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Post op pain levels

noseovertailnnoseovertail Posts: 387
edited 06/11/2012 - 8:38 AM in Back Surgery and Neck Surgery
I'm starting to wonder if maybe my desired pain level is unrealistic. For those of you who are post-op, what is the ideal pain level that I should be comfortable with? My surgeon never went over this with me, so I'm curious. Right now my pain is about a 5 or 6 while laying in bed and higher when I walk. This is after taking all my pain meds. I know everyone is different but I'm so uncomfortable and I can't believe my surgeon didn't prepare me for this.


  • First let me say that I have been following your issues since your surgery. I am so sorry that you have had such a tough time. After my surgery I was in quite a bit of pain for a good week or two and at times thought I would never get relief. (It is dissapointing to hear that you are having so much pain considering that you had MI surgery. My impressions have been that there is less pain with that type of surgery versus the open surgery.) Try to remember that your body has been through a very traumatic event and that it takes time to heal and recover. You are only 6 days out! I know that you want to be better NOW. You will begin to get relief and hopefully your pain meds will begin to work as they should. Try to relax - I know, easier said than done. It will get better and I do not think your expectations are unrealistic. You want to be more comfortable. We all get that.

    You seem to be upset that your doctor didn't discuss this with you. Mine didn't address it with me at all either. The nurse practitioner filled me in on most of my expectations but no-one ever warned me how excrutiating it would be at the beginning. I'm curious if anyone's doctor was up front about pain expectations.

    Each passing day should get a little better.
  • You know, I'm thinking that I should say my overall pain level was about a 2 with meds on board post surgery. BUT, then I think about the horrible problem I had with the pain in my legs which required the Lyrica prescription and I remember tears streaming down my face and my brother being so freaked out because I was in uncontrollable pain, so I would have to say it had to be a level 7 or 8. For me, the Lyrica (after I got about 3 or 4 doses in me) brought the pain down to about a 2-3 I guess. As my orthopedist says, "the wonderful thing about the brain is, it forgets about pain -- otherwise, we'd never learn to walk." Ah yes - what other stupid things do we do a second or third time because we've forgotten the pain? Childbirth is probably one of them. I pray the pain passes quickly enough and becomes just a distant memory for you.


    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • I remember that I was in a lot of pain for atleast 2wks. Just remember to take your meds as scheduled and not miss a dose as you may end up chasing your pain. I wrote down all my meds and times I took them cuz I was a little dopey and would forget if I took them or not. If your pain levels get too high, this may be your body's way of telling you that you need to slow down. Are you doing too much? This is definitely something you will want to discuss with the surgeon when you go back for your checkup. Do you have a 2wk checkup appt?
  • I wrote a post to you yesterday on the topic of excpectations but I decided to delete it for fear I might upset you. If you look back through that thread you will see a post from me (#24) where I said:

    "Just remember that nerves were moved and they don't like to be touched, so you will probably feel new and different sensations for awhile. This is perfectly normal.
    Just try to relax, think positive thoughts and realize that the first couple days are tough, but then it will get better. I'll save my "you've had a BIG surgery..." speech until after you get home. "

    I too have been following your thread ever since you decided to go ahead with this surgery and I cannot help but feel you had unrealistic expectations regarding the ease of the surgery and recovery. It seems that you have been surprised by each new twist, and I couldn't help but wonder if you thought you would wake up after surgery and pretty much feel pain-free?

    From what I can tell from your posts, most of what you've gone through so far has been within the range of "normal" aside from the Nurse Ratchet experiences in the hospital, etc. I think the fact that you were torn about having the surgery to begin with probably hasn't helped.

    And I am so glad you posted with this question because I really do believe you will have a smoother recovery if your expectations are more in line with the reality of the situation.

    Regardless of whether a patient has an open fusion or a minimally invasive one, it is still major surgery. Major muscles are moved to the side; nerves are sometimes rearranged, but usually "touched" and since they are so sensitive to begin with, this can cause an increase in pain or even new pain symptoms.

    It is perfectly normal to feel worse for a bit after surgery. While it is very frustrating to wake up and have pain in a new area, it is not unusual and is not a sign that something went wrong during surgery.

