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Old 02-24-2007, 03:18 PM   #1
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Jack-Chicago-45 HB User
12 Days Post S1-L5 Fusion: Is Walking the Correct Path to Rehab?

Hello, This is my first post here.

[b]My ortho surgeon is very clear that he wants me walking,[/b] that this will be the main element of my rehab. While I trust him implicitly as one of the top specialists in the Chicago area, I'm seeking assurance from those who have been through it that this somewhat non-intuitve course of action will work for me. I expected to feel pain after my surgery and those expectations were granted in spades. I am now feeling every flavour of sciatica I ever felt for the past 17 years all at once. Pain ranges from 4-7 on a scale of ten. I have Percocet, Tylenol #3, and Darvocet. I've not quite figured out which works best yet. Even a passing glance here informs me that this increase in symptoms post surgery is not unique. Having said that, I'm still chewing on the following questions.


[b]Question 1:[/b] I have the ability to get downstairs for meals and back up the stairs in my house 3-4 times per day. I can stand for about 3 - 4 minutes. Can sit at computer for up to 40 minutes. I can do 4 laps around the inside of my home at a time. I feel pain through all of this but am able to do it. How am I doing for 12 days post surgery? I have no way of knowing what an average rate of recovery is.


[b]Question 2:[/b] After reading some of the posts here it seems that some Docs suggest getting the pain under control first. Seems reasonable that excercise would simply inflame already inflamed nerves. Since there seems to be various approaches in the Medical community, I'd appreciate any personal testimony on the issue. Links to scholarly articles on the topic would be cool too.


[b] Food For Thought:[/b] In 1957, Dr. C.P. Richter of Johns Hopkins Medical School Laboratory carried out an experiment to measure the motivational effect of hope. Rats were placed into 30" deep cylinders of water. After a short time, half the rats were momentarily rescued, then returned to the water and half were not. The group that was given hope of another brief rescue swam for more than 3 days. The other rats drowned almost immeadiately.


I could use some hope right about now
-Jack
__________________
1990 : Grade 2 Spondy 40% Slip
2006 : Grade 3 Spondy 75% Slip
2006 : Dec 15 : Epidural Steroid Injection
2007 : Feb 12 : S1 - L5 Fusion & Laminectomy (Cages, Rods, Screws)

Last edited by Jack-Chicago-45; 02-24-2007 at 03:26 PM.

 
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Old 02-24-2007, 03:41 PM   #2
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ala3 HB User
Re: 12 Days Post S1-L5 Fusion: Is Walking the Correct Path to Rehab?

Hi Jack,
We all need hope. I did not have surgery yet and I am hoping to avoid it, so I can 't give you any advice as far as recovery. Many people here talk about walking and how important that is after surgery. I heard many doctors saying that you should try to keep your pain under control with drugs because that speeds up the recovery. I really hope that you will heal fast and be able to enjoy life.
I am also from Chicago area , could you please tell me the name of your surgeon and if you would recommend him.
Good luck and heal well.
Alex

 
Old 02-24-2007, 03:48 PM   #3
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Re: 12 Days Post S1-L5 Fusion: Is Walking the Correct Path to Rehab?

Hi Jack
Welcome to our little community. Here you will find a great group of people all at different stages of back issues. Some are here because they are just experiencing back pain some have chronic pain and some have had surgery such as yourself. We have a few awaiting surgery such as myself. My surgery is Monday as wll as a couple of more people.

123DietDrpepper has had surgery and has been posting daily for us. You might want to read her posts.

I think you are doing great at Day 12.

I hope this works for you and you become painfree. Please feel free to share your experiences as that is how we all learn. Personal experience weighs alot more than what the Dr's tell us to expect.

Please excuse my typos as I am queen at that.

 
Old 02-24-2007, 04:49 PM   #4
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Re: 12 Days Post S1-L5 Fusion: Is Walking the Correct Path to Rehab?

Jack,

I am 3 weeks out from my fusion of l5/s1 and to be honest I think you are doing to much but then again I am not a doctor. My doctor told me once up and down the steps per day and no more. I am not allowed to sit for more than 20 minutes at time. He also told me if you have pain doing something to STOP. Your body is telling you that you are not ready for this.

Just my 2 cents.

Hope you have less pain soon.

 
Old 02-24-2007, 05:15 PM   #5
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Re: 12 Days Post S1-L5 Fusion: Is Walking the Correct Path to Rehab?

Hey Chicago Jack! Welcome to the boards.

Walking is the single most important exercise you can possibly do right now in your stage of recovery. You are using your back, hip, buttock, and leg muscles combined, and you would be surprised how much back muscle is involved. You also get the benefit of the added "in with the good air and out with the bad". O2 in, Carbondioxide out. Really great for total mind and body.

