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    Old 09-04-2003, 11:09 PM   #1
    april1270
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    Question L5-S1 surgery, questions

    I am seeking suggestions/answers from anyone who has had back surgery for L5/S1. I also have early onset degenerative disease (surgeon said it is rather sever for my age-32) Arthritis is present also but I can't say for sure what the exact locations are for this. Numbness in right leg that has started to be felt in parts of left leg. Shooting pain that does not go away this time (may have an hour or two of relief of shooting pain in a 2-3 day period) My surgery is scheduled in 12 days.

    12 years of back pain with various injuries

    Chiropractor, DR and surgeon all suggest surgery

    Have had: physical therapy, chiropractors, MANY different meds, physical training, weight management and so much more.

    Was told to loose 50 pounds and it would go away/lost 70 and it was still there

    Told to do stretches and it would go away. This time has been four months of that and it is only worse.

    No relief from chiropractors anymore

    Presently taking: Neurontin 300mg daily, 800mg Motrin 4Xday, Tylenol3 every 3-4 hours and Elavil 10mg (suppose to help with depression but have been on 14 days and I truly believe Elavil brought on the depression)

    OK, there is the basic short story!

    I am wondering if anyone has had positive results with this surgery?

    Have you had repeaat surgeries later in life?

    How long were you on bed rest post-op? (DR is saying 3 weeks)

    How long after until I can finally be off of pain meds?

    Also have early onset degenerative disease in lower 4 discs. If you have this do you know of a med to slow this down. Mine apparently is rather severe.

    Any suggestions to get comfortable when sleeping? I have not slept in weeks.


    Sorry for long post but I am getting a bit more nervous as this approaches. I truly believe it is the best decision and it helps to have so many professionals agreeing. If you have any info or personal experiences that would be appreciated. I would like to make sure I am asking the surgeon all the "right" questions before we go on with this.

    April
    __________________
    Sept 16 will be surgery for L5-S1 disc herniation and fragmentation due to degenerative disease (early onset)
    I am 32 with two children and want to play with them again so I am going ahead with it.

     
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    Old 09-05-2003, 05:31 AM   #2
    stormy32
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    Hi April,

    I just had a microlaminonotomy with dicectomy at L5-S1 last Tuesday. I too have significant DDD for my age(25). What kind of surgery are you sceduled for?
    I had lots of luck with mine so far, although I have had a minor set back, as I was coming home from my first post-op visit I was rearended, so the pain is worse now. But before that I would say the surgery as of a week after it relieved my pain by at least 70%. I was having both back and left leg pain, with occasional numbness in the left foot. I was not on bedrest after surgery, they had PT working with me the next day.
    I am still on pain meds, but a lot less than previously and the doctor said we will start getting me off them once we see how I feel during PT.
    As for the Elavil for depression, you need to give it some more time. Antidepressants don't normally kick in until after two weeks of taking them, I am surprised your doctor didn't mention that the result would not be immediate.
    I hope this helped a little, I don't have much input yet as I am so soon out of surgery but I hope everything goes well with you and your surgery. And stick around here, there are a lot of knowledgable people and everyone is very supportive!
    I hope you are feeling better soon!

    -Lauren

     
    Old 09-05-2003, 07:04 AM   #3
    theresagreene
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    Hi April,

    I'm in the same boat as you are. I have DDD. I am 5 months out of L5-S1 fusion. It was an anterior entry (back, scar from the top of my butt to about 7" up) and I had 2 cages inserted. Donor bone was taken from the scraping and leveling of L5-S1. L4 and L3 are also shot and will have to have surgery for those later in life.

    First off, what type of surgery are you having? That has a lot to do with recovery. Mine was 2 days in hospital, was supposed to stay 4, 1 month no driving, 3-4 months no work.

    For myself, I'd do this again. I was in so much pain and didn't even realize it that I wore a hole in the seat of my recliner shifting all of the time.

    After the first 3 weeks I was feeling great! Quit the pain meds. Then the more active I got, the more it hurt. Which is OK. I am now on morphine sulphate slow release, kind of like a contact pill, only you get a little more stupid! (most people can't even tell with me tho!!) Not too bad, I can drive, etc., but I also have a high tolerance for pain, and the meds for it! I now hurt, but with the morphine I can do a lot of things now. Heavy physical things no, but thank god I can vacuum and dust! (he was supposed to do it...)

