3 weeks post op

I’m starting to recognize that this recovery is a whole lot of ups and downs – 2 steps forward one step back.  Although, I also recognize that I am constantly  making small adjustments to what I’m doing.  While I do mostly have good days, it is the overnights that prove the biggest challenge.

First off…overnight I’m in one of two positions in bed – flat on my back with pillows under my knees  – or on my right side with knees bent, pillows between my knees and feet, and a pillow behind by back.  When I’m on my back, it’s pretty easy to keep the ice pack right where it needs to be, but after a couple hours the ice pack is no longer ice – it’s body temp.  When I’m on my side, the pillow behind my back is both for a bit of support – but also to hold the ice pack in place.  It’s the best I can do, but not the most effective for keeping the ice in place.  And of course, again it’s the melting factor.  So I’m also up several times a night.  I get stiff and uncomfortable no matter the position after a bit – and inevitably the cat wants to sleep on my feet or something which doesn’t help matters at all.  So I get up and pace the hallway to loosen up the muscles – stop at the bathroom since I’m up – pace some more – get a fresh ice pack, and back to bed.  I’m blaming it mostly on back surgery – but a 15 year old cheap mattress doesn’t help the situation I’m sure.

Inflammation is still an ongoing management issue as well.  During the day I walk quite a bit – which helps to keep the blood flowing and reduce the inflammation – or encourage it to dissipate anyway.  I do a lot of walking to the mail box and back – a couple walks in the morning, a couple in the afternoon, and one in the evening as it’s getting dark out.  If I’m in town at the winery, I take a longer walk around town every 2-3 hours.  My fitness app says I’m getting between 4500-8500 steps a day depending on what I do.  My surgeon wants at least 5000 right now.  I’m also supposed to ice my back frequently and for at least 20 minutes each time.  I try and be good about sitting down every hour or two to ice.  It’s actually a good pain management strategy too, as it decreases inflammation and increases blood flow.

My surgeon wanted me to wean off the back brace so that my muscles will gain strength.  I’m mostly off of it now – although I have been wearing it when I drive “just in case”.  It gives me just a bit of extra support as I gain confidence and get more comfortable with how to get in and out of vehicles without straining muscles or twisting my spine the wrong way.

My surgeon also has me weaning off the pain pills.  I’ve managed to reduce them to half doses every 6 hours (down from full doses every 4 hours) – which conveniently coincides with the 6 hours between muscle relaxers and the 6 hours between doses of OTC Tylenol.  I’m feeling pretty good at this level, and may start dropping the daytime doses and see how that goes.   I’m still only 3 weeks post op from major surgery – and the phrase my surgeon used was “First, you need to rest, Second you need to Ice, Third you need to walk, Fourth you need to do-but not overdo. Listen to your back.”  Seems like solid advice to me, and as I’ve said before, he has a great success rate with his surgeries.

Healing takes time and work….and rest.  But I do feel like I’m doing so much better, able to do most things around the house, and concentrate enough to do some telecommuting and help out with other projects for the winery and a few church deacon things too.  I’m trying to stay positive and be a good patient who follows directions!

Follow Up Appointment Day 18 Post Op

It’s  been a busy few days – I’ve been to town a couple of times. My parents, Uncle, and 2 Nephews all stopped for an overnight camping visit – and I had my post op follow up with my doc.

So let’s back track – Day 16 I ventured into town (25ish miles) for x-rays and groceries.  My mother-in-law came and picked me up with all my “stuff”.  Pillows, cooler bag with ice packs, bag of medications, water bottle, cane, back brace, wallet, and the discharge note from the doc saying get x-rays please before your followup.  Well, turns out I was early and the docs office hadn’t sent the “order” down to the hospital yet, so the nice lady called up to the docs office and took my phone number and said hopefully they’ll get that to us soon.

So, back to the car, and we decided to go do our grocery shopping trip while we waited for the call back.  I hadn’t been shopping in probably 3 weeks, so the fridge was pretty empty.  I managed to get through the shopping experience without too much difficulty.  But remember, I’m not supposed to lift anything over 5 pounds.  I did pretty good I think – but by the end of it…I was tired…ready for a pain pill…and some lunch.  Mom in law had a bunch of stuff too, so we got it all out to the car and loaded in the back.  As we were finishing up the hospital called and said I could come get my x-rays.

Back to the hospital, checked in, and got called back for my x-rays.  It was the same tech as before my surgery, and so I sweet talked him into letting me take pictures of the x-rays too – he laughed at my nerdy-ness but let me.  I wasn’t really surprised by them, I mean I’d googled plenty of pictures of spinal fusion x-rays – so I knew pretty much what to expect, but it was kinda cool to see it with my own eyes.  But…I wasn’t quite sure what I was seeing, and wanted to confirm with my doctor before I shared them.

