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8 weeks post op lumbar fusion L4-S1

AnonymousUserAAnonymousUser Posts: 51,465
edited 06/11/2012 - 8:28 AM in Back Surgery and Neck Surgery
Please if anyone could let me know if they had surgery and how they did around this time I would appreciate it. I am around 71/2 week post op of my double fusion L4-S1. I am still in pain and can only walk for about 7-10 minutes on the treadmill 3 times a week. I spend half the day down and half the day up. I hurt if I do to much. I was told no PT at this point. After my laminectomy I was in PT at 6 weeks but not this surgery I guess. I am on Lyrica for nerve pain, which I was hoping I wouldn't have any more after surgery. NS said just angry nerves, too much scar tissue from first lami 4 years ago and staph infection that set in after that surgery. Should I push myself to do more even though I pay for it the next day and end up in bed more or should I be happy with this slow progress? Any advice I really appreciate. So sorry all of us that have this struggle. Take care all.

Warmly,
Lisa
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Comments

  • Hi Lisa. I can relate. First, you need to know if what you have is "bone pain" from the surgery, or "muscle spasms," which is a tight and painful "squeezing" sort of feeling. I was like you (in bed a lot) until about 7 weeks, but I also had a post-op stress fracture at S1 (and they are still debating going back in if it doesn't heal correctly). But at seven weeks, I was fed up and decided to do whatever I could to break the muscle pain/spasms. I am now at nearly 3 months, still with lots of muscle pain, but I'm getting around, although I can't be on my feet more than 30 minutes at a time, at best. I do a lot of practicing standing straight, and breathing and other mental work.
    Here is a good way to know if it is bone versus muscular: when you first get up in the morning, or after a good rest, do you feel basically okay? Then after a few minutes, does the pain begin to set in? Is the pain surrounding your spine but not on your spine? Then it is likely mostly muscle pain. I've been told this can take a very long time to resolve. I'm frustrated, too.
    dana
  • How old are you? I am post 2 weeks PLIF L2-L5 and start PT this upcoming Monday.

    Reason I ask age is because it makes a difference in treatment plans for most.


    It
  • How old are you? I am post 2 weeks PLIF L2-L5 and start PT this upcoming Monday.

    Reason I ask age is because it makes a difference in treatment plans for most.


    It seems
  • How old are you? I am post 2 weeks PLIF L2-L5 and start PT this upcoming Monday.

    Reason I ask age is because it makes a difference in treatment plans for most.


    It seems every
  • How old are you? I am post 2 weeks PLIF L2-L5 and start PT this upcoming Monday.

    Reason I ask age is because it makes a difference in treatment plans for most.


    It seems every doctor
  • How old are you? I am post 2 weeks PLIF L2-L5 and start PT this upcoming Monday.

    Reason I ask age is because it makes a difference in treatment plans for most.


    It seems every doctor is
  • How old are you? I am post 2 weeks PLIF L2-L5 and start PT this upcoming Monday.

    Reason I ask age is because it makes a difference in treatment plans for most.


    It seems every doctor is different
  • How old are you? I am post 2 weeks PLIF L2-L5 and start PT this upcoming Monday.

    Reason I ask age is because it makes a difference in treatment plans for most.


    It seems every doctor is different on
  • How old are you? I am post 2 weeks PLIF L2-L5 and start PT this upcoming Monday.

    Reason I ask age is because it makes a difference in treatment plans for most.


    It seems every doctor is different on their
  • How old are you? I am post 2 weeks PLIF L2-L5 and start PT this upcoming Monday.

    Reason I ask age is because it makes a difference in treatment plans for most.


    It seems every doctor is different on their means
  • How old are you? I am post 2 weeks PLIF L2-L5 and start PT this upcoming Monday.

    Reason I ask age is because it makes a difference in treatment plans for most.


    It seems every doctor is different on their means and
  • How old are you? I am post 2 weeks PLIF L2-L5 and start PT this upcoming Monday.

