[libra]

I am having a back fusion on Feb 16 and will be having S1, L5 and L4 fused. I was diagnosed with pd in 2004. So far my symptoms have been kept under control with medications. I take mirapex (1/2 mg 3/day), stalevo(150 mg 3/day), and carbidopa/levo tabs(25 mg 30day). For depression I take cymbalta and welbutrin.

My question is this - after sugery is there an increase in one's parkinsons symptoms because of the trauma of surgery?

I am concerned because of what happened to my parents. THey both had alzheimers (I'm doomed). Whenever they got really sick or trauma tized, their alzheimers would get significantly worse. As they got better, their symptoms somewhat subsided, but they were never as they were before the cold. i'm wondering, is this same situation the same in parkinsons?

[reverett123]

I'm sure that you are past the "is it necessary" point, so I'll skip that. And I have never had to face surgery with PD so I can't comment directly. I will, however, tell you what I would do in these circumstances.

First I would search this forum for "anesthetics". That should turn up an article I posted a couple of years ago about the different options for PWP by a world class anesthesiologist. Make sure everyone has a copy well in advance.

Second, I would be sure that everyone on all shifts knew just how essential it was that my med schedule be followed and that fiteen minutes delay can be more than inconvenient. Also, I'd get my doc to note on my chart that I was in charge of my meds and could take extras if needed. And I'd have an advocate on hand to enforce it.

Third, as you suspect, the stress is the big thing. Both physical and emotional. I would get my doctor to prescribe anti-anxiety medication but under my control. If I didn't want it then that should be my decision.

Finally, and I am speaking from experience here, I would find myself a psychologist who was also a hypnotherapist and I would work with him or her so much that I would be the coolest and most relaxed patient ever. Don't underestimate the good that this could do. The last time I had an MRI I dreaded it because of my claustrophobia. I know a bit about hypnosis and made myself a tape assuring me not only that I would chill through the whole thing but that my time sense would be altered so that it would seem to be no more than five minutes. The thirty or so minutes flew by and really did seem to be five.

-rick

Originally Posted by libra

I am having a back fusion on Feb 16 and will be having S1, L5 and L4 fused. I was diagnosed with pd in 2004. So far my symptoms have been kept under control with medications. I take mirapex (1/2 mg 3/day), stalevo(150 mg 3/day), and carbidopa/levo tabs(25 mg 30day). For depression I take cymbalta and welbutrin.

My question is this - after sugery is there an increase in one's parkinsons symptoms because of the trauma of surgery?

I am concerned because of what happened to my parents. THey both had alzheimers (I'm doomed). Whenever they got really sick or trauma tized, their alzheimers would get significantly worse. As they got better, their symptoms somewhat subsided, but they were never as they were before the cold. i'm wondering, is this same situation the same in parkinsons?

[libra]

for your advice. I really appreciate it. In my opinion this surgery is very necesarry, one can only stand so much pain and I have tried every other option available to man. As to anxiety, I have had alot of surgeries unfortunatelly, but never when I had pd. I am always anxious before surgery but it hasn't been unbearable. If anything, I am pretty depressed, feel like my body is just falling apart.
I am pretty lax on taking my meds - I take them3 times a day, but give or take 2 hrs or more sometimes and hasn't been too bad. I will break out into a sweat and get nervous if I am too late or miss a dose.
Another thing that worries me is the pain. I have been on and off vicodin for a long time and it just barely cuts the pain. I have become pretty immune to the pain relieving benefits of pain meds. My doctor has assured me the pain will be taken care of. My last surgery was on my knee and it hurt like he*%, the pain meds didn't evey touch it.
I just hope I fully recover and am no worse off than I was mentally and physically with my pd.
Reading back over my post, I guess I am just a little anxious. I pray everything goes well.

[Jaye]

It will be in your favor that you're not that dependent on meds yet. BUT if you have a family member around who can do the insisting for you, in case the nursing station doesn't get it, it would really be a good idea to have them be in charge of your PD meds. Rick is right that they don't know how much difference timing makes to us. I've heard a lot of horror stories--no details necessary here--search on hospital if you want to know. I'd like to emphasize that hospital personnel will NOT take your word for what meds you need, nor will they necessarily accept that those pills in your daily packet are what you say they are. You MUST have your neuro write out what you're supposed to have, and it must be ahead of time, again, as Rick said. I had the shock of the nurses telling me the first day that my pills all had to be in their original bottles. Fortunately I had engaged the chief pharmacist in pleasant conversation by chance, and he was interested in my meds, so I showed him the computer-printed list that I got off my account at the online mail-order pharmacy that my insurance company uses, with the last 18 months of PD meds on it. He took the list and scanned it and said, "This looks like original bottles to me," then went to the nursing station and squared it with the nurses.

Ice is good for pain. Nurses bring ice packs if pleased with you, and let you use them for, like, 20 minutes an hour. I like ice on top of my head, too, for any kind of pain. I have talked to back-trouble patients in the chat rooms, and they mostly use a combination of acupuncture and attitude to deal with the pain. Being very religious helps, at least for the duration of the healing, or finding some way to get "in a zone" above your body. When I had a hip replaced a couple of years ago, I used narcotics to take the edge, but only the edge off.

Another caution: don't expect anyone on staff to know the first thing about PD, but you can teach them. For example, a wheelchair pusher intent on getting you to physical therapy can get impatient, but you can explain that you're a slow mover on account of the PD--you get the idea.

Back to your main concern...I didn't experience any worsening of the Parkinson's during my hospital stay and recovery. In fact, PD was the least of my problems, once the med question was settled. I actually felt better in the recovery room than I had in a couple of years (and the nurse gave me a sinemet as soon as I awoke). With my increased mobility and some good physical therapy and more exercise, I got better for quite a while--for about two years, actually.

APDA has a wallet-sized fold-over card that carries a list of meds and anesthetics to avoid. You can get them from any APDA chapter, or call one of their offices to get some.. The also say "I am not drunk" and other useful info for getting around town. I'll bet their website would be helpful, too.

Good luck and good wishes,

Jaye

[libra]

You certainly did reinforce what Everett had said. It scared me a little, I will definitely make sure my meds are squared away. Fortunately I see my pd doc before surgery so I can talk to him about it. I will also have to check what kind of containers to bring meds in, I'm sure what you say is true, just need to talk to hospital first.
Boy, having pd constantly challenges you does it not?