Same surgery. Same surgeon. Same hospital.
You really can’t blame Dee Vashus for expecting the recovery from her May 2019 lumbar surgery to be the same as it was when Denver neurosurgeon David Vansickle, M.D., performed the same procedure nearly 10 years ago.
But instead, thanks to a new program at NeurosurgeryOne and Littleton Adventist Hospital, the experience was like night and day in terms of reducing her postsurgical pain and easing her recovery.
Although Dee’s outcome isn’t a perfectly controlled experiment, her results do tell a very compelling story. She believes that the difference in her recovery can be directly attributed to a new program called ERAS, which stands for Enhanced Recovery After Surgery. ERAS is designed to get patients home from the hospital sooner, decrease their use of opioids and other narcotic pain medications after surgery, and get them back to regular activities as soon as possible.
Pain Relief After Spine Surgery
One of the biggest factors that makes those results possible is a specialized pain medication protocol that uses different drugs. The protocol includes scheduled medications like Gabapentin (a nerve pain reliever), Robaxin (a muscle relaxant), Celebrex (nonsteroidal anti-inflammatory drug), and Tylenol, which all work on different pain receptors, says Kelly Boals, BSN, NeurosurgeryOne’s Spine Nurse Navigator. Opioids are used if needed, but other modalities are exhausted first.
During surgery, the team utilizes a novel approach to pain management in conjunction with post-operative multimodal pain control methods. As a result of the multimodal pain control and unique intraoperative anesthesia, there is reduction of post-operative opioid usage.
‘Miraculous’ Recovery After Spine Surgery
After Dee’s first spine surgery in 2009, she experienced a good deal of pain but didn’t tolerate the medications well. The drugs made her so nauseated, she threw up, which was quite hard on her newly repaired back. She was dreading recovery this second time around.
But her second spine surgery in 2019 was quite different, thanks to the ERAS program. In fact, she says the results were “miraculously different.”
Dee’s surgery was on a Tuesday. While in the hospital, she requested pain medication twice When she got home on Thursday, she took an oral pain medication before bed. But after that, it was just Tylenol.
“They sent me home with some pain meds because it just seemed too good to be true that I wouldn’t need them. But I was pleasantly surprised how good I felt coming out of it,” she says.
Dee experienced what she calls “a straight and steady recovery,” with each day better than the day before. “Any setbacks I had were my fault,” she says. “I had trouble behaving myself because it just didn’t hurt. I had to force myself to take it slow.”
Preparation and Expectations for Spine Surgery
The other integral part of the ERAS program is a NeurosurgeryOne’s Preoperative evaluation and risk stratification clinic where patients who are preparing for spine surgery undergo testing and assessments under the guidance of the nurse practitioner, and take part in a formalized spine class taught by Boals.
During the class, they receive information on surgical, preoperative and postoperative expectations, strategies to prepare themselves for surgery, and recommendations for home recovery.
Although Dee is a bit of an old pro — she’s had five spine surgeries — many first-timers find the spine class an invaluable step in their surgical preparation.
Boals says, “Education before surgery helps improve postoperative outcomes.”
To learn more about ERAS for quicker spine surgery recovery or register for a Spine Class, call NeurosurgeryOne Spine Nurse Navigator Kelly Boals, RN, BSN, at 303-925-4915.