Tag Archives: Stenosis

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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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5 Months post Lumbar Fusion

6 screws. 3 rods. 2 inter-vertebral cages. That’s what’s been holding my spine together for the past 5 months. I’m well on my way to a good solid fusion, my bone growth is good. My muscles have reattached, and I’ve worked to strengthen muscles I’ve ignored for years – probably decades. I’m feeling pretty good overall, and I’m working on the areas that sneak up and bother me. I’ve been in physical therapy for 12 weeks now, and am looking at another 6. Rehab and Recovery is WORK – but it’s also working.

My physical therapist Danielle has left now – to be a momma to a 2 year old boy they are adopting from another country. I’m thrilled for her, and we talked a few times about bringing him home and how excited (and nervous) she is about it. I never did ask her why she went the adoption route, but I know she doesn’t have any other children. Whatever her reason, I’m just thrilled that this dream is becoming a reality for her!

So Danielle left to be a mom, and I got referred to another PT in the clinic, Brenda. I worked with her one of my first visits, but I felt it was a good opportunity for fresh eyes and to talk about my current symptoms and see what adjustments we might need to make. She reviewed my chart notes and did some assessment and moved me around and watched me move. She is comfortable with how my spine is healing and how I’m moving around the fusion. My deep core work is keeping the fusion and my spine in general supported and aligned. My pelvis and the pesky SI joint was a little out of alignment, so she worked to line me up better, and doing so, she found that my Iliotibial Band (IT Band) is inflamed. It runs from the hip to the tibia along the outside of the leg, and helps to support the knee. What I had been attributing to sciatic inflammation on the right side (and had me quite concerned actually) is actually a muscle pain memory – and caused by the inflamed IT band – not the nerve.

So, our focus is now to change the muscle and pain memory. We are working to heal the inflammation in my IT band and then work on my body mechanics to prevent it from flaring again. Remember me talking about bossy muscles before? Well, that’s what’s going on again. My hamstring is trying to compensate for what my hip and glutes should be doing. My pelvis is out of whack making the SI joint inflamed, and so then I move wrong and cause new problems – like an inflamed IT band. IT band injuries are often attributed to running injuries – overuse when there is a bio-mechanical misalignment. I’ve done that in spades…so time to work on releasing the IT band and hope that allows me to work on continued strengthening in my hips and glutes.

So…how to release the IT band – well trigger point massage is the best way, but let me tell you…it’s NOT fun. Brenda used a torture device and really massaged where the IT band connects to the tibia (outside top of the calf), and along the edge above my knee where the hamstring connects. I don’t remember what she called it – but that’s probably because I was gritting my teeth and trying not to hyperventilate. She also did some work on my hip, with the trigger points as well. We talked about home care and how to continue working on the IT band. I have a tennis ball and a wall – and I lean into the hot-spots in my hip and glute and through direct pressure and tiny micro movements, I am working to get the tension (aka nearly cramping they are so tight) out of my muscles in my hip and glute. I also have a “massage stick” that I use to roll massage along the outside of my thigh and search for and find all the tender hot spots along the IT band and hamstring. When I find a hot spot, I stop and put direct HARD pressure on it, and slowly roll off of it. It’s not fun…I suck a lot of air through clenched teeth…but hopefully it’s doing the trick. Kind of like a begging toddler – you just irritate it, nag it, and keep after it constantly until the muscle gives up and relaxes. It’s still very, very sore – but the memory pain of the sciatic nerve that I thought was going on, is diminishing. So that suggests that what I’m doing is helping.

I’ve also been doing massage on my left foot – the one with the nerve pain, trying the same theory – lets see if I can irritate it into healing through persistent massage. I’m also working on ankle stretches, because as Brenda put it, “On the spectrum of flexibility – you are quite stiff. Your joints don’t move enough to be able to stretch the muscles that are tight.” Um…thanks, I think. So ankle stretches a couple times a day has been added to my PT rehab plan.

Since my last post I’ve been doing well with eating clean and with tracking my calories. I’ve reigned in most of my bad food habits. I’ve set up a routine of riding my exercise bike each day and have worked hard to move more in general. The scale has appreciated my efforts. I’ve also gotten much better about taking my supplements each day. I think all these things together are working to help me feel better not only physically, but emotionally. The whole adage of garbage in= garbage out is so true. When I fuel my body well, both nutritionally and with exercise and movement – the results are always better. So that’s my words of advice for all of you – treat your body like a temple. Be respectful and humble, know your limits – but push them a little too!