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Back Problems Message Board


Back Problems Board Index


I have read everything I can on this board but don't see exactly what I need to know..
I have put off the surgery until I was put on the GROUND and could not walk!

Recent Reports Summary:
Severe Retrothenesis L4/L5 area, 3mm disc bulge.
T11-T12: Moderate disc space narrowing.
T12-L1: 2mm left disc bulge indents thecal sac.
L1-L2: 2 mm bulge moderately degenerated disc indents thecal sac with mild stenosis.
L2-L3: No disc abnormality.
L3-L4:3mm broad disc bulge indents thecal sac. Mild left side neural foraminal narrowing.
L4-L5:Severe degeneration 4mm central disc osteophyte indents thecal sac.
Moderate right sided neural foraminal narrowing severe left sided neural foraminal narrowing.
L5-S1: Narrowing of disc space. Mild right side narrowing.

HAVING THIS SURGERY: 360 Anterior Posterior L4 L5 S1 Fusion Surgery 01/22/14.
Visited with 5 of the best Spine Surgeons in North Dallas. All said "Spinal Fusion" would be the only way to fix.

Spent 6 months Chiropractor.
Spent 2 months ESI Injections.
Spent 4 months PT including Pilates Reformer work until garage came down on me hard in December. Put me on the ground and in the bed since. Only relief was after taking a few Methyl Prednisone pills (3 total).
If I get up to leave the house, Tramadol helps. Otherwise I am in bed.

Surgery Procedure:
In from the front to remove disc. In from the back to put in screws, rods, etc.
He says, "You can ride the Goldwing in about 2 months....

QUESTIONS (Since my last major surgery was Brain Surgery Clipped Aneurysm 1992):

1. Really, what will I do when I first come home? (Bed 24 hours a day or walk every hour)?
2. Where will most of the pain be and how do I control it (besides Meds for pain)?
3. What will the Nausea level be like and will eating crackers with pills help?
4. Will taking SS and Fiber pills daily help with the Constipation I have read about?
5. What would would you recommend eating the first week? (I have jello, oranges, peaches and crackers) stocked up.
6. Will I be a "ZOMBIE" for the first week or 2 weeks?
7. How often will I need someone here to help me?
8. People say, "Ask your Doctor when you can Shower!"... Fine, but what is the average? (I have a stand up shower with no tub?
9. Do you know anyone who is riding a Goldwing after a fusion? (IT has air ride shocks and air ride seats which cause little or no pain on my back at all)....unlike other motorcycles.

Any additional comments appreciated as my Pre-Op meeting is 1/14 at 11:00 to get the brace and stuff.
Thank you for your patience....and
Welcome to the board. I will try to answer some of your questions, but I preface the attempt by saying that everyone's experience is unique, and what I have to say may or may not apply to you. I have had two lumbar fusions and had two very different experiences. Things I had always thought were essential, such as a raised toilet seat and a satin bottom sheet, turned out not to be with my second surgery. With my first surgery (PLIF L4-L5) I had much more difficulty with mobility post surgery. The second fusion was also from the back, using the same incision, L3 to S1...with screws and rods being removed from first fusion, and replaced as they turned out not to be "compatible" with the newer hardware. Even though this was a bigger and more complex surgery, I was much more mobile, and was off all medications by the 11th day post surgery. To this day I cannot figure out why the last surgery was so much easier.

So, you will be having a 2 level fusion. They will get you up the first day for a short walk. I would assume you will have a catheter and an IV pain "pump" to administer your drugs, probably for the first 24 hours. Then they will be eager to transition you to oral pain medications. You will be taught have to move, navigate stairs and will learn ways to take care of yourself before you will be released. Patients who are unable to accomplish this within 3-4 days are often sent to a rehab center for interim care, until they can take care of themselves.

Once home, you have two important tasks: walking and resting. It is important to take short, frequent walks as walking is the best way to stretch out the spinal nerves. This is very important as it helps to prevent scar tissue from attaching to the spinal nerves as it forms and fills in, especially during the first 12 weeks post surgery. You are not walking to get back into shape. At this point, walking five minutes multiple times per day is the best way to accomplish this.

