Friday, 17 February 2006

(This is not a techie post, but since there are many people out there asking how I am doing after surgery, I'll write about it here. It will also help me remember how things went and what happened when)

It's two days after my surgery, and I'm heading home this evening from the hospital, which I am looking forward to. This hospital is great (truly), but somehow the idea of having a fire in the fireplace and being in familiar surroundings is more appealing.

My body hurts, pretty bad. Like I got hit by a truck. but it's not the old pain, which is great. I can walk a short while (well, it's a lot like walking, but it's labored at best), and the physical therapist had me walk up and down a flight of training stairs. Who would have known it could be so much work? This is a lot like learning to walk all over again.

I was able to take a quick shower today (they do some fancy stuff with the incision when they close you up, and showering is actually a good thing to do once you're up to standing for that long). Thank goodness! The hot water helped relax some of my tense muscles.

Yesterday was hell. Starting with X-rays (which came out just fine), standing up was very painful - I had terrible muscle spasms in my lower back and legs, along with pain and nausea. Nothing like feeling nauseas and (forgive the graphical discussion) having to puke, which of course hurts like hell since your abdominal muscles contract hard each time. I'm glad that phase seems to be over with.

Kineflex-1More than a few people have asked me what exactly they did to my back during this surgery. I've decided its not a big secret or anything, and that in fact it's really very interesting. First they removed the inter-vertebral disc in the lowest part of my lower back, at the L5/S1 space. Discs in your back are the softer tissues between the bony vertebrae that act as shock absorbers and allow your back to move in all directions. think of them as like a little pillow filled with squishy stuff (well, sort of). Mine was herniated (torn and pooching out into the space where the nerves run) and degenerated (loss of water and height, thinner than it used to be). In other words, pretty much all ragged and shot. The medical term for the thinning and drying out of the disc is "Degenerative Disc Disease." You body won't correct it on it's own - the physical damage is done and it usually just gets worse over time.

Once they removed the bad disc, they put in an artificial disc replacement implant - a spinal prosthesis, you could say. It's called a Kineflex lumbar artificial disc, and you can see a quick video of what it looks like and how it works here. The Kineflex device is a newer design, and I received it through a study program that is comparing the Kineflex disc to the Charite disc as part of a FDA clinical trial in the United States (email or call me if you want some details - contact info is in the right-side menu bar). I did a lot of research - on fusion options, artificial disc options, do-nothing options, individual surgeons, etc - before I decided to go this route. Artificial discs are - in the right patients - an alternative to fusion of the two bones. The ADR devices don't act like a shock absorber (neither does fusion, for that matter), but they do retain close to natural motion in the joint. As you might imagine, it's a fairly expensive procedure, and at least for now insurance companies in the United States are rarely paying for the procedure because it's too new for them (the first model to get FDA approval was the Charite and that was in the fall of 2004), and they instead prefer the fusion route. That's the way health care works.

And for those people looking here for technical posts - well, sorry. They'll be back soon enough.

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Kineflex Artificial Disc Surgery | Personal Stories
Friday, 17 February 2006 13:59:15 (Pacific Standard Time, UTC-08:00)
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Saturday, 18 February 2006 01:11:49 (Pacific Standard Time, UTC-08:00)
And I thought it sucked trying to make it through airport security with a belt on... they're going to think you're smuggling a remote detonator back there or something. Body cavity search AND bomb squad... maybe you should rent a car.
Sunday, 19 February 2006 14:29:26 (Pacific Standard Time, UTC-08:00)
Hi Jason - Hehehe, I have actually been wondering about that since I traavel a lot. I am told there may be some form of official documentation to help deal with that potential problem. I have also been told that the device won't set off the metal detectors - not sure if I believe that one though. :)
Wednesday, 20 September 2006 16:08:53 (Pacific Standard Time, UTC-08:00)
I am undergoing a combination fushion of L5-S1 and artificial disk in the two levels above it in 3 weeks. I travel a lot, but due to the healing process am not scheduled to board a plane until April 2007. I can hardly wait until I have to display a gnarly scar to convince the folks that I am not a terrorist. Let me know how it goes...
Linda Shepard
Monday, 23 October 2006 05:45:45 (Pacific Standard Time, UTC-08:00)
Hi. Thanks for your posts on line on post op results. I am facing a total disc replacement at L5 S1 on October 30th. At this point I am at a pain level of 2-3 without being able to be too physical. I can not do gardeneing and other real physical things without extra pain. I am scared to death but have an excellent surgeon who comes very highly recommended. He studied over in Europe and has done a lot of these surgeries. I am still worried that I will end up in more pain than I am now. I pray not. Please keep your online update going to help others make such a difficult decision. The hardest one I have ever made in my entire 48 year old life.
Deb Phillips
Sunday, 03 December 2006 17:37:10 (Pacific Standard Time, UTC-08:00)
I am part of the same study; Charite vs. Kineflex. I also received the Kineflex. My surgery was done a week ago tomorrow.

So far so good for me. I was in the hospital one night and am expecting to be back to work after 2 weeks at home. The pain levels are steadily decreasing and managable with meds. Sleeping is still trying since I am not permitted to bend or twist etc..

I have been able to (required to) take short walks and pretty much care for myself. My wife has been great and strictly enforces the doctors orders. My first follup appointment is next Friday. Other than a little sore (I like your being hit by a truck analogy) things look good from my standpoint.

I am wondering if this will set off any alarms at the airport.
Monday, 04 December 2006 21:02:51 (Pacific Standard Time, UTC-08:00)
Hi Tim, I read your blog, cool to see someone else chronicaling their experience. A couple things of note:

1. My Kineflex device has not even once set of a metal detector, and I have been overseas twice and one nearly 90 flight legs since the surgery.

2. The popping you mentioned on your blog is almost ceertainly a clunking-like feeling and maybe sound? I had that. The doc helped me figure out that it was the tendons popping over the bone, which makes sense when you consider they are stretched out due to the extended length of the joint once the new device is in place. It takes a few months but eventually it stops. No big deal.

3. Glad you're doing well. I was not given a brace to wear, and I am glad. In a couple more weeks you'll be feeling great. Don't worry about the meds - use them while they're there as needed.
Sunday, 07 January 2007 15:45:47 (Pacific Standard Time, UTC-08:00)
I am tryiny to see if i am able to get into a trial for disc replacement. it is long overdue. if you can guide me it would be great . i am a 48 year old male from New Jersey. I have DDD at L4,L5,S1. And have tried everything, Thanks, JIMMY
Jim Loures
Sunday, 07 January 2007 15:57:58 (Pacific Standard Time, UTC-08:00)
Hi Jimmy,

Have you checked trial listings online? Is pain coming from all three levels or just one or two (have they done a discogram test to determine which levels cause the pain)?

Generally speaking the trials have only allowed a single-level disc replacement. Multi-level replacements are regularly done in Europe, but I don't think it's common in the US, and almost certainly it would not be covered that way by insurance (just getting insurance to pay at all is quite an accomplishment, I was not able to get mine to pay).

It looks like the study I was in (Kineflex) has ended, which means they've had enough test patients to fulfill their study requirements. I don't see any lumbar artificial disc trials going on right now, but there are some others that are interesting (although I know almost nothing about them). I always suggest people keep an eye on this page to know what trials are taking place:

Also, this is a great site with some good forums for finding out all sorts of info and talking with people in a similar circumstance:

Hope that helps. :)
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