Admission Day (Tuesday, April 3rd, 2018):
Before I begin, I would like to point out that the hospital was undergoing renovation efforts during my stay there, which explains the somewhat improvised waiting area. Furthermore, the Sana Dreifaltigkeits-Hospital is an orthopedic specialty clinic and never really advertised their services outside of Germany. They are still in the process of developing better guidelines and resources to serve their international clients more efficiently. However, I was very pleased with my care and the outcome of my surgery, and I would do it again in a heartbeat!
With that being said, things were a tad discombobulated when I first got to the hospital. I am bilingual and speak German fluently. This, I assume, led to the assumption on the part of staff that I was a local, rather than an international patient from the United States who prepaid for her surgery and hospital expenses. Since Dr. Desai’s administrative assistant was on vacation, we were told to go to Admissions, pull a number, and wait in the waiting room that looked somewhat improvised and featured white, wooden, uncomfortable chairs. Throughout the morning, I would get called by someone and told to do something (e.g. sign admission papers, get vital signs checked, blood drawn, x-rays taken, and meet the anesthesiologist), only to return to that dreaded waiting room full of other patients.
About halfway through the morning, I was told that I could check out my room and bring my luggage upstairs while I waited. I then was summoned to have my blood drawn by the assistant doctor for a type and screen (to determine my blood type). Then I finally met Dr. Desai, who stopped by right after, and I was instantly relieved because he was so approachable and caring! He explained the surgery to me in great detail, including what to expect before and after, and patiently answered all my questions.
After settling into my room, the nursing staff provided me with fancy mesh panties and a gown to be worn the next morning for surgery. I also got a laxative to make sure nothing remains in my system, and that was that. In the meantime, my fiance went to the main train station to pick up my mom, who had arrived to be there for the big day.
I later found out that American patients like me usually first meet Dr. Desai's administrative assistant, then get to speak with Dr Desai himself, and afterwards are chaperoned through the admission process, which is great.
Surgery Day (Wednesday, April 4th, 2018):
I was second in line to have surgery. I think it was around 10 AM when I was picked up in my room and transferred to pre-op, where the IV was started and oxygen was applied. Since I still had to wait for the prior surgery to be fully concluded, Dr. Desai came by and we talked for 15 minutes until it was time, which was very reassuring. Once we got the green light, the anesthesiologist administered the proprofol, and that was that.
Next thing I know, I was waking up in a large room full of patients, and we all were separated by curtains. My back was really hurting me, which concerned me a tad, but besides feeling groggy and tired, I didn’t feel too bad. However, my entire left arm and hand felt numb and tingly, which I was told is sometimes caused by positioning (especially in slim people) but is only temporary.
Judging by the shocked face of my fiance and the tears in my mother’s eyes (both were allowed to see me for a minute each), my appearance was rather “rough”. I received a few more rounds of pain meds IV before I was finally transferred back to my room around 6 PM. Again, my back felt sore (for which I got a dose of oxycodone) but otherwise, I didn’t feel nauseous or “unwell”.
Since I still had the foley catheter in, I took full advantage of not having to get up to pee, and I drank lots of water to get my system going. I didn’t leave my bed that night anymore. During the night, I woke up from a painful bladder and realized that the tubing wasn’t draining at all. After fixing that issue I started to get a cough (from being incubated I suppose), which was really mean since the incision was brand-new and hurting. Again, some cough syrup fixed the issue, and I went back to sleep.
Day 1 (Thursday, April 5th, 2018):
Day 1 went mostly well. In the morning, after rounds and drain removal, I was able to get up and walk (with the nurse) into the bathroom, where the nurse pulled the catheter. I was allowed to wash my face while seated. I was still not allowed to eat, even though gas was rampaging through my system, so I settled for a peppermint tea.
After that I walked (with a walker) all the way down to radiology to have my x-rays taken and met again with Dr. Desai to review the images of my brand-new disc. He asked me if I “felt different” than before surgery. At the time, however, I wasn’t sure, especially since a lot of my prior pain was provoked by bending, twisting, and picking objects, which are all activities I wasn’t allowed to do for next six weeks. But rolling out of bed and standing for the first time made me realize that the true "old pain" was gone, even though my back still felt quite sore.
