Saturday, August 4, 2018

Posterior Lumbar Fusion (October 18, 2017)

It's Surgery Day!!!
October 18th, 2017

Hey all! First, let me thank every one of you for your prayers, love and support. You are all amazing, and I'm blessed to have you in my life. Now, about the surgery - God blessed us with a gifted surgeon with gifted eyes and hands especially. He had planned on going in and needing to do a fusion of the spine at levels L4, L5, S1. This would involve going in (via open surgery) and replacing the displaced and damaged discs at these levels. He also planned on reinforcing the bone-harvested discs with screws and rods. He did NOT have to use the screws and roads, and said that things were cleaner (on the spine) than what appeared on the MRI, and they did NOT NEED TO USE HARDWARE! (Talk about little miracles from our Creator Above!):D :D :D They did, however, do a lot of bone-work as they "cleaned" (drilled at and through the bone) the area of the growths from the stenosis, arthritis, and bone spurs. They did perform a complete spinal fusion at L4, L5, and S1 using discs that are harvested and then impregnated with bony growth tissue from the damaged bony tissue that was removed due to the stenosis, arthritis, spondylosis,etc. (they had to create spacing for those discs). That will eventually turn into solid bone from the L4 down to the S1. My pain is less than it would be on a really rough day (which is a lot, granted, but amazingly good for just having had a spinal fusion procedure). We are praising God for His over-abundant blessings, and praying our way through today and tonight especially! My God be praised!

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Update on Recovery from Posterior Spinal Fusion
October 30th, 2017

Hello sweet friends! Thank you SOOO much for your prayers! God has performed a miracle through this surgery, and not to mention my recovery has been smooth-sailing for the most-part (I will go into details later). I don't feel at all like I had surgery, and I'm getting around better than before surgery. The difference is that I have to be careful to not bend, twist, etc. for the next 3 months (time frame for the new fusion to form completely). We've also had an amazing support system through our family, friends, church and a few ministries, who have generously prayed over us (whether in secret or known), given financially, taken care of childcare (spoiled my kids...hehe), building a ramp for our house, stocking up on freezer meals, AND bringing us hot meals for dinner for these past 7 days. I've been doing so well that I told our friend in charge of hot meals that since we are actually doing fantastic and better than expected, we feel we no longer need the hot meals provided, although it blessed my stomach (and my heart). ;) We can't say thank you enough to all that have shown your love for us! God has genuinely blessed us through your willingness to joyfully serve Him by serving others. Thank you!! All Glory to God for all that He has done!

PS - As you read, keep in mind that we went into surgery expecting a certain method/procedure, unless we were the minority of cases where he would amend the plan after opening me up on the table and exploring the spine. They changed our plan of surgery completely (which I was ok with, I trust my surgeon completely, and moreso, I trust the ultimate Surgeon and Physican - our Healer; God had a plan for all of this, and I was at complete peace that I was in His sovereign hands). Well, we were one of those minority of cases where the plan of surgery was amended in the OR. So when I woke up from surgery and saw the hubby, I got the first report about the surgery. Because the plan was amended, I didn't know the details of the procedure, and was left filling in the blanks. If you know anything about me, you probably know that I love to know details about health issues (each step of the process). So my post on Oct. 18th (below) was what I understood simply from my husband's 2nd hand report from talking with the surgeon (my husband also isn't as curious as to the details of things like a surgery - not a bad thing - just different from my personality, so I assumed a lot of what he didn't say was simply part of the originally-planned procedure). SO, I now have the correct details on my surgery. ;)

PPS - I like to go into details, as there are many that follow my page that go through similar circumstances and benefit from learning different methods of treatment for pain management. I tried to explain as best as possible. Please feel free to contact me further and ask questions if you need more details on the procedure.

I had a three-level lumbar spinal fusion performed, but it was achieved with a completely different method than our original plan (original plan - a posterior lumbar INTERBODY fusion / PLIF). I AM fused at the L4, L5, SI levels via a posterolateral / posterior lumbar spinal fusion (PLF; no INTERBODY / hardware was used; also known as a Fusio facet joint spinal fusion & Nufix facet joint spinal fusion). The PLIF (originally-planned) surgery focuses on fusing the vertebrae and reinforcing the spine with hardware at the site of the fusion. The amended fusion (PLF - no INTERBODY) focuses on the fusion of the posterior spine along the facet joints. The benefits with the amended surgery is a slightly shorter recovery time, all with the same (overall) result as the PLIF, in that both would achieve a full fusion of the desired joints. The recovery time for a PLIF is 3 years, and the recovery time for a PLF (amended surgery) is approx. 2 years. And for me, I was thrilled when I heard that they didn't have to use hardware! Medical science and technology amaze me.

