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  • 2-level ALIF 6 week post surgery pain

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    Old 07-20-2012, 12:52 AM   #1
    nevadadesertrat's Avatar
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    Unhappy 2-level ALIF 6 week post surgery pain

    Im no stranger to surgery, I've had 8 with 3 of them being on my spine since2007, plus countless epidurals, trigger points and prolotherapy. Both my husband and I have been EMT for 18+ years so medicine is second natur to both of us.
    I underwent an L4-s1 ALIF fusion with fixation on June 12. Going into the surgery was stressful, both at home and at work, do I never got in the right mind set for this surgery. I'm 43, my neurosurgeon is on of the top 50 in the USA and is awesome. I was told around week 2-3 I could drive...HA! Anyone who thinks they can is putting themselves and fellow drivers at EXTREmE risk. But that's not we're my problems start. In the hospital, pain management was challenging since I have been on narcotics for several years, despite reducing my meds to 1/2 maintenance dose 2 weeks prior. My O2 levels kept dropping into 70% range in hospital on O2, and I was sent home without O2 or discharge instructions. I was just told to walk,walk,walk. Well it's hard to walk went you have migraines the whole first week at home triggered by lack of O2... My levels were routinely in low 70s. After my husband secured home O2, and my pain was finally getting managed after a week at home, I started walking more, 7-8 minutez 3-4 times a day on treadmill at a toddlers speed as i live on a mountain side, there is no flat, level even ground. This lasted 3 days then I couldn't bear weight without excruciating pain in my thighs and hips. This prompted another call to dr. And was told that due to extensiveness of surgery I shouldnt be walking but to the bathroom and kitchen for first couple weeks. Only single level fusion patients are vigorously encouraged to walk like I was walking. Then he told me no treadmill as it is not a natural gait... I get doc, but find me a piece of ground that is flat without 4-10% slope with no gravel or rock! I was told to just do what I could.
    So here I am 6 weeks. I walk about a mile a day around my "block" whose road is gravel and had a 3-5% slope on on end and 10-15% slope on other end. I am still in excruciating pain! My spinal pain has started to settle this past week unless I make the tiniest twist (several of you mention trying to wipe butt without twisting) it's not bad but gets my attention. My calfs and hamstrings are tighter than a banjo and I can't stretch them out and nobody will massage them. My groin muscles have been getting increasingly worse since week 2, and I think my stomach hurts more now that right after surgery. I have lots of rebound tenderness, my whole lower abdomin is generÓlly firm/hard (mind you Im probably average by todays standard for a 5'-8" woman at 180lbs who is...was physically active hiking and sking). I also have a mass on right side from all the lovalox? Injections to prevent clotting (dr. Assured me this would eventually go away). I have a internal suture that has worked its way thru the incision site and is very much attached to me, but my incision looks great! I can't sleep at night... Insomnia... Not pain. And like most, I'm fighting a bit of depression. I am an active person. I hate sitting stilll, mostly because it has hurt for so many years to be still, sleeping was impossible this past year due to pain.
    I know I've rambled a lot, but this forum allows such a great sharing of information and I know there are those that just passively read others stories to see if what they are feeling is " normal". I guess I'm seeking general feed back from some of you guys on this stomach pain and leg, specifically groin pain. It seems like it should all be settled much more than it has at 6 weeks, even with some of my setbacks. I have F/u Monday with dr. This whole surgery just seems to really be taking its toll on me. I was quick to rebound after lumbar laminectomy and neck fusion, both in 2007. But this number 8 of surgeries is frankly, kicking my ***! I have two good days then a bad day... Today, where I slept until 10:00 am, ate about 11:00 napped until 2:00 finally got dressed to try to motivate and my gut has just been killing me. Tried to work thru its pain by organizing bookshelves and had to give up after 30 min. I don't mind my brace, but today it hurt to have on. I had BM this morning, nothing feels backed up. Anyone else have a lot of stomach problems 6 weeks post ALIF or increasing leg pain... This is muscular pain not nerve.
    Thanks for any insights.

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    Old 07-20-2012, 12:00 PM   #2
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    Re: 2-level ALIF 6 week post surgery pain

    My three back surgeries have all been open posterior surgeries so I can't help you with the stomach pain. There are several people currently on the board who had ALIF and I'm quite sure someone will respond to your post.

