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Old 11-20-2010, 08:11 AM   #1
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7 weeks out of Lumbar Fusion - Activities / Sleep question

Hey all,

I'm 7 weeks out (coming up on 8 weeks in a few days) and have made a lot of progress with my lumbar fusion. I had a fusion on L4-L5 with a spacer in between them (was bone on bone - no disc left). I'm 34 years old and have pre-diabetes.

I got a huge wake up call in the hospital following my fusion as they had to give me several shots of insulin because my blood sugars kept going up over 180. This scared the crap out of me and since the fusion have started working on my diet and exercise. I've lost 36 lbs since the fusion by just changing the amount of food I eat as well as making sure to follow Dr's orders to get out and walk every day. This has really inspired me to keep on losing weight and to return my body to the once healthy state it used to be in about 8 years ago. I'm a big guy (6'0") and am "skinny" at around 210-215.

I have a few questions regarding my recovery. The first obviously being exercise. My Dr gave me the green light at my 4 week post-op visit to be able to lift up to 30 lbs. He also told me no running and that walking is the best exercise for me. I'm a huge MMA and martial arts fan and want to continue on with my weight loss journey. I have another 25-30 lbs to go. I was talking to a friend of mine who runs a martial arts class and said he could work with me and understands my fusion since his brother had one. I am really wanting to get into some form of martial arts again but don't want to mess up my fusion healing up either. Do you guys think it would be too much for me to get into this right now or should I wait? I'd also like to start lifting weights, but don't want to over-do it either. I am really just so excited about my weight loss and am starting to hit a wall where I need more exercise in order to lose more. Any thoughts or suggestions here would be great.

Second, I've noticed that by the evening, once I lay down, forget about it. My back is hurting a ton to the point it is very difficult for me to get out of bed if I need to get up. We have a pillow-top mattress and also we have a 2 inch thick memory foam on top of that. This has been a great help during my recovery since it molds itself to my back when I lay down. At the same time it kills me to get up! Is this totally normal? By morning I wake up fine and feel good and don't really have a lot of problems getting out of bed.

I've noticed something that has bothered me lately though and that is my sleeping positions. I've been a stomach sleeper pretty much all my life and have adjusted my sleeping to laying on my sides and on my back. I will roll from side to side all night and this doesn't seem to be that big a deal.

The problem I've found is that sometimes I wake up in a strange position. I am on my side, but I've rotated my hips/legs to my old stomach position where I have one leg raised. To get a picture of this stand up, raise your right leg and rest your foot on your left knee. Then twist your body to the side... It's kinda like that but with my crotch legs being on the bed, and then from the waist up just being on my side. Yeah i know it is very strange. I would totally classify this as "excessive twisting" How do I stop myself from doing this? I've tried pillows but I end up just kicking them off the bed. I've also been sleeping with a pillow in between my legs but it ends up on the floor. Any ideas on this one?

Thanks everyone.

 
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Old 11-20-2010, 10:54 PM   #2
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Re: 7 weeks out of Lumbar Fusion - Activities / Sleep question

First, congratulations on feeling so well so soon after your surgery, and for being able to lose that much weight. I in no way want to throw a wet blanket on your enthusiasm, but I really want to caution you in trying to hurry along the healing process. You have the rest of your life to continue on losing weight and getting into shape, but you will only have ONE opportunity to heal and recover from this particular surgery.

Any spine fusion is a big surgery and healing well and completely is a long journey. There are landmarks along the way that mark progress, but the bone will not be strong and hard for a year. Many patients see good bone growth early on and are considered fused anywhere from three to six months, or so. But the bone continues to set and harden after that.

I personally think it is best to err on the side of caution. I've seen too many people push and push to become active as soon as possible and they end up living to regret it. It is so easy to do too much, to bend too far, or once too often and cause a flare up, leading to inflammation, etc. Also, until the bone has grown in solid around the screws, there is a risk of the screw loosening, which can cause a whole different set of issues.

I've never been given the green light to lift that much weight so early, so cannot comment on that. Lifting that much on occasion is much different than lifting weight for exercise. I would certainly ask your surgeon about it before embarking on any weight-lifting program or activity such as martial arts. Any sort of twisting should be avoided until you are fully fused.

I'm sorry not to have any suggestions regarding your sleeping positions...which sound like they involve a lot of twisting! Maybe your best bet would be to train yourself to sleep on your back (with a pillow under your knees). Have you tried one of those long body pillows tucked tight behind you? If you use that behind you and put big, dense pillows directly in front of you when lying on your side, it might provide enough support to keep you from rolling over. Sometimes you can "hug" a firm pillow with your top arm and it will help to keep you stable and from rolling over.

Continued good luck with your recovery. Try not to be in a hurry. Some things just cannot be rushed. Your body will heal in its own time. Walking will remain your best exercise for now and the near future.

 
Old 11-21-2010, 08:31 AM   #3
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Smile Re: 7 weeks out of Lumbar Fusion - Activities / Sleep question

jonwh25, welcome to the board. Sounds like you are doing very good from your fusion. But I would follow tetonteri66 advice and not rush it. It can cause you more harm and set back. I had a one level fusion in 2004 and I remembered my doctor did not allow me to lift over 15 lbs. for 3 months. Its just not worth it.
I have learned that walking, walking, and more walking is the best exercise you can do.
I use to lift weights and work out all the time and I wanted to get back doing that after my fusion but my doctor told me about past patients he has had that did to much and had all kinds of problems. So even though you think you feel pretty good I would err on the side of caution if I was you.
Good Luck on your recovery and once again, welcome!

