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Spinal Cord Disorders Message Board

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The following are the basic instructions I think most docs give out. I did searches for acdf post op instructions. You may get several to come up. I had steri-strips but wrapped my neck in plastic wrap for the first few showers (I took one the day I came home). This worked great to keep bandage dry. These instructions do not cover if you have a collar. I wore an Aspen for 3 weeks 24/7. I did shower in a Philadelphia and eventually switched to a soft collar to shower in.

ACDF Discharge Instructions

Your Incision
Your neck incision is closed with a stitch under the skin. The stitches will dissolve in time and do not need to be removed. When the bandage is removed, you will notice suture knots at the ends of the incision. These will fall off within 4 weeks.
You have steri-strips over your incision. About ten days to two weeks after surgery the steri-strips will likely fall off, and your incision should be nicely healed. If the steristrips remain after this time, you may remove them.
The bandage should be removed 3 days after surgery. At this point the wound should be left open to air; however, the steri-strips should not be removed until 2 weeks.
You may shower and shave when the dressing is removed. Your wound is waterproof at this point and can get wet. In addition, you can wash the wound with soap and water. Be sure to pat the wound dry after showering. Do not use ointments or antibacterial salves on the incision.
Call the office if you have continued drainage from your incision. Someone will be available to give you advice about what to do. Change the dressing as necessary until the drainage stops.
Watch for any signs of infection (redness, foul odor, fever>100.5, chills). If you are concerned about the possibility of infection, call doctor office.

Hoarseness, sore throat, or difficulty swallowing may occur during the first 2 weeks. These are common symptoms after surgery. A soft or liquid diet is the best until you are able to easily swallow. Avoid meats and other foods which are hard to swallow until you are having no difficulty swallowing.
Eat regular healthy meals (lots of fruit, vegetables and lean cuts of meat). Your body needs the vitamins and minerals found in healthy foods in order to heal properly. Supplement your diet with multivitamins with iron and calcium. These help the bone graft become strong. A good source of calcium is two TUMS daily.

Pain Medication
You will be sent home with pain medication (usually Vicodin or Norco[hydrocodone]). You should not need strong pain pills for more than a few weeks after surgery. If you need more pain medication, be sure to give the office 24 hours notice in advance to refill your prescription on weekdays. We do not refill prescriptions during evening hours or on weekends.

Some patients find that they have some difficulty with constipation after surgery. This is due to a combination of things. Most of this is due to the pain medication and iron supplements you may be taking. The medications, along with a decrease in activity, can lead to a great deal of discomfort from constipation. The best treatment is prevention. You should eat plenty of fresh fruits and vegetables and drink plenty of water. If you are having difficulty, there are some stool softeners that can be bought without prescription (Surfak, Correctol, Doxidan, etc.) Use Metamucil on a
daily basis along with the stool softener. You may use nonprescription suppositories or enemas if necessary. Again, the best treatment is prevention.

Gradually return to your normal activities. Fatigue is common and expected. Let pain be your guide. Walking is encouraged. Start with a short distance and gradually increase to 1 to 2 miles daily. An early exercise program of gentle stretching, conditioning, and strengthening may be advised. Exercise to the point of discomfort but not beyond. Learn the proper way to stand, sit, sleep, and lift. Generally, maintain a neutral spine.
Be committed to working hard during the recovery process. Don't let minor setbacks discourage you. Concentrate on the progress you are making.
It is common to have twinges of pain in your arms or muscle cramps. These feelings should improve with time. If you have numbness or tingling, it usually is the last symptom to resolve (weeks or months later). As you become more active, you may notice some aching in your neck.

Do not use NSAIDs (e.g., aspirin; ibuprofen, Advil, Motrin, Nuprin, naproxen, Aleve) for 3 to 6 months after surgery. NSAIDs prevent bone fusion. If you are unsure, ASK.
Do not smoke. Smoking delays healing by increasing the risk of complications (e.g., infection) and inhibits the bones' ability to fuse.
Do not drive for 2 to 4 weeks after surgery or until discussed with your surgeon.
Avoid sitting for long periods of time.
Avoid bending your head forward or backward.
Do not lift anything heavier than 5 pounds, including children.
Housework and yardwork are not permitted until the first follow-up office visit. This includes gardening, mowing, vacuuming, ironing, and loading/ unloading the dishwasher,w asher, or dryer.

Sleep on your usual mattress - don't make any special arrangements for a bed. The first few nights will be difficult, but you will adapt.
Some people are more comfortable sleeping in a recliner for a few days.
You will be more comfortable in bed if you do not pile up a lot of pillows behind
your head. A small, folded towel may be more comfortable than a pillow.

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