Spinal Surgery Consult

I am so very thankful for a productive visit today with the surgeon in Georgia. I also had a special friend to share it with - thank you, DeeAnn Plopper for allowing me to talk your ear off and cry on your shoulder for 3 straight hours. Thank you for praying for me as you sat just inches away. I can't tell you how much I appreciate you!

After looking at past files and new x-rays, the Dr. feels it is a pretty solid decision to go forward with not only fusion of the sacroiliac (SI) joint, but also an additional portion of the lumbar (for instance: L4/5 or L5/S1). His words when he walked in the room for the first time was "let's get this done". I began to cry from relief.

As for the location of the 2nd fusion, it will become more clear when we get additional CT scans and MRIs. He said it looked like it was in pretty bad shape from the x-rays alone, especially the left SI joint. The left SI joint looked fused already, which puzzled the physician assistant & Dr. as to the cause, although they noted that x-rays can be deceiving. We will be unable to accomplish surgery before the desired goal date (December/Christmas break) due to Blue Cross Blue Shield not covering the SI procedure (I-fuse system). Therefore, we must go through an appeal process, using a company that advocates for the patient and communicates to the insurance provider, and the process takes about 60 days, roughly.

 So we are now looking at something down the lines of Spring Break, which would not give Rence much time to be home with me as I recover (as I will be held in the hospital after surgery for 4-5 days, depending on my progress post-op, in which Rence will be by my side; however, after discharge, it leaves Rence at only a remaining 3 or so days before returning to work due to the completion of his week-long spring break). We will be trusting and relying heavily on secondary help for care of myself and the boys as Rence works throughout the day and unable to take off.  It is the best option at this point. I am not letting the timing of surgery bother me - I am trusting God with it all and very encouraged by today's visit.

God was truly working through everything today. Even my medical records got there. The nurse, PA & Dr. all commented about how organized my personal files were. They loved my documentation of things, and the nurse said I was the first new patient all day (out of 5) that had all of my medical records from other facilities sent to them. Thank you, Father, for working everything out - even the small details. With everything falling into place so beautifully, it was so evident that there was a special covering of prayers over this situation. For those of you who pray over these needs and concerns - please know you make a difference in God's kingdom. That's how God designed it. Keep the prayers coming, as we still have to jump over the wall of insurance coverage for the SI fusion.

With thanks and love,
Beth Anne

Feeling the Results of the Nerve Ablation!

Our God is Healer! I am feeling about 70% relief in the severe pain in my sacroiliac joints! Yes, it may be a temporary "fix" in this case, but it doesn't make the evidence of answered prayer any less powerful. Even more amazing is that I felt this relief in a matter of DAYS, not WEEKS (as is typical), and I did NOT feel the post-op pain (past 1 day) that I was told I would experience for up to 4 weeks, which included the "cigarette-like" burns deep in the tissue. One day post-op, I was feeling well enough to take the boys to the small "pumpkin patch" at the FUMC. On Sunday, many could tell by looking at and talking with me that my pain levels were much improved...there was a definite "glow" about me that hadn't been there before. I praise God for working through the hands of these physicians!

What I can still feel is about 30 % of my normal amount of pain directly in the SI joints (which is amazing compared to what it normally is, but still using back braces, EMS units, etc. to help me out along the way), as well as the misalignment of the joints and the shooting pain from the peripheral neuropathy stemming from the SI joints (from the misalignment). Once again, this is nothing compared to my normal pain levels, and the ability to "breathe" from the constant, severe pain is indescribable. When you are constantly in that kind of pain, your mind and body forgets what anything close to "pain-free" feels like. When you experience it again, you can't help but praise God especially for those precious moments, even if they are temporary.

