Things to prepare for Pre Spinal Fusion for scoliosis surgery

Being informed by the spine doctor that you or your child need to go through spine surgery to correct scoliosis (the disorder of the spine where the spine vertebrae twist and bend abnormally) is indeed very tormenting.  Most people will go back to the drawing board to do risk and benefits assessments.  Then as you go through you began to see that the list of benefits is more than the risk.

Do not hesitate to take up surgery for spinal fusion for Scoliosis as per the spine doctor recommend.   Let me paint a picture to your mind.

Body structure the external look = a house

Spine = post and beams

Internal organs (heart, lungs, stomach, intestine, bowels system) = furniture and fittings inside that house.

Of unknown reason, somehow the beam/post of the house slant and go out of place day by day.  The house in the initial stage the structure still look good at first glance, the furniture in the house are not affected.  Each day the beam/post slant more and more.  Eventually the house structure got distorted.  If the beam/post could not restore on time the furniture inside the house will get crush.  Therefore never delay and regret later when discover that the beam is too faulty and the only option left is wait and watch the very moment the beam crush down the furniture.

With the above I hope that you would not procrastinate anymore.  If the curve is under severe category do not have wavering thoughts. You need to accept the fact that surgery is the only option.  Source a good spine surgeon and plan the date of the surgery.  Start to do planning for pre-operations and post-operations. Mentally/emotionally prepare and having physical readiness makes a lot of difference on recovery rate.

List of things to prepare for Pre Spinal Fusion for scoliosis surgery

• Abstain food/supplement that do blood thinning for at least 2 weeks before the surgery eg (gingko, ginseng, chicken of essence, vitamin E supplementary).  Personally I stopped consume any vitamins/supplement prior 3 weeks before the surgery to avoid excessive bleeding during the surgery that may lead to complication.

• Is very important to maintain the body in the top-notch health as possible to enter the operating theatre.  Make sure no sickness not even the common flu, cough and fever for at least one month prior to the surgery.  This is to ensure the body is well prepared and ready for the upcoming tremendous stress during the surgery and have a good recovery rate.

• Practice the logroll techniques how to get in and out from the bed.  I practice and habitual this technique prior to the surgery as I am aware at all time we need to ensure to keep the body straight, no twisting and body bend after the spinal fusion surgery. No body bending/twisting is the temporary restriction until the spine is fussed up.  This is normally about 9-12 months. Click this to discover  What is logroll technique?

• I also change and start to habitual some movements eg wash my hair on standing position.

• It is also good to prepare the home for post-ops recovery needs.  As temporarily restriction of no body bending during the recovery period, rearrange the bed to downstairs in a double storey house really help. This is due to after surgery the patient will takes some times to get adjusted to the straight spine in their movements.  Climbing up stairs is quite challenging initially.  

• Change/buy new mattress if it is sagging.

• Re-arrange some of the necessities items eg clothes, toiletries and some others household items to be easily assessable with no body bending is required.  

• Besides no body bending, there are weight limitations during recovery period as well. I did up to the level of re-organised my liquid detergent to a smaller bottle.

• Get some special equipment like grabber.  It is really handy for picking up things from the ground. 

• Depending on some people, some during the initial recovery period they need plastic chair for them to sit down during shower.  

• Being advised by some past patient that it is also handy to have clothes that are button in front during the recovery period as some may have difficulties to raise their arms. Every individual body are different I have no problem in lifting my arms and hands. In fact I did my shower and hair washing with no one to assist me since the very day all the IV tubes are detached from my body.

• Pack only the necessary items to be use at the hospital eg toiletries, a sets of clothes to wear when discharge from hospital is sufficient.  Do not overly pack cause the hospital single room is not as big as the hotel’s suite.  Anyway while you are in the hospital you need to wear the hospital gown instead of your normal clothes. Normally patient who undergo spinal fusion for scoliosis are discharge after 3 – 4 days.  My surgeon wanted to discharge me on the third day but I request to stay one more day. 

• You may want to include a pair of sock, blanket and favorite small soft toy into your packing list for your hospital stay.

• If you are a female, include sanitary napkins as one of the items to pack along to the hospital. I discovered many are like me, somehow our body due to keep thinking of the up-coming surgery it just mess up the usual cycle.  Only after the surgery when the body is not so tense then menstruation appear immediate back. I believe you are like me have own preference sanitary napkin.

• Pre-arrange to have someone stay at home to assist you in the initial recovery period. You may be like me capable to take care of your own hygiene however you still need people help to prepare and take care of your meals.  In the initial stage of recovery I spend a lot of time sleeping and bed rest.

• If you have long hair, do considered to trim it short before the admission in order to ease hair washing during recovery period. 