    Reason I ask age is because it makes a difference in treatment plans for most.


    It seems every doctor is different on there
  • EDIT: SORRY FOR THE MULTI POSTS!!! I had hit post comment then decided to ask for more info so as I typed it kept posting, very sorry.

    How old are you? I am post 2 weeks PLIF L2-L5 and start PT this upcoming Monday.

    Reason I ask age is because it makes a difference in treatment plans for most.
  • When I was 7 weeks, I was already at work. My surgeon told me to walk as much as I can right after surgery. My husband bought me a walker and every hour I was walking back and forth through out the house. I was told by my surgeon that by a month out I should be able to walk a mile with no problems so I was shooting for that. He told me that the more that I layed around the worse that I would get because your muscles will get tight from not being used. So I used my muscles as much as I could and walked. Even if it was from the front door to the back door over and over again. In the middle of the night when I would have a muscle spasm, I would get up and walk. I was in tears but I was determined not to let the muscle pain and nerve pain beat me. By 6 weeks post op I was back to work. By 8 weeks I did a month of PT just to help me learn to walk straight again and help get my leg muscles working.
    I don't know your situation. There must be a reason that your doctor is not having you up walking as much as possible to keep your muscles strong. I walked 15 minutes at a time every hour. If I were to have walked only 7 to 10 minutes 3 times a week I would have stiffened up as well.
    My muscles and nerves went through a lot of repair work and I am sure that yours did too. It takes a while to heal. I am now close to 10 months post op and still get the twitches.
  • Glad to hear your pain is better. I am 40. I have no idea why my doctor does not want me in PT. I have been in 6 times prior to this surgery. I have always done yoga and walked and been fit. Who knows? Some say I must wait until fusion is complete and that is not until 3 months. Take care. Lisa
  • Dana said:
    Hi Lisa. I can relate. First, you need to know if what you have is "bone pain" from the surgery, or "muscle spasms," which is a tight and painful "squeezing" sort of feeling. I was like you (in bed a lot) until about 7 weeks, but I also had a post-op stress fracture at S1 (and they are still debating going back in if it doesn't heal correctly). But at seven weeks, I was fed up and decided to do whatever I could to break the muscle pain/spasms. I am now at nearly 3 months, still with lots of muscle pain, but I'm getting around, although I can't be on my feet more than 30 minutes at a time, at best. I do a lot of practicing standing straight, and breathing and other mental work.
    Here is a good way to know if it is bone versus muscular: when you first get up in the morning, or after a good rest, do you feel basically okay? Then after a few minutes, does the pain begin to set in? Is the pain surrounding your spine but not on your spine? Then it is likely mostly muscle pain. I've been told this can take a very long time to resolve. I'm frustrated, too.
    dana
    Dana,

    OK--this is VERY interesting. I have never heard this before, but it makes sense. When I wake up in the morning, or after resting, I feel pretty good. Before my surgery, mornings were the hardest time--now they are the easiest--as long as I don't lay in bed too long. However, the pain settles in shortly after I start moving around. I'm not sure if the pain is on my spine or around it---I would say probably more around the spine. So, it sounds like my pain is more muscle related according to your theory. I also have found that laying around makes it worse. The more active I am the better. The more walking, the better, the more stretching I do, the better I feel. Can you tell me more about this muscle/bone thing? I've never heard this but it makes sense.