    I think you will get along better if you don't worry about where you "think" you should be at this point in recovery, what is "normal" for most people, where others were at this point in recovery. It won't make a bit of difference to YOUR recovery, and that is all you need to be concerned about. I would suggest you don't even ask yourself "Am I better today than I was yesterday?" Recovery has its good days and bad...its ups and downs, and when you look day to day, it is often hard to see progress.

    Some of us were quite miserable for the first two to three weeks. I was barely conscious for the first week, and I mostly napped the second week. I planned my walking around my trips to the bathroom, and for the first two weeks I just walked back and forth in the house. I wasn't capable of going much further. But gradually things improved and by three months I was able to fly half way across the country and spend 5 days with a realtor and my son, looking for houses.

    I really believe your recovery will go better if you can relax a little bit, not worry so much and try to just take it day to day. If you are taking your pain medications exactly as prescribed and you are still in more pain than you can handle, call your surgeon and discuss this with him. Otherwise, try to stay positive, do the things that will help your recovery and for now, push everything else away.

    Things should start getting a little better now -- the hardest part is behind you. For whatever reasons, I'm afraid you were just not properly prepared for the enormity of what you were entering into. Some surgeons, for whatever reason, tend to downplay the difficulty of the surgical experience. I guess if they were 100% honest, they wouldn't have many customers. @) You have lots of friends here on the board that are pulling for you. Just take it a day at a time, and before you know it, you will be feeling the way you hoped to feel right after surgery.

    xx Gwennie
  • I'm glad to know I'm not the only one who was not sufficiently prepared for the amount of post-op pain that is considered "normal." (Not sure what a TLIF is?) I had a MicroDiscectomy a week ago (Nov 5th), and am still in worse pain than I was pre-op. Probably about a 9 or 10 when I first wake up in the a.m. after pain meds have worn off, and a 5 or 6 when walking around, even with meds. I too was completely unprepared for this. Many people I spoke with, including my primary care doc and orthopedic injection doc, made it sound as though after a week I will be up and running and back to normal levels of activity. I realize every person is different, and every procedure is different, etc., but, I wish they had done a better job of preparing me for the worst-case scenario. My husband scheduled a business trip for next week b/c we figured I'd be okay by then for sure. NOT!!!

    Anyway, glad to have someone to commiserate with...please keep us posted on your progress...I'll be praying for you!

  • As usual, Gwennie gave excellent advice. I was useless for the first 2 weeks, pain was terrible. It is so true that your recovery will go smoother if you try to relax and not keep worrying about where you think you should be.

    Take one day at a time. Rest when you need to, walk when you can.

    I am 5 days away from my 2 level ALIF. I am mentally preparing myself for the possibility that the damage may be more than the Dr. thought and will have to have a PLIF (tougher recovery). He did advise me that it is a possibility. I know positive thinking is great, but we also need to be realistic and deal with the hand we are dealt.

    Give yourself a break. Lower your recovery expectations a bit and let your body heal at its own rate. Best wishes, keep us posted on how you are doing.
  • i wrote a response and then deleted it, because i think i might have misinterpreted what you posted, gwennie.

    i'm sorry for all my posts asking questions about everything. i definitely feel like i wasn't prepared enough for the surgery and since i'm alone a lot and have terrible communications with my doctor, i turned to the forum for any and all question i had.

    i know i shouldn't compare myself to anyone. i know we all heal differently i just wanted to know if what i was going through was somewhat average. thank you for giving me your experiences and its honestly a huge relief to hear that im not alone.

    i find that writing eases my anxiety immensely. that's why i write so much in my 'surgery tomorrow' thread. i also like to keep track of when things happen, and i also like to document everything in case someone else is going through something similar. i know when i research things i always love to find other people's perspectives that have gone through the same thing.

    gwennie, i sort of feel like you're sick of seeing my posts or something. i know you said you didn't want to upset me but i just get the feeling from your post. i do appreciate your advice, i hope that i'm wrong and you're not tired of reading my rants and questions.

  • Andrea, I sent you a PM
  • Hi Andrea. I'm glad you're postop and moving on with recovery.

