Back surgery

Have I had a chance to tell you about the back surgery that I had on May 18, 2015, at the Cleveland Clinic, by Iain Kalfas, MD, who happens to be the head of the Spine Institute at the Cleveland Clinic?

I was suffering from severe spinal stenosis, which is hereditary. My father suffers from it as well. I suspect the spinal stenosis has actually been causing me pain, since I was a small child. I always begged everyone to rub my lower back, even as a small child. As a teenager, I took long soaks in the tub, hoping the heat of the water would soothe my lower back. Later came multiple rounds of physical therapy, chiropractic treatments and shots of steroids put right in my back at the Cleveland Clinic’s Pain Management Center.

I suffered from two herniated disks, L4 L5, while carrying my twins around, in and out of the car, and such. It became especially prominent when they were two and three years old, with accompanying sciatica. By the time they were four, I was a basket case.

Somewhere in the mix, I developed spondolythisis or slippage of the vertebrae. Taken to its extreme, spondolythisis can lead to complete loss of bowel and bladder control, although I understand this is rare, thank goodness.

So the surgery I had took 7 1/2 hours to complete and was designed to fix all three problems. They did decompression for the spinal stenosis, fusion for the herniated disks and fixation for the spondolythisis. The fixation involved putting in two titanium rods and a few screws to keep the rods in place. That should prevent further slippage of the vertebrae overtime, which makes me quite happy.

The pain that I had from these three conditions is not yet gone. I am hoping that I am simply a slower healer. The doctor told me that I would have 12-16 weeks of horrific pain after the surgery. He further told me that the full recovery would take a year. That said, many walk away from the surgery without any pain to speak of. This has not been my experience. I am more than 16 weeks out and still waiting for that to be my reality.

Regarding results for a surgery like this, 85% experience relief, 14% are neither better nor worse, and that unlucky 1% that is left over are actually worse. I clearly want to be in the majority group! Before it is over, I expect to be!

Interestingly, after my surgery, my internist, whom I love and adore, Dr Elena Borukh said to me, “You know, you are so brave!”

My reply, “Really? What makes you say that? Brave in what way?”

Dr Boruhk went onto explain, “So many of my other patients have a great need to undergo one surgery or another and they can’t, because they are too afraid. You are different. You are brave. You already had the surgery you needed. I really applaud you.”

So I ask you in turn, what surgery have you been avoiding and why? Do you think you don’t have the time for the surgery and recovery? Are you afraid to have the surgery? How could you summon the necessary courage to actually do it? How does not having the surgery limit you? What are all of the costs? What could you stand to gain by having the surgery? Are you sure you can afford to continue to put the surgery off? What is the worst thing that could happen by postponing? Are you really willing to pay that price? Are you sure there aren’t more possible consequences? Are you willing to do some research to be sure?

Now, get out a piece of paper or your cell phone or tablet and write out a list of pros and cons regarding the surgery you have been putting off. Has your position changed any as the result of taking the time to put your ideas down on paper so you can look at them frankly and honestly!

Best of luck to you and your loved ones, should you choose to have you surgery! Every surgery has risks, but you can research the risks, weigh them and make the best and most informed choice possible about whether or not to have the surgery that has been recommended to you. Should you choose to move forward, I salute your bravery!

Lisa J Lafave, PhD, MBA, ACC
The Wellness Coach from Building Better Bodies Rocks
CEO & Founder of Coaching Rocks, LLC
ASingle Mom By Choice Raising Surrogacy Twin Boys
One Woman’s Experience Recovering from Near Medical Disaster
Written in My Little Brick in University Heights, Ohio

Leap Into Action!

Did you know that if you are unable to perform the stress part of a cardiac stress test, there is a non-stress stress test? Well there is! Instead of walking and then running on a treadmill, they give you medicine to invoke a state similar to that of exercise or stress and attach a nuclear tracer to it, so they can take images of your heart pre and post the stress produced by the medicine. I just learned this a month or so ago.

Today, I am finally completing my non-stress stress test at the Cleveland Clinic’s Cardiology and Nuclear Medicine departments. This stress test is also sometimes called a pharmacological stress test.

I tried to do the test last week, but it was a no go. While in the Nuclear Medicine Department, I was given radioactive Regadenoson, which is a vasodilator. This medicine dilates your blood vessels in a manner which occurs during exercise. Subsequently, images of my chest were taken by the gamma camera. I then went to Cardiologyy just to find out that my heart rate was 142, which was too high to perform the full test and cause further increases in my heart rate. Apparently, 140 is the heart rate they aim for on the traditional stress test with exercise, and without the vasodilator.

