pain you can walk through. I have done this and so have others here.

Think about pain, and that's EXACTLY what you get....

Old scolis ignore a lot of pain....and we get pretty good at it. I became an expert at it, and you will too.

Ed

[titaniumed]

Ed I thought you had posted or responded to an earlier thread about the benefits of Ketamine for surgery? You had provided the YouTube re: Dr Joshi which I thought would be great for anesthesia? Am I wrong about this? I questioned Dr G about using Ketamine even though I knew it was probably up to the anesthesiologist & he confirmed my thinking. Do you still think it’s worth using Ketamine?

Its up to your surgeon, and its good that you brought it up.

There are benefits that K offers. It doesn't depress circulatory, its the opposite. In anesthesia, Opioid based anesthesia lowers blood pressure, and infarction can produce undesirable results like stroking. Ask Joan Rivers. She did not have a procedure. This is an anesthesia related question that only an anesthesiologist can really answer. You will have to study the Dr Joshi material. My thread has some of the material, and I did notes on that video. Watch and review it a few times.

There are studies on K that state that patients will wean much faster off opioid's. And I will vouch for that since I cant stand oral opioids. IV and injectable's are the ticket, and the orals are horrible for me.... I didn't take any after my shoulder rebuild or gall surgeries. I told my shoulder surgeon that I cant take Percoset and wont do it, and didn't. I took one Celebrex and that was it. I was in rehab 3 days later working through that pain without medications. Scoliosis surgery is different and impossible to skip the oral opioid recovery process. It something we have to do, and try to balance our digestive difficulties vs pain. Its why I used hot soaks.

You can look at studies and get all sorts of answers depending on which study. All sorts of percentages. How do you make a decision when all of them run between 30 and 60%? Its best to look at things in a Low, Medium, or High manner. What are the chances of a rocket explosion going into space? Everybody is on line waiting to pay millions to do this and they call us crazy doing spine surgeries? They don't need to go to space, but we actually need our surgeries.

Like Johnny Carson who had his written answers for reporters, here is my new list of answers for the forum (Scroll down for Johnny's personal life)
https://en.wikipedia.org/wiki/Johnny_Carson

1) Yes, I did
2) No, I didn't
3) Maybe
4) Not a bit of truth in that rumor
5) Only twice in my life, Anterior and Posterior
6) I can do either, but I prefer the first
7) I cant answer that question
8) As often as possible, but I'm not very good at it yet
9) It happened to some old friends of mine, and its a story I will never forget
10) Living flesh over Titanium Endoskeleton
11) Homo Erectus
12) No, Tin Man is wrong
13) Low, Medium, High
14) No, the screws don't hit my organs
15) Yes, my pelvic anchors are large
16) Ti-6-Al-7Nb Synthes Pangea System PEEK Spacers
17) Pain? Only on alternating Tuesdays, and on April 15th

Ed

[Scared]

Ed, Initial appt was 12/17. This was Return appt. IF I decide to go w/ Dr G next appt will be Pre-Surgery. It’s not likely I’ have opportunity to build relationship given I’ 4 states away. I want to emphasize that I was not a “weany” throughout appt & certainly didn’t “paint picture of impending doom” -that’s not me. I only emphasized pain,lack of quality of life, emphasizing that I wanted surgery AFTER he had made his mind up (a last ditch effort). Plus I told him how I was going to obtain a support system. I am a strong willed, logical thinker who has learned how to deal w/ & talk to drs esp. ortho docs who often present as having their frontal lobe (hypothalamus/amgydala) removed during residency. I go into each appt prepared w/ bullet or questions knowing docs have limited time w/patients. My career path lead me to achieving Joint Commission Accreditation for Behavioral Healthcare w/in 1 yr by myself. This experience educated me in learning many things re: how the medical world operates from infection control; Credentialing/Privileging of drs.; Developing drug formularies & doing training on progress notation among many other requirements.Dr G appears to be a kind person (so far) + he’ known for his expertise. Both meet my requirements. I look at this as a 2 way street- Surgeons operate as a business & I’m a Consumer. Without purchasing services (my $ ) they don’t make $. BTW don’t feel like Forest Gump as there’s no where else to run- I’ at the end of I-90. I know about the risks, know it’s a crap shoot. I’ as ready as I’ll ever be. The forum + lots of reading about risks & recovery has been so helpful in preparing me for the good, bad & the ugly so to speak. Although posted as scared isn’t everyone fearful at the prospects of being fused? BTW enjoyed the Johnny Carson’s answers (sounded like what I would say)

[Scared]

Kathy, You were coming off anesthesia....Lights on, nobody at home.

I don't remember what you said.....You were in the hotel room across the street hanging close to TCSC for a few days (which is a good idea).

I don't remember anyone that came to visit me in the hospital. I heard all these stories, "I came down, you don't remember?" multiple docs commented in my hospital reports that I am a excellent historian....I wonder what era I was talking about? I have no idea.....I didn't feel a thing in ICU. Ketamine is a different planet.....Bad kitty. I have always known it as being cat tranquilizer.....

(Anyone who does K as a recreational drug is crazy....This is NOT a good idea. It dulls or reprograms the pain receptors in the brain....modifies your CNS. I don't know if I could be in pain, and don't feel it as much anymore? How would you know? I don't think there is any way of knowing.

On the ortho wing, that changed, and weaning is the hardest part.... I quit my meds cold turkey at 6 weeks. Couldn't take it anymore. I replaced meds with nutrients and it worked like a charm. Painful, yes, but it worked.

On the subject matter of this thread, I was asked how many steps I have in my home by my surgeon about 6 times over the years. I have 2 steps.(Into my pup tent) Just kidding..... I hired a CNA who was basically a gopher, and my surgeon sent all the nursing and PT staff out to my home every day for a few weeks. Its way cheaper than a rehab facility and I saved my insurance company a fortune. I basically ran out of the hospital after 10 days since I was tired of playing doctor and wanted to return to normal. Scoliosis surgeons do not want to hear about staircases, or things like parachuting next week. (smiley face) Better to say I will set up a bed on the first floor. My surgeon wanted me to hire the CNA. I only had her come for 2 hours in the morning. I spent about $1500 having her come out to the house. She came for a month.

Operating on someone does involve the recovery process. From the beginning to the end. If the end result isn't favorable, or an improvement, why operate?

Ed

Ed- I am assuming CNA is like in-home health aide? Not familiar w/term. How did you find a CNA & do you recall the charge? The charge for in-Home health aide where I live is $22/hr. Thanks Nancy