Back to our story! We last left off here.

As I discussed with my neurosurgeon at my appointment, my husband and I went to St. Michael’s Hospital in Toronto bright and early on a chilly Sunday, August 30th. We went to the emergency room and found a few people ahead of us – an injured paramedic, a (likely) drunkard, and a limping man in his 30’s with what seemed to be a broken ankle. When my turn came, I told the nurse of my “arrangement” with my neurosurgeon, Dr. J. Dr. J was supposed to have told the nurses here and his residency team what the plan was for me, since he was not around that day.

This day involved a lot of waiting around within the banal confines of the hospital. Luckily my husband and I both brought books to keep us from going insane.

I WISH I HAD STICKERS

After some time, we were called and led to an examination room where we met Dr. I, a young bearded man no older than 30. He was probably just a bit older than us. I told him everything, and didn’t cry this time! I was placed on a waitlist for my surgery, meaning I would go home and get called for surgery sometime in the next three days. I would have to go to St. Mike’s immediately for surgery that morning or afternoon, depending on when there would be a free spot in one of the operating rooms. It was indeed an awkward arrangement, but it was the only way I could get the surgery right away.

Dr. I arranged for me to get my CT scans and X-rays, so their team would have a recent set for the surgery. It took around an hour and a half to get them all done, though the scan themselves took only two minutes each. The rest of the time was spent walking to the CT scan and X-ray rooms, and well, waiting.

After my X-ray for my left arm, we weren’t sure what to do so we just waited for Dr. I to come back to release us home. When he returned, he said that he spoke to Dr. J and Dr. J thought it would be best to admit me to the hospital right then and there. My husband and I took it as a good sign, that perhaps I would get the operation as soon as tomorrow. Arriving the night before (Saturday), my husband was in town only until the following Tuesday afternoon. He was able to request a few days off from his work in the Canadian Arctic, of all places, for my unplanned-but-planned surgery. To get to and from work, he needed to drive eight hours from the province of Québec and then take a plane up to the northern territory of Nunavut. Words cannot express my gratitude to him for being with me during this time. Since there was no telling when the surgery would happen, I hoped that it would happen before he needed leave on Tuesday.

We were led to a fairly spacious ward with six beds separated by curtains. There were two other patients waiting, a man with a broken back and another with a broken arm. Both were in terrible, terrible pain. I just needed to lay down because my shoulders were fatigued from wearing the unwieldy Minerva jacket… I guess I had it pretty good?

And then the waiting continued. We couldn’t help eavesdropping on the other patients in the ward. The man with the broken back had quite the story. We soon felt hungry and my husband went to get shawarma, one of my favourite meals. I would be fasting starting midnight that night so I made that day’s meals count!

We were a third of the way through our meal when the nurse told us that a room had opened in the Orthopaedic/Inpatient Mobility floor. And off we went upstairs, bags of takeout in tow! I probably still had bits of parsley in my teeth from my tabbouleh salad.

Day 1

My nurse that afternoon was named Joseph. He was Filipino too, so we completed the patient intake questionnaire speaking in Tagalog. My nurse assistant was Filipino as well, and she gave us a small box of toiletries (toothbrush, toothpaste, etc.) and a pitcher of water with cups. (I wasn’t the least bit surprised that 30% of the nursing staff here was Filipino.)

I shared a room with an elderly Chinese lady. There was only a thin curtain separating our beds, but I got the window side with a nice view of St. Michael’s Cathedral. Her family was visiting at the time and they all spoke either Mandarin or Cantonese.

Evening soon came and I had a lovely hospital dinner of turkey meatloaf with green beans (seriously, it wasn’t bad), plus some leftovers from my shawarma plate. At some point my mother-in-law arrived with the bag of clothes and toiletries I had prepared for the hospital. Another one of Dr. J’s orthopaedic residents also visited me to explain what the surgery entailed, allow me to sign the consent forms, and entertain any questions I had. An anesthesiology resident came by to do the same.

Visitors could only stay until 9:00 pm so my husband had to leave. It felt strange that he had to leave me there, as he was with me 24/7 in the hospital in California. I stayed up reading and listening to Serial until 11:00 pm when I ate more food to stock up for my midnight fast. I slept fine, except that my roommate kept wailing in distress. No one could understand her because she didn’t speak a word of English, except for poo-poo, pee-pee, and thank you 😕 Her resident came by and told her she was going home in the morning, and she didn’t even understand him.

Day 2

At 5:30 am a resident by the name of Dr. C, a Chinese man around my age, woke me up to perform a quick neurological exam and explain what the plan was for today. “You’re still on the waitlist, maybe the surgery will happen today,” he said.

I drifted back to sleep and woke up dying of thirst. I was permitted to eat only ice chips in the morning so I downed all that I could handle. By 10:00 am my husband arrived to keep my company. I walked around the hospital floor to get some exercise, but my husband said that it was probably not a great idea to use up calories since I wasn’t eating or drinking anything at all. It was so annoying dragging my clunky IV machine around (my bodily fluids needed to be replenished somehow). It also kept beeping with the slightest clog or fold to the line, which made it even more annoying.

