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My post-op experience

Started by BBJ on 07/18/2018 12:11am

Had my surgery on Monday, the 16th. We had to drive about 70 miles to the ambulatory surgical center where it was done. I was up and walking (with the help of a nurse) not long after I woke up from the anesthesia. Was a little wobbly but she sort of held me up. Then 2 nurses helped me get into my sister's car and we had to drive the 70 miles back home. Nurse gave me a couple of pills -- not sure what they were, but they helped me to ride a little more comfortably to get home.

I had a micro-laminectomy and a coflex implant around the L4, L5 area. I don't know why so many people are still having fusion surgery. I have read many stories about fusion procedures that fail. When you talk to your surgeon, ask if you are a candidate for this minimally invasive procedure and the coflex device, which is to keep your spine stable after the laminectomy.

When we got home, I used a walker to get from the car to the house. Sat down in my recliner, using the walker to help me get up and down. I was not hurting very badly when I got home, and didn't really hurt a lot during that night. The next day, though, it was like my whole body "woke up" and I was feeling more pain. Most of the pain was in the area of the incision, which was about 2-1/2 inches long. I had a harder time Tuesday getting up and down than I did Monday. I have staples in my back to close the incision.

Right now, it is Tuesday night, late, about 11:25. I woke up to go to the bathroom. I got a call earlier in the day from the surgeon's office to check and see how I was doing. I told them I was having some pretty bad pain in the incision area, which made it hard for me to get up and walk. They gave me a prescription for hydrocodone (norco) for pain and Keflex (antibiotic) when we left after the surgery. She told me they might call in a prescription for a muscle relaxer. I haven't heard anything back from them about that. Right now, I am sitting in my office chair and the only real place I am having pain is in the incision area. I started walking without the walker early Tuesday morning. My legs are holding up well and are strong enough to walk. I hope Wednesday will be a better day with less pain.

My advice to anyone having surgery is to have somebody to come and stay with you for at least 2 or 3 days. You will find that there are lots of things that you cannot do because those things require some bending and you just can't do them by yourself. I have to go back to the doctor on Tuesday, the 24th, for a follow-up. He might take the staples out then. I don't know. I don't know why they used staples instead of sutures. I think most of my pain right now is coming from those staples.

My post-op instructions said to inspect the incision every 24 hours. So Monday, we had to take off the bandages and check the incision. As of right now, it looks okay. I'm just having that pain that hinders me from getting up and down. Then we had to re-bandage it. That is something you cannot do by yourself. You have to have someone else do it because you can't see the thing, and you can't twist around to try to re-bandage it.

I can walk on my own into the kitchen and make myself a sandwich. I can walk to the bathroom and get up and down off the toilet (very carefully). I still have a little bit of an "aching" feeling in my low back. But most of the pain is from the incision area. If I don't see some improvement in that area of pain, I am going to call the doctor's office again and ask them if they can "jack up" the pain medicine. I think there is definitely a war going on against pain meds, which makes it harder for those of us who really need it to get what we need.

I will go back to bed in a little while. I didn't really sleep well on Monday night. I am a lot more comfortable lying in the bed, but they tell you they want you to get up and walk as much as you can.

I will try to keep you all posted on the progression of this thing.

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BBJ, I’m so glad to hear how well your procedure went!! The thing that helped me the most with incision pain was ice! Using a package of frozen peas was super helpful. It conforms to the incision site and doesn’t leak! Twenty minutes on, twenty minutes off as often as needed. Best wishes for your continued recovery!

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BonnieRae Good suggestion about the ice. I will try that. I am just amazed at how much pain I am having at the incision site. That is really the only place where I am having such significant pain. I don't know if that is normal or not. I don't seem to be having serious pain anywhere else except at the incision site. Did you have that kind of pain at the incision site? I can't stand for anything to touch that area.

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Well, surgery buddies, I went yesterday to get my staples out of my incision. I did not see the doctor, but I saw who was, I think, a PA or NP. I don't know why they use those staples to close an incision. I'm sure they have a good reason. But taking them out as they do is absolutely barbaric, in my opinion. It was a painful experience for me. One would have thought they could put some kind of topical numbing med on the incision before they just start pulling them out.

She asked me to describe my pain at this point. She said the pain I was having in my incision area was probably due to the staples. I could certainly feel a big difference when those staples were out. But she did say I had some swelling on the left side of my incision and told me to put ice on it -- 20 on, 20 off -- to get that swelling down. Or moist heat, like letting warm water run over it in the shower. I am up very early this morning and I can feel that swelling. So out with the bag of frozen peas in the freezer. I have them on my incision right now. We'll see what that will do. (My thought: As brutal as that staple pulling was, it's no wonder I am swollen around that incision.)