• Most probably you are not allowed to squat for a period of time during recovery. It is very practical to trim the toes nails one day before the admission unless you have someone to assist you.

• Get ready some interesting books.  Books are good company beside laptop/ipad and hand-phone during the recovery period.

• Put up a big reminder “remove nail polish before admission”. Nail polish deter oxygen level monitoring as it block the true colour of the nail bed.  Do not paint your finger or toe nails with Henna (inai) as well.

• It is much practical to use spectacles than contact lenses during your hospitalization.

• Remember to remove all jewelry from your body before admission. Do not take any risk of possibilities being stolen. Even so they are worthless, the necklace image in the full spine x-ray will confused the spine doctor.

• Check all the shoes, sandal and slippers make sure the sole are not worn out.  This is to ensure that they are still in good condition and have good traction in helping to avoid slipping.  It is advisable during spinal fusion recovery not to slip/fall.

• Particularly for female to get ready at least a pair of comfortable flat shoes.  My surgeon advice me to shelf off my court shoes for at least 4 months. 

• Get some comfortable loose fits cotton clothes these really help during recovery.  Personally in the initial recovery period I wish to give breathing space for my incision scar. 

Additional items for adults to take notes 

• How soon you will be driving again depends very much how long can you sit on a chair without getting up to walk around.  I only start driving on the 8^th weeks post operations after I could feel that my muscles are fit and ready to handle my manual cars.

• If you are being employed pre-inform your superior about the surgery.  Perform a proper work hand-over.  This is to avoid matters related to work disturbance during your recovery period.

• Upfront handle your utilities bills and any up-coming bills in the next 1 – 2 months.  This is to avoid servicing interest charges.

• Based on the facts of having weight restriction and no body bending during recovery, I do spring cleaning on my closet and  did a good cleaning thoroughly the whole house before my admission.

For those who are student

• Guardians/parents need to pre-inform the form teacher about your child will be absent from school for at least 3 – 4 weeks due to spinal fusion for scoliosis surgery.

• Inform the teacher about the weight limitation of your child when she/he return back to school.  Arrange with the teacher is it possible to leave your child school bag for the teacher to manage or sharing of books with other student during class.

• Inform the physical education teacher that your child will need to abstain from PE during the recovery period.

• Remind the form teacher to educate the other students not to push or engage in any sort of activities that can accidentally cause your child to slip/fall.

• Inform the form teacher to educate the other student to gives moral support and assistance to your child.  In some cases the patient after surgery is required to wear lumbar brace for a period of time. This piece of gadget may cause your child to have an extra nickname.

• Pre-inform the transporters the condition of your child if you do not ferry your child in and out to school.

• As most school toilet are squat.  Inform your child do not be ashamed if required a trustworthy friend assistance. 

x

Posterior spinal fusion for scoliosis or spine surgery ?

Notes :- I had Posterior Spinal Fusion for Scoliosis on 17/2/2014. I underwent this treatment at UMSC  (University Malaya Specialist Center). My surgery was lead by Prof Kwan Mun Keong. University Malaya Specialist Centre (UMSC) is the private wing of Pusat Perubatan University Malaya (PPUM).

This blog was initially meant to share my birding field trips reports. Ever since I started to use Facebook I  have not post anything since then.  At current I am in my recovery period from my spinal fusion for scoliosis.   Once I start to update this blog with nature photographs and field trips reports that means my spine has fussed up and my restriction has being uplift.

I hope my sharing on scoliosis and me will serve as an encouragement to those who have spinal deformities like me. For those who  have Scoliosis, spinal disc herniation, spinal disc degeneration, spondylosis, kyphoysis, do not be afraid/avoid when the  spine doctor recommend the solution is surgery. There is hope for you in today modern medical technology.  Please do not endure the pain in silence.

Should I (or my child) have spine surgery for scoliosis?

After hearing your spine doctor said  “…OK I recommend the option is surgery due to the curve is over 45 degree and it is severe…no brace can help in this situation….no drugs/medicine to cure… ” If the patient is you yourself or it is mean for your child, I can sense that eerie statement send a shiver down to your spine.  Your knees are wobbling now.  101 questions suddenly runs in your brain now.  Sure?  Huh,… Isssh ..Is there any special tailor-made exercise for scoliosis or alternative treatments to avoid surgery? … yoga for scoliosis? … special gym tailor made program?  What happen it end up a fail surgery…. Oh no…on wheelchair? Bed ridden?  Then whole life will crumple down overnight. 