Many have asked if this changes our plans for surgery. Unfortunately, this is a temporary fix. This ablation can last anywhere from 3 months to 1 year, although most patients' nerves start regenerating and their normal pain returning close to 3-5 months. We won't be able to do surgery again until next December because of Rence's work schedule, and we feel at peace with looking into the surgical options at this point. That still doesn't yet guarantee that this will be the path we take, although we are praying that this may be a good step for us, as it seems extremely hopeful through this procedure and surgeon.

The first surgeon's appointment (consult) is on Wednesday, so we will need an extra covering of prayers for that day. Please be in prayer that I can find someone to attend the appointment with me, as well, for support purposes (my mother will be keeping the boys, Rence will be working in AL). Thank you all so much for your prayers through everything! God is working mightily in our lives - may He always be the One lifted high!

Tips & Tricks: Pain Level & Medication Log

I began using a log for my medications, as I take many during the day and it is very hard for me to remember how many I took at 8 a.m. when it is 8 p.m. at night. Taking 6 tablets a day for 4 different medications gets tiring and difficult to count. So, I am on day 3 of using this simple and custom-made pain level & medication log. I thought I would share in case it helped anyone out there in similar circumstances get a little more organized.

* For privacy purposes, I used the medications written in the document below as an EXAMPLE. My personal medication log looks very different. You can customize yours as well.

You can copy and paste the below text & grid into a Word Processing program on your computer.

Pain Level & Pain Medication Log

Patient: Beth Anne Cochran (Bday: ____________ )

 

Date	Time	Pain Scale Rating	Medicines Taken	Notes
10/16	10 a.m.	5	Motrin 400 mg -  2 (tablet)          Tramadol 50 mg - 2 Topomax 50 mg - 1                    Cymbalta - 0	In pain, but mostly preventative (grocery shopping)

 

Nerve Ablation Complete!

Thank you, my sweet friends, for all the prayers! I just wanted to update you on how everything went yesterday.

They called me at 6:30 am the morning of the procedure to see if we could move my procedure time up from 1:00 to as early as 9:00 am. Considering we are 2 hours drive, had to get the boys dressed, ready, and to a babysitter (whom I had to re-arrange and check on things with as well, not to mention my driver), this was an interesting process. Thanks to a flexible babysitter and driver, we decided that 10:45 was a good time to aim for, but told them no guarantees. Sure enough, we were there by 10:45. Thank you, Rebecca Owens & Felicia Waugh for being so flexible so early in the morning (Rebecca - the boys can't quit talking about yesterday ;) ).

Prior to the procedure, they gave me some preventative antibiotics (two of them) and Benadryl and Pepcid to prevent another allergic reaction like I had been having at the injection sites recently (hives). They took me back to the OR and got me situated and started promptly, so nerves weren't a huge issue. The procedure lasted 1 1/2 hour, roughly, and they gave me some decent pain relief in recovery (which is unusual for me), as I was feeling the effects of the procedure (I'll explain more below).

Dr. Nesbitt (anesthesiologist & the one performing the procedure) said I would be extremely sore for 2-4 weeks post-op, and that the spots he was targeting (10 total instead of 6 as he originally thought - 5 on each side, which increased the chance of targeting the pain generators) would feel like cigarette burns for that time frame (deep inside the tissue, as the laser heats up to 700-800 degrees for 90 seconds each at the least). The top of the tissue isn't burnt, because it wasn't touched with the laser. I am bruised already and feeling the "burns" he was talking about. He said I would also be pretty sore from using fairly large gauge needles - larger than they use for epidurals and spinal blocks. He offered me a script for pain relief for the month while I recover, but I can't use it because of some of my current medicines. I'm not worried about that, thankfully, although I'm glad he offers it to patients who might be able to use it. I believe that is yet more evidence that Dr. Nesbitt is a great Doctor and anesthesiologist.

On a side note - Thank you Felicia for staying with us until 7:15 last night until my hubby got home from work. It was so nice to know I had some help for myself or the boys if needed. I enjoyed the company as well.

