April’s Surgery

Hello all,

This is Neil, April’s husband.  April wanted me to give an update on her surgery and post-op status.  Bare with my writing, I am not sure I will be as stylistic as April.  So with that being said, I will give you an update and in accordance with April’s wishes, NO SUGAR COATING!

First off she is fine.  She is healthy and doing well.

Here are some pre-op photos below

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Now here is the breakdown of what I know about her surgery: Incision was at 8:30am and she came out of surgery and headed to the ICU at 7:05pm.  During her surgery she lost 7000cc of blood, this is 7 liters. Her body only holds about 5 1/2 to 6 liters of blood.  So most of you are wondering how this is possible?  First of all, she did not just lose 7 liters straight away. She bled for hours during this 11 hour operation.  So as she was losing blood, the anesthesiologist was replacing her blood in a couple different ways.  One way was to give her back her own blood using what is called cell saver.  A cell saver machine is hooked up to the operative suction and basically spins down her lost blood and then they process it and give it to the anesthesiologist to transfuse. April was given back 1200cc of her own blood.  On top of this she was given 10 units of red blood cells (RBC), 8 units of fresh frozen plasma (FFP), 2 units of platelets, 5 units of cryoprecipitate (CRYO, this increases fibrinogen which is what helps your blood form clots), and a couple units of albumin (this is the main protein in blood plasma) and each unit is about 325cc of volume.  This is a lot of product to put into someone’s body, and all of this volume caused some major swelling throughout April’s body.  Since she was prone (laying face down) for several hours the majority of the swelling was in her face and surrounding areas.  Due to the large amount of blood loss and swelling April went straight to the ICU.  Since she was so swollen in her face and throat April was kept intubated and asleep over night.

Intubated in the ICU below

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After her surgery the doctor came out to talk to me.  I was a little freaked out because before I even spoke with the Doctor I had to watch my wife get wheeled down the hallway into the ICU intubated.  Some may know, but the majority of you probably do not know, that I work in surgery, so of course my mind was racing with all kinds of terrible thoughts.  Luckily about a minute after seeing her go down the hall her doctor found me and talked to me.  She said the surgery went well and she is stable and doing fine.  In my head I’m thinking “fine does not equate to intubated and heading to ICU.”    She said she had lost a quite a bit of blood (uh ya 7 liters is a lot) and she was really swollen and they wanted her intubated until the swelling came down.  Last thing you want to happen is to extubate a patient with a swollen throat and have it swell up cutting off their airway.  So I understood why she had to be intubated and stay in the ICU and I calmed down.  I see people intubated everyday for a living, but it truly was hard for me to see her like that.  The doctor also informed me that there was difficulty putting in her L3-L4 interbody and that ultimately they couldn’t put it in safely due to the location of her nerve root, but that the L3-L4 level was the least crucial of the three levels she needed.  The doctor did say though that April was corrected from about 80 degrees of curvature to now 30 degrees which is awesome, then there was a BUT.  But during the decompression part of the operation, this is where the bone that is pushing on her spinal cord is removed, they somehow hurt the spinal cord.  They know this because during this type of surgery April is connected to what is called neuro monitoring.  Little sensors are placed all around her body and these are connected to a computer that shows a read out of nerve and spinal cord activity.  When the cord was hurt, or damaged, or they just some how pissed It off, they got a reading saying that this area of the spinal cord was not working normally.  When the spinal cord reading finally calmed down, her levels were below base line.  They came back up but never reached where she was before surgery.  Basically this means the doctor was worried she could have spinal cord or nerve damage and they will keep on eye it.

April was extubated Wednesday morning around 8am.  She immediately noticed that her left leg felt funny.  She couldn’t feel her foot and toes on her left side.  She could move everything, but she said her left leg felt like a ton of bricks and was really heavy and hard to move.  Also, she was having excruciating pain in both of her legs all the way down to her feet.  The doctor said this was to be expected because of what happened during the decompression.  April was obviously very scared and didn’t know what it meant. The doctor explained everything, which did not make her feel any better but she at least had an explanation.  Since April was now extubated and able to talk she told me about her terrible early morning.  I was unfortunately not allowed to stay the night in the ICU, well I was allowed to stay as long as I didn’t sleep. I had been up since 4am and left her side around midnight and I was drained and needed to sleep so I found a hotel for me to get a few hours of rest.  When we finally were able to talk she told me how she was awake with the tube in her throat and was trying to tell her nurse that she had to throw up. She said she was banging her hands on the bed and table next to her trying to get the nurses attention and the nurse was just trying get her to calm down and relax.  She was panicking and scared of choking to death, so she was anything but relaxed.  She eventually wrote down on a piece of a paper what was happening, so then the nurse gave her anti-nausea medicine and some more pain meds.  Throughout the day April was fighting pain.  The staff was trying to control her pain but it was tough. April was moved to the Ortho unit in the early evening and has a nice private room thanks to one of the mothers of a student of April’s and we are very appreciative of her help and time. The night was real rough for April.  She woke up multiple times in shaking pain, but by this morning her pain has become much more controlled.

