12/06/2006

Laser surgery helps one patient back to her feet
By Betty Cianci

This is the second of a two part series.  Part I (The Courier 11/29/06) detailed Mrs. Cianci's need for back surgery and her decision to have it done by laser. This installment details her actual experience.

Day 1 - Thursday
The next morning Sal and I went to the institute for our appointment.  Everyone we met, from medical assistant to surgeon, was friendly and efficient.  After filling out the required paperwork, we met with one surgeon on my team.  He reviewed the lumbar area in my MRI films and showed us where my spinal cord had compressed and narrowed.  He told me I am one of the few fortunate people not suffering excruciating pain normally associated with this condition.

The laser surgery would "decompress" or clean the lumbar area of soft tissue (osteoarthrititis) taking pressure off my spinal cord.  The surgeon also pointed out bone spurs that had formed on my discs and would be removed by laser.  He told me I would be under light anesthesia, similar to what people receive during a colonoscopy.  I had the option of viewing the procedure on a monitor in the operating room. 
 
The surgeon ordered more in-house spinal x-rays to double check for possible hidden problem areas.  My husband and I were impressed with his thoroughness.
 
The staff provided us with a lunch of sandwiches, fruit and beverages.  Later we returned to the surgical suites where my x-rays revealed nothing new or unusual.  I received pre-op instructions and a prescription for a week's supply of antibiotics to be started immediately after surgery.  The institute arranged with our condo shuttle driver to take us to and from the pharmacy.
 
The accounting department then requested a check for the use of the operating room.  It is hard to understand why Medicare pays for the procedures and surgery but refuses to cover this expense.  The institute is state-of-the-art, cleaner and better equipped than many "approved" hospitals I have visited.

Day 2 - Friday
Our shuttle driver brought Sal and I to the institute early Friday morning for my scheduled surgery.  My husband stayed in the waiting room where he met patients and their families from all over the Unites States.  Most patients were awaiting post-op check-ups with doctors before returning home.  They conveyed to Sal how pain-free and well they felt.  
 
I was taken to the pre-op suite and donned surgical garb complete with blue net bonnet to cover my hair and booties for my feet.  I was told to recline in one of the lounge chairs and the pre-op nurse put me at ease as she went over the process.  Next the anesthesiologist spoke reassuringly to me while reviewing my reports.  The nurse started the IV and told me an antibiotic had been added with a steroid to prevent nausea.  She mentioned my blood glucose count could increase but would return to normal within a few days.
 
With help, I was able to walk into the operating room where I climbed on the table and lay face down.  The nurses placed pillows under my head so I could comfortably view the monitor on the floor.  My surgical team consisted of two surgeons, an anesthesiologist, two operating room nurses and two physician assistants.  I was told anytime I wanted more anesthesia it would be administered.  I was then shrouded in sterile cloths with my back exposed.

During the operation, I had a brief moment of discomfort when I felt extreme lumbar pressure but it quickly abated.  When the monitor came on, I watched as the narrow pen-like laser cut away tissue that had entrapped and compressed my spinal cord. I chatted and asked questions of the operating room nurse in front of me.  She monitored my breathing and pulse rate while providing lemon-flavored glycerin swabs for my parched mouth.

The surgery lasted one hour and 45 minutes.  Afterwards I was wheeled into the recovery room and sat in another comfortable lounge, amazed that I felt no pain. My husband came in to stay with me and he was laughing.  He had been told about my "endless chatter" during the operation.

After a half-hour in recovery consuming ice chips I felt ready to return to our condo. 

A nurse walked me to the dressing room, helped me into my clothes, and the shuttle returned Sal and I to the condo.  After a brief rest, I thoroughly enjoyed a Greek salad and pizza.  

Later that evening Sal and I took a walk down the long hall to the lobby.  It was hard for me to believe I felt so well after undergoing major surgery that afternoon.

Day 3 - Saturday
On Saturday morning, when monitoring my blood glucose, I found it extremely high.   I also felt shaky and nervous.  I called the institute and was advised to track my glucose count throughout the day.  If the numbers did not drop, or if I felt worse, I was to call immediately.  As the day progressed, my count leveled off and my body calmed.  It was comforting knowing that help was always available.

That afternoon our daughter Jeannie and granddaughter Michelle flew in from Pennsylvania, picked up a rental car and came to the condo.  That evening we all went to an elegant seafood restaurant.  As I sat there enjoying my meal, again I found it hard to believe my surgery was yesterday.

Day 5 - Monday
My husband and daughter went with me to the institute on Monday.  My bandage was changed and a staff doctor examined me.   She showed Jeannie and Sal my incision which remained clean and dry.  She applied another small bandage and gave my husband a supply with orders to change the bandage every three days.  In two weeks my internist would remove the sutures and apply steri-strips (small bandages) to be worn until they fell off.

I mentioned my arthritic knee to the doctor who was concerned about the swelling and warmth.   She called a diagnostic clinic in downtown Tampa, arranging for an immediate ultra-sound in order to rule out a blood clot.   The clinic sent her a "wet reading" by the end of the day.  The ultrasound was negative.

After another delightful meal on the town, I went shopping with my daughter and granddaughter at the International Mall.  This is recuperating?

Day 6 - Tuesday
Jeannie and Michelle swan with the dolphins in Orlando while Sal and I returned to the institute. I received physical therapy and then released by the institute with a prescription for continued therapy at home.

Day 7 - Wednesday
Jeannie, Michelle, Sal and I boarded a morning flight to Philadelphia.  Jeannie and Michelle continued on to Harrisburg and we caught a flight home.

It has been 15 weeks since surgery.  My small incision has healed and my back is pain free.  I have completed my prescribed physical therapy but I will continue with aquatic therapy and gym for toning    Summing up my surgical experience - incredible.