    You are in a tough situation regarding the walking. Personally I think you'd be better off walking on a treadmill than walking the inclines. My surgeon would agree with your regarding the treadmill, but many spine surgeons allow their fusion patients to use one. With a lower lumbar fusion, walking on an incline is very hard on the muscles and soft tissue. I had a 3 level fusion two years ago and I was probably about 8 months out when I went out to upstate NY to help my 90 year old aunt who had a stroke. It is very hilly where she lives and I quickly learned that going out the door and walking for 40 minutes was beginning to cause pain that I hadn't experienced since my surgery. My surgeon explained how the inclines change the biomechanics of the spine and it really puts a lot of stress on the area where you are trying to grow new bone cells.

    Until you start driving, could you just walk around your house and then have your husband take you somewhere flat where you could do one longer walk, like a big box store or a mall or something?

    Regarding the insomnia, that is fairly common after having several hours of a general anesthetic. I found it easier to be on a 24 hour schedule and I never worried about going to bed for the night. I found I could sleep comfortably for about 4 hours. Any longer at a stretch and I would stiffen up. So I would sleep as long as I could, then watch TV, read, otherwise entertain myself, half a snack or eat a small meal and walk until I got sleepy...then I would nap and the cycle would repeat itself. This way I didn't get frustrated because I couldn't sleep and over the period of 24 hours, I imagine it all evened out.

    Your surgeon doesn't sound "awesome" to me if he sent you home with no instructions for post surgery. I suppose due to your emt training and medical history with all the previous surgeries, he assumed you were experienced and would know what to do.

    Did he give you restrictions on the amount of time you should sit at one time? Also, you'd be better off taking many short walks to stretch out the spinal nerves rather than taking one long walk. The point of walking is to keep scar tissue from attaching to a nerve while it is filling in.

    Are your sure your leg pain is muscular rather than nerve pain?

    Old 07-20-2012, 09:49 PM   #3
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    Re: 2-level ALIF 6 week post surgery pain

    I guess i should clarify the instruction process I experienced. My post surgery appt the day before surgery I did get TOLD I would have a 20 lb lifting limit for the better part of a year, dont plan on working much the first 6 months, and of course no BLT until I get started with PT. but so far as the hospital discharge, this is the first time I walked out of a hospital with NO paperwork. I got more paperwork when I got strep last year. Even as i was getting in the wheel chair my husband is asking me if i signed anything that morning, as he was coming off shift and did not arrive until after noon. There was a lot of confusion in the hospital... Staff kept assuming I had only a single level fusion. To give to an idea, PT and a murse came in on day 2 with a neck brace, insisting i had to wear it... I told them they could run it up the flag pole... That they better read my history... My neck is fused and i just had a2-level ALIF. They left the collar in the room and when PA came in next day I Explained what happened and he made it dissappear. I saw the doc the day of surgery that evening and the morning of day 2 when he said I could go home following day if I got PCP by midnight and oral meds and patches were holding me.
    Oh, I got to add to this lack of discharge instructions from hospital or signing any paper, I just got my EOB and my insurance, that pre-authorized everything is denying benefits... Like not paying for surgery because I wasn't admitted to the hospital? Which could go back to my lost paper trail.
    So far as husband me driving somewhere...he just returned to work on a fire fighter schedule for the marine corps. Every time he goes back on shift for 48 hours it ends up being 72, and we are 50 miles from a box store, 30 from grocery store.
    My best wish for my Monday appt would be ok'd for pool therapy. That we have and as almost everyone in this boat will say, pool therapy is so beneficial on so many different levels.

    Old 07-21-2012, 12:10 AM   #4
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    Re: 2-level ALIF 6 week post surgery pain

    I had a one-level ALIF and had stomach pain for about ten weeks post surgery. I wore pretty much nothing but yoga-style pants for months. The small amount of compression, evenly distributed across my torso felt good, since I kept feeling like my stomach would fall out!

    I spent a lot of days walking laps around my living room. Or, down the hall and back, down the hall and back, etc. The objective is just to walk, not to meet any particular fitness goals.

    I started PT at week three post-op. The first PT visit was almost entirely evaluatory, with some leg-streching techniques and ab-setting exercise (just practicing tightening the abs). The second visit (week four post-op) was in the pool. Hopefully, your doctor will clear you for PT; the water therapy is great.

    Sorry about your hospital bill headache. It must be a GIANT headache.

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    alif recovery, groin pain, insomnia, leg cramps, stomach problems

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