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    Old 11-18-2007, 08:34 AM   #1
    Zinnias
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    What causes nonunion?

    Hello! I just had Flexible Fusion done in my lumbar area 9 days ago.

    Of course, I am worried about nonunion and I want to know what to do to avoid it....What causes it?

    Of course, I have the instructions of no bending, no lifting, & no twisting. Hwvr, the therapist didn't explain to me the definitions of these - What degree constitutes a 'bend?' If I keep my spine straight & lean over - is that a bend? Is standing still and looking at the person off to my side a 'twist?' I thought someone would explain these things to me.

    I have a brace b/c I asked for it. My MD doesn't brace patients coming out of this surgery (I had it at 2 levels). The reason I asked for one is b/c I have 2 very young kids, and I can't trust them to keep off of me. I tried to explain this to him! Even if I'm not touching them - if I hear one scream, fall, hit her head, etc - it makes me of course jump and jerk! I thought a brace might protect me. I don't know.

    Other than that - I'm just wondering - What is it that causes nonunion? If I'm careful at all, am I going to avoid it? Nobody explained to me how to get in/out of the bed (they only mentioned 'log roll' once in it) - I don't know the best way to get in/out of chairs - I'm scared I will end up w/ nonunion, and I don't know HOW I would handle that. Not very well!

    Thank you!

     
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    Old 11-18-2007, 10:29 AM   #2
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    Re: What causes nonunion?

    What's a flexible fusion?

     
    Old 11-18-2007, 12:24 PM   #3
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    Re: What causes nonunion?

    Zinnias, You'll probably get some great responses. I'm a thoracic, so I can't answer all your questions, but I'll give you what I can.

    1. Don't take any anti-inflammatories: advil, glucosamine, and others. The list of meds they told you not to take prior to surgery because they increase bleeding? Don't take those for at least 6-9 months! Ever! Tylenol will be your new best friend for aches and pains.

    2. A diet rich in protein and highly nutritious (lots of veggies, not a lot of junk) is really supposed to help your fusion.

    3. DO NOT OVER-DO IT EVEN WHEN YOU'RE FEELING GOOD! This is one of the hallmark mistakes people make and mess up a good thing. Especially since you have little ones, you're going to be tempted to get back to doing things the way you did sooner than you probably ought to. I'd strongly suggest you have a family/friend meeting sooner rather than later and come up with a 3-6 month support plan. You're investing in you lifetime future. Not just the next few weeks or months. I'm not trying to be dramatic, just hoping to keep you on a good, healthy path.

    4. Log rolling - from my thoracic point of view - you may get input from other lower back folks - keep your body in a log shape, everything in until you're at an angle where you'll be able to land your feet on the floor and then push up with one elbow. You feel like a surfboard with limbs, but it really avoid helps the ouchies. Or, at least it helped me. Maybe search some past posts on that.

    5. Do you have a bone stimulator? I didn't with my first surgery and I now (that I'm a "failure") wish that I had.

    Best of luck to you. This board is a great support. Stay in touch,
    Margaret

     
    Old 11-19-2007, 08:48 AM   #4
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    Re: What causes nonunion?

    Hello, and thank you.

    What I'm upset about mostly is how SICK I am. I am on Oxycontin, Oxycodone (Percocet), & Lyrica. I spent all day lying/sitting w/ my stupid plastic throw-up bucket underneath my head. The dry-heaving is the worst. But doesn't the dry-heaving cause a bend? My poor husband keeps yelling, Don't Bend! Don't Bend! I've even wrapped the brace up high where throwing up makes you bend. Can this throwing up/constantly being sick cause nonunion? God, it just won't stop!

     
    Old 11-19-2007, 10:44 AM   #5
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    Re: What causes nonunion?

    You need to call your doctor ASAP about this. You should not be vomiting. Call now.

     
    Old 11-19-2007, 11:57 AM   #6
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    Re: What causes nonunion?

    You are on some really strong pain meds. Why not ask for some anti nausea meds to go along with it. Phenegren works really well. Also remember if you can get food down, they are better with food in your stomach.
    Your doc may need to lower your pain meds or take one pain med out to relieve your nausea. I am confused on the oxycontin and oxycodone together. I think that would make me sick too!
    As for non union, wear your brace and you should be fine. Lying and sitting seem to be fine for me.
    Hope you are feeling better!
    Jen

     
    Old 11-20-2007, 05:22 AM   #7
    shawley
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    Re: What causes nonunion?

    [COLOR="Red"][B]
    Hi - Thought I would jump in , non-unions can happen even if you do everything right , I had 3 revisions to correct my non-union and still after 4 years not fused . of course they tell you its ok because the hardware will keep you stable but they can be broke also . During a work hardening program so I could get back to my job I broke a pedical screw , found out I wasn't fused . Don't smoke , its not good for bone growth either .
    I wouldn't worry about it , most people fuse just takes time .
    Good luck[/B][/COLOR]

     
    Old 11-20-2007, 01:51 PM   #8
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    Re: What causes nonunion?

