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    Old 08-15-2007, 11:27 AM   #1
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    Need fusion surgery advice

    Hi all - I've posted on here before, back when things were still on the "wait-and-see" level. Well, after seven months of trying non-sugical methods for my grade 2 spondylolisthesis + L5 nerve compression with no improvement, I've decided to opt for surgery - October 9th is the day. I'm going to have a minimally invasive "anterior/posterior decompression fusion" at L5-S1 and I'm apprehensive about what to expect. (For example, I've never had general anesthesia before, and I'm nervous that I won't wake up, or that I'll wake up in the middle of it! I know that sounds silly, but I just don't know what to expect-- even though I know what's "technically" going to happen in the surgery, from what my doctor has told me a million times!) Has anyone had this type of surgery (esp. minimally invasive)? Do you have any advice for me to help prepare for before and after? Thank you so much.

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    Old 08-15-2007, 12:32 PM   #2
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    Re: Need fusion surgery advice

    bcuse - I want you relax about waking up during the procedure. There is a special headband with leads they can put on your forehead during surgery so that they monitor your brain waves to ensure that you are asleep during the procedure. All you need to do is express your fear to the anthesiolgoist and ask for them to put it on you. Tell them that you had a friend who this happened to if need be. You want to be lying because I had this happen to me in 1980. Since that surgery, I have not had a problem because they have used this headband in three lengthy surgeries. Also, technology has come so far since 1980 and there is no reason for this happen today. Hopefully this has helped you feel better and has not further scared you.

    At the top of the main thread page is a post entitled "Post Surgical Tips" which is chucked full of information that you might want to read.

    Good luck and remember that we are here for you 24/7.

    Old 08-15-2007, 01:22 PM   #3
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    Re: Need fusion surgery advice

    [COLOR="Navy"]First, take a deep breath! Now release. You will get through this fine....the first thing you need to do is to be prepared. My fusion was a three level - first surgery...but it was not minimally invasive. BUT it was anterior/posterior. AND I have the scars on both sides to prove it. will not wake up during surgery. I metabolize anesthesia extremely rapidly. My dr. informed me that there was NO WAY that I would wake up during this because it wasn't something that you wanted to be awake during. They have you either so loopy that you don't remember going into the operating room, or you are out before you get in there. I know that that is a frightening thought, but those doctors are specialists, and their jobs is to make sure that you stay out for the entire time.

    Make a list of questions that you have for your doctor. Take your hubby along, or some other adult that has full reasoning powers-which you don't at this poiint. Make sure that your doctor or his PA takes the time to answer all of your questions. Don't let him operate until you are comfortable with all of your answers.

    If you check through the archives, there are alot of threads about what you need to do before and after the surgery. There is a thread at the top of the board with a sticky about after surgery tips and how to survive when you come home.

    Don't let anyone fool you. Even though the incision is minimally invasive, it is still major surgery and it will be major time for healing. You will need to plan on at least 2 months recovery time for starters. I know lots of folks will chime in. Search the archives for starters....and good luck..[/COLOR]

    Old 08-15-2007, 03:22 PM   #4
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    Re: Need fusion surgery advice

    Hi bcusebabe,
    Welcome back, and congratulations on setting a date. It will be one that you'll remember! It will be the beginning of your new life!

    I had an anterior/posterior fusion, too, though not minimally invasive. My understanding is that the only real difference is that you'll have a number of tiny scars rather than two long ones, which also means less scar tissue to deal with as you heal. Other than that, a fusion is a fusion and your recovery will be the same as non-minimally invasive fusions. You'll be told no BLT's (bending, lifting, or twisting. The sandwich is allowed.). You'll need to rest and walk, rest and walk, rest and walk. You'll have good days and bad days. It will be months, not days or weeks, that you'll be in the recovery phase. But in the long run, chances are you'll be much better off! There have been a few threads on here about whether people would still have the surgery if they could make the decision again. Even those who have had continued problems have said they'd do it again.