    Anyway, for me, and everyone is different! I'd do it again. I'm in pain, but not as bad! and with the morphine even less. I was having pain like storymy32, only pretty extreme.

    Some things to think about:

    Watch you pain meds! I got addicted to vicodin and was taking 12 a day! I called the dr. when I finally realized I was in trouble and we worked out a pain management contract.

    Also, you meds are metabolized thru your liver. Get you liver enzymes checked! Mine are elevated so have to watch them.

    Get one of those easy grabbers, for picking things up off the floor. ****** was great in telling me the things I'd need. I was bed-ridden for about a week, moved to the couch after that, and am now pretty active (so happy I can do housework blahch!).

    Let us know how you are doing and the type of surgery. Also remember it is very normal to be nervous, so don't hesitate to ask questions.

    ------------------
    47 Years Old - Female
    15 Years of Pain (I waited too long!)
    Discogram 3/2003
    L5-S1 fusion 3/27/03 (in hospital 2 days)
    L4 Disk - torn, ruptured
    L3 Disk - torn, ruptured (I'll worry about these later)
    __________________
    47 Years Old - Female
    15 Years of Pain (I waited too long!)
    Discogram 3/2003
    L5-S1 fusion 3/27/03 (in hospital 2 days)
    L4 Disk - torn, ruptured
    L3 Disk - torn, ruptured (I'll worry about these later)

     
    Old 09-05-2003, 11:06 AM   #4
    april1270
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    Thank you Lauren. News like that is certainly in the right direction. I would love to hear from you from time to time as to how yours is going.

    I don't think I made the explanation clear on the Elavil. I was not depressed but my PCM decided to put me on it to "prevent" depression. I do have a history of post-partum. Since starting it I am spiraling very fast and am loosing control. I have not been depressed for quite some time until I started this med. I am working on several options as we speak to change this.

    Best wishes to you and your health. Speedy Recovery

    April
    __________________
    Sept 16 will be surgery for L5-S1 disc herniation and fragmentation due to degenerative disease (early onset)
    I am 32 with two children and want to play with them again so I am going ahead with it.

     
    Old 09-05-2003, 11:31 AM   #5
    TexMich
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    Hi April

    Pretty name - were you born in April? (I had a sister who was born in & named April)

    I had a L5-S1 Micro-D w/hemilaminectomy about 6 mos ago. Please see my signature below for my current status on this. You will find much useful info on the L5-S1 Microdisectomy Hemilaminectomy thread #2. The original thread was very long & told many poster's stories from pre-surgery to several months post-op. You can find that long but very informative thread back several pgs or do a search for it. On pg 14 or 15 of the original there's a list of everything you need to make your home post-op ready/friendly. Please just ask me if you don't find that thread/info & I'll be happy to copy/repost the post-op list of items you'll want & also some post op exercises/instructions we rec'd from our docs.

    Are you having a Micro-Discectomy or a fusion? Is your Doctor a Neuro or Ortho?

    Much luck to you - please ask any specific questions you like - &/or read the threads mentioned above- several L5-S1'ers there - but mainly micro-d's rather than fusion.

    Laura

    ------------------
    Mar 2003:Micro-Discectomy w/Hemilaminectomy L5-S1
    Prior to that 4 mos of Sciatic pain; left side
    Herniated Disc L5/S1
    Bulging Disc L4/L5
    09/05/03: At 5 mos post-op: Doing well - requested PT -because pressure sensation in low back is not going away. Into 5th wk PT: finding the strengthening/stretching exercises are helping back tightness only temporarily, but back is getting stronger - important in supporting spine. Still have pressure/tightness/pulling sensation constantly in back, more noticeable when bending slightly fwd - believe this to be scar tissue adherance. Will pursue this with approp.doctor (?) & seek treatment if available.



