6 Months Post Spinal Fusion

It hardly seems possible that it’s really been 6 months since my surgery, but I can’t deny the truth of the calendar. I’ve gone from the heat of summer, to a beautiful fall of color, to the depths of a snow packed winter. I’ve gone from walking with a walker, to a cane, to slow but deliberate walking, to the ability to walk as much as I want. I’ve gone from no lifting, bending, twisting, through a slow and steady recovery, to being able to lift what I need, bend forward and touch my toes, and gentle twists in my upper body. I’ve learned how to protect my back muscles and keep my spine stable. I’ve learned to kneel and squat down instead of bending at the waist to reach things on the floor. I’ve strengthened my hips and legs, and I’ve worked to strengthen my core muscles, the big and little ones, and I’ve worked to strengthen and stretch my back muscles and the muscles in my legs and hips. It’s been a huge recovery process, but I feel good with my process and what I can do now.

This past week I had a visit with my surgeon. New x-rays show my fusion is growing stronger, and all the rods and screws and cages are doing their job. He is pleased with my progress, and the strength and flexibility I’ve gained. He commented that it looked like I’d dropped a few pounds (yes, validation!), and that it looked like I was more comfortable. I agreed with him, and asked him about continuing restrictions. For the past 6 months I’ve been to avoid using a heating pad, and no use of NSAIDS. I’m cleared to use them now if i feel the need. I’m cleared to lift safely and smartly. We talked about craft shows, and that I am to be careful and not lifting while bending or twisting, and to keep my boxes packed on the light side. I’m allowed to walk, jog if I want (not likely), ride a bike, swim (also not likely), and do as much yoga as I like so long as I’m careful during twisting poses and don’t ask too much of my body. I’m to be careful and extra cautious in the snow and ice – NO FALLING. The fusion itself will continue to heal for the next year, but I’m right on track. His parting words to me were, “Call me if something comes up, but you MUST DO YOUR EXERCISES EVERYDAY FOR THE REST OF YOUR LIFE.” Alrighty then, message delivered doc!

The next day was my appointment with Brenda, my physical therapist. She put me through the paces and did some massage on my whole back (I was a little extra stiff apparently). She talked about challenging my strength and using some resistance along with more repetitions. She sent me home with some bands to use. She agrees with the doc’s assessment to keep doing what I’m doing, and keep adding strength challenges. She talked a lot about being aware of my body mechanics, and listening as my muscles gain strength. When you get stiff or sore, take the time to rest and stretch things out before doing more. When you feel like you need to sit and rest, do so. When you feel like you need to get up and move, do so. When your muscles get tight, use your massage stick and tennis ball to release the tension. And you MUST DO YOUR EXERCISES EVERYDAY FOR THE REST OF YOUR LIFE.

So apparently, I keep moving along and doing my exercises for the rest of my life. I knew going into this surgery that as important as what happened that day in the operating room was, that my recovery and rehab would be even more important, and a life long commitment.

My food tracking app tells me that I’ve been tracking food and eating cleanly for 47 days now. I’ve also been riding my exercise bike regularly, and working hard on my PT exercises and doing yoga a few times a week. I feel like I’m in a healthy mindset, and the doc was right, I have lost weight since the first of the year. I’m not dieting per say, but I’m also not eating crap. I’m monitoring my calories each day, and avoiding eating grains and starches, and avoiding sweets and overly processed food. I don’t feel deprived, and I’ve been enjoying looking for and trying new recipes. We have been eating a lot more fresh produce, and I know I’m feeling much better in general – I have more energy and am sleeping better too.

If you aren’t in the Pacific North West, let me share that we have been given our entire dose of winter…in a couple week’s time. It just keeps snowing…many inches in the cities, a lot of wind, and out in the hinterlands where I live – we are measuring the snow in FEET. There have been school closures, road closures, and when you do get out and about, the roads have been a mixed bag of snow covered, slush covered, clear, and drifts. Don’t get me wrong, it’s beautiful…but I’m tired of it. The closed the university for a day last week, and we had late start another day…and those things hardly ever happen. It’s been several years since the last time it happened.

