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OK, I want to use my case merely as an example to get some clarity on a bigger issue -- where does appropriate recovery from ACDF stop and overdoing it start?

I am Day 9 after 2 level ACDF (C4-5,C5-6) with donor bone and plate. No hard or soft collar prescribed. Discharged 34 hours post surgery with rx for 1 Vicodin every 6 hours and 1 Ribaxin every 6 hours. Told no extreme flexion, extension, twisting, bending or lifting, no driving or sex until follow up appointiment in 5 weeks. Period, end of instructions, other than incision care.

Since getting home, I have spent most of the days sitting, standing or walking. Lying down is not easy for me yet, as I have bad spasms when I wake up in the morning, whether I use recliner or various pillow configurations in bed. Wife bought me cervical pillow today, so we will see how that feels. When seated, I either am reading, watching TV, working on computer or on the phone. I have setup computer (laptop) so that screen is at eye level on desk in front of recliner, and I have extra keyboard and mouse in my lap, so I do not have to raise my arms or move my head a lot. Similarly, I have headset for phone so I do not bend neck. This enables me to work and maintain some mental sanity, without physically taxing myself.

Nonetheless, I have ongoing muscle pain and spasm issues in my shoulders and upper back, as well as a little ongoing tenderness in the throat and some swallowing issues, which I understand are normal. So, am I overdoing? By some standards people have received, I am, by others, not so much. I can't envision laying flat on my back or in a recliner 24/7, nor can I believe that is healthy. I also can't envision driving or doiong neck exercises at the moment -- if I inadvertently flex or extend much, my neck lets me know, and I took one short ride with my son yesterday, and paid for it. So, where is that "golden mean"?

It still boggles my mind that there can be such huge differences in post-surgery instructions for what are functionally identical procedures. Without a brace, it is virtually impossible to not move your neck in ways that are probably not indicated -- though pain is usually a good indicator when that occurs.

This may be more a rant than a topic, but worth a shot . . .:dizzy: Thanks!

Jeff
Your mileage may vary...

I've had two ACDFs - each time I was overnight in the hospital and home the next day, and the Dr recommended that I never again lift 75 pounds or more, no overhead work (like painting a ceiling), and no activities like roller coasters, or forcing my head too far (like a look over the shoulder for a lane change), etc. My situation sounds like yours - donor bone and plate (so no hip incision to deal with), and no collar (my Dr said that would just weaken my neck muscles, and make the recovery time longer). I had some shower restrictions to not get the incision wet for 3 days.

The first 2 or 3 days home was kind of grim - hard to sleep, change position, etc. On the second day home, I started walking on the treadmill (winter and snow outside). Every hour I would walk a few minutes, and added time bit by bit. Sitting or laying around too much is, for me, bad for the body and bad for the spirit. Within 2 to 3 weeks I was driving and getting out pretty much as I felt like, although I did take 6 weeks off from work to get my new neck off to a good start.

Two years after the last ACDF, I still have some chronic pain and cramps in my neck and shoulders - but I'm much better than if I had not had the operation. Driving is different since I don't have the same range of motion, and its hard to look down the long aisles at the grocery store or Target, for the same reason.

My advice - stay within your comfort zone, but get back to normal as soon possible, by walking and getting out and around as you feel able. Take it slow, but do a little more each day as you feel able - you may find that you have to learn a 'new normal'. If I had no surgery at all, and did nothing but sit or lie down for 6 weeks, I would feel terrible from the inactivity.

Best luck!
Bob
Jeff,
As you've obviously already figured out, the recovery process is different for each person. You know best what you can and cannot do; it's just a matter of learning to 'listen' to your body. Whenever you are hurting the most, try to think about what you've been doing. Look for commonalities. I know I always tell folks, "If it hurts, don't it it", but there IS a difference between 'good hurt' and 'bad hurt'. If you think it will help at all, keep an activity/pain log and see if you find any correlations. At least you're trying to understand instead of being like some dimwit who goes out and, say, jumps on a trampoline and then says, "Dang, why am I in so much pain?"

Does that make any sense at all?

I will note that sometimes healing nerves are 'slow'; i.e., they do not always respond with pain right away. I know sometimes I'd do a questionable activity, feel OK afterwards and think everything was fine, then be in agony two days later. The whole process is a little freaky.

You mentioned being on the computer several hours a day. I don't know if your mouse hand is on the side where you were having pain, but the forefinger and thumb are associated with the C6 level, so even something as simple as that could potentially cause you some pain. Same with turning pages in a book. And I don't know about anyone else, but talking made my throat sore for several weeks after surgery. Swallowing and eating weren't a problem. Go figure.

You [I]sound[/I] as though you're doing pretty well and trying to keep yourself occupied, which is good, while at the same time being conscious of the fact that your body is healing. You are, however, only [I]nine[/I] days out from surgery, which really is not a very long time. Maybe consider shorter stretches of work with rest in between. Work for an hour, then watch TV or listen to music or an audiobook for 10 minutes. Even that gives the muscles a little time to relax and recuperate.

In the end, though, you're the boss of yourself. You can be a good boss or a bad boss.

Good luck, and hope you're feeling better soon.

p.s. I couldn't get up, even from a recliner, without cradling the base of my skull in my hands for about the first two weeks.

p.p.s TF - what [I]IS[/I] it about the public chairs? I can't believe how many of them make my neck hurt!
Hey Jeff,
You must remember you are ONLY 2 weeks out of major surgery and these things take time to heal. Why no collar (?) but I would a least get a soft collar for sleep. I am 3 months post op ACDF c5-7, still sleeping in a recliner and wearing a soft collar. Try to do what you can gently, your body will let you know when you are going overboard. I will start my first round of P/T next week to loosen up everything that I haven't been using for a long time. But again remember, the fusion can take from 6 months to a year before 100%. Walking has been my main source of exercise, so i'm looking foward to doing a little more. Everybody does heal differently and at their own pace so don't get discouraged if you don't think you are where you should be. Good luck and keep us posted on your progress!!
I live in the Philippines (I'm an American) and my spine doctor has just informed me things in my cervical spine are bad, very bad and my only option is now fussion surgery. I have 3 levels of discs indenting my spinal cord and one vertebre pressing on the cord. He has me wearing a soft collar except for sleeping and eating, am not allowed to sit or stand for more than one hour at a time. Or do anything I absolutly do not have to do.
My husband and I arrive in San Francisco MArch 9 and I have an appt with a specialist on the 13th.
I am terrified of the surgery!!! But when I read one of you went home the same day others the day after...that gives me a better feeling. As for recover, I am not worried about that, I have a large supportive family.
It's the surgery that is scaring me to death!!! I have night mares of not waking up from the anethesia or having a terrible reaction to some medication they give me. My nerves are a mess and I work hard at being possitive and keeping up my spirits...but I'm still so scared.
I'm assuming I will need a two level fussion, maybe a three..how long does the surgery take? Is there a good chance of going home the same day? I'm really freaked out about staying in the hospitol.
Thank you for reading this and letting me vent my fears!





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