Tuesday, February 22, 2011

11 weeks post op from XLIF and PLIF

Had films done today then saw my surgeon.  Everything looks good on all films, hardware in place,  cage in place, signs of bone growth already!   I am 11 weeks out (they call this the 3 month check) finished with physical therapy.   Next check in 3 months.  Off most pains meds except for occasional Tramadol (Ultraset).

 I have returned to work part time and hopefully will try to go back full time next week and see how I feel.
  I do have pain from time to time, my left thigh is still quite numb, surgeon expects this to resolve eventually (its a side effect from the lateral incision going through the psoas muscle). 

I think that any patient going for spine surgery has to have realistic expectations at the outcome.  I for one know that after three spine operations I can not expect things to be perfect.  I expect to be able to walk, sit and stand fairly comfortably perhaps with some discomfort from time to time.   I expect not to have to take drugs the rest of my life for pain management.  I expect that I will be able to enjoy life again although somewhat limited in what I can and cannot do.   I DO NOT expect to downhill ski, do sit ups, touch my toes ever again, lift 50lbs bags of pet food,  or have a spine like I did when I was 25 years old prior to my skiing accident.  I have lived with recurrent back pain for 34 years and three surgeries within 6 years time.  I have been fortunate to find and be treated by the best hospitals, surgeon, pain management teams and physical therapists.  I am also fortunate to have an amazing husband and children who have supported and helped me more than they will ever know.

All in all, I am one of the "lucky" patients.  I know there are so many people out there with failed surgery,  debilitating back pain, unable to work, on disability and on pain medication the rest of their lives.   I wish all of you the best and urge you not to give up. 

Thanks for reading, I hope I have given some insight to at least one person out there somewhere.....


Monday, January 31, 2011

7 weeks post op

7 weeks today......every time I think I am completely better, I realize that I still have a long way to go.  I still get muscle spasms in my back, after walking for just a few minutes my muscles tighten up.  The thigh muscle is still sore, the nerve still bothering me.  A simple day of just doing a few things completely exhausts me.  I am not sleeping well.  I feel like THE THREE BEARS.  One bed is too hard, one bed is too soft, and I can't find the one that's just right. 

Using Tylenol for pain control but doesn't seem to help at times, I tried to get myself off Tramadol but I think I will need to rely on it for a while yet.  Heating pad helps with the tight back muscles.

Physical therapy tomorrow.  

Tuesday, January 25, 2011

Physical Therapy

Just a quick follow-up note:  I hurt like heck today.  I really think my PT pushed too hard yesterday and I wasn't ready for ankle weights.  If PT hurts too much SPEAK UP!  You are suppose to work to get better, not work to get more pain!  Right?  I'll speak with her tomorrow.

I was up half the night throbbing and using a heating pad!

A look at 2010 and pain relief prior to surgery

Prior to having surgery at two levels in December 2010, I underwent evaluations for pain management.
  Make sure your doctor is  Board Certified in Pain Management and Fluorscopy!  I had 3 epidurals,  a caudal block and finally a facet joint injection bilaterally at L-5-S1 (this was done between 2/2010-11/2010)

The first epidural relieved some of the lower back ache but did not relieve the stenosis symptoms.   They had a problem getting into the epidural space due to scar tissue.  The other injections were placed at different levels.

In addition, I have been on Tramadol since Feb 2010 and still take it for pain relief.  Everyone is always worried about addiction to meds, well, I would rather be somewhat pain free, and that's a choice one must make for oneself.

Not all types of pain management works, some people benefit greatly while others do not.  My decision to undergo pain management was strictly to delay surgery for as long as possible.  In retrospect, I think it was the right decision, particularly since this was my third spine surgery.   I was frightened and reluctant to have yet another procedure.

It seems like once you have a spine surgeon, you become a patient for life!!  You just keep going "back" for more!  (Not by choice) 

Laminectomy 2005, Fusion L-4-5 2006,  XLIF & Posterior L3-4, L5-S1 2010

Monday, January 24, 2011

6 weeks Post Operative/Physical Therapy

Today is 6 weeks since my surgery.  Although I thought I was feeling fairly strong, able to walk and to things, I learned today just how far I still have to go.