    [This message has been edited by TexMich (edited 09-05-2003).]
    __________________
    10/02:Per MRI: Hern.Disc L5/S1 * Bulg.Disc L4/L5
    03/03:Micro-Discectomy w/Hemilaminectomy L5-S1 (left sd)
    08/03:PT @ 5 mos post-op for 6 wks: Results: Back & abdominal strength MUCH better - stretching exercises help only temporarily. Heavy feeling of pressure, restriction thru-out incision area post op. ~scar tissue adhering?
    To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

    11/03:Working with "Rolfing" expert to release scar tissue - Jury's still out on this procedure

     
    Old 09-05-2003, 03:09 PM   #6
    daubie
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    Welcome April. Well, there's not too much left for me to say, but I wanted to welcome you. I had a micro-d on 6/6/03 and although I still have symptoms of foot pain and numbness, I am certainly glad I had the surgery, because I know that disc fragment is gone. And I am certainly not any worse off. Hope this helps. Please let us know what type of surgery you're having, and feel free to join our thread that TexMich mentioned in her earlier post. Take care ~Daubie

    ------------------
    Car Accident 2/2/02
    Herniated disc L5/S1
    Epidurals x3, PT 4 mos, some relief
    Microdiscectomy 6/6/03
    __________________
    Car Accident 2/2/02
    Herniated disc L5/S1
    Epidurals x3, PT 4 mos, some relief, but constant foot pain and numbness continued
    Microdiscectomy 6/6/03
    9/5/03 still have foot pain and numbness but recovered fine from surgery
    1/19/04 I am 7 mos post op. I still have the same foot pain as before surgery. Doc agrees it is probably permanent nerve damage. Started neurontin this week. Still glad I had the surgery though!

     
    Old 09-05-2003, 03:22 PM   #7
    Mary Anne9998
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    Have had 6-8 years with all you have been thru, but nerotin(sorry didn't spell that right) did nothing for me. I did want to comment on the Elavil. My doctor gave that to me and I am still taking it only at bedtime. I have these whole body jerks, and it has helped with that, although if I take it too late in the evening, then am groggy the next morning. He told me it was to help with pain. And you are taking it for depression?
    800 mg ibuprofen is what I normally take and if pain is severe then Vicodin, but nothing other than the Elavil. The rest did nothing to help me. I did get samples of Bextra today, as I couldn't take Vioxx, Celebrex, or Relafin.

     
    Old 09-06-2003, 06:52 AM   #8
    TexMich
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    April

    Here's that info for getting your home ready for post op:

    -raised toilet seat
    -shower chair
    -long handled reachers/grabbers
    -handicap rails put in shower
    -long handled back brush for showering
    -shower mat so you don't slip
    -soap on a rope, or liquid soap for showering
    -extra bed pillows to prop your back up when side lying & for between knees/down to ankle
    -remove all throw rugs so you don't slip or trip on them
    -elastic shoelaces for shoes that tie, or slip ons
    -straws for drinking while laying down
    -a stack of good books, magazines,or small crafts to keep you busy
    -go to movie rental store and/or library and make a list of what you will want to watch/read during your recovery
    -if you have cable, get a couple of movie channels
    -put new batteries in the remote control
    -a walkman with your favorite music
    -have all your clothes and pjs easily accessible
    -prepare meal ahead of time and keep in the freezer
    -get paper plates, napkins, and plastic silverware so you have less clean up to worry about
    -list of emergency phone numbers close by
    -keep prescriptions close by
    -check your drawers around the house, & if they stick, use bar of soap to make them glide easier
    -re-arrange cabinets, refrigertor etc. to have the things at a height that won't cause you to bend
    -if you'll be wearing a brace, wear it for a while pre-op to get used to getting around in it
    -raise your bed on blocks for ease in getting in and out of bed
    -move your computer to your bedside so you can keep in touch with all your cyber friends(or position so you can stand & type)
    -have lots of extra cotton t-shirts or tank tops to wear under your brace.(not everyone has a brace)
    -make sure your clothes will fit over a brace
    -teach your significant other, or kids to work the washer and dryer
    -build a platform for the clothes dryer. It has been raised up approx. 2ft. I can just reach in and pull out with no strain, when I am more healed.
    -Make sure that all the liquids you drink are in light weight containers.
    -Also make sure if you have pets that you have help in feeding them or walking them if you have a dog that requires such. You should not bend over to feed and water your pets. I used a very low computer chair with wheels and very carefully leaned over to feed my cat. I didn't bend, I leaned. It was quite a trick, but I figured out how to safely do it.
    To the above I would add Ludens (to soothe your throat from irritation caused by the tube that is pushed down it during general anesthesia), satin sheets (to make it easier to move around in bed), and Johnson and Johnson First Aid Waterproof Dressing Kit (to cover the incision during your first shower 3 days post op).

