FAQ

    Throughout this whole ordeal, I have gotten many questions (and repeat questions) from people about the basics. Here are a few of the questions I've gotten and their corresponding answers:

Q: Is the stimulator on all the time or does it just "zap you" every so often?

A: First of all, there is no "zapping" of anyone or anything at anytime. :) Kind of felt the need to clear that up. For me personally, I have this thing on all the time. I have the ability to turn it on, off, change programs and change any other settings by using my remote.

Q: What do you mean by "change programs?"

A: The fine people from Boston Scientific and I have worked together on two occasions now to set up 4 specific programs. Each program is different in what it feels like to me and where I am getting coverage. For example, at night when I am asleep I like to have it set on Program 4. Program 4 covers my entire right leg and has a pulse rate of 70 pulses per second. At 70 pulses per second it just feels like a soft buzzing in my leg. On the other hand, during the day I prefer Program 3 which goes at 30 pulses per second. This one feels more choppy and is more noticeable in a different way. Wow, this is hard to explain... Anyway, you get the picture (kind of).

Q: How long does the battery last?

A: Well, seeing as it is implanted inside my body, hopefully a long time! Actually, the battery is rechargeable. Now this is really cool - at least I think so. The charger sits on the base station most of the time. This is a picture of the charger on the base station.

This is the charger off of the base station. It's not very big at all as you can see.

So about once a week I take the charger and put it inside this nifty (and stylish) belt to charge my IPG battery. It usually takes about one hour to charge. The nice thing is that I'm not tied down while I am charging. I just slip this belt on while I am making a gourmet dinner for my dear husband to be ready by the time he gets home from work.... Ok, maybe (probably) not. It's a nice thought though and I've been told many times that it is the thought that counts. Before I get anymore off-topic, here is a picture of the charger and belt. I just position the charger over my battery and it charges through induction. (Think of those fancy cell phone charging pads that don't require you to plug your phone in.)

In hopes of keeping this post short (for all you short attention span people like myself) I will call things good for now. More FAQ to come though! Hope you find this informative. Feel free to send your own questions to be added to the list!

Oh, and Merry Christmas!!!

Follow-Up

    So, it's been almost a week since my last update. In the last week I have been feeling better and better everyday which also means it is getting harder and harder to keep myself from bending, lifting, twisting and reaching above my head. This is also known as "BLT" to those of you back surgery friends (that's you AJ). I feel up to it but still need to keep myself from overdoing things. I have tried to keep busy by wrapping (and shopping for) all the gifts under my parents tree with my mom while Aaron is at work. I think I did a heck of a job if I do say so myself. See below...

    On Tuesday, my mom had an appointment at NKCH so I tagged along and went to say hello to my rad friends. 
    Wednesday was Aaron's day off and overall we were not very productive. Sometimes that isn't such a bad thing though.
    On Thursday, I had my post-op appointment at Dr. B's office. I went in and asked when the soonest possible date I could safely go back to work was. Dr. B's NP asked me what my job expects of me. I informed her that I could only be "officially" medically cleared to go back when I am able to bend, twist, push, pull and lift 50+ pounds. She gave me a "look" and asked if I felt like I ever actually lift 50+ pounds during my shifts. At that point, I pictured myself doing CVICU portables at 6:00 in the morning lifting heavily sedated, intubated, post-op cardiothoracic surgery patients by myself. This was quickly followed by visions of moving numerous morbidly obese ER patients from their carts to our x-ray table and back again over and over. I promptly responded to the NP that yes, I think 50 pounds is probably putting things rather mildly. I was then told that 3-4 weeks would be what was necessary to wait before going back to work 100%. So, long story short (or not so short), I am officially back to work on January 6th! Thank goodness.
    Also at my appointment on Thursday, I worked with one of the Boston Scientific reps to tweak some of my programs. I'm pretty dang happy with the changes we made. Isn't technology fascinating?!
    Anyway, Friday consisted of more wrapping and helping Aaron paint our bathroom. Due to the no bending, lifting, twisting or stretching rules I was pretty much in charge of cleaning out the paint brushes and rollers at the kitchen sink *woohoo*. 


That's where I'll leave things for now... Oh, one more thought, today is what I like to call "Christmas Eve Eve" or "Haley's Half-Birthday." Every December 23rd I seem to think of this and I felt I should share.


Merry Christmas everybody!!


**For those of you wondering what the deal is with the new larger font - my mom kept reading my posts on here and calling me to say that I had misspelled a word only to find out *every time* that my spelling is fine, the words were just too small for her to read correctly. Getting old is a bitch, huh?! :) This one's for you, Mom!

A Big Day

I felt pretty darn productive today. I woke up fairly early for the first time since surgery. When I got out of bed I felt much less stiff than I had previously felt. Aaron went to his last Saturday class of the semester - yay! While he was in class I made some pumpkin bread and pumpkin muffins. Here is a picture of them.

How very domestic of me. Ok, I'll fess up, I had a little help -

Today was the first day that we changed the dressings on my incisions. Aaron did a great job of putting me back together. **GROSS OUT ALERT** Here are some pretty pictures of my incisions. This first one is of my back around T11/T12. No stitches, just Steri-Strips.

