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Need advice, not happy with post-op care.

pammieppammie Posts: 79
edited 06/11/2012 - 8:34 AM in Back Surgery and Neck Surgery
I had an ADR done at L4,L5 on May 14th of this year and I am not very satisfied with my post-op care from my surgeon and his PA and nurse.
I had a 36 hour stay in the hospital. When my surgeon came in to check on me to release me, he had me stand up out of bed and he pulled the back of gown open to remove the bandage from my back and check my incision but my surgery was performed through my stomach! I guess this should have been my first clue. At my 3 week check up, he told me "most people" that have had this same surgery are back at work at 3 weeks. I could hardly walk at this point and wasn't drving, in fact I wasn't released to drive until 6 weeks post-op. So how was I supposed to get back to work if I couldn't drive myself the 55 miles to work?
My next appt. at 5 weeks, the PA told me that the Dr. wouldn't send me back to work for a while due to the fact that I was still in so much pain. PA wanted me to get another steroid injection (the first 2 didn't work and I had flu like body aches from them) then Doc says no steroid injection, he wanted me to get a CT Myelogram which made me sick for 4 days with a severe headache and vomiting, until I finally went back to the hospital and got a blood patch.
At my 6 week appt., the Dr. sent me back to work even though I told him that I was still in quite a bit of pain and that the nerve pain that I was experiencing in my right leg had returned and was worse than before surgery. Doc has put me on Neurontin starting out at 200 mg a day and to increase by 100 mg a week to a max of 1800. When I ran out and needed a refill, I called his office and explained to the nurse that she needed to write the prescription so that I could increase weekly like the Dr. said and have enough for a month as my insurance won't cover a refill before 30 days are up. Nurse tells me no that I only need to take 600 mg a day and writes the scrip for 60 300 mg pills. Okay, so how am I supposed to increase weekly like the Dr. says?
My Dr. wants me off of Vicodin but the anti-inflammatory meds he has prescribed are too hard on my stomach. I try not to take any Vicodin throughout the day until evening when I can't take the pain any longer. The Dr. reviewed my CT Myelogram, xray, and MRI and says that the artificial disc is in place, nothing is wrong, see you in 4 months. So now my next appointment isn't until November.
What am I supposed to do in the meantime? I can't take the anti-inflammatory meds that he prescribed, I take the Vicodin sparingly, but will run out eventually. My Dr. is convinced that nothing is wrong, the disc is in place so I shouldn't have any pain but I do. Its all I can do to make through the day at work. I can't bend forward very well at all (I have gotten mixed info on bending as well all from the Dr. himself...work on bending, no bending, let me see you bend, etc.). When I do bend forward a little, it feels as though the disc is pushing from the inside of my body out. In fact sometimes, my lower back feels sore to the touch like the area is bruised and it hurts to lay on it. Then I get the sharp stabbing pain in my back to the right and left of my spine along with the nerve pain that is about to drive me crazy. Most days, I feel worse than I did before surgery. I wonder why I even had this surgery. Should I be further along at this point in recovery than I am? I feel like my Dr. thinks that my recovery is done but I don't. Is this as good as it gets? I also feel that Dr. thinks all is fine either because he was so sure that an ADR was the right way to go, or he thinks that I am a drug seeker which is so far from the truth. At this point I take 1 maybe 2 Vicodin a day only after I get home from work and a Soma when the muscle spasms kick in. I'm also upset with the fact that I get mixed info from the Doctor's office, Dr., PA, and nurse all tell me something different even though they are all looking at the same chart.
So should I make an appointment with this surgeon or go to my primary care Dr. and request a referal to another Ortho, or a referral to a Pain Management Specialist? I am so tired of being in pain and being told that nothing is wrong. It is my body and I know this can't be right, this can't be as good as it gets.
Sorry this is so long but I had to vent, as well as get it out there so I can get some much needed advice.


  • It seems like your surgeon is brushing you off. They don't want or like to hear about you having continuing pain. Of course this isn't true of all surgeons, but this one comes off as not wanting to take your complaints seriously.

    I would go back to the PCP and let him know what's going on. I'm sure you'll get the Vicodin refilled until things get figured out. After all, you had major spinal surgery goodness sakes! Only in extremely good circumstances can somebody go back to work in a few weeks. This is the scenario that they hope for but most doctors know that people heal at different rates. Everybody is different in this regard and it can take a long time to fully recover.

    Anyway, if it were me I'd go back to the family doctor and get another referral to another surgeon. Make sure you get all your records. You deserve much better treatment than this. Take care O:)
  • I concur with Meydey. Surgeons seems particularly useless when the outcome is not textbook perfect and the patient is still in pain. I'm afraid I cannot share with you what is "normal" recovery with ADR as I have not had that procedure and don't even know anyone who has had it.

