Back Surgery & Covid-19

August 3, 2020

The morning of my microdiscectomy.

4:00 AM. I’m waking up to the sounds of the alarm. It’s 4 already? Ugh. Better get my sister up. We had an hour and a half until I had to be at the hospital. I was finally having back surgery to fix a herniated disc. I was scared, as I haven’t had the greatest experience with medical procedures, but I was looking forward to the relief it could provide. It had been 5 months of dealing with excruciating pain and nerve injury.

5:15 AM. My sister Rachael and I arrive at Paoli Hospital and head to the parking garage. Since we’re in the middle of a pandemic, she can’t come inside with me. I wait until literally the last minute to get out of the car. We exchange hugs and tears, and I make the trek into the hospital…alone.

By 6:30 AM I’m all prepped and ready to go to the operating room. Just waiting on the anesthesiologist and my surgeon for a final run down on everything. Thankfully I had the best pre-op nurses I could ask for. They knew I was petrified, and did all they could to make me comfortable.

7:00 AM. Everything’s moving quickly now. After repeatedly having to state my name and what surgery I was having done, I get wheeled into the cold O.R. and my surgeon asks me if I’m ready. As I nod yes, a nurse holds my hand, I feel the propofol being given in the IV, and the mask goes over my face. “Take some nice deep breaths. I’ll see you in recovery.” Within seconds I’m completely under. The team can now flip me onto my stomach and begin my 2 hour surgery.

I keep hearing muffled voices. What are they saying? Who is that? Why can’t I understand them? I must be dreaming…wait…I thought I was having back surgery? Ok this has to be a dream…go back to sleep.

I fade into the nothingness.

OMG!! Why am I rolling?!?! STOP!!! Why won’t you stop?! OMG the pain!!! I’m trying to scream but nothing will come out. Why can’t I tell them they’re hurting me?! Oh God the pain! Where am I? What is going on?!

Once again, I fade into the pitch black silence.

“Amy, Amy can you open your eyes? Can you squeeze my hand? I’m going to call the sister again.”

Yes, call my sister! I know I had my back surgery. I remember now! I remember being in the operating room. Why can’t I open my eyes?? Are my hands tied down?! Oh God, something must have gone wrong.

I hear machines beeping wildly. “Twice already she failed the trial. It’s doing it all for her.” Trial of what?! Will someone please help me?! Won’t someone tell me what’s going on?!

They’re rolling me again. OMG there’s so much pain and I just want to tell them! I’d give anything to tell them! “Amy, I’m sorry, I know this hurts but we have to turn you. I can’t give you any pain medicine right now until you wake up more.” But I’m not asleep! Why can’t I tell you?! Please I’m begging you to make the pain stop!!!

As I’m being rolled I start coughing and gagging. Oh my God I have a breathing tube. I know that’s what that is. Which is why my hands are tied down…I’m restrained. I must have failed the breathing trial. OK…I am in the hospital…but WHAT THE HECK HAPPENED TO ME? Past hospitalizations in the ICU are what helped me to start piecing together where I was. It was an all too familiar atmosphere.

Little did I know, it was Tuesday, August 4. Sometime in the afternoon. I’m more awake and can understand what the doctors and nurses are telling me. “Amy, today’s Tuesday. You’re in ICU. You had your back surgery yesterday but you had some problems waking up. We’re going to try to take your breathing tube out, ok? We want to try to make you more comfortable but we might have to put it back in. We want to give you pain medicine too, but you have to be more awake for us to do that.” I nod yes to taking the breathing tube out. I was so uncomfortable. I couldn’t stop coughing and gagging on it, but apparently I was still not breathing on my own as well as they wanted. I was extubated, and placed on bi-pap…a mask that goes over your head and tightly covers your mouth and nose. It forces air into your lungs so hard your cheeks blow up like chipmunks with every breath it gives. But I WAS more comfortable. And still not completely certain of what was going on. Trying to make sense of it all. Later that evening I was taken off bi-pap and switched to oxygen through a nasal cannula. I don’t remember a lot of that day. I think I tried to make a few phone calls to friends and family. Mostly I slept.

This horror story was my reality after my back surgery. At the end of the surgery they gave me a second bolus of propofol because I was waking up too much, before flipping me over and onto the stretcher. They gave me reversal drugs and sent me to recovery…but there was a problem. I wasn’t waking up. For whatever reason, this time having anesthesia didn’t go well. My body metabolized it too slowly, so its effects just lingered. It wasn’t until Tuesday morning that I began waking up and responding to commands. That is when I started hearing the medical staff’s voices and realizing I was in pain. They couldn’t give me pain medicine because of the sedating effect it has. They wanted me to wake up, not sleep more. And pain medicine tends to slow down your drive to breathe, so it would only hinder me more in getting rid of the breathing tube. So for basically 2 days, I was given absolutely nothing for pain after my back surgery until I was just receiving oxygen through the nasal cannula. That experience was pure hell all the way around. And because I wasn’t fully awake while on the ventilator, I didn’t understand what was happening. Nothing made sense. Normally when you’re on a ventilator, you’re given some type of sedation to make you more comfortable with it. In my case, there was none whatsoever.

The complications I had after surgery put me behind in my recovery. I spent 3 days in ICU and then moved to a step down unit. My pain had been so difficult to manage, partly due to the fact that we had to wait so long for me to be able to receive any pain medication. I still had a catheter. They were keeping an eye on my heart rate and blood pressure. Both had been elevated, but no one was terribly concerned. There was a plan in motion for me to go to Bryn Mawr Rehab Hospital for a week or 2 to get back on my feet. They just needed a negative covid swab before I could be transferred there.

