Saturday, November 10, 2012

So what's wrong with having surgery?

When you are sick, it pays to be well informed.

But even if you are well informed, there are others who think they are more informed than you and try to offer their ‘medically unwarranted’ advice even though they don’t even have a clue what you are suffering from.

So, make sure the ‘well informed’ information comes from the ‘rightly-guided’ source. For example if you want an expert opinion on a medical condition, get it from a qualified doctor, not from an illegitimate one. There are too many quacks out there trying to make a living out of the ignorance and gullibility of others through their so-called ‘well informed’ information.

A ‘rightly guided’ and balanced information help us make the right decision, especially in deciding treatment on crucial sickness, some of which involve life or death. The doctor that treats us can help to a certain extent by giving us the options of treatment. For example, if surgery is needed to cure a condition, then it is up to the patient to decide whether he/she consents him/herself to the option. No one is compelled to opt for surgery.

We always hear of the statement “Surgery should always be the last resort…”. Meaning if we want to opt for surgery to cure a sickness, there’s always other alternative to choose from. More so if it involves crucial parts of your body, like the head (brain), back (spine) or neck.

But most of us take this statement at face value without even going to great extent to study the facts, results and implications if we do consider surgery to treat our sickness. We just regard surgery as something orthodox, conventional, very risky and carry other side effect. The very mention of the word SURGERY leaves the uninitiated terrified or at least, confused.

Yes, surgery involves complications and risks, but if we weigh them with the risk of not having any, and the risks are far more dangerous, then the option is clear. For example if one has back pain, which involves spine problem, the patient would have to risk getting complications such as paralysis if the surgery on his back fails. But then, if by not getting the surgery, the risks are twice as much to get paralyzed as opposed to the surgery, so it is better to have one.

Nonetheless, if someone is faced to decide on surgery of the spine, it will be such an important decision that he should consider having more than one expert opinion. But do make sure the opinion comes from a real expert and not from some quack.

So, this is the story of how I decided to opt for surgery on my back, i.e. lumbar spinal stenosis, less than 2 weeks back. And after more than a week of recuperating from being under the knife, I felt better now. Before this, I was constantly suffering in pain due to the lower back pain and sciatic nerve pain on my right leg. (read my earlier post: August 2012 Family Visit to London)

To be exact the condition I was having is the narrowing of the spinal canal or in medical terminology Lumbar Spinal Stenosis.

The first time I knew about it was when I felt pain struck my right foot while on a family tour of London. I thought it was just a muscle strain and it ended in an inflamed feeling in the calf. So the pain was treated, as it is – a muscle pain. Actually it was an internal inflammation symptom due to the effect of compression of sciatic nerve, which starts internally at the spinal cord, which is at the area of the buttocks.

The pain was at time unbearable, as I couldn’t even walk and at times it struck at night and when it happens I would usually have sleepless nights. So, I had no option but to find a cure, and to find it quick, before it really gets on my nerve.

The pain on my lower back has been a recurring problem to me for the last 5 to 6 years, so I didn’t thought it was related. But after a lecture on nerve pain from dear wife and googling around for simple answers on the Internet, I got some good news and also scary ones. The scary part is if all else fail, surgery is not to be recounted.

Good news is that sciatic nerve pain can be cured naturally with health therapies, exercises and avoiding the causes of the symptoms. Other treatments available are anti-inflammatory medications, muscle relaxers, herbal cures, acupuncture etc. Majority of the people are cured by these conventional therapies. But basically, all these non-surgical treatments focus on symptomatic relief of the inflammatory issue and not the real problem. 

The surgical treatment for the condition that I had -- lumbar spinal stenosis is something I don’t see as a choice, if you really understand what the term means. How do I know I have lumbar spinal stenosis? By analysing the MRI scans, which was done much earlier at USM's Advance Medical & Dental Institute (IPPT), Bertam, and the diagnoses are agreed upon by both the radiologist and spine experts at HUSM.

As explained by the spine surgeon who treated me, Dr Abdul Halim Yusof from the Department of Orthopedic, HUSM, the spinal canal where the nerve resides had swollen and compressed the nerves and this condition makes it impossible for the nerves to function well. The only way out is to open up the canal by removing excess bone particles that have grown to compress the nerves. This can only be done by surgery.

Yes, I wish I can undo this with conventional therapies, but there is no time for experiment. I’m no fan of surgery either, but if surgery can help cure the pain and sickness in the shortest amount of time and won’t cost me my arms and legs then I’m willing to be counted as a surgery ‘groupie’.