 
Old 11-21-2010, 09:36 AM   #4
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Re: 7 weeks out of Lumbar Fusion - Activities / Sleep question

As far as activities go, I would absolutely not do the Martial arts until you are much further along in your recovery. You may be feeling great but it takes quite a while for a full fusion to take place. You wouldn't want to accidentally cause yourself a setback in your healing process. I say keep up the great work with your weight loss and lots of walking.

Did your surgeon have you wear a back brace? You definitely don't want to be twisting...you may want to invest in a soft brace to wear to bed.

I would run all this by your doctor...he knows your situation best and can make recommendations for you.

The thing with back surgery is that we often feel like we are back to normal, yet full healing takes longer. Best of luck in your recovery!

 
Old 11-21-2010, 11:04 AM   #5
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Re: 7 weeks out of Lumbar Fusion - Activities / Sleep question

Thanks everyone. I will take your advice to heart. I def don't want to go screw up a good thing, no pun intended. I do have a Aspen Quick-Draw back brace they told me to wear every day for the first 4 weeks. I was told at my post-op that I don't have to wear it all the time now and I can take it off from time to time but if I feel my back starting to hurt then to put it on.

I'm lucky in the sense that I do computer work for a living so I'm sitting behind a desk all day long. I just gotta tell myself to get up every hour or so and give myself a short break to stand and stretch my muscles out. Tomorrow is my first day back to work full time. Dr said a short week like this will help me ease back in.

I'm not sure the reason why they said I can lift up to 30. I got an x-ray prior to the appt and they looked it over, said it was good and I can now lift up to 30 lbs. They did say good job on the weight loss and that it helps with the healing because I'm not carrying so much weight on my back around.

I'm gonna go see if I can't clean out the garage here in a bit. I'm gonna take it easy though. Thank God I have a teenage son I can tell to move this or move that. I'll be putting him to work.

 
Old 11-21-2010, 01:25 PM   #6
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Re: 7 weeks out of Lumbar Fusion - Activities / Sleep question

Just remember that sitting puts approximately three times the amount of pressure on the spine as standing or lying down...so be sure to take those breaks. It is easy to get involved in work and the time slips by, and you end up with a painful spasm to remind you! If necessary, set an alarm to remind you to get up, and walk.

Are you prescribed physical therapy for rehab? Not all surgeons do so, but if yours does, you will have a set of guidelines that will give you a better idea of what you can safely do now, and in the months to come. This varies a lot among surgeons. My surgeon I used for my first fusion provided no guidance at all. Luckily I had been reading forums such as this and knew about the "no BLTs" and other simple guidelines so I think I saved myself some potential problems. (My surgery was a success -- there were other reasons why I ended up having more surgeries....) Some doctors are very cavalier in their post-surgery instructions. I just figure it is better to be safe than sorry! You have your whole life in front of you to become active again. The alternative is a lifetime of dealing with chronic pain...so be smart, and try to be patient. Recovery is baby steps....

 
Old 11-21-2010, 05:13 PM   #7
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Re: 7 weeks out of Lumbar Fusion - Activities / Sleep question

Thanks. I didn't know that sitting puts that much more pressure on my spine. No wonder my back keeps spasming. The 1 hour drive to work won't help I'm sure but I'll def schedule a break in there and also set my computer to beep at me every so often at work.

My Dr didn't give me any physical therapy. All they told me was to walk. I find that kind of funny as he is the best surgeon for this in my area. My wife works at the hospital and that helped me know who was good and who wasn't. He has the highest success rate in all his surgeries. So anyway, I'll have to figure out what you mean by the "no BLTs" and things to help in my own recovery. I'm glad I found these forums .

 
Old 11-21-2010, 05:26 PM   #8
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Re: 7 weeks out of Lumbar Fusion - Activities / Sleep question

Wow if you can sit in front of a computer at work you must really be doing well. I am lucky to be able to eat my dinner sitting. I hope that one day I will be able to sit again. I would love to have guitar lessons but I can't sit for a lesson. I have to lay down to play now or to watch TV. I can stand for a bit so long as I keep moving. Maybe one day after my surgery I will be more normal. At the moment I have no life I can't even go out for lunch without really paying for it. I also can't walk far without nerve problems. I have a lot to look forward to if things go well. I hope you go well and are able to work. As Jonwh25 said make sure you do get up and stretch and walk around. Also ensure you have the best seating available as it is so important. Let us know how you go.
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25-Nov-2010: ALIF fusion L5-S1. 9 years of Chronic lower back pain. Nearly 18 months of pain across my upper pelvis, through my butt and down my left leg into my foot. Sciatica relieved by surgery.

 
Old 11-22-2010, 11:48 AM   #9
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Re: 7 weeks out of Lumbar Fusion - Activities / Sleep question

Allan ~ Keep the hope going. I was literally driving to the end of my driveway to collect my mail prior to surgery, and now I am easily walking 2.5 miles each day...and have NO nerve pain (after five years of nerve compression!). This was my third surgery and everyone told me I had permanent nerve damage...and, they were all wrong. Woo-Hoo!

Jon ~ I wanted to mention that you might be interested in a book by Jolie Bookspan, PhD. on the safe way to perform Martial Arts. She has an interesting background -- writes on exercise, safe stretching etc. now but spent years doing research in the military on human performance in extreme conditions -- lots to do with cold-water exercise, scuba, etc. She is not a medical doctor but has a doctorate in physiology and anatomy. I noticed she was inducted into the International Black Belt Hall of Fame...whatever that is! I know nothing about martial arts so cannot personally say if the book is any good, or not, but I like her other books. She has a somewhat unorthodox approach, but seems to get good results. Might be worth checking out....

 
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