March 15, 2010

     Well, let me just quickly say that as I give a quick synopsis of the past 3 months, you have to understand that I was heavily drugged and I actually have very little memory of most of it. That is the absolute truth. Oxycontin does that to you. Everyone can attest that even at the times I seemed very lucid TO THEM, I have no memory of. Someone will say, "Remember when.....?" and I say, "No" and they insist that I must remember, but I simply do not. I had great difficulty when I came home from rehab. Oh my goodness, I cried and cried, because I just couldn't remember anything but pain, but now I am accepting it. What other choice do I have anyway? The point of my telling you this is that there will be so much more that others could add to this part of my story, that there are some things that perhaps they wouldn't agree with, or as the case may be, just maybe I will surprise everyone with what I feel I experienced - but in the end, this is MY story and MY perception of MY experience.

    At 3:00 AM on March 15, I was still awake. I had stayed up all night getting "things done" off my to-do-list! I never was able to cross everything off. Oh well. I was doing things without any dread or fear, but maybe I was a little apprehensive? On second thought, maybe I was a little scared. But more scared of what lay ahead. Maybe I had a sense of trouble deep-down that I didn't want to come to terms with. If I had only known then what I was actually about to embark on, I definitely would have backed out!! This decision to move ahead was not made easily or quickly as you all know. It took me 6 years to make this move and here I was. I jumped in the shower and washed myself with a special anti-bacterial soap that I was told I had to use and by 4:15, I had said my goodbyes to Erica and Ben and we were on on our way. The ride was miserable as it was raining very hard and it was very windy. I settled in and immediately put in my earbuds from my iPod and I truly relaxed listening to various meditation's. We arrived and I registered and was soon brought upstairs. No sooner had I sat, they called me in. Before long, I was in a johnny and meeting my OR nurses and anesthesiologists. They also called Bob in and he sat with me as everyone was bustling around us. when they showed up, I insisted that the attending anesthesiologist, NOT the resident, do my intubation or any other work on me in the OR, but agreed that she could put it my lines before I was brought in. I remembered their names for the longest time and now at this moment, I can't recall them. This happens alot. I swear anesthesia kills brain cells and since I was under anesthesia in March, April AND May, I worry if my memory will ever be the same. Dr. Campbell came in too and explained that he would be working along with Dr. Glazer. Dr. Campbell is a vascular surgeon and he would be responsible for opening me up and moving all of my abdominal organs aside for Dr. Glazer to reach my spine. Within minutes of him leaving, Dr. Glazer appeared and he was calm and carefree and I was for the most part too. He had just come home the night before from a conference in New Orleans and he gave me some green beads that I put on! He had beads for everyone! It was a strange moment because it was as if I were there and yet it was as if I were watching it from afar. Everyone was laughing and working and talking and for a minute it was as if I wasn't really there. Their voices were distant, along with the laughter and I was suddenly filled with dread. I wanted to get up and run. Then I realized how foolish I was being and found the strength to ignore what had just happened and "came back". Being perfectly on time and afterI had signed all my papers practically giving my life over to them, agreeing to all that could go wrong and that I wouldn't sue them, stating my name and date of birth more times than I can recall, I was finally told it was time for my "cocktail". Thank God - let's just get this show on the road!I had told the anesthesiologist that I didn't want to be awake when I was brought into the OR. I hate that. I told him of when I had my knee's done last year that the anesthesiologist gave me the equivalent of a very large glass of Pinot Noir and he laughed and said he would make sure I had a glassful!. So at last, he reappeared and said, "Here's your wine. You better say goodbye to your husband right now because you won't remember anything in about 1 minute". So Bob kissed me and I was wheeled off. I don't remember anything after that. I found out after that what they give you usually is Versed. That is the "date-rape drug". Interesting............