For the facet joint spinal fusion (PLF; the amended surgery), the Dr. first performed a laminectomy (trimming excess / bulging / herniated discs, which I had at all three levels). This procedure was performed on the front side of the spine (spinal cord had to be pushed to the side in order to access the area). He then moved to the posterior side (back) of the spine, which is easiest to access, and began the fusion procedure. He cut back (a great deal) my facet joints (posterior spinal bone) at all three levels in order to give the nerves more room, and therefore better pain relief. The trimmed bony tissue was collected and harvested to be used in the fusion procedure, which was mixed with an agent to encourage quick bone-growth. Trimming down the posterior spinal bone (facets) also remedied several issues I had developed, including severe spinal and foraminal stenosis, severe spondylosis (abnormal bone growth and bone spurs - the Dr. said I had countless bone spurs, which he took care of), and arthritis of the spine (which also caused several nerves to be compressed {pinched}, as I mentioned previously).

I have to be extremely careful to avoid bending, twisting, and lifting in order to allow the bone growth to strengthen and become complete. This takes approximately 3 months on average. My back brace must be worn at all times during this 3 month period (except for resting in bed), which helps avoid any strain, bending, or twisting.

So how is my recovery progressing thus far? I have been doing MIRACULOUSLY-well! All glory goes to our Lord and Savior and ultimate Healer and Physician!! I praise God for leading us to this surgeon and for giving us the gentleness to yield without frustration to the changes made in surgery. As of day 1 of recovery, I was walking normally, without change in my "normal" gait (I do limp slightly). The pain associated with this surgery has been the least amount of pain I've felt with any surgery I've had (including my spinal cord stimulator implant - the worst pain I've had, and the bilateral sacroiliac (SI) joint fusions - the longest recovery I've had). I likened the pain with this surgery to a rough day with my pain levels. For a spinal fusion, that kind of pain is nothing compared to what most people experience. I've never heard of anyone with anything less than miserable or intolerable pain levels with a spinal fusion within the first few days of recovery to the first week. In my view, that is simply a miracle of GOD!!! "Taste and see that the LORD is good! Blessed is the man who takes refuge in him" (Psalm 34:8).

We had a slight complication from surgery, which is a subdermal hematoma (also called a seroma) that developed at the sight of surgery (underneath the incision). It is continuing to drain, which is actually beneficial, and we are praying that it will heal on it's own and not require surgical intervention (if it does, it is not a big deal at all, and is actually quite a common complication of surgery). Since it is draining, the signs are that it will heal with time, praise God!! The Dr. is monitoring it closely for change, and feels that the odds are it will heal naturally.

For the best results of the fusion, I am encouraged to walk as much as my body can handle without pushing myself too far. I have been walking daily (without assistance from adaptive equipment, thus far), and have had minimal pain from this simple exercise. Pressure and weight on the bones encourages bone growth. There have been a couple of days (only) that I have had rough pain levels and unable to do my walking exercise. I still need my crutch for long distances, and if I stand for an extended amount of time, I am still bringing my wheelchair with me and either pushing it (using it as support and walking) or sitting and rolling in it (I usually alternate evenly between using it normally or sitting and pushing the chair while using it as a support while walking).

I am praying that with time, I will be able to gain enough strength and pain relief to walk unassisted all-together. I know I am in God's precious hands, and that healing can sometimes take time. My Dr. has said time and time again "don't over-do" when I tell him how well I am doing. I have to remind myself of that. My body has been through much trauma following surgery, and time will bring healing. Many don't understand that. They think that one surgery should heal it all - get rid of the wheelchair, the crutch - when healing doesn't come quite that quickly, nor does one surgery necessarily heal all (I have over 40 diagnoses of my spine and lower extremities, including autoimmune and chronic pain disorders), although I pray and believe in the possibility that God can heal me if He wills, and I certainly pray that is the case this time around, yet I yield to His perfect and mysterious and unknown will.

I have been so uplifted by the miraculous results I am seeing during my recovery! PLEASE CONTINUE TO PRAY:

1. ...that my body will respond well to the fusion and that the fusion will "set" in the best position possible for my pain relief and the fusion complete itself over these next 3 months.

2. ...that I will be able to come off one, if not several doses or completely off several of my medications.

3. ...that the seroma / hematoma would heal naturally and not require surgical intervention.

4. ...that this is the miracle we've been praying for, although I trust my Lord in His precious will and sovereignty for whatever He has planned.

5. ...that my recovery will continue to move forward (current home therapy, which is walking daily for next 3 months; future physical therapy, which will begin in 3 months; complete fusion, which should "set" {be completely fused} in 3 months).

6. ...that I will continue to have the positive energy to homeschool the boys during my recovery (we took several weeks off for surgery, which is the beautiful thing about homeschool, as we homeschooled through the summer, and we are starting back this Wednesday; pray I will have the positive energy and motivation to plan lessons and activities, etc.).

