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I think my surgeon is out of date...

B52BB52 Posts: 247
edited 06/11/2012 - 8:41 AM in Back Surgery and Neck Surgery
Hey y'all! I gotta ask something. First, I think my NS did a good job on my November L5-S1 fusion. I don't have as much pain as I might expect at this point. BUT.. getting advice or info from him is near impossible. He's quite aged and I think his methods may be from a bygone era. He's quite a proponent of "bed rest". I asked about maybe doing PT or some exercise. He really didn't like that. He still either wants me in bed or in my recliner and not much else. Then I read about a lot of others on here who are in PT or walking 3 miles a day and I sure wish I was. I can feel myself wasting away by the day.

I've always been a semi-tough guy who does hard work. I usually feel strong as a monster, but anymore I'm feeling more like a shadow. I guess I should keep with his orders, but damn. He says I'll be 9 months or a year before I'm healed all the way. I'm down with that, but a year from now, I'll be too weak to get out of my chair. Seriously. I walk down the driveway most days and it's getting harder to get back. Not like real hard yet, but I can feel that it ain't going right.

I kinda don't know what to do. Physically, I feel like I'm good enough to do moderate exercise. I realize that I'm fairly early in to this adventure, but I'm a little over 2 months.

Any good ideas? I'm open and I'll be a thankin' ya for 'em!



  • Aaron,

    Let me share a quick version of my story. I am an alpha male, loved football, loved hitting people, loved lifting weights, pushing my body, feeling the pain so to speak. I suffered my first back injury when I was 17 doing squats while training for football. Played my Senior year of HS, had a good season well enough to be all-league Defensive End. But I was miserable, in the Chiropractic office 2-3 times a week just to get through the season and had to hang up my ambitions to play further. Additionally, I still think of what if I was healthy my Senior year would I have perhaps had opportunities further in college. Of course being 5'9" and 200 pounds back in 1992 wasn't exactly Linemen size, however I was good.

    At any rate, I finally had my lower back operated on 2004. My 20's I felt were pretty wasted in dealing with agonizing on again off again back pain. I got an ADR. It took me 2 years to adjust to the new disc. By 2006, I became pain free and spent the next 3 years going for it. Running, playing, lifting harder than ever. In January 2009, I could squat 405 pounds, clean 225 pound, bench press 315 pounds. Then in February 2009, my neck went bad. I have now spent a year dealing with it, feeling like I'm wasting away. But then I had a daughter, I'm now approaching 36 and because this is my second stint with back/neck issues and not my first, I know that once I can get my neck well I'll get it back like I did when my lower back healed. Of course I need to adapt though and do things more in moderation. I'm OK with that, I just want to be happy and feel good.

    What you're going through sucks, I had my neck fused in August and I'm still told not to do pushups. I cannot wait until I can go in the gym, exhaust myself and feel satisfied. Hang in there buddy, I'm with you. You won't waste away being patient. Our bodies have muscle memory. As soon as I can, I'm doing P90X.

    Your conditioning will come back.

  • It is certainly NOT our position to say anything contradictory to what your surgeon has told you, BUT every article you read today states that bed rest is a bad idea. Most surgeons have their patients begin to walk in the hospital and continue walking from that point on. Walking is a very important activity, more than anything else one could do, as it replenishes the blood supply, providing freshly oxygenated blood to the surgical source. This aids in healing and also stretches out the spinal nerves which helps to prevent scar tissue from attaching to them.

    From this point on, surgeons differ in their approach. Some start PT earlier than others. Some do not order it at all. Here is something from this website:

    "There is a natural anxiety about resuming normal duties, although once the fusion is set, the more the back is stressed, the bigger and stronger the fusion becomes. Bone is a live tissue and responds to stress by growing stronger It generally takes about three months for the fusion to set, and once it has set up it is not fragile and is very unlikely to break. Stressing the bone involved in the fusion after three months helps the spine fusion to become stronger."

    Read through this article to see what one spinal specialist advises:

    Of course I have no medical training and am not suggesting you begin any type of exercise program. I am just letting you know what other patients have experienced with different spinal specialists.

    Good luck to you.
  • First to Jon, I'm glad to hear that you came back after being down. Not too good that you now have neck trouble. I just miss doing stuff. I'm a steel mill worker, welder, a medic and a biker. Or was, now I just feel discouraged and like a couch potato.

