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You don't have to read this....I'll understand!

I had severe DDD at L-4-L5 and L5-S1 with instability (spondylolithisis) at L4-L5 and a herniated disc at L5-S1. On May 6, 1997 I had fusion L4, L5, S1 and disectomy at L-5 and decompression of the disc at L-4. I had instrumentation placed; 2 Harrington rods and 6 Isola screws. On 6-2-97 (a Monday) I developed a severe wound incision literally opened and began draining. I was seen in the emergency room, x-rayed, given antibiotics and sent home with instructions to call my spinal surgeon in the morning. I called the next morning (Tues.) and his secretary told me he was in surgery all day, she's pass along the message. He never got back to me until late that day and told me to meet him in his office before hours on Wed. Upon seeing me he decided he had to hospitalize me and clean out what he *thought* was merely a suture tract infection. No biggie but I'd need to be put under anesthesia as it would be quite painful. I expected to stay overnight and return home Thursday. Upon opening me he discovered I was totally infected...the bone graft and hardware too. They removed much of the bone they'd harvested from my hip and tried to clean up the hardware as best they could. I woke up that night and knew I was in deep doo-doo; I should have woken up much earlier if it had been just a suture infection.

They couldn't close my incision because I was too infected and I needed to be cleaned out twice a day. From what I've heard, it was comparable to being a burn victim; they come in twice a day and remove your dressing and clean the wound. Needless to say, I was on a morphine pump but they had to *boost* me with injectables before they could even start to remove the dressings. All I can say is I wouldn't wish this on anyone. I was sent home a week later...still wide open. I had a visiting nurse in twice a day to change dressings and clean the wound and I was still on IV antibiotics three times a day, which I had to learn how to run myself. (Try learning that skill when you're high as a kite on pain meds!)

I was home about two weeks when my visiting nurse noticed my incision was opening again. She could see my hardware poking through the granulation tissue. It was obvious I was still infected. Back into the hospital I went. This time they called in the chief of trauma plastic surgery (on a Saturday, no less!) to try to close my wound. Since most of my muscles and tissue had been debrided away in an attempt to eradicate the infection the plastic surgeon was not only going to clean me out one more time but also going to have to try to figure out how the heck he was going cover fourteen inches of open wound when there was no tissue available to do so.

The answer? They did what is called a pants over vest tuck. In plain English, they took my lower lat muscles (the muscles you might call *love handles*) and upper glutes (upper butt muscles) and pulled them into the center of my back and stuffed them all around my hardware. They stretched the fascia from my sides and sewed everything in place. Then they threaded in two drains to deliver on-site antibiotics and two drains to remove fluid. This is done by threading pointed tubes from my back down into my hips and out the side. Come to find out, these drains damage most of the tissue and nerves they pass through. Compared to the damage that was done to surrounding soft tissue when they did the tuck I suppose the drains were nothing to get my panties in a wad over.

I stayed another week or so in the hospital and then I was sent home. The plastic surgeon told me if this didn't work we were pretty much out of options. He told me I had one heck of an *erector set* (meaning my hardware) and it was pretty badly infected. At that point all they wanted to do was maintain the hardware and clear the infection. Praise God, three was my lucky number and it worked. On the down side, salvage surgery isn't designed to be pretty, it's intent is to save your life first and foremost and worry about the ensuing damage later. And boy, were there problems later!

Although several boo-boos were made over the course of three operations I don't harbor any ill-will or bad feelings about what happened to me. When I was recovering at home after the first surgery I knew the first (fusion) operation had been a success. Sure, I had post-operative pain but for the first time in my life I could stand properly and I could tell the difference. I was eagerly looking forward to my life after recovery. In fact, I was walking about two miles a day (slowly) by the beginning of the third week. (Something I now rather regret having done.) Usually when people ask me if I could go back and do it all over again would I have chosen to have fusion I say yes, I would. I didn't expect to be that one in 1,500 who has a serious surgical complication. One time when my spinal doc came to visit me I asked him how many of his patients have had infections. He told me that in 15 years I was the 9th patient he's ever had develop a surgical infection and the ONLY serious, life-threatening deep wound infection out of nine. (The other patients responded well to antibiotics and didn't require extensive salvage surgery.) He was very concerned, upset and bothered by what I went through and expressed a sense of responsibility even though there was never any proof I contracted my staph infection in the hospital or during his procedure. (Though the likelihood is good..)

The only reason I bothered to tell this in such detail is because what happened to me probably had significant bearing on the medical reports filed on my behalf. I had excellent medical care by some of the top specialists in the New England area and each and every one of them gave timely, detailed accounts of my condition when I applied for SSD. I can't for the life of me attribute my receiving SSD benefits (on my first and only attempt to file) to anything other than what was in those reports. I've met people who've had just as much pain and suffering as myself that have been denied SSD not once but several times and trust me, it angers me to no end. I don't know if the contents of my reports had any bearing or not on my SSD but I can speak for myself when I say I gave a very brutally honest and heartfelt testimony about the effects my disability has had on my life to date. There is no chance of improvement for me. Basically, I can look forward to my condition deteriorating over time and I've already started to see that happen. Nonetheless, my outlook is bright. I take life one day at a time or sometimes, one minute at a time; whatever works. And more importantly, I know God is with me every step of the way.

My heart breaks when I read or hear about people who've been treated badly by *the system.* I've had my difficulties in some areas but great success in others. I do resent the hoops chronic pain patients are made to jump through at every twist and turn of our journey. Few people really understand our plight unless we're confined to a wheelchair. I've yet to get a handicap sticker for my car because I think people would harass me if they can't see anything *wrong* with me. Although I walk slowly and carefully (stiffly) I don't limp or shuffle. Most people don't even realize there's anything wrong with me because I've become very good at disguising my handicap. (Good in some ways, NOT good for others.) Sometimes I think we need a darn union or something in order to be heard and get the respect we deserve. Nobody should have to live a life of chronic, debilitating pain and have to worry about how to keep a roof over their head, food on the table or pay for much needed treatment and medication. Nobody.

Keep trying for SSD. Drive them nuts if you have to. You've got nothing to lose but the time it takes you to fill out the paperwork.

Good luck!


[This message has been edited by BluMoon (edited 02-05-2002).]

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