I felt no pain walking or sitting but I got a tad nauseous, which I attribute to the oxycodone on an empty stomach, but I managed to return to my room without barfing. Once I laid back down, the nausea subsided. Again, my main concern at this point was the fact that my back hurt as soon as I laid down but I was fine standing or walking. I was told to give it some time.
Furthermore, I was given a laxative to “get things going” which I found out was a criterion for getting food. As inconvenient and cumbersome this was, the mission was a success that evening, and I allowed to eat the next morning. The numbness/tingling sensation receded to the hand and had lessened as well.
Day 2 (Friday, April 6th, 2018):
All was well up until 4 AM in the morning when I woke up with severe back pain and spasms. No matter how I positioned myself, I couldn’t get comfortable. I ended up getting up to “walk off the pain” but that didn’t work either. As I dragged myself down the hall with my walker toward the nurses station, vicious cramps shot down my buttocks and legs. I was sent back to my room and given 20 mg of oxycodone. After sitting for 15 more minutes, I was finally able to lay down again. I was concerned and discouraged about this development, but Dr. Desai, who stopped by during morning rounds, reassured me that the implant didn’t move and that distraction pain is quite common after being stretched over one cm in height. I could tell, though, that he was a tad disappointed that I had such a bad episode, and he didn’t reduce my pain meds as he initially planned on doing.
After the doctor left, the breakfast cart arrived, but to my dismay, not much food was left due to unexpected newly admitted patients, who were apparently very hungry. But the lady with the food cart made sure I was taken care of. Anyhow, I actually felt “fine” like before, and even the pain while laying down was getting less. I noticed a sore spot in my left butt cheek that was a tad “pissed off” but nothing major.
Later on, a lady stopped by to measure me for the back brace, which I was supposed to receive and wear that same afternoon. I had visitors all afternoon, and I was able to sit in a chair for a prolonged time (with intermittent standing and walking) without any issues. My sit bones where getting a tad sore but my back was fine! Just before my friends parted ways, my sexy new brace arrived, and my set-up for the next six weeks therefore complete. Numbness and tingling was now mild and only in my fingertips.
Day 3 (Saturday, April 7th, 2018):
I felt really good, especially since I was allowed to shower and wash my hair. I had a waterproof bandage covering the small incision and drain site, so showering was not too difficult. I had breakfast (full selection!) at the table and felt well enough that I omitted the oxycodone that morning and only took the ibuprofen. After my mom arrived, I put on my fancy brace and we walked all over the hospital. Later on, after my fiance's mother arrived as well, we got to walk outside through the small garden behind the clinic and enjoy some warm sunshine.
My pain was now mostly at the incision site, especially since the brace kept pushing on it but wasn't too bad. I asked the nurse to reduce my narcotics and was told that the oxy had already been reduced to 10 mg twice a day and that I should try the next day to go without it in the morning. To avoid getting into trouble, I didn’t tell her that I had already skipped that morning's dose and was going to take only the one dose at night to help me sleep.
I knew I wasn't out of the woods yet, but I was cautiously hopeful that those painful events won’t be happening too often and that I would have a somewhat smooth recovery. As I was sitting here, the main discomfort was at the incision site, and my left buttock felt sore. I also got tired more quickly and would take off my brace and go for a snooze now and then. Again, the pain I felt initially while laying down had subsided significantly! My fingers felt about the same, a very mild tingling.
Day 4 (Sunday, April 8th, 2018):
Today marked my fourth day after surgery, and I was happy to say that I was off all narcotics. I could sit, walk, and lay on my back without pain or only minimal discomfort. Yes, I could feel the incision (especially since my brace was pushing on it) but it was really not that bad. The next day I should be discharged and only return for my stitches to come out in another week. It appeared that some very faint numbness and tingling residue remained in my fingertips but I usually only noticed this when pushing on them.
