Post-op advice please - worried about dh

[sb6699]

My dh had a discectomy on Monday and was discharged on Wednesday feeling absolutely fine.

On Friday he developed a headache which seems to have got worse and he has now vomited.

I have called the hospital and his consultant has asked that he comes in first thing tomorrow morning to be checked over.

Just wondering if anyone knows what could be causing this and whether I should be worried.

TIA

Bumping for the night owls!

Well it could be a number of things that are not operation related.

But I think the complication they're concerned with is a dural break (the dura is a membrane that surrounds the spinal cord).

If this has happened (about 5% of discectomy patients) then the patient experiences altered Cerebral-Spinal Fluid pressure which leads to headache and nausea.

This mostly heals by itself in a week of two and is "treated" with bed rest" but sometimes if it's slow to heal/more severe then a surgical repair will be considered.

Hope that explains without inducing panic...

Wow. DBennett you're the person I'd want around in an emergency.

Hope you get on ok this morning op.

Wow, you were absolutely right

He has been readmitted for total bed rest and will probably be in for 4/5 days at which point they will decide whether they need to operate to fix it.

Was a tad that it says in his notes that he was already complaining of a headache before he left but nobody picked up that anything was wrong.

Tbh it has been a bit of a shambles, his consultant had said that when he opened up he had to do more than was expected and had said that dh was not to be moved for 24 hours (the original plan was that he should be up asap), yet the physio had him out of bed and walking up and down stairs in 12. Understandably, when the consultant saw them he went a bit mad.

Dont really want to dwell on the blame factor though, the most important thing is that dh is where he needs to be and its being sorted.

Thank you both for your concern.

Glad things are getting sorted.

Hope he gets better soon.

Calling DBennett or anyone who can help put my mind at ease.

DH had surgery today to repair the tear. We spoke to the consultant today who said the op would only take around 40 minutes but despite going into surgery at 3pm he wasnt deemed well enough to bring back to the ward till after 8pm but nobody seemed to know why and his consultant had gone home by the time I got there (last time he was wide awake and fully coherent by 5.30).

DH really doesnt look particularly well and has said he feels ten times worse than when he woke up last time and is in alot of pain but the nurses said he's not allowed any more pain relief as they've already given the maximum allowed. He's quite a tough cookie and isnt the type to ask for more pain relief unless he's in agony but he said he can actually feel a stinging sensation in his spinal area but around it is still numb.

One of the nurses commented after the MRI that the tear seemed to be alot larger than she normally sees and I'm just a tad worried that things havent gone quite to plan when repairing it.

Is it possible that he's just feeling so bad because its his second surgery in the same site or should I be worried.

Oh dear ,no advice I'm afraid apart from perhaps be a bit more assertive/persistent with the staff regarding the pain relief .
I imagine a Sunday is not when people are around at the hospital but you definitely need to be insisting on seeing someone senior asap .
Hope someone comes on here with more advice - could you PM DBennett ?

Thanks for replying.

Dont really feel comfortable PM'ing her tbh. If this is her line of work she might be deliberately avoiding the thread because she doesnt want to get too involved giving out advice which is her right.

Was just hoping that maybe someone/anyone would have professional advice as I'm not particularly assertive when I don't know what I'm talking about!

The nurses had a big debate today as the consultant said yesterday he should have whatever pain relief he needs to be comfortable but the nurses wont override hospital policy and I'm not sure who's right - he doesnt seem to have had much tbh and all they had given him today was paracetamol.

Hopefully the consultant will be round tomorrow and I can speak to him properly.

Yes I see what you mean about Pm'ing - but you could try and add a rider to say you'd totally understand if no reply .

I'm not particularly assertive and I sympathise with your position .....but I think you need to persue this ( sorry that sounds wrong , of course you will ,I'm just trying to encourage you ) .

What kind of hospital policy can there be that means that a consultant's instructions aren't followed ?
Or maybe the consultant's instructions weren't clear ?

Um ,the only "advice" I can give is to ring ward tonight and say that you really ,really really need to talk to consultant ( if they as staff aren't sure about his instructions perhaps they'd understand why you also need clarification about your DP's situation ) and can they tell you when he's likely to be seeing DP tommorrow so that you can see him ? Or ask for clear guidance about how can you talk to him - will they get him to phone you ?
IME every one is so busy that this kind of thing quickly gets overlooked and you'll only get a conversation with enormous persistence .

And - just a thought - I'd start a new thread here ,saying something like DP in hospital , how can I get staff to give him the pain relief he needs .

And do feel free to ignore me - not much help I know ,but maybe at least this will bump your post and someone better can help ?

Really you have helped - I've just phoned the hospital (its easier to sound assertive when its not face to face

The nurse has said that they are going to give DH something stronger tonight which will hopefully at least let him get some sleep and have made a note that the consultant is to see us at a specific time tomorrow so I can be around (DH is still feeling rough and I worry he wont remember to ask the things we have discussed).

The nurses dont know why he was kept in recovery so long as the notes taken after surgery arent there! It doesnt say in his notes either that the surgeon made the tear during surgery, just that that is what he was re-admitted for as if it occured naturally -although I'm not sure that would matter as obviously I'm not medically qualified.

The consultant had also said to us that DH would be given anti-biotics as a preventative measure and he's not been given any and apparently the nurse wont give them until she's seen the consultant tomorrow.

He just seems so ill compared to how he was after his last surgery it makes it difficult seeing him so poorly when I know he wouldn't be complaining if it was nothing.

Have no advice but how worrying for you.Hope he is feeling better soon.Having two GAs so close together would knock anyone for six without the added pain etc.

Thanks helly

No advice either but just wanted to say, how stressful. Hope all becomes clearer tomorrow. Great that they're giving him more drugs tonight. WhatHelly says is true: GAs really do knock it out of you. Poor him (and you!)

Sorry I wasn't around, I don't think I hit the "watch this thread" button.
I have now.

And I'm very sorry you & your DH are still struggling

I'm not sure I would have been useful in any case, I don't have professional knowledge of spinal surgery (I recognised symptoms relating to cerebral-spinal fluid and did some checking about discectomy).

Having said that I agree with the previous posters that two GAs in a short space of time is tough.
I also don't think it's the intention to leave your DH in pain, it sounds like he needs to move up the "pain ladder" but the next step is to opioids and you can need quite specific paperwork in place for.

Which is no doubt frustrating.

I'm glad your DH was getting something extra last night, hope it helped.
And that he improves with time as I'm sure he's expected to.

Just wanted to update you kind ladies - dh is feeling much better and he was finally allowed to sit up and stand for a short period this afternoon.

Hopefully he will be discharged on Thursday.

Thank you all again x