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Old 01-27-2013, 08:46 PM   #1
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Upcoming TLIF

Hey.. I'm new here.. I have surgery on Thursday L4/L5.. TLIF...What I'm concerned about is Post OP. Can anyone tell me how the felt post in the hospital and coming home.

This is my 4th surgery for that level..
2 Microdiscetomy
1 IND

Thanks guys.. any info and tips are welcome!

 
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Old 01-27-2013, 10:21 PM   #2
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Re: Upcoming TLIF

Hi there -- I had an ALIF at the same level. My biggest problem post-op was from the effects of the anasthetic and pain killers -- extreme nausea and constipation. I wanted to get out of the hospital as quickly as possible, so I had surgery on a Tuesday and was released on Thursday. The time in the hospital was really disorienting, because of the constants interruptions to sleep. I would recommend bringing earplugs and a sleeping mask to the hospital. Getting to and from the hospital was really difficult, as I was trying to maintain good posture (no brace) and sit in a compact car for 45 minutes. I should have borrowed a fancier car.

I spent about two weeks wandering around the house, trying to walk as much as possible, but really, really tired and in a lot of pain. I used a walker whenever I left the house, for balance and to signal my fragility to the rest of the world. Around week three, I was able to wean off the pain meds and start driving short distances. I started working from home, for short time periods as well. A good deal of the pain was from muscle spasms, as my back tried to adjust to the changes made to my spine, so I was taking Skelaxin during the day and Soma at night.

I started physical therapy early, at week three, so that I could do aqua therapy. Being able to walk in a nice, warm pool really helped with getting the muscles to adjust. I also had a lot of nerve pain and PT taught me new leg stretches which were appropriate post-op. (If you have gone through PT, DON'T try to start the exercises post-op without supervision. My exercises were modified before and after surgery.)

 
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Old 01-27-2013, 11:41 PM   #3
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Re: Upcoming TLIF

Thanks for responding and for the tips!
My Neuro said I could be in the hospital from 2-7 days..
It depeneds on me and how my body handles everything, I guess.

I think I most scared about the pain level when I get home. I know it SHOULD be handled well in the hospital. But at home is a different story.

My first surgery.. I ruptured a disc in 2004 while 8 mos pregnant..
Got the run around.. MULTIPLE times misdiagnosed..PT made it worse
Finally got the MRI .. and had surgery a week later. Painful.. but I had a newborn motivating me I guess.. I was walking at the park 2 weeks post op..

Second was Oct 2012.. Same disc.. same surgery.. WAYYY different recovery and pain levels. I used a walker for the first week and a half after surgery.. then cane.. Ended up back in surgery for an IND, December 20th for possible infection. Wound Vaccum.. Home health nurse, IN home PT..

I still have my walker and cane.. hoping I won't need it. Just seems as if my recoveries are harder and more painful as I get older. lol

When I'm home, my neuro is really good about meds and muscle relaxers to try to give some relief.

I am just nervous about a new surgery.

 
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Old 01-28-2013, 06:21 AM   #4
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Re: Upcoming TLIF

If the anesthetics tend to make you nauseated, tell the anesthesiologist prior to surgery. They can give you something to make the immediate recovery process easier. Stock up now on all the foods, drinks and meds you will need to counter the constipation. You may not need something like Dulcolax and stool softeners, but it is handy to have at your house in anticipation -- just in case.

The one thing I have found is that every surgical experience is unique. I began with a fusion, later had a smaller procedure, foraminotomy, and then a couple years later, a three level fusion and some spinal reconstruction, which should have been the most difficult surgery, but proved to be much less painful than my first fusion.

You will find that this surgery takes a lot out of you. Most people complain about feeling tired for a long time. It takes awhile to get your "normal" level of energy back. Recovery requires a great deal of patience.

It seems like most people are in the hospital two or three nights, depending on when surgery is performed. Do you know if your surgeon will have you in a back brace? If so, that initially makes mobility a bit more difficult. You will want to hang on to your walker. You will most likely use it at hospital, when leaving, and some people continue to need them for several weeks post surgery. The cane will not be desired as it does not encourage you to spread your weight evenly and not favor one side over the other. After surgery, they will want you to walk so that you are engaging all muscle groups equally and not favoring one side.

The first week is pretty rough for most people, but beyond that things are manageable, especially if you are patient.

If you have specific questions, a number of people have had lumbar fusions...but I'm not sure how many had TLIFs....

