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Old 05-18-2006, 10:25 AM   #1
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merryish HB User
Post 2-level ACDF -- realistic expectations for recovery?

I've been posting in other threads a tiny bit but this is my first thread of my own. Eep!

I'm 35. On 3/6/06 I had C 5-7 ACDF with hardware. I was in a rigid brace 24/7 for 2 weeks, then that came off and I wore only a night-time soft-brace for 2 weeks, and then that went away, too. I was out of work a total of 4 weeks, but two of them were prior to the surgery. I have a geek-job, so I mostly sit and type all day (probably why I needed the surgery - I had no specific injury, just long-term ow that I thought was sleeping wrong until it came with hand-numbness and stayed around and got worse.)

So, I'm just over 6 weeks post-surgery and I've been at work for a month. The pre-surgical pain was gone immediately after surgery; I'm dealing with the new stuff that popped up after surgery. I still have pain -- for the past three weeks it's been pretty bad -- across my shoulders and between my shoulderblades, and up and down beside my spine on either side in my upper back -- spasms, if I understand correctly.

I've been in PT for 2 weeks now, for the upper back issues. My neck feels fine -- I can't see any real difference in my range of motion with my head. I have transient numbness and tingling in my hands, but it's slowly disappearing. The PT is doing wonders for me, I feel really positive about it. My pain is decreasing steadily, and I'm starting to feel like myself again.

The pain that most concerns me is the pain I have when I lean back - have any of you guys ever had this? When I keep my head level and my spine straight and try to lean backwards -- like leaning back into a chair -- there comes a moment when I'm using muscles in my upper back to keep my head level, and that hurts a LOT. With the PT the pain is decreasing, and now feels more like a deep harsh soreness than like a dangerous pain, but it's still there. I was just wondering if anybody else had that.

Anyway, here's what I'm wondering. When I ask my orthopedic surgeon, or his nurse, they say that my fusion is going great, and that I should make "a full recovery". But they're not the most communicative people on the planet. There are some specific things I used to do that I love, that I still hope to do in the future.

Specifically, I used to bike in to work almost every nice day. I live in Chicago, and there's a multi-use/bike path that runs the length of the city beside Lake Michigan, and I would take it morning and evening -- about a 14 mile ride each way. I'm not in great shape, but the biking was slowly fixing that before the ACDF laid me out.

I also love roller coasters. There's a Great America nearby and I want to be able to go! I know it's totally out of the question until I'm 100% fused, but I'm not sure if it's possible even then.

So, thoughts? Is it crazy to expect to be able to go back to my biking and my roller coastering eventually?

I'm really hoping to be released back to the bike after my next check-up x-ray, June 12 -- they've said that's possible. I feel like I could bike easily now -- and it's so gorgeous out there now!

I haven't even mentioned the roller coasters to the doc; I think I'm scared to.

 
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Old 05-18-2006, 09:04 PM   #2
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Re: Post 2-level ACDF -- realistic expectations for recovery?

What's realistic can vary depending upon the individual.

Everything involves risks, y'know? And that's irrespective of the ACDF.

Don't be afraid to speak very candidly with your Dr. I would follow up the "Can I do..." with "and is there an increased risk of injury because of my new neck..." along with "and precisely what type of injury could that be?"

Your Dr. may surprise you.

 
Old 05-19-2006, 06:41 AM   #3
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Re: Post 2-level ACDF -- realistic expectations for recovery?

Hey Neighbor,

I'm about 50 miles nort-west of you, I dont get down there much these days and I sure miss the food. You cant even get a decent beef out here!!!!!!!!

The upper back thing is common for this surgery, I'm sure you've seen it on these boards alot. These symptoms tend to fade with time, like you said the PT is helping. ANYTHING that persists should be taken up with the doc. Better safe than sorry. Besides, it would hurt to shrug this one off, right?

Sounds like you're enjoying a great recovery! Most on here are having problems of some kind and if you have an issue, you can surely find it on here. But I hope you are one that fully recovers and returns to your old life, just stop by and say hi now and then, huh???

Sounds like the biggest issue is getting answers from your Dr. Bunches of us have faced that too, I'll tell you what worked for me, as I think it applies to you as well! Ask him/her about malpractice rates in Il., If anything will get em talkin, that will. After mine railed for half an hour, I slipped in some questions and the appointment lasted over an hour. True story. Once we had that common thread, ya know?

Like Funny says, the limitations depend on the individual. I wouldnt get in a hurry though. Think about it. It took five years for it to come to this and it can take a year or so to fully fuse. If I wanted to get back on the Red Racer I would want to be positive that my body was ready for the pounding.

