Scoliosis Patient’s Journal

Hope Outweighs Fear: Scoliosis Surgery with Dr. Pashman

Surgery Date: July 8th, 2002

Luck on the Internet

It was during the spring semester of my sophomore year at college that I first came to know Dr. Pashman. I had been diagnosed with scoliosis while in elementary school and was then told to wear a brace to correct my curve. But I, being a defiant child, had chosen to avoid what I felt would have been a traumatic experience for a young girl. My short-sighted decision led to considerable growth of the curve. I had ignored the development of the curve for most of my adolescent years, but once in college, I began to experience back pain, as well as an increasing wobble in my step. It was then that I knew I had to do something about it. So, late one night, I worked up the courage to go online, and typed in “scoliosis surgeon” in the search field.

With that, popped up Dr. Pashman’s website: espine.com. I looked through each and every one of the many informative pages on his website and finally stumbled upon his curriculum vitae. To my amazement, he had graduated from Penn! How could I not trust someone with such amazing credentials, but who was also an alum of the university I attended?

The next day, I immediately called his office and scheduled an appointment. I was going to be going home for spring break, and it seemed like perfect timing. It was then that I took a moment to take in what I was really doing. I knew in the back of my mind, if what I expected were to be true, surgery was inevitable. Fear rushed through my body. But, I knew that there was no stepping back at this point. I had to face the truth.

Meeting Dr. Pashman

It was on a typical sunny and breezy California afternoon that I first made my way to the Mark Goodson Building on San Vicente Blvd. I was nervous, but, at the same time, a bit excited to find out what my spine really looked like. I had done a lot of research on the Internet in the days following my appointment scheduling, and oddly enough, rather than fuel my fears, the Internet had quelled most of them.

I made my way up the elevator to the Cedars-Sinai Institute for Spinal Disorders, filled out all the necessary paperwork, and waited to be called in. After a few minutes of nervous thumb twirling and fidgeting with the free coffee dispenser, I heard a nurse call my name. I was led to an examination room, and soon after, a young doctor came in and asked me to do a variety of things, which I presume were the usual diagnostic tests for scoliosis patients. To say the least, I probably failed most of them, as I couldn’t walk straight, and when I bent over, my back was as uneven as most Los Angeles sidewalks.
The young doctor, whose name I never caught, left the room, and returned with Dr. Pashman. I had already taken a set of x-rays by this point and was led out of the exam room to see them. “Oh My God!” was all I could say at first glance of my x-rays. I had no idea that I was that crooked! After Dr. Pashman measured the exact degree of the curve, he told me that it was an astounding 48 degrees.

Dr. Pashman then walked me back into the exam room and sat me down. He told me about what doctors do given a curve of that size and my age (At the time, I was 19.) The curve had obviously grown, despite my not growing any taller, meaning that, more than likely, without any treatment, the curve would continue to grow at about a degree every year.

There was only one logical choice- surgery. After seeing the x-rays with my own two eyes, there was no way that I could deny that. My mind was made. That summer, I was going to have surgery.

Pre-Op Adventures

For the next few months, I spent my time back in Philadelphia finishing up my sophomore year. It was quite easy to keep my mind off of the impending surgery, as I
had courses and exams to worry about. But, as soon as I returned to California, surgery became a major reality.

From the moment that I returned to California, my days were filled with pre-op activities. I had scheduled my surgery to be a week after school let out because I had to
travel to Japan for study abroad three months later, in October. I had no time to waste! My first pre-op appointment came on Monday, July 1st, 2002. I was scheduled to see an internist and have every nook and cranny of my body checked out to make sure that I was physically ready to undergo surgery. They tested my lung capacity and performed countless blood tests. I didn’t realize that this was just the beginning of the skin pricking that was to come. But, all in all, it was an endurable experience that ended before I knew it.

Immediately after my appointment with the internist, I headed over to the Blood Donor Center at Cedars to donate my own blood for my surgery. Because there was only a week between my donating of blood and surgery, I could only have one unit of blood taken. The actual process lasted only fifteen minutes, but my fear of blood and needles made the whole experience quite scary. However, perhaps noticing the fear in my eyes, the nurses treated me with particular care and made the experience as painless and as fun as could be.

