Surgery Recap

My friend, Melany Unrau, compiled all of my facebook messages to her and some other friends, and added a few things that she knew, to compile a chronological story of my SI surgery experience as a memoir for me and to be able to share.  Melany also suffered with SIJD and was crippled for several years and lived out of her bed.  I have been honored to get to know her, and she is now living a normal life after her surgery.  She is a very Godly woman who coached me through this entire process.  The text also contains a response from Amy, another SIJD friend.  Lots of punctuation and grammar errors... I was texting from phone and while heavily medicated!  Thank you Melany!



*The following is Caroline's journey these last few days here in Georgia, written in first person...

My First Trip To Georgia Was Several Weeks Ago-
Prior to traveling to Georgia for my SI Surgery, I'd decided to go ahead with Vicki's 6wk Conservative SI Stabilization Protocol. So, I had already been to Georgia a few weeks ago to see Vicki for evaluation and learn the program (also saw Dr.Weiss at that time for a pre-op consult just in case). 4wks into this program we could see that I was just too unstable due to SIJD for 8 yrs.

The Following Is My 2nd Trip To Georgia-
*order of events the last few days here in Georgia from pre-op to immediately following post-op...

DAY #1, Arrival in Atlanta-
Pre-op Testing For Common Associated Conditions with Dr.Howard:

Loved Dr. Howard! It took much longer than expected, he spent almost two hours with us!

1. Piriformis Syndrome via EMG with Fair Testing:
*I do not have Piriformis Syndrome - yeah! The piriformis muscle itself is sending out pain signals though, suggesting SI problems.

2. Lumbar Disc Nerve Testing via EMG:
*Dr.Howard tested my lumbar spine + pathway for possible contributing nerve interaction from my L-Spine discs. We got concerned at first because he was getting positive pain signals in both calves at L5 (where my annular tear is). uh oh.

He continued via EMG to follow the nerve pathway and he went up to my lumbar back. Howard said this area was more important and there were zero pain signals at all levels! He said that if my disc was causing the significant pain I was having he would have gotten strong pain signals in the lumbar - where the "roots" are and he got absolutely nothing.

When I asked him why there was positive pain signals in my calves, Howard said that if disc was part of the problem it was likely 10-15% of on a pie chart:
he felt very strongly that SI was my #1 pain generator. He definitely thought I had biomechanical SI dysfunction - my scoliosis and shorter leg causing a lot of problem to the SI, thus biomechanical.

Dr.Howard also said the manual pressure to relieve shoulder dystocia of baby given during McRobert's maneuver is likely what caused the femoral nerve injury (which he said looks great now),  likely too much pressure. But McRobert's maneuver, the maneuver used to relieve shoulder dystocia likely caused the stretch injury to SI joint. The baby was stuck and time was of the essence. 

Feeling pretty good about my bulged disc at L5 now. Dr.Howard said I was very complex (due to having Scoliosis since childhood), Vicki said it too...i hate hearing that..but greatful about being here.

Pre-op Testing to Confirm SI Joints as Pain Generator via Flouroscopic SI Injection with Dr.Stewart-
*We chose to forgo this test as it would be a repeat procedure for me. I'd already had SI Injection prior to coming to Georgia to see Vicki/Weiss.

DAY #3, Pre-op appointment with Vicki, day before SI Surgery:
Discussed my test results + surgery recommendations and manually aligned my SI Joints..

Vicki is still quite concerned about disc and said to go ahead and plan on working on the disc as soon as we get through the six week therapy after SI surgery

Pre-op appointment with Dr.Weiss, day before SI Surgery:
Discussed test results and SI Surgery options.

Due to my scoliosis, Dr. Weiss had already decided that we needed to fixate and fuse my left SI joint.  He said the scoliosis and shorter leg causes more shearing and strain on the joint.  My sacrum also has some defects so we did a ct scan in order to determine where he will put the implants and make sure he has room. The fusion means a more involved surgery, and we chose the ifuse implant since it is the least invasive.

