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Old 04-17-2012, 05:16 AM   #1
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soniq911 HB User
TLIF soon...

I'm new to the boards but have been lurking around in the shadows reading everyone else's posts, trying to educate myself and mentally prepare myself as much as possible.

I'm 28 years old, was diagnosed with DDD and Lumbar Stenosis with an L4-L5 bulge (2-3cm) in 2006. I went through a round of pain management, and finally got fed up with taking 10 pills a day (lortab, tramadol, and motrin 800), and my GP recommended chiropractic therapy. I went through a round of this and it actually did me some good, but I was going 2-3 times per week and not long after I stopped, the pain returned. I did multiple rounds of physical and occupational therapy with no relief, tried another round of pain management with pills with no relief, and finally my GP referred me to a neurosurgeon about a year ago. I got another MRI done shortly after which revealed the disc had herniated and was protruding 5-6 cm now.

After a consultation with the NS, he sent me for an epidural injection to use as a diagnostic tool. Either way, I got about 2 days of relief, then I was back to the pain I was in before-hand, plus some. Another meeting with the NS and he basically said "you're young, this is obviously affecting your quality of life, you're taking very strong pain-killers, and I'm not going to TELL you that you need this surgery, but I'm going to recommend it and leave the ball in your court. If you want to schedule it, I will tell you that you have a very high chance of a good outcome."

I talked it over with my girlfriend (whom I live with) and she begged me to do the surgery, because she sees on a daily basis what this does to me. She said she would work every day if she had to in order to make it work, because I don't have any PTO/Sick Time to use. I scheduled it, and I'm set to have the surgery in 6 days (4/23/12).

I've read over a lot of good advice here on the boards and plan to go out Thursday, which is my only day off this week (I've been working almost non-stop), and get all the things I'll need post-op. My girlfriend's mom is going to come over and stay with us for a while so she can help with the kids (2yr old and 5 yr old) while my girlfriend is at work, and help me if needed. I even set up a ride home from the hospital with the company I work for (free ambulance ride home). I'll take that over getting in a car that sits low to the ground and dealing with all the bumps and sitting up, then getting out and into the house.

So anyways, I'm currently taking usually 3, but up to 4 percocet 10/325 per day, some days only 1 or 2, but usually about 3. I absolutely can not wait to get off these things. I'm forced to take them at work and it clouds my mind and makes me groggy, but without them I wouldn't make it through a 12 hour shift here.

As far as the pain goes, and even though I hate using the pain scale, I'm usually at a constant 5 or 6 out of 10, and some days up to a 9 or 10. The pain is a stabbing pain on my spine near the herniation, and radiates outward to one side or the other, sometimes both. I have sciatic nerve pain, mainly down my left leg but sometimes my right. In the left leg, it goes down the back of my leg, usually just down to my knee, but sometimes it goes down into my foot. I get a little relief from laying on the floor (any hard/flat surface), or standing for a short period if i've been sitting. Fortunately the dispatch consoles at work raise and lower to accomodate standing.

Sorry it's so long...just a lot to talk about I guess!

 
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Old 04-17-2012, 08:06 AM   #2
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Re: TLIF soon...

Welcome to the board. I just wrote a long post to a 22-year old who is having a 3 level ALIF/PLIF surgery in a month. Please read my post to her (melissaxxann --"what to expect with 3 level .....") as even though your surgery should be less invasive that hers, most of what I wrote will still apply to you.

I hope you are planning on taking a sufficient time off post surgery so you will not be rushing your recovery. It is most important to give your body enough time to heal. Even with a minimally invasive procedure, this is still a big surgery and a major assault to the body....

When you go out to stock up on supplies, be sure you have some stool softeners on hand. The pain medication and anesthesia are very constipating so it is very important to drink lots of fluids, particularly things like prune or blueberry juice if you can tolerate it and be sure you are drinking juice or water -- nothing carbonated. Stock up on high fiber foods too but it pays to have a product like Dulcolax on hand. The last thing you want on top of the surgical pain is to be constipated -- this can become a big problem that can be avoided with just a little prevention.

Be sure you have some sweatpants or something with an elastic waist as you probably won't feel like having the pressure of jeans on your back.

You will want to somehow convey to the kiddies that you will not be allowed to pick them up or tussle with them for awhile...that Dad will be off-limits for awhile except for gentle snuggling!