The Tuesday before surgery, I was scheduled to have my last pre-op appointment with Dr. Pashman. I took many more x-rays, with some being in very awkward positions, where I was told to bend as far as I could to the right and left. Dr. Pashman also kindly answered some last minute questions of mine and I left with a feeling of overwhelming confidence.

Surgery Day- July 8th, 2002

Surgery day had finally arrived. I was supposed to be at Cedars by 5:30 am, two hours before my scheduled surgery time of 7:30 am. The night before, I didn’t sleep
very well because I was most definitely nervous, and a lot of other things, all at once. Admittedly, I was a tad scared of what to expect, with this being my first surgery. What kept coming to mind at this point were the infamous horror stories of never waking up from anesthesia, having the wrong limb cut off, and never being able to walk again. Although most of my fears were unwarranted, the night before surgery proved to be long.

After going through an enormous stack of paperwork, I was led to the waiting room on the 8th floor of Cedars. After a few tense minutes of waiting with my parents and other people scheduled for surgery that morning, the patients were taken to a cold, stark room with many beds, each separated by curtains. There I was given a gown and paper slippers to wear and two bags to put all my belongings in.

With that, I undressed completely (a new thing for me), and sat on my bed, nervously waiting for the next set of directions. Soon after, a male nurse came with a big, thick folder, telling me all about my surgery and pointing to places where I was to sign. Quite frankly, to this day, I have no clue what I was signing!

While I was still signing away, the anesthesiologist came. He seemed like such a nice and jolly man, almost resembling Santa Claus in a lab coat and scrubs. He sat down next to the bed on which I was sitting and asked how I was doing. The first thing I told him was how utterly afraid I was of needles, blood and the like, and he promised me that he would make the process of inserting the IV as painless as possible. I prayed that he was telling the truth. And he was. He gave me a shot of something near the vein he chose for my IV, which numbed the area a bit. And before I knew it, the IV was in and he patted my hand and said, “All done.” I was so relieved to have that part of the journey to surgery done.

After the anesthesiologist left, came a stream of doctors and nurses. One put very tight white stocking like things on my legs to prevent blood clots, as well as little pads with wires attached to them on various parts of my body. Then came my nurse, who also wheeled me into the operating room. I still remember fondly how she told me about her cat and how she loves to travel. Last to arrive was Dr. Pashman. He said a quick hello and asked how I was doing, and left with a reassuring, “See you in the operating room.”

With that, I was done with the pre-op procedures and was wheeled off to the operating room. It was a little past 7:30 am on a cold Monday morning. My memories of the operating room are few and far between. I remember being wheeled into a very cold, white-tiled room and then being moved onto the operating table. There was loud music playing, which I thought was quite humorous. Before I could really take in the sights and sounds of the operating room, the anesthesiologist came and said, “Here’s the liquid.” I remembered that I had asked him
how long it would take for the anesthesia to kick in, and he had said about 15-20 seconds, and boy, was he right. From that point on, I don’t remember a thing until…

After Surgery…

My first words after surgery: “I feel like I’m going to throw up.” Before I was fully aware of the fact that I was awake, I felt the urge to vomit. The anesthesiologist once again came to my side and put some anti-nausea medication into the IV. He also laughingly said, “You were asleep for seven and a half hours, of course you’re feeling weird.” His lightheartedness made me feel relieved that I was not experiencing something completely out of the ordinary.

The next thing I remember is being in the same room that I had started the morning off in. I was hooked up to a variety of complicated machines. I had a chest tube poking out of the left side of my body that I wasn’t told about before surgery. I had a catheter in place as well. Despite the fascination that came with these new additions to my anatomy, the thing that I cared about most at that moment was if I could move my toes. My first conscious decision was to wiggle my toes and I was so relieved when they moved.

For the next few hours, I was too scared to move anything but my head. I thought that if I moved my hands or legs, something would fall off, or I would mess something up and it would lead to some chaotic scene with doctors screaming and yelling. I tried my best to stay as still as I could.

