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[amlithist]

Not sure if this is the right place, as this isn't MY health issue on the job, but it certainly is/will affect me, depending:

I posted here earlier re:  spouse's falling apart.  He was told over the summer he needed shoulder surgery (torn rotator cuff), left hip replaced, and both knees replaced.

He had the shoulder done November 4--is already back to full mobility and starting weight-bearing PT.  The tear was less severe than thought, but he did have a torn bicep, which was repaired.  He's been off the pain meds for 2 weeks already.  He goes back Dec. 3 and will probably be released.  So that's good news.

Today I went with him to a different ortho surgeon in the same practice who does hips/knees.  (We figured, let's see what the plan is, once the shoulder is healed, so we know what we're up against in terms of scheduling, rehab, etc.)  They did x-rays, then the exam.  The poor intern (teaching hospital, very good ortho school/practice) took his history, kept asking questions and scratched his head.  For the x-rays, which show bone spurs and severe deterioration of the left hip ball, the pain should have been here, here, and here, but it was only here (not the other 2 places).  He manipulated, poked, prodded, and couldn't get the pain where he expected it.  He said, "This is when I call the boss."  Big Name Ortho Surgeon came in, looked at the notes and the x-rays, and said, "No."  Went through the same routine--couldn't get it to hurt where, by all rights, it should have been excruciatingly painful.  Then he started moving hubby's legs, bending the knees, bending the hips--nothing on the left leg hurt (except the knee), but when he bent/moved/twisted the right leg, the left hip went nuts, with excruciating pain.  (It was like a Three Stooges routine.)  BNOS got the nurse and said, "More x-rays--both knees, and lower back."  After reading them and further examination, he confirmed:  the sacrum is displaced in front of the spine (pretty substantially), the lumbar spine is collapsing, there are bone spurs on several vertebrae, with nerves involved in the spurs.  The discs look OK.  

So now--to a spinal surgeon on Dec. 15 for a consult, with likely surgery to expand/fuse the lower spine.

(The knee x-rays look OK--lots of arthritis, but not enough deterioration to do surgery/replacement immediately.  Good news there.)

The hip is shot, and definitely needs to be replaced, but as BNOS said, there's no sense in doing it now, because it won't stop the pain, and the spine has to be done first so that the hip can be done correctly.  Pain is an issue, as is mobility--he walks worse than Mom did after her two broken hips, and that's saying something.  He takes 6-inch steps because it hurts too much to do more; he's just gotten this bad in recent months, and actually got a cane over the weekend, just to give him a little stability.  Pain meds and NSAIDS don't help--he's been through every new NSAID under the sun over the years, and even the darvocet, tramadol, and percoset pre-shoulder surgery, and the vicodin post-op, didn't touch it.

I tried not to freak out, but I've heard so many horror stories about back surgery, it was hard not to, esp. when BNOS dropped the term "permanent post-op paralysis" into the conversation.  

The good news is, this can be fixed (theoretically)--I mean, it's not bone cancer or some similar horrendous thing.  And certainly we've both lived charmed lives into our middle ages, with a few serious acute problems for me and the chronic things for him (mostly arthritis related, since his 20s).  We haven't had car accidents or the like.  So I should be thankful, and I am.

But I'm also scared, maybe more than I should be.  It's going to be a long haul to December 15.  I'm keeping a happy face and trying to keep upbeat for him, but still.  This is the kind of thing I used to talk to Mom about, and it's the first big thing to come up since she's been gone.  And hubby has always been the physically fit, workhorse one of us (probably what caused most of his problems--he always did manual labor, landscaping, delivery driving, and warehouse work).

Help.  I need somebody to tell me it's all going to be OK, because I'm not listening when I try to say it to myself.

ETA:  Our friend Google mostly talks about chiropractic.  He's had enough chiropractic over the past 30 years to put several of their kids through school, pay off several boats and houses, and by rights have the healthiest back in the world.  We're beyond chiropractic at this point.

[lizzy]

Amthihist, What a lot to take in. My thoughts are with you and your husband.

It probably will be OK. But would it make you feel better to get a second opinion outside the practice you've been dealing with for the previous work?

[amlithist]

Yes, I'm thinking second (and maybe more) opinions will be in our future.  This isn't to be taken lightly, I think.

And thank God we have health insurance that (so far in 6 1/2 years) has covered everything under the sun.  (Interesting/infuriating sidebar:  the insurance paid $49xx for the shoulder.  The dr/hospital billed $22,xxx for it.  They wrote off the other $16,xxx as an "adjustment."  Good for us--we owe $0.  But what about the poor guy in the next [hypothetical] bed, for the same procedure, and no insurance?  He can't afford insurance--how the H. can he afford a $22,xxx hospital bill?  And you damned sure know they didn't do it for free at $49xx, either.  It's obscene.)