I am not having a lot of pain in my back this morning. She told me my next step is to start walking as much as I can. My problem began with pain and numbness after lengthy walking, so we're going to go back to that and see if that situation has changed. I think I will start keeping a pain diary. That will give me some facts to discuss at my next visit. I go back to the doctor (or whoever I see there) in a month. They will take some x-rays first and then I will have a discussion with whoever I see.

They did not release me from the bending, lifting, twisting restrictions. My activity will be mostly walking. If my pain level remains low, I plan to start backing off of the hydrocodone and take it only as needed. It is really causing me some problems with constipation so I am more than willing to taper off of those. They did not refill my antibiotic as she said there was no apparent infection around the incision, just that bit of swelling.

I can already see that this road to recovery will be longer than I anticipated and will require the same restrictions I have been on since the surgery on the 16th. But I think that opting for a minimally invasive laminectomy and a coflex insertion was a much easier way to go than an open laminectomy and a fusion procedure.

As I begin my walking program and proceed, hopefully, to recovery, I will post my progress and any pain that I have or don't have during that period of time.

All that horrible pain I was having at the incision area must have been from those staples, because that particular problem seems to be so much better after the removal of those staples.

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Well, here's more information: I did some research on the Norco I was taking for pain. What I found was that the best thing I could do for myself was to get off of those things as soon as possible! No wonder I have been feeling lethargic. No wonder I have had no appetite! No wonder I have not been able to think straight! No wonder my bowels just stopped working! Those things actually mess with your head and your body! Look it up. Read what the heavy narcotics actually do. I took my last one about 10 hours ago. I am up this morning about 5 am, and for the first time since July 16, I do not feel drunk! I am going back to my regular naproxen. I have swelling. Swelling is from inflammation, right? There is nothing in Norco for inflammation. Naproxen is for inflammation and pain. So, duh! I did not do my walking yesterday because I didn't feel like it. I was in that "brain fog" from the Norco. I am thinking that if I can get some real sleep instead of drug-induced sleep, perhaps I will feel more like myself and be able to think clearly and get going on that road to recovery with a better attitude. I thought I would be in "screaming pain" when I stopped the Norco 10 hours ago, but I'm not. There may be some residual amount left in me, but I'm not planning to add to that. I will just let it wear off and continue with the naproxen.

The neurosurgeon's NP that I saw Tuesday must have been pleased with my progress after one week, since she doesn't want to see me back for a month. That next visit will include X-rays. I will be most interested in what they show. Remember, I did have a minimally invasive procedure. I think that has a lot to do with it.

So my advice is to search for a neurosurgeon who can tell you if you're a candidate for a minimally invasive procedure (also one that does not require fusion), It took me five years before I found one who confirmed that I was a candidate for the coflex and did not have to have a fusion. Plus the incision is a lot smaller. Also, get off those heavy duty narcotic pain meds as soon as you can! Medical technology is rapidly moving, so don't just accept a fusion surgery without researching and asking about your options. There are more and more less invasive procedures out there that are alternatives to traditional fusion if you are a candidate.

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Hi, BBJ--We've been reading your post-op updates and are so happy to hear that your recovery appears to be going so well! You offer many excellent pieces of advice that we know will help others facing the prospect of spine surgery.

One of your suggestions--asking questions to your spine surgeon before accepting a procedure--is especially important. We'd like to share a resource with sample questions to ask for future readers of this post: ( Spine Surgery: Questions to Ask Your Doctor ).

Thanks again, BBJ. We'll stay tuned for more updates!

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I like your section on questions to ask before deciding on having surgery. I have two additions to that. First, when looking for a second opinion, I'm not sure you should ask your current doctor for a recommendation on who to see about that. If you do some research, you can find another surgeon for a second opinion on your own. I have dealt with practices who seem to be very "territorial" and support each other's position. I asked for a second opinion from a doctor who was in the same practice as my original surgeon, but I had to fight to get to see him. You ask any questions you need to ask to ease your mind about surgery.

My second suggestion (and I don't know if you can post this) is to be sure you understand what kind of pain medication they are going to give you and do some research on it. Know what it does and know the dangers it could pose. I was given hydrocodone for pain when I came home. I didn't know anything about it. So I took it. The directions on the bottle said to take "one or two" every four hours. I didn't seem to be getting enough with one, so I took two. Then after about a week, I decided I wanted to stop taking the stuff and go back to my regular old NSAID. So I just stopped taking them! Then the next several days, I felt really sick and had actual symptoms of withdrawal. I did not know that you are supposed to gradually decrease the dosage until you wean yourself off. Those medications are powerful. They give you these narcotics to help you with your post-op pain. That's what they're for. Just do your research and know what you are taking and wean off of them as soon as you can.