Once I realized that everything was securely in its place and that it was fine to move, I was overcome by the nausea that had hit me right after surgery. With nothing in my stomach to throw up, my body would randomly begin to shake, without warning, in an attempt to expel something, anything from within my body. It was one of the hardest physical ordeals of the recovery process because I, nor the nurses, could do nothing about it. The reaction was uncontrollable. I was told by the nurses that I had no choice but to tolerate the nausea because, the only alternative choice was to take me off of pain medications.

To control the pain, I had an epidural put in place during surgery. It was very effective at controlling the pain, perhaps even a bit too much! I must say that for the first few days, I did not feel any pain, but then again, I didn’t feel very much at all. I vaguely remember my parents coming in to see me, but I did not have the energy to talk to them. I’m sure that it was not a pleasant sight for them to see their child with
wires and tubes coming out of every possible part of her body and am quite thankful that I didn’t have to witness the sight myself. Dr. Pashman also came to see me and asked how I was doing, and all I remember is
saying how nauseated I felt. He reassured me that it would be fine. The next day, I was moved into the intensive care unit. In that room, there seemed to be more monitoring machinery than I had organs to monitor. I had two little clips on my fingers, a weight on my right arm to prevent the arterial IV from falling out of place, and the existing chest tube, epidural and catheter all coming out of my body. It was here in the ICU that I had my first bed bath. It took two nurses to essentially
wipe me down with wet towels. As rudimentary as that sounds, after undergoing a seven and a half hour surgery, it actually felt very refreshing. After my bed bath, I was rolled onto my right side, with pillows behind my back to keep me in that position.
Apparently, it is not a good idea to lay in one position for extended periods of time.

Post Surgery- Day 2 Tuesday

Most of my second day, I spent either sleeping or in a daze. I wasn’t eating and thus was receiving nutrition intravenously. All tubes remained in place, which I had grown quite used to. I enjoyed the idea of not having to get up to go to the bathroom, because the thought alone of moving was tiring. The epidural kept all pain away, which I was also very grateful for. But, apparently, moving was on the to-do list that day. Two physical therapists came to my room and suggested that I should try to stand up, and get the blood flowing again. Since the surgery, I had had these pump-like devices placed on my calves to push the blood up from my legs. So, the first step in preparing me for my attempt at walking was removing those. Then, the therapists had to make sure that there was enough “line” from the tubes extending out of my body for me to walk around. After all the preparation was complete, then came the big moment for me to actually get up. This was a failed mission. I log rolled onto my side and attempted to prop myself up using my elbows and arms. I made it to a sitting position, but all of a sudden, I felt extremely light headed and thought I was going to faint. My blood pressure had dropped significantly. The physical therapists said that this was fairly normal when sitting up for the first time post-surgery. Thus, that was the end of this day’s attempt at getting me to stand up.

Later in the afternoon, I was moved from the ICU to my other room on the regular floor. Most of the monitoring devices were taken off because the room on the floor was not equipped to handle those. This meant that I regained control of my right hand, no longer having the weight bound to it, and my fingers on my left hand were also freed of the little clips as well.

My new room was much brighter and cozier than the one in the ICU. There weren’t monitors everywhere, and I had a TV. It reminded me of the rooms that one sees in television shows. But, before I could enjoy my new accommodations, I was back to sleeping.

Post Surgery- Day 3 Wednesday

This day proved to be very exciting. I became a tubeless person! The first things to go were the epidural and chest tube. Dr. Pashman came in with another doctor mid-afternoon and said that it was time to remove both. I was laid on my side and before I knew it, the epidural was out. It was painless and quick.

Then, came the ordeal with the chest tube. Seeing that I didn’t quite understand how it was in place in my body, I didn’t understand how they were going to be taking it
out. But, I was soon to learn. Dr. Pashman instructed me to breathe in and out, and on the count of three, he was going to take out the tube. Simple as that. Or so I thought. Things became a bit complicated when something obviously didn’t go according to plan. I heard the two doctors speaking to each other about “not yanking it out” and “tying it in one or two places.” I couldn’t quite understand what the issue was, but with the tube pulling on my skin, I was in pain! I prayed that the tube would come out soon. Thankfully, within a few moments, the tube was out of my body and three staples were put in place to close the opening in my side. I had never had staples put in before, and, much to my surprise, it was not too painful.

