A concerned looking adult male looks forward to a floating spinal column depicting sharp spinal curving. The man has a hump back due to Kyphosis

Kyphosis - New Year New Thing

I am preparing for a major surgery in March. I have been preparing for several months. But now, I have a date, place, and time and the countdown is on. As the days tick forward, I have to admit that I am contemplative. But before we get to the feelings part, let me explain what the surgery is about and why it is necessary.

What is kyphosis?

It is one of those words that, until last year, I had never heard of before and frankly, I could have lived my entire life without ever hearing of it. The condition is an abnormal bend in the upper back. I say abnormal because most humans have at least a small amount of upper backbend.

Kyphosis is the medical term for what is often referred to as hunchback. The numbers themselves mean little to me, but I am told that my bend is near 90%. Surgery is called for when a person is leaning forward at more than 60-70%. As I said these numbers mean little to me; what does matter is that my back hurts badly and it has for a long time.

Extensive imaging for my spine

Last year I was discussing this with my rheumatologist, and he suggested I see a back specialist. Fortunately, I was unable to see the person he suggested. I had seen the suggested specialist a few years ago and he did not seem to take it very seriously. Instead, this time I was scheduled to see a Nurse Practitioner who also suffers from back issues and she decided to do fairly extensive imaging. 

More on this topic

Last August and September I underwent Xray’s, CT-scans and MRIs to determine if I had structural spinal issues or if the issue was cosmetic. In other words, as my mother told me when I was a kid, simply stand up straight and this will go away. Stand up straight was what the first specialist I was referred to suggested. It turns out the problem is structural and is worsening.

Types of kyphosis

So I get a quick (like the prize in a crackerjack box) education about kyphosis. The first thing I came to understand is that the doctors do not know why I have it. It might be poor posture (though it usually does not get this bad), congenital kyphosis (present at birth) or, Scheuermann’s kyphosis (usually corrected in our teenage years). Unfortunately, none of the three kinds seem to fit exactly. But, Scheuermann’s kyphosis seems to fit the best.

Rheumatoid arthritis makes kyphosis difficult to treat

Could it be the result of RA? Though arthritis can be a cause, it is unlikely that this condition is linked to RA.  But having rheumatoid arthritis and ankylosing spondylitis makes the issue more difficult to treat. In my case, the surgeon wants to do the surgery one month after my Rituxan infusion. To get to the Rituxan infusion, I am to see the rheumatologist and then, after the infusion, I will get a list of other appointments to keep getting to surgery. 

That means even one little missed checkmark, pre-surgery appointments, infusion consolation with the rheumatologist, cardiologist, and the list goes on and on could move the surgical schedule and moving that schedule would be like destroying a shaky house of cards that is the schedule. I hate having so many moving pieces. But one cannot have a surgery like this and completely control the events leading up to the outcome.

Surgery and recovery time to correct kyphosis

Speaking of schedule, the doctor has told us to expect up to six hours of surgery and a hospital stay of 4 to 7 days. As he put it, this will not be easy, quick, or even decisive. While the first surgery will be the most intense by far, he said to expect up to two more surgeries (each one less severe than the previous one) before this issue is corrected. The future schedule will depend on how much he can adjust my back each time. So, as I start 2020, I might be looking at a tough year of surgery and recuperation. Again, not my idea of a good time.

The anxiety of waiting for surgery

I’ve never done well waiting for things to happen. I prefer to be decisive, make up my mind, and move forward. I figure I can always sort out any bad outcomes along the way. That attitude has been both a blessing and curse in my life. Usually, things turn out like I thought at the start and, if not, things work out alright.

Thoughts that turn into worry

In this case, I have been wrestling with this decision since late last summer. Frankly, the more I wait the more anxious I become. I want to get this done, but as the days and weeks have ticked away, it gets scarier. Something about rods, spinal adjustment, schedule, and future surgery just weighs on me. Even as I get closer, my mind is not more at ease, but more restless. 

I know it is the right thing to do, but the what-ifs are enough to give me pause. I hate trying to speed up time, but I do think of it constantly and, yes, those thoughts easily turn to worry. As most of us know, worry is not the best pace for a person with RA.

 

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