D4 Update?

[Jolly]

How is she doing?

[George K]

@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.

[Axtremus]

Sorry ... haven't catch up to what's going on with D4, but wish her the best.

[George K]

@Axtremus https://nodebb.the-new-coffee-room.club/topic/32161/so-how-was-my-tuesday/16

[Jolly]

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).

[George K]

@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."

[Mik]

Jeez. I'm so sorry it has come to this. She's much too young for these issues.

[Aqua Letifer]

I'm really sorry, George. Please keep us posted.

[89th]

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.

[George K]

@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.

[Friday]

Damn. I come back after a year and this is the first thing I read.

I'm very sorry to hear about D4, George. Hope everything goes well on Tuesday.

[jodi]

Oh wow. I sure hope they can get her pain free. I can totally relate.

[blondie]

Just a question George because I know nothing of these things, but are her surgeons orthopaedic surgeons or neurosurgeons?

[George K]

@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.

[blondie]

I spent 27 days in bed in 2015 with back pain. I can’t imagine how much worse this could be, but she and you are living this. I’m so hoping this surgery can help her.

[Jolly]

@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.

[Jolly]

@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.

[George K]

@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]

Staff bent the rules and let G2 and G3 visit (they are 6 and 2 years old).

I lived in this building in medical school.

[Jolly]

That's great!