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Perhaps I did not explain thoroughly why I did see a surgeon for a second opinion who was in the same practice as my original one. These surgeons are part of an Institute. They are connected, but they also work independently of each other. I confirmed that before I proceeded. Also, I knew that the doctor I was trying to get an appointment with was trained in the coflex procedure and I don't think the first one was, because he never offered that alternative to me. So however or whoever you seek for a second opinion, just ask your questions about what kinds of procedures he/she can offer other than what you have already been offered.

You see, when my pain management doctor referred me to this second surgeon, the Institute looked up my records and automatically tried to send me right back to the first surgeon. But with the knowledge I had gained with research, that's where I had to fight to get to this second surgeon, who turned out to have the best alternative for me. I just would not take no for an answer. Sometimes you have to stand up for what you believe is best for you! Just make sure that your mind is satisfied with what you have been offered, and if you're not, keep searching. There is a website that gives information about doctors and what they specialize in and what their patient reviews are, etc. I don't know if I can post that site on here, but if the moderators say I can, then I will. I gained a lot of information and found doctors I didn't even know existed.

I was glancing up this page of posts and saw where I actually thought I needed more pain medication. Boy, was I wrong there! But I have learned the truth about the dangers of the opioid painkillers, and now I will openly refute my own statement about "jacking up the meds." I know better now.

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By the way, I am doing very well in my recovery. I am almost pain free. I believe that is because my procedure was minimally invasive, and I chose the right surgeon. The only problem I am having is not being able to do normal ordinary things because of the no bending, lifting, twisting restrictions. But that's just something I have to deal with and comply with in order to obtain a good recovery. Yes, I get so bored at times. I get frustrated because I drop something on the floor and can't bend down to pick it up. I have to go get my "grabber" and pick it up the best I can. I am learning how to get up and down by bending at the hips and using my legs more and not bending my back. There are many things you just have to learn how to do, especially if you don't have anyone at home with you to help you. But I think it's important to comply with those restrictions in order to obtain a good recovery. You have had surgery. Whether it was minimally invasive or open, it's still surgery. Don't push yourself too hard before you are healed. That's easier said than done. But I think it's worth it in the long run.

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Went back for x-rays Aug. 23rd, six weeks out from my surgery. Everything looks good so far. They let me see the x-rays and it is amazing to see exactly where the little coflex device is placed. They lifted some of my restrictions so I can do more things around the house without having to use my "grabber" for everything. I still have little "twinges" in the operative area -- not anything like hard pains, just little twinges, I call them. Of course, I am not totally healed at this point but I am able to walk and function better. This is a whole lot better than the months and months it takes to heal from a fusion. I go back in two months for more x-rays and a check-up on my progress.

I can get back on my lawn mower now. I can bend over to do things, just not deep bending yet. I am walking to strengthen my legs. I can do yard work again, just not the heavy stuff. They told me not to lift anything heavier than 25 pounds. That's not a problem because I never lift anything that heavy anyway. So I have fewer restrictions.

We will see how everything looks in two months. So far, so good. Before you settle for a fusion procedure, ask your surgeon if you are a candidate for coflex. And go to a good, reputable neurosurgeon. I think that for some people, eventually fusion will not be necessary, and this coflex device will take the place of fusion.

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Well, it is September 27th now, so I am 2 months and 11 days post-op. I have been a lot more active lately, and I am spending more time up on my feet and moving around. I am going outside and doing some light yard work to get some exercise and walking into my routine. However, I have started to notice as I increase my walking and standing that I am having some symptoms just like the ones I had before the surgery. After I am up and walking for about 45 minutes, I am beginning to have that same numbness down my left thigh, and it sometimes is preceded by that same pain in my back on the left side right around the waistline. Sometimes the pain comes first followed by the numbness and sometimes the numbness comes without the pain first. I am very concerned about this. It did not start until I increased my walking and standing and moving around, and I wanted to increase my walking time in order to strengthen my left leg, which had become very weak. It now feels like it is a bit stronger, however, that numbness is still a problem. I do understand that there is no 100 percent guarantee that surgery will stop all the problems. I will see the surgeon's NP again on October 23, and I intend to tell her about what is going on now.

I have done a bit of research and read that sometimes when you have that numbness, surgery may or may not alleviate it, and that in some cases, if you still have that leg numbness after about 1 year post-op, then you might as well accept it, that the numbness is permanent, and modify your lifestyle to accommodate it. Right now, I am doing exactly what I did before surgery. I stay up on my feet as long as I can before the numbness begins, and then I just sit down and the feeling comes back into that leg. Then I get up and go at it again. So the jury is still out on the results of the micro-laminectomy and whether or not it will eventually stop that numbness.

Now, on the coflex device, I don't seem to be having any trouble with that at this point. I know that it was inserted between the place where I was having the spondylolisthesis ( L4 slipping over L5). So it was inserted between L4 and L5 in order to stabilize the spine and slow down the progression of the slippage. At this point, I feel that it is doing its job. I do not seem to be having any specific problems with it. It certainly was an easier process than a fusion procedure.

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