Tag Archives: Spondylolisthesis

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One Year Post-Op Spinal Fusion

I’ve been thinking about this post for a while now. For obvious reasons, it’s time to update you on how my back is doing, but I’ve also wanted to just kind of catch you up on life in general.

So a year ago today I was in Post Falls, Idaho having surgery. I woke up after surgery the proud recipient of 6 titanium screws, 3 rods, and 2 intervertebral cages and a 6 inch incision. Oh…I also had a small drain and a catheter in. Within a few hours they had me up and out of bed and walking (ok shuffling) down the hallway. Overnight they transitioned me from a morphine pain pump to oral pain killers – and made me get up every few hours and walk. Early the next morning they took out the catheter and I had a visit from the physical therapist who showed me how to put on the back brace and made sure I could walk without assistance and go up and down stairs. I was taught how to “log roll” to protect my new spine hardware – and minimize my pain – everything had to move as a unit – knees, hips, and shoulders all at the same time. I stayed a second night in the hospital and the next day I had the drain pulled out and was able to take a shower before getting dressed in my own clothes and headed a few blocks away to stay at my pastor’s home for a few days before I headed back south to my own house.

So the biggest question I’ve gotten when folks hear I’ve had spinal fusion is, “What did you do to your back? Was it an injury or car accident? ” Nope – it’s just me and the way my joints wear out. I’ve probably had a few muscle injuries over the years – pull a muscle moving hay or whatever – but I didn’t fall off a roof. I wasn’t in a car accident.

I have a condition called Mayer Rokitansky Kuster Hauser Syndrome (MRKH) Type 2. I was born with an incomplete reproductive tract – missing my uterus, cervix, and the upper 2/3rds of my vaginal canal. I have a pelvic kidney, mild scoliosis, and all the joints in my body tend to wear out quickly. Over the years I’ve had surgery on both of my shoulders, both of my feet, and now my back. In all cases, there was considerable damage to the cartilage and the bony structures of the joints themselves. For my back specifically I had advanced degenerative disc disease, paired with spondylolisthesis, and stenosis. Basically that means that I had two vertebrae that had slipped out of place causing bone on bone contact – creating arthritis and narrowing of the canal where the nerves and spinal cord pass through, and it destroyed the discs. I had pinched nerves causing issues of sciatic pain primarily on the right side, with numbness going all the way down to my toes. I had spine and hip/pelvic pain on both sides with daily muscle spasms that I just sort of lived with for years.

So after an MRI and a visit to the top spine specialist in the area, I was scheduled for surgery. I am now fused from L4-L5 and L5-S1 – so my sacrum between my hip bones and the two lowest vertebrae are all now fused together with screws, rods, all the bone that grew together.

Over the course of my recovery I’ve had a few struggles and set backs, as you might expect – but at the end of the day I’m glad I had the surgery. I am walking everyday, and I do yoga during the week – continuing to rebuild strength and flexibility. I have to work specifically on strength and support in my core – deep core muscles to support the spine specifically – while I’d like to have a flat toned tummy – that isn’t my priority. My priority is having strong and balanced muscles that keep me healthy and my spine supported – which is more than a 6-pack abs package…it’s deep pelvic floor muscles, it’s strong and flexible hips, its the glutes and hamstrings doing their part, and it’s flexibility and mobility in my upper back as well. It is a well rounded and planned out series of routines that keep my whole spine and body in good shape. I still struggle with the stability of my SI joint specifically because it wants to take over the mobility that my spine lost. I have to remind myself to move my hips with my waist and use the deep pelvic muscles to keep everything moving as a unit. It’s the twisting movement that gets me in trouble. My lower spine just doesn’t articulate anymore, and so I have to turn ABOVE the fusion, and keep my spine square within my pelvis. What tends to happen now if I’m not paying attention is that I turn further than my spine is capable of, and so the lower spine where it’s fused tries to turn and “displaces” itself out of the pelvis. My hips/pelvis must stay straight and square and my turn needs to originate basically at the rib cage. When it comes to my workouts, I have to work specifically the glutes and hips to keep the pelvis strong, and not just my abdominal core. It’s been an interesting challenge and change of mindset. But let me assure you, my body tells me when I’m not following the rules – having my SI joint out of whack is no fun – but I’m learning what to do to help ease it back into place – and more importantly what to do to help prevent it happening in the first place (aka do your therapy and pay attention to how you twist!!)