    It seems like a waste of time to try to get into this surgeon sooner. I guess if you can't make an appointment with another spinal specialist on your own, I would see your PCP. You may need an interventional pain management doc to help with your pain, or you may want to see another neuro or an orthopedic spinal specialist to find out if there is a problem with your surgery. You will need to find someone who is experienced in ADR, which will not be all spinal specialists in your area.

    I'm sorry you are having all these problems. You should be getting better care from your surgeon's office. The more I think about it, the more it seems like you need to let him know how much pain you are in, that you didn't get the medicine he prescribed, etc. I don't know how you feel about him, but in a way it seems like you shouldn't just walk away and let him think everything is OK. But these are personal choices you have to make.

    There are others on the board who have had ADR surgery. I hope they see your thread and respond so you have some personal experiences of others' recoveries.
  • I hated the after care I received after my first lumbar fusion and went to a bigger hospital with a well known neurological dept and talked t them. turned out i was not fusing and my screws were falling out, I just had 360 revision and one other level ( so 2 levels now) and I feel so much better and the after caer is terrific!!

    Try another surgeon
  • I am so sorry you're having such a terrible time! I can't give you any comparison, as I had an ACDF, but it sounds to me like your surgeon and his staff aren't taking you seriously. Furthermore, they aren't communicating between themselves, either, as they're all giving you different info.

    If I were in your shoes, I'd be getting with the PCP to find another surgeon to perform your aftercare. I also agree with Gwennie that your current surgeon should be at least informed of your concerns and why you are seeking other care.

    Good luck, and remember, you are your own best advocate. Be assertive and don't let them brush you off. You will only get one chance to recover from this surgery, you want to be sure you recover well!
  • "What's the difference between God and an Orthopedic Surgeon?... God doesn't think he's a surgeon!" ;-)
    (a very old joke)

    Hi Pammie,
    You are NOT alone!
    First let me give you a bit of my history so you know where I'm coming from: I am less than 2 weeks post-op from a diskectomy and fusion at L5/S1. It was an ALIF (Anterior Lumbar Interbody Fusion). I am doing pretty well physically considering everything... including the fact that my surgeon, and the hospital staff gave me ZERO info about post-op care! His quote to my husband was "she has no restrictions or limitations." That's simply not true and it's irresponsible to say. SO, again... you are not alone in your lack of info from the your surgeon.

    The good news is that my back pain of years is actually at about an 80-90% reduction with good days and bad. Walking helps the most- really. This pain relief is fantastic news of course! And to me it means that the surgeon did his *technical* job well. But that's about where my compliments end. A skilled surgeon and a good doctor are 2 different things to me.

    It appears the surgeon did his technical job well, but he and the hospital staff gave me ZERO information at discharge about post-op care. Not very good or professional health care if you ask me.

    I was treated like a total scum bag drug addict in the hospital because I was already on full-time pain meds... under the competent care of a Pain Management Specialist... that MY SURGEON REFERRED ME TO! They had me on less pain meds post-op than I take on a daily basis for pain management! They had all my records and authorizations right there in front of them... but chose to ignore it. This drug addict apparently needed to be taught a lesson. I asked for TYLENOL and they wouldn't even give me that. There's more. of course, but that story is better save for another time and topic. I just wanted to let you know that there seems to be a serious disconnect between pre-and post-op care... and your case is not isolated.

    I have had a LOT of experience with surgeons, especially Orthopedic surgeons. My personal opinion and experience with them is this: they have the typical Surgeon "God Complex." They really believe that once they operate on you... tah-dah! You are FIXED! And there is nothing more to it. They are so focused on that ONE thing they do that they have never found a need to develop "people skills." Period. My opinion is that they believe that what they do is the ONLY answer and if you don't progress as THEY expect you too... they look at it as something wrong with YOU personally. They are of course SURGEONS and above making mistakes or overlooking anything ;-)

    Many surgeons I have ever dealt with (mine and others)automatically jump straight to the conclusion that if you still have ANY pain after surgery that you must be a drug seeker... or a wuss. My surgeon actually told me... the day after surgery to "BUCK UP. It's not that bad. I've had the 'PROCEDURE' myself." (I've been through natural childbirth! I'm no wuss! I'd like to see my surgeon handle THAT! ;-) )

    "PROCEDURE???" He called it a procedure- like getting a wart removed, or a colonoscopy ;-) Where I come from, when they put you in a hospital, put you under general anesthesia, cut you wide open, remove parts, insert new ones and screw some hardware into your bones and sew you back up... that's called major surgery!

    The surgeon probably got his "procedure" at the FIRST sign of problems,had the BEST medical care possible, and did not have to wait or months or years for proper medical treatment and fight workers comp or insurance to get it!