Last weekend the snow created all kinds of havoc. Wind gusted snow across the roads creating white out conditions, and drifts accumulating in the roads. It just wasn’t safe to travel out of the cities. After a series of messages between our pastor, the elders in the church, and myself, and a bit of prayer – I was asked to not only lead our service because our pastor couldn’t make it down, but also to deliver the sermon. I’ve had to do this before due to weather, but she wrote the sermon, and I just read it. This time, she and I spoke at length, and her sermon wasn’t a good fit for me to deliver. God has been pushing me recently to step out of my comfort zone more and more. So I spoke to my pastor about a sermon idea I had. She approved of the direction I was being led, and I sat down Saturday evening using a sermon outline another pastor had written, I wrote a sermon on the Power of Prayer. I used my lovely new bible to find appropriate scripture references, and listened to my heart as I was writing. I sent it to my pastor to look at, and for any last minute changes, and I went to bed.

Sunday morning I got up and ready for church, printed the bulletin that Pastor E had sent me, read her words of encouragement, and printed my sermon notes. My little country church congregation was lovely and supportive as I not only lead our service, but delivered my first official sermon. I went ahead and recorded it with my phone, to send to pastor, and a few close friends. After prayerfully considering my options, and the motivations behind them, I’ve decided to share it with you as well. May my words truly bless you.

Power of Prayer

A Graceful Rehabilitation

I’ve been thinking I need to give an update, let you all know how the rehab is progressing. The change of physical therapist has been good. I’ve been able to switch things up and make some real progress. I’ve seen Brenda 3 times now, and have been doing my home exercises and when I see her each week she works on something else.

The first week was that darn IT band and trigger point massage in my hip and glute, and using my roller massage stick on my hamstring and the IT band itself. The incredible tenderness has diminished, and the tension has released significantly. I continue with stretches and work to build balanced strength. It’s clear it’s all working, as my SI joint is much more stable, my pelvis aligned, and the IT band isn’t holding so much tension.

The second week, she worked the soft tissue in my hip and then put me through the paces on the Pilates Reformer – doing a lot of core work and leg work. More stretching and a reminder to keep the rest of my spine above the fusion mobile. While we want good stability around the fusion, we want strength and mobility in the rest of my spine.

This week when I saw her, I asked her to help me trouble shoot the left foot nerve pain. We went through what I have been doing at home, the stretching and “neural flossing” and she did a body mechanics assessment. She had me make some small changes to the way I had been doing the neural flossing, and focus on a couple different ways to stretch and work my ankle and foot. With some soft tissue work – more trigger point massage- in my calf and ankle area she helped release some tension, which should help that nerve to glide more freely. I’ve had to do some home massage and really work at the hot spots – so as it heals from the massage work, the hope is that the nerve will glide smoothly and that annoying nerve pain will diminish. Again I’m in a work it hard for a couple days, and let it rest and heal a day or two and then go back after it for a couple days. Hopefully soon I’ll see some progress.

I feel like I’m at a point finally where I’m really ready to go at this rehab and recovery thing on my own. I’m glad I’ve pushed to continue with the physical therapy past the initial 6 week protocol. I’ve needed to work through problems that have developed as I’ve healed – the SI joint, the IT band, the nerve in my left foot – all the while continuing to retrain muscles to support my spine. I’ve been careful, but I’ve also pushed myself in rehab. I didn’t want to just heal the incision and let the bone heal – I wanted to really rehab my body to get back to a place of strength and stability that I haven’t had in several years. I wanted a new lease on life, so working on healing and rebuilding strength has been important to me – a full recovery. I’m so thankful that I have good insurance and the ability to take the time to recover that I’ve needed.

I see my surgeon again in February – almost exactly 6 months from my surgery. That’s about when my physical therapy “prescription” runs out again. I feel like I can see the light at the end of the tunnel, like my recovery and rehabilitation has been a success, and that I will back to myself and my “pre-fusion” activities soon.

