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Old 10-22-2011, 10:52 AM   #1
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how long out of work after a fusion?

Hello everyone! I can say that after my first "real" (vs just evaluatory) appt at back school this morning, I am not a happy camper - I could barely walk from the car to home.

Anyway, while we are trying to avoid the "s word" (as my therapist put it this morning), how long could I possibly be out of work (at an office/call center job) after an L5-S1 fusion (not sure which method my ortho spiney will use)?

I'm on FMLA leave now and have a few weeks left. I'm trying to decide whether or not to go back to work as long as they will work with me on PT & dr appts, etc. My neurosurgeon wanted me on 4 hr shifts/3 days a week, and that's when the company said they typically didn't work with people on that kind of restriction unless it was a worker's comp case.

When I left, I was basically the shift supervisor (#3 in my dept), and I want to go back to just being a customer service rep to make it easier on the dept, as that position can tolerate someone who is out more.

I'm enjoying being at home, but the extra few weeks of income before surgery (if that does happen) would be nice. I certainly can't tolerate 8 hr shifts, 5 days a week.

I'm confused as to what to do... any suggestions?

 
Old 10-22-2011, 12:13 PM   #2
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Re: how long out of work after a fusion?

Hi Andrea ~

What did they have you doing in back school that caused you to be sore?

I'm not sure what you are asking. Before surgery, you can work as long as you're able to tolerate. After surgery, you will probably have a "sitting restriction". For the first couple weeks, most people are only supposed to sit for 15-30 minutes at a time. This time gradually increases as the patient gets further out in recovery.

The purpose of this is that sitting puts 30% more stress on the discs than either standing or lying down. In the early stages of recovery, it can cause inflammation -- in rare cases to the point that it can ruin a perfectly good surgery.

I think the soonest "most" patients are able to resume work is between 6-8 weeks, BUT, that is rushing it. People on this board who had to return to work early often regretted it. Healing from fusion is a bit tricky. There is a very fine line between being able to do enough and crossing the line and ending up with a flare of the nerve, irritation of the nerve or inflammation that is really difficult to get under control.

I learned this the hard way. After my second surgery, I had no nerve pain. I was feeling really wonderful for the first time in about 4 years -- no leg pain; I could walk without pain. After a week, there was a family medical emergency that required me to ride 45 minutes one way to the hospital, stand around the ER on 2 separate occasions for about 8 hours each time, and then go through the whole hospital admittance procedure....After the second trip to the hospital, I could tell I was having a lot of inflammation but there was nothing I could do....and, after the emergency passed, I never did recover. The nerve remained seriously damaged...and it caused me problems and pain right up until I had a 3rd surgery about 18 months later.

It is very easy to cause internal inflammation after a surgery, and once it gets going, it can be really difficult to get rid of. It can damage a nerve to the point that it cannot recover.

When I had my first fusion, a one level at L4-L5, I was told to count on being off work anywhere from 3 to 6 months. I personally feel that doctors who tell their patients they'll be back at work in 3-4 weeks are being less than truthful.

Let's see what others have to say!

 
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Old 10-22-2011, 01:04 PM   #3
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Re: how long out of work after a fusion?

My doc said he starts with a two month recommendation for a desk job return after a single-level fusion...my context was L5/S1 ALIF, rods but no graft). Of course, every case needs to be evaluated individually and often can only be really judged as recovery occurs since they can only predict so much

 
Old 10-23-2011, 12:27 PM   #4
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Re: how long out of work after a fusion?

*Hugs* Andrea,

It's really tough when your spinal problems interfere with your work, and you have to endure surgery on top of it all. Add in financial strains and it's the making of a nightmare.

There are some tough decisions to be made regarding your work situation. Do you have any kind of short- or long-term disability through your employer? If so, now would be the time to sign up for benefits through those programs.