I think you are right where you need to be 12 days post op. I was able to tackle my stairs about the same as you can at that point. Once you are further into your recovery.. added PT (in my opinion) is called for. It loosens up what's gotten unused for awhile and tensed up from the surgery. Plus you begin to regain some muscle you've lost and regain control of them as well and getting that core back up to par is essential to help control the changes in the spine and also to help prevent other levels from weakening further.

Physical exercise has also been considered to lessen scar tissue buildup.

Your spine and your body in whole must adjust to the new spine configuration. Your doc phsyiologically changed the mechanics by doing the fusion and it takes awhile for your body to work and compensate from the change. Which also accounts for some new aches and pains to go along with the surgery recovery pain(s).

Keeping your pain level under control is very important also. If you hurt.. it tenses the body and puts it in protective mode and also wears the body down, and can cause slowness in healing. A relaxed body (less pain/stress) heals much faster on average.

As to what is "average"? While there are certainly many "medians" on things.. we are all different and heal at different rates. One can be a tortoise or a hare. It all depends.

I dont know about you, but until I had this surgery.. I TRULY HAD NO CLUE what to expect, despite all the reading and knowledge I had gained beforehand. And my body also did not respond the way I thought it would either. I assumed I would be back at work at 4 weeks. HAHAHA.. NOT! It took 7 weeks to return part-time and then worked back to full time over the coming weeks. And the exhaustion that came with the surgery is incredible. I am almost 11 months post fusion now and I can still get worn out easily when I used to be like the energizer bunny! New adjustments.

Anywho.. in closing this post.. I think you are doing just fine, just need to get your meds to a comfy control for you and you sound good to go! Keep posting and again welcome! Tammy
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"believe in the beauty of your dreams"- E. Roosevelt

L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
Solidly Fused Nov-2006
A Success, but still improving!

Last edited by Justoneofus; 02-24-2007 at 05:18 PM.

 
Old 02-24-2007, 05:24 PM   #6
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Re: 12 Days Post S1-L5 Fusion: Is Walking the Correct Path to Rehab?

Jack,
When my daughter had her fusion 20 months ago, like Pepper, she was allowed to go up and down the stairs once per day. Her dr and therapists put no limit on the amount she could sit. The therapist in the hospital wanted her up more than down in bed.

Her dr's only therapy post up was walking. He told her to walk, walk, walk. For the first two weeks she could not even be a passenger in the car so she began doing small laps in the house. After a day or so she went outside and walked only about a house or two, but she did this three or four times a day. She was gradually able to increase this amount. It was June and it was a very hot summer in Mich that year so when she could be a passenger I would take her to the mall and we would mall walk where it was cooler. It did become expensive for me at times. Since it's snowy where you are when you can be a passenger in a car some mall walking may work for you. We were lucky that we have a mall about a mile from our home so we would go a couple times a day and walk.

Keep walking to a great recovery. cas

 
Old 02-24-2007, 05:54 PM   #7
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Re: 12 Days Post S1-L5 Fusion: Is Walking the Correct Path to Rehab?

I think in this area of recovery there is no one size fits all. If it hurts stop there is no benefit in "working through the pain". This is not a Rockie Movie it is your recovery and everyone's rate of recovery can be different.

Some doctors are the "rah rah team types" others are more reasonable and realize that their patients needs can be very different. Some patients bounce back and the nerves don't go into firing mode others can be less fortunate with nerve pain shooting down their legs for quite some time after surgery. At 12 days I think you are doing fantastic just make sure that you don't push yourself to overdue it and end up going two steps back for every one step forward.
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Old 02-25-2007, 09:50 AM   #8
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Re: 12 Days Post S1-L5 Fusion: Is Walking the Correct Path to Rehab?

Hi Jack,
I agree with everything already posted. In addition, I'll add that while you're lying down, there's not much blood circulating around the spine. That greatly increases with walking and is necessary for healing. At 12 days post-op, I was walking about 1/2 hour to less than an hour a day, but in 10-15 minute increments. Every time I got up to use the bathroom, I took advantage of already being up to walk for as long as my pain would let me. Since getting up and lying back down are the hardest, that made sense to me. I was told that I had no limit on how many times I could go up and down the stairs, but once was enough for me at that point. Let your pain be your guide.

Do keep up the pain meds. You don't want your pain to get ahead of you. If your pain isn't under control, your muscles will be tense and will just make it worse. You heal better if you aren't in pain. But don't wait to be pain-free to get some walking in. As long as your pain is at a reasonable level, try to walk as much as you're able. But it's not a contest and no one's going to give you a medal for being a hero if you walk more than the next guy with this surgery. Everyone is different. Comparing has some value, but only you know how much pain you're having and how tolerable it is to you. Do what you can, no more and no less.