I’m looking at spring and summer craft fair dates, and feeling like I am physically able to do the work of setting up and tearing down shows. I need to spend some time making soap in preparation for that – and I feel like I’m physically able to do that too. I have to admit, there was a time when I was wondering if I would be able to get back to the soap biz – so it’s a very good thing that I’m feeling like all my hard work in rehab has been worth it!

I’ve been consistent for over 3 weeks with clean eating and exercise. I’ve been taking my vitamins and supplements every day and doing everything I can to fuel my body well. And I’ve been giving myself grace to just live a little too. I have found the balance that has been lacking for a while in my life.

Oh yeah…and it was recently my baptiversary – so I treated myself to a new bible and bible cover. With my focus on women’s ministry I have been doing a lot of bible study on women in general, and leading our local Ladies Night In ministry – so I wanted a bible that would help me do that. One of my favorite blogs put out a devotional bible recently, and so I treated myself to one. It’s visually a beautiful bible, but it’s also chocked full of reading plans, devotionals, and highlights over 50 women of courage. I’ve really enjoyed skimming through it and prayerfully considering which reading plan I wanted to start with. As usual, God had a plan and led me right where He wanted me to be.

Stability

As any healing journey progresses, you have highs and lows, hills and valleys, starts and stops – but the goal is stability.

Tomorrow marks 4 months of healing from Spinal Fusion surgery.  Overall I feel pretty good.  I’m off all the muscle relaxers and pain pills, and I rarely use ice packs now.  I do physical therapy exercises every morning, and add in gentle yoga routines most days.  I do as much walking as possible, but now that the weather has changed, it’s not safe to be walking outside – nor is it warm, for the record!  I need to establish a routine to get some time in on the spin bike a few times a week, but finding a consistent time is always a challenge.  

I saw my surgeon two weeks ago.  He says I’m doing great.  He will see me again in February, and then probably, I won’t need to see him again – it will just be my regular primary care doctor.  I did talk to him a little bit about the nerve pain in my foot – but nerves are slow to heal, and what I’m doing with physical therapy does seem to be having an impact.  I also talked to him about the movement and shifting in my pelvis and specifically the SI (sacroiliac joint).  He poked and prodded, and offered to do a cortisone injection into the joint.  We talked about extending my physical therapy, and about my recovery and rehabilitation in general.  I opted to not have the injection yet, and to see if more physical therapy will help stabilize it.  He agreed to the conservative approach, and approved another 6 weeks of physical therapy.  

In the past few weeks as I’ve increased my activity level, and done more and more muscle work for both flexibility and strength – essentially loosening up the crazy tension I was holding for so long…we’ve created a bit of a stability issue.  My body is learning how to move with and around the spinal fusion.  As I move and rotate my upper spine – my back pops a bit as things realign and adjust.  This isn’t causing any problems, but it is an indication that my muscles aren’t as tight (from chronic pain), and as they loosen, those joints can actually shift around and go back into alignment on their own.  I’m not concerned about the upper spine pops, nor is my physical therapist and surgeon.  But as I am moving, stretching, healing more an more – I am getting some popping and shifting happening along side my sacrum(that is now fused to the vertebrae L5 above it), through that SI joint which leads to a misalignment in my pelvis and hips.  Also the pops and shifts are the tissues themselves making noise – and creating a bit of inflammation. 

So…we are focusing almost all our attention during PT now on stabilizing the sacrum and pelvis through deep core stabilization.  We are backing off on some of the strengthening and flexibility in the big muscles (hips, glutes, thighs, etc) to focus on the inner most deep core stabilizing muscles – transverse abdominal and the multifidus.  Hopefully this step back to work on the less obvious muscles will give me the stability that we are after.  I also have to pay very close attention to body alignment.  No side bending; no twisting while reaching; feet, knees, and hips always squared up; no rotation unless hips are square and core is engaged. I need to really reign in my movements until we have the stability back on track.  

I’m finding myself in a valley, but with a clear path lined up to get me out of it. Three steps forward, and 2 steps back.  But no one said that recovery from spinal fusion would be easy!

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