Along with the daily walking and yoga and core work, I’ve also worked very hard to fuel my body in a much healthier way – I’ve cut out all artificial sweeteners, and focus on lean meats, lots of vegetables, some fruit, and limited starches and whole grains. Sure, I still eat the occasional sweet treat – but I feel better when I eat better and do my exercises. I use a step & activity tracker on my phone, and I track my calories everyday too. Each day I take a handful of supplements – a multi vitamin, calcium, glucosamine, chondroiton, MSM, Vitamin E, and collagen – and I drink as much water every day as I can. My goal, and my doctor’s goal is to try and keep my body and specifically my joints as healthy as possible to avoid more surgeries. Bottom line, I’m glad I had the surgery on my back. It wasn’t a walk in the park – but it has made it possible for me to be much more active and pain free than I was a year ago. This recovery process has taught me patience, resilience, and as funny as this might sound, it’s taught me about direct consequences. Just when I think I’m fine and should be able to whatever I want – my body reminds me that nope – you can only do what you are CAPABLE of doing. That’s not to say that I don’t challenge myself – but just that I have limitations that are reinforced with titanium – and recovery is a long slow road.

Kind of like life, right? We aren’t here for just a moment, we are here for a lifetime. We have opportunity every day to glorify God – to allow His light to shine through us and onto those we encounter each day. So smile! Hold the door open for someone. Wave at a child. Tell that young girl she is beautiful. Visit a friend in the hospital or nursing home. Pray for someone. Share the good news of God and His Glory that is waiting for each of us, and God promises us it will come to those who believe and trust. How have you been a blessing to someone lately?

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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.

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Hills and Valleys

Happy New Year! Welcome to 2019 and all the opportunities it presents!

This past month of healing and rehab has been challenging. I’ve been fighting with my SI joint, working on core strength, and trying to live my best life. But I must admit…it’s been a bigger challenge than I’ve maybe let on. And honestly, I’ve been feeling a bit sorry for myself. Post-surgical depression – it’s a very real thing – and a normal thing, and to be expected.

I had a major surgery – I intentionally broke my back and have had to heal. I’ve got screws and rods holding me together, and bone that is knitting itself back together. Muscles were cut, nerves were moved aside to do the work that needed to be done. I’ve got a six inch long incision to commemorate the event. I spent nearly 2 weeks hardly able to lift myself up out of a chair. Sure, I had pain before surgery – that’s what we were trying to fix – but I spent a good month in pretty intense pain as I healed. I lived on an ice pack and moved oh so carefully for weeks.

I’ve been walking since the day of my surgery – only a few steps at first – literally enough to get me from the bed to the toilet and back. And it wasn’t long before I was walking more to cut the muscle spasms and get the blood flowing to help ease the pain. Up and down the hallway, round and round I went. I gradually worked up to walking outside and down the driveway. Over the weeks, the walking increased as I healed. I traded the walker for a cane, and eventually gave up the cane too. I moved easier and easier, and increased my stamina to where I could easily and pretty comfortably walk a mile or more. With the increase in circulation, and healing in general I got off the pain meds and eventually the muscle relaxers too. I finally disabled all the medication alarms on my phone, so I wasn’t interrupted constantly. I felt like my life was returning to normal.

A new normal anyway – one that involved physical therapy and a rehabilitation process. I’ve gotten some of my flexibility back, definitely gained some strength, and we’ve been working on retraining different muscle groups. So much of the last 10+ years, I’ve relied on the strength of big muscle groups – and have lost muscle tone and strength in the smaller muscle groups that support everyday movements and specifically the spine. My quads and hamstrings were doing the work of moving my legs, and the hip muscles were letting them. My para-spinal muscles were holding me upright and taking the strain of lifting instead of having my deep core muscles hold me up and stabilized, and letting my legs and hips lift. I’m having to re-learn all the right body mechanics to support everyday life. I also now have a spinal column that doesn’t move the same as it was designed to.

I bend at the hips, not the waist. I don’t twist at the waist either. My pelvis must stay square and straight, and my spine above must maintain neutral spine position so as not to stress the lowest vertebrae nearest my pelvis. But I’m not a stiff board either (or I shouldn’t be)- I have to be able to flex and bend and twist throughout my mid and upper back. My shoulders need to move and flex and bend, my rib cage needs to move around – all while keeping my hips and pelvis straight. It’s working on those lower deep core muscles that keeps that straight and steady while allowing more movement above. So while I work on transverse abdominal strengthening, I also have to work on loosening up my upper spine and rib cage.