 
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Old 01-28-2013, 07:57 AM   #5
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Re: Upcoming TLIF

[QUOTE=DaltonsMom;5124024]Hey.. I'm new here.. I have surgery on Thursday L4/L5.. TLIF...What I'm concerned about is Post OP. Can anyone tell me how the felt post in the hospital and coming home.

This is my 4th surgery for that level..
2 Microdiscetomy
1 IND

Thanks guys.. any info and tips are welcome![/QUOTE]

Welcome DaltonsMom,
I had TLIF November 6 2012,
I am doing very well now, but recovery is heavy duty for that surgery. It wears you out and you need assistance for the first few weeks. No lifting anything heavier than milk jug and that is from waist high no bending at all and or lifting from the ground level. I had a grabber stick and that was helpful. No twisting movement at all. I had no brace to wear, just titanium rods and screws inside.
A raised toilet seat is good too. Write down when you are due for meds and check it off because you will forget if you took it, and you don't want to take too much or too little. And yes the narcotics from surgery will shut down your digestive track so drink prune or plum juice often. And you will most likely be taking them for some time afterwards too.
I had a lot of pain from just my gut. Sorry if too much info but I hope to help you avoid it.
I also had a memory foam mattress pad on my bed, it was wonderful because of all the tender places when you lay on your back. It is about three weeks before I began to feel better. My surgery did relieve my pre surgical pain but I had lots of sciatic pain after, from nerves either uncompressed or aggravated by the procedure. But they will pass so keep that in mind.
I am a little less than 4 months out and virtually pain free now.
So look forward that and keep you spirits up!
Keep us posted
AGW
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TLIF L-5 S1 November 2012
Degenerative Dsk disease
Dystonia
Arthritis

 
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Old 01-28-2013, 03:34 PM   #6
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Re: Upcoming TLIF

Hi I think you shouldask for some prometazine if you star feeling sick from the med's it realy helps and aoso take ducalax for thebowels to work. Depenting on the amount of pain you are in and the amount of pills you will be taking. I had a 3 level some years ago and I still have to take at 15 pills a day to keep my self half *** feeling okay. I wish you yhe best and also go to the medical supplies stores and find a lumbar pillow for your back it helps to sit ,I still have alot of feeling like the hardware isgoing to push itself out of my back but it cant. I now have my L1 disc detereating and the one above the 5th disc. Remember also t do the log roll when yu get in and out of bed. I had a hospital bed for 1 mnth and that really helped . Anyway good luck and let us know how you are doing. As ever georgie782.

 
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Old 02-01-2013, 07:10 PM   #7
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Re: Upcoming TLIF

I had the surgery back in late March 2012 for 3 levels and it is a very long recovery. The first two days in intensive care were very difficult, couldnt sleep because the pain was so severe. Had to stop my pain pills and neurontin the day of surgery and that was a shock to my system. I couldnt start back on them until the vascular surgeon heard bowel sounds, so nothing was allowed via mouth, not even shaved ice! Mouth got so dry and i felt like i had the flu because of the withdrawl from pain meds was so sudden. I was tired for a very long time and still get fatigued.

I still am taking 10 - 12 pain pills a day to keep the nerve pain to a tolerable level. Am still taking dulcolax to keep bowels working. Taking showers was very hard and drying off afterwards, as was just walking. My surgeon has the patient use a brace that looks like a tortoise shell and I wore it for the first 6 months, along with using a walker for a number of months. The back brace really helped in the beginning for laying down, seemed to keep things in place and allowed the muscles to relax. I remember feeling very anxious about ever having to sneeze and avoided dust or other triggers.

I also kept a sheet of paper with all the medications listed at the top of the page and the dates down the left hand side. My husband and later myself marked off whenever meds were taken as you will forget or someone will give you the wrong ones. My husband accidently gave me a sleeping pill at 9 in the morning instead of a pain pill and that is what made us go the list route.

My surgeon also had a home health center send a nurse and physical therapist out to my house for the first few weeks. Those minimal exercises helped in keeping my muscles stretched until the 3 month mark when physical therapy at an off site was allowed. As previously mentioned, patience is really required to get through for the most part. I wish you well and hope your surgery is successful.
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Old 02-02-2013, 07:17 AM   #8
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Re: Upcoming TLIF

DaltonsMom~

Please keep in mind that you are having a surgery on one level and that your experiences will not be the same as others you read about.

Just to give you an explain, compare my experience to Beachgirly. I had a three level posterior fusion which was technically a revision to a one level PLIF I'd had two years earlier. My pain was easily controlled in hospital. I just had the incision in the back so I didn't have a vascular surgeon, and I was allowed to eat clear liquids the night after my surgery. I too had a brace but it was required only when I was on my feet and I wore it the first seven weeks.