    (and I'd add plenty of protein - chicken & fish to help your body repair itself - lots of your favorite beverages, fruit & soft drinks, fruits,icecreams/sherberts- whatever can pamper yourself with!)

    Also, - some posters didn't receive post op instructions- here's a copy of mine:

    Micro-Disc/Laminotomy 0-3 wks Post Op Instructions that I received:
    Bed mobility: Need to roll like a log out of bed:roll both hips & shoulders at same time in one direction to sidelying position;from this position move legs frwd off bed w/hips flexed, then use your elbow & other hand to push up to sitting position. (They offer a 3 mos course SOMEWHERE in how to do this!) (just kiddin) - (it is easier tho if the PT or nurse had showed you how in the hospital). Shoulders & hips shld move as unit always. I found by tensing abdomin it was easier to move this way. This prevents using your back to get up. Important not to twist or bend from waist til okayed by Doctor.
    Sit to Stand: Slide fwd in chair & use your legs to stand - don't lean fwd when getting up
    Stand to sit: Keep trunk straight, sit on front part of chair using legs to let you down, then slide back in chair,don't lean fwd & sit back in chair.
    Posture: Sit w/back straight against back of chair. Place both feet flat on floor. Hips & knees shld be level. Protect your back w/a rolled up towel or lumbar support.
    Sleeping: best sleeping positions are:
    On your back w/one not too big pillow under your head & 1 or 2 under knees
    Lying on side w/pillow under head & 1 pillow between knees. Firm mattress is preferred.
    General: don't twist back, move body as unit always(in bed or standing)
    don't reach or bend over to get things til cleared by Doc
    Don't lift anything heavier than a plate til cleared by Doc (no groceries, trash, small kids, etc.)
    Take lots of short walks, gradually increasing distance. Walk at steady pace that's comfortable for you. Good walking shoes - no hi heels or boots.
    Exercises: Gluteal isometrics:squeeze buttocks together & hold for count of ten
    Quad Iso's: Tighten up top thigh muscles, keep knees straight as possible, push the back of knees into bed & hold for count of ten
    Ankle pumps/circles: Point toes down then up. Repeat. Perform ankle circles in 1 direction - then the other.


    ------------------
    Mar 2003:Micro-Discectomy w/Hemilaminectomy L5-S1
    Prior to that 4 mos of Sciatic pain; left side
    Herniated Disc L5/S1
    Bulging Disc L4/L5
    08/20/03: At 5 mos post-op: Doing well - requested PT - into 5th wk now - finding the strengthening/stretching exercises are helping back tightness - but only temporarily. Back & abs are getting stronger to support spine. I Recommend PT after 3 mos post op. Started mine @ 5 mos, has not removed constant extreme feeling of tightness,pressure,
    pulling & am currently concerned it is scar tissue adhering. Looking for approp. Doctor to help me confirm this & appropriate treatment for it.

    [This message has been edited by TexMich (edited 09-06-2003).]
    __________________
    10/02:Per MRI: Hern.Disc L5/S1 * Bulg.Disc L4/L5
    03/03:Micro-Discectomy w/Hemilaminectomy L5-S1 (left sd)
    08/03:PT @ 5 mos post-op for 6 wks: Results: Back & abdominal strength MUCH better - stretching exercises help only temporarily. Heavy feeling of pressure, restriction thru-out incision area post op. ~scar tissue adhering?
    To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

    11/03:Working with "Rolfing" expert to release scar tissue - Jury's still out on this procedure

     
    Old 09-08-2003, 01:10 AM   #9
    Brooke79
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    Texmich

    Hi, I'm having an L5S1 Fusion in 8 weeks. I have printed out that list of advise post-op as one of my biggest worries will be disregarding doing things (like bending) that I have been doing all my life and all of a sudden can't do.
    Just wanted to say thanks again for the info.

