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Old 01-07-2008, 08:25 PM   #1
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Smile Update! 10 weeks post-TLIF

Hey everyone!

I figured it was about time for an update. It has been two and a half months since I had my TLIF at the L5/S1 level. So here’s what’s been going on since.

Let me set the scene: before my surgery, I had been essentially bedridden for nearly 4 months, because the sciatic pain in my right leg was so bad due to a ruptured disc. Ironically, I ruptured it during physical therapy for a bulging disc! In August of 2006, I had a microdiscectomy, which worked for a while. But the pain came back after a few months, and got even worse than before. My surgeon gave me a choice; we could either try another micro-D or go with a fusion. He said, “How sick of this are you?” I went with the fusion.

The surgery went well. The surgeon was very happy with how it went. My sciatic pain was completely gone! Strangely, I had more numbness in the leg than before, but to not have the pain... that was wonderful! Within a day or two the tingling and some of the numbness went away. I was left with some significant numbness in the outer half of my right foot and a slight numbness up the length of the nerve. The surgeon said that he encountered a lot of scar tissue, and did what he could to clean out as much as possible from the nerve canal.

The first few weeks were really tough. I felt as though my upper part of my spine was just balancing on my pelvis and leaning any way would cause my upper body to fall off! I used a walker to walk down the block and back – about 75 yards. The walker is valuable for getting up from a sitting position and maintaining my balancing while walking.

About a month after my surgery, I went down to my folks’ house for a long visit, which is exactly what I needed to do. My folks were great, making sure I was eating right and helping me to do little errands. When I first got there, I could walk about 150 yards with the aid of trekking poles. I increased my walking a little bit every day. By the time I left a month later, I was up to 2 miles. I brought the poles along, trying not to use them on flat surfaces.

Last week, I had my evaluation from the physician’s assistant who first worked with me in the hospital. She was pleased at the x-rays; although you could not tell if any fusion was taking place, she said that what she was looking for was to make sure that the hardware was seated properly and that everything was in the proper position. You could make out the cages, but you couldn’t really tell if any fusion was going on. She said you can’t really tell for at least 6 months.

To my surprise, she said I could loosen up a bit on the BLT rules! I wasn’t expecting that! I still plan to not bend, lift, or twist more than necessary. She said I could start doing PT, gave me a little booklet of abdominal exercises, and set me up for my first PT appointment, which will be next week.

So... how do I feel? Physically I feel OK. I haven’t had any recurrence of sciatic pain, though I occasionally feel a little “heat” along the nerve – particularly at bedtime. I have a decent amount of stamina from walking, but my core is [I]very[/I] weak. I can tell that I have a lot of work to do to get my core into shape, and that that is the area I really need to concentrate on.

Naturally, I haven’t been able to exercise at all for almost a year now – not that I really enjoyed it before. So I’m about 30 pounds overweight. I’m not a dieter or an exerciser, so I do not relish the idea of getting into shape. Sounds like a lot of pain to me. But sitting around isn’t much better.

The numbness has not really improved since about the third day after the surgery. The PA said it might never get better, but that it is too early to tell. She said that acupuncture may help, and that it may improve as I become more active. At first, it was very weird trying to walk with the numbness in my foot, but I’m getting used to it.

Mentally has been a challenge, particularly in the last few weeks. I’m prone to depression, and I’ve been having some real down days. This could just be a natural part of the healing process, but I’m going to discuss it with my GP the next time I see her, and talk to her about possibly adjusting or switching my depression meds. Part of it is dealing with ongoing depression issues and some of it I think is a little bit of a “mid-life crisis” (I’m 44).

Still the hardest thing is just getting up!

I’ve been really lucky to have a supporting family and also really lucky that I’m not in acute financial distress. I’m also very grateful that this happened at the time in my life when I happened to be employed at a company with very good health insurance! And I’ve been very lucky to find this group of awesome people to help me. That’s you guys!

I hope 2008 is a great healing year for all of us!

David

 
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Old 01-07-2008, 08:38 PM   #2
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Re: Update! 10 weeks post-TLIF

David, that is the most positive thing I have heard all day. I am so glad that things are going so well with you and you are even walking 2 miles a day!! You took a leap of faith going ahead with the fusion and it looks like things WORKED for you. Thank you Jesus!!

Really, I would try not to do any BLT's for awhile. Guard that back like gold --protect it with everything you have. It has to last you a life time. I know I am not a doctor but.....please be careful. Remember once a spinney always a spinney.

Again, I am just so happy for you!!

 
Old 01-07-2008, 09:24 PM   #3
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Re: Update! 10 weeks post-TLIF

it is so good to hear good updates i had a failed first fusion in 02 and now going for my second and all these positive results really help. Thanks

 
Old 01-08-2008, 06:42 AM   #4
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Re: Update! 10 weeks post-TLIF

David,

God Bless your supportive family: this means a lot to us, who in pain and who in recovery after major surgeries.
I am glad you don't feel as much pain anymore. I am so happy to hear this since most people on this board have continues problems after multi surgeries. Good luck to you and keep up with a good work.
Soon summer comes and maybe you will enjoy walking outside more and it will help you with your weight issues. You have time, don't worry about it now.

Depression is a very common thing for patients with CP. I did not experienced it, but can tell you many times I was on a edge. Right now, only 3 weeks after huge surgery, where my body fights a lot of comlications, some days I feel I can't take it anymore. And I am a very strong girl, can take a lot, but when you in pain for years, when all this ups and downs bring your spirits down - no wonder so many people have to take antidepressants.
Honey, do what you have to do to get better. I am sooooo happy WITH YOU and please, let us know about your progress.

