How to care for scoliosis surgery patients

Mikaail’s operation went smoothly and the surgeon is also very happy about it especially since the surgeon was out of town 3 days after the operation for 10 days.  Mikaail was discharged a week after his operation.

At the follow up appointment, we were told that his wound dressing needs to be changed. His wound dressing was changed a day before he was discharged.  One of the nurses showing us how to change his wound dressing.

Wound Care

• Keep the wound dressing clean and dry. The doctor said that it is ok to shower as the waterproof dressing will protect the wound. Being the kiasu parents, we decided to sponge him for the moment.  We started giving him a bath about 3 days after his discharged from hospital.
• Over the next month or so, we need to change the dressing twice a week for the first 2 weeks and weekly for the subsequent weeks till another follow up visit a month later.
• The nurse told us that when cleaning the dressing, we need to look out for any increase in redness around the wound area, swelling, gapping of the operation wound, pus/dampness around the wound area or we would need to go to the hospital for a check.

Home Environment

• Sleeping on a bed with a firm base is encouraged.  The funny thing is that though the hospital encouraged us to do this, there is not one available in the hospital.
• We bought Mikaail a gigantic wheelchair as this unit can be tilted and also set to a lying position so we can minimize movement to allow his back to cure properly.

Diet & Medication

• Though there is no special diet or fluid restrictions, the hospital food is so bland.  I really wonder who plans the menu!  This morning, one of the doctors who saw Mikaail was surprised that I ordered "mee rebus" for his breakfast and the doctor said "hospital food is much to be desired!".  I personally feel  that the meal planner/dietician should ensure that the food served to the patients should be healthy and at the same time tasty as the patients need to recover from their illness!
• No special medication prescribed to him except for paracetemol and ibuprofen to be taken for 2 weeks or when there is pain.

Physical Activity

• After the scoliosis operation, it is advisable to turn around with your entire body and feet instead of twisting your waist and back.
• In order to keep your back straight, do not bend at your waist.  Instead bend at your knees.
• Advisable not to carry heavy loads of more than 5 kg (10-15 lbs).
• Shift your body weight so you do not remain in the same standing/sitting position for more than 30 minutes.
• Treat your back with care.
• A good form of exercise is walking.  Take short walks daily and gradually increasing the duration or distance of your walk as you recover. Climbing stairs is fine.
• As you recover, you can slowly increase your level of activity.
• If you feel more pain than usual after an activity, you many have overdone your activity. Stop and take it easy for a few hours.
• I dont think Mikaail will be prescribed with a brace.  However, if you are, do remember to wear it when you are awake.  No need to wear the brace when sleeping.

Scoliosis Operation: Day 4 (Saturday, 14 May 2011)

Four days after Mikaail’s operation, we gave him a super quick bath with help of 2 of the ward nurses. I’m sure he is refreshed especially after sponging him with water instead of the aloe vera wipes.

Today, Mikaail complained of back pain and he said, “so, so, so, very, very, pain”. Usually he is very tolerant and if he complains of pain, it must have been very painful.

When I saw the cut on his back, it was really scary! I could see the blood patches especially towards the end of the cut and the mid section. The length of the cut is approximately 14” long – almost the full length of his back towards the buttocks. 

Scoliosis Operation: Day 3 (Friday, 13 May 2011)

Mikaail had a bottle of Brands Essence of Chicken (42 g), half of a half-boiled egg, soya bean drink (15ml) for his first breakfast today, after 2 days of no food, no drink. So far he was able to keep his food and did not throw up and that’s a good sign.

For lunch, he had about 1.5 tablespoon of tofu and 17 ml of Paediasure milk followed by 17.5 ml of paracetemol and about 10 ml of water. Half way through his medication, he said he is full of medication!  Usually he will say which food he is full and which he will continue. 

This is his lunch:

Looks are so deceiving!  The burger is really soggy as the mayo sauce and butter spread on the bread make the bread really yukky!  Then there is the fish fillet on the bread which is just as bad as the bread.  How does the dietician plan the meals?

Considering that he is just out of a major operation, I feel he is managing the operation fantastically well!

He was transferred from ICU to the general ward late this afternoon.

Scoliosis Operation: Day 2 (Thursday, 12 May 2011)

Mikaail is still not breathing on his own and had to be hooked on to a ventilator to assist with his breathing. We presumed that he was drowsy due to the effects of the general anesthesia and morphine. Doctors said that the machine needs to show up more “S” as this signifies that he was breathing on his own.