    Gwennie, my buddy! I get what you're saying 100%. Everything I read DOES stress that bed rest is a thing of the past and generally bad for recovery. I agree! So who should I listen to? Stuff I read and advice of people in this forum or the surgeon I just paid a quarter million bucks to fix me? Actually, I'm tending to lean more toward the former. Moderate exercise and walking just seems to make so much more sense.

    I guess I'm just whining. I read where Andrea (noseovertail) had gone to PT and liked it and that really hit me. Why not me? I'll shut up for a bit.

    Thanks for the responses though, y'all!

  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    I have to agree with Gweenie. On all of my surgeries the Dr. has wanted me Up and walking on day 1. And by 2 mos. I was walking over 1 mi. 2xday. Look at your x rays. Fusion should have started by now. Ask him if you have special circumstances preventing you from walking. I'm 1 week post op and walking 5 blocks.
    It is universal thinking that walking promotes healing and the fusion process.
    You need to know if you have special circumstances.
    Good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • Jim makes the best point. I can find 100 websites that say the patient should walk after back surgery, but what we don't know is what is appropriate for YOU. I would want to know if there is some reason you should not be walking.

    I'm not talking about going on an "exercise program" or even necessarily going to a physical therapist. Some very up-to-date spinal specialists do not recommend PT because they have had too many patients who ended up worse off as a result...one specialist I know is at the Univ. of Michigan and is very well thought of. I am just talking about walking on a level surface for a short period of time...and then very gradually increasing the time and distance.

    Walking is what builds bone and then makes that bone strong. Without walking the oxygen supply is not as good. The discs and vertebrae do not have very many good sources of blood supply.

    When I had a one level PLIF at L4-5 I did not start PT until about 15 weeks post surgery. But I did walk short distances several times each day.

    I would ask politely :) if there is a reason why you should not be walking. If you can determine that it is more his training than your situation, I'd be tempted to go ahead and start to build up a walking program. You can go on just about any spinal clinic or big hospitals' websites and look under "post-surgical rehab for lumbar fusion" and you will see the same directions on just about all of them. And I can guarantee you will find instructions to walk, walk, walk.
  • Good suggestion on finding out if I have special circumstances that prevent me from walking. I asked the Doc at my last exam how things were going. He said that he didn't see much bone growth, but all in all things were good. That was at my 1 month post op look-see. I don't go back for another look 'till March 1st. As far as I know, though, I'm doing well.

    I really think I'm going to just have to get out and get to stepping! Within reason, of course. I know already that if something hurts, stop.

    I think I'm mostly just in a cross mood because I'm tired of sitting on my butt. That plus I'm rapidly tiring of winter is making me sour :(

    Gracias amigos,
  • yep-I refer to it as the Official Mini-Meltdown.Even if you just walk around your yard or up and down the drive will make you feel better-it has really helped with my mood.I am ready to paint every wall a bright yellow,so I can pretend it is summer!I don't suffer from winter weather as much as some of our spineys,but when the wind is coming from the north across the pastures,it is cold!!!Do you live close enough to a mall or enclosed area where you could meander around for awhile?I live about 40 min.from any mall,so it is silly to drive that just to walk,but I may do it as I get stronger and the weather is cold.You still have your sense of humor,that is good!
  • Hey Aaron,

    He maybe old school or just doesn't want to take a chance you will do damage. My surgeon is more like what is described above. I was gotten out of bed that night after my fusion surgery. I walked as far as a mailbox and it hurt. I did it several times before being discharged. At home I was walking around the house as much as I could tolerate. My surgeon told me first 3-10 days will be very painful. Go easy but you must get up and move. This is not a lay back and feel sorry for yourself surgery.

    When I went in for my 2 week post op I was told to start walking outdoors. Only on flat land. No more than a mile. Done in short spurts. Control sitting. Lay down more than sit.

    My 4 week checkup I was given a script for PT. He has a PT group he trusts. I've used them before and I trust them also. The PT I have is being very conservative. I started with pool for exercise and land was only massage. After 8 weeks we started some very basic and simple exercise that is more stretching. Not stressing. I was also told I could walk 2 miles/day no problem. At 10 weeks average closer to 3 miles. I have no problems walking that much. The PT helps. Pool lets me work muscles without gravity. The land session she massages and works muscles that are tight, locked, or otherwise need to be stretched.

    Next week I do 12 week visit. I'll be getting Xrays so we can see how the spine and hardware are doing.

    I can tell you that sitting around all day would drive me crazy. I understand the "don't be so quick to exercise". But not walking. That has always proven to be helpful for me.

