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    Old 10-06-2011, 06:36 AM   #1
    cheryl1213
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    2m post-alif (L5/S1)

    Since blog links aren't permitted, thought I'd crosspost instead. The "I confess" is my silly little intro on every post. I'd talked a lot about the journey pre-op but not a tone post-op beyond the first weeks...

    ---

    I confess...I feel the need to post a quick update on my surgery but don't have a ton to say.

    Saturday is the two-month mark since the operation. Honestly, it all just feels slow and frustrating. I'm still dealing with pain and feeling frustrated. I know I've come a long way since the immediate aftermath when I couldn't get out of bed alone or without tears, but it is hard to see the more recent progress. Intellectually, I knew it was a six month ordeal to recover...and a year to fully have the vertebrae heal...but it is tough in practice. My "baby biceps" and toned tris have pretty well disappeared, making me a bit more psyched than I'd usually be about soon switching to long sleeves. I'm also pretty much ready to torch my brace, which I'll have at least till my next follow-up appointment in another month (though I got one doc-okayed night off last weekend...so freeing but def had pain the next day from tensing unconsciously).

    I try to focus on one big rule -- I get one shot at recovery and need to let my body do its thing. I can get the muscles back. The pain IS different than the pre-surgery pain which gives me confidence that it is "recovery-pain" and not "injury pain". Here's my SAT throwback...recovery hurt is to pain as student loans are to debt. No debt is great, but student loans are "good," productive debt. Recovery hurt is good, productive pain. My spine is still adjusting to the change, which makes sense when you replace mush with cages and encourage bones to grow.

    The scale battle has also been an issue, but I'll save that for another post. Bottom line: Slow but steady, moving ahead even if only baby steps.

     
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    Old 10-06-2011, 08:54 AM   #2
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    Re: 2m post-alif (L5/S1)

    I'm not sure if you wanted any responses or if you meant this to be more of a journal -- I can remove my comments, if the answer is a journal.... People, particularly people new to the wonderful world of back surgery, appreciate reading about recovery, especially while you are going through it.

    You definitely have the right attitude toward recovery, and even though it is straining your patience, you realize that being conservative now will prove the wise choice in the ultimate outcome. As far as I'm concerned, as a veteran to all this, that point cannot be stated often enough or emphasized strongly enough. Too many people inadvertently ruin their surgeries by pushing too hard too soon...or, at least lessen their chances of a complete recovery.

    You are going to be in the brace a long time. Is that standard procedure for your surgeon?

    At sixteen months post surgery (and lest everyone faint at this timetable...this was my 3rd and what I consider, my last chance at "getting it right") I am still amazed at the fine line there is between doing enough so that I can increase my overall fitness and strength, and just crossing the line to where I have irritated the sciatic nerve. And you'll find it becomes more difficult as you become able to do more, because you are starting to feel really good. You have a lot more energy and you want to just break out and go full speed ahead. I think of it in terms of my dogs after they have been kenneled for a period of time. They get outside and run around like crazy, in giant circles, as fast as they can go.

    You will probably feel like this too in another month or so...and you will need to keep reminding yourself that you still have a ways to go until you are solidly and reliably healed.

    There's no doubt that healing and recovery is a long process. Try to look at it as an opportunity to learn something about yourself. And, keep up the good work and great attitude. A year from now, you'll look back and realize it wasn't actually all THAT long....

     
    Old 10-06-2011, 08:59 AM   #3
    cheryl1213
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    Re: 2m post-alif (L5/S1)

    Replies are welcome.

    I do think the doc usually does 3m in the brace as his standard.

    Thanks for the pep talk on keeping the time in perspective!!

     
    Old 10-06-2011, 01:29 PM   #4
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    Re: 2m post-alif (L5/S1)

    It was interesting to read your post but sorry to hear recovery is slow and frustrating. I can relate as I am 4 weeks post-op from a 2-level ALIF...I feel okay, but my optimistic outlook thought I would be MUCH better off by this point. I, too, am surprised to see you'll be wearing a brace until the 3-month mark. I am allowed to start PT next week (5 weeks post-op) and at that time, can start weaning myself from the brace, which I'm very much looking forward to.