It was my first PT session.  After 15 minutes of ultrasound and heat therapy to loosen up very tight back muscles, I then peddled a recumbent bicycle.  At the two minute mark I thought my left leg was going to fall off.  I stuck with it and managed 8 minutes.  8 minutes!!!!  That's all!   I then did standing in place (holding on) leg lifts (like marching) with 1 lb weight on each ankle.  The right leg works, the left leg is still a struggle.  The thigh is still really tight and the nerve still irritated.  We are avoiding any bending, twisting, rotating workouts and I have a 5 lb restriction.

By the way, I walked to my therapy appointment 8 blocks there and 8 blocks back (it was 10 degrees).
By the time I got home, I needed a pain pill, lunch and a 1/2 nap.  My butt muscles hurt and my back is sore but not painful and my knees are stiff.

So I realized that after be inactive for over 8 months and 6 weeks, I have a very long way to go.  I also think that being overweight is not in my favor and being 59 years old certainly doesn't help the situation.  But, it is what it is, so I have to work harder!   Can't wait to get back there on Thursday!

Thursday, January 20, 2011

XLIF and Psoas muscle

I learned today from my Physical Therapist that the psoas muscle really gets disrupted and stressed after having surgery with a lateral incision.  I am still having numbness in the thigh and weak muscle (quad).  I have read a number of postings on the  Spine forum website that many patients undergoing this have had similar problems.

  So hopefully with a few weeks of P.T. I will feel stronger.  I guess if I had to choose a ALIF over a XLIF I would choose that later, going through the abdomen was a very long and painful recovery (surgery 2006)

Wednesday, January 19, 2011

5 weeks post op

Hi Again-
I am five weeks out now.  My walking has improved considerably.  I am wearing a bone growth stimulator 12 hours a day (I can't sleep with it cause the dame thing disconnects and the alarm goes off and wakes me up), wearing a Velcro brace.  I gave up the walker, I take the cane when I go outside to steady myself if I should feel unsteady.  also indicates to others "WATCH OUT, I'm disabled".   Totally off morphine, vicodin.  Taking Ultraset only if I really need to, trying to control the aches and discomfort with Tylenol.  My left thigh is still numb with sensitivity nd some muscle tightness.  Tomorrow I start physical therapy to see if they can help it along.  My back feels good except early in the morning when I first get up, really stiff and achy.  Hot showers really help.  I am doing better mentally after having a meltdown last week, just crying and feeling depressed after going through this a third time.  I guess that happens.   Trying to keep busy, reading, downloaded music on my Ipod,  hooking a rug, TV, Netflix.  I try to get out and walk every day but the darn ice and snow makes it difficult.   Incisions mostly healed, side incision looks a little worse (need to watch this for a few days).  Still wearing loose clothes, gym, sweat pants, loose tops,  gave up on underwear, just too tight.   So, in summary,  I feel that I am doing fairly well at this point.  I know some patients are still in pain at 5 weeks, so I consider myself lucky in that respect. 

Sunday, January 9, 2011

The Complete Guide to Spinal surgery from a Patient's Point of View, One Month Later

Hi Everyone:
 Well, its 4 weeks post-op tomorrow.   I gave up my walker last week and switched over to a cane.  I find that it really helps, still not able to support myself walking alone for too long.  I am doing leg stretches,  knee bends, and leg crossovers.  I can walk a good distance, although it makes me very tired.  Tried steps yesterday, not too good....can only do about 3 steps.  My pain level is almost 0.  Gave up morphine last week and switched over to Ultraset.  Still taking Lyrica for nerve pain.

