Wednesday, September 28, 2005

The Surgery – Part I: The Day Before

Ok, I promised you I’d tell you about my recent surgery. Prior to having total disc replacement surgery (TDR), back patients must endure a “discogram,” a diagnostic procedure for validating the degenerative disc disease diagnosis.

I had my discogram done the morning before surgery, on 8/26, after flying across country and arriving in Seattle late the night before. I hadn’t slept that night, and I’d slept very little in the previous three weeks – mainly due to “annual performance review” job stress. I'd actually rather have another discogram than another unfair performance review at work. But that's another story altogether.

For the discogram, I had to lie on my side on a table. I had been forewarned that it would be painful. (See An x-ray or CT machine of some sort is positioned above the table, with a monitor off to my left so that I can watch the needles going in. Robin, the discographer assistant, sat in a chair at the other end of the machine, facing me.

Patients have to be awake for the discogram in order to report pain levels to the doctor as he injects a radioactive dye into the disc. That’s the fun part.

I gripped the edge of the table like a steering wheel in NY traffic during several very uncomfortable injections of lidocaine. I tried to distract myself by smiling and chatting with Robin – another wonderful member of my doctor’s staff.

Dr. Schwaegler genuinely felt sorry whenever I winced in pain. He truly is the world’s most compassionate doctor. I must say that his empathy and Robin’s smile went a long way toward making the procedure bearable.

Dr. S threaded a long needle into my L4-L5 disc. Then he did the same in my L3-L4 disc, which participated as a control in the procedure.

As my doc injected the dye into L4-L5, he was successful at recreating some of the pain I’ve experienced for nearly two decades. But the pain wasn’t an exact reproduction. It didn’t seem powerful enough. We were at the end of the procedure when Dr. S said he could take it one step further - with a larger injection - if I was up to it. I still wasn’t 100% sure we’d fully recreated the pain, and I was already lying there in pain. . . so I said, "Go for it!" What the heck.

And that he did. The final injection is what did it. I screamed, "That’s IT! That’s the pain I know so well!" We had a wiener. Perhaps I was a tad gleeful despite feeling like I’d just herniated a disc in a big way.

The doc showed me on the monitor my pancake-flat L4-L5 disc. It was completely black with dye. The healthier L3-L4 disc, on the other hand, only had a tiny oval-shaped puddle of dye right in the middle of it. It was obvious that L4-L5 was practically 100% degenerated. So the surgery was a go.

They slowly helped me off the table after I carefully turned onto my back, the familiar pain shooting out my hip and down my right leg. As they helped me walk out the room, I joked, "Dr. Schwaegler, I didn’t fly all the way out here for you to make me worse! You’re supposed to fix me!"

After that I headed back to my teenie room at the Providence Inn. I took a cab shortly after that to Mercer Island for an MRI before returning to my room. I proceeded to spend the rest of the afternoon and evening drinking fleet phosphosoda to clean out my colon (fourth time this year), sitting on the toilet, taking antibiotics on an empty stomach, and throwing them all up. This went on til about 11:00pm. All I wanted to do was sleep. . . a wish that would not be granted for some time yet.

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