If the patient is your child, you have a quick glance at your child who has just past her/his birthday who is still in a small frame size.   You feel like crying, have a lot of why, how come questions but need to swallow down the tears as you continue to listen what the spine doctor says.  “….curve increase in a fast rate as your child is still in the growing stage…...it affect the child  lungs/heart function  as well as bowels function when the curve touch….. surgery risk are  nerves injury, infection, fever…internal organs failure due to a sudden stretch … bleeding … blot clots…spine implant hardware failure ….etc..etc..

Now some of patients might have the thoughts is this doctor is all about meeting the KPI (key performance indicator) of how many spine surgeries need to be done in a year?  Hmmm wonder how many extra $$$ this spine doctor will get in each surgery?  Is surgery necessary?  Is this doctor words are worthy and trustworthy?  Most patient will do spine doctor shopping to have 2^nd, 3^rd …or even 4^th or 5^th opinions.

My real life experience being a scoliosis sufferer
I am being diagnosed as a scoliosis sufferer ever since I was 12 yrs old.  Mum was then informed that ultimately she need to send me to the hospital for further diagnosis and very likely it will then lead to spine surgery.  Mum came back to discuss with dad.  After so many decades, I still recall Dad the statement he made…no matter what the final decision is No ..NO. over my death bodies.. our daughter will get paralyse…. She will have no future…we cannot afford of having our daughter bed-ridden.  Being a child who is unable to decide for oneself, scoliosis and me tag along as I grow from a child till adulthood. I still recall in my early working life daily I commute by bus to my workplace.  Usually at the bus stop I would bump into a lady who is more curvy than me.  Her curves start from cervical (neck).  Her head is slanted to the left side glue together with her shoulder.  You can’t notice that she has a neck. Whenever she want to see what is on her right, she need to turn her whole body. Her torso is also compress with a very huge obvious rib hump.   There is one day I noticed she has a neck.  She can use her neck to turn left and right.  I asked her what she has done, she advice me to seek consultation from her orthopaedic at GHKL.   That time I was 24yrs old, quietly without my parent knowledge I went to GHKL. I still recall dutifully paid my RM1 join in the long queue of sick and sorrowful face group of people as though tomorrow never turns up. Walk into the orthopaedic room when my named is being called, he test my reflexes using a rubber hammer to tap my elbows and knees cap. He ordered me to do the Adam’s forward bend test.  Then ordered me to go to another counter to pay RM5 for spine X-Ray.  Once they hand me some big pieces of black and white film, I will then need to walk back to his room again.   I still recall those days in order to take this X-Ray, the patient need to wear the hospital gown with the back fully exposed.

He looked at my spine X-Ray and he said hmmm roughly your curve is 45 degree now. Do you have pain on your heels when you touch the ground? …as of date spine surgery is really dangerous… need to be in body cast for 6 months…cannot bath.. I predict over the years due to gravity pull over body balance your C curve will turn to S curve…. don’t know when with a normal slip/fall you will be paralyze.. in this world there is no drugs/medicine to cure this…since you don’t have heels pain .. then you need to come at 2 times a week at 4 pm to learn physiotherapy…at that hospital block… in the mean time walk in your journey of life heads up girl.  Don’t let the deformities to over take and drown you.

Since he pronounced no cure…over the years off and on I source alternatives treatments. Some treatments required to press my muscle here and there, press my rib cage,  press at certain vertebrate, twist my body here and there.  I end up more painful than before.  Few occasions I end up having a tremendous level of back-ache after the alternative treatment.  I will chart my level of pain as level 12 in the standard pain chart of 10 being the max.  I am in so much pain.  Ooossh as I reflect back my ignorant and stupidity could have landed me up in big trouble.  Beside gone through this physical torture, over the years my rib cage hump become more and more prominent.  I could not find a piece of dress that could fit me well even during the days when my waistline is only 24 inches.  Some people commented I don’t know how to wear my skirt properly?  Why can’t I walk and stand properly? 

I ended up with some days I have forgotten how to smile.  I am very cautious how people look at me physically.  I wear more clothes to hide my deformities even in our Malaysia hot and humid weather.  I still recall for about 2 years I was so depress I hardly utter any words and there is no smile on my face.  Some nights my brain keeps churning miserable, uncertain of the future thoughts that makes me more sober and miserable and I ended up in tears.   My torso shrunk over the years.  I suffer mild breathless and right pelvic bone pain and soreness. My right leg is starting to have sign of weakness before the recent spinal fusion surgery I take up when my C curve reading was 64 degree. 

Anyway my long years of scoliosis experience miserable life due to my ignorant not only enable me to have a safe spine surgery with modern medical technology, it has unintentionally turn me to be a living testimony that spine surgery is not eerier but safe.  My limbs and brains function are not affected.  FYI I walked to the bathroom, take shower and wash my hair on my own after all the surgical IV tubes detached from my body.  