    This forum is definitely for posting the things you post. I know Gwennie is not sick of your posts (she's a very understanding and kind person and I consider her my friend) - I believe that she was just concerned that you've set unrealistic expecations for your postop recovery like almost everyone here. Unfortunately, there are way too many members who don't get the guidance they need from their surgeon post op, and therein lies much of the problem. Please don't misunderstand her concern for her being tired of seeing your posts. I don't think anyone here feels that way either.

    I once made a post that spoke directly to new spineys that are facing surgery that talked about postop expectations. You won't believe some of the replies. I'm going to resurrect that post for you to read - it's called "New spieys, what we've learned..." and it's in the Back and Surgery section. Below is a link.

    Read up on all the members that were as amazed as you are about what spine surgery and recovery is all about. I think you'll find it interesting.

    So, with all that said, please keep on a-postin' girl. You need support and we're here to give it to ya.



  • Howdy Andrea,

    I for one am glad you posted all that you have! My lower back isn't the greatest, but for now trying to get the neck in order! When *I* see posts such as yours, and too of others, that allows ME to see a real sliding scale of what people go through! Good or bad recovery stories help people like me make more informed decisions! Yes, we all heal in different ways, experience pain in different ways etc. but isn't that part of what sharing is all about! I applaud you for your strength in what all you have and are going through!!! You're staying in my thought woman!!! Take it easy okay? *HUG*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Thank you Cath & Brenda. Deb, I am so sorry you were so unprepared as well! Was your husband able to change the date of his business trip?

    Cathy thank you for posting that link, I will be sure to read through it. Sometimes it's hard to interpret what people mean to say online. I'm sure I misinterpreted Gwennie, and if I did then I apologize :)
  • Andrea,

    The fortunate thing for me has been support from my husband. He has been wonderful in coming to appointments that he knows have me "concerned" if you will - freaked out is better - but I don't let him know that part! He also LOVES that I found this site, because as he put it, he has no problem listening when needed, but even he "can't" relate. We even discuss some of what I see on here that is similar to what I am going through. He actually engages in good conversations on that topic! LUV him!!!

    While I was pretty well prepared for what to expect, we didn't discuss pain issues should a fusion "break lose" or anything. But my NS has been very helpful in trying to help me since it did! He did advise me of possible revision surgery, but we are both hoping his efforts and "my" behaving and following his instructions will fix that!

    Please keep us posted good or bad on how it is going with you. *HUG* Continue to take care!! :-)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • No, Andrea, please do not think I want you to stop posting or not say exactly what you were and are feeling. I just get so mad when I feel someone has entered into surgery because the doc has led them to believe it isn't a big deal and they'll be back to "normal" in a matter of weeks. It seems to me this situation happens more than it should. It is hard to be fully prepared if one is led to believe it is the same as having a simple surgery where you go into the hospital, have the surgery, recover from the surgical process and then are "fine."

    I just can't read your posts without feeling you were not made aware of the level of pain involved, and the length of the recovery.

    I shouldn't have said what I did (perhaps, the way I said it). I in NO WAY meant to make you feel bad. I just thought that you will do better if you can be less stressed and maybe that would happen if you realized that a lot of what you've been through is pretty normal (minus the crummy hospital experience.)

    One of the best parts about the forum is members being able to write about their experiences, and not just the "facts." I'm glad you feel up to writing and I know others enjoy reading and will value learning from your experiences.

    I feel strongly about what I was trying to say in my post...but I obviously still didn't say it very well...since I deleted the first one, but thought this one kind of conveyed what I was trying to tell you! I just was hoping that if you understood what you were going through was somewhat similar to others' experiences, you could relax a little and that would lower the stress, which would help your healing in the long run....

    Feel free to PM me any time -- I enjoy hearing from you and welcome any comments, questions, or rants, directed at me, or otherwise!

    xx Gwennie
  • I too can vouch for Gwennie. She has been a tremendous help to me. I was told by my orthosurgeon about 3 teachers he did the same fusion as me on and they were back to work in 2wks. He felt by 6wks I should be weaned off all meds and feeling fine. It was about 3months post op that I found this site because I wasn't doing fine and was in fact doing worse. I had unrealistic expectations as well and feel I was not properly prepared by the orthosurgeon regarding my healing process and pain levels. Gwennie has been amazing at helping me and proving me with a wealth of knowledge. I know that she would never mean to indicate she was sick of hearing anyone complain about their pain levels. She's been so helpful to so many, including myself.

