3rd Surgery Pre-testing

I waited November 2016 to June 2017 for Dr Kaibara to make his decision to do the 3rd surgery to correct the Bertolotti's syndrome for the 3rd time.  I had to stop working the Fall of 2016 as I was physically unable to get around any longer.  The driving had flared up the Pudendal Nerve again causing the Pelvic Floor Myalgia (Spasms).  My pain was through the roof. The L5 Vertebra had grown through the Sacrum/Ileum on the right side for the 3rd time.  It had been explained to me it was due to the bone graft used by the Orthopedic Surgeon that had Reabsorbed (disintegrated) and allowed it to happen again.  My visit to the Mayo Neurosurgeon, was just for a second opinion in November of 2016, but the imaging had showed some things that now needed to be addressed.  The pelvic xray showed Chondrosarcoma, how did this come up again?  I thought this had been ruled out?  It was always on the back of my mind.  In the same xray, I now had severe degenerative joint disease in my hips (osteoarthritis), and pubis symphis, Much of this had been the result of the pseudoarticulation of L5 growing through that area.  I was already seeing a Rheumatologist who has the suspicion I may have Ankylosing Spondylosis.  The HLA gene I test negative to, although individuals test negative and still have this auto immune condition.  One of the symptoms of the condition is the spine fusing.  Mine has fused 3 times now. I also have Sacrolitiis and many other symptoms.  Treating it requires going on Biologics or TNF meds (Tumor Necrosis Factor Medications). He needs to rule out the Chondrosarcoma and is a bit concerned this has never been 100% ruled out by biopsy.  I am sent to an oncologist/hematologist who I know from a previous visit for abnormal bloodwork.  Dr Goldfarb becomes my Hematologist/Oncologist for this. He is thorough and wants to make sure this is ruled out prior to surgery I have coming up, surgery can not be done if there is Chondrosarcoma in this area, nor can I take a certain class of medications if it is determined I have AS. He sends me for a Abdominal and Pelvic CT Scan.   We meet to go over the results quickly. There is no sign of Chondrosacroma and he had it reviewed by an expert radiologist. I will be able to move forward with surgery and medications if needed.  Medications for AS will be put on hold until I am fully healed from surgery which could be several months to another year.  I discuss with Dr Goldfarb my severe fatigue and how it impacts my daily activities, he runs bloodtests that day.  I will follow up at a later date.  After surgery, more discussion will follow with the Rheumy, for now, there is not anything that can be done.

I have my Pre-surgical tests done at St Joes, most of the information is in the system as I have had Botox twice already this year, January and May.  I am set to go on August 8th, I have my care set up, meals have been arranged my a friend, and Dr Kaibara seems confident as well.  My pain management Dr will handle post op pain management as he has known me for over 3 years now and I trust him.  I meet with him and make a decision to go off long acting medications I have been on for over 2 years.  He leaves that decision up to me.  I have no problem with "withdraws"  People are funny when they ask about stuff like that.  I was not dependent on the medication, you know why?  Because, I took it like I was supposed to, my brain used it like it was supposed to, the pain receptors absorbed it like they were supposed to and my body was never physically dependent upon it.  When you over-use or misuse medications, you start to become physically dependent upon them.  When you use them correctly that wont happen.  So, I was ready to go!  Scared, but ready!  I prayed a lot, I wrote in my journal, I talked to my dad almost daily, I talked and talked and talked to my husband.  I was also excited, because I knew some relief was on the other side of this. 

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