------- This photo was taken in Mar 2010.  Based on the estimation of curve increase 1 degree each year.  This is how I look in standing position when my C curve was 60 degree then.

------- This is my standing posture now after spinal fusion for scoliosis surgery performed on 17/2/2014 

Choose quality life

Please do not let yourself or your child to end up the same life experience as mine.  Quality life and healthy life need to be restored ASAP.  Don’t be surprise your small build child of 13 yrs old falls into the prime age group category for this type of surgery. If the spine surgeon pronounced surgery then have a great thought about it. The good news is in today modern medical technology spinal fusion for Adolescent Idiopathic Scoliosis is only < 1% fatal risk for a healthy patient.   For adult in additional to that < 1% fatal risk will also expose to 10% other forms of risk.  When I discovered fatal risk  < 1% YES!!  I have being waiting for it such a long time.  The 10% risk factors, the level of pain, the cost, anesthesia and painkillers allergy and recovery period restriction eg weight, no body bending, no running, no body twisting...etc..etc.  I will worry for them later.

To undergo this surgery the patient must in good medical condition, not pregnant and having an acceptable bone density level.

Do not get paranoid hearing news of failure spinal fusion for scoliosis.  Daily there are around 27,000 cases of scoliosis each year are serious enough to require surgery. Spinal fusion is the most frequently performed surgical procedure to correct severe scoliosis  *** http://www.medtronic.com ****

Percentage of spinal fusion surgery successful is tremendously many more times higher than the failure. It is just somehow human nature like to magnified failures.

The continuous research over many decades has allowed advancement of medical technology and equipments.  It has made spine surgery less risky today compare to two decades ago. ****http://www.theborneopost.com/2011/11/20/spine-surgery-now-faster-and-safer/#ixzz2z75NKmfL  ****

Moreover these orthopaedic implants need to pass through a long stringent series of Industrial and Medical ISO world standard. The spinal hardware implants are improvised from time to time.  As well as the list of Industrial and Medical ISO standard, more and more world standard added as it progress. 

Benefits

The objectives for this surgery are :-

• To prevent the curve keep getting worse and then lead to lung, heart and bowel problems. 
• Restore body balance by straighten the spine as much as possible in a safe manner.
• The other tag along benefit is cosmesis – smaller rib hump.

How to select good spine surgeon

Cost should not be priority factor as there are many more criteria that supersede it. Since this is a major surgery it need more consideration factors for you to choose the surgeon. Below are some of the questions that you use:-

1.  Is this hospital has up to date modern medical equipment? Fully equip?
2. Is this hospital has all the personnel medical team in one single location eg a team of spine surgeons, anaesthetist, neurologist  This question is for you to access the surgery is done by internal/external doctors.
3. How many patients did the surgeon performed the same sort of surgery?  How many patients in a year? Month?  Week?  This question is to access how much experience the surgeon and the team has. This will also able to access how skillful the surgeon and the team.
4. In the normal standard scoliosis case like this how long does the surgery takes in terms of hours?  This question is to access how many hours you or your child is going to lie on the operating table.  The longer the surgery will have greater exposure to infection, facial swells, longer recovery and others unforeseen.  
5. What is the industry success rate for this type of surgery?  Ask the surgeon what is the surgeon personal level of success rate?   This is to access the surgeon skill set.
6. Any 2^nd surgery within the admission period that the surgeon did before?  The reasons for the redo work?  If 2^nd surgery is required within the admission period that means you can judge yourself how confidence and skillful is this surgeon.

Your Homework

• Search in the web what sort of achievement/recognition this surgeon have/obtained?
• How long in terms of years this surgeon being in this field?
• From your clinical appointment how do you judge the surgeon level of confidence/knowledge.
• Did the surgeon hand you the list of patients that has undergone the same kind of surgery that is proposed for you/child? Look at the list  when was the surgery done. Any phone numbers that you can contact them?  notes **** do not purposely ask for the list.  This will allow you to access how many patients successfully operated by this surgeon.  Normally the past patients had given the consent that they are use as the reference. You can put a doubt on the surgeon work if this list was not hand over to you.