We finished out our trip to town with A&W root beer and burgers, and headed home.  Unloaded groceries and I then blissfully sat down with some ice and just relaxed – probably dosed off for a bit – for the next couple of hours.  Fixed some french dip sandwiches for dinner and went to bed – exhausted.

Going to town is more tiring than I expected.  Not sure why exactly, but it is.

When I got up Wednesday morning, while making coffee, I got a text from my mom.  They were leaving Anaconda, MT and headed our way.  Whoops…I thought they were coming on Thursday….oh well – they would be here in 8ish hours.  I did some light housework that didn’t require me lifting anything over 5 pounds…and tried to rest and ice throughout the day.  We had a great visit, mom and dad made us a simple but yummy dinner, they were impressed with my mobility 17 or so days after spinal fusion, and the boys…whew….well behaved…but go, go, go….always doing something.  Bella enjoyed the distraction and people to play ball with her!!  Silly dog!  We all headed to bed about 10…and yep….I was TIRED.  This healing thing apparently takes a LOT of energy.

Got up and made coffee, walked the driveway to get the blood flowing, and visited with everyone for a bit on a crisp Idaho morning.  Uncle Steve got started on breakfast (BACON!!!) and visited with an eye on the clock.  Had a quick breakfast with them, and then it was off to the shower for me so I would be ready with mom-in-law showed up to chauffeur me to town for my doc appointment.  Got me packed up with ice, pills, pillows, back brace, cane, wallet, etc.  Gave hugs and kisses all the way around – and off we went to town.

Doc was pleased with my progress.  He pulled the mesh off my incision, and proclaimed it looked perfect.  I can’t see it without a mirror, so I’ll take his word for it until I can examine it nekkid in the bathroom mirror – or convince someone to take a picture.  Ever tried to take a selfie of your lumbar spine???  Yeah…I wouldn’t recommend it…LOL

I am supposed to continue to rest – healing takes energy.  I’m supposed to walk lots – I’m doing about 5000 steps a day, but am supposed to listen to my back and DON’T OVER DO IT.  It’s time to wean off the back brace – so that my muscles can get stronger.  Continue to ice every hour if possible, again, listen to my back – don’t over do it.  Continue to wean off the pain meds too – but be smart about it – no points for being a hero in pain.  I’m not at risk for worrying about liver damage or becoming addicted – healing takes time, and pain slows down progress.  I asked about transitioning to tylenol and he strongly encouraged it, but to pay attention to the 4000mg per day dose – as I taper back on the pain meds, I can take more of Tylenol – but he again assured me – I’m young and healthy – stay ahead of the pain, be smart, and listen to your back.  Rest.  Also, stay on top of the muscle relaxers – they will be the biggest help through this transition.  What I’m feeling nerve wise is totally normal, and should continue to diminish each day.

We talked about my returning to work….he would really like me to rest as much as possible, but understands that most folks need to get back to work.  He has asked me to take an additional week off.  He also issued me a handicap permit so that I can park closer to my office on campus for the next few months.  Bottom line, I need to be on light duty, very limited lifting, bending, twisting in the work place for at at least another month.  Thankfully I know I can continue to tele-commute some, my boss is being great about that.

My final conversation with him was the nerdy part – what did he actually do, what am I seeing on the x-rays?  He started out sarcastically (making me laugh), telling me about positioning and draping in the OR – but finally got down to the actual surgery part.  He cleaned out the damaged disc tissues and cleaned up the arthritic bone changes between L4-5 and L5-S1, and used “cages” as spacers and then filled in with bone material.  You can kind of see the  cages a bit on the x-ray but I wasn’t for sure.  He also placed 6 screws, 3 on each side, plus 3 rods – 2 vertical and one horizontal as a cross brace.  Bone material was placed all around the area too – kind of like packing it around all the hardware like putty – and it will ultimately fuse to the bone in the vertebrae to create a solid mass of bone in that area.

In 2 more weeks I am to start the exercises he gave me in the “Back owner’s Manual” – some simple stretches in preparation for actual physical therapy.  For now…just walk, control pain and muscle spasms, REST and heal.  I’ll follow up with him again on September 25th.

So here are the post-op x-rays of my back….

   

It is expected with this new stability in my spine that I will continue to have diminished nerve pain, diminished arthritic pain, and be able to physically do more.  Walk more, stand more, exercise more, and just generally just be back to my normal self.  It will happen, I just have to be patient and let the healing take place.