I woke up in recovery and as what usually happens to me, I was suddenly freezing and shaking. Anesthesia does that to me. They explained that it happens in about 40% of people. That made me feel better because I always wondered about that. I'm actually amazed right now that I remember that moment of asking the nurse that question. Hmmm. I wasn't in any real pain but yet I felt uncomfortable. Several nurses kept walking by saying, "Breath Valerie, Breath". I was breathing, wasn't I? Every time I started to dose off, one of them would literally shout, "Breath Valerie, breath!". OK, now I was getting pissed!! All I wanted to do was go back to sleep. Well, evidently, my breath would decline rapidly as soon as I would go to sleep. So I looked at the monitor and I started breathing heavily and I saw the number rise to 40-something and they said, "Good job, keep it up" and I thought, "Are you kidding me?? If I breath this deeply constantly, I am going to hyper-ventilate AND I can't sleep like this!". But I said nothing and kept watching the monitor. Every time I would feel myself dosing off, I would find the number down in the teens and before I could even start  my deep breathing, there would come the shout , "Breath Valerie, breath!!". Ugh!! What the heck? But I must admit, now I was afraid to dose off for fear that I would die. I asked the nurse why this was happening and she said it was apnea!! I said, "Like sleep apnea from snoring? Am I snoring, is that the problem?" and she said, "No, it is apnea from anesthesia. The meds they give you decreases your breathing rate and it isn't all that uncommon that it takes awhile for the body to rid of it and to help that happen faster we increase your oxygen, that's why you have the oxygen cadula (the thing that is in your nose tto receive oxygen)". Now, I was wide awake, but so tired. I couldn't help but chastise myself for having stayed up all night and I remember wondering WHY the heck would Michael Jackson do this?? Weirdo! If you will recall, this was surgery #1, where they entered through my abdomen. After experiencing a C-Section when I had Ben, I was familiar with the abdomen pain I would have. It really was similar except that all of a sudden my sciatica was hurting and it quickly became very painful. I told the nurse and suddenly Dr. Glazer was there and she was asking him what he wanted me to have and I heard him say to give me Valium. Valium? I thought,, "Does he not believe that I have sciatica pain and that I'm just crazy nervous and scared?", but I soon learned that Valium was originally created as a block for nerve pain!! Duh! And only later was it realized that is was also helpful for mental nerves as well!! The things you learn in hospitals! Then he walked up to the bed and I saw his face and he actually looked sad. Please recall that I have come to know this man a little bit and I instantly knew that something was wrong. I just looked at him, too scared to ask what had gone wrong. He held my hand, leaned down and said, "Valerie, it didn't go as well as I was hoping. We ran into some trouble and you lost a lot of blood. We had to give you a 3 transfusions in the OR". He waited a minute and continued. "We came across something like I've never seen before. Your dura, which is usually sort of draped over the spine, was actually ADHERED to the spine, which made it difficult to get to where I needed to be. We accomplished what we could, but at some point we realized that if we didn't close you up, we could have problems and you know I would never do anything to compromise you". I was just laying there trying to digest what he was saying, which is not an easy accomplishment when on heavy narcotics. I said, "What does all of this mean? What did you actually do?". He said that he was able to complete the partial vertebrectomy at L3, L4 and L5, he fused from L2-S1 using 2 spacers. He also said that although he used mostly BMP (Bone Morphogenic Protein, which is the "fake" bone used from cadavers), he was able to harvest a bit of my own bone (allograft) taken from a little of my illiac crest area where they obtained bone back in 1974. He went on to explain that the disc spaces at L4 and L5-S1 were completely collapsed, so he removed the discs and he performed the vertebrectomy with spacer at L4 and L5 and then he inserted another spacer at L5-S1. Then he went ahead and performed another partial vertebrectomy at L3. It was at this point that because of my dural membrane being a major issue, a dural tear was encountered. A large one. Dural tears in these type of spinal revisions are NOT all that uncommon. They are actually very common, but evidently mine was huge. At this point I was losing blood like crazy and so they quickly packed the tear. He commented that my dura was "friable and adherent" to the posterior margin of the vertebrae. So he rapidly moved on to the fusion aspect, and that time harvesting my own bone as stated above and mixed with the BMP and packed. With that all done, he sutured me up as quick as possible after X-rays revealed accurate placement of the spacers and fusion. I was then brought to recovery and here we were.

I was still confused though. What did all of this mean? He explained that scraping at the dura to reach the spine is dangerous and unlike what he usually encounters. He said because of the large dural tear that I would have to lay completely flat for 5 days and he was not going to proceed with surgery #2 the next day as planned. Instead I would stay about a week and go home to regain strength. He said he would be jeopardizing my life if he continued the next day. He also said he needed time to "think" about his next moves and how he was going to proceed from this point. He said because he feared that if my entire spine was like this he was going to have to "form a new team" and "strategize" their next moves. I felt dread. Why did I agree to this? I wanted to back out, but like Dr. Glazer, I knew I couldn't. We had to move forward because we had no other choice. He certainly couldn't leave me like that without completing the entire work. His last words to me were to just rest and sleep. He then turned and left and my mind started winding. OMG - EVERYTHING, and I mean EVERYTHING was now messed up! What did he mean? How long was I going home for? I timed this so that I would be able to attend Ben's graduation in June without using a brace. I timed this so that I could enjoy the summer, even though I wouldn't be able to do much. I planned this so I could go back to work by Labor Day. I spent YEARS planning this!!! How dare it get messed up. And more importantly, HOW dangerous was this going to be for him to go back in? Wait a minute.....my mind was so confused and I was scared and I was mad and I was in pain. It was all too much to take in at the time. Suddenly I was tired and the nurse was starting yet another blood transfusion. She was such a kind nurse and I told her I was scared and so tired and that I couldn't go back to sleep because I was afraid I was going to die because the last time they screamed for me to breath I saw the monitor had gone down to 9. She didn't say much except she kept gently reminding me to breath every time I started to dose and to push "the button" for pain. I did remember that. I pushed and pushed and pushed. Every time they woke me with "Breath Valerie, breath!", I pushed that button.

I lay there afraid and in some sort of pain I couldn't describe. I finally did fall asleep and the next thing I knew was that I was being told that I was being moved to a room. I think I spent several hours in the ICU/recovery. I don't really remember going to my room or arriving. I remember Bob being there at some point, but the next couple of days I have no recollection of, except for tiny moments. Little blips. It is a blur and besides, when I did awake, I just wanted to go back to sleep and make believe that this really wasn't happening. Everything was all messed up. All of my planning and it was kaput!! Just like that. I couldn't believe it was happening. But it was.