So, after my first meeting with Dr Abdul Halim Yusof on 14 October 2012, his department had set the operation to be slated on 30 October 2012 (2 weeks later). There was not supposed to any operation on that date, but Dr Halim was kind enough to slot an ‘extra OT’ as he see the graveness of the ‘pain’ I was in (I was walking with crutches) and had trouble myself to fire-flyz to Kota Bharu from Penang on my own accord just to see him and show the MRI scans.

So, on the morning of 29 October 2012, I was at the Orthopedic ward in HUSM (4S) getting ready to meet the doctors there, the MOs, HOs, Matrons, Nurses, including medical students, who are there doing their job, asking all sorts of questions for their ward postings. And after meeting the most important person before the surgery, the anaesthesiologist, and on request, I was transferred to the staff ward (8TD), which is exclusively for USM staff. I do not know what are the qualifications for the comfortable two-bed room, but I was given one.

For the night, the anaesthesiologist said I was better off sleeping early and with the help of a sleeping tablet given by the nurse, I dozed off like a baby. The next morning, 30 October 2012, I woke up feeling refreshed in a hope to start the ‘surgery’ day on a right footing. I was given a pair of surgery gown plus cap to wear and was pushed on the same bed I slept that night to the operation theatre (OT). Halfway to the OT, everything went blank.

I woke up about 8-9 hours later with a very dry throat. Somebody asked me if I can talk, and I said I needed to clear my throat from sputum. The person shoved a tube in my throat to suck the sputum off and after that I went blank again.

About 1 hour later, I realized I was pushed to a ward (Wad 2 Zamrud – Orto Akut), which is the acute orthopaedic ward meant for post-surgery observation. After a few more hours lying in bed, I realized I can sit-up, stand and even walk, albeit with much difficulty. There I stayed until 10pm after which I was transferred back to the staff ward 8TD. Initially I was supposed to stay at Zamrud 2 but upon insistence and that since no food were given to me at the ward, I wanted to go back to where my things were as there’s where I stock my food.

For the whole night, I couldn’t sleep and the next morning I told this to the nurses and a group of young doctors who came to examine me. They couldn’t make up their mind what was the reason and said they’ll leave it to Dr Halim to decide. After a few hours later, Dr Halim came to ask about my health and briefed me about the surgery. He told me that he had taken 4 hrs non-stop to operate my back. I asked if there was a complication, he said no, just that my spinal canal that he plowed was extraordinarily constricted compared to what he had done before. So, as he was alone doing it, he had to take more time and it was very tiring. The technique used by Dr Halim was the Endoscopic Decompression Surgery with minimal invasive through the skin and this method involves the use of endoscopic devices with indirect observation of surgical site through a large monitor (Read:

USM Hospital Offers Endoscopic Decompression Surgery for Spinal Problems)

Dr Halim tells me I was ready to be discharge if I wish so, but also welcome my decision if I wanted to stay for another night as the nurses can observe my overall heath, BP reading, ECG etc. I opted on the latter and later the nurse gave me a pill (it was the same one the night before) that can help me sleep through the night. I slept with a little difficulty and for two hours only as the pill didn’t work well this time. Later I found out that the reason of my being non-sleepy was because of the steroid (dexamethasone) given to me twice daily. I wasn’t sure what the steroid was meant to do, but when I ask the nurse, she said it was to prevent blood clotting. Since 3 days ago, I have stopped taking the steroid, on my own advice..hehe! And now I sleep like a log!

It has been 11 days now since the surgery, and although I cannot sit up straight for a very long time (the pain will seep slowly as the cut is directly on the back), I can walk better, even better than I was before the surgery. Lying down and sleeping also feels better as long as the bed is not too hard or too soft.

So, what is wrong with having surgery?

I wish to thank all the doctors and staff at IPPT, especially Dr Liau Kai Ming and Prof Ibrahim Lutfi, and the doctors and staff at HUSM, especially the orthopedic surgeon Dr Abdul Halim Yusof and the nurses, matrons, attendants and friends who visited me. Not to forget my wife, Dr Bakiah Shaharuddin who was supportive of the decision and did the initial contacts with Dr Abdul Halim Yusof even though she is a few thousand miles away in UK, my two aunts (Maknun & Makyang) who drove me all the way to Kota Bharu from Ipoh for the operation and waited and nursed me throughout the process (before & after) and those who gave their support and doa' especially to whom I forgot to mention their names here.

Thank you all and may Allah reward you for all the good deeds that you have done.


When Back Surgery Should Be Considered?

Treatment For Spinal Stenosis


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