A doctor typically will list the restrictions their patient has, and the employer can decide whether or not they can work with those restrictions. If your employer meets the qualifications where FMLA applies (such as 50+ employees), then you have job protection while under FMLA. Once that ends, though, your job is no longer protected. Also, as soon as you return to work your job is no longer protected by FMLA.

If you have signed up for STD or LTD, however, those benefits can't be taken away if you qualify for them (meaning you have to have a doctor on board who is willing to say you can't work your regular job and regular hours) as long as you don't return to work meanwhile. If you go back to work, however, it would start the date over again when you would qualify for STD or LTD, and even for SSDI if it were to come to you having to apply for that. Most of those programs go by your last day worked to see when you qualify for receiving benefits.

I really hope you are able to have this surgery and return to work in a few months, but it's important to plan for the what if's in case it goes that way. I was always a hard, responsible worker, and never though I'd go out on disability. However, 6 spine surgeries later I'm on SSDI. Early in the process I wasn't thinking ahead to this being a possibility, so I just want to open your eyes to that being a possibility for you.

Regarding when you return to work, most surgeons give a very aggressive return to work date, and then wait for you to say you're not ready before they back off of it. Don't return until you are good and ready, and be specific in your pain problems and triggers until you feel you are ready. Try doing some sitting at your computer at home and simulate what it would be like to be at work, and don't return to work until you're able to comfortably simulate working at home.

You may also want to check out the disabilities board here as there are some good discussions on STD, LTD, and SSDI there.

Best wishes!

 
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Old 10-23-2011, 01:40 PM   #5
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Re: how long out of work after a fusion?

My job provides NO benefits whatsoever. If I don't work, I don't get paid. I work for a state-supported institution of higher learning (OK, a state college), who I think could care less about its employees, especially us "part-time" (even though I used to work 39.5 hours a week some weeks) ones.

My manager is about to have a baby (like if not by Thursday they are going to induce), so I think they would be glad to have the help for a couple of weeks, but w/the really long-term implications (meaning SSDI) of doing that, I think I may go in and put in my formal resignation next week. If I do it on good terms, then that of course will help my chances of coming back if there's a position open when I finish PT/surgery (my PT end date is 3 days after I run out of FMLA time), as well as apply for other positions in the college.

Thanks as always for the advice. Being a newbie at all this, I'm still learning about all the long-term implications.

 
Old 10-23-2011, 03:41 PM   #6
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Re: how long out of work after a fusion?

Andrea -- If that is an option for you, I think that would be the smart thing to do. You will heal better if you don't have the stress of a deadline hanging over your head.

I've observed many people on this and similar boards struggle when they had to return to a job prior to when their body was really ready. (like, at 8 weeks.) They did it because they had to, but most of them were pretty miserable.

How are you feeling? You haven't been on the board much, and you haven't said a word about your pain levels. Hope you aren't still so nauseated.

 
Old 10-24-2011, 02:46 AM   #7
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Re: how long out of work after a fusion?

I've been looking at the boards a decent amount lately, just haven't found much to which I felt qualified to respond.

Pain levels are much more manageable with this new combo of meds, and I've started eating a bit from time to time. I haven't eaten an entire meal yet - few bites of this, some of that type thing, but I'm getting there. My husband's been great in bringing me whatever I want if I don't feel like riding in the car with him to get it. I just have to be careful, because of course one of the side effects of pain meds that tends to get me is mild nausea. I have a prescription for that though I may go pick up today - if I feel like getting out for a bit.

My husband totally supports my decision to resign and I think tomorrow's going to be the day (I have a PT appt in the afternoon and will probably stop by the office on the way -the letter is already ready). Shows you how much the dept cares when no one has tried to check on how I'm doing, there was no get well card after the surgery and no birthday card (and there are three others in the dept with birthdays within 4 days of mine). I'll blame it on the boss' pregnancy, but still...after six years...

 
Old 10-24-2011, 09:09 AM   #8
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Re: how long out of work after a fusion?

