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Old 02-01-2012, 07:20 PM   #1
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ALIF L5/S1 on 8/8....follow-up and ramblings

I had an early version of a six-month follow-up from my surgery today. If you are a new reader, I had an anterior lumbar spinal fusion (L5/S1) on August 8, 2011. The surgery followed two years of increasing pain that I'd first chalked up to gym soreness but eventually became much more severe.

Anyway, the goal is for the bones to fuse (hence the name "'fusion"). The doc removes the disc (mine was one of the worst he'd seen in years...and he does like 5 a week so that's a big statement, esp with a fit and young patinet) and puts in a titanium cage ($32,000!!! luckily mostly on the insurance co). Ultimately, though, it is my body that does the work and the bones need to grow over the cage to make one solid fused chunk o' vertebrea.

So, today's appointment did show bone growth (last set of images was in November). Not fully done yet, but seems to be on track. I still have pain and it can spike pretty high (esp after the health issues that took up 3/4 of January) but that seems on track too...I still hit a 7 but spend less time there. I'd worried the appointment might be cancelled b/c the doc had a family emergency but the nurse practitioner saw me. I find NPs to be AWESOME in general....I think nurses are often better at the bedside manner stuff and NPs have an extra level of medical training beyond the normal RNs. She said all looked well (and that she wouldn't get the surgeon's head swollen by telling him how good it looked!) and was encouraging in general.

I've made HUGE strides in cutting the pain meds....really tough since the body (especially my body) becomes dependent on them even when they are for "real" reasons and not "recreational"...and hope that by the next appointment I'll be pain-pill-free. I'll throw in my distinction b/w addiction and dependence with the former being someone seeking meds for pleasure and the latter being someone having a medical need for a true ailment. withdrawal ignores the distincion and is hard even for those who "did it right". Feels unfair when the creepy crawlies cover all four limbs

Back in May. If all goes well, that's the last of the follow-ups and I can put this saga behind me. I totalled the bills that came in for 2011...the bigger hospital one actually only came in January ($750 co-pay, hospital bill was about $52K)....over $5,000 in co-pays for docs, images, and labs. I'll need to get CVS to give me a printout on meds and get some documentation from X on insurance premiums since I do expect I'll be able to meet the tax deduction floor.

Well, at least I should get a nice present from the IRS given spending will be less that 7.5% of my income meaning i can deduct the costs. i can go "all iin" and include premium costs, contact lenses, CVS presciption totals......gonna make an interesting sit down for the tax prep! only lived in PA but has MA UE oayments so will nee to do an MA filing and i have some project work that i need to file in PA,,,,,, ok, my head exploaded.

 
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Old 02-01-2012, 10:14 PM   #2
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Re: ALIF L5/S1 on 8/8....follow-up and ramblings

What is the cause of your pain at this point?

 
Old 02-02-2012, 10:47 AM   #3
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Re: ALIF L5/S1 on 8/8....follow-up and ramblings

I don't know how to answer that. The LPN seemed to think it was within normal range for healing, including discomfort. It def originates in the back....most of the other stuff is secondary and I think from compensating (plantar fasciiitis is ld but kicks up at times)

 
Old 02-02-2012, 11:00 AM   #4
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Re: ALIF L5/S1 on 8/8....follow-up and ramblings

I just wondered if you felt it was "recovery" pain or just what it was. I don't know percentages but certainly not everyone is still on pain meds after about 3 months.

I know with my first fusion, which was a PLIF at L4/L5, with a cage and BMP, by six months it was beginning to dawn on me (despite what the doctors told me) that what I was feeling was not "normal" healing. I realized I was pretty much over that part by 3 months...and this, while not really "different" in location or even symptoms, was not "healing" pain. It's hard for me to explain the difference between the two, and this probably doesn't make sense to others, but it seemed evident to me at the time.

Do you think part of the reason you had withdrawal symptoms was due to the use of pain meds for your other health issues, like the endometriosis that you had mentioned previously?

 
Old 02-02-2012, 11:16 AM   #5
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Re: ALIF L5/S1 on 8/8....follow-up and ramblings

Well, the endo and history meant needing a LOT more meds than a normal person so that did make for more w/d too.

I think that it is also just in my blood to get more dependent than most folks. I do have an uncle who struggled with drugs at one point. Dr Dad made a call and found normal w/d on the Lexapro is 5d (which are pretty commonly awful) and I had it BAD for 8d and a couple more days still foggy. I've actually tried to warn my half-siblings....I've never taken any "recreational" drugs (I suppose being a dork in HS had its benefits!) and know that, even more than others, I never should.

 
Old 02-02-2012, 03:20 PM   #6
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Re: ALIF L5/S1 on 8/8....follow-up and ramblings

And, I bet you didn't even need fusion surgery to learn that lesson (rec. drugs)!

How is the PT going? I know you were so eager to get going. You know, I can't remember who I wrote this to, but even though I thought I was pretty good at a year, it has recently occurred to me, that I have been making progress all along, and now that I am almost 20 months post surgery, I feel like I am about 99% there....

So, don't be discouraged. Recovey really is baby steps. Fusion really is a trauma to the spine, even though surgeons usually do not discuss any of the details with their patients. The guy I went to for acupuncture worked exclusively with back and neck patients, and he had several spine docs that he had a strong working relationship with. Last year one of the big companies that makes stuff for spine surgeries (neurostimulators, hardware, etc.) was in town putting on a seminar for the local neuros and ortho spine docs and my friend was invited, too. They had the training materials they use to train these surgeons on how to do some of the new techniques and my friend was able to practice putting in a cage in the lumbar spine, etc. He was telling me how he was shocked at the force it took to wedge the thing into place...and just in general, how much force many things took. He came away being amazed that so many spine surgeries actually turn out OK. He felt it was really violent!

A couple weeks ago had surgery on my nose. The surgery took as long as my first fusion (2 hours) and was a general anesthetic. I remember the nurse asking me what my pain level was as I was coming to in the recovery room. I remember just kind of laughing as she started to explain the 1-10 pain scale...and just saying "Honey, I've had three lumbar spine surgeries. This barely registers on the scale." She looked surprised, but did laugh...and stopped bugging me. I clearly didn't think I needed anything for the pain....

I guess it's all what you get used to.

 
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