    Honestly, your body is the best indicator: if you are doing something and it's hurt -stop. I am 20 month after my fusion and I can't do any BLT (bending, lifting or twisting). Sharp pain just strikes through the area and I have to stop.
    Smoking is the worse for the bones; my Dr told me before the surgery if I don't stop smoking he will not bother to do any surgery since risk of nonunion is very high on smoking people.
    Take it slow, don't push yourself too much. Stop and rest in between your walking, stretching, etc.
    And positive thinking helps too!!

    Good luck to you!

     
    Old 11-20-2007, 09:45 PM   #9
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    Re: What causes nonunion?

    Please call your Dr, as stated before you should not be vomiting. The stress that puts on your body can not be good. Your brace can only do so much. I have never been on that much pain medication? let us know how it goes.
    Lisa

    Last edited by lisa3451; 11-21-2007 at 07:13 AM.

     
    Old 11-21-2007, 01:23 AM   #10
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    Re: What causes nonunion?

    It sounds like you might be having an allergic reaction to the meds. Good luck and please keep us posted.

     
    Old 11-24-2007, 08:59 PM   #11
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    Re: What causes nonunion?

    From what I've gathered talking to fellow spineys, a lot of people (myself included) don't do well with percocet. It made me very sick. See if you can try vicodin instead.

    As for the nonfusion thing - firstly, do not smoke AT ALL. No patches or gum either. Even a good amount of second-hand smoke is bad. According to some, it is the number one reason why fusions fail. Try to eat right and make sure you're getting enough calcium and vitamin D. Get lots of rest, but not too much... you need to get moving and start taking walks as soon as you can. Not long ones - just up and down the hall is good to start - but bone grows where it's needed.

    But first see if you can get some meds that work for you.

    Good Luck!
    David

    Last edited by camperboy; 11-24-2007 at 09:00 PM.

     
    Old 11-25-2007, 05:47 AM   #12
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    Re: What causes nonunion?

    [QUOTE=Zinnias;3313685]Hello, and thank you.

    What I'm upset about mostly is how SICK I am. I am on Oxycontin, Oxycodone (Percocet), & Lyrica. I spent all day lying/sitting w/ my stupid plastic throw-up bucket underneath my head. The dry-heaving is the worst. But doesn't the dry-heaving cause a bend? My poor husband keeps yelling, Don't Bend! Don't Bend! I've even wrapped the brace up high where throwing up makes you bend. Can this throwing up/constantly being sick cause nonunion? God, it just won't stop![/QUOTE]
    It sounds like one of the meds is making you feel sick as this is sometimes a side effect. I would try omitting one and trying a different pill for the pain. It took me two weeks to figure out what combo worked out for me and how often to take it but the vomiting shouldn't prevent fusion. I too was afraid of this so I did everything possible such as eating Tofu, its high in protein and is flavorless so you can add it to food and it will absorb the flavors, also, I'm taking B-complex, Calcium and Vitamin D and drinking Milk in the morning and soy milk in the evening with my meals. Do have a balanced diet but add protein and stay away from the cigarettes and sugar which are said to prohibit fusion, also don't forget to walk. A little at a time.

    Make sure you take your meds as directed, i.e. with or without food. If it says, "With or Without," do try taking the med. with your food, it may help with the uneasy stomach. The first month is the worse of it and little by little it should get better. God Bless

     
    Old 11-25-2007, 10:21 AM   #13
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    Re: What causes nonunion?

    Hi Zinnias,

    You've asked the million dollar question!! I sure wish I knew!!

    All the things I been told, and read regarding non-unions have been metioned by the other posters, so I don't have anything to add. Sorry.

    At the top of the board, theres a "Post surgery tips" thread, there you will learn of some great ways to get in and out of bed, up and down in chairs, ect. Great advice for all sorts of things.

    You'll do fine, your already protecting yourself, just by asking others and taking caution in what your doing.

    Take care

     
    Old 11-25-2007, 01:11 PM   #14
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    Re: What causes nonunion?

    I think it is as simple as you fuse, or you don't. I have been told by 4 doctors from the test they ran, that I am fused. One of the things listed for my next surgery is to determine first that the fusion is solid. That up close look by your surgeon is the determining test, I guess. I even had a bone density test on the fusion site and it is good. 5 x-rays show solid something. I had cadaver bone stuffed with my own bone from my hip. The main thing is no BLT's. When the pain started at about 3 months, I started on Oxycotin, then Methodone, and then Morphine.(Not at the same time) They all made me have dry heaves and I had to go into the hospital with breathing problems. I can only take a limited dose of Norco for the pain. My chances of fusion were lower than most. I smoke, something that I just couldn't give up. I have tried. It's the nicotin that slows the fusion. So like Camperboy said, no patches or gum either.

     
    Old 11-26-2007, 03:15 PM   #15
    Zinnias
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    Re: What causes nonunion?

    Hi Chris54,

    Are you saying that the pain that came was 3 months AFTER surgery? Oh, I'm so sorry. Good luck to you.

    Thank you everyone. I put more effort into making sure I do things "correctly" than anything else. So watch it not happen. I'm sure it's on everyone's minds.
    Thanks!

     
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