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The dastardly IV

12:30 pm rolled around, and then began an unexpected stream of visitors who had come from their lunch hour! I knew my mom was coming to see me, but not the others. First it was my mom’s friend Tita Tere, then my mom and her friend Tita Jopen came from their offices downtown. It was the first time I saw my titas again since this lunch we had after our wedding. My friend from university, Karen, arrived a few minutes after my mom and Tita Jopen. Tita Tere gave us a book of jokes which my husband read from time to time. Sweet Karen gave me some awfully nice presents – some Archie comics, Sudoku puzzles, coconut water, and that month’s Food Network magazine!!! (Side note: My brother and I saw a mouth-watering lemon bar on the cover of this very issue while lining up at the grocery store, creeped the recipe right then and there, and dashed to get the ingredients to make them at home! They were delicious!)

Their visit was a welcome treat for me. Before they left, we all said a meaningful prayer together led by Tita Jopen.

My husband and I walked around the hospital floor shortly after they left to get some “fresh” (i.e., non-room) air. We did perhaps two laps around the maze that was the fourth floor of St. Mike’s, when we saw Felix, our friend from the industry, at the nursing station with a small pot of red flowers!

Though we talked about it via Facebook, I didn’t expect that he was coming that day. We last saw him in March at PDAC, but he had seen my Facebook updates about our wedding and untimely accident. We had a wonderful time catching up.

After we received our visitors, I began to wonder what the deal was with my surgery. I was so thirsty and hungry and I just wanted to get it over with. Unfortunately there was no sign of me getting to the OR that afternoon. I just slept to get my mind off how famished I was. Oh, and my husband actually fasted with me! Like in my first surgery, he did it out of solidarity as he didn’t want me feeling alone in this arduous endeavour. He’s just awesome like that. Both his mom and I forced him to drink water at least, but he stubbornly refused.

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Waiting… with a view!
Removing my nail polish for the surgery
Removing my nail polish for the surgery

What a long evening it was. Since Sunday, my parents and mother-in-law kept texting and calling me EVERY FOUR HOURS to ask me if I got any news about the surgery. Nope, not yet, I don’t know yet, I would reply. I knew that if the nurse hadn’t informed me by 7:00 pm, the surgery would definitely be a no-go, since they didn’t perform surgeries after 10:00 pm. I counted down the hours. Four more… three more… two more. Ugh. My husband and I both fantasized about our impending meal. I couldn’t eat or drink until my nurse confirmed 100% that I wouldn’t get the surgery that day.

And that didn’t happen until 10:00 pm.

Because my husband was not permitted to stay later than 9:00 pm, we asked the nurse if he could stay a little while longer and bring me food. He hurriedly went out to get Indian food for us – samosas, biryani rice, and chicken curry! While waiting I replenished my electrolytes with the coconut water from Karen.

Ravenous since morning, I ate my fill until 11:00 pm. I took a break and ate a bit more until my midnight cut-off time. Then fasting began once again…

Day 3

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Good morning!

And so began our third day waiting for my surgery on an empty stomach. My husband duly arrived at around 10:30 am.

I hadn’t showered fully since Saturday. While I could gave myself a sponge bath in the days that passed, my hair was getting so oily and I needed a shower. Because showering in the Minerva jacket is a cumbersome process in and of itself, needing at least an hour to dry the brace, my nurse didn’t allow me to shower as I could get called for surgery anytime. Sigh.

At long last, I was called for my surgery at around 12:30 pm. I told everyone who wanted to be in-the-know, including my parents and mother-in-law. My dad said he would go to the hospital at once with my siblings.

Transport services fetched me in my room and wheeled me to the pre-operating room. There my husband and I waited until doctors and other personnel gave me more information about the surgery. I have to say, the staff at St. Mike’s is just incredible. They surely keep their patients informed and well taken care of.

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Before getting wheeled off to the OR

It was a Tuesday afternoon, September 1st. I underwent a procedure called multi-level ACDF, or anterior cervical discectomy and fusion. The surgical team was to make an incision in the front of the spine through the throat area. By moving aside the neck muscles, trachea, and esophagus, my damaged vertebral disk and bony vertebrae would be exposed.

The damaged disk between the C6 and C7 levels was already removed, polished off, and replaced with a spacer bone graft in my previous surgery done from the back of my neck. Unfortunately the bone graft (taken from my hip) didn’t grow fully, resulting in non-union of the C6 and C7 vertebrae. This is why I had to get another surgery.

Because I already had surgery done from the back, there was no choice but to do this one from the front (i.e., anteriorly). Another bone graft from my hip would be placed in the same area, along with some artificial bone. A plate with screws would also be installed from the C5 to C7 levels in my neck to stabilize them while fusion occurs.

I was told that the surgery would take two hours.

Off I went to the OR. The entire surgical team greeted me and then one of the lead surgeons briefed us to ensure that we were all on the same page. He confirmed my name, age, condition, and procedure. Shortly after, Dr. J came into the OR, looking rushed and carrying a backpack over his shoulder. We were to begin soon. I hadn’t seen him since our appointment two weeks ago. Of all my concerns, a pressing one at the moment was when I could go to Québec City to be with my husband. He said, “Maybe after the second follow-up, in four to six weeks.” Okay, that was what I expected.

Then the anaesthetic was injected and I was gone.


Source:

ACDF surgery, Mayfield Brain and Spine