Hey, I'm not a damn doctor so dont take my advise for any of this. Thats why we pay those big deductibles.

Take it slow....Mike

P.S. My Dr. relocated to FLA last month.
What a suprise

 
Old 05-19-2006, 09:13 PM   #4
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Re: Post 2-level ACDF -- realistic expectations for recovery?

I have one note to add because, well, opinions on this board clearly differ.

I realize that Mike only mentioned a conversation referencing ins. rates.

With that caveat:

I don't know how wise it is to bring up the issue of medical malpractice to one's treating physician. Your physician will be well informed with respect to Medical Malpractice. Raising the topic will most likely not make you look good.

Moreover, if your physician indicates that it's okay to do XYZ and you break your neck, Medical Malpractice is probably not even an issue. In fact, MedMal would probably be the least likely grounds on which one would be able to obtain relief.

Physicians are afforded an entirely different standard because of the good they bring to society as a whole. Physicians can and will lie for a patient's benefit -- to you, the patient. Physicians can and will make statements (warranties) that if made by someone selling a toaster oven would probably be legally actionable. Physicians can make things up out of thin air sheerly for your therapeutic benefit (i.e. to ease your anxiety or give you hope).

Generally, a specialist's performance (Ortho or NS) will be judged based upon a national standard, including various medically accepted "schools of thought." Step number one would be asking what kind of specialist performed your surgery. An Orthopaedic Surgeon would be judged according to the national standards of care employed by Orthopaedic Surgeons nationwide, again, including the many different medically accepted "schools of thought."

The standard for a NS is entirely different than that for an Ortho. NSs receive a greater amount of training, generally perform more difficult procedures, and are held to a higher standard of knowledge, skills, and care.

In conclusion, if you raise the issue of MedMal, you better know what you're talking about, because the surgeon doesn't have to perform your surgery. You may not like getting bounced if you need future attention. Getting bumped from a NS to an Ortho isn't a good thing, IMHO. Although, both are more than capable of performing some similar procedures successfully.

All that said, your particular doctor may say it's okay for you to engage in a certain activity while someone else's doctor may indicate it is not okay for him to engage in the same activity. Neither doctor need be wrong.

Last edited by funny4mony; 05-19-2006 at 09:44 PM.

 
Old 05-20-2006, 06:00 AM   #5
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Re: Post 2-level ACDF -- realistic expectations for recovery?

Hi merryish:
I've had 2 ACDF operations.

The first sounds like yours (C5/6/7). The surgeon told me that I should not do over head work (like painting a ceiling), should not do amusement park rides (like roller coasters), and should be careful doing look-over-your-shoulder (like backing up a car), and should not lift anthing heavier than 75 pounds. Those were 'permanent' instructions.

A year later I had a 2nd ACDF (C4 was added to the C5/6/7 stack). I had been careful, I thought, after the first operation to take it easy, but ended up with a repeat of the problem. It's impossible to say if the 2nd time was related to anything I did or did not do, but I thought I was being careful and still had a repeat.

You should specifically ask about the bike riding - on some bikes the riding position requires you to hold your head and neck up (maybe like doing overhead work?). There are different bikes that have different positions, so I'd ask specific questions (maybe even take photos of bike riders in different riding positions) and make sure you get an answer that you have confidence in.

Every case is different, but my experience has been that you almost can't take it too slow or careful after this kind of surgery. And after two times, I still struggle with trying to understand what is 'safe' to do, so I don't ever have a 3rd time.

How many months a year can you ride, before the winter season shuts you down? That ride sounds like a great routine for beginning and ending a day at work, I can see why you'd like to keep doing it.

Good luck for a good recovery -
Bob

 
Old 06-01-2006, 02:30 PM   #6
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dennisgb HB User
Re: Post 2-level ACDF -- realistic expectations for recovery?

My doctor said no roller coasters EVER!

2 level ACDF with Plate.

Dennis

 
Old 06-02-2006, 09:58 AM   #7
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Re: Post 2-level ACDF -- realistic expectations for recovery?

Merryish -

I too have had the pain between my shoulder blades. Sometimes it was like someone poking me in the back with a stick.

My NS told me that it is sometimes a side effect (I heard trade-off) of ACDF surgeries (3 levels for me).

My physiatrist told me to schedule some therapeutic massage. It took a few sessions, but they got really down deep in the muscle tissue for my back. I think that with all the surgery and such, I was really overly tense. Things are a lot better these days, and I make sure I get a massage at least once a month. Now if I can only figure out how to claim it on my insurance, LOL.

One other thing, your NS might prescribe you Flexeril or Skelaxin to help you with the spasms. It might be worth a shot.

wb

 
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