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Old 01-24-2010, 05:26 PM   #1
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Need Reassurance 10 days Post ACDF

Hi,
I'm hoping you thing I may just have overdone it? OK, I hurt. I suddenly started having a return of nerve pain (burning pain) along my right arm and its gone into my left now as well. I had burning pain in my right arm pre-op. This is actually worse. I got let go from hospital next day. My stay was terrible with several screw ups. I had/have severe muscle spasms so sleeping has been hard. I was given very little instruction. I have a soft collar but was told to wear it "for comfort". I wake all frozen up and with painful spasms all over my torso and arms too. I had to call to ask for a medication - they sent me home with only a narcotic pain med. The robaxin helps a little. Day 5 was when the nerve pain returned. I'd love to think its because I'm doing too much. What's too much? I'm futzing around the kitchen - cooking. I tried some knitting - but it hurts. Even holding a book makes the burning worse. Aside from telling me not to lift more than a gallon of milk, I wasn't told of any restrictions. How much resting is the norm for 10 days post-op?
I'm sorry for this confused and sorry post. It's so discouraging. I guess I can only cut back even more and hope this calms down. And I will also sleep in my collar after reading some of your posts. I had left it off but I can see that was a mistake. Any support would be appreciated. I'm sure miserable on my own. SQ

 
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Old 01-24-2010, 07:02 PM   #2
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Re: Need Reassurance 10 days Post ACDF

The knitting and book holding are likely not helping. I found it best to keep my neck in a neutral position for 6 weeks. I barely did any reading during this time and nothing that required looking down at at all When do you see the doctor next? Perhaps you need more muscle relaxant (higher dose or ability to take more often?)

The nerve pain at this point is normal as there is swelling in the neck in the area of the surgery. Have you been given, or ever tried, neurontin (gabapentin) which is a nerve pain medication?
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Old 01-25-2010, 04:39 AM   #3
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Re: Need Reassurance 10 days Post ACDF

Hail and well met,
It's such a relief to connect with you. If you kept your neck neutral for 6 weeks then I have been moving way past overdoing it. It helps so much to have some markers for comparison. Yes, I have been on neurontin for 3 years. I have permanent nerve damage in my left leg from a failed lumbar fusion attempt in 2005. I am currently taking 1800 mg a day. I have been on 3600 mg a day at times. And I have emailed my surgeon to ask that I be able to up my dose today.
Just to know that this kind of pain is expected is a relief. My doc didn't guarantee but he repeatedly said "many people have a total resolution of the nerve impingement symptoms immediately". I've had very little luck on this spine journey and I must admit my heart sank when the pain returned and I jumped right to the fatalistic conclusion that my surgery had failed in the sense that this might mean I had permanent damage and I'd be stuck with the pain despite that the surgery was a technical success.
Which by the way, surgeons say it was. They tell me it went very well. Hears something that sot of amazes me. Pre-op I had a pronounced jutting of the c5-6 vertebrae. I could see it in the mirror and I was aware that I was beginning to have a noticeable hump. And now it is gone! I had only a single level fused but that prominence is just gone. I have tons of muscle pain back there. Do you think this is mostly due to the vertebrae being realigned and bolted into a new position. Or could they have removed so much bone from the posterior processes? Anyway, it was a surprise to me to reach back and find smooth flat spine where there was a handful of bone just a few weeks ago. Thanks again for the reassurance. It means so much. SQ

 
Old 01-25-2010, 06:15 AM   #4
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Re: Need Reassurance 10 days Post ACDF

I have to say although I hate the hard collar, Im glad I had it. I would have botched it up some how. Even in the hard collar I managed to do to much. Im the prime example of a bad patient,lol.
I agree, its best to just take it easy & do the least amount of activity.
I felt pretty good pain wise for the fisrt couple weeks, then started getting brave doing laundry & this & that & pain returned with a vengance. It did improve but only after I rested alot & restricted myself & it took awhile. I would say at least a matter of weeks if not longer to settle down with rest.

After the 3mnth recovery I jumped into doing everything, Work, housework, lifting whatever, & was right back in pain. I think even after the 3mmths for some its best to ease into doing things, not jump in like I did.

My surgery was a success according to my surgeon other then finding other discs not in great shape, but still it did not get rid of every little thing. I will always wonder if it was my own fault. Lifting set everything off. Easing back into things over time would be smart I think & I can see where it could take time as it takes time to fuse. I definantly needed a muscle relaxer & as soon as I was allowed an anti inflammatory.
Hopefully with rest you'll feel better, you have nothing to loose by giving it a try. If you feel you want to cook try to do alittle at a time. like preparing part in the morning & then finishing up later if possable. Slow cookers can become ones best friend at times like this. good luck & I pray you have a successful recovery. Sammy

 
Old 01-25-2010, 08:49 AM   #5
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Re: Need Reassurance 10 days Post ACDF

Suzy:

A few things are probably contributing to the muscle pain and spasms.

