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I'm scheduled for ACDF - And I'm Scared because of my size - can you help?

ray78640rray78640 Posts: 18
edited 06/11/2012 - 8:39 AM in Back Surgery and Neck Surgery
I am scheduled for cervical fusion(s).
C 6-7 for sure, possibly c3-4 & c5-6 (really don't understand this). History of intense pain on right arm neck and hand.
I weigh 290 lbs - I'm a big man. I have a little bit of sleep apnea. I'm so scared, I do not know what to ask or who to ask. I'm affraid of not being able to breathe afterward or being able to swallow afterward.
Surgeon says much more difficult due to my size.
Does anyone here have expereience with this?
Or have you heard/read about another large person going thru this?
I'm so glad i found you folks - I'm just so nervous that I don't even know what to ask now that I'm here.



  • SpineAZSpineAZ WiscPosts: 1,082
    Much of it depends on the size of your neck. Someone who weighs 290 but carries not much of that weight in the neck won't be much different than anyone else. The challenge may be in getting you sedated and making you comfortable after the surgery. They'll also want to make sure you are breathing well. They will likely place an oxygen monitor on your finger and that may stay for a day or two. That shows them how oxygenated your blood is so they can have you change your breathing or add oxygen as needed.

    I have had an ACDF. The surgery was relatively easy for me. I will say that I've heard some people experience more throat pain than I did. I had about 1 day of it and cepacol lozenges helped me. When they do an ACDF they move your trachea/windpipe to the side to get to the spine - thus many wake up with a sore throat and a little difficulty swallowing. Although you may not want to eat solid foods the first night you will be able to eat soft foods. I compared it to the type of diet someone would eat after a tonsillectomy.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • I won't be much help to you here, but here's my 2 cents on your post. Me, I'm average sized, but someone near and dear to me has put on a lot of weight due to an array of health complications. She had a long surgery last Nov which kept us in the hospital for over a week. She never had any difficulty with airway management. The did with her, like most surgical patients, have the little tape on pulse/ox monitor on her all the time. I slept in the room nights with her and never heard the O2 monitor beep or heard any sign of breathing distess.

    Obviously, and I know you've heard all this before, extra weight does complicate almost all areas of health and health related procedures. The fact is though, the majority of our population is overweight or obese. With this in mind, it stands to reason that surgical procedures will be up to date and prepared to handle heavy people.

    I wish you the best on your surgery. Double check with your doc and maybe get a second opinion on what you hear from him. The right doctors and staff will keep you fine.

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  • SpineAZ & B52

    Thank you both so much for taking the time to reply.
    I've been reading lot's here and feel lucky that everyone here shares their experience's with the rest. There is no substitute for actual experience or as close as being with a loved one thru the entire ordeal.
    For what it's worth to all here, I am not obese, although very overweight. Prior to my symptoms I worked out regularly and all of a sudden just stopped. This was baffling to me and my family and I had no real reason to give. I had started experiencing some severe pain in shoulder and thought I was simply giving myself "a break". Shoulder pain lead to arm pain, then wrist, then hand, etc, etc. Before I realized I had a serious issue that took some time to diagnose, I had gained a lot of weight. My PCP had some test done, and i was diagnosed with arthritis in many places and i was sent to a rumotologist who basicly prescribed pain meds. I eventually went to an emergency room at local hospital as i thought I was going nuts one night with the painn from face to neck to shoulder blade and all of my arm and the numbness was just maddening. A CT Scan was performed and I was told I needed a Neurologist and an MRI "right away".
    This is probably so familiar to most (if anyone is actually still reading).
    I'm now under care of the surgeon that will perform the ACDF on 12/23. Looks like XMas in the hospital for me he says.

    My greatest concerns are:
    Long ride home from hospital - 75 miles
    No Pain Releif
    Breathing Difficulty, at home, not monitored, while sleeping.
    Swallowing Difficulty
    Extensive recovery due to my weight.
    A failed fusion - or not being able to return to work and remaining on disability.

    My Goals Are:
    Positive attitude while recovering -
    Getting back to being as active possible
    as quickly possible -
    Losing all weight gained -

    My spinal history is minimal -
    L4-5 Lamenectomy with no releif of pain.
    Opted to work thru pain and learn to live with as opposed to another surgery/fusion.
    There is no injury that can be ruled as the cause for my herniations and bulges in my cervical area.