[southerntransplant]

My mother-in-law went through many spinal surgeries in her lifetime, and none have led to paralysis. Chances are excellent that it will be ok.

I noticed the same disparity in "adjustments" when I had lymphoma 10 years ago. The overall bill paid by the insurance was several times my mortgage, but without the adjustments it would have been a decimal point to the right (at least). The fact that that would have been my medical bill had I not had insurance was too frightening to contemplate.

In any event - good thoughts sent your way...

[concordancia]

Having been through some none threatening health junk myself, I came to the conclusion this morning that when things are threatening a lot of people build up a soldiering through attitude that allows them to hold things together. However, with the non-threatening health issues, it is just another source of stress, just one more thing to deal with and it just absolutely wears you down with none of the overcomingness.

It will be OK, it will probably be a slodge, but it will be OK.

[ms_turtle]

amlithist, I have some sense of your unease about your husband's surgeries and prognosis. Brother #3 is currently recovering from the 2nd of 3 replace/repair and reconstruct surgeries. He had a complete hip replacement about 6 weeks ago and a cervical fusion (C6 and C7 vertebrae) a week and a half ago. In the second week of January he will have a complete shoulder replacement. He is 46. He has had two back surgeries in the past. All of this has been brought on by years of college and semi-pro football, weightlifting, and coaching. I have never been more nervous about someone's surgery than his most recent one. The key is a good surgeon and it seems like your husband is in good hands.

[msparticularity]

I'm so sorry to hear that you are having to worry about this--along with the usual stuff, of course. In ways it seems promising to me that this has been spotted, since after it's done it may turn out to correct many, many things. It also sounds to me like the kind of surgery that tends to lead immediately to lots and lots of rehab and a fairly lengthy recovery, but then again things are so bad now that even a slow-ish recovery may feel like an improvement! I also think that spinal surgery, by its very nature, is scarier to think and talk about because of the gravity of the potential complications--the complications of other kinds of surgeries definitely exist, but often they don't sound so bad.

So, I guess I just want to validate your sense that this is definitely a very big deal--but also to say that, given the severity of your husband's condition, it almost sounds as if the danger/discomfort of the surgery may not be any greater than the danger/discomfort of his current situation.  (Which doesn't sound particularly comforting, I'm afraid, now that I've written it.)

[alastrina]

This all does sound like a big deal as MsParticularity said and second (and third) opinions are never a bad thing.  That being said, it sounds like you have a good doctor (and excellent insurance).  There is risk but the rewards is well worth it.

I have a friend who had surgery on her back for damaged vertebrae about 15 years ago.  Now she has good mobility and even recently received her brown belt for Tae Kwon Do. As long as she stays fit and keeps up with her PT, she does pretty well.

When your husband hits the point where they want to do the knee replacement, it might simplify things if they did both at once.  My aunt did this 2 years ago and it cut down on her total recovery time and costs. 

Everything should be fine. <virtual hug>

[theatremom]

I'm so sorry you're both going through this stress. I agree that a 2nd opinion may be warranted, and I understand your trepidation about surgery. Personally, I'd rather go through half-a-dozen invasive medical procedures myself than be the spouse sitting in the waiting room while my other half is in surgery.

I wish I had some direct experience or advice for you, but I don't. I will offer you all good thoughts and positive energy as you make your way through the next couple of weeks.

[amlithist]

amlithist, I have some sense of your unease about your husband's surgeries and prognosis. Brother #3 is currently recovering from the 2nd of 3 replace/repair and reconstruct surgeries. He had a complete hip replacement about 6 weeks ago and a cervical fusion (C6 and C7 vertebrae) a week and a half ago. In the second week of January he will have a complete shoulder replacement. He is 46. He has had two back surgeries in the past. All of this has been brought on by years of college and semi-pro football, weightlifting, and coaching. I have never been more nervous about someone's surgery than his most recent one. The key is a good surgeon and it seems like your husband is in good hands.

Yikes!  Maybe we should get the two of them together and ask for a bulk discount! 

I'm feelling a little better today; thanks, everybody.  Again, I know some of you are dealing with much, much worse things.  Best thoughts and hugs to all of you, too.

[msparticularity]

Yes, of course others here are dealing with stuff--but the really nice thing about this little corner of the Fora is that we don't rank/prioritize our struggles. We are one in our whining. :)

[compdoc]

Amlithist, How did the Dec. 15 surgery go? Hubby should be two weeks into recovery, though I know backs take a long time.

I hope everything went far better than your wildest hopes.

[llanfair]

Yes, AmLitHist, any word? Or was the Dec 15 a consult?

So sorry you're having to go through this.  The SO has had many post-traumatic issues as the result of a major car accident in 1987, so I have some inkling of how you're feeling.

