More Prodisc drama

More on the Prodisc lawsuits, and Dr. B is quoted. For some reason, this doesn't bother me; I figure if they've got some financial investment in seeing that a surgery is successful, then the chances are better that it will be. There's probably all kinds of things wrong with thinking like that, but there you have it.

Comic relief

At first glance, this xray doesn't look too much different fromt this one, but if you look closely, you can see that the fused area is filling in a bit more with bone.

That's good.

Right after I was shown into an exam room, one of the interns came in to see me. Last visit Dr. B. brought this kid in to see my progress and introduced him, saying that he had "scrubbed in" on my surgery. (Thanks to Grey's Anatomy, I now know what that means.) So this kid (I kid you not, he was like 12 years old) comes in and asks me a bunch of questions about pain, activities, etc. He examined the scars and said they looked "good," whatever that means, and took some notes. I asked him about the slight sciatica feeling pain I was getting when I lean forward sometimes and his answer was basically, don't lean forward like that. *rim shot* Who is this guy, Jackie Vernon?

Dr. Balderston came in a few minutes later and said it looked "absolutely beautiful," and was healing exactly as it should, which of course is great to hear. I joked with him that usually when someone says I look beautiful, they are looking at my face, but I'd take the compliment however it came. He joked back (unusual for him, he's usually all business)that for him, face, back, whatever, it was all the same. It felt so good to joke around with him, after all the seriousness in the past year or so. What a relief! I'm now allowed to start swimming again, and can use any of the elliptical machines in the gym, as well as the stationary bike. This will give some much needed variety to my workouts, and help to redevelop my leg muscles. I still can't believe how much walking still hurts my legs (and feet!).

My next follow up appointment isn't until June (three months from now!) and I joked to Dr. Balderston that if at the three month follow up had the intern coming in first, I wondered who would be coming at the six month visit, the janitor? *rim shot*

But seriously folks, everything is going just like it should, and that's no joke!

Surgery Countdown: Seven Days

The surgery is seven days away.

We spent Monday filling out forms, producing insurance (or as I like to call it, “UNsurance”) information and getting stuck with needles.

The lowlight of the day was when I had to see the cardiologist for a routine EKG. This is like a 40 second test. We were in the offices of Drs. Mandal (a father-daughter cardiology team) for 90 minutes, with only one other patient in the whole place. WTF? It was like a Three Stooges movie, with two admins and the doctor and her “Medical Assistant” running around and literally bumping into each other. And can I just add that they had the absolute worst magazine selection ever? There were three copies of the same issue of a golf magazine and some Prevention wannabe. The highlight of this lowlight was when the MA was taking my history and asked if I ever drank. I said yes. She said how much, I said a lot. She said how often, I said a lot. She asked if I went to AA. Well! I don’t, but hello? It’s ANONYMOUS!? Finally we were released so I could go donate my own blood to be used in the surgery.

The blood donation was definitely the highlight of the day. Darlene was the phlebotomist and once we started to joke around a little with her, she really loosened up, though she still wouldn’t let me take my camera out to take a photo of my blood, all neat and warm in its little pouch …

I found out that another surgeon will be making the incision in my stomach and pushing my organs to the side, exposing the spine anteriorly. They referred to this doctor as a “general surgeon.” Yeah, I know, doesn’t sound good does it? Sounds sort of like the interns are in the back flipping a coin to see who cuts my belly open (I’ve GOT to stop watching Grey’s Anatomy). That’s actually not the case, thank goodness, the General Surgeon that will be making that incision is Dr. David Wernsing and he’s been working with Dr. B for years. I’ll meet with him briefly the day before the surgery. Theresa told me that some patients don’t even ask to meet with him, laying eyes on him for the first time just prior to letting him cut them open. Ack!

She also told me that because of the anterior approach to the spine, I won’t be able to have anything by mouth for 3 days. This is what I’m dreading the most. I do like to eat and am worried about what my stomach will feel like. I get all gurgly after not eating for about 6 hours, I can’t picture three days! But I will definitely be on morphine and out of it from the surgery for at least two of those days so I’m hoping it won’t be too bad.