    I'd be interested to hear what type of pain you're still having. Incision pain? Sciatic pain? Back pain? Another question I have for any other fellow ALIF-ers out there - how long until we know the fusion worked? I know it can take a full year for the bone to fully fuse, but I'm wondering when I will be able to tell if this surgery did the trick to take the pain away (I had mostly all leg pain before surgery and it's still there...) No doubt it differs for everyone but just curious if anyone can shed light on that.

    Cheryl, thanks for posting your story. I guess I'm just interested in hearing other people's stories since I don't personally know anyone that has gone through this surgery before. :-)
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    L4-L5, L5-S1 ALIF - September 2011
    L5-S1 Discectomy - February 2007
    L4-L5 Laminectomy/Discectomy - February 2003

     
    Old 10-06-2011, 01:49 PM   #5
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    Re: 2m post-alif (L5/S1)

    Please be VERY careful when you start PT next week. 5 weeks is very early to start if you will be doing much more than what we all received in the hospital right after surgery. Many surgeons don't like to start until the patient is showing signs of bone growth or between 10-12 weeks.

    I don't think there is any one point where you know the surgery "did the trick." Sometimes even after a patient is fully fused, there will still be some pain. Statistically speaking, a fusion surgery is considered a success if the patient fuses.

    I think one way to measure progress is when the symptoms for which the patient has the surgery gradually resolve. If you feel yourself gradually making some improvement, no matter how small it is, you probably can assume that you are healing and progressing. If months have gone by and the patient is no better, then I would start to worry.

     
    Old 10-06-2011, 02:07 PM   #6
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    Re: 2m post-alif (L5/S1)

    Thanks for the response. It's so nice to find others out there who have either gone through or are currently going through a similar situation. I thought 5 weeks seemed a little early to start PT as well, but I really trust my doctor and my therapist. I'm relatively young (31) but not sure if that would have anything to do with how early they would start PT? I will be sure to be careful. At this point, even moving around in bed is still painful, so I can't imagine I can do any sort of exercises quite yet. We will see!!

    Thanks also for your insight on the "success" of the fusion. I guess I am (like many other people out there) very impatient and would have loved to have woken up with zero leg pain. I didn't expect that, but boy, that would have been nice!

    I have come to realize that recovery from fusion is most definitely a marathon...not a sprint...and just need to continually remind myself of that!!

     
    Old 10-06-2011, 04:01 PM   #7
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    Re: 2m post-alif (L5/S1)

    [QUOTE=ddp11;4856309]

    I'd be interested to hear what type of pain you're still having. Incision pain? Sciatic pain? Back pain? Another question I have for any other fellow ALIF-ers out there - how long until we know the fusion worked? [/QUOTE]

    It is back pain and tightness. All along the spine. The incision had some soreness till about 1m but is painless now.

    My doc does xray checks at the follow-ups (1m, 3m, 6m, 12m...maybe 9 too...not sure) so does glance at the fusion progress at that time.

    Edit to add -- I'm 33 so also on the younger end. I asked about PT at the 1m mark and doc said it would be too much to try at that point and he would likely order it at 3m

    Last edited by cheryl1213; 10-06-2011 at 04:03 PM. Reason: adding detail

     
    Old 10-06-2011, 04:41 PM   #8
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    Re: 2m post-alif (L5/S1)

    Sounds like we have a very similar situation in terms of our age and procedure (although you have a month on me in your recovery). I'll be interested to see how my PT goes next week since it sounds like it's very early in the process as compared to other things I've read. I, too, have a lot of back pain that I'm hoping is normal. I had almost none pre-op (all leg pain) and this new back pain actually just developed in the past week. I'm chalking it up to all the drilling, pounding, cutting, etc. they did during the surgery and crossing my fingers that it's "normal" post-op pain. I like your "SAT throwback" in your original post, btw. Might as well have a sense of humor through all of this, right?

    Are you back to work yet? My surgeon originally said I could go back as early as 4 weeks (if I had a desk job, which I don't) but more likely 6-8 weeks. I'm SO ready to go back mentally, but pretty sure I'm nowhere close physically. I'm hoping that PT helps me progress more quickly but I guess time will tell.

