Nothing could have prepared me for the next several days. All I knew was that I was going to get a neck surgery, recover for a few days, and finally prepare to go back to Canada. We explored various options to return home, including an air ambulance. We communicated with my family doctor and a neurosurgeon at St. Michael’s Hospital in Toronto so I could have a bed ready for me when I arrive.

Cervical spine surgery

Although I would obviously be asleep for the procedure, I was quite nervous leading up to the day. There were a number of things that could go wrong – permanent nerve damage or paralysis being some of them. My neurosurgeon was top dog though; he never once had a case of paralysis from 30,000 operations in all his years in the OR. I was nevertheless uneasy about it. I began fasting by midnight on Tuesday, which meant absolutely nothing to eat or drink until the surgery. My husband was the sweetest and joined me in my fast. Would you want someone eating beside you if you were starving?

And starve I did. I just slept it off and watched a few episodes of MasterChef Canada as I waited to get called down for surgery at around 2pm. Transport services arrived and down we went to the operating room. My husband, my mom, and I waited in the waiting area for quite some time, talking to several nurses and doctors before we actually saw my neurosurgeon. He went through the procedure with me for the nth time and I signed the consent forms.

I’m joking.

I was undergoing a posterior spinal fusion operation with wiring. The goal was to fuse my C6 and C7 vertebrae into one solid bone in order to stabilize my spine after all the fractures and dislocations. This stabilization was particularly important as I did not injure my spinal cord. Stabilizing the spine surgically would protect me from spinal cord injury during the healing process. As for C5, we were to let that heal on its own as I wore the halo (no surgery needed).

In a posterior fusion, a bone graft taken from my hip would be placed on the backside of the vertebrae. During the healing process, the vertebrae would grow together, creating a solid piece of bone out of the two vertebrae. Wire would be added to hold the bones rigidly together as they heal.

I was wheeled to the operating room. The nurse talked to me for a bit before the anaesthetic was injected. She asked, “Are you relaxed?” “No,” I said. I was out soon after that. That was the last thing I remember.

I was probably positioned like this.

Instead of taking three hours, the surgery took five. It felt like taking a really long nap in the afternoon. To my surprise, I woke up with a thick, ribbed tube being pulled from my throat! IT WAS THE WORST FEELING EVER. At the same time, a nurse was yelling in my ear, “Are you in pain? Are you in pain? If you’re in pain, press the button!!!” There was a little button in my hand. I saw my husband and my mom. I felt hazy. The nurse kept shouting at me, like she was practically begging me to push the button. “Press the button if you’re in pain!” I thought, OKAY FINE, ANYTHING FOR YOU TO SHUT UP!!! Though I wasn’t in pain, I pressed what I didn’t know was a PCA (patient controlled analgesia), a button that allowed me to get small doses of Dilaudid through my IV. She shut up, thank God.

We arrived in my room. My relatives were there too. I already felt my mom wanting to ask me a billion questions with my relatives, but I just needed some time to chill. My neck and hip were just cut open, after all. I asked my dad, “Pwede ‘wag maraming tao?” (“Can not many people be here?”) He understood I needed to be alone with my husband. I was incredibly thirsty and hungry and he gave me some water and fed me jello. We chilled out for a bit until I felt okay enough to receive visitors. He broke his fast before I finished my surgery.

My hip hurt. I couldn’t move in my bed. I was sore all over. It didn’t make sense – I barely moved the entire day! I just accepted it and went to sleep. Surprisingly, my right shoulder wasn’t hurting anymore. I thought they numbed it during the surgery because I was complaining about the pain so much (I don’t know???) but they didn’t. It was genuinely gone. It turned out that bone fragments from my fractures were sitting on some nerves, that’s why it hurt much more when I began moving around more. The surgeons simply removed these fragments (think of them like glass shards), virtually eliminating the source of my pain. It felt miraculous.

Check out the wire at the back of my neck here.

I had to get up and moving the next day, even though it was hard and it would probably hurt. It wasn’t so bad. We didn’t do four laps around the hospital floor at least three times a day like before, but I was able to get out of bed and walk down the hallway a few times. Probably good enough for the first day post-op? Getting in and out of bed still sucked.