As the weather here in North Idaho has changed to welcome in winter snow, I’ve had to adapt my rehab routine. No more walking the driveway for exercise – it’s too slippery, even with Yak-Tracs on. I can’t walk casually and relaxed – I’m too tense. I don’t have a treadmill at home – although I think I would actually use one if I did. I thought that I was getting enough walking in just by “doing life indoors” but it’s become clear that it hasn’t been enough. I’ve been doing my PT exercises and stretches in the mornings each day, but as you know if you’ve been following my last few posts – I had to back off some of the yoga and other stuff I was doing to try and calm down my SI joint. It worked…mostly. My SI joint is more stable, and the core work I’ve been doing seems to be helping with that….but I took the “rest and recuperate” a bit too seriously, and got lazy. And my reward for my laziness is weight gain, inflammation, stiffness, and yes…pain.

I was feeling sorry for myself. Frustrated at slow healing with a couple of set backs. It was the holidays and so I ate my feelings into submission. Bread, cookies, candy, you name it. I drank more wine, I ate more mashed potatoes and gravy, rich holiday decadent meals – you name it. I’ve always been an emotional eater, and I’ve always had to pay attention to what I eat and the effects of stuffing my face to soothe my emotions. But I let it get the best of me. I wasn’t feeling great, and I wasn’t dealing with my emotions much at all. So I ate caramels, chocolate, toast with butter, and drank more wine. It’s my standard coping mechanism.

Truth be told, I knew exactly what I was doing. I’ve known for months – probably the last 2 years actually – that I needed to reign in the bad food habits. I’d been watching the scale slowly creep up little by little. But dang it – my life has been a stressful mess for a while. Add in back surgery and rehab – and this girl was in a full on pity party. A few months back I really started thinking about cleaning up my eating – thinking through which diet plans and nutritional information I could buy into. I thought back to what I’d tried in the past, and how successful each attempt had been. And I though about all the things that derailed me over the years. I was deep in research and reflection mode – but not yet ready to really jump in and take control.

Until now. New years day often results in resolutions – eat better, lose weight, exercise more – it’s all cliche really, why does one day on the calendar make it “the day” to start fresh. Marketing at it’s finest. Every business out there capitalizes on the new year in some way. A weekend of watching nutri-system, jenny craig, bow flex, and peloton commercials – and ads on the internet for different diets, exercise routines, supplements, shakes, and whatever are sure to make you think about your routine and wouldn’t it be smart to start fresh in the new year. Marketing genius I’m telling you! But that wasn’t what got my attention and spurred me into action. It was 2 things. Getting on the scale and seeing a number that was ugly but full of truth, and a visit to Physical Therapy with talks about inflammation and winter activity level and set backs – the hills and valleys of recovery and rehab after surgery.

Yep – I’d lazied myself into a mess. I need to move more in order to move comfortably. I need to reduce inflammation caused by sitting around and eating too much. I’m asking my compromised and healing body to carry around extra weight, and my choices about what I’m eating is causing inflammation of not just the fat cells. I was trying to get away with doing the bare minimum…instead of doing all I can to heal my body and my mind. It was the jolt I needed to get back on track. Hard core evidence of poor choices equals poor health.

So I took several steps in the positive direction. I downloaded my fitness pal again and put it on the home screen of my phone. I went home and set my alarm for 20 minutes earlier in the mornings. And I made a commitment to clean up my eating that resulted in a shopping trip to get good stuff back in the fridge and allows me to plan some healthier meals that don’t involve mashed potatoes and gravy. Yesterday I had my first clean eating day in MONTHS. When my alarm went off this morning, I crawled out of bed and headed for my exercise bike. I did 10 minutes on the bike, and then did 20 minutes of my stretching and core work. I’ve iced my back to reduce the inflammation around the nerves twice today. I packed a healthy clean lunch and snacks for today, and I’ve tracked my food so I have a clear idea of what I’m eating and how it’s affecting my nutrition.

My main goal is to get my body strong and healthy. This means I will move more and eat better. A pleasant side effect will be weight loss. But I also know that when I fuel my body well, and move my body well – I also FEEL better about myself and that ultimately will set me up for the best possible me this year and in the years to come.

Have you heard this song before? If not, take a good listen. It’s been on my mind a lot the last few weeks, and I hope it will encourage you and remind you that God is with you through all the Hills and Valleys.