Others items to consider

1. Is this hospital  located in another state?  If so then where is the possible nearest recovery site for at least 2 weeks?  This is essential as usually in the initial stage of recovery the patient is in so much discomfort therefore travel long journey is a torture even though permitted for car ride. In additional to that patient need to go back to the hospital for bandage removal normally that is usually within 14 days from the day of surgery. If you do not have any possible near recovery site, please check with the hospital do they have such facilities?  What is the rate per day? What is the rate for food and laundry?
2. Is the propose surgery cost affordable?  Does the patient have medical policy? Find out in much more details what does the medical policy cover? Do you have staff medical benefits? What is the limit? EPF withdrawal? Credit card limit?  Personal loans? Delay on spending on the items wish to have eg new car/house/furniture, renovation, jewelry, holiday and etc..etc Have gone through the whole list of possibilities yet the bill is still cannot afford then make a clinical appointment to discuss with the surgeon.  A good surgeon who understand repair spinal deformities is restoring lives as well will help you to explore the surgery cost to fit your pocket.
3. Plan and schedule with the surgeon the possible date to undergo this surgery. 

Your other doubts

1. Is the hardware safe for our body?  At present the hardware is titanium. It is non-toxic and not rejected by human body. It is light, strong and non-corrosive. FYI I am installed with 16 screws and 2 rods, additional weight to my body is less than 1 kg.
2. Need to take out the hardware after the spine is fussed up? NOT required.  People with spine implant need to be more stringent in back care for their daily life eg proper posture in lifting heavy things and no crouching (proper sitting posture).
3. How long is the imposed restriction on weight, no body bending, twisting, jumping, running?  Temporary until the spine is fussed up. The surgeon are keeping tab on your spine progress on 14 days, 2nd months , 6th months, 12  months post ops clinical appointment.  The surgeon will let you know when. 
4. Is it possible for a person who has undergo Spinal Fusion for scoliosis to go through pregnancy? Yes you may if you wish to, however please wait for your spine to fussed up.  Inform your gynecologist that you had gone through spinal fusion for scoliosis.
5. Can scoliosis spine surgery lead to fatal? Yes less than 0.1 percent based on the database data at the hospital where I undergone the surgery.  In my opinion 0.1 percent is equivalent to nil or too negligible a figure to consider. Fatal possibilities occurred in our normal daily activities are any time greater than 0.1 percent.  Example once we are on the road we are exposed to fatal risk and total permanent disability due to accident no matter how careful and how good is our driving skills.
6. Would I prone to lighting strike with the metal implant? Titanium is fairly hard, non-magnetic and poor conductor or heat and electricity.  http://en.wikipedia.org/wiki/Titanium

This is most likely some of the questions people ask. If you have others doubts, feel free to drop your comments.  I will try to explore with you to get the answer.

Notes:- credit for images taken from http://www.mdjunction.com 

             https://www.uichildrens.org  and http://www.scoliosis-australia.org

5th Week post Ops - Posterior spinal fusion for scoliosis

Notes :-  This blog was initially meant to share my birding field trips reports. Ever since I started to use Facebook I  have not post any updates since then.  This series of posting on Scoliosis is my personal experience.  I had Posterior Spinal Fusion for Scoliosis on 17/2/2014. 

I hope my sharing will serve as an encouragement to those who have spinal deformities like me.  For those who  have Scoliosis, spinal disc herniation, spinal disc degeneration, spondylosis, kyphoysis, do not be afraid/avoid when the  spine doctor recommend  the solution is surgery.  There is hope for you in today modern medical technology.  Please do not endure the pain in silence.

On 21.2.2014 

I discharge from the hospital with my personal belongings and painkillers (panadol), anti-inflammation pills, 1 box of iron supplementary pills, anti-itchiness pills (5 tablets).

I also hold this disposal container just in case I throw out during the car ride. Today I get out from the hospital on wheel chair.  No doubt the spinal operation did not damage any functions of my limbs and brain but I am too weak to walk for long distance.  I feel so helpless today.  I can’t lift up my backpack and my others belongings to walk out from the hospital.  Even get into the vehicle also I need assistance.  The 30 mins car journeys seems to be like eternity to me cause I am in pain and discomfort.

Before my next doctor appointment I need to be very careful.  Even though the op-site bandage is water resistance, I need to make sure that it is not wet/damage.  I also need to remember to eat the medicine as per instructed eg omit this if this symptoms does not happen… eat this 1 tablet after meal for 3 times per day… eat this 1 tablet per day…

On 27.2.2014

initially was my second clinical appointment for getting advice for surgery is it a must turn out to be my op-site bandage removal date.  The surgeon is very pleased on my progress.   My next clinical appointment is 2 months from now.

On 24.3.2014 

Today I am passing through my 5th week post posterior spinal fusion surgery for scoliosis.  In my initial recovery period I spend most of days on bed-rest.  As the days past I am able to sit up longer compare to the previous day.  My shoulder region soreness is lesser as the days past.  Sometimes I have a few second of tingling sensation on my leg, on my certain parts of my limbs. I will keep monitor this and inform my surgeon on my next appointment,

My days of recovery period are very frustrating sometimes, chores that I used to be able to do eg handle my own laundry, cooking, lifting up things all these I need to abstain from. Temporary I am forbid to lift up anything more than 3kg.  I have to be very careful each steps my feet launch out.  I cannot fall/slip.  I am forbidden to bend therefore wearing my pants/panties are indeed a great challenge. 