In closing, we once again want to THANK YOU SO VERY MUCH for your prayers, love, support, and servitude. Rence and I have been touched by the outpouring of support we've received during this time. For all that have had a part in positively effecting our lives during this time (including our prayer warriors), we can't thank you enough! We pray God's blessings upon you, and praise God for His touch on our lives through you. Thank you & may God's blessings be overflowing for you and yours!!

With love in Christ,
Beth Anne (& Rence) Cochran

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Recovery Update & A Happy Thanksgiving!
November 23rd, 2017
Happy Thanksgiving, sweet friends and family! There is always so much to be thankful for, without doubt in overabundance. We give God all the glory for working in our lives in such an incredible way. I remember this time every year, looking back at where God has brought us in that year's journey. No doubt, Rence and I have been tremendously blessed with the people we've interracted with - our church family (past and present), discipleship groups, chronic illness ministry and those who helped us get there, the preschool ministry at our church, and even my sweet friends I've met through prayer groups. We are especially grateful for our families. In some way or another, every one of these precious people have helped us meet our needs by acting on God's calling to serve, when he leads you to do so. Because of God's faithfulness to place such wonderful people in our lives, He has always, always provided for us - even when we had the greatest needs, whether they be spiritual or physical needs. We know these friendships are a treasure, and we truly pray God blesses you in accordance to the measure you have blessed us.

We are especially grateful for God's healing hand. My progress following surgery has been incredible, which we attribute to nothing less than a divine intervention from God alone - my Jehovah Rapha! We are continuing to pray and believe that my precious Physician Above has a perfect plan for my health both in the near and distant future, and we are relying on Him to continue guiding us on medical decisions in the near future if they come. We praise Him for the amazing work of healing we are seeing in this fragile and temporary body.

An update on how I am feeling physically:
My updated progress from laminectomy, facet reductions, and posterior facet spinal fusion via pre-grafted bone screws (screws comprised of bone - no metal hardware!), L4, L5, S1 as of 2 months post-op (has it really been 2 months already?). My most recent post-op appointment was at 6 weeks post-op. I had staples removed, had the seroma checked, and had x-rays to check on my progress. The x-rays looked great and showed that the 6 facet joints that are reinforced with the pre-grafted bone screws (screws comprised of bone) are holding strongly in place. Within the next month (3 months post-op), the fusion of these joints should become solid (although fragile). I also thought that I would be back-brace free at 3 months post-op, but my surgeon wants me to wear my brace consistently for at least a year. I've had more pain lately than normal, but pain-wise, I'm still managing fairly well overall in my recovery. We are praying that I will be able to continue coming off my medications, one by one. This is a lengthy and difficult process, as I've been on most of these medications for at least 10 years (onset of my issues was at 15 years old - 15 years ago); even so, I've had success with coming off 1/4th of my medications already, which again shows God's mighty hand in the midst of our situation. There is a way to go yet, but we are very hopeful in the entire situation and feeling confident in what our Lord deems fit for this and the next steps in our journey in this great mission of life. In the good times, in the rough times, may our God and Savior continue to be praised for all He is and all He has done and will continue to do! Hallelujah!

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2 Month Post-Op Visit
December 21st, 2017

Today was my 2 1/2 month post-op with the spinal surgeon, and everything looks beautifully on-target as far as healing and bone growth. The placements of the bone-comprised screws (grafts) show basic and solid bone growth (in the beginning stages - it will continue to grow and strengthen greatly in the next 9 months). In other words, my facet joints are now interlocked bilaterally (on both sides of the spine) and are now one solid joint from the L4 to the base of the spine. Also, Dr. Jones performed a partial (L4/5) and a complete (L5/S1) laminectomy (removal of the protruding and/or affected disc) - the partial laminectomy has relieved a lot of numbness and tingling in my feet and legs (amazing!) and the complete laminectomy has allowed for the two vertebrae - the L5 and the S1 to complete the process of auto-fusing (a natural fusion process, helped along by Dr. Jones removing the affected L5/S1 disc). The trimmed-back facet joints have also made a massive positive impact on my pain levels! I'm still recovering, still on restrictions, still required to stay in the brace 24/7, still needing rest, still taking it slow, still having pain (as expected, but nothing in comparison to the pain I was in before surgery), but most importantly still 100% blessed to be on the road to recovery. God uses every situation, every ounce of pain, every teardrop, every laugh, every shout of joy....but only if we allow Him. Nothing is wasted in God's Kingdom. <3 May glory "rain" down on you this Christmas!

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6 Month Post-Op
March 13th, 2018

Today was my 6-month post-op visit with my surgeon. He took the standard post-op x-rays and everything looks fantastic! I was quite relieved to be honest, as I've had a lot more pain in my lumbar (to a worrying extent), and I wondered if I had dislodged on of the "wedges" of bone graft that is placed into my facet joints. He advised me to continue taking care in how I'm doing things to avoid damage to my back as it continues to strengthen, and asked to see me in 6 months. Praise to God for great progress!

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