    Maybe as suggested you can prod him. Being polite but stressing that laying around all day is killing you. You really feel better when you get up and walk a little. Maybe he'll agree to the short spurts and under a mile. So you can walk up and down the driveway half a dozen or so times each day. Just to break up the couch/bed routine and get circulation moving.

    Did your surgeon beat a rubber chicken or sprinkle fairy dust around the OR table? Now that's old school ;-) LOL... Sorry I couldn't resist.

  • Hi Aaron, it's been a long time.. sorry for the lack of posting to you. To be honest my surgeon never told me to walk either, though he did prescribe me the PT pretty early one. But before PT I was pretty much laying flat in bed or on the couch all the time.

    Have you expressed your concerns to him about the lack of exercise? Maybe tell him you think you are ready to do some walking, see what his response is. Tell him friends of yours are having success with PT and they had the same surgery, maybe if you really sell him on feeling better he will oblige.

    I'm glad you are feeling better & want to be more physical! I think it's helped me a lot.
  • Did you get up to walk in the hospital the day after surgery? Did your dr tell you not to walk much or mostly not to do anything else? Maybe where you live he feels it isn't safe to walk outside yet?

    My dr is very well known for asking patients to help themselves improve, very pro walking,pt and doing whatever you can to improve. But he treated me differently than his normal. I was on very strict restrictions for a long time after my fusion. Basically, like you, except walking, he did tell me to walk around the house every hour or so,day or night when I was up, short walks were better than long, no inclines at all so not outside unless it was flat, no driving, of course the no BLT, no recliner/no sitting longer than 10-20 min at a time so on my back was his preferred position for me, and lots of other things. I have read others did alot before I could. I didn't start PT until almost 6 months post op and it was limited pt. It was 9 months before he lifted a few more things and I couldn't drive for almost a year! But it has been worth it! I am 15 months post fusion (L-2/3/4) now. It takes time and patience.

    For you, my opinion it's still early and you haven't even started to fuse on your last visit, maybe when you go in March he will see some fusion then he will give you some more freedom. Also, do you think he knows that you have a go-getter, do it all personality and might do too much if you were given the chance. I can understand where he wouldn't want you in the steel mill, welding,medic or biking yet! Like Gwennie mentioned, ask your dr these questions you have about what to do,not to do, and why.

    It takes time and patience but I do remember hoe ticked I was because I felt like life was passing me by and I'd never get up and out again! It's the hardest thing ever! But take it easy (if you can! LOL) until you find out what your dr has planned for your future! Hopefully, he has your best interest in mind! Good luck!

  • I didnt start PT untiol almosst a year because of problems. But I was told to walk. Not so much distance but frequency. He told me to walk a little and do it three or four times a day. Then after three days go a bit further. And keep doing this, increasing distance. He always stressed not to push the distance part, just to get out and walk. And I couldnt use a treadmill. He didnt want me loosing my balance and falling.
    I would call and ask Dr if your appt isnt until March. I am sure the Drs nurse can relay it to him and give you a answer. Good Luck Love, Robin
  • Kathy, Gwennie, Andrea, Robin, Tex & the Guys, all y'all thanks for the get-back! No Tex, I don't live close to no dang mall! Hell girl, I live in the country:)

    I think I'm just letting cabin fever and winter get to me. I got out and moved around a good bit this afternoon and I feel better. I am going to find out more from the Dr next time I see him. Yea Kathy, the doc knows I'm beyond ready to get busy, so maybe he's keeping a lid on me so I don't get out and get hurt.

    Mostly, I think I just was needing to blow off steam around y'all; people who understand what this is all about. I feel better already.

    Aloha nui loa (big love)
  • Come here to vent anytime! I was so happy to find SH and meet people that really understood where I was coming from and could relate to their storeis. Nothing like having friends to lean on. The one thing that kept me in line and still does is I don't want to start at square one, surgery again! Take care and be careful when you do venture out.

  • Boy you're right about not wanting to go through that surgery again. Homigawd that was rough! I was thinking tonight that same thought; don't mess anything up. I go back in March for a check, and I'm already nervous about it. I feel well and I think everything is going right, but ya never know.

    I am glad, as you are, that there are folks here who know what all this 'spine stuff' is about and can listen to me when I'm having a hissy fit!