First, as you mentioned, if you had a significant jutting if one vertebrae then your muscles and nerves had, at least a little bit, become adjusted to the abnormal position. When everything was re aligned now the muscles were manipulated into a different, and now correct, positioning.

Second, once a level of the spine is fused the surrounding areas take on more of the responsibility for movement and your body's biomechanics are altered. So muscles now have to do different work and just as when someone exercises to much and has pain after - you now have muscles rebelling after being "worked out".

Third there is the simple fact of recovering from surgery. The best thing you can do is listen to your body. Give it the rest it needs, the positioning that feels best, etc.

I was lucky to have one specific chair in out home (part of a sectional couch) that reclined. The best part was that the back of the seat hit my neck in the exact right point to help me keep a neutral and comfortable position.

Hopefully over time the symptoms will subside and you can get back to many of the activities you like. I found I could empty the dishwasher as I could keep my neck straight but washing a pan which required looking down while scrubbing was not an option.

I had a hard aspen brace which helped. My doctor had said it was as much for avoiding moving the wrong was as it was to aid healing. I thought I'd hate it but it was livable for 6 weeks. I took it with us on our first plane trip after surgery just in case I needed it, so keep that in mind.

I had significant nerve pain relief after my ACDF. About 18 months later I had pain return and since that wouldn't be swelling the surgeon did tests and found bone spurs and just a bit of stenosis. I was looking for a new job at the time so I had to solve the problem and shots (ESI) had not worked) so he did a cervical posterior foraminotomy. He told me, upon waking, that the stenosis was WAY worse than tests showed. For that no brace was required but he had me bring the old one to wear home from the hospital. Again, more for comfort. I say this not to scare you but so you know to always advocate for yourself and push for a solution.
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Old 01-25-2010, 05:17 PM   #6
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Re: Need Reassurance 10 days Post ACDF

And thanks again for the support,
I emailed my surgeon and heard back today. He is not concerned and takes it as a good sign that I had the 5 days free from nerve pain. Yes, he agrees my car accident with whiplash 5 weeks pre-op may be making my spasms worse. But he reminds me many people have severe spasm and no car accident so.... I'm to increase neurontin to 2400 a day and proceed as planned. "Let's get you thru the next several weeks and into PT at 6 weeks post-op..." is what he says. I see him Friday so I'm OK with this.
Yes, it all fits. I've been doing too much. Too much reaching and bending and washing. The nerve pain is there and I just plain hurt. So, I agree the tissues are angry and the new alignment is probably upsetting the entire chorus of muscles and tendons and ligaments and so on. I pressed my hubby into cooking duty and I am really going to try to do less. That is very hard for me. Silly but I expect the docs to tell me exactly what I can and can't do. Childish, really. Well, must limit the keyboarding. I'll be around. SQ

 
Old 01-25-2010, 06:15 PM   #7
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Re: Need Reassurance 10 days Post ACDF

By the way I found it hard to type post-op as even though I'm a fast typist I tend to look down at the keyboard more than I thought!
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Old 01-25-2010, 06:47 PM   #8
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Re: Need Reassurance 10 days Post ACDF

Amen! I never learned to touch type. Really very terrible on my neck as I am now in admin and I do document work every minute I'm not in meetings. Ah, the irony!.. SQ

 
Old 01-25-2010, 07:18 PM   #9
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Re: Need Reassurance 10 days Post ACDF

SpineAZ gives some good advise. I found wearing Cervical Collar at night helped me the first couple of weeks. Then spend the money and invest in a good Cervical Pillow. They can be found online and at most Medical Product Stores. It basically provides support for you neck while your on your back, and has a square in the middle for your head to sink in and rest. Wouldn't trade mine for anything. If you can stand it, Walk alot. This will help with your circulation and healing. DON'T over do it. As SpineAZ said. Listen to your body. I wish you the best of luck.
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Old 01-25-2010, 07:45 PM   #10
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Re: Need Reassurance 10 days Post ACDF

You need to take it easy SuzyQ - great advice here. Watch those neck positions! The 10 day mark is a very common time for when people start feeling the way you do.

My opinion is - this is your shot to get well and put this behind you. Why not spend 6 weeks taking care of yourself, limiting certain activities and just let the body do it's thing. It is normal to want to feel better and rush, but in the span of a lifetime - 6 weeks - even 3 months is really just a short time. Just go slow and when your body gives you the little warnings, slow down for a day or two and then get up and try again another day. You may go through cycles of this where you feel good then one day you don't, that is your signal to take a break. Take it easy and ask for help around the house.

Take care and good healing.

P.S. if you are typing at a desk please watch your arm positions and do not put stress on your neck and shoulders or cause tension - that will irritate those muscles and nerves during this time.