That has to hurt. I'm sorry they were all so thoughtless. If you had something else, they'd probably be falling all over you with offers of help, meals provided, cards, etc. There's something about an injured back that others all think they know what you're going through because at some point in their life, they had back pain, which was cured by taking two aspirin and going to bed for a day. So they think they understand what you're dealing with...plus most spineys "look fine" so the general public assumes they are OK.

When you do have surgery, be sure to tell the anesthesiologist how easily you become nauseated and how severely it affects you. They will give you something extra when they are bringing you out from under that will prevent nausea.

Please try to eat more so you will be ready for the surgery (not run-down or in poor condition). Try to make yourself eat several times a day even if it is just a bit of protein. Your body will not be in an optimal condition to grow bone for fusion if you are run down.

Hope PT goes OK today.

 
Old 10-25-2011, 11:45 PM   #9
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Re: how long out of work after a fusion?

Andrea, before you go in and just resign, please find out how to do it properly so as not to hurt your chances for SSDI. Unless you have a doctor saying you can't work, SSDI will frown on you just quitting your job. Normally the doctor will write limitations for you and the employer has the option to choose whether or not they can still provide employment for you given your limitations. If they can't accomodate you, then they can decide whether or not to keep your position open and for how long. Most people will wait and let the employer be the one to terminate the employment instead of quitting.

Many SSDI attorneys will offer a free consultation or will talk to you over the phone and give you limited advice. You might want to talk to one before making any moves right now that may affect your chances of getting SSDI down the road if it comes to that.

Also, you need to find out if you have enough work credits to qualify for SSDI - contact Social Security to find out.

 
Old 10-26-2011, 09:45 AM   #10
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Re: how long out of work after a fusion?

My previous doc put me on limited duty (4 hr shifts, 3x/week) and HR went nuts - I was told they don't work with people on restrictions unless it's a worker's comp case. I don't go back to my current doc for another 3 weeks, but he was very happy to hear that I wasn't working and was able to rest and concentrate on my PT as much as possible.

Speaking of PT, my therapist told me yesterday she was proud of me and I was doing great! (maybe that was her migraine medicine still making her loopy, but still...) Hubby now thinks we might be able to avoid surgery altogether, but we'll see - I'm still in pain from the time I wake up until I go to sleep.

 
Old 10-26-2011, 10:59 AM   #11
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Re: how long out of work after a fusion?

Andrea ~

You have to remember that your pain is not going to go away suddenly or quickly. What you want to look for in PT is whether you are making progress in the right direction. If after several weeks, there is improvement, then you might think you are moving in the right direction. But your issues will not be resolved after several weeks or a month.

But then, they won't be resolved right away after surgery, either. You'd still be going through a long recovery. Very few people wake up from back surgery of this nature and know that their pain has been resolved.

So don't be discouraged that you're still in pain all waking hours. On the other hand...what criteria is the PT using that allows her to conclude you're doing great?

 
Old 10-26-2011, 11:07 AM   #12
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Re: how long out of work after a fusion?

I guess she was really happy about how I was able to find my core muscles and hold them while doing a couple of simple exercises. That, and I was doing really good with the log roll getting on and off the table.

She was a lot gentler doing the soft tissue work on my back than the male therapist I worked with Saturday, that's for sure! Of course, I did take a pain pill right before therapy started (hubby drove, so I knew I'd be OK with doing that) and that definitely helped.

I don't go back until Friday and work with a different (female) therapist, and then all three times next week I'm with my "regular" therapist. I can't believe how soon this is flying by, but I'm actually kind of enjoying it. I'm going to try and get a visit with the male therapist at least once (he rotates on Saturdays between their various locations), because I think his soft tissue work really loosened up my muscles and helped quite a bit. The ortho spiney gave me 4 weeks of therapy, but the therapist said we can get more if we need it. I go back to the doc on the 21st, and I guess we'll make the decision then on whether or not we go with the "nuclear option" (as hubby calls it -meaning surgery) or keep going with therapy.

Last edited by andrea32225; 10-26-2011 at 11:10 AM.

 
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