When I started PT, my therapist did some measurements to see how far I could straighten my knees while sitting, hips joints, etc, along with a bunch of strength measurements. She did it again two weeks later. From the amount of change I had, she concluded that what I was experiencing wasn't muscle weakness as much as the nerves and muscles not communicating well. When you have such a major surgery, everything can get out of whack. The focused muscle tightening and loosening she taught me quickly got things headed in the right direction. Patience, though, is essential. It can take a year, she said, to get back what I lost from moving the nerves around during surgery. What I found interesting was that it wasn't all just loss of strength from not using my muscles. So if your legs/knees feel a bit different -- weak, stiff, not able to bend the same -- , don't fret over it. It will come back. Give it time.

At only 12 days out, I'd say you're in the normal range. Just don't overdo it. Sitting for 40 minutes at a time might be a bit much. I was told no more than 20 minutes, as sitting is the hardest on your spine. No limits on standing or walking, just whatever can be tolerated.

I hope you continue to heal well. You'll probably have other questions as you progress, some big and some little. Lots of us here have been through it and are happy to help you with our own experiences. We're not doctors, though. Anything serious should be brought to your doctor's attention. We're very good for peer support, though.

Hope you have a relaxing day. Get some movies!

Blessings,
Emily

 
Old 02-25-2007, 09:55 AM   #9
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Re: 12 Days Post S1-L5 Fusion: Is Walking the Correct Path to Rehab?

I am pre-op still so I can't comment ofcourse on what you should be doing. But loved the thing of hope and the rats. I truly believe that. I believe to that we have to visualize what we want to create and take actions to get what we visualize... I know recovery isn't gonna be some simple walk in the park but it sounds like you are doing great!!! Take good care and don't overdo it!!! Wishing the easiest pain free recovery.

 
Old 02-25-2007, 12:00 PM   #10
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Jack-Chicago-45 HB User
.

[b]Thanks to everyone[/b] for the swift, thoughtful, and spot on replies to my questions and concerns. Feeling much better having checked in with the community here.

[b]Good Morning Alex [/b] - Yes, I'd be happy to pass on my surgeons contact info. Like you, I also sought to avoid surgery for as long as possible. I was offered the choice 8 years ago but chickened out. Part of the reason was that I did not have 100% confidence with that first surgeon. Something in my gut said no, I listened to it, and am glad I did. I eventually found Dr. Purnendu Gupta at The University of Chicago Hospital. U of C is consistently rated as one of the top 25 Hosptials in the nation. Dr. Gupta an outstanding specialist in this area. Just be sure to clear 3-4 hours off your schedule for appointments. If you have an 8 am appt, you might not leave the building until noon. Dr Gupta is very generous with his time once it is your turn to see him, but this unusually generous approach ( in addition to occasional bottlenecks in radiology ) can lead to traffic jams in the waiting room.

It's difficult to give precise explanation, but according to his surgical assistant, Dr Gupta managed to pull off something in my surgery that most other docs would not even attempt. For several structural reasons we assumed that surgery might involve merely fusing the slippage into place as is. Dr. Gupta was able to not only bring me back from a 75% slip to a 40% slip, but I also got the cages as spacers back to original position vertically. He was also able to harvest bone near the incision site instead of the typical source from the illiac crest which made the whole procedure much less invasive. He also does a lot of revisions, meaning fixing other fusions that did not work. From this I think he learns much from the mistakes of others, about how to do it right the first time. You will need 2 things in order for you be seen as a new patient. An MRI, and a physician referral. It can be hard to get him, if your primary care doc is not at U of C, but well worth the effort.

[url]http://www.uchospitals.edu/physicians/physician.html?id=5978[/url]
[url]http://www.uchospitals.edu/specialties/minisurgery/spine/[/url]
[url]http://www.uchospitals.edu/about/awards/usnews.html[/url]
[url]http://www.uchospitals.edu/news/2007/20070214-magnet-status.html[/url]

[..]..................................

[b]Clover - [/b]Thanks for the warm welcome, I wish you well with the upcoming surgery. Yes, I agree with you there is no substitute for the sharing of personal experience. Best regards and take care.

[b] Pepper - [/b]Thanks for the word of caution, you've confirmed my hunch I might be over doing it a bit. We seem to be in very similar circumstances, you've been very generous with your posting and it seems i could learn much by reading what you've already shared. Thanks again.

[b]Tammy - [/b] The way you describe the benefits of walking make me want to sign up for the program. Just the kind of assurance I think I need, thanks.

[b] Cas - [/b] That's an inspiring story. Much appreciated. I wish your daughter continued recovery.

[b]Pooby - [/b]Thanks for a look at the big picture, good advice, much appreciated.

[b]BlueAtlas - [/b] Wow, great post. Thank you so much.