    The bottom line Pammie, is that you DO NOT have to put up with that kind of crappy treatment that "pooh-poohs" your concerns. That is SUBSTANDARD medical care. And you are not likely to ever get what you need or want from the Ortho surgeon.

    My advice to you would be to find a good Pain Management specialist doc and start there. It is VERY hard to recover properly when you are in constant pain. Pain control is very important part of your recovery... and you should have it from a properly trained professional who understands how pain affects us physically and emotionally. And you need someone who will follow up with you in case something did go wrong with your surgery, or was overlooked.

    The pain d0oc is also far more likely to (a) not judge you because you still have pain, and (b) listen to your concerns about your body and recovery. They can suggest, and sometimes even authorize further imaging- such as X-rays and MRIs, or help you find a doc that is right for you. Pain management docs OFTEN see people who are there as a result of failed surgery, NOT that your surgery is "failed"...you just need a doctor that's not so busy defending his ego and skill and will be open to examining the source of your pain no matter what.

    Everyone heals at different rates and ways... and it's IMPERATIVE that you have INFORMATION about your recovery as well as proper and consistent medical care from professionals who will listen to you and treat you with RESPECT!

    Again, I would start by finding a good pain management doc (also because I think Vicodin is a crap medication for treating anything more than a toothache... and especially not right for post-op pain!)Then figure out what the next best move is for you.

    I wish you the best! Don't take anything less than the best treatment from your "professionals!"

    Send me a private message if you have want to chat more!!
    Take it easy on yourself :-)

    ~Jeanne (rednorsk)
    Murrieta, CA
  • I am horrified at how some surgeons brush off patients in pain, expect them to go back to work in pain and won't see them when they are needed.

    I do not understand the US system but I can't help but think it's the squeaky wheel that gets the oil. Maybe you just have to be more vocal, more assertive and demanding?

    Sorry you have to go through this. As if the surgery isn't enough to deal with.

  • Thanks for all of your comments. It is amazing how many patients there are out there that have gotten inadequate post-op care. It just isn't right. It seems as though my surgeon doesn't want to admit that maybe this surgery wasn't/isn't a success or that there may be something wrong. He did tell me right before surgery that it would be 2 or 3 months before we would know if this surgery is a success or not. At my 5 week appointment, I asked what determines a failed ADR and never got an answer, he was pretty good at skirting the question. I guess I should have been more vocal about wanting an answer.
    Well you all have certainly given me a few different things to think about. I have decided that I will call my surgeon's office tomorrow and see how soon I can get in. I will go see this surgeon again for two reasons
    1) to let him know how much pain I am in and give him one more chance to see what else (if anything) he can or will do
    2) like Gwennie17 said he really does need to know how much pain I am still in and that I am not getting the meds I am supposed to be getting and to make him aware that I am not at all happy with my post-op care. He needs to know that his office staff aren't in sinc with him.
    If I don't get satisfactory results from this visit, I will call my PCP for a referral to a pain management specialist and get this pain under control.
    Nursedina001 - this surgeon is supposedly "the best of the best" and came highly recommended by my spinal specialist. He is the Spine Service Medical Director for 3 major hospitals. If he doesn't take me seriously, hopefully I can get a referral to someone who can.
    Thanks for all of your well wishes. I will post again later with an update. I hope you all have a great and relatively pain free week!
  • I just wanted to add my comments about this subject. I had ALIF done in Dec of 2007. My surgeon was highly recommended as well and I checked his credentials out, meaning checked to see if he had any lawsuits, reprimands that kind of thing.
    Anyhow, I received some post op information prior to the surgery but I was led to believe that after about four weeks I should be feeling quite well. First off, I was anything but well after four weeks,and the surgery caused perm nerve damage in my right leg. Naturaly the surgeon will never admit that. But I had NO pain or nerve damage of any kind in either leg prior to surgery, once I was awake enough from ansthesia I knew something was wrong with my leg. I was told that it was common for the nerves to be "irriated" from surgery and that they would calm down. I went to my PM doctor about a month after surgery and he told me the same thing. The surgeon told me the nerves would calm down in about six weeks, but when they didnt he would say 4 months, and so on and so on. Finally, my other doctor told me at the one year mark that it was permament damage.
    Also, I never did fuse totally either. I had zero fusion at six months, I finally started some fusion at nine months but to this day there is not a total fusion. I dont blame the surgeon for that. But what angers me is he bragged about my surgery being the "perfect surgery" so when I came in with pain complaints it was like how dare I muck up his perfect work.
    I have not gone to another surgeon for another opinoin, I need to I just am afraid of any more surgery because of the nerve damage that happened last time.
    I wish you well...
  • Good luck Pammie. Sounds like you know exactly what to ask and are determined not to be brushed off. Nor should you be, this doctor has a responsibility to you.

    I look forward to hearing what progress you make.
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