PERCS Surgery Day
NOVEMBER 2020 UPDATE: DR. DOBBS HAS MOVED HIS PRACTICE TO THE PALEY ORTHOPEDIC AND SPINE INSTITUTE IN FLORIDA. He is still accepting patients there. Dr. Park is currently partnering with Dr. David Anderson at Mercy Hospital in St. Louis for PERCS.
I had hamstring PERCS on both legs at St. Louis Children’s Hospital. Your PERCS experience may vary depending on the hospital you’re at, the type of PERCS you need, and the severity of your tightness. My understanding is that the age policy at St. Louis Children’s depends on the department. For example, neurosurgery patients are admitted to the Children’s Hospital up until they turn 26. However, the policy for orthopedic patients is different: their age limit is usually 21. If you’re older than 21 and younger than 26 and had SDR with Dr. Park, though, they can often make an exception for you so that you can have PERCS at St. Louis Children’s Hospital too. Otherwise, adults will have their PERCS done by Dr. Dobbs (the same surgeon), but at the adult hospital, Barnes-Jewish. PERCS surgery at Barnes is done on Fridays, and at St. Louis Children’s, it’s done on Tuesdays and Thursdays.
Morning of Surgery
I was allowed to drink clear fluids up until 2 hours before my surgery time, so I downed grape juice like it was going out of style. (I was also told I could have water or apple juice, but no milk products or food after midnight before my surgery; Barnes patients may be told that they can’t have anything at all after midnight, even clear liquids. The guidelines may also vary from person to person; a nurse will contact you in the days before surgery to let you know when you can last eat or drink.) All that sugar was making me shake, and I’m sure my pre-surgery jitters didn’t help the situation!
The day-of-surgery pre-op protocol was very similar to my SDR surgery experience (like what is outlined in this video). About an hour and a half before my surgery, I arrived at the hospital and checked in on the 6th floor (Same-Day Surgery Suite). If you’re a teenage girl or adult woman, you’ll also have to pee in a cup so they can be sure you aren’t pregnant. Then a nurse checks your height, weight, heart rate, oxygen, etc. and you’ll be asked to wipe yourself down with disinfectant wipes and change into a hospital gown.
Young children (usually under about age 6 or 7) will get to pick a scent through a mask to go to sleep, but older children, teens, and adults get an IV put in during pre-op. If you’ve got tiny veins like I do, be sure to let them know. My nurse warmed up my arms and hands with a warm blanket before trying the needle, which makes the veins easier to find. (If you’re allowed to drink clear liquids up until 2 hours beforehand, drinking as much water as possible will also help with this!) They also gave me a motion sickness patch to put behind my ear to help with post-op nausea, because I had told them that this often happens to me.
Then a resident came in to write on my legs with a marker. This is just to be extra careful so they don’t accidentally operate in the wrong spot! Shortly after that, I hugged my mom and they took me down to the operating room. Unlike with SDR, I didn’t receive Versed (a sedative, often known to children as the “silly medicine”) before going to the operating room. This may vary by patient though, as children typically are given this before PERCS; if you’re anxious and you think it’ll help you, you should absolutely ask for it! I didn’t want it though; I don’t really like that feeling of losing control.
The OR staff was super nice as they wheeled me into the operating room. They were being friendly, asking me about my life and my stay in St. Louis, and I could tell they were just trying to distract me from the fact that I was about to have surgery, but I appreciated it!
I felt oddly calm as they worked on me, putting the monitor stickers on my chest as I stared up at the giant surgery lights. Then they asked me to sit up so they could untie my gown and they said they were going to inject the anesthetic. Immediately after the injection, I felt a sort of achiness (I’m not sure what that was!), but within less than a second, I felt extremely tired and just fell asleep.
The surgery usually takes about an hour, but it depends on your situation, how many areas you’re having lengthened, and whether they’re doing both sides or just one. Mine took a bit longer than that, partly because I had a ton of scar tissue from a previous surgery that Dr. Dobbs had to clean out. Of course, I don’t remember any of that, so to me, the surgery felt like it took no time at all!
Post-PERCS Hospital Stay
My next memory is just waking up in a blurry state of confusion. I didn’t know where I was at first, but my mom was there, and a recovery-room nurse was hovering nearby. The nurse asked me my pain level (I said three), and she said that’s what I had told her earlier, although I have no memory of waking up before that. They kept me in recovery for a while, and then they wheeled me to my room on the 10th floor. I didn’t have a roommate, but many people do; it just depends how busy the floor is. Every little bump on the way there made me cringe, but otherwise I was much more comfortable than I thought I’d be! I wore knee immobilizers for the first 24 hours (and thereafter only at night for the first 6 weeks or so—post-hamstring lengthening, it’s 6 to 8 weeks for adults. Children are typically told to wear them at night indefinitely, until they stop growing.) The immobilizers actually weren’t uncomfortable in the hospital; I actually didn’t feel much like moving my legs anyway.
I wasn’t in much pain that night as long as I stayed still. The main struggle for me was the muscle spasms. Even with no more spasticity, those spasms hurt. I had fallen asleep only for my IV monitor to start blaring, which set off a whole new round of spasms, and I think that was the roughest part of the night. (Pro-tip: ask them to turn the IV pump volume down as low as it will go!) But they can give pain medication and muscle relaxers to minimize the spasms as much as possible.
I had a few issues with my blood pressure being low, and it wasn’t exactly fun being constantly woken up for vital checks (temperature and blood pressure), but otherwise, the night was pretty uneventful.
The next morning, the PT came, took off my knee immobilizers, admired my orange, iodine-covered legs 🙂 , and then helped me to my feet. With her support, I shuffled down the hallway using a walker, and I just remember the awe I felt when I realized that my knees could go ALL THE WAY STRAIGHT. Yeah, it hurt—a weird burning sort of pain behind my knees and down my calves (kind of like a really badly pulled muscle)—and my legs were weak, but I was so excited!
Sitting down wasn’t painful at all, really, but weightbearing was painful, especially going from sitting to standing. Once I was up, the pain wasn’t as intense, but that transition was hard sometimes. When someone helps you stand after PERCS, ask them not to pull you up, because that’ll make it more difficult and more painful. Just have them support you as you slowly rise to a standing position.
I couldn’t manage the step into the shuttle to get back to the hotel (my sore muscles just couldn’t generate enough power, no matter how hard I tried!). So my mom took me back in my wheelchair, and we stopped at a Steak ‘n Shake for a quick bite to eat. A lot of people say that Steak ‘n Shakes are pretty mediocre, but it’s all about perspective! After a hospital-food breakfast that I’d barely eaten, that Steak ‘n Shake hamburger felt like fine dining. 😉