    Chuck
  • 2 level fusion, discetomey. my Dr will not start pT fot a few months. That is how he does it also. Then is it water therapy first. I also hurt still and am on pretty strong pain meds. I walk when I can. Try not to lay down to much. But I am still limited to sitting at 1 hour. Sounds like our Drs went to same school. I dont know if mine is muscle or bone. I just know it is brtter than when I woke up from surgery and that I had pain for 2 1/2 years, so I dont feel that it is gonna be mircaulusly gone. I had 3 discs with tears, 1 wasnt as bad so that one wasnt done. Probably in the future I was told by Dr,. So I try to do what I am supposed to do, but like you if I have a full day, like ride to Dr which is 2 hours, next day I am down. I just think it is a major surgery and I was prepared for several months of recoup. So keep chin up, we will get better. Everyone has different recovery. My friend has my Dr do a 1 level fusion 3 months before me. He told us, dont compare each other. You both will do things at different rates and that dont make it bad. I had 2 levels and she had 1,I am sure it makes a difference. She had 4 hour surgery, and mine was almost 8. Spring is coming and it will make everybody feel better. :H
  • That's amazing going through so long on iv antibiotics. I agree maybe you need some pain meds. Can you get an appt. with your Dr. soon? If the pain is too bad can you go to ER. After one long infection like that you should be able to call your Dr. for some pain meds. I find heat soothing for pain. I hope you're feeling better soon.. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Thank for the reply Charry,

    Hope you are doing as well as can be. I agree. I can't believe I am left out in the wind on my own here. It seems these NS or what ever doc. they do the surgery and it is their ego's that everything is perfect and you don't need any pain med's afterward....they fixed you. Are you kidding me. I couldn't jump out a window when this pain hits and that is most of the time. How can you leave someone like this. I can't even take a motrin do to the fact that anti inflammitory's inpeads the process of the bones fusing. So I am left with Lyrica and Tylenol. REALLY? This is cruel. I can't sleep I can't eat. I have lost 10 pounds and I really couldn't afford to do so in the first place. Now it just gives me that depressed look so doc's can say..."Oh, are you drepressed?" No damn it I am in pain. If you go looking to good your not in pain if you look like crap, your depressed. I have had it. I just need some relief. I have never had a problem with anything in my life. I don't even drink alcohol. I just need to have some relief before I lose It. Thanks for listening.
    God help anyone in pain in this country. Uk and Germany so far more advanced than us in palliative care. Not that I don't love my country but crap. I know I have a degree in Hospice care.

    Lisa
  • Don't go for the window. I think your family or PCP Dr. should help you with meds. Even the ER. I know people don't like to go there but if your pain is 8+ you need to go. I had to here because my Dr. was on vacation. Also her office is far from here where I live. But they usually have a minor area where you can go. I can't say our health system is much better but since I've worked in the healthcare system for over 20 years. That's great you have your hospice care. I was a companion/Nursing aid and visiting homemakere before. I hope you get some pain meds or muscle relaxants whatever that you need. I live in Canada and it's the same everywhere mostly, a shortage of Specialists. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Okay, Chuck, sorry it took so long for me to reply.
    Yes, from what you and others write, this sounds familiar. The pain settles in after. I am at nearly the 3 months mark, and by my photo, you can see how much fusion I had. It is slow going, and I'm usually very active and determined, so it is frustrating and depressing. But slowly, it is getting better. I still must take strong pain meds, but now not until afternoon or evening.
    Today was a milestone: I walked 2/3 of a mile, even at a moderate pace and on some moderate sloping. My torso still feels alien to me. At the end of the walk, I was "gripped" by the squeezing pain in my torso and abdominals (and yes, it involves the buttocks, too). The moment I sat down, the pain subsided. The "bone pain" was mild, and not like what I had before surgery. So I still believe that most of what I have now is the "muscle lockdown" that is causing most of the excruciating pain and limitations. Muscle relaxers DO NOT HELP. I am told it can take a very very long time for the muscles to stop behaving this way--it is a normal reaction to the body being "injured." It is a way the body "protects itself." By tightening the muscles around the "injury" and limited your movement. Makes sense, right? If you didn't have this "lockdown/lockout" you'd probably feel great enough to try bending and running--thus then breaking the fusion and destroying injuring yourself. Since it takes 6 months to a year for a fusion to take, it will likely take that long before the muscles stop crippling us.
    I get fearful every day wondering if I am ever going to be pain-reduced, or if I am stuck with these new limits. I was already limited and told I'll always have SOME pain, but this is worse than before surgery, and very frightening. But my surgeon says he refuses to discuss pain issues for AT LEAST A YEAR, because it can take a very long time. Mostly, he is concerned that the stress fracture I got as a result of one of the screws heals correctly (or they have to go back in, God I hope not).
    I hope this helps
    Dana
  • How in the heck are you only on Lyrica??? You've got a bit of a complicated case. Maybe you could walk more if you had some pain relief.

