Surgery

Spina Trivia;

Skeletons discovered in a cave in Taforalt, Morocco showed signs of spina bifida – bones dating back to 10000 and 8500 BCE

From Spina Bifida by Stephanie Watson

https://rosenpublishing.com/product/spina-bifida

November 16th 2006, I recall it being an unseasonably mild, beautiful, blue sky morning in Aberdeen; The kind of day which brought the unique architectural sparkle out in the Granite City; in a city not often recognised for its bling, quite a spectacle.

I had been nervous for months about the upcoming surgery – time off can do that to you. Books and music filled the void somewhat though my usual appreciation for such pastimes seemed to have been diluted by my glass-half-empty mood and prospects for a successful surgery.

I had been in contact with the surgeon, through face to face meetings and, here’s a thing – writing letters, basically asking for all the reassurance he could muster. Instead, I would find his responses to be professional and courteous, and somewhat reassuring, but there could be no guarantees. I was informed it would be 60-40 in my favour for a successful outcome.

A successful outcome would be to return my mobility levels to somewhere approaching those prior to the slip and fall on ice.

The procedure was called a Laminectomy.

‘Laminectomy is surgery that creates space by removing the lamina — the back part of the vertebra that covers your spinal canal. Also known as decompression surgery, laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves.’ (Source: https://www.mayoclinic.org/tests-procedures/laminectomy/about/pac-20394533)

The surgery would likely take up to three hours and my stay In hospital would likely be for two weeks. I packed accordingly;
Book: The Silver Darlings by Neil M Gunn
Music: My Sony MiniDisc player; Jesus & Mary Chain, My Bloody Valentine and Shoegaze
Magazines: Mojo, National Geographic
along with the usual toiletries and change of clothes.

Given I’ve spent plenty of time in hospital, this still felt nerve-wracking. I had been fortunate to have escaped major surgery up to this point but I was under no illusions that this was a potential life-changer.

On arrival at the hospital, I had some time to wait for a bed, but the nurses were attentive and I was soon to learn ARI served consistently good meals for patients, indeed the best hospital food I have ever had.

After lunch, and having been allocated a bed, I was feeling far more settled and relaxed than It felt like I had at home, for months. The nurses have that knack of offering the same reassurance you tend to brush off from family members, but it somehow means more coming from them.

After being briefed by the surgeon and the anaesthetist, I had most of the afternoon to myself. I began reading The Silver Darlings and having had such a long build up to get here, I was now strangely calmed by finally, actually being where I had been dreading being, for so long.

This proved to be something of a false dawn for the fear that would follow. Later that afternoon, the ‘nil by mouth’ sign went up by my bedside. I love my grub. Then, the surgical procedure called for me to be taken for an EMG…

There are 31 pairs of spinal nerves which are grouped according to where they leave the spinal column. There are eight pairs of neck (cervical) nerves, 12 pairs of upper back (thoracic) nerves, five pairs of lower back (lumbar) nerves, five pairs of pelvis (sacral) nerves and one pair of tail bone (coccygeal) nerves. It is important for the doctors to detect any abnormality in these nerves’ function when dealing with spine problems. The specialized nerve tests like EMG, NCV and SSEP are designed to diagnose any abnormality in the functioning of these nerves. These studies investigate the functioning of the nervous system, while imaging studies like the CT scans or MRI scans look at the structure or anatomy of a particular body part or organ.

EMG, or Electromyography is a technique for evaluating and recording the electrical activity produced by muscles. EMG is performed using a machine called the electromyograph, to produce a record called an electromyogram. An electromyogram detects the tiny amount of electricity generated by muscle cells when they are activated by the nerves connected to them. Specialists analyze these signals to detect medical abnormalities in the spinal cord, nerves and the muscles that are connected to specific nerves.

