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Old 03-30-2012, 01:52 PM   #1
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Can't sit - post op lumbar fusion & instrumentation.

My symptoms began about 5 years ago with a bit of butt pain (left piraformis) which gradually got worse and lead to an MRI which revealed 2 bulging discs. The sciatica pain was down my left leg and worsening to the point where I couldn't be on my feet for more than an hour and, at it's worst, I could barely lift my leg to get in/out of a car, etc. My doc referred me to an orthopedic surgeon who recommended & ultimately performed an L4-L5 fusion and instrumentation. I'm at 5 1/2 weeks post-op and off pain meds, save for the occasional muscle relaxant & tylenol. The good news is, I am pain free when I stand or walk (I do about a mile a day, sometimes brisk, sometimes easy). The bad news is, I can only sit for about 10 minutes before pain in my leg begins: a muscle twinge building into searing pain down the side of my left calf.

I fear I've traded one problem for another. I realize that it will take time to heal, but I'm concerned about my inability to work (I have virtually run out of leave) and whether this actually will get better. I will soon be 61, but I'm not ready to be put out to pasture! While my employer has been generous and very supportive, I know there is a limit to that. They need to start seeing a return on investment, so to speak, and soon.

I guess I'm looking for a little reassurance, here, or perhaps some solutions to the sitting problem that will allow me to work (on my back, in bed, only works for an hour or two). Or is there anyone who's had to go on SSDI as a result?

Any words of wisdom or advice will be greatly appreciated!

 
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Old 03-30-2012, 03:50 PM   #2
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Re: Can't sit - post op lumbar fusion & instrumentation.

Welcome to the board. This probably won't be what you want to hear, but at five weeks post-op with a fusion, it is often recommended that you not sit longer than about 15 minutes at a time. Sitting puts 30% more pressure on the discs than standing/walking or lying down. So it is best to "recline" with the back fully supported with pillows when you are not walking.

Hopefully the nerve is still irritated from the surgery, and once you are further along in your recovery, you will not be having this issue.

I would suggest you use ice or a cold gel pack. There is probably still some internal inflammation going on around the nerves.

Would it be possible to vary your positions at work? Could you get a desk or something that would allow you to do some of your work standing?

 
Old 03-30-2012, 09:59 PM   #3
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Re: Can't sit - post op lumbar fusion & instrumentation.

Congrats on all your walking. Walking is the best thing after a fusion.

I started working about four weeks after my fusion. Just a few hours a day, and from home. I was able to work from bed, sit at the desk for a while, go back to bed, etc. I bought a high, high leg wedge so that I could prop my laptop on my thighs and type somewhat ergonomically. It sounds like you might have the luxury to work home, so take advantage.

I have found that it is much, much easier to start working part-time, than to try to start immediately working 40 hours per week. You can also stretch your leave a little more. You should also ask your employer's HR department about FMLA. You are still very early in the recovery process, and disability claims are tough, as some other posters have asserted. Some states and employers have short-term disability insurance, and you might ask HR about this, too.

The burning pain in your calf is probably nerve pain. You can try to work this out by doing nerve glides, if you were taught to do these in physical therapy. Nerves do not like to be stretched, but can be tugged for brief periods. You might ask your surgeon if you are ready for physical therapy. Do NOT do the exercises you had before surgery, if you were in therapy. The exercises will be greatly modified. This will help to rebuild your core.

Finally, as teteri66 said, try not to sit for more than 15 minutes. If you must sit for longer (my train ride to work is 38 minutes; I can either stand and get jerked around or sit), put a small pillow in the small of your back. I bought a special lumbar support pillow for the car, too.

 
Old 04-02-2012, 09:24 PM   #4
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Re: Can't sit - post op lumbar fusion & instrumentation.

Thank you for the info. I have my 6 week followup tomorrow. I'll find out how well the fusion's going.

 
Old 05-12-2012, 12:06 PM   #5
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Re: Can't sit - post op lumbar fusion & instrumentation.

Just wanted to give a bit of an update and perhaps provide some encouragement to anyone else out there who's having similar difficulty.

The short version: it gets better!

Since my original post, I am now almost 3 months post op. I returned to work part time the 2nd week in April and had a fairly difficult time of it for a couple of weeks. I had severe cramping in the left side of my left calf making it nearly impossible to sit for more a few minutes at a time. After 3 days of that, I contacted the doc & was prescribed a 5 day regimen of methylprednisolone. This helped me turn the corner. The cramping quieted way down and has allowed me to put in an average of 6 hours a day of work. I let my body tell me when it's time to call it a day and I ice down my back when I get home.

I think that is the most important lesson I've learned in all this. I'm not super woman, and I musn't push myself too hard. My body will let me know what I can and can't do and it's critical for the healing process to listen to it and obey!

At the end of April, on my 61st birthday, I walked a 5k memorial walk. This was my goal from the day I entered the hospital. I wasn't sure I was going to be able to do it right up to start time. At that time, I felt good so I started and told myself if I didn't make it the full 5k, it'd be ok. I made it the full 5k.

I continue to have spasms and cramping (one particularly wicked and extremely painful leg cramp in my right leg one night), but my doctor says it's normal. I've also had some sciatica, but not nearly as bad as before surgery and walking helps quiet it down.

Every day there's improvement. Yesterday I worked a full 8 hours! I listen to my body and don't try to push myself beyond what it's telling me I can do. Before surgey, I couldn't be on my feet for more than 45 minutes, had to sit frequently when trying to cook dinner and had zero energy. Now I can walk at least a mile a day, cooking is a joy again and my energy level is real good. Pain is still present, but it's healing pain and I understand now that this recovery road is a long one.

So if I have a message to ya'll out there who're experiencing what I have, it's to pay attention to what your body is telling you. Don't hesitate to call your doc with any concern you have. And have faiith that it will get better.

Hugs, everyone!

 
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