We consistently encouraged him to breathe.  Told him that he needs to breath harder to get the "A" and "S" on the computer screen.  So each time we tell him, he will breathe then he stops.  So the doctor said it is unsafe to remove the ventilator for the moment.

Scoliosis Operation: The Day!

Getting Mikaail ready for his operation.

The whole operation took about 6.5 hours!

His stay in the ICU.

He is still not breathing on his own very well and needs a ventilator.  He is also running a slight fever and maybe in some pain as well as his heart rate is increasing as well.  The plan was for them to weane him off the ventilator then administer morphine to help him control the pain.  Such a young person to go through a major operation and when you see all the wires, it is so heart breaking!!!

We waited for his return for more than 6.5 hours although the surgeon told us the operation will take about 4 hours. He was wheeled into the Operating Theatre at about 8:15 am. Anyway, at 3 pm when I checked with the staff at the Operating Theatre reception desk on whether the operation is finished, the lady told me that the operation is still in progress. He eventually was wheeled into the ICU ward at around 4 pm.


The number of wires and tubes stuck to him is really heart breaking! At 12 years old, he’s gone through a real great number of hospital stays!!

Met a couple who told me that their daughter is also going for the same operation after her Primary School Leaving Examination in another hospital.  She wanted to have a view of another parent feedback as she overhead the doctor talking to us about scoliosis.  We told her to expect at least 6 hours though the surgeon had intially told us that it will be 4 hours.  As Mikaail was just wheeled into the ICU after his operation, we could not provide much information.

She said her daughter's condition is considered an inverted "S" with a 60/70 degree.  Mikaail's was around 40 degrees or something but that was a couple of months ago and the curve would have already increased.

Our main concern was the aftercare!

Scoliosis Operation: Preparation

Several blood samples needed to be taken to test his haemoglobin level, oxygen level, setting up of plug for drip, etc, etc.

Protocols are unfortunately inconsistent. Some of the medical professionals are not using the gloves when handling blood. Thought this would have been a more mandatory element.

More blood tests taken - quite poor thing for someone so young to go through so much! Strangely enough the doctor was unable to locate a suitable vein to insert the plug! One of the nurses then helped the doctor and was able to get the plug set up. The nurse also helped with getting the blood to test the oxygen level!

Scoliosis Operation - Pre Op Discussion

Mikaail's surgeon contacted me on Monday, 9 May to ask if I would be comfortable if he is away the weekend after the operation.  I was a little surprised that he asked about it.  Anyway, I asked him instead is there anything I should be concerned and also if there is any other doctors who would be monitoring my son's condition in his absence.

Sure, his team will be attending to my son during the period he is away and that he will also be contactable, if need be.

Can I stop the surgeon from being away?  Definitely not.  Can I reschedule the operation?  Possible though not likely as we've waited for almost 6 months!  We decided to proceed with the operation.

Went to the hospital on Tuesday, 10 May for Mikaail to be admitted.  Met with his surgeon as well as he wanted to have a quick look at Mikaail before surgery on Wednesday.  Everything is good to go!

It's Now Confirmed

After meeting with Mikaail's doctor who is also the surgeon in school on 31 March and two follow up calls, his scoliosis operation is now confirmed!  It's scheduled for Wednesday, 11 May.  In a way, we have also sort of prepared him for his operation.  We explained to him that this operation would help him to breathe better and also help him to sit up better.

When I met the doctor, I expressed my concern over the surgery and whether this would be the best option.  We also talked about the pros and cons.  Anyhow, it doesnt really looked like there are any better alternative apart from the operation.  Without the operation, the curve would get worst over time which will make it difficult for his breathing and sitting posture as he will be slanted further.

When one of the nurses called to fix the appointment, she said Mikaail would need to stay in the ICU for about 2 days before being transferred to the general ward, possibly a week.  However, his neurologist said he would probably be staying for about 2 weeks stay in the hospital, in total.  He also said this is a major operation and I told him that yes, we are aware since it takes about 4 hours.  He said it is not so much the duration.  He mentioned that there will be loss of blood and blood transfusion may also be required.

On hindsight, I should have asked him to elaborate on what he meant by "major operation".  I did tell him that I had spoken with his surgeon on whether we should proceed with the operation.  The primary factor that we decided to get the opeation done was the breathing issue.  As he gets older, it will become much more difficult for him.