One year anniversary, T4-S1 revision fusion surgery

62, F, 126.5 lb, 5'3". I've had three fusions: 

• L5-S1 - (2018); left with left leg nerve damage. 
• T11-S1 (Feb 2024, then PJK failure) 
• T4-S1 (revision, Oct 2024)

So it's been a year since the last fusion, and I have to go back to UCSF for full eval. I also participate in several studies, as I am in an older demo from most long fusion patients, it's useful to see how my creaky-ass body makes it through such a traumatizing process, lol. 

ANYWAY, the goal I had set for myself after two fusions/recoveries in one year, and much of it in bed, or PT (6 months of pool therapy & 2 land based; I now do treadmill and resistance band PT at home) is to br able to make the 2.5 hour drive alone to SF. It's no small feat because driving places an incredible amount of stress at the top of my hardware (T4), where your natural spine takes over at that point in your thoracic spine, up to the cervical/neck/skull. I was able to drive very short distances at about 12 weeks, and it was extremely draining. In the interim the longest drives before this one to SF were about 90 mi RT in one day, and the longest about 200 mi RT (w/a rest day).

Holding that steering wheel is brutal just because of the position, so rest breaks are advised. I planned it all out because from my part of CA, if you don't time your drive right, a 2.5 hour drive can become a 6 hour nightmare because of traffic. So I had to work out all the logistics for what would be a mere 3 hours in the actual clinic.

Plan:

1. Leave on Sunday night, check into a hotel that has indoor parking;
2. Take an Uber to the actual appt on Monday AM and back to hotel after it's over;
3. Stay over at the hotel for either several hours of rest and drive home later that night OR stay until the AM and check out.

So yeah, that's a very expensive, extended doctor's appointment, but it's the only way to be able do this alone and to be safe. It's incredibly difficult for me to safely do stairs as I can no longer bend at the waist because of the fusion hardware, and my balance is craptastic now, so a hotel is the most comfortable way to do it. 

So I packed a bag - no small deal once you're disabled and need assistive devices for dressing, putting on socks, grabbing things off of the floor, etc., and the right clothes, shoes, and toiletries, medications - required me to make lists and check them twice. I'm also stubborn and only use a cane if I'm going to be on uneven pavement where it's easy to topple me over. I'm like a tortoise on its back; it's hard for me to roll over and get up. But I always keep a cane in the car.

Took a small cooler & my trusty thermos to stay hydrated and I was off.

Sunday, Oct 26, 2025

The drive was pleasant as I left in the afternoon so I planned to arrive around check-in time. The Central Valley weather is dry and cool in the fall; once you get to the Bay it's humid and cooler; it was in the 40s-50s, but felt so much colder to me since I don't tolerate cold damp weather at all (if you have rheumatoid arthritis it's a double whammy that humidity and big swings in barometric pressure are horrid on the body). Now that I have a spine full of hardware, the cold I can feel very acutely. It's a known phenomenon for spinal fusion patients to feel like the titanium conducts cold, so winters can be brutal. It has always been so for me. Ugh.

On this day it was tolerable. Sundays are an easy drive going to SF, but coming back in my direction this time there was quite a bit of traffic as I neared the Bay Area. But driving into the downtown area was actually pleasant. My room at the Holiday Inn Golden Gateway was nice; it wasn't my first stay there, so I knew the bed would pass the "broken spine test" - I could actually sleep on the mattress, not too hard, not too soft. Once you're sliced up and turned into Robocop, bed comfort is HUGE. No great view, but I wasn't paying for that (I had accrued points to save $). Just a clean comfortable convenient room (and it has indoor parking for the car, so it was safe for the duration). 

So I was hungry, and decided I'd landed successfully at my destination, so I ventured out a couple of blocks away to get some takeout Indian food (something I had not had since before the 2024 surgery!). The walk was down a long block, so the walk back was cold, a lot harder, and dicey as the wind nearly blew me over...but it was worth it. It was yummy, and as you might imagine as it's SF, pricey. This is what you get for $30: 

I surfed for a while, let folks know I was ok and it was jammie time. No TV, just put my earbuds in, watched a few vids, then crashed out, since I knew I would have to be up around 6 and head to the hospital.

Monday, Oct 27, 2025

Got up without needing the alarm, but I felt pretty sore all over. But I was excited to get going for the day. Got an Uber, was checked in and didn't have to wait long to get underway. I had imaging done and, thank goodness, looks like all is well, in terms of things fusing properly. It can take up to 18 months, but the one-year point you want to make sure there are no hardware issues or signs of adjacent segment disease (fractures at top of the fusion that are under a lot of pressure, even if you are strict about no bending, lifting, twisting during recovery). 

So I'm in the watch and wait, was able to continue PT, walk, stretch, but still mindful of falls and ways that you can still screw up your fusion. I continue to do acupuncture once a week, because I am too this day thrashed by driving. 

I was very tired after all the tests and things during the appointment, so I was glad to get back, finish what was left over from last night for a meal, and then crash out in bed to see how I would feel later once the roads were dead, long past rush hour, I decided to drive back that evening on Monday, but left around 8:30PM. 

Got home in about 2.5 hours, great timing. Was VERY glad to slowly unload my stuff, get into jammies, hydrate and get my legs up. Pain management can be challenging when you overextend yourself. Most of my pain is nerve related -- existing severe neuropathy in my legs and feet, and nerve damage related to fusion #1 and #2. 

Everything seemed to go well...for a few months anyway. Sigh. 

Saving that for the next post...