This next picture is of the pocket they made on the right side of my lower back where the battery lives. There is some nasty bruising going on there. Again, no stitches, just Steri-Strips and some glue. Ah, modern medicine.

Aaron got me put back together picture perfect!

I also drove around a bit for the first time today. I went to Zona Rosa to try to finish some Christmas shopping. I don't know what possessed me to go there 8 days before Christmas but there you have it.  Anyway, not much to report here so I'll leave it at that. Hope everyone is having a great weekend.

Thursday/Friday

Sorry for the delay between posts...

First of all, here is a LOVELY picture of myself after surgery. Thanks Mom, thanks  a bunch! :)

In the wee hours of the morning on Thursday, I got to be disconnected from IV fluids due to my exemplary urine output. Yes, I know, thank you very much, I'm very proud. I also got my drain pulled which made things considerably better seeing as I no longer had a tube the size of a BIC pen coming out of my fresh incision.

I would now like for everyone to see the very festive socks I was given.

So, Thursday morning Dr. B came to check in on me and the nurses told him how fabulous I was doing so he said I could go home. Then, someone from physical therapy came in and took me for a walk and to try out some stairs. I passed with flying colors. After all of the glorious paperwork was done, Aaron took me home. Or should I say, our first stop was to NKCH to drop off some leave of absence paperwork in HR. How fun. The rest of Thursday was spent vegetating for the most part.

This morning (Friday), I woke up extremely stiff. For the most part, I feel better getting up and around rather than lying down. The problem here is that I get pretty worn out quickly so I want to be laying back down! Oh well. On a better note, I am just taking Ibuprofen for pain now. I had a little incident last night when I took a Percocet at 1:00am and ended up puking at 2:30am. Needless to say, fresh back surgery and vomiting don't mix real well.  And now I am back on my "No Narcs" soapbox... But I digress.

I went and hung out at my parents house today for a little change in scenery. It is day 2 and I am already getting bored. Houston, we have a problem. Aaron lovingly took me to Blockbuster tonight to get LEGO Harry Potter for Wii which is tons of fun for 7 year olds and 25 year old alike.

Once again for my rad friends, here is an intra-op image of my lead placement. They had a GE OEC 8800 c-arm (same as some of ours) there but the image quality was crappy... Should someone call Biomed??!!

Anyway, this is me signing off for the night so I can play Wii.

Post-op

Well here I am sitting in this lovely hospital bed having some much needed quiet time. I'm feeling great with some pain but it's not too bad.

So let me tell you about my day! Aaron and I got here to check in at 1:15 this afternoon. They took me straight back and got me all set up in pre-op. They proceeded to take away my Kindle and my iPhone. Even though I was in literally nothing but a gown, it was the taking away of my dear electronics that made me feel quite naked. Dr. B, some nurses, the nurse anesthetist, and the anesthesiologist all came in to talk to me before surgery. I got the same reaction from each person: They'd look at my chart and then look at me and start quizzing me about my snakebite story. I've got to say that I do get some joy out of actually surprising a healthcare worker. Take it from me, that's not too easy to do when you've "seen it all." I was wheeled into the OR and the anesthesiologist gave me an epidural. Dr. B came in and started.

What a surreal feeling. I am usually on the other end of surgery cases - not the patient. It made me wish I knew much less than I do. I mentally cringed when Dr. B asked the scrub nurse to pass the Rongeurs. Rongeurs are a plier-like tool used to cut small pieces of bone to make an opening. Yikes.

I could not feel any pain, just lots of pressure. Once the lead was in place, Krista from Boston Scientific started testing different areas of stimulation. They hit it right on the money on the first try. After that they started the process of suturing everything in place and closing things up. I then went to the PACU for a bit to recover. Then I went to my room for the night. Mom, Grandma and Aaron were there for a bit to hang out but I pretty much just wanted to rest. I have since been up walking around the unit twice now. At this point I'd say it's time to sign off and start reading for a little while. This whole thing has been a bit easier than I thought it would be. So far so good! We will see what tomorrow brings. Goodnight all and thanks for following up on me!

The Beginning

This is a recap of what happened with the whole snakebite thing 4 years ago.

Flashback to October 9, 2007.....
I was watching Ryan and Dylan (twin boys I nannied for years) who were 6 years old at the time. Here is a picture of them in 2007. <3 (Anyone want to guesstimate how long it took me to figure out how to make that heart??)

We decided to go to the Parkville Nature Sanctuary which is a group of walking trails through the woods in our area. We had done this many times before. I was wearing flip flops on this particular venture **foreshadowing**. The boys were racing each other to a bench ahead of us on the path. I was walking behind them and felt a sharp prick on the inside of my right foot. My first thought was that I had stepped on a thorn. When I looked down I saw a smallish dark-colored snake coiled up with its head sticking up right next to me. I proceeded to walk away quickly. My first thought was that I wasn't going to say anything to Ryan and Dylan because I didn't want to freak them out. The more I thought about it, I wasn't sure how serious the whole thing was so I sat down at the bench with them and told them what had happened. Dylan asked if I knew what to do. *Nope* I did what any 21 year old would do and called my mom. She said we should go to the ER and get it checked out and that she would pick me up at the trails. I called the boys' dad and had him come get them. The three of us walked out of the nature sanctuary and met up with our respective parents.