Later in the day, my catheter was taken out, which I was quite disappointed about. I had gotten quite used to not having to get up to go to the bathroom or even be
concerned with needing to go to the bathroom. I was also quite fearful that I would not be able to sense the need to urinate any longer.

The nurse was very casual and calm about this rather embarrassing situation. She simply deflated the balloon, and thanks to her deftness, it was over in a few seconds.
Now I had to contend with having to go the bathroom on my own, which also meant that I would be forced to walk about.

That evening, I felt that it was time I went to the bathroom. But, the bathroom looked so far away, even though in reality, it was only a few feet away. I was still hooked to an IV, which made moving a difficult task. Luckily, the same nurse, Stephanie, was nice enough to get me a mobile toilet. She placed it next to my bed and despite it having to be emptied every time I used it, it was a very convenient device (for me, at
least!).

Post Surgery- Day 4 Thursday

Since having the catheter removed, I had begun walking around much more. Physical therapists have come to work with me, getting me to walk around more and
more. I have also gone on short walks around the floor with my mother. It is still hard to sit upright and stand because my legs have gotten weaker and there is additional
weight to support. All in all, things feel a bit funny when walking around. On this day, I was fitted for my brace. A white sheet was placed over my upper body
and lines were drawn on it to mark a variety of things. It felt very cold, but then I realized that there was a reason for the coldness. The strips of fabric, I believe, that they began laying on top of me were much, much warmer. They also hardened seemingly instantaneously. After placing layer upon layer of fabric, the technicians
waited for a few minutes before lifting off the entire
mold. A similar process was done on my back and the next day, I was to have a spiffy brace to wear.

Post Surgery- Day 5 Friday

Lo and behold, my brace was done! It fit fairly well, but required a few minor adjustments. The brace definitely helped to support me when I was walking around,
and it also helped me when I sat in a chair. The strain was taken off of my back muscles to do the work, finally.

I was also taken off of the IV on this day, which meant that I had to actually eat. Quite frankly, I was in no mood to eat, as I was still fairly nauseated from the pain medication. But, if I was to survive without the IV, I was going to have to force myself to eat. Meals consisted of chicken or beef broth, Jello, Italian ice, tea and water. I could not stand the smell of the broth, so, while pinching my nose, I forced myself to consume the Jello and Italian ice. But, my favorite food in the hospital must have been the ice chips. I never thought water could taste as good as it did.

Post Surgery- Day 6 Saturday

Dr. Pashman came in at about 6 a.m. to see me, and I was still asleep. I had been waking up every four hours to beg for more pain medication, and 6 am was in between
a four hour period, but nonetheless, the thought of missing Dr. Pashman forced me awake, once my mother told me he had been in. I went out onto the floor and said
good morning. He said that today was the day I was going to be able to go home! A part of me was excited to be leaving the hospital, but another part of me was deathly afraid of what I was to face on my own. I had grown so accustomed to having an army of nurses and doctors to rely on constantly. It was time to start doing things on
my own again… Dr. Pashman checked on my incision that morning and changed the dressing. I was still bleeding a bit, but was told that with a new set of steri-strips, I would be ready to go home. Before being discharged, I asked him the usual questions about what I could
eat, what I could do, how often I was to wear my brace, etc. By 12 pm that afternoon, I was in the car heading home. I was going to miss Cedars and their wonderful staff greatly.

Life at Home

I arrived home after about an hours drive, and upon arriving home, I refamiliarized myself with my house…and three dogs. They were jumping up and down, running all around in a frenzy. I was very afraid that I was going to trip on one of them and stumble, landing myself in the hospital all over again. Thank goodness that didn’t
happen.

For the first week that I was home, I was still very nauseated. I was taking both antibiotics and pain medication and I realized that the problem was that I wasn’t adjusting well to the antibiotics. I called Dr. Pashman’s office, and was given the green light to stop taking the antibiotics.

