Not sure what this means

[LindaRacine]

Did you see where she mentioned that they put something in her nose for Staph and MRSA before her hip operation? Linda might know about this. I don't believe anyone has mentioned this here on the forum...Staph is everywhere you know. It's up to us to fight it off....

Ed

I would assume it was a swab for testing for infection.

[Tina_R]

I had my nose swabbed a few days before my surgeries. I have heard that some people carry MRSA in their noses and that it can be harmless as long as it is limited to there, so that they may never know they have it.

But there is some kind of risk of it spreading when the person has surgery, hence the test.

[jackieg412]

The problem with the brace is that nothing but a blanket or tent will fit over it so anything I have for clothes hard to fit under it.
I understand that it will take 2 people to change my clothes or wash up. One to take the brace off and one to hold my arm still. There is to be no movement of the arm for 6 weeks. I will be able to move the fingers. I am not sure if they will have me move the wrist.
I was also told that I would need a power recliner or a hospital bed as I will not be able to get up or lay flat.
The doctor acknowledge that the isn't a lot of information out there about recovery. He told me bigger button shirts will work best . But I have to protect my skin and most definitely the wound. I purchased some men's white t shirts. Even if they have to be cut to get them on or off.
The test is for MRSA. Easy test. I had to do a pulmonary function test that was normal.
The rest is blood work and EKG.
We plan on 3 days in the hospital if there isn't any lung problems. Since they deflate the lung to avoid putting a hole in it. If there is a hole , a chest tube will be used. Doesn't sound like fun.
Some of this stuff is really unusual.
It's getting through the first six weeks. And you are correct, I will have to be extremely careful not to fall on that arm. If I do ,once it is healded, I could break my ribs.

[titaniumed]

Your going to need some help with all of this...no doubt, but I didn't think it would take a threesome. So, no rehab?

I am sure you have discussed recovery logistics with your doctor, is there anyway they can send 2 trained CNA's out to your place to change every day? Funny how insurance companies work, they didnt cover CNA help at my home, but covered nursing and physical therapy. But this is a special case.....In the old days, they would put you in a plaster cast like the older scoliosis hardwareless cast methods before the Harrington era of 1960.

Here is a video testimonial...One year in a cast or casts. 1955. No hardware.
https://www.youtube.com/watch?v=F4FJ...l=TheHeyClinic

Dr Hey main page video testimonials, all ages.
https://www.youtube.com/user/TheHeyClinic/videos

I had a chest tube... They do come out easy.... I remember begging the day shift nurse to call my surgeon and pull some hoses. I had a lot of hoses. When the catheter came out at the end, that one really hurt....I kept humming Peter Gabriel's song "Sledgehammer".

We had a member here (about age 25) from Denver that had a pleural effusion (fluid buildup) many years ago and they had to put a new drain in after she got in trouble about 2 weeks post. She stated that when they put the drain in "after", that that hurt like heck. My drains were installed during surgery....coming back out when they sew you up.

The shirt under the brace should be changed often, like everyday. ..bacteria builds up quickly. It's been a lot of years since my brace days...and that was a challenge. But then they wore casts for months and months back in the old days.....

Ed

[jackieg412]

Yes the skin under the brace has to be closely watched. I have some white men's t shirts for that. If they have to cut part of them it isn't a big deal. Remember I cannot duck at all due to the cervical fusion. I won't be able to move the right arm so it will be a challenge.
I was told it will take 2 people to change this . One to hold the arm and one to remove the brace.
Right now, according to surgeon, the social workers at the hospital will do an assessment and then decide. It may be rehab and then skilled nursing facility.
This depends on my insurance. I can go home to one of my daughter's house, but there isn't people home while they work. Also we will need to check for room for the hospital bed and no easy access to restroom. We will see..
Dr already ordered special dressing for over the spine wound. It was just checked and no signs of infection but the skin isn't normal. He also commented on the fact that I have had so many spine surgeries that he will consider all skin very delicate. He ordered some special dressing but I haven't explored that yet.
And with the brace holding my arm out, remember I had the nerve decompression on that elbow. That was 3 months ago so still not completely healed.

[jackieg412]

I forgot to add that the neurosurgeon keeps saying that my body size complicates things. Not a lot of muscle or body fat and very small bones. That is just what we have to work with.

[titaniumed]

Right now, according to surgeon, the social workers at the hospital will do an assessment and then decide. It may be rehab and then skilled nursing facility.
This depends on my insurance.

I see...I guess a lot of the more serious procedures do have that "fly by the seat", see how the patient does decision making for recovery....As much as we want our recoveries to be textbook style, sometimes Doctors and patients have to be prepared. I also was prepared back when I did my surgeries.... but I forget this stuff. I have been lucky and I do think about it everyday....

The insurance thing was also on my mind and was one of the reasons why I wanted to leave the hospital should I have a complication down the road and needed more surgery....I used up half of my total insurance amount in 10 days. $3.9 million total insurance coverage 13 years ago. Like a 2 foot hole in the bottom of a swimming pool.

If you take a t-shirt and cut it just right, you could have somebody sew a few velcro straps to make things a lot easier putting on and coming off. Cut the sleeves off and cut under the armpit all the way down on the sides. That way you can just go over the head. Or, you can also cut the tops of the shoulders and use velcro straps there and create a 2 pc t-shirt. Like a clam shell brace.

You know, like a Chippendales dancer. You have to be able to take it off "on cue" to the music or bass drum. Ole! Ha ha

Here is that testimonial scapular fusion video. I can't remember if I posted this....
https://www.youtube.com/watch?v=BFva...nel=LexiPappas

Ed

[titaniumed]

I just noticed in the video at 3:42 where they took bone graft off of both of her hips. 2 scars up high for both scapula's, and 2 scars down low by her waist.