Nevertheless the things I enjoy are I can spend time watching a few series of Korean medical soap drama, read books in between,sleeping, keep tab on MH370 . stay active in FB and read articles to learn new things  from the internet.

During my stay in the hospital, the nurse told me that the Surgeon and his team have done their part to correct the curve of my spine. It is my duties then to take care of their handiwork.  

For those who have good spine please take good care of it. For my case being a scoliosis patient regardless the series of pain and $$$ spend this is what I can achieve.

To build strong muscles to hold my new spine I need protein.  To avoid hearing my surgeon break the news that my spine did not fuss as expected I have included calcium supplementary pills.  Got to know that daily we need  1,,200 mg calcium.  Our body will have Calcium poisonous if we overdose it to 2,500 mg.

Cheese and milk most ladies would try to avoid for upkeep a slim figure but it has calcium that is needed for our bones.  A cup of full cream milk only can provide 330 mg calcium, a slice of hi calcium Kraf cheese provide 240 mg calcium.  Calcium supplementary pills are expensive therefore it is still worth to drink milk and consume cheese if you opt for calcium intake through your natural food.

For the time being the only exercise that I can do is brisk walking.  Despite haze or good day I would do brisk walking for about 10 – 15 mins everyday.

In the mean time I hope everything progress well as what my surgeon expected me to achieve.

20/2/2014 - My presence in the hospital is a blessing to others.

Notes :-  This blog was initially meant to share my birding field trips reports. Ever since I started to use Facebook I  have not post any updates since then.  This series of posting on Scoliosis is my personal experience.  I had Posterior Spinal Fusion for Scoliosis on 17/2/2014. 

I hope my sharing will serve as an encouragement to those who have spinal deformities like me.  For those who  have Scoliosis, spinal disc herniation, spinal disc degeneration, spondylosis, kyphoysis, do not be afraid/avoid when the  spine doctor recommend  the solution is surgery.  There is hope for you in today modern medical technology.  Please do not endure the pain in silence.

20/2/2014 - I am 3.5 cm taller after the Operation.

Since I developed no fever, blood pressure in a normal state after this major surgery, my surgeon has given the order to the nurses that they need to observe me only on a 4 hourly basis.   Without them frequently drop by I seems to be passing my day in great loneliness is also due to I am not a TV addict. TV seems be of no use to me. I wish that it can be replaced by laptop/ipad.

Medicine in the form of anti –nausea, oral pain killers,anti-inflammation and multivitamins was dispatched to timely by the nurses.  I just pop in whatever that was in that small medicine cup.  Today I started the day with a bit of dizziness. Throwing out once before the two nurses came in with my new sets of hospital gown and bed-sheets.

My breakfast was home-cooked plain porridge cooked by my younger brother.  I remember the advice from the surgeon “…eat in small portions but in many times..” . I need to eat more ...I need to finish it.   Prof Kwan drop by during his ward round greeted me  “你 好 ?”  … I replied “你 好 ?… Doc I did release out gas just as per your description and today I throw out once could it be due to the oxyco_ _  pill? … I still feel nausea. ”

After checking my lungs function with the stethoscope,flipped through the records of my body temperatures, blood pressure.  He scribble some notes on my medical file and proclaimed “ today you ready for discharge”….

I quickly replied “Doc… may I stay one more day?  My mum is not willing to accept me in this state… I still have the throw out feeling…”  He replied  “ I have no problem to let you stay as long as you wish but hospital is full of germs.  It would be troublesome if you get infections and contacted with virus.”

Huh…. No…NO … I don’t want infections and unknown virus for sure Doc. I will discharge tomorrow for sure.

Today I did more times of walking out from my hospital’s room.  This type of exercise is needful to strengthen my weak muscles.  Each time I walk pass the nurses counters I would said “Hello Dear… I am out again…I feel so boring …can I help....?”

Each time I reached to the “the hall of fame board”  (board that use to display patients photos with their notes to express how grateful/thankful to the hospital and surgeon on their spinal fusion for scoliosis successful surgery) , I look meticulously at each photo.  As I l did that I could feel how fortunate they are cause they are born in this modern medical technology.  I encounter some people on the streets who are also having the same Idiopathic scoliosis like me,  some are very badly deform but surgery option is no longer their option due to age factor.  Some young girls/boys did not managed to seek any medical help cause their parents are unaware that there is help after the pediatrician pronounced  "....your child has scoliosis ... there is no vitamins/pills to cure this..."  Some parents are still unaware that this horrifying surgery it is much more safer than they have ever thought of.  The most pitiful ones are those whom their parents could not afford such an expensive treatment. Those patients displayed on the hall of fame board are very fortunate to have parents who are willing to sacrifice their wealth to help them.

