November 17 marked Titanium Girl’s final surgery to correct the two right angles in her spine, and December 17 marked the first month since that surgery officially made her Titanium Girl. It also marked her first follow-up appointment with Dr. C. But first, let’s recap what November 17 ultimately gave to Titanium Girl:
Pretty striking, no? The first image is her first x-ray taken in August 2014, and the second is her last x-ray before leaving the hospital Nov 23, 2014. Titanium Girl left the hospital that day with a 7 inch incision on her left side; a 4.5 inch incision on her right side; a 13 inch incision down her back; 3 drain wounds; missing sections of 2 ribs that were relocated to her spine as part of her fusion procedures with donated cadaver bone making up the rest; literally dozens of bruising needle marks along her arms with a few on her legs and scalp for good measure (some of those bruises are still there on her arms a month later); 9 hooks; 9 screws; and 2 titanium rods.** Not a day goes by that I’m not thankful for the remarkable advances in medical technology and skill that we have access to today.
So, the follow up. Our appointment time was 10am, and we were asked to get there by 9:45. We got out the door in plenty of time, but managed to hit every bump in the road, which is still painful for Titanium Girl. To top it off, I realized about halfway there, that I’d forgotten to grab her pain pills, and she’d be due for more meds at 11. We’d intended to walk over to the hospital following the appointment to donate one of the galaxy lamps that were so helpful to Titanium Girl while she was there, but seeing how difficult the half-hour ride over was, plus time sitting in the waiting room, I knew we’d have to save that for another day.
Thankfully, Dr. C. is generally quite prompt, and shortly before 10 we were taken back to meet first with the assistant. There were the usual questions about how she was feeling, whether she had any numbness or tingling, etc. Then they took her back for a couple of x-rays. Her pain level was increasing, so she lay down on the table while we waited for Dr. C. Upon entering, he greeted us with his usual handshake and genuine smile and asked if he knew us, since we looked so familiar. We agreed we must know each other from some place, wonder where? ha ha.
I helped Titanium Girl off the table, and Dr. C. asked if she was going to talk to him. She smiled and said yes. Then he asked if she was mad at him, and she smiled bigger and said no. He asked if she wanted to kick him, and she laughed, shook her head, and said no. He took a look at her back and the incisions and pronounced that the remaining steri-strips can be removed because the incisions look great. He noted her back looks really good, with some residual fullness at the upper right, but improvement there. He took a look at the x-rays, which looked like she’d been standing funny when they took them, but a comparison of all the hooks and screws showed that nothing had moved.
He asked Titanium Girl how he could help her, and she said she wanted to know what her curves are now. He immediately set about measuring them, asking us to remind him if he’d estimated at the time of surgery (he had–35/35 was his guess then). Due to the positioning of the hardware, it’s a little difficult to get an exact measurement, and there’s a bit of room for measurement error there anyway, but he measured her out at 35 thoracic and 41 lumbar, which is pretty darn close to his estimation. And while that sounds like a lot of residual curve when you hear the numbers, just look back at the x-rays and see the difference (a picture’s worth a thousand words, after all). Curves below 45-50 degrees don’t require surgery, so she’s essentially corrected to below-surgery thresholds. And the bigger picture is that Dr. C. shaved 49 degrees off her thoracic curve (58% improvement) and 50 degrees off the lumbar (55% improvement) when 50% correction is considered a win with such big curves. And that’s if her curves going into surgery were only 84/91. They weren’t measured after the initial August measurement, but I had my suspicions that they increased in the months we waited until surgery, so it would not surprise me if the correction Dr. C. achieved is actually even greater than the official numbers.
I did ask if the residual angle at L4 was a problem, and he said no. He showed us how her head, shoulders, and pelvis are now in a straight line as they should be, which was of course the biggest goal of the correction–a balanced spine. I mentioned her tendency to carry one hip higher than the other which she appeared to have done during the one x-ray today. He took a look again to be sure everything was good there, and she stood just fine in front of him. He did caution us not to be too concerned about things right now during this healing period, and he suggested having her look in a mirror and shifting herself to stand straighter since her body isn’t used to how that feels yet.
We of course talked about pain management. She’s been on a muscle relaxer in addition to her pain pill, but she hasn’t been having muscle spasms the last couple weeks, so Dr. C. said there’s no need to continue taking it. We’d also shifted her to a pain pill to every 6 hours rather than every 4 in an effort to let her (and us) sleep more at night and to see how she did with less medicine. When we asked about continuing in that vein, Dr. C. turned to Titanium Girl and asked her how that was working for her. She answered that she liked getting more sleep. He redirected and asked if it was enough for her to control her pain. She thought about it and said she thought every 4 hours worked better for her, and he said that isn’t a problem. He checked in with her about her rib pain, and she emphatically told him they still hurt quite a lot, which didn’t remotely surprise him. He thinks she’ll be on pain meds at least 8 weeks given everything that was done to her.
We mentioned having her play her clarinet to improve her lung functioning, as well as increasing her walking distance (she’s up to 0.25 miles regularly and did 0.4 miles the night of the band concert). He wasn’t concerned about lung functioning at this point and didn’t think the clarinet would further improve anything, and he didn’t seem concerned about specific distances for her to walk, though the quarter mile sounded fine. His main concern was for her to walk every day, and he said it would be good for her to sit up for 2 hours now and only lay for an hour at a time during the day. Our main take away was that we’ve perhaps pushed her to do more and to do it more quickly than even he would expect. It was a good check on our expectations, though it was also helpful to have some concrete time limits on laying vs sitting up.
Our last discussion point was about returning to school. Dr. C. said (completely seriously), “You guys weren’t looking for her to go back to school any time soon, were you?” and DH and I just looked at each other and both said, “Uh…yeah, January”. He nodded and said, “Ah ok, yes, January sounds fine.” But he began thinking out loud and mentioned how the start of school following Winter break is really just 2 weeks away, and did we think she would really be ready to return in that time? We told him we had our doubts, and he turned to Titanium Girl and asked her what she thought (as an aside, I really appreciate that he has always included her so much in the conversations about her care, and that he’s completely validated her concerns, her experiences, and her reported pain level). Titanium Girl also expressed her doubts about being ready in 2 weeks. I asked if he thought returning to school January 5 would be too ambitious, and he said he thought it probably would be, and that mid-January might be more realistic. He also agreed with our thoughts of her returning to half days to transition back initially. We briefly covered accommodations she’d need to return to school, and he was on board with anything we thought would help. He suggested meeting again in a month to see how things were going and discuss school more then. With thanks and handshakes, we said our goodbyes.
A few minutes later, Dr. C.’s assistant E. brought us the school accommodation list. We realized Titanium Girl had never had her height or weight taken that visit, and she really wanted to know how much height she officially gained. E. said she’d do it for us on our way out, so DH went to move the car closer while we did that. Oddly enough, she measured only 3/4 an inch taller than before surgery, which seriously doesn’t seem right given how many people comment about how much taller she is now. Dr. C. had estimated he gave her a couple inches in that last surgery, and obviously his estimates have otherwise been pretty good, so we were more than a little doubtful. On the other hand, she was measured on the same device she’d been measured on before surgery (at 5 ft even), so it wouldn’t be due to a difference in equipment. Regardless, I measured her in the evening around 5ft 1.5″, which sounds much more plausible. It will be interesting to see how much height she gains from leg growth in the next couple years…
**Partridge in a Pear Tree sold separately.