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Day 14 Post Op Spinal Fusion

It’s been a couple of good days – each day just a little better than the day before.

Friday (day 12) I called my doctors office to see about making an adjustment to my meds to help me avoid having my hips and butt cramp up in the middle of the night.  I know it’s been related to the inflammation at the surgical site, and that it takes time for the nerves to stop being so pissed off…but when it makes the  hours fro 2:30am to 5am absolutely miserable, the worst in a 24 hour period…it seems like there should be something to be done about it.  After they consulted with the surgeon, they adjusted the meds I was taking for muscle relaxants, and added another round of steroids to help get me over this hump. Since I’ve been feeling so good during the day, it seemed like a reasonable request.  I adjusted meds Friday night and Saturday morning, and things were looking up.

Saturday (day 13) I had gotten a bit more rest, no complete cramp relief, but not pain scale 8-9 cramps for 3 hours in the wee morning hours…so I was happy.  I got up and made plans to go to the winery for a while.  I packed up pillows, ice packs, walker and cane, meds, and my mom-in-law came to pick me up.  I got settled in, and soon started the visits from friends I hadn’t seen in 2 weeks.  It refueled my soul…visiting with people I care about, and seeing the love and help they offered to me and to my hubby while I recovered – it was a good day to feel much better and to heal.  I walked around town a few times, feeling pretty good.  I even stopped for a quick visit with a friend who had hip surgery on Monday.  The change of scenery, fresh air, and friends did me a whole lot of good!  Hubby brought me home, and we reheated some lasagna from the freezer, had a nice green salad, and a few pieces of homemade bread that was gifted us a day or two before.  It was delicious and a fine end to a good day.  I changed into jammies, did my evening bathroom routine of braiding my hair, washing my face, brushing my teeth, and headed with all my paraphernalia to bed.  I’ve been starting on my side for a couple hours in the bed, and then moving to the recliner to finish out the night.  I dosed until the 10:30 alarm to take the stronger muscle relaxer and a steroid pill….took those, and off to sleep I drifted.

Sunday – I woke up at 3:15am and realized I had slept a full 5 hours…and apparently shut off my 11:30pm pain pill alarm.  And I wasn’t in screaming pain….as my groggy self woke up, and I log-rolled myself into a seated position to assess my situation.  I was kind of achey – but not really in pain…but goodness I needed to pee.  I was trying to decide if I needed a pain pill before actually getting up – but decided nope.  So I put the back brace on…got up and into the bathroom to empty my bladder.  I still wasn’t quite awake, but looked at my alarms and was due for a pain pill at 3:30 – and a muscle relaxer at 4:30.  I could feel the need for the muscle relaxer for sure….but managed to get all my stuff moved into the living room and the recliner – pillows, meds, fresh ice pack, water in the bottle, lights off in the bedroom and bathroom.  I then just paced the hallway quietly waiting for the 3:30 pain pill alarm.  Took the pill, and settled into the recliner in hopes of dozing again until the next alarm.  It took a while for the pain pill to work it’s way through my system, so I did some more pacing and a bit of massage and stretching my hips and hamstrings while waiting for the 4:30 alarm that would allow me to add a muscle relaxer to my system.  Got settled into the chair, moderately comfortable, 4 on the pain scale, but with a 6 for muscle cramps as they flared up.  Took my pills, and put in my ear buds – started a 20 minute Psalm meditation, and don’t remember much of it.  I crashed again until my bladder woke me up again approaching that 7:30 pain pill alarm.  I paced a little, got some more water, and settled in to doze a bit more before actually getting up to start the day.

Coffee, breakfast with hubby, a walk up the driveway with the dogs, started a load of laundry – thank goodness for the grabber tool!, and then off to take a shower and get ready for church.  Switched the laundry around, packed up my meds, spare pillows, ice packs, and stuff I would need for another afternoon at the winery, and my ride showed up about 10:15 .  A great service, lots of hugs from friends, and then back to the winery for the afternoon.  Been able to help hubby with some computer projects, took a nice walk in the light rain, and have visited with a couple friends while trying to relax.  I’ve started tapering off the pain meds, and that seems to be alright so far.  Pretty much I just need to focus on using and stretching my leg and hip muscles to keep them loose – avoiding those darn overnight cramps.

Every day seems to be better.  And the fact that it’s cool and rainy today is refreshing!  Makes me a little sleepy, but it’s been so hot and dry – this is a wonderful reprieve – and we need the moisture from a light rain to freshen everything up after a nasty dusty hot past few weeks of summer!