  • Hello. I have been following your treatment and recovery because we came here about the same time. I would like to say that I think you are doing a splendid job recovering. You're one of those dominant personality types who likes physical exertion and action. It's really hard to be still and to be careful and to tread on eggshells when you're used to charging fullspeed ahead, isn't it? I'm a 40 year old woman and my mother still is having to constantly tell me to 'slow down' and 'be careful.' I have two speeds, stop and full speed ahead.

    Let me just say this, your body was probably very pumped up and healthy before this, right? You got it that way by your lifestyle and diet and care that you put into it. You worked at a healthy, athletic body. Well, now you have had a setback. Is it the end of the world? No of course not because you still have your life, and your movement and the wonderful blessing of surgery to help repair you. My point is this...in time, your ability to get to go on hikes will come back(when doc says yes) and your ability to maybe ride your motorcycle will possibly come back, and your ability to exercise and pump weights and be active, all of that will come back. You will probably have to start from scratch and build yourself back up....but...you have already proven you can do that. So be patient with your body and let it heal real, real good. That way, you won't have to be like this again in ten years. Give yourself more than enough time and just realize you are going to have let a bit of muscle and stamina go for now. It's only temporary though. If you take the proper time now, you will hopefully not wind up in this condition again. Your body is strong but it needs this downtime to heal. Allow it to have it and just keep telling yourself that when the timing is right, you will train and workout and maybe be even better than you were prior to injury. Hang in there. Patience is one of the hardest lessons we learn.
  • Why Shannon, I don't know what to say. What a nice note. And just on a day when I was needing to hear it too! Today there's a foot of snow out, so nobody's going anywhere. I've been in my house for days and I'm kinda wondering "what in the world did I do to myself?" You're right of course. We do need time to heal.

    I don't know if I'd have called me 'athletic' before, but I was doing OK. Sure enough, now I'm kinda puny. I got to tell you this though. My whole family, excluding me had always been health nuts. My mom and sisters have been influencing me lately to watch what I eat a little better. I have been, too. I want to use this episode as an opportunity.

    I'm going to have to change jobs (I'm pretty sure)and I might as well go to a better, more natural diet while I'm changing. If things go as I'd like, I'll come out of this looking and feeling better and working for myself instead of 'the man' Thanks for the encouragement!

    Big Aloha,
  • I too am in the snow belt, and know the frustrations of bad weather and being housebound. Last year I was recooping from Dec 11 on. So I know how you feel. Do you have a school or hospital that allows hall walking. If you are able to drive there, it is a good option, to avoid the ice and snow. It also gets you out of those 4 walls.
    It was a good thing for me last year, as it was pretty icey here. This year it is really icey and snowing here in good ol Iowa. I havnt been walking, as my Ortho wants me to take it slower and rest. But once I get the green light, I will be back at it. It is amazing what 1/2 hour can do for ones spirit. Good Luck and keep your chin up. You sound like things are going well, and I hope they keep getting better. Take care Love, Robin
  • Yea, I think all in all, I am doing well. I know things could be a ton worse! In answer to your q about indoor walking, nope. Our school has a real crime problem and I don't think they're big on visitors. Heck I'd be scared of getting mugged in there anyhow. Options for indoor walking are limited out here in the boonies. Last couple days I have just been walking around the house like a nut.

    How are you making out anyhow? Did you notice a big difference when you had your hardware removed? I'm guessing mine will stay in and it's not that bad; just curious.

  • Hi Aaron! I am in the boonies too----lets see if we can come up with something---are you close to a Wallyworld? I swear they are everywhere.Not my choice,but at least they are big enough to walk around.--or a Home Depot,Lowes,etc?How far out in the boonies are you?
  • Morning Tex! Hey, you do know that WalMart is the devil right? Like everyone else, we do have to shop in there sometimes, but I hate that place and everything they stand for. We are just a few miles from our little town, and yep there's a Lowe's. I hadn't thought of walking around in there. I'll just have to resist the temptation to buy home improvement items!

    How are you doing this morning? Well I hope.
  • This is really off-topic but I am surprised in the Sierra Nevada there is a big crime problem in the schools. How sad.

    I don't know about you, but walking into a big box store like the ones you mentioned makes my back go into spasms, two years out from my fusion. This does not happen in any other store or location. I think it must be the poured concrete floor....You might want to pay attention in case that happens to you, too.