There are two types of EMG: intramuscular EMG and surface EMG. The intramuscular EMG is the most common. It involves inserting a needle electrode through the skin into the muscle that is being studied. Surface EMG (SEMG) involves placing electrodes on the skin over the muscle to detect the electrical activity of the muscle.’
(https://www.knowyourback.org/KnowYourBack/Treatments/AssessmentTools/SpecializedNerveTests)

The EMG meant I be taken pre-op to a darkened room, not unlike a recording studio, banks of technology surrounding a chair placed in the centre. I was to sit there. Two specialists with laptops then methodically began dabbing a glue to strategic spots on my head before attaching a number of wires which led to points down my spinal cord and specific areas of my legs where electrodes were stuck on to my skin. (I felt I suited dreadlocks!) This would inform the surgeon whether he was in danger of severing a nerve during my op. Surgery would not be unlike the boardgame ‘Operation’.

This procedure in itself took well over an hour and I went back to the ward with renewed apprehension. The evening and overnight proved to be restless and sleepless. I watched the sun rise.

I was ‘first up’ for surgery and it seemed like it was no time before nurses and the surgical team were swarming around my bed in preparation for me being moved to theatre. Once there, one short, sharp prick of anaesthetic would make me blissfully unaware of the surgeon’s work.

On being brought round, it was immediately obvious to me that it was dark outside. I had been in theatre some eight hours. Over tea and toast, the clearly exhausted surgeon explained it had been a far more complex procedure than the scans suggested. He had found cysts and tumours prevalent and, as he cut, he was having to work his way further and further up the spinal cord than he had anticipated, removing these unexpected growths – “I didn’t know where it would end” he would admit to me. Now, I was faced with a nervous wait to see whether the cysts were benign or malignant.

I was numb, thanks in no small part to the morphine, but also due to having no function in my legs, not to mention the threat of a cancer diagnosis hanging over me.

Over the next number of days, the surgeon and physios combined with a number of tests to ascertain my level of function. Gradually, my left leg responded to this probing and sensation and some mobility returned. My right leg remained numb though. I would remain in bed over a long weekend. My ward mate took great delight in an unbeaten run against me at Chess.

I had acquired more than fifty staples up my back, gunk in my hair, a loss of bladder function, concerns about the bowel, as well as concern over how I would be physically. Given all that, I was just relieved to have come through the surgery.

Spina Trivia – Famous and born with spina bifida;

Roald Dahl

Dame Tanni Grey-Thompson

John Cougar Mellencamp

Frida Kahlo

Improvement came on a daily basis as I was allowed some time each day out of bed. I was to learn to appreciate the most basic aspects of life, all the while under no illusions it would be a long haul back to health. Soon, the glue was washed from my hair, I came off the morphine; I was pain free, the staples removed and the Histology report showed no cancerous cells. All positive.

Physically, my right leg continued to show no response but my left leg continued to improve. For the first time I would hear phraseology such as ‘paraplegia’ and ‘incomplete’, and the Spinal Injuries Unit (Glasgow) being intimated as a likely destination for continued, more intensive, specialist rehabilitation and guidance than they could facilitate in Aberdeen.

After a week or two, during which time there had been contact between ARI and QENSIU, I was just about to settle down for sleep when, with the ward in darkness, a figure appeared at the bottom of my bed. “Mr Spalding?”

Mr Fraser, consultant in Neurology, had travelled to Aberdeen from the Spinal Injuries Unit, in Glasgow, following a day of neurosurgery, just to meet with me to discuss my impending transfer for physical rehabilitation to the Unit.

After half an hour, having carried out a physical assessment, made clear the next steps in my progression and describing the set up of the Unit, he shook My hand, thanked ME for MY TIME(!!), and left for Glasgow – some three hours drive and likely, given the lateness of the hour of departure, a 2am arrival home. And I felt more knackered than he did!

I remain in total awe of the dedication our health workers commit to the cause, and it’s not just that visible presence on the ward. I would soon learn my newly acquired Consultant and his team would epitomise this commitment, and then some!

Next Time: Return to Glasgow

I am blogging my own unique experience of spina bifida to highlight a relatively little known yet no less significant condition to those born with the condition and their families. I hope that my experience can offer a positive view of life with spina bifida.

Photography: Bloggers own

I support and fundraise for https://www.sbhscotland.org.uk/@SBHScotland in the exceptional work they carry out across Scotland, in a challenging funding environment. Please see links for further info, contact details and how you can support this vital, donation led charity. Thank you for reading.


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