[b]yvette777 -[/b] Yes, the drowning rats experiment is more than a little dark as a point of reference for inspiration. But it gets the point across non the less. Thanks for the warm wishes, back atcha.

Best regards and take care
- Jack
__________________
1990 : Grade 2 Spondy 40% Slip
2006 : Grade 3 Spondy 75% Slip
2006 : Dec 15 : Epidural Steroid Injection
2007 : Feb 12 : S1 - L5 Fusion & Laminectomy (Cages, Rods, Screws)

Last edited by Jack-Chicago-45; 02-25-2007 at 01:05 PM.

 
Old 02-25-2007, 03:35 PM   #11
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Re: 12 Days Post S1-L5 Fusion: Is Walking the Correct Path to Rehab?

Jack just keeping giving us positive outcome sucessfuly storys ok, two of us are having fusion tomorrow and me...well I have twelve days..but whos counting. In all seriousness, any tips etc from what has helped you please pass them out, cause I AM LISTENING. Wishing you a speedy pain free recovery vette

 
Old 02-25-2007, 07:36 PM   #12
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Re: 12 Days Post S1-L5 Fusion: Is Walking the Correct Path to Rehab?

[QUOTE=yvette777;2821067][COLOR=BLUE]Jack just keeping giving us positive outcome sucessfuly storys ok, two of us are having fusion tomorrow and me...well I have twelve days..but whos counting. In all seriousness, any tips etc from what has helped you please pass them out, cause I AM LISTENING. Wishing you a speedy pain free recovery vette[/QUOTE][/COLOR]
[B]Evening Yvette - [/B]

I feel a bit sheepish about offering tips, because I am nowhere near feeling like I've got my situation squared away. I'll do my best. There is one thing I [u]do[/u] know with absoulute certainty, and feel comfortable expressing. There is pain and there is suffering. Although they frequently occur at the same time, they are entirely different species. There is the pain, as a physical sensation in the body. Then there is my emotional reaction to that pain. I find that while my pain levels are rising and falling gently, and dissolving away little by little, my emotions are marked by huge peaks and valleys, sometimes in complete disproportion to the actual pain level.

There were (and still are) thoughts that drifted through my head that had real leverage to send me spiraling into despair. When I was in post surgery ICU for the first few nights I kept thinking... "This amount of pain can't be normal, the surgery must have failed somehow.... This pain might never go away, I will be one of the unlucky 3% stuck with this forever". These thoughts, these visiting deamons can really get to me if I give power to them. I've learned to just let those thoughts drift through me, to notice them, but not invite them to dinner so to speak. I can handle todays pain. It's the suffering about what tommorow will look like that really hooks me. What I can't handle is the idea of the surgery doing nothing to alleviate the pain, or elevating the pain. I've decided, quite intentionally, that today is all I need to worry about. Works for me.

I really am making progress when I think about it. I can remember only a week ago being in the hospital bed and having spending hours drumming up the courage to get to the restroom on my own. Tommorow will be my first day home alone with out assistance, Mrs. Jack will be returning to work full time again, and I'm honestly looking forward to having some time to myself. I'd say that is real improvement. I'm off to bed, Best regards to you yvette, and take care

[b]-Jack[/b]
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1990 : Grade 2 Spondy 40% Slip
2006 : Grade 3 Spondy 75% Slip
2006 : Dec 15 : Epidural Steroid Injection
2007 : Feb 12 : S1 - L5 Fusion & Laminectomy (Cages, Rods, Screws)

Last edited by Jack-Chicago-45; 02-25-2007 at 07:42 PM.

 
Old 02-25-2007, 08:32 PM   #13
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Re: 12 Days Post S1-L5 Fusion: Is Walking the Correct Path to Rehab?

Jack I am sorry you are having such a hard time right now..from listening to others I have learned that everyday will get better, and sometimes there will be set backs. They say six weeks is usually a huge turning point and just remember your body has been through so much it takes lots of energy to heal. I will pray for you to feel better and heal. vette

 
Old 03-01-2007, 11:35 AM   #14
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Re: 12 Days Post S1-L5 Fusion: Is Walking the Correct Path to Rehab?

Hi Jack,
Thank you for the name of your doctor. I will try to get a second opinion from him. I was wondering how are you doing? I hope that you feel better every day. Please keep us updated.
Alex

 
Old 03-01-2007, 01:43 PM   #15
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Re: 12 Days Post S1-L5 Fusion: Is Walking the Correct Path to Rehab?

Jack - I am recovering from the same surgery and you are right there are definitely ups and downs physically and mentally. I believe it is simply the healing process and the hard part is recognizing that. What amazes me is that you feel ready to do things and when you go and do them, you pay the price - exhaustion and pain.

Jack, take care of yourself and let your body heal.

 
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