    Otherwise, hope things are coming along OK.
  • I know-I am completely with you on the Wallyworld thing----glad you have a Home Depot----I am doing well---Sat.night we went to a family party about 1 1/2 hours away--we went in our daughter SUV--my upper body and arms are really sore from climbing in!I realize I am not near as perky as I thought I was.I am going to get out of the house for a bit--the craft store,and the library.I need to get past the nervousness of driving.Much as I love being at home,it does start to wear on ya--especially with the yucky weather!Let me know if you get energetic and get building stuff at HomeDepot!
  • Hi Gwennie, how are you this morning? Funny you mentioned how the big stores mad you have back spasms. That's one of the reasons I decided to go on ahead with this surgery. I could go a couple of aisles shopping in WalMart and my back, right above my belt line, would hurt like crazy. It got so bad that I would have to lean on the shopping buggy for the rest of the trip. This didn't happen nearly as bad anywhere else, but Walmart or Lowe's just killed me! I wonder what's up with that?

    As far as crime in school, it's so bad. The town where I grew up (pop. 500) and went to school never had any crime and still doesn't. Where I live now, it's so bad. Not just in school, but everywhere. Makes me sad :(

  • You know Aaron, I have been thinking about your situation all day today since I got home from physical therapy. I know it sucks not to be able to be more physically active but your surgeon is the only one who has seen the inside of your body, and is also the only one who knows exactly what he did & found while in there. I would listen to his instructions to a T if I were you, even if it's boring.

    I know everyone on here preaches about how important it is to be active & walk walk walk walk walk, but they haven't been inside your body like your surgeon has, ya know?
  • I hear ya, and true dat! My surgeon is 376 years old and I imagine he's done a zillion fusions. AND, while I don't understand being so physically limited, I do think most of my surgery went well. I do think he did a good job. I have so much less pain than what I could have. Guess I'll have a better idea come the 1st of March when I see if there's any bone growin' going on!

    He's given me his blessing to take 'limited' walks and specifically warned to walk slowly. Other than that, I ain't gonna do it, whatever it is, as much as I want to. The Doc may know what he's talking about; I sure don't, so I might as well listen to him.

    No working out, no bike - just nice slow walks. I can do that. And you're right, it is boring. Hey, how are you lately? Did you ever look into SSDI or are ya back to work? It's nice to know you were thinking about me today :) Makes me feel better all over!

    Cya... Aaron
  • Hahaha Aaron your post made me laugh out loud like 5 times.

    I'm not back to work at all... I am feeling better but I have no job to go back to. I can't do what I used to do, it's too physical a job for me now, so I'm stuck at square one. I have an appointment with an SSDI lawyer this Friday but I'm thinking about canceling it after I asked my surgeon if I'd qualify... he said probably not.

    Have you started those limited walks yet? My insurance only covered 18 PT visits so far so I have to cut down on how many times I go per week. I'm kind of excited because when I leave there I'm so sore for days after, but now I'm going to be bored in the house again...so I totally understand your boredom.

    Hope you're doing okay and your chest pain goes away soon too!!
  • Afternoon there Andrea! Well, I hope ya find something job or income wise that works for ya. Really. I'm wishing this for you at the same time I'm wishing it for me. Starting out on square one, as you put is, could be a real drag. I'm kind of excited about it tho. Who knows, I may go back to the mill working sometime, but I'm really trying to line something up where I can come out of this workin' for myself. And yea, I'm taking those little walks frequently. Matter of fact, I'm fixin' to put on my hoodie and go out here in a minute.

    Ain't it crazy that one little bitty ole back problem can have such major impacts on our lives?

    Hey, I don't know if you ever watched the 'Simpsons' on TV, but if you have, then you know who Montgomery Burns is..the old creepy company CEO. That's exactly how my Doc looks and sounds! Ha...

    Take care of you
  • Hahaa yes I know who Montgomery Burns is! I was actually picturing someone more along the lines of that other old guy... ugh I can't remember his name. He's on The Simpsons as well, he plays Bingo and says "You sunk my battleship!". He's old and wrinkly and I love him.

    Do you watch Lost? If not, you should try to rent the ENTIRE series and watch it marathon style. It's the best show I've ever seen. It's in its last season right now. SOOOOOO good.

    My father in law works at a steel mill! My husband sometimes works in places like that, he's a pipefitter and does welding a lot. That's a pretty strenous job, no wonder you have back issues. Working for yourself sounds like it would be a great alternative, then you could slow down whenever your back acted up. I'm kinda excited a bit too, though I have to go back to school before I really do anything else fun job-wise. I'm feeling torn on what to do.

    Take care, have fun on your walk!
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