DAY#4, Pre-op...here's what my SI Surgery will be:
(Morning of surgery day April 7th at 6:27am):
Vicki to manually align in the Operating Room on the table while I am asleep. Weiss will surgically insert ifuse implants on left, fixate via screw implants on right..partial non weightbearing for six weeks..here we go...

DAY#4 con't, Post-op, (afternoon/same day as surgery...April 7th at 2:58pm):
Just got up with PT...I could not tell anything done on right side screw fixation! It is nothing..very sore on ifuse side, guess larger incision and implant? all went well..thx for your prayers.

DAY#4 con't, Post-op, (early evening, same day as surgery...April 7th at 7:44pm):
Hurting on my worst side at of my hip around ifuse incision area..i want to bear full weight to feel it but don't want to get my hopes up. I can’t express the feeling of this enormous power of prayer that goes up on our behalf!

DAY #4 con't, Post-op, (late evening, same day as surgery...April 7th at 10:45pm):
Surgery went well, the side with screw fixation feels like nothing there. Dr.weiss and vicki wanted fusion with ifuse on left, and that side hurts but not awful! vicki came by and said all is EVEN now! I know I will have some hard times but so happy . thank you sincerely for prayers!

DAY #5, Second day of post-op...(Late afternoon, April 8th at 4:16pm):
I have beautiful screws on one side and ifuse on the my worst side. it seemed to me that weiss is reserving ifuse for ones that do need a fusion. he also told me I will feel more stability in the screw side for a while until ifuse fuses. the incision is much bigger and they do have to pull some muscle back. Vicki wants weekly updates since I am one of first ifuse. I can def say the post op pain is much better with screws.

DAY #5 con't, Second day of post-op...(Evening, April 8th at 6:36pm):
Pain is very tolerable right now. I do still have SI pain..hope that is normal, but the pelvic pain is GONE! Even without wearing tape! I went into surgery with pelvic pain at 8/9..and now gone. Hope it stays this way!

DAY #5 con't, Second day of post-op...(Evening, April 8th at 6:36pm):
So, we are back at hotel and after the activity of walking with walker, my back is really hurting on bad side. I am getting nervous. It seems like I have heard people are immediatey pain free in SI
Caroline's Question: please tell me normal and when did si stop hurting? it makes sense to hurt after surgery..robert says I am worried over nothing.

Amy's Reply: It's ok caroline - it's ok - it is normal it it was hard - you JUST had surgery- take a deep breath... it is ok sweet, sweet Caroline! it will hurt like this for awhile and then it will get better and then you'll start PT and it will hurt on and off again...you are just a few toes into this journey...it's OK to hurt, it's ok to cry, it's ok not to know what to feel. Your going to be nervous and unsure for awhile.... Carol and I both were and expressed the same fears - rest... rest in your husband, rest in your all mighty God. rest praying for you and rejoicing with you - you have your firm foundation - it will take time for your body to heal form surgery. Many hugs and much love!!

Melany's Answer: It is worry over nothing, 100%!!! But I had it too, I have to guess that most of us do post SI Surgery! You will still have SI pain for several months yet.

Expecting immediate pain free results is akin to trying to suddenly stop a tidal wave, mid-swell, instead of allowing it to gradually simmer down and recede back from the shoreline!

That's why my mantra to people heading into SI Surgery has become, "It took me TWO years to get completely free of pain!"

I know it won't take you as long as it did me as I was a wreck (as you already know!). I promise you, from one SI sojourner to another, it will happen it just takes a LOT of patience!

Lots of love to you and THANK YOU for the updates!

Day #6, Post-op- Sat./April 9th at 9:39pm:
I am now home in my bed! Whoa that airport was tough..pain really kicked in after all the bumpy chair rides :( I started to wonder if driving may have been better. at least we are home..can not wait to wash my hair! All I could think about on way home was what if there was no vicki. still blurry vision..a little troublesome. lots of love to you!