I had been asked to refrain from using caffeine, Acetominophen and Metoprolol, for 24 hours. I take the Metoprolol to minimize tachycardia, or high heart rate. I had stopped these drugs for 36 hours and that was just too long. Since the initial gamma images of the flow of blood through the heart are good for one week, I was able to reschedule within one week, and continue as usual. So here I am today, for the next two parts of the test.

I had the stress portion of the exam already today. Basically, they attach leads to monitor your heart, put the IV into your arm, put on a blood pressure cuff, inject the medicine, Regadenoson, for the test. They then monitor both your heart rate and blood pressure for 4 minutes, while you pump a soft ball and march your feet up and down, alternating left and right, to get the blood flowing through your veins.

Thank goodness the chemical stress test only lasts 4 minutes, because it made me feel really weird. First, I felt breathlessness, then dizziness, then I experienced distress in my stomach and lower abdomen.

Next up, will be the post gamma camera images of the blood coursing through my heart detected by the nuclear tracer, given to me earlier.

Tomorrow, I have a CT scan of my heart to rule out pulmonary embolism, as the cause of breathlessness, often referred to as dyspnea in the medical community.

So remember, if you are having trouble with your heart and having difficulty getting around, you can still have a stress test. It’s called a pharmological stress test or a chemical stress test or a non-stress stress test. Don’t be shy to call your doctor today, if you are experiencing breathlessness or chest pain.

If you feel really badly, do not hesitate to call an ambulance or go immediately to your local emergency room. It has been my experience, and I have more experience than I would care to share in these matters, that when you call an ambulance to go to the emergency room, you essentially jump the line in the waiting room, and receive more immediate attention. So if you think your need is urgent, for goodness sakes call 911, and have an ambulance, more safely, take you to the hospital.

I know I am out of shape owing to increasing back, knee, and hip pain, over the course of the last five years, with accompanying decrease in exercise. Prior to my boys being born, who are now 5, I used to walk 45 – 90 minutes, everyday for years, with my dogs, in the woods. During the last year, I have become woefully out of shape and have been hardly able to walk to the corner! No wonder I have been experiencing breathlessness.

This is really the story of on middle age woman’s journey from the brink of medical disaster, back to health. I am over weight, and at risk for diabetes. I have been fighting diabetes for some time, but now I am fighting off heart disease. I have a mandate from my rheumatologist to have total knee replacement in the spring.

After back surgery 4 months ago, I am now able the walk around the block! I can also swim for about 20 minutes.

I have a history of severe acid reflux and have experienced esphogeal spasm, which mimics heart attack. That could have been the cause of the chest pain I experienced last month.

After getting the results of the non-stress stress test and the CT of the chest, I will know if I am suffering from heart disease and what I have to do about it.

I hope it’s not heart disease for two reasons. First, I hope I haven’t gotten myself into that much of a health problem. I really don’t want to add heart disease to my list of health concerns. Secondly, I am on a roll with Dr Mark Hyman’s Detox Diet and don’t want to upset the apple cart. If I just have another 11 months to pursue this diet, unobstructed and as is, I think I can make some dramatic changes in my overall health.

I am wondering if this anti-inflammatory diet might be able to buy me some time with the total knee replacement. Technology improves with each passing year and I’d like to take advantage of that, as much as I can. Plus, it’s just a lot of stress on my boys to have their Mama in the hospital and then in rehab. After having gone through the back surgery this year, I surely would like to spare them the drama of having to go through it all again so soon. These things are especially challenging when you are a single parent!

What medical issues are you facing square in the eye? What can you do about them. Have you discussed these issues with your internist? Have you seen a specialist? Don’t bury your head in the sand and hope it will go away. There are things you can do about it to reduce the severity of your problems. Why not start by noodling it around with a trusted friend or family member. Ideas abound when your share your problems with others!

Why not take out a piece of paper or grab your cell phone or tablet and write a list of the three most urgent medical issues you have been sitting on. Below that list, write three names of people you would be willing to discuss it with. Then give yourself a reasonable time period to have that discussion. Actually write that date down. Next, stick with the plan! Then, write a similar list, after your discussion with each your trusted others, and put down another date. Follow through with this plan, as well!

Lisa J Lafave, PhD, MBA, ACC
The Wellness Coach at Building Better Bodies Rocks
CEO & Founder of Coaching Rocks
A Single Mom By Choice Raising Surrogacy Twin Boys
One Woman’s Experience Recovering After Near Medical Disaster
Written in the Nuclear Medicine Department @ Cleveland Clinic

Leap Into Action!

Back Surgery or Should I Say Decompression, Fusion and Fixation?

Non-Stress Stress Test