I guess you should inquire about allowgraft. What will they use? What have they been using on you for spine?

Did they use any products on your T1 PSO? Or do they close it down and go bone to bone? I have not seen anything on this subject matter. When you see your spine surgeon, that would be great if you could ask.

I don't know if they still use the hip for autograft on scoliosis surgeries anymore. I wonder if this practice has stopped by now? Some have complained about hip pain being worse than the spine pain.

Ed

[jackieg412]

I watched the video. She seems to do OK. I know this surgeon plans on doing the graft from my hip.
I never had that done with the spine but they used some of the bone that was removed, and cadaver bone and the artificial bone .
We have to try to keep his record of never having to do it twice. Once for me is enough.
I do have some shirts that snap open. I purchased a few from Amazon and made some from bigger shirts.
The problem with Velcro is if it isn't exactly put together correctly it rubs.
But I have a few that snap and some that button and one that zips.
This is an adventure for sure.
When I looked at the video, the Dr. That came up on the side is the surgeon for me.
He does a video about the form of muscular dystrophy she speaks about.
I have followed him for years. So he seems familiar to me. He was at Rush in Chicago, then in New York,and now in the South suburbs of Chicago.

[LindaRacine]

I know I've said this many times, but I like to remind folks that grafts are taken from the iliac crest (which is part of the pelvis), and not the hip. The reason I make a point of this is that I've had several people ensure me over the years, that there was bone taken from their actual hip, which as far as I know, is never actually the case.

[jackieg412]

Yes you are correct. I am sure that a surgeon would not take the bone from the hip as you say. I think sometimes I just get confused between the hip and the pelvis.
But this surgeon will be taking the needed bone. I need to look up what he called it.

[titaniumed]

Yes, hip is incorrect, but for lay people it's going to be the only way to describe this area of the body. Who doesn't know where the hips are? If you ask, "Doc, are you going to dig on my hip?" They know exactly what you mean. Many years ago, I asked this very question.

Different Doctors graft in all sorts of places besides the iliac crest. Tibia, Fibula, Etc are also used....I turned down grafting on my jaw a while back..... I still have to get new x-rays to see what happened after the antibiotic injections, it will be 1 year in December. So far, so good with no pain with my Mandible (Jaw)and Maxilla (Face) infections. The Oral surgery grafting sites are things that need a lot of thought....hopefully, I won't have to go there. They actually graft off the skull in some cases...I am extremely hesitant on heavy duty oral surgery even though I might not have a choice.

All my facets and spinous process's were removed in my scoliosis surgeries and none of that bone was used. I had no bone used at all as I specifically asked this question. It was all synthetics, and BMP. 13 years now, so far so good.

What is interesting is that the scapula is not a spine procedure and you can see how large her Iliac crest (ICBG) scars are....There are donor site complications that can happen.

https://en.wikipedia.org/wiki/Bone_grafting

Jackie, With all the major spine work you have had, you dont seem to complain about spine pain too much. Its all about the scapula winging and the ring and pinky hand pain. That T1 PSO (Pedicle Subtraction Osteotomy) was a extreme procedure. Your neck re-build after the broken rods, and the T5 infection...these were all 10 level spine procedures. Incredible. Your procedures 5 years ago were also extreme procedures.

Once again, will you do this scapula fusion on Tylenol and Gab? Do you think that this is possible because of the Ketamine, and or the pain pump? Do you think the pain pump is doing the brunt of the pain control? Was there any discussion about the pain pump leads or tubes on this scapula fusion, and how high in the thoracic do they run? With the arachnoditis, are they using morphine in the pump? I believe you mentioned that you couldnt take morphine.....

Of course, will the pain pump help with the scapula pain?

Ed

[jackieg412]

I am now down to 2 weeks before scapulothorasic fusion. This is new to me and I'm not sure what to expect. The little info that Ed sent is valuable.
I know what to expect with spine and there is a lot of information on that, but so little about this.
We are now discussing the type of block to be used in surgery, with the full fusion complicating that.
I guess the surgeon is concerned that it I am to much pain, it will complicate my breathing.
The right lung will be deflated and hopefully will not have any other issues.
Almost there.

[jackieg412]

One week away and so far this scapulothorasic surgery is still scheduled for November 9. I did pass all testing but it is still a week away.
I did watch my surgeon give a presentation on this scapulothorasic surgery that he does on young people with a form of muscular dystrophy. We said he does 4 or 5 a year and has done around 100 in his career. It is obvious that this is an unusual surgery.
He has never done this for someone my age. There is only 2 things to do-- stay like this or try the surgery, with hope of fusion and recovery. Big choice.
When I expressed the fact that I wAs nervous, he said he was also. But that would keep him focused.
I did forget to ask how long the surgery was ,but I don't think it is as long as spinal fusion surgery.
We will see.

[titaniumed]

I remember being jumpy before my surgeries....I had the attention span of a cat chasing a laser. Here is the perfect video, left, right, left, right, left, right. Funny stuff....

If you wanted to trigger off a seizure, this would be the way to do it.

https://www.youtube.com/watch?v=Vo4y...elseyUuskallio

When my vascular surgeon came in right before to knock me out, he asked if I was nervous. My reply was "Am I supposed to be?"....I guess this was me giving up on anxiety, (chasing that laser), and conveying complete trust....he inserted an IV in the top of my wrist in 2.5 seconds flat which was impressive....

Jackie, I think you will be ok....There will be some learning curve but your good at that. Fingers are crossed that this helps with the hand pain.

Pre-surgical anxiety 17 tips.
https://njnbi.com/scared-of-surgery-anxiety/

Ed