    [img]http://www.healthboards.com/ubb/heart.gif[/img] Brooke
    __________________
    October 2003 PLIF for L5S1 Spondy
    May 2004 PLIF revision RHBMP2

     
    Old 09-08-2003, 10:24 AM   #10
    april1270
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    Thank you so much TexMix. What a wonderful post. That is some of the most helpful information that I have received. I printed it out and handed it to hubby when he got back in town! Thanks again and best wishes.
    April
    __________________
    Sept 16 will be surgery for L5-S1 disc herniation and fragmentation due to degenerative disease (early onset)
    I am 32 with two children and want to play with them again so I am going ahead with it.

     
    Old 09-08-2003, 11:18 AM   #11
    TexMich
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    Brooke & April

    You're very welcome! You might want to get the 'whole nine yards' or just pick & choose items you want. The list has made it's rounds on this board - we were never sure who the original list came from -but we were all thankful for it & we've added to it as well! - espec. the pampering stuff! The post op exercises were mine for a micro-d - so you should check with your doc as to if those exercises are appropriate for post-fusion- & also as to how soon after surgery you should start. I believe the walking is standard for gentle yet effective exercise - in short but frequent walks ending before you tire.

    April, concerning the neurontin - I tried that for about a wk & did not like it at all - if you feel it's not doing anything for you - I'd ask for a change. I took Vioxx for inflammation & Hydrocodone for pain - but only as needed for a short period of time. They both worked very well for me.

    One thing either of you might ask your doctor IF you're having fusion (instead of a Micro-D) is : would you be a candidate for ADR (artificial disc replacement) instead of fusion. Since I've not considered fusion or the ADR, I'm not very knowledgable about either of those specific surgeries. However, I've heard that ADR is gaining much attention & is done routinely in Germany & in trial phase here now in the U.S.A. I believe it will be a standard/common back operation within a yr or 2 here. I beleive however that once you have a fusion, you cannot have an ADR on that particular disc should the situation arise in the future. Of course, from your symptoms - it sounds like (to me) you need to address your herniated disc now before permanent nerve damage occurs, & can't wait. If you are interested in the ADR however, you can check into the ones being done during this trial in the US. They are randomized however, meaning that you have a 50/50 chance of getting either the ADR OR fusion. Also, concerning fusion info, if you're looking for more info on that particular surgery & what to expect post op, etc, you might want to do a search on this board on 'fusion'. There are many posters who've had it done. OR - start a new thread with your fusion question as the subject?

    Concerning anti-depressants, if you find after a few wks that the drug you were given is not making you feel better (& even making you feel worse!) - there are many others you can try - they are not all the same - some really do work if you need them - so I hope you don't let one bad experience scare you off from them if you need a little help for awhile to lift your spirits.

    Much luck & well wishes to you both for a very successful surgery & recovery!

    Laura


    ------------------
    Mar 2003:Micro-Discectomy w/Hemilaminectomy L5-S1
    Prior to that 4 mos of Sciatic pain; left side
    Herniated Disc L5/S1
    Bulging Disc L4/L5
    08/20/03: At 5 mos post-op: Doing well - requested PT -into 5th wk now - finding the strengthening/stretching exercises are helping back tightness - but only temporarily. Back & abs are getting stronger to support spine. I Recommend PT after 3 mos post op. Started mine @ 5 mos, has not removed constant extreme feeling of tightness,pressure,
    pulling & am currently concerned it is scar tissue adhering. Looking for approp. Doctor to help me confirm this & appropriate treatment for it.



    [This message has been edited by TexMich (edited 09-08-2003).]
    __________________
    10/02:Per MRI: Hern.Disc L5/S1 * Bulg.Disc L4/L5
    03/03:Micro-Discectomy w/Hemilaminectomy L5-S1 (left sd)
    08/03:PT @ 5 mos post-op for 6 wks: Results: Back & abdominal strength MUCH better - stretching exercises help only temporarily. Heavy feeling of pressure, restriction thru-out incision area post op. ~scar tissue adhering?
    To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

    11/03:Working with "Rolfing" expert to release scar tissue - Jury's still out on this procedure