    On the PT issue-the surgeon who did my lumbar fusion, I had to push for PT. It was delayed a bit because of a postop infection, but I got my wish and started out with water PT. If you have never had water PT, I just can't tell you how wonderful it is. Yeah, you're sore afterwards and need some ice packs, but it is so much less stressful to do the exercises in the water with the weight lifted up. At the end, they would let me float in the deep end in a vertical position(holding a noodle under my arms) and it was great. Gives a great gentle traction and it made that crunched up squished accordian like feeling in my back relax. I never wanted to come out of the water. I really didn't like graduating to land, the water was so wondeful!

    I always advocate for a second opinion. Many doc don't like to deal with another surgeon's mess, but if you can find someone, it never hurts. Even if you hear exactly what your own doc has told you, I think it may at least ease your mind. You've been through a lot, you deserve to make sure you have the best chance now.

    Interesting info: I had a superficial skin infection with the original fusion operation. I went to a different surgeon in a different practice in a different state. He's done a few operations on me and when in early January he removed my left sided hardware(first one he did on that side) I developed a staph infection that caused necrotic muscle tissue(another surgery to scrape that out in January, so 2 surgeries in January) and now have a PICC line getting home antibiotics. The infectious disease specialist told me that staph can be knocked down but then lay dormant in hardware(I still have cages in but rods and screws gone) until you are opened up again. He told me that once you have a postop infection in one area, you are more at risk to have one in that same area. This is not to scare you with a horror story, just to make sure you are listening to your body and if you don't feel right, get seen. I sure that amount of time with Vanco killed whatever you had growing tho! :)

    Anyway, with your history, I would be having fits if I had no pain meds. I would also ask(as long as incision is healed good so doc is not worried about infection) about water therapy. I am currently undergoing scar tissue massage by PT to help break up some of the current scar tissue and prevent future scar tissue from forming(and I hear you can order some ball thing to lay on and roll around that helps keep more scar tissue from forming, PT told me about it, got to look that business up.)

    I struggle too with finding a balance between activity and pain. I refer to it as budgeting my pain. I know if I do a particular activity or number of activities one day, I'll pay for it the next day. I want my life back and try to do too much, but how do you balance your mental health activities you need and PT activities with taking steps backwards because of pain flare-ups? If you find an answer, please let me know the secret! :)

    If your surgeon will not give you pain meds, maybe your primary doctor will. Many surgeons don't want to prescribe narcs after a certain point and refer you to pain management or your primary. Even some pain medicine that will help you sleep(not a sleeping pill like ambien, a PAIN pill.)

    I also like to take Mr. ER with me to appointments. Sometimes I am so emotional(this has been so long and so many surgeries) that I can cry at the drop of a hat(I love my zoloft tho.) Sometimes a spouse can help communicate when you cannot. Also, I believe sometimes male docs may listen to a male spouse more than one of us emotional females.

    This was very long. My main points: 2nd opinion can't hurt, you need pain meds, ask about water PT or scar tissue massage from a PT, take support person with you to appointments always.

    Please post updates.
  • I can completely relate to crying at the drop of a hat, especially at a dr's appt. My hubby went with me to every appt and I truly believe it was for this reason my pain was taken seriously. He was able to communicate to my dr my past experience from the other dr and that of being judged by the pharmacists. He stayed calm when I couldn't stop crying because I was so tired of being in constant pain. I am only 2 weeks out of a 1 level PLIF at L4/L5, but feel like I'm doing pretty well. I try to walk as often as I can. I go in for my 3 week check up tomorrow afternoon, but supposedly won't start PT til 6 weeks.