I am praising God for a routine procedure and the ability to have this done! I am so excited to see if this will help between now and surgery. Thank you so much for your prayers. They mean so much, and it is obvious that the body of Christ is lifting me up in prayer. God continues to amaze me at how He works!

Please continue to pray fervently for my first appointment with the surgeon next Wednesday, October 22nd at 1:30 in Georgia. Surgery has not been made official, but by basic medical standards, I should fit all criteria. However, every Dr. sees things differently. Please pray for my nerves (that I hand EVERY aspect of this appointment over to God, our ultimate Healer), that we would have all the medical documentation/test results/MRI's/CT's, etc. needed for the Dr. to make his final decision. Our goal is surgery at this point. The success rate is high for this particular Dr. and this particular surgery (using the "I-Fuse System"). Thank you, once again, for all of your prayers, support, and show of love and concern for our family. You are all precious!

Bilateral Radiofrequency Nerve Ablation Scheduled for TOMORROW...Hurray!

Radiofrequency nerve ablation being performed
Image from www.indiamart.com

I'm calling on all my precious prayer warriors to lift up several specific requests regarding this Wednesday's nerve ablation at 1:00 on my sacroiliac joints (in spine near pelvis).

First off, what is radiofrequency nerve ablation? This process is a minimally-invasive procedure that is done either under local anesthesia or with the patient under general anesthesia (I will be under general anesthesia) and takes about 45 minutes per joint to complete (I am having 2 joints completed, which will be a 1 1/2 hour long procedure). The anesthesiologist (performing the procedure) locates the location of the nerves in the particular joint causing the pain and places a Teflon-coated catheter needle in each of the locations of the nerves. For the sacroiliac joint, there are only 3 nerves on each side that typically cause the pain. Therefore, 6 (total) Teflon-coated needles will be inserted. These remain throughout the entire procedure. The radiofrequency device helps the anesthesiologist verify the accuracy of the needle location. After medications, steroids and local anesthetics are injected into the nerve, the tip of the nerve is then burned (using the radiofrequency device) to keep pain signals from reaching the brain (ideally).

I have been praying that this will give me some, if not much relief from the severe pain that is so difficult to cope with, despite attempting other means of "pain management" unsuccessfully. This is also the last step of intervention before I see the surgeon next Wednesday, and before I possibly (and prayerfully) have surgery on these joints.

There will be a time frame post-op that I need to rest (stay off my feet) and that my pain levels will be higher than normal due to the aggravation of the joints & spine. Please also keep me in your prayers as I try to keep a house running with 2 toddler boys and a full time working hubby.

I will try to update you all as soon as possible following the procedure. Thank you to all of those who have faithfully been praying and encouraging Rence and I. Thank you, also to my driver Felicia Waugh and Rebecca Owens, who will be keeping the boys tomorrow. I feel so blessed to have such immediate access to great healthcare where I live. God is so good...ALL the time! :)

2 Corinthians 12:9

My grace is sufficient for you,

for my power is made perfect in weakness.

Preparing for Possible Spinal Surgery

Image from www.toonvectors.com

October 7th, Facebook Post:

Please keep Rence and I in your prayers. We are feeling at peace with pursuing spinal surgery (on the sacroiliac joints - bilateral). This will be a bilateral SI joint fusion using the "I-Fuse Implantation System". This involves placing three rods/screws in each SI joint to stabilize and fuse the joint. Using this particular system, this procedure is much more successful than other spinal surgeries. Therefore, we are even more encouraged.

We have come to this step in the road due to my increasing pain levels and the certainty that the pain generates mainly from this area. The tests I have recently been going through have helped diagnose this even more positively.

As much as I feel I should be "scared" about this major next step, God has given us both an overwhelming peace about all of it. We are in the early steps of getting to the right doctor/surgeon (in Georgia) who specializes in this fairly rare procedure (with the "I-Fuse System"), and therefore we are not sure if we will be able to get a surgery date before the end of the year, but are praying that this will be the case. Please pray that we can get all of this taken care of smoothly, including the referral to this surgeon (my specialist is being stubborn about referring to any physician b/c it adds to his workload).

