Month: September 2017

Surgery 7 Spinal Trial Simulator – The Story Volume 2 – Part 9

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If the odds on surgeries were the same as in roulette, I was laying all of my hopes and prayers on a single number on the wheel. Betting on a single number to win was the worst odds, but if the outcome came in my favor I would strike it rich.  Rich not in a monetary value, but rich in regaining my freedom and releasing me from pain that spreads throughout my lower body from waist down to my toes.

The greatest expectation I was told by the spine pain specialist was an improvement between 40 to 60%.  I was thrilled.  When you’re desperate, your thought process and expectations becomes cloudy.  I did not hear the 40% at the time.  All I thought about as I lay on the floor the night I was told the range was the 60% value not the 40%.  I told Amanda that I may be able to go back to at least a part-time job for a few hours or be able to work at home if my medicine dosage goes down – which my neurologist agreed was a reasonable expectation.  Amanda was quick to respond that I would still have pain, it may take a long time to feel better, and I still had ankle issues.  She was trying to lower my expectations to save me from disappointment, but that night I heard nothing.  I ignored everything she said, and stated, “Just think, I don’t have to put all of these tens pads over me anymore and carry this huge remote (that controls the intensity of the shocks sent to the pads).  I can’t wait!”

I am not sure what happened that night, but I had a bad nightmare that may have been from my nerves or stress or to quote Scrooge, “an undigested bit of beef, a blot of mustard, a crumb of cheese…” but the next day I was not feeling as happy as I had been  the night before.  I had six surgeries before, but they were all on the ankle.  “This was going to be on my spine!”, I thought.  If something went wrong with my ankle operations I risked losing a foot that has plagued me for over eight years, if something went wrong with this surgery, I could end up paralyzed.  They were going to be soldering a device on my spine connected to my nervous system.  It all sounded crazy.  I was up four hours before Amanda was, and during those four hours I was feeling too nervous to look on the internet for information.  I was always told by my doctors that the internet was the worst place to go seeking a diagnosis for an illness.  The internet  made it easy to make one think that their normal cold may become a deadly disease.  Misinterpreting information like this makes patients feel more stress and makes them more nervous As they wait for a real diagnosis. So, thinking of this advice I decided to stay off the internet.  I had learned there were more people on medical blogs complaining about undesirable outcomes, than successful ones.   By the time Amanda woke up, I was a nervous wreck thinking about the surgery.  A feeling I had not felt since my first or second surgery.

Having a wife who is a nurse is a blessing and a curse.  Amanda provided inside knowledge of the medical field, However, I felt she was more desensitized to my emotions that morning.  That’s a trait I feel is good for a nurse’s emotional stability when dealing with the medical issues of a multitude of patients.  Fortunately or unfortunately this lack of emotion is brought home as well and not left at the hospital.  Amanda walked down the hallway, rubbing her eyes as she was trying to wake up.  I turned around and looked at her and stated, “If they screw up, I could become paralyzed!” Now it may be because she was a nurse and desensitized like I stated above or perhaps she was tired, but she looked at me on the floor and retorted, “They put pacemakers in for people’s hearts all the time, I am sure they can handle a stimulator.  It is done all the time.”  She then turned into the kitchen for breakfast.  In her mind, she had allayed my four hours of worry, and reassured me with a few words.  The topic was closed. However, in my mind it would not be over until it was done, but instead of pushing the issue, I lay on the floor in silence and waited…

The day for the trial surgery came without much ado.  My nerves were calmer, it was either from medication or it felt like I was just jumping on the same horse I always ride.  When we arrived at the facility, I was pleased to see that the paperwork I had to fill out for the trial was only a few pages long.  I quickly initialed and signed the forms and waited with Amanda to be called back.

Only five minutes passed before the surgeon came out and told me they were ready to go. The room was only a few feet away, and since it was an outpatient procedure I was able to walk into the room, instead of being wheeled in on a gurney.  I was instructed to lie on my stomach and put my head in the hole of the pillow and my arms in the arm rest below.  It was the same position I assumed for receiving a shot for my back.

During the next few minutes the doctor instructed me on what was going to take place.  “Mr. Donnangelo you are here for a trial spine implant?” he asked while his voice recorder was on. “Yes.” I replied.  “What we are going to do is numb your back.  Once numb, we will place a lead onto a nerve ending in your spine that will be connected to wires that will come out into a box.  Once done, we will adjust your device using a  remote to your liking and then you will go back into the room for instruction on how to use your device.  Do you have any questions?” Lying on the table, I felt the cool disinfectant gel followed by the pinch of a needle going into my back releasing the numbing medication, “Ummm…..no.”  I stated, but that was a lie.  I was having wires sticking out of my back connected to my spine, what could go wrong, I thought.

