Uncertain Dawn
Cindy in Mammoth, CA (You can see Kyle and Kirsti in the reflections)
They have told us day 2 would be the worst, so Cindy is bracing for it.
Nurses came in and the room buzzed with activity at about 6:30AM. Change of shift, review of the day’s goals, and assessing of pain. We have had lots of friendly attentive caregivers.
The surgery meds are slowly wearing off and Cindy’s nerve endings are beginning to complain. The breathing treatment made her cough and now we know that coughing is the enemy.
During the night Cindy was turned from side to side trying to find a comfortable way to sleep, but with all the tubes it was complicated and she did not sleep very well. I did alright on my backpacking air mattress on top of a very firm couch in the corner,
We are anticipating the Doctor’s visit.
The Night Falls
Cindy at the van Gogh museum in Amsterdam.
Some increase in pain brought the nurses with some meds. They turned her on her side, a relief from being on her back all day. She wakes easily and then slips back to sleep quickly. Spoke to both of the boys and was glad to hear about all those that have been praying for her.
The medicine to combat nausea makes her mouth dry as a spoon of cinamon. She has had ice chips and sips of water, but her lips keep sticking to her teeth. Chapstick is on the way. Respiratory therapy came and she did a little lung workout,
In a few minutes, they will bring her night meds and hopefully a few solid hours of sleep. Her temperature is normal, her vitals all steady. Everyone says, “Your doing good.”
She has not been on her feet yet and knows that is literally the next step in this journey. It is creating a bit of anxiety.
Most of the lights are off in the room, the curtain is pulled across the opening in the hall, the institutional florescence seeps through the fabric. Shadowy shapes drift across the undulating cloth. The air is filled with the beeps and pings of medical equipment and the soft hum of oxygen. Occasionally, words waft into the room creating a jumbled nonsense conversation.
They turned her, fluffed her pillows and settled her into the bed.
They offered me a pillow and blanket and a place to curl up.
“And so to bed…” – Samuel Pepys
Recovery Room
Just got word that Cindy has been moved to recovery. Waiting for her to be in a room before we can see her. The nurse said she was sitting with Cindy and she was dong great.
Post Op
Dr Cattorini, the surgeon, visited with us after his portion of the surgery. He was very pleased. Showed us pictures and said everything went great. There are still procedures to finish, putting the abdomen back together and then pain blocks and the final closing. It will be about an hour before we see her.
Before. Notice the gap near the bottom. There is a bright spot and bone on bone. Compare to the gap below.
report one
Cindy looking out at the Tetons.
I got this report at 12:40 PM. “She is doing great, we began at 11:25”
Phase One
Tuesday, Jan 28, 2025
Cindy during a hailstorm on Mt. Whitney.
Tuesday, January 28
It’s 11:00 AM.
I just sat down in the waiting area. Cindy and I prayed together with much of the team just a few minutes ago and then they slid her away towards the OR. They are expecting about an hour of prep before the actual surgery begins.
Lots of set-up.
Met a new Doctor who does Neuromonitoring during the surgery. Very interesting. Her name was Esther - very encouraging to us. Cindy told her - “for such a time as this” Esther 4:14.
Cindy has been on a roller coaster of emotions from calm to crying.
The paralyzing pain has subsided and she was able to ski, but not anywhere near her capacity. The limits of her back pain have become determinative of her activity and that is not a long-term solution. She consulted with numerous medical professionals and the unanimous opinion was that her surgery was necessary and it was a matter of time before it became urgent. It’s a lot like walking around with a time bomb in her back.
Her body is feeling good right now, not in a back crisis, and we are praying that this will accelerate her healing.
Surgery Day begins.
Tuesday, Jan 28, 2025
Drove to Frisco last night to avoid the stress of a morning drive.
Cindy finished filling out her advanced directives- everyone should do this.
Arrived at the hospital. Filling out forms. Started the day with surgical scrubbing soap, fresh sheets, unworn clean clothes (infection prevention procedure).
Still in the process of checking in, meeting nurses.
Surgery Info
Sunday, Jan 26, 2025
Surgery Nerds
Cindy’s surgery will be at
Medical City, Frisco
Tuesday, Jan 28, 2025
11:00 AM
They will insert two devices.
One in between S1 and L5
One between L5 and L4.
The device is called
It has an intimidating look.
Here is a video (again not graphic or intense, but animation) from a similar device that describes the surgery. At 1:45ish it presents two options IFSA or Inner fixated stand-alone or Anterior plating. Cindy will have IFSA.
Pre Op
What is most personal is most universal. Henri Nowen
Friday, Jan 24, 2025
Pre-Op
Cindy is preparing for back surgery next Tuesday, Jan 28, 2025.
Background
During December Cindy had another serious back event. Her pain continued to increase and her mobility has continued to decrease to the point where she could barely walk and was in constant pain. After about 3 weeks right at Christmas time it began to relent, but since it had gotten so bad, we made an appointment with Dr Cattorini. He had been the neuro-surgeon who operated on Lance's back several years ago. Lance's surgery has been a huge success.
She had multiple x-rays and MRI's comparing her back from last year..
Diagnosis
1. Spondylolisthesis (disks out of alignment) on 2 disks. (See Photo 1). Notice the yellow arrows and the disk that has slid to the side.
2.. And one disk that has degenerated to bone on bone. (See Photo 2). Compare the red area and the dark spaces above. The red area is collapsed and bone on bone.
Exam
He examined Cindy and had a careful conversation. After his review of her medical history and treatments he said surgery was her best (and only remaining) option. She has done injections and PT.
Treatment
He reviewed 2 choices. He recommended ALIF (See below). He said she was going to be a bit taller after the surgery.
We met with a vascular surgeon who cleared Cindy for the surgery.
Operation Expectation
The operation will take place at Medical City Frisco. 5500 Frisco Sq Blvd. Frisco
The surgery is expected to take between (4-6 hours). 1 hour to prepare for the back doctor. 2 hours per level. 1 hour to close and put in saddle block for pain.
Cindy will be in ICU recovery initially.
If all goes well she will be released on Friday to go home.
Post Op Plan
2 months in a back brace.
1 month of getting off the brace.
Physical therapy.
About 6 month recovery.
Not great news, but not unexpected. We have lots of confidence in the Dr after seeing Lance’s results.
We agree that she has tried medicine, shots, physical therapy and the situation continues to get worse.
Thanks for your love and concern. Prayers welcomed.
Information Links
Spondylolisthesis: What Is It, Causes, Symptoms & Treatment
Anterior Lumbar Interbody Fusion (ALIF)
FYI. Cindy was able to ski last week by staying on the green slopes only, the doctor thought she was crazy to do it, but said she could not mess things up worse than they were unless she fell. She did not fall.
Photo 1
Photo 2
Ski Trip