After that, I felt much better and could finally tolerate food. I was still favoring simple things like Popsicles and jello, as well as fruit juices. While I could not eat very much, I decided that I was going to take up cooking, something I had never done before in my life. I attempted to make a whole slew of things, but not one has yet to pass the human taste test.

Sleep used to be the easiest thing for me, but after arriving home, I was still waking up every four hours or so. Because I wasn’t able to move as I wished, sleep was just not very comfortable. In addition, during the night, the pain medication would wear off, sending pangs of pain down my side. Although it was irritating at first, this became a welcomed wake-up call, as it forced me out of bed and made me walk around a bit.

First Post-Op Appointment

I went back for my first post-op appointment the Thursday following my surgery. It was the first time that I had left the house for an extended period of time. I was very worried about the car ride and the possible nausea returning. But, the trip was uneventful, thank goodness. I had x-rays taken of my spine, which has become quite routine by this point. I also had the sutures and staples from the chest tube taken out. Jodi took out the staples, which was very quick and painless. Then came the removing of the suture. That was a bit more painful, with some of tugging on the skin, but not at all as bad as I had imagined.

The last thing to come off was the dressing on the incision. I hadn’t yet seen the incision yet and was quite fearful of seeing it. But, once the dressing was off, Dr. Pashman led me to a mirror and when I looked, I was pleasantly surprised. It was a thin red line. But, the area around the incision, where the steri-strips were once, was turning bright pink.

Life Back at Home Again

It is now the middle of August and it has been a month since my surgery. The incision seems to be healing well, in my opinion, but what concerns me more is the marks left by the steri-strips. It makes my incision look much more grotesque than it really is. For reasons unknown to me, my body has been undergoing a variety of changes. For a few days, every time I put weight on my legs, they would begin to tingle and send little shocks up towards my waist. Now, my arm and leg on my left side feel a bit numb and tingly. I have high hopes that these effects are temporary and I will soon be able to resume a normal life. My brace and I have also been getting along quite well. Often, I fall asleep with it on. The tingling in my legs has now somehow spread to my left arm. It has been difficult to leave it in one position for extended periods of time and I’ve learned that, sometimes, banging it against a hard surface is the only hope for relief. Thank goodness my second post-op appointment was near!

Second Post-Op Appointment

It was now the middle of August, and I was back at Cedars for my second post-op appointment. I took the usual set of x-rays and waited for Dr. Pashman to tell me how things were looking. I was told that I was fusing well and everything seemed to be progressing in the right direction.

I also asked him about the tingling in my arm and legs. He brought another doctor along with him to figure out what was causing the tingling in my arm. He suggested
that perhaps it was because of the brace, which could have been putting pressure on the nerves extending into my arms. So, his advice was to not wear the brace for a
couple of days, and to call if things did not get better.

Last Few Weeks in Los Angeles

Two months have passed since I had surgery. I am feeling much better, with significant improvement in the last few weeks. I can walk much more normally, sleeping
is no longer difficult and life has resumed its normal pace. I still cannot, of course, lift heavy objects, and sitting in strange positions is still difficult, but nevertheless, most people cannot believe that I had surgery only two months ago.

I am going to be moving to Japan in about a week. I am very excited of this opportunity to study abroad, but of course, am also a bit scared of what could happen en route to Japan, as well as in Japan. With Dr. Pashman all the way on the other side of the Pacific, concern obviously exists. But, he has reassured me, as usual, that the chance of something going wrong is so minimal, I have nothing to fear. With those thoughts, I am off to Japan, and will be back in February of next year to return for my next post-op visit.

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For any individual or family that is considering the option of surgery for scoliosis,there always exists apprehension and concern of the possible negative outcomes. In my personal experience with Dr. Pashman, that fear was easily overcome. I have never met anyone who cared as much about his patients, nor was as amazingly qualified. Given that combination in Dr. Pashman, it is hard for me to see others give in to their fears of surgery. The possibility of paralysis, infection, and other complications are there. That has been proven through past experience. But what has also been proven through that experience is the joy and hope that surgery can bring. With Dr. Pashman and his
amazing staff, hope outweighs fear.