As always, we can't thank you enough for your encouragement and prayers. (Please, no advice - just encouragement.) 

___________________________________________________________________________________

October 8th, Specialist's Visit in Birmingham (Update):

A big "thank you" to Julie Crews for helping me out today with the boys as I had to discuss some really important things with the doctor today, including a referral to the surgeon (which the same doctor had been stubborn about due to his workload).

We began the visit by discussing the referral to the surgeon in Georgia for the possible SI joint spinal surgery. I asked my Facebook friends and prayer warriors to pray that we could get this referral accomplished smoothly, and that happened. God is good! Please continue to pray that all will fall into place quickly and smoothly. The appointment with the surgeon in Georgia has been set up for October 22nd (things are starting to get a little more real). Please pray specifically that we have all the films (MRI's, X-rays, flouroscopies, etc.) & procedures that the surgeon will want to see. If not, please pray that insurance can process this quickly so we can do surgery before the end of the year, if possible (and if in God's plan), as insurance has that popular tendency to drag their feet.

I also had to discuss the extreme fatigue I have been experiencing lately (due to chronic fatigue syndrome & adrenal fatigue stage III). Due to cost of treatment (up to $100/month for a low-income family with many medical treatments monthly), I had to discontinue several treatments. Surprisingly, the over-the-counter (and extremely expensive) supplement did indeed do it's job, and I have been missing it's benefits to the extreme. The doctor made it clear to me that if we didn't make a way to pay for this (this in no way benefits the doctor directly), it would be possible that my body could respond by declining into adrenal insufficiency (Addison's Disease). I'm only one step away from that point. So, we will begin treatment again, which will hopefully & prayerfully help with my energy levels once again.

Regarding the above - For those of you who do not know, my body is under so much stress from the severe chronic pain that it has been unable to reproduce the hormone that is responsible for responding to stress (adrenal glands). When this happens, the body goes into a form of adrenal fatigue. In my particular case (as I mentioned), I have adrenal fatigue stage III as well as chronic fatigue syndrome (CFS). For anyone who thinks they can relate to CFS due to a lack of sleep for one or several nights....it's not the case. CFS feels like you just woke up from a full night's sleep, yet you are dog-tired. You have REM cycles all day with your eyes open. You want desperately to sleep...to take a nap, but you can't fall asleep. I thought I could relate to "fatigue" in college, especially when we would pull "all-nighters" studying in preparation for finals. Only now have I realized how untrue that is. These last few weeks have been the roughest, especially when one has to care for children. I'm lucky there is a bed in the playroom. ;) 

I also have had increased pain levels, but we (my Dr. and I) are in agreement of hanging on until nerve ablation (bilateral) this coming Wednesday (October 15th) and praying that the nerve ablation will target all of the nerves that are triggering the severe pain in my sacroiliac (SI) joint. Thank you in advance to Felicia Waugh and Rebecca Owen for helping me get to and from my procedure as well as taking care of the boys! This will be a radiofrequency nerve ablation, which burns the ends of the nerve roots using Teflon-coated needles and high levels of electricity. The nerve roots grow back and pain relief lasts anywhere from 3 months to 1 year. The procedure itself will take place while I am under general anesthesia and each side/joint will take approximately 45 minutes to locate the nerve roots, verify the correct needle placement, and burn each nerve root individually. PLEASE pray with me that I can get a decent level of relief from this. I do know that no matter the situation, God is in control.

We also talked about the insomnia issues. I have had more issues lately falling asleep, which much of it is due to the lack of treatment of CFS for the last month or so. Once that resumes, falling asleep should be a much easier thing. Thinking of spinal surgery and everything leading up to it probably doesn't help things right now, but I am trying very hard to put this all in God's Almighty & Sovereign hands.

Once again, thank you all for your prayers and support. You are loved and appreciated more than you could every realize!