    Please keep in mind as you read on the board that although you will read of some who have had lingering problems, most people who have this surgery get their lives back and are out there working and enjoying their families and friends. They aren't the ones hanging out here on the board. There are some of us who are still in recovery or who simply feel that we want to give back, as we were so helped by the board, so we're still around (though maybe not as much as before). But do take the sadder stories with a grain of salt. Most people have very successful outcomes from this.

    The anesthesiologist you'll have for your surgery sits at your head for the entire procedure. No potty breaks, no getting up and stetching, no quick phone calls to the wife. He does nothing but monitor you. His job is to make sure all your vital signs are remaining stable and that you are appropriately sedated. It is very, very, very, very rare for anyone to wake up during a surgery or to not wake up from it afterward. Those who don't wake up are generally people with underlying problems (elderly, heart disease, etc.). Unless you're 90 years old and have major health problems other than your back, this is really not a concern. If it still worries you, add to your list of questions for your doctor: "what percentage of patients don't wake up from the anesthesia?" Every surgery has its risks, but I'm sure he'll tell you it's nothing to worry about. But it's easy for someone else to tell you not to worry. Not so easy to stop! Maybe it would help you to just keep focusing on how much better off you'll be this time next year. When you start to worry, you've got to crowd those negative thoughts out and replace them with positive thoughts. I'm not superstitious and I'm not unrealistic. I'm just practical. This works for me.

    You'll go into the OR area and be prepared (you have to lose your clothes, first of all. No shyness or dignity allowed! ) They'll give you the very latest in hospital style to wear. You'll lay down on either a litter or a bed and a nurse will attend to you, asking questions, making sure you understand what's going to happen, etc. You'll get an IV. The doctors usually try to stop by and see you before the surgery while you're in the prep area. When they're close to ready to take you to the OR (or in some hospitals, right after they get you to the OR), they'll give you something in the IV to make you drowsy. That's the last thing you'll remember. The next thing you'll remember will be hearing fuzzy noises and a nurse will be smiling at you. You'll slowly become aware of things going on around you, but you'll pretty much just lie there and not really care too much. You'll probably be getting something for pain already, but they'll probably give you a little more once you're awake. You will probably be cold. That's a result of the anesthesia. Tell them. They have blanket warmers and can cover you all tucked in from head to toe with lovely, lushious warm blankets! I wish I had one of those warmer cabinets at home! Once you're awake, they'll have you hang out in the recovery room for a while and then wheel you to your room right in the bed. No effort on your part. You can just relax and let them do all the work.

    You'll be in the hospital for usually 3-5 days. You will have pain, but they'll give you strong pain killers. Make sure you communicate with them and get your pain killers on time. You'll get up and walk around a bit either the same day or the next day. PT will make sure you're stable walking around, either with a walker or not, depending on you and your doctor, and will make sure you're able to handle stairs, etc. Then it's off to home!

    You'll spend the better part of the first weeks lying in bed. You won't have much energy, and it will hurt to get in and out of bed at first, but it gets better and better. You will need to take it easy. If you have a brace, wear it! It helps! Keep on top of your pain meds. Take them even if it's not bad for a while. As your body is trying to heal, it's important to keep the pain under control so you're using your energy to heal, not to deal with the pain. For me, the first threee months were spent mostly in bed with walking periods multiple times everyday, gradually increasing in length. 10 minutes at first is fine. By 5 months, I was mostly up all day with just a two hour or so time lying down in the middle of the day. But I was still very much in a recovery stage. A girlfriend who had a fusion 3 months after me told me she had asked her doctor if it's harder to come back from more levels being done, or once the surgery is done if it's pretty much the same for everyone. He said it's most definitely harder for those who have more levels. I had 8 levels this time, so I hope that means recovery from 1 or 2 levels is easier than what I described. For most of us, though, regardless of how many levels, it's just a long recovery. Figure on a year for a full recovery, but many people feel pretty "normal" by about 6 or 7 months.

    I hope I haven't scared you. My intent is to give you an accurate and realistic picture of what this will be like. For me, that made it so much easier going into it, just having a good idea of what to expect. I am so much better off now than I was before. I hope you'll be able to say that, too!