If you are supposed to take pain meds during the night, get up, maybe use the bathroom, and take a stroll around your home. During the day try to walk a little bit every hour or two, if you aren't asleep.

Rest is equally important as it takes lots of energy, in addition to healing, to grow new bone cells. Do not allow yourself to become overly tired. This is another good reason to make your walks short and often!

How energetic you feel will depend on how much pain medication you need. I was practically comatose for the first two weeks with my first fusion. My son was able to work from home, so he would arrive in the morning as my husband was leaving for the office, and he would usually stay until he returned home at night...I started feeling better during the third week.

With my second fusion I didn't need any help and in fact, my husband had trouble keeping me following doctor's instructions. I felt good and I had no leg pain for the first time in about 6 years....but I was careful and took my rehab very slowly. I was not completely fused for 15 months.

I understand that the incision across the abdominal cavity can be very sore. You will want a small pillow to hold over it when you need to cough or laugh...so I've been told. I think you can count on the first week being pretty intense, but then it gets better after that. Hopefully the oral pain medications and muscle relaxors will keep you somewhat comfortable. You may also want to use cold gel packs or ice packs too.

I've never been nauseated so cannot comment on that. I have the anesthesiologist put something extra in my meds that helps prevent nausea.

Regarding fiber, etc. you will want to drink lots of fluids, water, fruit juices, etc. lots of fruits like blueberries and prunes and high fiber grains or breads. A stool softener helps as you will not want to have to "bear down." Again, they shouldn't let you out of hospital until you are urinating and defecating normally...or at least somewhat normally. Fortunately I like prunes so I ate lots of them, drank prune juice, etc. and lots of water.

You may find it helpful to get a shower chair. I would get weak when in the shower -- due to standing and the hot water. You might get dizzy too depending on your meds. You might want to wait to take a shower until you have someone there in the house with you...just to be on the safe side. I cannot remember at what point I was allowed to shower. I think it was as soon as I was home. The bandage has to be changed at least every day so it wasn't like it had to be kept dry....but this may vary from surgeon to surgeon.

You will not necessarily be a zombie -- again it depends on the drugs you are taking and how they affect you. You will be tired. It takes quite a while for energy levels to come back up to a "normal" level.

As soon as you feel like eating, you must make sure to get plenty of protein and calcium...both important for the growth of new bone. Yogurt, cheese, dairy products are good sources...lean meats and poultry, etc.

Two more points: if you have your brace, practice putting it on every day between now and your date of surgery. You want to be very familiar with it because the first time you have to wear it in the hospital, like to get up to use the bathroom, you will be on pain meds, may be not as mentally sharp and may not remember how the heck the thing straps on!!

Second, personally I would take your surgeon's timetable with a grain of salt. I think telling you that in two months you'll be back on your motorcycle is a bit on the optimistic side. Actually I think it is irresponsible for any surgeon to say something like this as it sets unrealistic expectations and makes the patient think something is wrong if it turns out that he/she doesn't feel great at that point in recovery...and in some people, it causes them to force the body to do things before it is really able to and ready to...they feel like they are on a timetable and will reach Point A by so many weeks, and Point B by this many more weeks. When it doesn't work out that way, they are crushed and assume the surgery is a failure. Better to just take it one day at a time.
Learn to listen to your body and do what it needs...and no more. Pushing to try to heal faster usually results in an aggravated spinal nerve and symptoms like you had prior to surgery. Best to avoid this!!

And, finally, keep in mind that it takes a good year for the body to heal and recover from a surgery such as this. You may fuse faster, but the bones will not set up and harden off for twelve months... it can take that long for nerves to return to the way they were and for energy levels to come back up. It is a long, slow process and ultimately requires a good deal of patience and faith to accomplish.

We are here to answer questions as you work your way through the journey.
Good luck.





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