 
Old 01-08-2008, 07:25 AM   #5
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Re: Update! 10 weeks post-TLIF

David, I'm so happy for you that things are going so well! That's just fantastic!

You still may have some ups and downs physically, but it sounds like you can be our newest poster boy for spinal fusion. 3 months seems to be a milestone for a lot of us, with a huge decrease in pain and an increase in stamina and strength. I hope it will be that way for you, too. And you're already doing so well!

If you have the option, try to find a physical therapist who has done a fellowship. Mine had done a fellowship and also had extra training in orthopedics. She has so many letters after her name (PT, OCS, FAAOMPT, and ATC)! Of all the PTists I've been to over the years, she was head over shoulders above all the others. She understood, for one thing, that I wasn't there for her to get me into shape. I was there for her to help me get stronger after my surgery, but mainly I needed someone to give me exercises especially tailored to my strange back that I could do on my own for the rest of my life. She was so knowledgeable and really helped me understand the whys behind my various pains, and why some could be improved with exercise and some would be with me forever. She listened well to me and was able to troubleshoot some particular problems for me, like shifting myself on the seat of the car, or turning in bed (I was sometimes getting sudden shooting pain that made me get stuck halfway, couldn't keep turning but couldn't roll back either). She would listen and then say, okay, try tightening this muscle and this muscle as you make that move. She was right every time! Of course, she had already worked with me to teach me how to isolate particular muscle groups. You're right, those core muscles are crucial! I have a couple of core exercises that I can do anytime, without anyone even realizing I'm doing them. I do them at red lights, sitting at the computer, whenever I think about it and often now without even thinking about it. Those muscles make such a difference!

Are you getting any help for your depression? Meds and/or counseling? Like Moldova said, people with chronic pain often have depression, too, and if you're prone to it already, it's probably going to rear it's ugly head. Add a little mid-life crisis stuff into the mix, and it could drag you down. It sounds like things are going well physically, and other things in your life are pretty stable, you have a great support network, but depression can still hit. I do hope someone's walking beside you through it.

Thanks so much for such an uplifting post. It's great to hear a positive story, especially for the newbies who are looking at an upcoming fusion. We've scared a few of them with our ongoing difficulties, but the success stories are much more common than the ongoing problems. We just don't hear about them very often on this board!

You keep hanging in there, keep being careful even though the PA said you could bend a little (yikes, I wouldn't until I heard that beautiful word, "fused"), keep exercising as you're able, and please let us know how you're doing.

I expect by summer you'll be camping again!

Take care,
Emily

 
Old 01-08-2008, 07:31 AM   #6
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Re: Update! 10 weeks post-TLIF

Oh, and by the way, I had a numbness issue a bunch of years ago when my hardware was removed after my first fusion. They apparently nicked a nerve (at least, that's what they said), and I had a numb patch on my back, a circle several inches across. It didn't really bother me, since I didn't have to walk on it or anything, like you do with your numbness in your foot, but it was just weird. It took a couple of years, but the feeling gradually came back. Nerve stuff takes a long time! Don't lose hope. It very well may get completely back to normal with time.

 
Old 01-09-2008, 11:07 PM   #7
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Re: Update! 10 weeks post-TLIF

Emily,

Yeah, I’ve been getting treatment for the depression for a while. I got sober from a drug and alcohol addiction about 5 years ago, and that’s when I started taking the Zoloft. And, like I said, it just doesn’t seem to be cutting it as well as it used to. I also used to go to a support group once a week, but the center closed down a few years back and I haven’t really found a substitute.

But, all in all, I couldn’t be happier with the way things have turned out so far. When I think of how much pain I was in just trying to stand up, it’s a miracle that I’m able to do what I can at this point in my recovery. I have to keep reminding myself of where I have been to have any perspective on my progress. When I look at it, I can see that I’ve made a lot of progress in a fairly short period of time, though often it didn’t really feel like it at this time.

I suppose I could look up the PTs on the internet, and they should have it listed whether they’ve done a fellowship, eh? (I have Kaiser, so I should have a choice.) I liked my old PT; however, she’s the one I was seeing when I ruptured my disc before... but I suppose that’s not really her fault. And I’m just assuming it was the PT; I don’t know that for sure.

You and Pepper and Moldova have been such a big help to me. If I am one of the lucky ones, then I hope some of my luck rubs off on you guys ‘cuz you deserve it! I'm so glad I was able to find this board before I had my surgery; it really helped a lot!

Love,
David

 
Old 01-10-2008, 08:00 AM   #8
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Re: Update! 10 weeks post-TLIF

I don't know if there's any kind of internet listing for PT's, but it's sure worth a try. I found mine through my doctor. When it was time to start PT, I told him I wanted someone with a lot of spine experience, like a rehab therapist. He immediately said he knew the perfect therapist for me. The therapist did say, in chatting with her, that there's really no such thing as a rehab therapist, just therapists who work at rehab facilities. There's not any specialty in their training for rehab. But I'd call them a rehab therapist if that's what they do all the time. Just a difference in terminology, I guess.

If you can't find someone on the internet and your doctor doesn't happen to know one who's done a fellowship, you can always call the listings in your local yellow pages and ask if they have any therapists who have done fellowships. Finding the right therapist is as important as finding the right doctor.

I agree with you about keeping things in perspective. It's easy to focus on the pain you still have. It helps me a lot to remember how bad it used to be and how far I've come!

Take care,
Emily

 
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