I stopped taking all pain medication on the 12th day post surgery. Unlike with my first fusion where I think I was over-medicated for the first eight weeks, I felt more energetic this time. Through three surgeries, I have found that for me the thing that works best is working off a 24-hour cycle rather than following my usual routine of being awake during the day and trying to sleep eight hours at night. I find that most people have difficulty sleeping "through the night" and resort to pills, etc. For the first couple weeks (can't remember for how long I remained on this schedule...maybe it was longer than a couple weeks) I would sleep for a couple hours, or as long as my body wanted to, then I would get up and take a walk through the house after using the bathroom, eat something, then read or watch tv or otherwise amuse myself until I felt sleepy, then the "cycle" would be repeated.

This worked really well for me as I was listening to and responding to my body. I was moving around at least every couple hours, so there was less stiffness. This walking was stretching out those spinal nerves, which is so important so that scar tissue has less opportunity to attach to the nerves as it is forming and filling in post surgery.

I realize this schedule doesn't work for everyone. I didn't have young children in the house, or anyone else I had to take care of and my husband can fend for himself!

I think it is very important to learn to listen to your body early in the game...and particularly when it comes time to begin moving around more, when you begin physical therapy, exercising, etc.

I think the best advice I would have for you is to be flexible and just take it one day at a time. Do not try to adhere to anyone's timetable other than your own. Plan on the first week being very difficult and that things will get better. You will be able to handle it.

Between now and your surgery, try to do what you can to relax and be calm. You've done your homework and now it is time to put your trust in your doctors and your faith. Surgery will be easier if you are calm going in.

 
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Old 02-02-2013, 11:28 AM   #9
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Re: Upcoming TLIF

Daltonsmom,

I agree with Teteri66, listen to your body. I also slept for short periods of time, then got up walking around the house with my walker, eating small snacks, amusing myself until sleepy, then doing the whole process again. I would also mention that you should try not to compare your progress from one day to another, but from one week or two to prior weeks. Maybe even keep a daily journal of how you are feeling and the things you are able to do. Then use the journal to compare your progress each week. This will keep you focused on the positive elements of your recovery and be prove of the things you have accomplished. You will have good days and then some days where you feel less energy and that is normal. Staying positive and keeping a sense of humor really helps. Also having others to talk with candidly really helped me and continues to help. Walking every chance I get has also helped in keeping muscles toned and nerves stretched out.

Try to have faith and go into your surgery with a positive outlook, as Teteri66 mentioned, you have done your homework, hopefully prepared things at home and now do some enjoyable things with family and loved ones. Try to get some rest and we will all be rooting for your successful surgery and from hearing from you shortly thereafter!
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Old 02-02-2013, 11:51 AM   #10
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Cool Re: Upcoming TLIF

I had my TLIF on 1/2. Believe it or not, I was not nauseated but very constipated. 10 days to be exact!! As for the post op, I was in the hospital 4 days, I left earlier than I thought I should, but that was because I didn't feel that I was getting the needed care from the nursing staff. My husband could help me better at home! Once I got home, I was happy that I was strong enough to do the stairs (once a day) to come down and eat with the family and relax on the chaise and watch some TV. Then I'd come back upstairs (the brace becomes uncomfortable and the bed is the only time that it can be off) so the bed became my safe place...and still is.

I had an extreme problem with nerve pain down my left leg and numerous painful spasms. I wasn't ready for them. I'm just getting them under control at 4 weeks out. I'm on dilaudid and gabapentin. Stay faithful to your meds to limit unwanted pain. After the third week I started to take them on a longer stretch, and now I'm down to taking them only at night. I found that walking was helping and relaxing with pillows under or between my legs. I'm not gonna lie, recovery is stressful. Your limited to what you can do, and how you feel today might not be how you feel tomorrow. But I have extreme joy to be able to walk standing straight up, no limping, and the surgical pain gets better with each day. I have no regrets of the surgery.

As long as you have a good support team, you will be fine. My hubby stayed with me for two weeks and my mom came up the third week. This past week was my first week on my own and it was lonely, but my family put everything that I would need at my level so I had no bending or lifting to do. Just think of it like this, for the amount of pain you have been in, to sacrifice another 2 weeks of recovery pain is nothing to worry about. You'll have a lifetime (I pray) of happiness! Good luck to you!!

 
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