The operation itself lasts about 3 hours. Once Dr. Wernsing opens me up, Dr. B. will go in and insert the ProDisc(s) in L5-S1 and (if he can fit it) L4-5. Then they’ll close that incision, turn me over and cut again (this one Dr. B. can handle as there are no organs in the way to confuse him, ha) and fuse L3-4, then saw through the bone grafts in my thoracic region and take out the metal rods that have been in there for 20 years.

It’ll be at least two to three days till I can get up out of bed on my own, though they will help me to stand up and take a few steps, if I’m able, the day after surgery. I’ll have a catheter and a pee bag so I won’t have to worry about using a bed pan. Yay! Life is good when you have a pee bag.

Oh, and she also told me that since they’ll need access to the incisions on my front and back, wearing my own pajamas is out. Tune in tomorrow for pix of my own chic handmade hospital gowns!

Big Changes/Small Worlds

There’s going to be some big changes in my world soon.

I’ve been struggling with intermittent pain for the past five years or so, but by the time I have my surgery on December 6th, it will have been eleven months since the rapid deterioration of three of my lumbar discs set in.

Eleven months of being pretty much stuck in the apartment most of the time.
Eleven months where I went out on social gatherings maybe eight times.
Eleven months where I rode the subway twice.
Eleven months where I watched from my perch on the bed as the bare tree across the street grew buds, then leaves, then lost them, and now is bare again.

Eleven months in which my world has gotten steadily smaller. Except for the occasional bus or cab ride, my world consists of the building that I live in (which is expansive, a whole city block), and the sidewalk that runs around its perimeter where I walk Tony in the morning.

I know the world outside my little environment hasn’t changed just because I rarely venture out into it anymore, but in the few times that I have gone via cab to get together with friends, to go to a doctor’s appointment or to get my hair cut it sure seems different to me. Bigger. Wilder. Weirder.

As much as I am looking forward to the surgery and seeing how things turn out (nothing is guaranteed you know, plenty of people go through things like this and get no relief, but I try not to think of that), I’m more afraid of what’s going to happen after the surgery. I was telling a friend in an email last week that I’m not sure if I remember how to be a functioning adult out there in the big, wild, weird world.

When you have to take a bus to go two blocks to pick up some fruit because you can’t possibly walk that far even with a cane to support you, taking a cab down to Horatio Street to get a hair cut or to the Upper West Side for a teeth cleaning is like going on safari.

While my world is so much smaller, my personal discomfort zone has grown. I’m much more aware of the space around me now, fearing, even more than a typical personal-space-obsessed New Yorker, the jostling of a hurried crowd of people; an accidental brush of an elbow could send a spasm running like an electric shock from my spine up to my shoulder or down my leg. Someone’s casual misstep could knock my cane out from under me, throw me off balance, the pain seizing at my twisted muscles.

Though I’ve attempted to describe, meticulously, all the developments in the two ongoing processes: my own deterioration and the bureaucratic plodding toward the surgery, it seems that my world of words has shrunk as well. There are a myriad of words and ways to describe pain and disability, but I feel like I’ve exhausted them all, and frankly am none too anxious to coin any fresh ones. So preoccupied have I been with my physical situation and the surrounding health care drama that my own novel, as concrete a fantasy world for me as is possible, offers no escape. My mind swings, with the regularity of a pendulum, from any feeble diversion back to my reality.

My photography has atrophied too. Being restricted physically means that I have been restricted in what catches my eye. Potential subject matter is suddenly in short supply; in recent weeks it’s now mostly dwindled down to what can be taken inside the apartment or at the swimming pool: me, my dog, or the TV.

On Monday we’ll be in Philly for the pre-admission testing and to donate blood and I’ll be happy to get out in the world for a change of scenery. It’s déjà vu-ish that I’m going back to Philadelphia for this surgery twenty years after the other surgery on my spine. Back to the same floor of the same hospital with the same doctor, so maybe it isn’t all so big, wild and weird; maybe it’s a small world, after all.