 
Old 01-26-2010, 06:40 AM   #11
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Re: Need Reassurance 10 days Post ACDF

Dont be hard on yourself, as its not childish at all. We dont realize how much we use parts or our bodies until we're restricted or in pain. I was always asking my surgeon if I could to this or that & the answer was always the same no. My surgeon really meant it when he said restricted! Most surgeons dont specify so you do wonder just how restricted am I?

SpineAZ Im not surprised at all as Ive only had 2 surgeries but both additional things were found or it was much worse then it appeared on film. Makes me wonder now when I go for testing just how accurate the test results are, but really what else is there to go on.

Tons of good advice here.

Take good care Suzy & I hope your hubby is a good cook,lol. God bless, Sammy

 
Old 01-28-2010, 04:19 PM   #12
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Re: Need Reassurance 10 days Post ACDF

Thank you all, I am taking it much easier. Have to, really. Muscle spasm are definitely reduced and that is a blessing. Sleeping? Very hard. I am now using rolled towels to brace myself so I can't move hardly at all. And I wear the collar. I already have a good cervical pillow but I can't use it with the collar.
See, I have this terrible pain in my left pelvic/hip area. If I roll onto either side, that pain wakes me right up. And if my head rolls to either side at all, I wake with strong muscle pains. And these often turn out to be charlie horse type of strains that last all day. Stinks.
Still having the arm pain but it isn't any worse. Overall, I am doing pretty good. Just had a consult with a new pain center doc on the left leg issue. He wants an mri of the SI joint and hip. I'm agreeable but it is very confusing. I specifically asked the previous docs why they didn't feel an xray or mri was appropriate and they had elaborate explanations...mri's of the si joint don't show anything because this joint is different and the standard of care is to do injections bla, bla, bla. When two specialist told me the same thing I accepted it but felt it wasn't reasonable. Now this guy tells me he can't do a thing until he has an image and he has no idea at all what these other docs are talking about! Makes me shake my head and wonder, big time.
But for today I am focused on my recovery. I totally agree - 6 weeks of recovery for a lifetime of a optimal outcome is a real good deal. OK, I must stoop typing and rest. Thank you all so much. I t is wonderful to talk with you. SQ

 
Old 01-28-2010, 05:49 PM   #13
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Re: Need Reassurance 10 days Post ACDF

There is an SI joint nerve ablation (RFA) that may be possible depending what they find. My pain doc did this for me 2 months ago (it was done in his office in their tratment room with light sedation, like an epidural injection). So far it has helped.
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C5-C7 foraminotomy 08

 
Old 01-29-2010, 05:07 PM   #14
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Re: Need Reassurance 10 days Post ACDF

Hi SpineAZ,
Yes, RFA ablation of the SI was exactly what I was suppose to have done back in early Nov. Previous pain place said no to the need for any images and did 2 SI nerve blocks. Both times the novacaine stopped the pain 100 % so they diagnosed me as having SI joint dysfunction and planned to do 2 -3 ablation procedures and PT to rehab the joint. Complicated but the RFA never got scheduled and the dropping of that ball led to other and unbelievable clerical/office staff-type missteps and I finally despaired of getting anywhere with them and meanwhile I'm seeing my neuro for this ACDF and I ask him what he recommends. He recommends this other outfit cuz I'm complicated and he's sent several of his complicated cases there and has had good things to say cuz they actually, really communicate with him. So, I switched. I hated the thought of having to go thru the whole new patient thing again but I'm doing it. And lo and behold the new place sees things quite differently. They think it is basic that they take a look and try to see what is causing this problem before they kill the nerves so i can continue to walk on the problem. We'll see.
Had my first post-op with neuro today. He is pleased but finds my reflexes off and the rather splendid assortment of nerve pains (tingles, electric jolts, tightness, numbness) I'm having in both arms (along right shoulder and below both elbows) a bit outside of the norm. For now he doesn't think it is neurologically indicative of anything more than a hyper-reaction to the overall trauma of whiplash and surgery. He sounded positive but warned me to take it slowly and to expect that it may be a few weeks before this all calms down. I'm fine with that. I go back in a month.
I'm so glad to hear you got relief from your RFA of the SI joint. Can you tell me if you know what is wrong with your joint? Did you also have the blocks to ID the source of the pain? SQ

 
Old 01-29-2010, 05:21 PM   #15
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Re: Need Reassurance 10 days Post ACDF

I'm not sure exactly what was wrong. I think with the SI joint it's a process of elimination. If the blocks work then they suggest RFA. If that works it can be repeated occasionally. I think it worked for me but I'm having L3-S1 fusion next week and after recovery from that I have to see if the "sharp" pain I have that was thought to be SI pain is also gone. (There's a chance I didn't have SI joint problems but they did the block and RFA to help alleviate some of the pain). It did help but I also had L5 ablation at the time and have had to lay down much of every day so I don't know yet if it really worked.
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Rt&Lt thumb arthroplasty 2012 ; RT TKR & Bilat CTS 2011
Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
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