     
    Old 09-08-2003, 02:05 PM   #12
    MarianJ
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    Hello April,

    Welcome, I have read all your reply's and just wanted to add one more thing about the Elavil. I take that medication every night, and it was not prescribed for depression for me. Elavil also known as Amitriptlyline, is also used for nerve pain. Because of having chronic pain some people also develop insomnia. Elavil is also prescribed to help you sleep. When I first started taking it I had no pain relief. It takes a couple of weeks to work. My husband was also prescribed this for the tendonitis that he has in his arm. I realize it is also prescribed for depression but I have been taking it for a while and I guess these days I feel somewhat depressed. Also remember to never abruptly stop taking a medication that has been in your system for a while, unless instructed by your doctor.

    Have you found out what type of surgery that you are having?

    I do wish you the best of luck....

    ------------------
    Lumbar MRI 10/02
    Lumbar Lordosis
    L5-S1 disc herniation with moderate thecal sac deformity.
    L4-5 disc desiccation with bulge which results in mild thecal sac deformity and mild bilateral foraminal stenosis.
    L2-3 disc desiccation with Schmorl’s nodule of L3.
    Lumbar Epidural 1/30/03
    Lumbar Epidural 2/12/03
    Lumbar Epidural 2/26/03
    Lumbar Discogram 5/23/03
    Lumbar CatScan 5/23/03
    [b]Posterior Fusion & Infuse on L4,L5,S1 6/30/03[/b]
    Cervical MRI 10/02
    Loss of cervical lordosis with reversal of the curvature.
    C4-5 and C6-7 disc bulges resulting in flattening of the ventral margin of the cord.
    C5-6 there is a left foraminal herniation which results in moderate foraminal stenosis In addition, there is flattening of the ventral margin of the cord due to bulging disc.
    Cervical Epidural 5/19/03

     
    Old 09-09-2003, 09:16 AM   #13
    ricebird
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    Dear April,

    I wish you the best with your surgery. It could make a big difference in your pain level.

    I've had two back surgeries, one with good results, one without.

    But just in case you haven't been told some things about what to expect after the surgery, here is what I have to say:

    1. Absolutely no BENDING, CROUCHING OR TWISTING of your back after surgery, no matter how good you feel.

    2. Almost no one comes home in pain these days after back surgery. Even if you have little pain after a week from the surgery, that still no assurance that your surgery has been a success.

    I don't know what they put in during surgeries these days to keep pain away, but you will not know for sure if your surgery has been a success until at least two weeks pass. If you are still pain free after that point, consider it a success.

    The problem is that often people feel so good after the surgery tha they start doing things they shouldn't. Then they go back to the doctor for the post-op and the doctor tells them, they have over done it.

    So Please, for your sake, if there is a hair dryer in a closet under the sink, have someone else get it for you. If you have something in the vegetable bin you need, Have someone else get it for you. If you have to reach for a pot under the counter top, Have someone else get it. This is crucial. Don't wait for your doctor to tell you this.

    Don't ride in a car after surgery unless it is the ride to the doctors office.

    Also there are sites on the internet about what to expect after back surgery. Just type in the type of back surgery you are having.

    In the hospital, have as many people as you can visit you the day you are discharged. They are your eyes and ears. When you are on an I.V. your account of anything happening in the hospital is of no use. The drugs being taken invalidate anything you may say about your stay. So have as many visitors as possible, even if you only stay a day or two.

    Best wishes, Ricebird

     
    Old 09-09-2003, 08:07 PM   #14
    april1270
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    Ricebird,

    Thank you for all of your knowlege and support. I am a very stubborn person when it comes to being independent so this will be a challenge for me. I have heard so many people stress the importance of following a strict regiment that I have finally surrendered myself to that. I know that I have to give up these few weeks ahead of me to have my life back. Fortunately I will have my husband home so that is a huge relief (he was deployed-in army).

    How soon after the surgery did you find that you could function without a great deal of help? I need to plan my husband's return overseas but it is just so sketchy right now.

    Thanks again and best wishes to you.

    April
    __________________
    Sept 16 will be surgery for L5-S1 disc herniation and fragmentation due to degenerative disease (early onset)
    I am 32 with two children and want to play with them again so I am going ahead with it.

     
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