I lay on the table for around forty-five minutes, listening to familiar noises such as the heart monitor beeping, instructions being given to the nurses, and the sound of pressure going in and out of a blood pressure monitor.  I only felt minor pressure on my back during the procedure.  After I was told the leads were placed, I felt only the slightest amount of pain from one of them.  They taped gauze pads to my back to cover the punctures that had been made, and applied extra tape to protect the device.

It was honestly painless; when it was over I moved my legs and was happy to realize Amanda was right.  It was no big deal, just like she said  After the tape was applied, a representative from the company stepped beside me and told me he was going to turn the device on low and I should let him know when I can feel it and he will adjust it accordingly.  I was anxious how it was going to feel.  I was not sure what to expect.  As I lifted my head the slightest amount, I saw he had a box in his hand with a dial or push button to raise the intensity.  As the first wave of “shocks” were felt, the sensation was very familiar.  It felt exactly like my tens unit.  This sensation was pleasing to me, but also worried me.  It was not a significant improvement over my tens unit, except it is without the pads.  If the tens unit didn’t help me a lot how would this?  I kept my worries to myself and answered the questions that were given to me.  Questions such as, where do you feel it, how much do you want it turned up, and how do you I want the sensation to feel.  It took only 15 minutes to program the device.  I could feel the “shocks” in my legs and lower back and a little in my stomach.  I knew the trial was only for four days and felt that it was good enough.  The representative was very pleased it did not take long.  After he disconnected his remote, the taping of of my back was finished and I was able to get up and walk to the room for instruction on how to use the device.

It was very simple to use.  It was actually simpler than my old tens unit. The remote was small and fit into the palm of my hand.  It had an on/off button, a plus and minus button to control intensity, and a sync  button.  It was very easy to understand.  After we were done, an appointment was made to take it out in four days. At that time I would report if I had decided to get a permanent implant or not.  It was the first time I had a trial surgery and was able to decide if I wanted the permanent installation. It was nice to have the option to either discontinue the trial without going to the next step or move forward with the permanent implant.

Amanda and I went home, and I told her over the next four days I did not want to do much.  I was afraid of getting a wire connected to my back stuck on something and having it pulled.  She understood and knew I needed to rest a few days.  The punctures that were created to put the leads in did not hurt too much after the  local anesthesia wore off.

I was pleased overall with how things went.  It was the first procedure I had ever had that did not end up with me in more pain then when I started. I spent the next four days adjusting the implant when I needed to.  I told Amanda that it felt just like my tens unit.  Meaning that it helps, but was not the miracle I was hoping for.  However, I also told her they stated that the permanent implant would work much better than the trial.  So, if I felt like a tens unit was on me blocking some of the pain, a permanent unit would block more.  It only took two days to know I wanted the permanent one.  I actually knew before I had the trial, I wanted it.  I needed anything new to help release me from this pain.

The four days passed, I sent an email to the insurance company warning them I better not have any issues with approval for the permanent implant. The email was sent to my appeals manager and the vice president I had the meeting with a month ago.  I had no doubts that the approval was made before my first phone call to check the status of my approval, and to no surprise it was approved.  With approval in place, Amanda and I went back into the office to have the device removed.  I told the doctor it helped some and was once again told the permanent implant would work better since that device would be soldered onto my nerve endings.  The removal only took a half hour as they checked to make sure the wound was healed and all of the tape was removed from my back with and place band aids over my punctures.

I was looking forward to the permanent implant which was scheduled a month out. All of my nervousness was gone and I was more than prepared for the upcoming surgery.  Until then, I had to wait once again on the floor connected to pads with wires connected to my tens unit to help with the pain…

Afterword

The tens unit was okay and it did provide almost the same relief the temporary implant did.  There were two things I liked the most about the implant. There were no wires outside of my body like the 8 used to operate my tens unit, and  that I was told the permanent device would be much stronger and better than the temporary.  There was a chance I would be 60% better which would lead to a decrease in pills.  To me it was a no brainer.  The trial  stimulator was just another step I had to get through to get the treatment I really wanted. 

As I left the office another patient was waiting.  It was an older lady who was just as nervous as I had been.  I quickly told her what I went through and told her that she did not have to worry and that they would take good care of her.  She smiled and thanked me on the way out.  I hope she is doing well . . .   

 

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The trial implant right before it’s removal.  I still shudder when I think of a wire that is inside my body was also outside my body.  I was scared the whole time that it was going to catch on something and pull itself out.