    My upcoming procedures are:
    Tomorrow 12/16 a CT Myloegram -
    Fri 12/18 a complete check by PCP, blood, EKG, chest XRay, etc to certify that I'm fit for ACDF.
    12/23 ACDF

    I am so grateful to be here in this forum.
    Please help with any and all info that can be shared.
    I plan to update and share all my experience right here and hopefully I can help someone else.


  • Good luck to you Ray. Wish I could help. As for your sleep concerns, do you use a sleep apap machine. Or something similar? What does your Doc. say about the breathing concerns?
    Ask your surgeon to be sure your concerns are answered.

    Best of Luck to you.

  • JanisD

    Thank You! I do not use a CPap or anything else.
    When my surgeon asked if I had sleep apnea i was not able to answer truthfully. I knew I snored. I had to ask my family - my wife and I have been married for a little over 30 years - she says that once in a while, I stop breathing and then make a weird sound and start again. She is a heavy sleeper so probably sleeps thru most of whatever it is I do.
    My oldest daughter-in-law lives with us and 3 of our grandchildren. My oldest son (her hubby) just came back from Afghanistan after being in Marine Corp for 8 years. Anyhow..she says she can hear me snoring and then it soundls like I stop and the kind of gasp for air and then calm right down and resume snoring after several minutes.
    I am making a list of questions to ask the surgeon and this is at the top of the list.
    I am so frightened, it's not even funny but I never thought I'd ever be as scared of anything, but I am.
    Thanks again for the good wishes.

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  • I think you're going into it with a fairly positive outlook, considering. You will be monitored for O2 level just about all the time you're in hospital. As for the ride home..mine was about 80 miles and guess what? It SUCKED!! I swear, I could feel every pebble in the pavement. The good thing though, is that it's so wonderful to get home that it was worth the ride. Now, 5 or so weeks after my fusion surgery, it's no real pain at all to do 80 miles in the car. You'll do OK. If there are going to be breathing concerns when you are at home, they make and prescribe one for you on your dr's order, breathing/02 monitors for home use. Just be sure to ask the dr if you may need one.

    Aloha brudda
  • Had myleo CT today - feel like I should not be on computer, very sore and off balance, so will update later....

  • One thing - make sure you've got a garbage sack to sit on in the vehicle - you don't want your backside sticking like velcro to the seat as you try to get in and out!

    I remember my 40 minute ride home - I was gripping that OMG bar for dear life the whole way. Once I was home I was great though, if I remember right I didn't want to go upstairs to bed, I wanted to stay up for a while.
  • welcome to spine health ray78640, and i believe you are normal to be scared. i was too. the best advise i can give you is to take a written copy of your concerns and fears that you listed above, and talked with your surgeon about them. your surgeon should be able to help you resolve each issue. some, like the weight issue might take a while. i know its scarey to sign the release papers for the surgery and not know to what extent they are going to fix in the surgery. i had a acdf c3-c7 10 hour + surgery over 2 yrs ago and it was a long recovery process for me. everybody recovers a little differently, but the main thing to remember is to follow your surgeons recovery orders excatly, and that way you have done the best job you can do for recovery. i wish and pray you have a sucessful surgery and a speedy recovery. God Bless, kc
  • I weighed 340 when I had my ACDF last Feb. (I have since lost 70lbs of it.) I didnt have any problems during the surgery. The anesthesiologist seemed concerned pre-op and asked me if I was that weight when I had had my hysterectomy 5yrs previously. I told him I was about the same and no problems then.

    I had no complications from my ACDF other than sounding like Minnie Mouse for three months.

    I have sleep apnea and I brought my CPAP for use during recovery. I had to use it with some oxygen because my pulse rate kept dropping for some reason. Once I was more awake this was no longer an issue for me.

    I think you are right on speaking to your dr about your concern. He might want you to get a sleep study prior to surgery. Sounds like you should have one sometime anyway. I have had my CPAP for 11 yrs and am pretty faithful with it. Since the weight loss I dont need it as badly as before but I am so used to using it I figure until I am closer to my goal weight I will just keep on with it.

    I live about 70 miles from where I had surgery. Make sure you get something for pain prior to leaving for home and make sure you have a plastic bag or something similar in case you get sick to your stomach. Oh and at least a couple of pillows in the car too. Plan your route to take advantage of the smoothest roads possible. Honestly you will probably sleep most of the way home and remember very little.

    Im having two more levels done on Dec 30th so will have to go through this all again. Hope you do fine. Sounds like you have a great attitude about it and that is a great thing to have.


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