    As far as X-rays, my surgeon does the same. I already had my first one at 3 weeks and everything looked good. I go back in a month or so and hope to see some progress with the fusion at that point.

    Best of luck to you with everything!

     
    Old 10-06-2011, 08:13 PM   #9
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    Re: 2m post-alif (L5/S1)

    Surgeons each have their own way of doing things depending on where they trained, how long they've been practicing, their personal experiences with patients, etc. I have run the gamut...the surgeon that did my first surgery was a man of few instructions and even fewer restrictions. If I hadn't been reading posts prior to my surgery, I probably wouldn't have known anything. His motto was "If it hurts, don't do it." Going to PT was left up to me. No brace. Didn't believe in x-raying unless the patient complained of pain. Was VERY casual.

    My other surgeon is much more careful, routinely uses braces, issues the typical instructions, etc. and lets you only go to "his" physical therapist. They've worked together for 20 years and are in sync. My surgeon doesn't entrust his patients to anyone else.

    I will warn you that some PTs are just a little bit too aggressive. Some are less good at adapting a program to a particular patient's needs. With my first fusion, I went to PT at 12 weeks...I went a couple times and decided I just was not ready. So I waited another month and went back.

    With my recent 3 level fusion, I started PT at about 13 weeks (Sept. 2010) and went for about 6 weeks...and then we decided to take a break. He really couldn't do much with me. Everything he gave me to work on would begin to irritate the sciatic nerve. He was under strict orders from my surgeon to do nothing that irritated the nerve...we didn't want to let that cycle get going again...so, I decided it was a waste of time...and that I would just keep walking and doing simple stretches on my own until later.

    I didn't return to PT until this past July. This time he could work with me. He could do some manual work, massage, e-stim, etc. which he could not do before. And, 16 months post surgery, I am still working on my rehab!!

    You won't have a similar situation, so don't let my experience trouble you...my surgery was very complicated and since we regard this as my last chance to get it right, we have been working slowly and carefully...and my surgeon has been very conservative and careful with me.

    But I just mention it...because recovering from fusion is a race that is won by the tortoises among us -- not the hares.

    If you have questions, speak up! Ask them before you do the exercise/stretch/or whatever, not after. Don't be afraid to question the PT--after going through all this, you don't want a PT screwing something up.

    It may be that the PT will just do gentle stretching, etc. They should not be doing any type of body manipulation at this point. You have to keep in mind that the bones cannot grow together if there is movement between the surfaces.

    Are you going to a physical therapist that was referred by your surgeon?

     
    Old 10-07-2011, 05:48 AM   #10
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    Re: 2m post-alif (L5/S1)

    Wow - tetoneri - sounds like you've been through quite the ordeal with your back! I've seen your posts on other boards and you provide a lot of great information/advice to everyone. Thanks for your input and I really hope that this last fusion does the trick for you. I'm on my 3rd back surgery in the past 8 years - the first two were discectomies on two different discs, but they kept re-herniating so I'm hoping that this fusion does the trick. That being said, I've come to realize that this isn't something that just "goes away." I know that I'll need to "protect" my back the rest of my life and just hoping I can avoid future surgeries.

    As for PT, my therapist also works very closely with my surgeon (they're in the same building), so I feel like I'm in really good hands with both of them. I'm in the medical industry for work, so I did LOTS of research in choosing a surgeon and every single person I spoke with directed me to this doctor. However, I will take your advice and be very careful and make sure to let them know everything I'm feeling. I certainly don't want to have any setbacks and I know that PT is supposed to help...not hurt!

    Again, thanks for your input and I wish you the best of luck with your recovery. Sounds like you made a good decision in taking this one slow!

     
    Old 10-07-2011, 06:13 AM   #11
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    Re: 2m post-alif (L5/S1)

    [QUOTE]Are you back to work yet?[/QUOTE]

    Well, I'm back to [I]looking[/I] for work!! I'm part of that longterm unemployed statistic...a freaky one with a JD who hated lawyer-dom and tried recruiting only to get hit hard by the economy. I'm deciding what to be when I grow up. It does make it much simpler to take the time to heal, but the docs also note it gives you a lot of extra time to dwell (both before surgery and since). I'd asked about his "return to work" rules though, just for a bit of context...he said usually 2m for desk folks.