The admin executive who assists the surgeon on all the paper works drop by. She measured my current height after the operation.  Based on her estimation by putting three of her fingers within the gap, she pronounces you are taller by 3 cm.  In actual fact I am actually taller by 3.5 cm . Today I also start to chart my pain level in a form. This form will then need to hand back to the surgeon in my next clinical visit.  Level 0  is no pain , level 10 is pain that makes one cry.  There are different symbols to indicate where is the pain eg wound/neck/shoulder...etc...etc

My presence in the hospital beside seeking medical help for myself has also unintentionally given encouragement and assurance to the parents of a 14 yrs old girl who is schedule for scoliosis correction surgery the following day.  Their hearts was set at peace when they saw that I can walk and none of my limbs are affected by this horror word of spinal surgery.   I also assure a uncle whom his wife in her 60s warded due to her lumbar  spondylosis  problem.  She also will go through spinal surgery.  My presence has given them an assurance that their loves one who will be going for spinal surgery are in good hands.  I am the living example of the outcome of that horror major surgery.  I told them I sat up in less than 24 hrs after surgery.  I also able to take shower and wash my hair on my own after all the tubes detached from me.  I told them how slanted I was before the surgery and now I am much more straighter and taller by having  16 screws and two seven inches long titanium rods installed.  They are titanium they do not need to take out.   I will be discharge tomorrow.  

19/2/2014 – Post Ops Day 1 and my 1st hurdle to pass

Notes :-  This blog was initially meant to share my birding field trips reports. Ever since I started to use Facebook I  have not post any updates since then.  This series of posting on Scoliosis is my personal experience.  I had Posterior Spinal Fusion for Scoliosis on 17/2/2014. 

I hope my sharing will serve as an encouragement to those who have spinal deformities like me.  For those who  have Scoliosis, spinal disc herniation, spinal disc degeneration, spondylosis, kyphoysis, do not be afraid/avoid when the  spine doctor recommend  the solution is surgery.  There is hope for you in today modern medical technology.  Please do not endure the pain in silence.

My 1st Hurdle 

While waiting for the dawn of 19/2/2014, in between my sleep the nurses came in  to my room change my saline drip, dispatched a small cute cup that contain some medicine.  I am just like a sick puppy when I saw that small cute cup I just throw into my mouth those pills one by one with a small sip of water.  In between naps I felt my stomach bloated.  What happen?  Has this surgery cause my waistline grow?  It is such an uncomfortable sensation. Whenever I sat on my bedside I would feel like throwing out.  I did throw out a few round but it is just bubbly water. Aaaark… Arrrk  did some burp yet it does not relieve.  Does wooops..wooops gripe water for babies work? Yikes should have packed this item to the hospital….

Yesterday I complained to my surgeon that somehow I feel that around my shoulder’s blade region has done some slavery job/super duper heavy duties manual jobs.  That soreness/tiredness is I had never experience before.  Every bed turn you would hear my mournful voice  “Ouch… Aw… Aw,… Aw.”   He told me that it is normal as it was due to the lying position on my stomach using my arms  & shoulder to support my body on the operating bed as well as due to sudden stretch of my squash/crouching muscles as now I have straighter spine compare to the previous day. 

He prescribe muscles relax cream (Fanil) for me,  told the nurse to applied for me.  That hotness sensation on my skin I know that if apply a few more times my skin will get burn, therefore one time is sufficient.  With this I did another press of morphine thinking that maybe it could help to relieve the soreness/tiredness of my shoulder. 

After many naps soon it is dawn again.  Two nurses walked into my room with clean bed-sheet and a new set of hospital gown for me.  One of them working on disconnect me from the saline drip informed me that I can take my own bath but my time-frame is only 10 mins.
Yahoo.. finally.  What 10 mins?… I need  at least 20-25 mins?  The nurse replied your dressing will get wet and you will get infections.  Ooops then 10 mins … 10 mins ok.. I don’t want infections.. definitely a big No.. NO..

I search for my panties, grab my thai towel and the clean hospital gown carefully walked to the bathroom.  I feel so robotic.  1^stthing first, wash my face with my tea tree facial wash. Performed the quickie teeth brushing.  Some individual advice that the 1^st shower after operation need to be seated on chair,having difficulties raising hands, need assistance from relative. Huh…. But I am alone here how? I request the nurse to wait for me outside just in case I need help.