[amlithist]

Picking up this thread VERY far down the line:

We did the Dec. 15 consult with the spinal surgeon, who took a conservative approach (allaying many of my early fears of, "hey, let's start cutting and see what happens!").  He sent spouse to a pain management center after determining, with some further studies and an MRI, that the displacement of the lower spine is largely congenital; however, this, combined with age, wear and tear, and arthritis, have created a narrowing of the spinal column (I think), which is coupled with a facet cyst in the lumbar area.  This cyst rubs on the nerve that comes out of the column and goes to the left leg, hence all the pain in the left knee and the odd pain in the left hip (not related to the needed hip replacement).

Over the past couple of months, we've gone to the pain management doctor, who's been great--three cortisone shots in the spine, over a month, did wonders, and the pain was gone.  The spinal surgeon's thinking, confirmed by the PM doc, was that if the cortisone worked, it would be a sign that it had acted to relieve the inflammation and shrink the cyst.  If there was no relief with the shots, the SS would then want to do surgery to see if it is, indeed, a cyst; perhaps it has calcified, or, worst case, would be some kind of tumor, that is causing the inflammation and resultant pain.   But the shots worked, and hubby was as good as new.

Until he wasn't.  Like a fool, he decided to shovel (the admittedly dry and powdery) snow during the first week of February, and he started hurting again; still, after a couple of days' rest, he was back to feeling fine.  However, the following week, the hip and knee and lower back started hurting again, and for the past two weeks or so, he's right back where he was when all this started:  using the cane, barely able to shuffle, and nearly in tears at points.

We went back to the PM guy this morning.  He did an exam and is sure the problem is in exactly the same place as before, but he's now not convinced it's a cyst.  We can't do any more cortisone shots for another 6 months (4 months, absolute earliest).  So he gave hubby an Rx for narcotics to hold him over til his next visit with SS on March 9.

::sigh::

Complicating all this, and stressing me out like crazy, is the fact of hubby's long-term unemployment--hey, he couldn't work anyway, the shape he's in--but he has been doing a pretty good lawn care business the past couple of years.  Now's the time to be advertising, building clientele, etc., in anticipation of spring, but it looks like that's not going to happen.  I can be the only earner, barely, during the winter months, but year-round?  I don't see how.  And Kid #2 is ready to go on to her 4-year school come fall, after 2 years of free CC tuition with me.  I don't see how that happens, either.  Of course, I've been working without a contract since July, my check is already $40 down since Jan. 1  (pension and tax changes), our health premiums are going up $60-70/month in July, and our copays are all going up $5-10 each.  I make good money, but a huge chunk goes to student loans and paying off Mom's medical/LT care bills, so I'm left with not much to live on, but too much to get any kind of help for the Kid or help with utilities, bills, etc.

God, I sound like such a whiner.  Sorry.  I should be glad that hubby's problems aren't worse, I guess, but the PM visit today kind of took the wind out of my sails, and hubby's.  He'd kept thinking he'd be OK to work this summer, then get the hip fixed next winter, but it doesn't look like that now. 

Is there such a thing as temporary disability?  It used to be that social security was only for permanent disability, and it was a bear to get qualified to draw that, but I don't know if that's still true.  Of course, he doesn't have any disability insurance--all the years he worked, we were living hand to mouth with the kids being small and me trying to get my grad degrees.  Any ideas of anything I should be looking into, in financial terms?

If it turns out he has to have something done to his back, I say we go on and get the hip done, too.  At least I still have the job and health insurance.  While I have no reason to think there'd be a problem in keeping that, you never know (cf. Wisconsin and other states).

Sorry for having a pity party here, folks.  I do feel some better, though, just having put my fears into writing.  And I really have to watch myself around him:  while I truly do sympathize, it's been rough these past few weeks, as he sleeps 14-18 hours a day, and then b*tches the rest of the time when he's awake.  (The PM doctor confirmed that this isn't unusual for someone with unmanaged chronic pain, as I recall all too well from Mom's last years.)  And of course, that's part of my pity party, too--I feel like I just got through all the stuff with Mom, and here we go again.  I should be nicer to him.  I know it isn't his fault.  ::sigh, again::

[msparticularity]

Amlithist, unfortunately Social Security disability is still only for permanent total disability. I have no idea whether your state might have any program that might help you, either. And I'm so sorry that you're having to struggle with this! Having a disabled spouse is no joke, and imposes both financial and emotional/marital strains, as I know from personal experience.

The thing I wondered while reading is why you're having to pay off bills for your mom's care--especially her medical care! Debt is not inherited in the U.S.; once your mother's estate is exhausted, her heirs have no obligation to pay off her debts. It seems to me that this might be the clearest place to begin trying to get some financial relief--perhaps followed by the student loans? There are provisions for reduction in student loans, or even deferments, for financial hardship. Also, are any of the student loans your husband's? His disability might matter there. It does also matter whether one has a child in college when financial obligations are calculated for loan relief. Have you looked into this?