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Post-op visit later today: What to ask?

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:29 AM in Back Surgery and Neck Surgery
Hi everyone.

I have my official post-op review and staple removal later today. As some of you know, I have not been improving much since the procedure:

- Numbness: Before surgery it affected most of my lower leg. Right after surgery, the entire leg felt numb (from buttocks to heel) due to inflammation. As swelling subsided a bit, the numb areas are back to where they were prior to surgery (lower leg from the knee down).

- Pain: This is the worst; shooting pain along sciatica has increased post surgery. The calf feels very painful and weak. It is overwhelming at times. It wakes me up at night, and makes sitting up very uncomfortable.

- Weakness: Major weakness in calf, ankle, and foot. Slightly more pronounced than before surgery. Ankle reflex has not returned at all. Limping considerably when walking.

So, as you can see, I feel back to square one overall, with more pain than before. I know I have to be patient with nerve-related issues, but...

- What should I ask the doctors in regards of my situation?

- Can I request an MRI to see if everything is ok?

- Any other tests they can safely perform to see what's up?

- Any other painkillers they can give me to manage the intense pain I feel in the leg? (I’ve been taking the prescribed Percocet with Advil every 4 hours)

- Would my fears and inquiry make the doctors feel defensive? I don't want to make them feel like I'm questioning their expertise, which I'm not. Far from that. I just want to get better.

Any suggestions and advice are greatly appreciated.


  • dilaurodilauro ConnecticutPosts: 9,865
    You are basically just out of surgery. All spinal surgeries recoveries take time to run their course.
    There are so many variables involved that could change any suggested timeframe.
    You may or may not have felt improvement right after surgery.
    Some people do and we hope the most do, but that is not the case for everyone. And during recovery you might have a good day or so, followed by miserable days. The 3 symptoms you identified are symptoms that you might also find in a person who is 6 months post op.

    In the different questions you've asked your self to be possible discussions with your doctor, I think the most important one is just discuss how you are feeling. Dont need to go into anything about a new MRI, additional tests, etc.
    If anything, you can say that the pain has either stayed the same, decreased or increased. Same applies to numbness and weakness, just like your doctor no.
    From that, they will easily be able to identify if any follow on should be done.
    About the only way you might make a doctor defensive is if you go in there, telling them you want This, that, etc...
    Allow yourself to be the patient and the doctor to do what they are suppose to do.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I suggest simply letting the doctor know what you are feeling and ask if it is normal. You had enough faith in him to cut you open so you should probably trust his judgement on your post op recovery.

    I hope the pain subsides soon and you can get going on your PT! Better times are coming...
  • I have had several spine fusion surgeries, and it does take some time for the body to recover from the shock of surgery. There can be swelling and irritated nerves that can take quite some time (many months) to settle down.
    Sometimes it will feel like "2 steps forward, 1 step backwards" for weeks.
    When I had my L4,L5,S1 fusion in 1999, it was several months before I felt like a human being, and the messed up nerves continued to improve for about a year.
    I am just 6 weeks out from having L2 fused to the previous lumbar fusion, and the first couple of weeks were really rough. Since I could not use most oral prescription pain meds (severe nausea), my surgeon ordered Durogesic patches to try to control my pain 2 weeks after surgery. Finally I got pain relief and some decent sleep, which then helped me to heal better.
    Try to tell your surgeon what is still hurting, and ask his opinion.
    But, keep in mind that the healing process will take quite a bit of time.
    No spine is ever as if it had never had surgery, but there should be some improvement so you have a better life.
  • Your situation sounds very similar to mine. I had radiculopathy L5-S1 and had a laminectomy November 2008. Loose fragments were removed and the disc was shaved and things around the nerve were cleaned up. Although I had instant relief from the leg pain, it started up less than 2 weeks after surgery. I had sciatica pain just a few days after surgery and I never had that type of pain before surgery. So I tried physical therapy for 3 weeks with no relief. The nerve pain down my right leg got so bad that I could barely walk. The doctor then ordered an MRI which showed that the L5 disc was bulging and hitting the nerve. I had a PLIF March 19, 2009, and I am back at work already. I am recovering faster from the posterior lumbar interbody fusion than I did from the laminectomy.

    I would be totally honest with your doctor and tell him you feel worse than before surgery and have him order an MRI because I don't think your pain is normal for the type of surgery that you had. This is just my opinion based on my own experience. I know everyone is different and everyone heals at different rates.

    Also, I am taking Neurontin and it has helped with my nerve pain.

  • Well, I wanted to share my experience regarding the post-op review, which took place about a week and a half ago.

    The doctor and assistants seemed quite dumbfounded that I had not experienced any improvement since the operation. They checked the leg, ankle, the areas that hurt, noticed the ankle reflex has not returned yet. They removed staples and made sure the incision is healing properly.

    Then they said my symptoms are probably due to healing, and how long the nerve has been pinched. So they suggested to give it another four weeks, then we will have a new review and decide what to do then (maybe MRI, maybe physical therapy). They suggested no MRI for now, but instead wait the four weeks.

    I understood their explanation, and agreed to give it a bit more time to see if anything improves.

    Then one of them did something that raised a bit of a red flag with me. One of the doctors tried to convince me that I'm better, trying to play some "Jedi mind tricks" on me. After my explanation that I have not experienced any improvement and increased pain and weakness, he says that I'm probably better but I can't feel it yet, and I should give it more time. He tried to convince me I'm better by mentioning things I could do now (some flexing, some bending)... but I quickly explained those same things I could do before surgery!. Maybe he was trying to apply some "positive thinking", but it came across as if nothing I explained or they saw by themselves mattered. It felt odd, out of place.

    Whatever. No "Jedi mind tricks" can convince me anything has improved, because it hasn't. Everything is the same, except for the increased pain and weakness.

    Should I go ahead and get a second opinion? Would another doctor just wash his hands and refer me back to the original surgeons?
  • Well you are less then 2 months out, so you definately should give it more time as your doctor said.

    Nerves can be damaged in a short time, and they take time to heal to a point where the pain dissipates.

    So you are not doing physical therapy yet, does the doctor want you to, or is it going to be a wait and see type deal?

    As far as nerve pain goes, narcotics will be unlike to help you there, I know they didn't for me. If it continues on perhaps they will prescribe neurontin or lyrica to you. Naturally you want to give it more time to see if the surgery was successfull as you do not want to mask your symptoms with drugs unless you must.

    You are still far to early to seek a second opinion. Doctors can't order MRIs without reason and post surgery nerve pain which you had prior isn't a reason, yet. If it keeps up as your doctor said then they will have to do tests to see the cause.

    Physical therapy helped me a lot after my surgery, helped resolve post surgery pains and regain normal function.

    Back surgery is not an easy surgery to go through, not that any surgery is easy :) We take a long time to heal.
  • I understand your concern due to the nature of this type of problem and long recovery period with many ups and downs. I had the same surgery in '07 and noticed that that pain got worse. I went in for a post op MRI and discovered I reherniated at the same level 1 month after and the other disc was still impinging the S1 nerve. On top of that I had slippage (retrolisthesis at L4-5 as well). We are all told to be patient when it comes to recovery, and it is very true but in the same token you should notify your doctor when the pain flares up worse. Only they can differentiate between a regular pain flare and another new problem. I hope you get to feel better soon. Take care
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