    Feel free to pm me if you have any questions or just want to chat. I think it's important to post your personal experiences as well as continue to update them so that it may help others and may also help yourself if you ever need to go back and see what may have/have not worked before. So please, keep updating your progress for you sake and for the sake of all the other spiney's.
  • I'm glad for everyone who comes here and honestly posts their experiences and expectations. I know what Gwennie means about how some surgeons portray this whole process as a walk in the park -- the discs will be off your nerves, your spine will be strengthened, and you'll be feeling just great! Yeah, right! They forget to tell you that they will be moving your muscles and nerves (even the previously undamaged ones) to the side to complete the surgery and things will be very riled up for a while. Nerves, which can heal, are extremely slow in doing so. Unlike bones, which knit themselves together without sending jolts out every second or two, nerves are our feelers, our pain conductors, and as they heal and change they will send us constant signals that they are doing so.

    I will have my one year surgical anniversary (from my second "surprise" surgery) next Tuesday. Today is my one year anniversary of the day I went into the hospital for my fusion. I still have pain. Some days I have severe pain. Most of the time, it's just a little annoying pain. Fusion is a big stinking deal. Microdiscectomies are a smaller deal, but they still are in the same area, they still hurt, and if something goes wrong or they don't get all the matter that is on the nerve, they can be just as painful. Pre-surgical patients who come here to read need to know this stuff.

    I can remember having my micro-d. For me, it wasn't bad at all. I remember waking up and feeling so much better. The pain was GONE! Over the next few days, I did get some pain in my leg, from the nerve trying to re-generate, but I felt great. I walked, and walked, and walked. I should have realized, and I think perhaps my doctor should have realized and maybe did, that pulling that piece of disc out from under the train wreck above it was setting me up for problems down the road. I had the micro-d in December '07, and by June '08 my leg began to buckle out from under me and I was in agony again. My sister came to visit from the east coast that July and we went to an orchard to pick cherries. I was good and only picked the ones I could easily reach from the ground, and I let my brother-in-law carry the buckets. That night, we sat around a picnic table pitting the cherries. Just the action of squeezing the pitter started to make me gasp in pain. I saw my surgeon the next week and was scheduled for surgery in late August. Everything was set, and then they decided to get a discogram two weeks before. I had the test done and when I went back to see the surgeon the next week, one week before my scheduled surgery, she told me there were too many levels damaged and she could do NOTHING for me. After a few moments of stunned silence I began to cry hysterically. It sounds crazy, but I was in such pain that I was actually looking forward to the surgery to relieve me of my agony. Then to be told there was nothing to be done and I would have to be like that for the rest of my life was more than I could bear. I finally made it out to the car and sat there for another hour crying. I couldn't drive -- I couldn't even see. Came home and had a couple of glasses of wine and slept nearly the clock around. I was in such despair. When I finally pulled myself together enough, I got on the internet and started to look for info on three-level fusions. I found surgeons, I found lots of articles that said you would be nuts to have one. I found all sorts of information that said don't do it. Okay, I knew it wouldn't be good, but I knew I could not live the way I was. I finally found a surgeon two hours from me. He didn't sugar-coat anything. He told me it would be rough. He told me it would be a difficult surgery (I had lots of scar tissue and lots of disc stuff to be removed because the discs were severely torn and needed to come out) and he said it would take me one to two years to recover. I guess I still thought I was made of stronger stuff and I'd heal faster than they expected. I was not correct.

    I go to physical therapy once a week. I'm scheduled clear through the end of the year, and after today's session, my PT told me that I should probably get appointments for the beginning of next year too. He's right. I don't know that I could stop PT any time soon. By the time I return to his office each week, I've gotten stiff and I start limping again. Once I have my treatment, I feel better and can go on for another week. I am fortunate that my insurance will cover 60 PT visits a year. That's one a week plus a few extra. Of course, I have to pay 30% until I meet my max out of pocket, so it can add up, but i simply have to do it.

    This stuff is not for the faint of heart. We are tough women and we will make it through, but the going is not easy. I'm glad you're all here to help carry the load.