    Lisa....If you have a loved one (male!!!) who can go with you to the dr to act on your behalf and might be able to calmly relay your constant pain, that might be helpful for you to receive some pain meds. I would say they are definitely in order!

  • Hi All, :H

    Just checking in to see how everyone is doing. Hope you all are hanging in there. Thanks for all your advise. I really do think my doctors lack of care about my pain is an issue. I have only seen him one time since my surgery and I called for an apt. they will not get me in for 3 more weeks. No phone calls from him, nothing. I feel abandon. Here is your double fusion and go home. Well gee thanks. Well anyway I hope all is well with everyone just checking in. It does help to read your posts and take in everyone else's knowledge and experience. Our journeys not all the same, yet the frustration we all feel is still somehow all connected. Like.....I dropped the toothpaste cap, crap how the hell am I going to pick that up? :? Take care, Lisa



    Fall in 03 thanks to my little dog. Pt countless ESI
    04 L4-L4 Laminectomy, Staph infection 8months that lead to Oteomyolytis IV vancomyocin at home, Rt hip labral tear (surgery to repair 05) all due to fall, crushed tailbone removed 07, 12-08.. L4L5 L5-S1 Fusion 6 hour surgery cleaning of scar tissue due to 04 surgery and infection. Wishing for this to be the last and pain to subside soon. I've had mylograms, discograms you name it I am over all this. If you have a question ask. I wish none of us had a question.
  • Attach some reversed masking tape or scotch tape onto the end of a light pole, (ex.broom handle, grabber,etc.) and the item will stick to it allowing you to bring it up to hands lenth.
  • Loved your description of how floating vertically on the noodle makes you feel -"it made that crunched up squished accordian like feeling in my back relax - that is it EXACTLY! Isn't it the best?

    I wanted to know more about the scar tissue massage - is it like a deep tissue massage? Also, what is this ball thing you mentioned for scar tissue? Is there a web site or something that tells about it?

    Thanks.
  • HI

    Any way I am still struggling I think everyone is so darn different. I had so much scar tissue from my first surgery and the infection that sat in there for so long. It took 7 months of IV vancomyocin to cure it. It was a long road....I have been at this since I have been 35 that was 5 years ago. I feel like I skipped those years. I would like to get them back. What I don't get it this squeezing pain from my hips/groin all the way down my legs. It is like labor pains but worse. I can't sleep and I have no relief. I am not on any pain meds, just lyrica. Maybe I should be. Last night I would have given my first born for something. Actually, last night I would have given her period (ha ha). Teens ha, what are you going to do with them, right? Anyway back on track. Will this ever dissipate. I can't possible think of a life that will include pain like this. Anyone with hope that this goes away with time. At am at 7-8 weeks. I am getting so scared. Please any encouragement. Hugs to all and pain free days.

    Lisa

    L4-L5 lami staph infect turned to osteo 7 months vanco IV. RT hip labral tear surgery. Tailbone crushed-removed. 12-17-09 L4L5 L5-S1. Digogram. Mylogram. Fusion To many to count ESI 6 PT
  • Hi - I just had an Anterior L5-S1 fusion, standard 2 plates, 4 screws and cage. Over 31 years I had 2 Laminectomies at the same level each lasting
    15 years. Finally, bone on bone led to a fusion at the same level. Now, I'm just over 3 weeks out and walking a mile a day with some leg pain and lower back pain here and there. My surgeon didn't feel a need for PT and BLT ( bending, lifting and twisting) were absolutely not in the post op protocol. I noticed above, someone was bending forward rather than from the knees, twisting and stretching. How far out of surgery were they?
    I'm also still taking pain meds but a third of what I was taking. I'm 64, in excellent shape but it isn't likely I have 40 years left ... lol ... I was curious what advantage the posterior added to the anterior only. With scarring after 2 back surgeries, my surgeon felt it best to leave my back alone. Does anyone know why both entries are done in some cases, only anterior in other cases. Thanks so much!
    Any input would be appreciated!
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