    THis is my first back surgery but I've had a total of six surgeries (not incl wisdom teeth...of which I managed to have SIX). But these others were all pretty minor (tonsils) or done through really minimally invasive methods (pelvic laproscopies for endo). So a long recovery is def new for me

     
    Old 10-07-2011, 06:25 AM   #12
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    Re: 2m post-alif (L5/S1)

    I imagine you are in good hands. There are some great spine programs in your city. The problem with a board such as this is not knowing the background knowledge of another poster, so I usually start with the basics until I realize the poster has done some reading or research on his/her issues, etc. Too many people enter into back surgery, even request back surgery without fully realizing what they are getting into -- a discectomy always seems like a quick fix to alleviate pain, and some surgeons are guilty of making it sound just that way. In hindsight I am grateful that during my first brush with a spine specialist, he told me that back surgery, unlike most other common surgeries, does not restore the patient to the way he/she was prior to the onset of pain or injury...that once you start down the path, you will always need to be conscious of your back...and there's no such thing as a quick fix. But that's a topic for another thread!

    Please let us know how therapy goes. I'll be interested to hear what they have you doing at 5 weeks post surgery!

     
    Old 10-07-2011, 06:29 AM   #13
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    Re: 2m post-alif (L5/S1)

    While Tetonteri is more cautious overall than I am, I do agree you need to avoid someone jumping to the OR. I didn't necessarily ENJOY the long journey, but I tried the conservative routes first. It gave me assurance that the surgery was needed and the right choice.

    On another note, since I started the thread I'll feel less guilty about the tangent...it is looking to be a LOVELY weekend here in central PA. Docs have confirmed for me that the extra pain in bad weather is very real so this is even nicer for folks like us than the typical folks. Going to a family thing for the BF...apparently people end up on couches and floors but I "reserved" a real bed months ago

     
    Old 10-07-2011, 07:28 AM   #14
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    Re: 2m post-alif (L5/S1)

    First of all, Cheryl, good luck in the job search! Fun, fun. But maybe it was a blessing in disguise that this happened when it did so that you can take your time with your recovery. I didn't realize you are in Central PA - I went to college out there and now live in Eastern PA so I'm not too far down the road from you. Yes, it looks like a beautiful weekend here as well which makes the walking much more enjoyable!

    I guess I should clarify that I, too, exhausted pretty much every conservative measure before jumping into any of my surgeries. You name it, I tried it! PT, all kinds of injections/nerve blocks, nerve medications...the list goes on and on. A fusion was the LAST thing I wanted (I've heard horror stories...) so I was trying to avoid it like the plague. I finally caved in after seeing three doctors that all told me that a fusion was the only thing that would help. So, here I am! (and at this point, I [I]think[/I] I'm glad I did it, but the jury is still out on that one...stay tuned)

    One other question for both of you. When did you start driving? I was told I could start as soon as I was off the pain meds (which I am). I haven't attempted driving yet - I just don't know if I feel quite THAT comfortable yet.

    Lastly, Cheryl, enjoy your party this weekend and be careful!! No doubt it will be nice to resume a sense of "normalcy." :-)

     
    Old 10-07-2011, 08:23 AM   #15
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    Re: 2m post-alif (L5/S1)

    ddp -- i grew up in lower bucks and went to haverford college. i did spent part of one grad school summer in philly as well. my BF and i are now just outside of state college....i love it here. bucks was so quiet as a kid but is crazy now....ten times the houses, twenty times the traffic

    my doc didn't give specific driving rules. i think meds are a big issue in the decision though. i may be on the smaller side (5'4", 120ish), but i am not impacted much by meds...i think it is a big issue in reduced response time though. i take quick trips and had to go a bit further yesterday but still try and limit driving b/c i don't feel like i can turn my head as well (or as quickly) as i'd like.

     
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