    Sorry I've been so long winded, but I hope my experience will help someone.

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Hi Andrea, I sent you a PM :)
  • Hi Andrea, I sent you a PM :)
  • I know this is an old post but I just had to relay something my Dr said. On my final visit just prior to surgery, I asked about pain levels and expectations. My Dr verbatim said "it will be hell." I have never had a physician be that direct or honest with me. BTW, he was correct. So maybe if more medical specialists told us what to expect and prescribed meds specifically for hellish pain, many of us would not feel so tortured after surgery. And as for them not giving realistic expectations due to loss of business, maybe it should mean loss of their license? Just a thought since they always complain about the cost of their malpractice coverage, be proactive with info and make the ride as easy as possible. Stepping slowly off soapbox.
  • I agree with you Trasee. I'm now 4 weeks post op and still in a lot of pain. My back pain feels like it's the same as before surgery and I'm getting very discouraged. My leg pain is still there, which I never had before surgery. I don't have a check up with the damn surgeon for another 2 weeks. I hate how they leave us in the dark like this regarding pain levels. I'm furious today!
  • I am 4 weeks today and said it takes time to heal it and you should baby it. But never told me that i would be worse than ever.I have to cry self too sleep pain meds will not touch pain.I was in misery before and know this is a different pain level.

    I was not told alot of things and today feeling wish i never had gotten this done but know it will heal with god willing and myself thinking positive...
  • Biggorb1, what pain medications are you on? If you are in so much pain that they don't even touch it, I would definitely call your doctor's office and let them know. Are you seeing a pain management doctor? You don't deserve to still be in that much pain. :( I'm sorry.
  • Just so you do not feel alone, I've lost count how many people come on here after surgery and say the same thing: I wish I never had this done. Those that don't post those words are surely thinking it at one point or another.

    Before my fusion, I had been advised to take all the medications given to me by my surgeon for post-surgery recovery and to take them on schedule, even if it meant setting an alarm and waking up. I did just that, and I have little memory of the first three weeks. I continued on most of the meds for eight weeks...and then, I just stopped. I was feeling pretty well and felt I no longer needed them.

    Have you called your surgeon and told him/her the level of pain you are experiencing? Don't be afraid to call the office and tell them whatever you've been given is not controlling your pain. You really cannot heal if your body is spending all its energy dealing with pain.

  • I think sometimes people are led to believe that minimally invasive surgery will be "easier." They are told that the healing time is shorter, and the recovery faster than open surgery. I don't know if this implies that it will be easier in the pain department, too....

    It seems to me that it is only easier in the access to the area where the surgery is performed. Once "inside," it is pretty much the same carpentry job -- whether the surgery is open or MIS. Bones are drilled; screws are inserted, etc. It makes sense that this part is going to be just as painful -- the bones and nerves are still traumatized and there is still plenty of healing that must occur.

    So, you didn't have any leg pain prior to surgery? What is going on now...like where is the pain located? Do you have it all the time or just when standing or walking, or sitting or...??

  • I was in exactly the same boat that you are in post op. Totally unprepared for the pain that I was in. I hate that the docs are not honest about how painful it will be. I would have been so much better off had I been prepared. That is why I try and tell everyone to prepare for the worst and hope for the best. I hope that you feel better soon.
  • Thanks JJ Grey! I hope the pain has eased up for you.

    Gwennie, I also think that people are led to believe the healing time for minimally invasive operations are much shorter & easier. I know when I heard minimally invasive I immediately figured it would be less traumatic to my body therefore the healing time would be much less. They didn't give me a definite time frame for healing but they definitely made it seem like it wouldn't take as long as an open surgery. And that's a shame, because as you said, the same nerves are affected, the muscles are still moved and bothered, etc.

    My leg pain is just when I stand. It goes away when I walk or lay down, but I can't stand on my right leg for more than about 1 minute before I start to get the pain. It hurts in my calf area, below my knee and above my ankle. It's like a burning pain. It's horrible. I told my surgeon's assistant about it today on the phone when I called about my IV issue, and she said that it's fairly common, "it happens". I'm hoping it goes away soon. I've never had any leg or sciatic type pain before this.
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