My husband and I were hanging out in our room when my orthopaedic surgeon came in. Random? He never came and saw me since the accident. I had some X-rays between now and then to monitor the fractures in my left arm. Apparently the fractures were being slowly displaced. He needed to operate on them and put a braces for stability. “When?” I asked. “Tomorrow,” he said.

COME ON, I just had surgery yesterday, I thought. “Can we do it on Friday???”

“I don’t do surgery on Friday.”

Left arm surgery

Back to the operating room I went. I was there so recently that THE NURSES EVEN REMEMBERED ME (to be fair, you’d remember someone with a halo too). I remembered some of them too. “Oh, you’re here again!” Yup.

I guess it was much of the same pre-op procedures. Nurses, doctors, consent forms. Falling asleep.

When I woke up, I was lying flat on my back. I didn’t even know I could possibly tolerate that in the halo. I felt the pain in my arm instantly. If you just had titanium plates and screws installed in your arm, you’d be in pain too.

arm7may

I immediately asked for Dilaudid from my recovery nurse. It helped, but only for a little while. I got shots every five or ten minutes. It felt like an eternity before I returned to my room.

That night was, hands down, the MOST PAINFUL NIGHT OF MY LIFE. I was on a mix of Percocet and Dilaudid throughout the night. I barely slept. Oh yeah, I was ALSO dealing with the pain from the back of my neck.

The pain in my left arm eventually subsided. The pain in my neck and head remained constant throughout my hospital stay though. As if this wasn’t enough, I had experienced another kind of pain and discomfort that week.

C. difficile

My uncle came to visit on Friday afternoon. He brought us some Filipino food, like pancit and Jollibee. I ate chickenjoy for dinner – its crispiness and oiliness were so comforting. Later that night, my stomach started feeling uneasy. I went to the bathroom numerous times… with diarrhea. Wonderful. My shoulders were too weak from my neck surgery a few days before that my husband had to take on the glorious task of wiping me. Now that’s true love.

I also kept burping uncontrollably the next day. The entire day. My nurse thought I had symptoms of C. difficile, a highly infectious colon disease, but she was not convinced. My stool apparently didn’t “smell like C. diff.” Okay? My stool was nevertheless sent for testing. The results came back the next day, and lo and behold, I had C. diff.

Clostridium difficile is a bacterium that causes mild to severe diarrhea and intestinal conditions like pseudomembranous colitis (inflammation of the colon). Most cases of C. difficile occur in patients who are taking certain antibiotics in high doses or over a prolonged period of time. In my case, I took a lot of antibiotics from my two successive surgeries. Some antibiotics can destroy a person’s normal bacteria found in the gut, causing C. difficile bacteria to grow. When this occurs, the C. difficile bacteria produce toxins, which can damage the bowel and cause diarrhea. However, some people can have C. difficile bacteria present in their bowel and not show symptoms.

C. difficile bacteria and their spores are found in feces. People can get infected if they touch surfaces contaminated with feces, and then touch their mouth. Healthcare workers can spread the bacteria to their patients if their hands are contaminated. I was immediately placed in isolation, meaning everyone had to wear complete protective gear when entering my room and be extra vigilant in washing their hands.

But without the hair net.

Symptoms include watery diarrhea, fever, loss of appetite, nausea, and abdominal pain/tenderness. Amongst these, I mainly had diarrhea, nausea, and abdominal pain. Needless to say, it wasn’t fun.

At every meal over the next few days, I would eat as much as I could before having to go to the bathroom. This certainly was not ideal at the time, since my body had to get as much calories and nutrients from food to heal itself. My stomach was in pain for much of the afternoon and I would just try to sleep it off. One morning I was eating breakfast with a chocolate-flavoured Ensure… and minutes later, I vomited all my Ensure. Luckily I was sitting down and my halo vest wasn’t ruined like on my second day!

I just needed to be treated with another kind of antibiotic, but it made me nauseous as a side-effect. So, I took some anti-nausea medicine too. I had to take them both for 14 days, the time it would take to re-establish the normal flora in my gut.

So much for going home?


Sources:

Clostridium difficile (Public Health Agency of Canada)

Posterior Cervical Fusion (University of Maryland Medical Center)

Advertisements