The surgery should help with your leg pain in particular. But don't be shocked if you do not have immediate relief. Sometimes the nerves are even a bit more traumatized from the surgery. Also they take much longer to recover than any of us think or imagine and it can be frustrating. I think the best advice I received is to not have any specific expectations and to just take things day by day. It can be frustrating to try to access progress on a daily basis. Be prepared for recovery to be a long, slow process...but always keep your goal in mind. You only want to have to go through this experience once, so do everything in your power to follow all instructions. Take the time necessary to recover and be willing to put everything else on hold while you devote all your time and attention to this one project. Learn to listen to your body and behave accordingly. You may need to modify your lifestyle in order to ensure a successful outcome.

Good luck and feel free to post with any concerns or questions as you move along through this surgical process.

 
Old 05-07-2012, 09:30 AM   #3
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Mjoseph HB User
Re: TLIF soon...

Hi.. Just started on this forum myself and started reading your posts. I am in EMS too.. I'm a flight medic and injured my back lifting a patient in Nov 2011. Anyway.. Did they do a fusion because of your disc herniating? I have a bilateral grade 2 annular tear at l5-S1 and bilateral neural foraminal narrowing at L5-S1. I also have disc bulges from
L3-S1 and facet arthropathy at L3-l4 and L5-S1. Anyway I'm set up to see a neuro surgeon next month. My pain mgmt doc said I needed a fusion with possibly a cage and he also said
I couldn't go back to the field after surgery. Do u have any permanent lifting restrictions? Did the surgeon tell you that you could go back to work in EMS? Also do you regret the surgery? Thanks in advance
Jessica

 
Old 05-07-2012, 03:56 PM   #4
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soniq911 HB User
Re: TLIF soon...

I haven't been given any permanent lifting restrictions as of yet, but I guess it'll all depend on what the doc says and how well I heal. I have another post...something called "6 days post TLIF" basically blabbing about how well I'm healing if you want to check that out.

Regardless, I'm not in the EMS field, I'm on the side that tells y'all where to go lol. So that being said, I'm not too worried about the lifting restrictions if there are any. I had considered going out into the field at one point but I'm still unsure which direction I want to go with my career.

To finally answer your question, they did the fusion because the disc at L4-L5 had degenerated so badly. So far, that looks like it's the only trouble area in my back aside from a very very mild bulge at L5-S1. All of mine's come from degenerative disc disease, just an unfortunate genetic thing. I've never been that easy on my back either, which probably didn't help matters any.

At any rate...good luck to you! It's real unfortunate the doc said you can't go back into the field after surgery, but hopefully you'll find something out there you can do...even though it won't be nearly as exhilarating as a flight medic

 
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Mjoseph (05-07-2012)
Old 05-07-2012, 04:39 PM   #5
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Re: TLIF soon...

Jessica -- Welcome to the board. Just from what you have indicated about your situation, it would appear that your problems are a bit more complex.
To begin with, you have problems at multiple levels already. If you have fusion at one level, you will likely find that the adjoining segments will need fusing in years to come...sooner rather than later if you continue on in your current profession, or any job where you are stressing your lumbar spine.

Also once you start having issues with the facet joints, and we know the arthropathy usually continues to get worse as we age, it often creates instability that can only be stopped by fusion -- making those segments immovable.

Hopefully the neurosurgeon will have some suggestions for you. You might also want to get an opinion from an orthopedic spine surgeon is they sometimes have a slightly different approach to the same problem. Good luck to you.

 
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Mjoseph (05-07-2012)
Old 05-07-2012, 06:58 PM   #6
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Mjoseph HB User
Re: TLIF soon...

I know.. I'd like to think that since I have never had back pain before my injury and the discogram was only positive at l5-s1 that I will only need a single level
fusion. But I'm probably being overly
optimistic. My PM doctor said the same thing about needing more fusions later since I am so young and the fusion will stress the levels above and below and those levels are already stressed by the facet issues and the bulging discs. My biggest issue
is that I love my job as a flight medic and I really want to be able
to go back to doing that. My fear is that evey company I have worked
for has a lift test that requires you to lift a 220lb dummy pt. on a 75 ln stretcher and put
it in the back of the helicopter. That doesn't seem very realistic post op. I'll update when I see the neurosurgeon in a few weeks.

 
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