D4 Update?
-
@Jolly said in D4 Update?:
How is she doing?
Shitty.
Still on a Dilaudid PCA at 0.2 mg every 15 minutes, in addition to a constant infusion of Dilaudid (don't know the dose). Besides that, she's on toradol 30, tylenol, and they've started a steroid dose pack.
I was able to FaceTime with the surgeon yesterday, and we discussed all possibilities.
We know conservative Rx hasn't worked. She's failed with the no-surgery option, and she's failed with the endoscopic discectomy. He said we could try another endoscopic discectomy, but he seemed to indicate that the risk of failure is high.
So...go big or go home.
She's tentatively scheduled for surgery Tuesday, the 2nd. It's going to be a big-ass operation 4-5 hours. Her past fusion was not minimally invasive, so the have to open everything up, expose the previous fusion and add to it - if they can. If they can't they have to take it down and put in new screws and rods.
The surgeon joked, "You know why it's called 'back surgery'? It's because patients always come back." Sad, but true.
Short term plan, as of today, is to try to get her off IV meds and see if her pain is controlled with oral meds. Neither she nor I are optimistic about that, but it's worth a try. If that succeeds, she will be discharged, but stay with us because her husband is working, and she can't be with the two terrors (G2 and G3, who are 6 and 2 years old). This way SIL can bring the kids over, but she doesn't have to tend to them.
What a clusterfuck.
-
Sounds like her back is really unstable. Is it just the lower part or does she have some issues higher up? Just spitballing, but would there be any benefit from the long Herrington rods like they do for scoliosis?
Because this sounds like a honey of an operation coming up. Be nice if it could be one and done (hopefully).
-
@Jolly said in D4 Update?:
would there be any benefit from the long Herrington rods like they do for scoliosis
I hate, hate, hate, that operation.
She has no upper back issues, yet. The problem with any stabilization is that it provokes adjacent areas to do unnatural work. There is something called "Adjacent-Level Degeneration."
-
I'm really sorry, George.
Please keep us posted.
-
@89th said in D4 Update?:
I'm curious does the doctor enjoy talking with you more than most parents because of your medical knowledge? I'd imagine it's a nice change for him/her/they/them.
I usually don't let them know. However, when I have questions, I end up using "the vocabulary."
After that, the conversation goes, "Are in medicine? Ah, I see.
What field? Oh, really,
Where? You worked HERE?
The good thing is that they don't have to go thru the preliminary explanations of shit. They can talk jargon and I can explain to D4.
-
@George-K said in D4 Update?:
@blondie said in D4 Update?:
Just a question George because I know nothing of these things, but are her surgeons orthopaedic surgeons or neurosurgeons?
Neuro.
Only way to go with a back. I detest orthos doing back work.
-
@George-K said in D4 Update?:
@89th said in D4 Update?:
I'm curious does the doctor enjoy talking with you more than most parents because of your medical knowledge? I'd imagine it's a nice change for him/her/they/them.
I usually don't let them know. However, when I have questions, I end up using "the vocabulary."
After that, the conversation goes, "Are in medicine? Ah, I see.
What field? Oh, really,
Where? You worked HERE?
The good thing is that they don't have to go thru the preliminary explanations of shit. They can talk jargon and I can explain to D4.
They know, usually by the second or third sentence. Then, they cut to the chase. At least you understand everything. Being a dumb labrat, it sometimes goes over my head.
I just nod and try to understand the biggest part.
-
@Jolly said in D4 Update?:
Only way to go with a back. I detest orthos doing back work.
Gonna disagree with you, a bit.
A well-trained ortho is probably fine for the non-complicated stuff. Emphasis on well-trained. I've seen some ortho guys do outstanding work. Former chair of ortho at Northwestern did all the scoliosis surgery there. He was really good.
But, that said, it's rare, and I assume it's not a huge part of most residencies.
Given the choice, I agree, neuro > ortho. But there are some fine ortho spine surgeons out there.
D4's doc:
-
@George-K said in D4 Update?:
@89th said in D4 Update?:
I'm curious does the doctor enjoy talking with you more than most parents because of your medical knowledge? I'd imagine it's a nice change for him/her/they/them.
I usually don't let them know. However, when I have questions, I end up using "the vocabulary."
That happens to me all the time. And obviously I’m not a physician. But I am immersed in that world and the vocabulary sticks to me. ‘Hepatocyte’ falls from my mouth easier than ‘liver cell’. So they ask if I’m a physician and I say ‘no, but I spend too much time with them’ and explain my job.