Day 5 (Monday, April 9th, 2018):
Discharge was pretty smooth. I got my blood drawn one more time and the brace lady came by in the morning to see how my back brace was fitting. I picked up my paperwork from the nurses station, including a letter of medical necessity from Dr. Desai, and prescriptions for ibuprofen and an acid reducer. I didn’t get any bandages, though, and had to order them at a local pharmacy, where I picked up my discharge medications. (After my feedback, I believe that all supplies and discharge meds are now provided to American patients directly).
I felt very tight in my buttocks, hamstrings, and calves, which is supposed to be due to the stretching of my spine and alignment alterations. I went back to the hotel to drop off my stuff and had lunch at “Cafe Bonnen” with my mom. After lunch, I had to lay down again, and after a last dinner, I packed and prepared for the next day's train ride to Uelzen to visit my fiancé’s family.
Day 6 (Tuesday, April 10th, 2018):
After check out, Ralf and I took a taxi to Hauptbahnhof Köln to ride the train to Uelzen, with one connection in Hannover. The total journey was about four hours, and I made the mistake of not getting up in between (other than during the stopover in Hannover).
After we arrived in Uelzen, we got picked up by car, then we sat in my "brother in law's" living room, and after that we had dinner at a restaurant. Since I had not laid down since arriving, I was in either sitting or walking/standing position (wearing the back brace) for at least seven hours. I increasingly felt uncomfortable and finally HAD to lay down. My buttocks, hamstrings, and calves were crampy and fatigued, and my lower back was also tight and sore (but different than the old pain). I learned that day that I had to alternate between positions to avoid too much muscular stress and soreness.
Day 7 (Wednesday, April 11th, 2018):
It had been one week since my surgery, and one of my main complaints are crampy, burning calves. I was very sore that day due to the previous day's sitting marathon, but overall, I was feeling ok. I still walked a lot during short day trips, including wooded trails and visiting a university, but I managed to take off the brace and lay down to get some rest in between. Muscle soreness in my buttocks, hamstrings, and calves was still present (but fluctuating), and I could reproduce the soreness when massaging the back of my legs.
Week 2 (April 12th through 18th, 2018):
Over the next two days, I was able to alternate between longer walks through nature and laying down, which helped a lot. Usually, during this second week, my back and legs were getting fatigued during the evening but were somewhat restored the next morning. On the third day, we took the train back to Köln, and this time I made sure to get up and walk whenever the train stopped. Still not perfect but much better.
After my fiance returned home to the US that Friday, I was picked up by my dad, with whom I stayed for the next four days. Again, lots of sightseeing, including a city bus tour (1 1/2 hours), a crowded fish market, Rheinufer expeditions, and a walk through the Kölner Dom. As soon as we got back from these outings, I laid down to rest my back and legs. I noticed that the cramping pain in my calves was getting pretty intense in the mornings (due to increased activity), but I was told by Dr. Desai that this will get better in time.
On Monday, April 16th, (12 days post-op), I returned to the hospital to have my stitches removed and the remaining paperwork processed. Dr. Desai was very pleased with my progress and assured me that the muscular pain, cramping, and soreness will go away in time. I was able to walk significant distances and also sit for prolonged periods of time. I even noticed that I could stand in place without triggering that nasty, crippling pain I would have gotten before surgery. I want to mention, though, that my tailbone was getting sore when sitting for a longer time. On Day 14, I took yet another train from Köln to Heide to see my mom, which is a 6-hour ride.
Week 3 (April 19th through 25th, 2018):
By alternating sitting and standing during the long train ride, I tolerated it well. As soon as I arrived at my moms’ though, I took off the brace to lay down. During this third week that was filled with walking and sitting during the day, I felt overall well. I went on long walks by the beach, sightseeing, and a couple longer car rides on most days. My calves were a lot less sore but my lower back felt tight, and at times I felt some sharper bolts of discomfort, especially when changing positions while laying down.