At the ER I was asked to look at a lineup of different types of snakes and try to identify my new enemy. We narrowed it down to either a Timber Rattlesnake or a Copperhead (both venomous). Most people ask the question at this point in my story, "Did they give you anti-venom?" Well, I learned that the rate of having an anaphylactic reaction to anti-venom is about 1 in 4. We decided to use that as a back-up plan. The strange thing about a venomous snake bite is that it doesn't really hurt when it happens but the longer you go after getting bit, the more painful it gets.

By the time I got to the ER at NKCH my foot was starting to swell. The concern when it comes to swelling is avoiding a compartment syndrome. A compartment syndrome in pretty basic terms is when you have so much swelling that it cuts off your blood vessels and nerves leading to possible amputation. If you get to the point of a compartment syndrome the doctors can choose to do a fasciotomy. A fasciotomy is when a surgeon cuts your skin open to relieve pressure and leaves it open until things start to return to normal size. Not fun. Not interested. During my stay in the hospital the nurses measured around my ankle and upper calf often to make sure the swelling wasn't out of control.

I have yet to understand why we couldn't have gotten a piece of paper to write the results on as opposed to my leg but some things we will just never know.... These next pictures show the progress of the swelling and bruising over the next few days.

This is one is of the inside of my thigh where I ended up bruising in a line where the venom tracked (assumedly).

Anyway, after a few days in the hospital I was sent home on Lovenox injections (a blood thinner) due to the lovely fact that snake venom tends to clot your blood. I was on crutches for awhile and driving wasn't too pretty.

So, believe it or not, that was the fairly abbreviated version. Now it is four years later and here we are. Feel free to ask any questions!

What's Going On?!

Ok, I've been asked by a few people to do a blog to keep everybody updated about my surgery so here we are. I'll start by explaining what in the world is going on. As most of you know, I can't tell a story without being pretty wordy, so brace yourselves :)

This whole thing stems from the snakebite I got 4 years ago. I have continued to have neuropathic pain (burning, numbness, tingling, aching) in my entire right leg. Recap coming later for those of you who haven't heard the thrilling tale.

I am having a neurostimulator (spinal cord stimulator or SCS) permanently implanted. SCS does not "fix" anything (alas, I am not fixable) but essentially confuses the brain into thinking that pain signals do not feel like pain. The pain signals from my leg go up through the spinal cord and into the brain where the brain interprets the signals as being painful (bad). The electrodes in a stim system give off tiny pulses of electricity in your epidural space that the spinal cord can "feel" that confuse the pain signals as they go past. Once these scrambled signals get to the brain, all I feel in my leg is a soft buzzing or tapping feeling (good). For more information go to www.controlyourpain.com.

Surgery was supposed to be this morning (Monday 12/12) but got kicked back to this Wednesday at 4:00pm. I am having this done at Heartland Surgical Specialty Hospital. Under epidural anesthesia, Dr. B will do a laminotomy at a certain level in my thoracic spine.

  

Then, he'll place a lead with 16 electrodes in my epidural space. Lead pictured below.

I am having the Boston Scientific Precision Plus system implanted. A rep from Boston Scientific will be in the OR as well and they will interact with me to see where the lead needs to be in order to cover my areas of pain. The lead wires will then be tunneled under my skin to a point in my back just above my belt line. Here they will make another small incision and place the implantable pulse generator (IPG) under my skin and connect it all together. A remote control programmer lets me adjust all sorts of aspects of the system whenever I want. Nothing is external except for the remote. Pretty fancy.

I am really excited about the whole thing. I have been a patient at the NKCH Pain Management Clinic for a while trying different things with Dr. A to clear things up a bit. I have been working in the same clinic for a few years (I love my PM friends!) and finally decided to try things out for myself. We tried a few sympathetic nerve blocks and meds without too much success so we decided to pursue trying out a stimulator. A couple weeks ago I did a stim trial. Very basically, a more simple lead was placed via a special spinal needle and all of the rest of the components were left external.

I tried it out for 5 days. It turned out to be amazing. I had from zero pain to minimal pain all week. I think I had that thing on just about the whole dang time! At the end of my trial week they pulled the lead out and left me with nothing but a Band-Aid on my back. I was quite sad to see it go! For my rad friends, here is a pic of the lead placement. Paul did a fabulous job getting such a lovely image!

So now we come full circle to the fact that I am having this lovely little device implanted permanently. The ultimate goal here is to have less pain and therefore be able to be more active. Again, I am very excited to get this thing going. Unfortunately, I cannot work for 3-4 weeks after surgery so I will be having some serious down time. Leave me a bunch of comments so I can have some entertainment!

I'll keep everyone updated...

--Haley