August 7, 2020 11:00 PM. I’m finally falling asleep when a nurse rushes in. “Your covid test came back positive. You can’t be on this floor.” She quickly throws all of my belongings in a bag and tosses it onto the bed. She covers me and my things with a clean sheet, and hands me a mask (the rooms are private so as a patient, you’re not required to wear one while you’re in it). I was transferred to the “Covid Floor”. I got settled into my new room, met my nurse, and then was left to try to fall back to sleep. What just happened? OMG. I have a positive covid test. I’m on the covid floor…. But I’m in the high risk group…no don’t think like that. Maybe it was a false positive. Or maybe I’ll just be asymptomatic. I mean I don’t have any symptoms right now. ok… I’m scared.

I tried to be positive about my diagnosis, but I was wrong. Saturday was the start of my symptoms. I had a heaviness in my chest that made it feel like I couldn’t take a deep breath. And a pounding headache. God I’ll never forget that headache. It lasted for days. Sunday I started a low grade fever, and by Monday evening it was up to almost 104. It finally broke Wednesday or Thursday. Along with the fever came vomiting and loss of appetite. I started wheezing more and had more shortness of breath, so I was put on oxygen. I actually had a conversation with the doctors about my options for respiratory support, should I go further downhill. At some point I lost my taste and smell. And literally all I wanted to do was sleep. My body was so weak. Throughout the week that my symptoms worsened, I was still having problems with my heart rate and blood pressure. Most of the time the numbers were through the roof. I would get up with a nurse to use the bathroom, and would pass out. I would pass out when they would just sit me up in bed. And then throw in the fact that we’re in the middle of a pandemic, so I couldn’t have anyone by my side. The whole ordeal was a complete nightmare, and absolutely terrifying.

Once I was medically stable, I was transferred to Encompass Rehabilitation Hospital on August 15. I still had a catheter in. I still required oxygen at times because I would easily get winded, and my oxygen levels would drop with activity. My heart rate and blood pressure were still a concern, and I was still having fainting episodes. On top of that, 2 weeks in bed does a lot to your body, especially when you had back surgery. And it was a surgery where I should have been up and walking right away, if everything would have gone as planned. My pain was still hard to manage at times. I could barely stand up. I was using a wheelchair to get around my room. I had a grueling schedule of physical therapy, occupational therapy, and lung therapy. Here I was at 31 years old, having to relearn how to walk and take care of myself. Learning how to conserve my energy. I spent 3 long weeks in the rehab hospital. By the time I was discharged, I had lost 30 pounds since my back surgery. I was using a walker, and could only go short distances. The shortness of breath would still creep up on me. I had constant headaches, fatigue, and brain fog. Any bit of activity I did would land me in bed for hours. I had an increase in my seizures. And I was STILL having fainting episodes, along with a high heart rate and blood pressure. And then I got answers…I was a “covid long hauler”. A term given to those who survived covid, but have lingering symptoms. And everyone deemed a “long hauler” was suffering from the same symptoms. Everything I was going through was a result of covid. Sadly, no one can say if/when symptoms will go away.

Once I was home from Encompass, I had tons of appointments. I had to see the cardiologist and have testing done. And I started physical therapy right away, which was one of the toughest things I’ve done. But with their help, I went from being barely able to walk with a walker, to learning to get around with a cane. I was finally making improvement. But the cardiac issues just wouldn’t stop getting in the way. I ended up in the hospital for a week in November with fainting and a high heart rate. When I was discharged, I was informed by a doctor that I was directly exposed to a staff member who had tested positive for covid. I was basically told not to worry about it, since I already had covid, and that I should just quarantine and monitor for symptoms. Well a week later, I developed a fever, shortness of breath, and a cough. I went and got tested. 3 days later I had the shock of my life when I answered my phone. “I was calling to inform you that your covid-19 swab came back positive”. POSITIVE. WHAT?!?! I couldn’t believe that I had contracted covid a second time. I actually posted a photo of my results on social media because I felt that no one would actually believe it without seeing it. No one really knew how long your immunity could last after having covid, and no doctor could say that getting infected again was out of the question. It was unreal. Suddenly I had immense fear that I would end up BACK in the hospital again to fight covid, and that this time maybe I wouldn’t be so lucky. I had gotten really sick again, but continued to fight it at home, although most people were urging me to go to the hospital. This time around I again had a fever of almost 104. But I didn’t have the nausea and vomiting. Instead, the coughing was a lot worse, and I was congested. And all I did was sleep. But after about 3 weeks I was finally starting to feel back to “normal” and could get back to PT and try to finish recovering.

It’s now been almost 8 months since my back surgery and first covid diagnosis. Multiple hospitalizations and health conditions gave me plenty of setbacks in my recovery. I’m feeling better though. I still get tired. I still get headaches. The cardiac issues are still a concern. We don't know how much contracting covid a second time has affected my body, since I was still dealing with issues from the first round. But I’m better than I was. Physical therapy is progressing in a way that I never thought I would see. I’ve been working at my job part time. I will soon be having an appointment with my back surgeon, and will hopefully have a lot of restrictions lifted. It has been a long, hard road, but I feel like I might soon be reaching the end. And everything I’ve gone through has only made me stronger. This past year has been a story of pain, strength, determination, and perseverance…and it’s my story to be proud of.