Being extubated

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This morning the doctor rounded on April and has become increasingly concerned about her leg.  She ordered an MRI to make sure nothing is going on and hoping it is just an angry nerve root or partially bruised spinal cord that will get better with time.  April today had a physical therapy session where the therapist got her to sit up and stand, even though her left leg is weak and she couldn’t feel the ground with that foot.  It was impressive to see her determined to stand and just grit and bare through the pain.  It is now 8 pm and we are still waiting for her to get an MRI.  So I will have to update again tomorrow.  Sorry this was so long winded, there was a lot of information and it’s not the easiest to explain.

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14 thoughts on “April’s Surgery

  1. Neil, thank you for the detailed update. I bet that was difficult to write. Especially to April’s standards! 😉

    I hope the MRI gives a satisfactory answer and that she continues to heal and feel better.

    Get some rest tonight!

    Liked by 1 person

  2. Thank you Neil for sharing April’s surgery and post-op with us. April you are so strong. My whole family is cheering for you and praying for you.

    Liked by 1 person

  3. The courage you both show here…incredible. Thank you for this absolutely unvarnished view of what April is going through. She is so lucky to have you at her side.
    I worked ICU for years as an RN and have seen all of this but…you write of it so that I feel that I understand the patient and family side of this in a new way.
    Thank you.

    Liked by 1 person

  4. Go April! 11 hours in surgery is no joke — I know because I’ve done it. And those first few nights are brutal, pain wise. But, I know you can do it. I’m saying a prayer that all resolves itself with this nerve issue. And hang in there Neil! This surgery is really hard on families too, so great job being cheerleader, giver of love, medical staff go-between, #1 supporter of April. You are in my thoughts and prayers, your scoli-sista, Marisa

    Liked by 1 person

  5. Praying for you April and you Neil. I pray you get stronger and stronger and your leg is back to normal. This broke my heart reading this. Stay strong mama!!!!

    Liked by 1 person

  6. Thank you for this great update. I’ve been thinking of you all. What a marathon for you.
    I recall in 1989 after my surgery that feeling of putting my feet down on the floor and not feeling it. Awful!
    You will both be physically and emotionally exhausted.
    Take care of yourselves and your babes and keep us updated. She will shock herself as to how much “grit” she has!

    Liked by 1 person

  7. Hi April,. I work in Pre-Op where Neil works. I wanted to let you know how impressed I am of you since your surgery… Your strength and determination. I am a firm believer in Jesus and I will pray for your full recovery because you need to get up on your toes and show your students how to dance. You are an awesome teacher (I saw your students in Alice in Wonderland) has much more to do for them. Go Scolimom, go😉

    Liked by 1 person

  8. Amazing! With tears in my eyes, you are both so lucky to have each other! April is a fighter & she will end up good within a few months, I am so glad she had the most amazing surgeon to do this job! Hats off to you both!! ( :

    Liked by 1 person

  9. I had similar surgery in January and I am doing well. I am happy to talk to you about my experience. Please let me know if you are interested.

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  10. Thank you for the update Neil! I’ve been thinking about you guys lots over this past week. Always amazed at the strength of scolio patients post op- the determination to walk, move, talk, its truly incredible to me. Go scoliomama you tough cookie you! Sending you guys more good thoughts and hoping the spinal cord bruising heals up fast. Much love.

    Liked by 1 person

  11. Praying for you guys. I hope everyday the pain gets better and more manageable. Your sure are brave. I don’t believe I could do it. Thankyou for updating us Neil!!

    Liked by 1 person

  12. Dear Neil and April,
    This all sounds amazing, terrifying and hopeful all at the same time. April is such a strong person! She is the perfect personality to make it through this scolio surgery as it is not for the faint of heart! Her strength and determination will see her through as will your support Neil. Take care of our friend, teacher and warrior!

    Maryanne Christoforou

    Liked by 1 person

  13. Thank you for posting about your experience. My 13 year old daughter, also a dancer, is facing the same surgery in a year or so. Your blog helps so much to know other families are dealing with scoliosis and what lies in our future. Stay strong and hoping you have a complete and speedy recovery. #bent not broken

    Like

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