Coccyx removal with epidural instead of general anesthetic

Shelley - rtzy1@hotmail.com

Posted 2008-07-20

My t-bone pain started a few years ago and has progressively been getting worse. It sounds very similar to other stories I've read here. X-rays revealed an old fracture that healed out-of-shape (bending in and then out again, like a zig-zag). I suspect it happened when I slipped off of a wet deck at a cottage about 5 years ago. I was airborne and landed right on the edge of the 3rd step down, resulting in the biggest, most impressive bruise you ever saw. Of course, I got no sympathy at all because I couldn't show it to anyone. Actually, it wasn't really that painful at the time (bruising aside), but the bruising has long gone, and the pain level has been increasing with time.

My doctor (also a chiropractor) said that cortizone injections, acupuncture or manipulation may offer some temporary relief of the symptoms. Well, it seems more logical to treat the cause, rather than the symptoms for the rest of my life. Somehow, I don't see this problem improving with age. I'm 49 and very healthy, so it seems that now, is the best time to resolve this problem.

I was referred to a ortho surgeon for consultation. He's in his 50's and said he performs this surgery about once a month. He examined the x-rays and booked a date. I'm now only 2 weeks from my surgery on July 24th. I discussed the possibility of having an epidural, rather than a general aesthetic for the procedure because I had memory problems following my last general anesthetic. Has anyone else had an epidural for their coccygectomy? I've read dozens of stories, but all seem to have had a general anesthetic.

I'm not usually the nervous type, but I must admit I am feeling a bit uneasy about this surgery. Presently, I can't go to the movies or sit in car for long and I squirm and shift from side to side after about 5 minutes of sitting. The moderate pain is there all the time (and occasionally intense), but I'm worried that I may be in worse shape afterwards as I've read in some of the other personal experiences. Naturally, it'll be worse right after the surgery, but the goal is to be pain free in the end (pardon the pun). I hope to be among the success stories. Keep your fingers crossed for me. I'll let you know how it goes.

Posted 2008-08-24

I had a coccygectomy on July 24th, 2008, carried out by Dr. Robert Carbin [as of 2012, Dr Carbin is no longer carrying out surgery]. This is due to a broken tailbone that healed poorly. I requested an epidural for the procedure because of problems I've had with general anesthetic in the past. The doctor thought it was a rather unusual request (as did the anesthetist) but both agreed. I was very nervous before the operation. As I was in the pre-op area and getting hooked up to my IV, I found myself feeling a bit panicky and looking for the 'eject' button on the bed, but alas there wasn't one. Once I was wheeled into the operating room however, my nerves subsided. They asked if I wanted any type of sedation, to which I said no thanks, so I was fully awake during the 45 minute procedure.

I was afraid of hearing bone crunching and power tools, of which there were none, thankfully. There was the sound of snipping and at one point he asked for a hammer. I'm sure my eyes widened considerably at that point! Then he started to 'chisel' the end of the bone to get it smooth. Feeling no pain of course, I told him he'd better not be building a fence back there, to which they all laughed. I think they'd forgotten I was awake and weren't used to the patient talking back. I was actually feeling alert and fine throughout the surgery. Mostly, I just heard the doctor and nurse talking about the cottage, landscaping that they just had done, kids etc. As he was closing, I asked him how many stitches he was putting in, to which he never really answered except to tell me that there are 3 layers of stitches. In the recovery area everyone around me was looking horribly groggy and in pain. I was wide awake and pain-free because I was still frozen from the waist down. My turn for pain would come.

It took about 5-6 hours before the freezing finally came out. I was on my back during this time (rolled from the operating table onto my bed and that's how I remained). I was in considerable pain the first night, but walking was much easier than I expected. Getting up or shifting positions in bed was particularly painful however. They gave me percocet the first night which upset my stomach. After a sleepless night of nausea and pain I finally threw up in the morning, after which I felt much better. I stopped taking the painkillers as soon as I got home and managed to sleep that afternoon as well as that night. After getting some much needed rest I felt considerably more human again.

I noticed daily improvement for the first week and was eventually able to drive short distances and sit briefly (just not leaning back on the incision area). I still wasn't able to bend down to pick things up off of the floor yet. I was going for walks and doing plenty of stairs since I live in a split level home. I think this helped. I got up each day, got (sponge) bathed and dressed in case of visitors. It felt much better than laying around the house in my pajamas all day. I am blessed with many friends and family who generously brought me meals, flowers, magazines and movies. I guess I can overlook all their 'butt' jokes. I'm sure you've heard them all ... Glad it's all 'behind' you! You won't be such a pain in the 'butt' now! It'll be better in the 'end'! You'll be glad to see the 'tail end' of this pain, huh? and on it goes! They are all having great fun at my expense.

I went to the doctor for my post-op appointment 1 week after the operation. He was very surprised that I was sitting when he entered the room. In fact, he kept shaking his head in disbelief and said he had not had anyone bounce back so quickly from this procedure. He'd performed the surgery many times, but never with an epidural, which he said he'll now suggest to future patients after seeing my progress. Then he removed the large bandage (OUCH) and said the incision was clean and perfect. It took 3 days to get rid of all the glue left on my skin though! It was glorious to finally be able to soak in the tub though. My stitches are disolvable, so I do not need another appointment unless I have a problem. I'm actually surprised that the incision is so small. It's only about 4 inches long with perhaps 8 visible stitches, from what I can see.

It's been 3 weeks now and I'm doing really well. I was so afraid of being bedridden and dependent for a month! I am able to do mostly everything, except lean back comfortably in a chair. The incision is healing well but naturally the area is still a bit tender when I sit directly on it. I have spent the past week painting the spare room, shampooing the carpet and sanding and refinishing a bedroom set. None of this involves sitting, so I'm making good use of my recovery time and getting some exercise at the same time. I simply can't watch any more TV. It makes me feel lazy and unproductive and I did plenty of that in the first 2 weeks. The soreness from the incision may take several more weeks to heal completely, but I'm feeling confident that I'm going to be able to go to the movies and live a normal life again soon.

I'll keep you posted on my progress. Best wishes to those who are also facing this surgery or pursuing other treatments.

Shelley

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