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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. 

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.

 

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • wandahughes68
    7 hours ago

    Best of luck with your surgery and recovery!

  • tckrd
    3 days ago

    Rick sorry to hear about this. Since I have the same diagnosis as you, ankylosing spondylitus and RA, and progressing to the same posture. My question is what happens if you do nothing?

    Thanks
    Tony

  • Cynthia Ventura moderator
    3 days ago

    So sorry Rick that you have this issue and that you need multiple surgeries in order to correct it. Wishing you all the best as you wait as well as during and after post-surgery/rehab. Waiting makes me crazy too. Once I make up my mind to pursue surgery I want it done as soon as possible not 6-8 weeks later; too much time to stress out. Just stay as positive as you can because I’m convinced that being psychologically ready is as important as being physically ready.

    Take care,
    CynthiaV

  • Lawrence 'rick' Phillips moderator author
    3 days ago

    Oh good suggestion Louise !!!

  • Louise1024
    3 days ago

    Hey Rick, sorry to hear about all these complications coming your way. It is a juggling act to get all the pieces together. I can understand your anxiety. Although having both hips replaced in February and November were easy compared to your surgeries. I hope you can find ways to ease your mind.

  • Lawrence 'rick' Phillips moderator author
    3 days ago

    Louise, thank you, This will be fine. I am excited to get it done and over with.

    However, while i ma waiting, I have some writing to do and a kenyx roller coaster or two to build.

  • Mary Sophia Hawks moderator
    7 days ago

    Aw Rick!! I’m so sorry!
    Having surgery with RA is difficult at best. Back surgery is another ball of wax entirely.

    I am a veteran of 19 surgeries in my 57 years. One thing I have learned, is that I MUST focus on the end result. I head into surgery knowing I will, yet again, have to be a warrior. I will have pain, and I will speak up and be vocal about it. But I also know that the pain will get better.

    Do not try to get along without the pain meds. Those are crucial to being able to get through rehab and the first weeks. Stay on top of the pain management.

    Prayers and gentle hugs for you.

    Mary Sophia

  • Lawrence 'rick' Phillips moderator author
    5 days ago

    Mary,

    I am feeling fairly good about how things will turn out. We have had a good number of months to consider the outcome and we have had a second opinion.

    Our goal is to process the time and have fun until March. I do think that waiting is the worst part, but we will get there.

  • Daniel Malito moderator
    7 days ago

    @lawrphil I’m glad you are getting it addressed, although I’m not thrilled you have to go through multiple surgeries. Then again, I always think of you as an upstanding member of the troupe on this website, and if you aren’t upstanding then you can’t be upstanding. Make sense? Does to me. 🙂 Good luck. Keep on keepin’ on, DPM

  • Lawrence 'rick' Phillips moderator author
    7 days ago

    Thank you Daniel !! This is going to be fine. The surgeon said the most difficult thing post surgery is the my feet will be 2- 3 inches further away. Sounds crazy but he said to expect to stumble around a lot for a year or more as my brain reorients.

    Now on the good side I get to pick the music they will play as they put me out. So I am asking everyone i know for suggestions. If you have any pass them along. So far my personal favorite is “Pink Floyd Comfortable Numb” but I am open to suggestions

  • Richard Faust moderator
    2 days ago

    Hey Rick. It is not necessarily one of their better known songs, so may need to look it up, but thinking Genesis “Its Gonna Get Better.” Best, Richard (RheumatoidArthritis.net Team)

  • Louise1024
    3 days ago

    I like “Better things” by the Kinks to cheer me up.

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