At times I felt afraid that something might be wrong but I kept reminding myself that some set-backs were to be expected and that my instant one cm stretch, coupled with increased activity, may be responsible for this tightness in my back. One huge difference from before is the absence of the “old” pain that I hadn't felt since surgery. That day marked the end of the third week after surgery, and I was back on the train for the next six hours to return to Cologne. The following day I was flying back home to the States.
Week 4 (April 26th through May 2nd, 2018):
On April 26th, 2018, I went on a 10-hour flight from Frankfurt, Germany, back to Orlando, Florida. Because I didn't know how I would feel, I reserved wheelchair service through the airline (Lufthansa), which was so convenient! I didn't have to wait long at all at security, and I was the first passenger on the plane. I also spent some time in the Business Lounge, which was an amazing experience. It's now also important to carry my "Implant Pass" when going through security, since I am now the bionic woman!
Paying extra to upgrade to Business Class turned out to be a great idea! Besides not having the back of the seat in front of me right in my face, I was able to fully (!) flatten the seat and lay down on my side, just as I would on a couch! I got greeted with a glass of champagne, got to pick my dinner a la carte, and I found a disaster movie in the extensive selection. Even though I really didn't want to spend any more money, this investment was well worth it. I am not sure if I would have survived Economy Class for 10 hours straight...Bad thing is: how can you go back to Economy after this?
After returning home, I started to go to our local gym to walk a couple miles regularly on the treadmill for rehab. Not as scenic as being outside, but May in Florida can get rather hot, and I started melting under my brace when I was outside too long. My main complaint at this point was soreness in my back (but higher up than it used to be), my butt, and legs. But overall, I was feeling good.
That day marked my 4-week post op day, and recovery was going well! Still tight in back, hamstrings, and calves (more or less) but nothing intense, really. In fact, I was amazed over and over again by how certain movements were just not painful anymore! Like leaning over to brush my teeth or wash my face doesn’t bother me at all anymore. Those used to be such agonizing tasks... I could not wait to move my rehab along once the restrictions are going to be (somewhat) lifted in two weeks.
Week 5 (May 5th through 9th, 2018):
At the beginning of week five, I did something stupid (but not on purpose): I was having breakfast at a local restaurant and was seated outside. Suddenly, there was an (almost) accident happening right behind me, so I turned around quickly - meaning I fully twisted my spine! Even with the back brace, it is still possible to twist under the right circumstances, I suppose. It wasn't terribly painful but I was still mortified about possibly screwing something up in my back before it was fully recovered.
I didn't know if it was just imagination but the soreness in my mid-back may had gotten more pronounced. It was hard to tell. My back felt fine but I wished the soreness would resolve for my piece of mind. For the following week I had a medical massage scheduled with Ben, and I hoped he would be able to put my muscles back together and help with the soreness. Since I didn't have a local PT I trust, I was still doing rehab on my own at the gym.
I realized that the rehab process is not only physical but also mental. Every ache or fluctuation in soreness makes me afraid that something is wrong but I guess that's normal. But I was in good spirits and exited to get better - one week at a time!
Week 6 (May 10th through 16th, 2018):
Today, I am 6 weeks post-op, which means that I can take off my back brace! I am still a tad afraid to bend or twist but I guess that is normal. Recovery is also a mental game for sure!
I really need to start stretching though, since my hamstrings appear to be much shorter than they used to be! However, besides the lingering muscular issues I am still dealing with, there is no more crippling back pain that I used to suffer from! Now I can (carefully) take my rehab efforts to the next level.
In a couple of days I am going to see Ben to start getting regular medical massages, and I hope he can help me with the soreness. I still have that sore area in my lower-mid back that is tender to touch but I hope this is not because of the twisting-incident from last week but rather part of the recovery time.
I can now bend sideways and forward without pain (won't do the back-bend though!), which I wasn't able to do at all before the surgery. So, I take that as a victory and will now move forward by increasing my workouts (carefully). Maybe some light jogging (on soft ground) and definitely more stretching.