Nerve pain:  apparently when there is a lateral approach incision it enters through the psoas muscle.  Well that incision still gives me some discomfort.  A nerve that goes down into the upper thigh quad muscle is affected.  I have numbness, tingling and hypersensitivity.  It is getting better, but not nearly as comfortable as I would like.  Some Internet research tells me that it is common after XLIF (extreme lateral interbody fusion) which is what I had.

Saw my surgeon this week, he is pleased (good for him), I guess I am pleased.  I haven't had any set backs or post op complications.  My progress is steady but slow.  All of my staples were removed.  I had a look at my x-rays, I look like the bionic woman.  My niece says " it looks like they implanted a chicken coop inside of you",  she's probably right!  Although I don't feel much like clucking and my feathers still feel a bit ruffled.

You really have to push yourself.  It takes every bit of strength to get up, shower, hook up my bone stimulator device (yes wearing this thing that sends pulses to the electrodes attached to my spinal area to promote bone growth), and get dressed.  If I go out for a small excursion I am completely exhausted.   So I rest.  It's easy to stay in bed all day, but not wise.  I walk the long hallway of my apartment back and forth dozens of times. I know that in 4 more weeks I will be a completely different patient with completely different views, so I try to stay positive.  After three spine surgeries, it is hard at times to stay positive.  If I ever require another spine surgery, I don't think I could do it.  I just don't have it in me mentally.  So, I hope for the best, that this surgery was the last, that my spine stays stable.   I don't want to do gymnastics, ice skate, jog,or ride a bicycle;  I just want to be able to walk and walk, hike a bit,  maybe be able to swim.  The flexibility of my spine is forever compromised, and I accept that.  I have 6 inches of rods, screws and a cage implanted,  with the hope of getting rid of the severe back pain I have had.  Only another person with back pain would really be able to understand the drastic impact this has on your life. 

I am thankful to my superb surgeon, Dr. John Bendo, who listened to me and made the decision to be more aggressive with this last surgery (7 hours by the way).  I am thankful to the nurses, the aides, the physical therapy staff, pain management, and all those involved in my care at Joint Diseases NYU Hospital, there care, concern, emotional support and kindness will be remembered.

 To every person out there, and there are many, who suffer from chronic long term back pain,  my thoughts and prayers are with you.  I was lucky.  Lucky to have a great surgeon, great care, an incredible family, supportive friends, but most of all determination.  Determination to get through this a third time.  It's been a long haul.

Love SCB

Tuesday, January 4, 2011

The Complete Guide to Spinal surgery from a Patient's Point of View, Other Stuff

Hi Again:  I am 3 weeks post spinal surgery, multi level fusion from L3-L5-S1, with pedicle screws, rods, and one cage.  Had post op x rays today and saw my surgeon.  All of the staples holding my incision were removed (glad for that they were feeling annoying and pinching).  Posterior incision looks great.  That lateral incision from the XLIF procedure, continues to be a "pain".  Still hurts,  hard to move around,  pain radiates down into hip.
I also have some residual nerve pain in the thigh muscle (quad) feels tingling yet numb.  My doctor says "it will go away". I just love when they tell you that as if they were a psychic with a crystal ball in front of them.   I am attached to a Bone Growth Stimulator Device which sends electronic pulses to the pads placed along my spine to encourage fusion of the vertebrae.  I have read controversy of this device, I had one 4 years ago.  I will say that I started showing evidence of bone growth and good fusion at 6 weeks post op, so I will wear this device again.    Besides this device, I am wearing a  Velcro brace around the lumbar region to provide support when I am up and around.  Certainly makes me feel more secure.  I am slowly weaning myself off morphine, taking only 2 mg at bedtime.  During the date I take Ultraset every 8 hours. 

Getting dressed is difficult despite the use of various gadgets.  I can stand up in the shower now as long as its short and can sit at the computer for about 1/2 hours at a time.  Getting in and out of the car is a challenge as you must be sure as not to twist but to pivot your entire body.  I do my leg exercises, and now walk several times a day.   Each day, a little better, the increments are small but I accept them, knowing that the surgery is behind me, and that within 3 months I will feel like a new person.