I carefully untied my hospital gown, switch on the shower tap wet my hair, foam a bit of the shampoo … eeeeeh I can do it.. I then use a bit of the body wash to continue my shower.  I grab the towel and then I then carefully wear my panties (yes… now I feel more secure) ,  put on the clean hospital gown.  Walked out from the bathroom carefully put my wet towel on the chair, the dirty hospital gown aside and walked back to the bed, quickly lie back. OOOshhh so tired.

I had my breakfast of oats with milk on my hospital bed with the bed propped up about 30 degree. Force in a few tablespoon in order for me to pop in medicines.

My younger brother turned up and I proudly told him I took my own bath.  We chat for while and then he told me he will  come back again during lunch.

I tried to sleep again while I feel my left hand seems to grow bigger and bigger. Has the water sip in through the IV tubes while I was taking my shower?  I slept and not knowing the time, suddenly I feel my arm was being tapped by someone..  My surgeon- Prof Kwan walked into my room without me realized his presence.   He is with my blue medical file, a box that  contain corset greet me  “你  好 ?”   I noticed today he look different. He is not in his usual white shirt but today he wore the corporate UM sky blue shirt.  Hmmmm …looks very casual maybe he will attend an official meeting afterwards or has just came out from it.  I like the various shade of sky blue on his corporate shirt.

I replied back “你  好?”and then continued  the conversation in  English even though I can converse in mandarin.   I told him my stomach is feeling awful, I throw out a few rounds. I show my swollen “bear paws” right hand to him. He replied that it will eventually subside and now he need to remove the IV needle  … He instruct me to look at the other side.  The IV needle was removed in second and he put a plaster on my hand.  He then checked my lungs, my throat, tap my stomach and told me my stomach is bloated with gas.  This is cause by the morphine and pain relieved medicine that was administered into me.  I was instructed to walk more today.   He instructed me to attempt walk out from my room to the reception, need to sit up for at least 1 hr on the chair.  With this exercise then I will have“puuuuut…. Puuuuut… putt” gas release out and I will be ok.

Each day my surgeon give me new instructions. He only reveal info what I need to know for the day only and this does overwhelmed me with too much of information.

He read the post surgery instructions and as he read he tick the items.  He then continue “aaaah wear the corset for 6 weeks …only take out for sleeping and bathing….today the nurse will monitor you in every 4 hours and not every 2 hours…. You are KIV for discharge tomorrow… anything press the button to ask the nurse for assistance..they will teach you how to wear the corset…no more saline drip today.. today you are on oral medication… don’t worry you are doing very well…..have you pass motion yet? …eat more today but in small portion …we need to do x-ray on your spine afterwards….”

Yes sir… and he walked out from my room.  Huh KIV Discharge ?  I still vomit but at least I am much better than yesterday.

During lunch break my colleague drop by and we chat about office matters.  Not long after that my younger brother drop in with his home-cook porridge unfortunately I refuse the food.  I told him that I am on KIV discharge tomorrow.  He told me that he is in the midst of sourcing air-con to be install at our parent home.  Dad will install water heater for me.  The family members prefer that I will use downstairs for my recuperating area. 

In between my naps whenever I feel my nausea subside, I sat up at the beside, wear the corset just at the nurse has educate me, I did my walk to the bathroom and then venture a little bit more out from my hospital room.  I also ask the nurse to assist me to sat on the chair.  Instead of 1 hrs I only managed to do about 10 mins only. Never mind at least I did sat on the chair.

A nurse walk into my room told me that I need full spine x-ray.  This time instead of going there on the wheelchair I reached the imaging room on my hospital bed, cause I am still very weak.  Knowing well that this x-ray required me to take out my panties. Eeeeh I have to feel unsecured again.  ok.. I have taken it out.. nurse I am ready.

Today I start to have more visitors.  My colleague turned up and we chat about office matters.  About 5 pm I was so surprise that my younger brother brought mum along.  Mum has cooked 2 flavor of porridge for me to choose.  I refused to have any cause I don’t have appetite but she pester me to have just a few tablespoon. I opted for the plain porridge.  Mum’s cooking is always the best even the plain porridge taste so good.  I ate a little bit more than my previous meal.  The hospital vegetable porridge I order was untouched then.   

After they left I took my naps again throughout the night.  Did the bed-rolled and bed physiotherapy whenever I am awake.  Out of sudden I start to “puuuuuut…..puttttt….putttt…”  releasing gas.  Yes …Yes! This is what my surgeon is expecting me to achieve.  Yahoo I pass this hurdle.