Almost there

We traveled to Philadelphia yesterday for my 8am appointment with Dr. Balderston, nineteen years almost to the day after he did my scoliosis fusion on September 4th 1987. Have I mentioned that this doctor holds a special place for me? He changed my life nineteen years ago and he’s about to change it again, in a big way. Rose petals should be strewn in front of him when he walks and beatific music, like angels singing a joyful chorus, can be heard. Do I even have to tell you that when I look at this doctor, I see a halo, an aura of golden goodness of hope and freedom from pain and disability around him so bright I almost have to turn away? Almost.


Ironically or maybe coincidentally is a better word, the two days leading up to the appointment were particularly hard for me. Trying to pack one little bag for an overnight trip to Philly for two people took the better part of the afternoon on Thursday; go to the bathroom for the toiletries, then walk into the kitchen to get a plastic Ziploc bag to stuff them in. Find out, after walking back to the bathroom that they don’t all fit in the zip bag, so throw them into a small Duane Reade bag and tie it shut as though it was some stinky garbage. Then hobble to the bed and lie down and rest for thirty minutes. Get up, go to the dressing room; get t-shirts and underwear for me and Tyler. Walk to the bed, sit down and fold them and put them in the overnight bag, lay back and rest for another twenty minutes. Make several more trips to get jeans and t-shirts, a sweater, Tyler’s electric razor, sunglasses, maps, but of course not all at once; repeat packing and resting routine till I’ve got everything in the bag, which I can’t lift or carry, by the way, and I collapse in pain and exhaustion on the bed at 6PM. I started at 3.

Dr. Balderston always starts out an appointment by asking me to “talk to him,” tell him what’s going on. I was sitting on the exam table, leaning forward and supporting myself with my hands on my knees, explaining that I could no longer hold myself up, by myself, at all, anymore. He told us that ProDisc was approved.

Really? No kidding. It’s not like I hadn’t spent a lot of time obsessively refreshing the FDA website or waiting for the daily Google alerts we’d set up for ProDisc and Synthes. He added that it was time now to submit this to the insurance company and “do something about your back.” Do I have to tell you that the aura brightened to an unbearably bright corona, the kind you can’t look straight into or you’ll damage your eyes forever, and I swore I could hear a chorus of angels singing, their voices swelling with joy as he said it?

He said he’ll ask them for approval for a three level replacement. Starting at the bottom, L5-S1 will be replaced, restoring movement in my hips. Then L4-5 will “probably” also be replaced, and L3-4 will “probably not” be replaced but fused. The reason for the questions on the other two discs is not financial or bureaucratic but anatomical; it depends on how much those discs have collapsed and whether or not the ProDisc can be physically fit in to the space between the vertebrae.

I asked him to take a look at my back, and pulled my shirt up so he could see the lumbar region, the place where I’m afraid I’m developing another scoliosis curve from being so uneven all the time, my right leg buckling under me and leaning on the cane and whatever else I can find to get around with. He said nothing about what he saw or didn’t see and just responded that he was sending me for x-rays as a first step in going ahead with the surgery. Of course now I’m frantic, over analyzing his facial expressions (or lack thereof; he’d be a formidable poker player) and inflections when he said he wanted x-rays, because now I’m thinking that if it is possible that I have the start of another curve down there, the ADR surgery is out.

So all this is maybe coming together for a surgery date in early November. He mentioned Monday, November the 6th as a possible date. I was stunned that we were at the point already where he had a date in mind. I joked that I wouldn’t be able to vote on the 7th and he said, totally straight-faced, that I could do an absentee ballot ahead of time, like I was really concerned about that!

When he stood up and said that he was going to start the process “right now,” I burst into tears, blinded by that damn halo again.

Now again, hold your cartwheels, for there is no guarantee that Aetna will come back with the decision we want, or any decision for that matter, by early November. Still in all, the ball is rolling, and this is great news. Above all the voices of doubt and fear chattering away in my head, I can still feel the warm glow of hope and almost hear those angels singing. Almost.