    Do be sure the read the "post surgery tips" thread. It's got some great suggestions! The best tip for me was to get a grabber tool. Mine was $30 and was worth every penny the first day I was home. It gives you some independence, as you'll be able to reach things for yourself and not have to keep calling someone to help you. Don't get a cheap one. I tried one called The Gopher which was worth it's weight in dirt, if that! It was so flimsy I ended up returning it and spent the extra money for a good one. Also, get a little notebook so you can keep track of your meds and write down little notes to yourself so you don't forget things in your grogginess. I also kept a running list of questions for my doctor so I wouldn't forget to ask anything.

    This is probably way more than you wanted to hear. Sorry. I had the time and got carried away.

    Please come back and ask whatever questions you have before and after your surgery. You're sure to have some, and none are too big or too little. We're not doctors, but we've been there and done that and will help you as best we can from our own experiences.


    Last edited by BlueAtlas; 08-15-2007 at 03:31 PM.

    Old 08-15-2007, 03:39 PM   #5
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    Re: Need fusion surgery advice


    I am 8 weeks post L5/S1 fusion and ALMOST feel like a million dollars. Just a few words of advice....
    1. Use the best neurosurgeon insurance can buy
    2. Allow those around you to wait on you at least for 10 days
    3. When you start walking for excercise, don't go too fast. Just stroll for as
    long as you can.
    4. Do NOT get discouraged after the first few will feel awful.
    Just rest and know better days are to come

    I wish you the very best of luck. Since I had the exact surgery you are about to have, please let me know if I can answer any questions for you.


    Old 08-15-2007, 03:59 PM   #6
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    Re: Need fusion surgery advice

    HI Ditto to what the others have posted to you, but wanted to add, that my surgery was minimally invasive, but posterior only.

    And ibakeandpray is right, surgery is surgery. The only difference is they make an incision through your skin, then dilate through the muscle walls, rather than cut through them. Less blood loss, no muscles to heal from being cut, etc. But instead of one long incision.. i had 6. Add them together.. probably about the same size as one long one would have been through conventional open surgery.

    The surgery to the spine is otherwise the same.. you will hurt at the spine just as you would had you had open surgery.

    Make sure your surgeon is very very experienced to do this minimally invasive, as this takes the most skilled of surgeons to perform correctly. And if this surgeon has not done too many.. I would be leary and find a new surgeon if this is your selected type of surgery.

    Hope this helps you some.
    "believe in the beauty of your dreams"- E. Roosevelt

    L5/S1 bulging @ 18, now 46; still there (but no pain)
    Fusion at L4/L5 Apr -2006
    Solidly Fused Nov-2006
    A Success, but still improving!

    Old 08-15-2007, 08:41 PM   #7
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    Re: Need fusion surgery advice

    I am a surgery veteran (lost count after 20 various procedures from tonsils to galbladder to neck and back). Anesthesia is very easy. They'll give you a nice sedative before you go into surgery which will be very relaxing. They monitor you constantly and adjust medications as needed so you awake...and you only awake when they want you to.

    If when you awake you are nauseous be sure to immediately ask for medication. Don't try to tough it out. Tell the anesthesiologist before the procedure that since you have no experience with general anesthesia you want to be sure anti-nausea medications are available. That is the ONE thing I always ask for (personally I can tolerate more pain than nausea).
    Rt thumb fusion '13. R&L thumb arthroplasty '12 ; RT TKR & Bilat CTS' 11. Fusions: L5-S1('87), L4-S1('93), C5-C7('06), L3-S1('10), C4-C5('13). C5-C7 foraminotomy '08

    Old 08-16-2007, 10:37 AM   #8
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    Re: Need fusion surgery advice

    Thank you all so much! This has really been helpful. And to Emily and Elle, you two really have made me feel like I know what I'm getting into-thank you. And I definitely need to get a grabber! (I wanted to find one with a little shark on the end for fun - ha! - no luck.) I know that this is the right decision for me, it's just hard coming to terms with the work that will go into getting my pain-free life back. Or close to it, anyway. -Brenna

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