Pre-operative assessment – Round 2

Thursday, 14th June

Today was my pre-operative assessment clinic, all 4 long hours of it.  Having had a pre-op before, I knew what to expect, and would describe it as a full-body MOT checking you are well enough to undergo an operation, followed by the final consultation with the surgeon (mine being named The Prof for this blog).

I had been preparing for both; vitamins for the former, research for the latter.

My main aim of the day was to talk to The Prof about something which has, quite literally, been giving me nightmares.  I get copies of all correspondence sent between the doctors – that's 6 hospital doctors and 2 GP's in my case; their commitment is unbelievable – and the most recent came from The Prof.  He mentioned the risks of the operation which we had already discussed, but seeing them in writing made them easier to process and one just stuck out at me.  I didn't actually realise how much I was subconsciously thinking about it, or how much it was worrying me, until I woke up shaking from a nightmare.

Loss of correction.

Memories of how my back used to look that I didn't even realise I still had were all coming back and, well, haunting me.  It is so easy to forget how something used to be and I think, in a way, I have come to take the new appearance of my back for granted. The idea of it returning to how it was genuinely terrifies and upsets me.

I was offered a 'plastic jacket' after my previous surgery but as they were so pleased with the fusion I was never fitted for one.  I will be going in to my final year of university this September, and it worries me that all the sitting at desks and so on will affect the healing and, in turn, increase the curving. I don't have any qualms about the appearance of a brace (though research has told me that they are barely noticeable) and I am of the mind set that it is only for a year at most – a year of recovery that once passed you can't alter.

I researched plastic jackets and braces extensively, explained to The Prof and asked his advice.

As the metal has been in for 3 years, he thinks the fusion should be good.  Therefore, while 'loss of correction' is listed among the risks, the actual risk of it is very minimal.  They will monitor my x-rays to check the fusion is as expected, and we will discuss it again once the operation is done.

I trust him completely and feel fully reassured that this is something I can stop worrying about.

We went through the risks and the operation process again.  The risks include infection (yes, you have to risk infection to treat infection), loss of correction, and tearing of the lining around the spinal cord which can lead to a leak of fluid.  I don't know the proper terms for the last risk but The Prof explained the leaked fluid can cause pain, and also how the nerves can come out through the tear – let 's just hope this doesn't happen!  Unfortunately though, there is a degree of uncertainty when removing metal.  They never really know how it's going to go, or how close screws are to nerves, until they are operating.  Again I am having to take a risk, but I am confident in my decision to go ahead with the operation.

Having met with The Prof quite a number of times now, and having always been polite, reasonable and understanding, I feel that he is much more relaxed during consultations.  This relaxed manner in turn makes me (and my parents who, forever there for me, come to all consultations) more relaxed too. I don't burst in to tears anymore, I don't forget what I wanted to ask and I don't get nervous before seeing him.  I feel that because we have always respected and listened to him, he also respects us for remaining calm and maybe even respects me a little for how I am dealing with this.

I feel even more proud that he seemed very impressed by my knowledge of what is going on and the interest I have taken in my condition and my care.  I told him how interested I am by what they do, and that I even watched a video of the surgery before I had it done.  He was surprised to say the least but it was amazing to have my thoughts on the surgery listened to by such a pioneering surgeon.  Even more amazing is that he then asked me to be involved in new research they have just been given the go-ahead for.  It feels overwhelming to have the opportunity to maybe be able to help him, and the rest of spinal research - especially after how much they have helped and will continue to help me again next month.  I will be sent the first paperwork soon...