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plif 1/15

talia22ttalia22 Posts: 15
edited 06/11/2012 - 7:41 AM in New Member Introductions
Hi my name is JUlie

I had PLIF L4 L5 S1 on Jan, 15th i have so many questions and My post op is thurs and he wont call me back. i want to know how anyones recovery is going?. r u in lots of pain? what meds r u on? I am on a lot of pain meds including morphine and i have needed such strong pain meds for so long i dont know when to lower my dosage. Also I dont have a brace? feel like i should it seems like everyone else does . As far as movement and "exercise" i dont know what is to much and what to little.He said do as much as i can but i am so nervous about messing up i dont know what to do. Also I of course had a bone graft- mine was for sure going to be my hip he said he'd have it no other way but during the procedure he ended up doing it with cadaver which is a less successful rate of fusion i cant figure out what he could have seen to make him change his mind?? ideas??. my Surgery was upposed to be 2 hrs it was just over 4. please give me any and all info about your selves that you think might help. i amj sorry this is such an overwhelming Post but i have no idea who to talk to. as of now i still am using a hospital bed at home and teh toilet seat thats taller but i can use the stairs without awalker just fine. I would like to add that my Dr is known as being one of the best in the country i have been to over 12 dr's who were awful and had no idea what they were talking about so i do know he is doing everything as far as the actual surgery great or i would be completly freaking out i guess he just has no bedside manner and i need someone that will talk me thru all my fears-clearly he is not the one. any takers? i know its a big task :) ha
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Comments

  • Welcome to Spine-Health. I'm sure glad you found us. There are plenty of members here who have been through what you're going through and we're happy to offer our experiences, but nothing we say can override anything your doctor says or does.

    I didn't have a 2-lvl PLIF but I've recently had a 1-lvl TLIF. I'm surprised you didn't get a sheet of paper (mine is on my refrigerator) that tells you your major no-nos.

    It's always the doctor's choice as to whether to use a brace or not. Each doctor has a different opinion, so don't worry about that. You never know - he might give you one on Thursday, but it's totally your doc's choice.

    A PLIF is major surgery and you're still so soon out of surgery that you shouldn't worry about still using a hospital bed or toilet riser. Anything that helps is good. You also shouldn't worry about meds yet - I'm sure your doc will talk to you about them on Thursday, but if not, talk to him. I'm five weeks out from my TLIF (Jan. 6) and am still on pain meds and muscle relaxers and my doctor says I'll still be on them for a while. (Don't try to take them from me - I'd have to kill you.) My doctor told me it takes about three months to recover from this surgery, but I'm sure it's shorter for some and longer for others.

    Also, you talk about what's going on with others - well, forget it. You're unique and will heal at your pace and it doesn't make any difference what goes on with anyone else whose had your same surgery.

    I have no idea about the autograft vs. allograft, but he may have chosen to use some bone growth helper mixed in with the allograft. Personally, you might want to be happy that you don't have the awful pain that comes from using your own bone. I've always had cadaver bone, but I've heard others say that when you use your own bone, the graft site can get pretty painful.

    I'm going to post the list that's on my refrigerator that my doc gave me for no-nos and you might want to take this list to your doctor and talk to him about these things. The main thing is to be totally honest with your doc, and write down any questions you have for him. I hate that you're so confused after your surgery, so try to get some definitive info from him at your appointment.

    Please keep in mind, this is just the list I got - your doctor may feel completely different but it may give you some ideas to talk to him about:

    Lumbar/Thoracic Surgery Instructions
    -No Bending (forward, sideways, backward movement of the back)
    -No Lifing (less than 10 pounds, keep item close to your body)
    -No Twisting (rotation of the back)
    (These top three things are known as no BLT (bending, lifting, twisting)
    -Do not sit longer than 30-45 minutes at one sitting (sit in a chair that supports your back)
    -No pushing, pulling (do not pull yourself up in bed, ask for assistance)
    -Log roll to get in and out of bed. Avoid lifting your hips in bed, or pushing your hips side to side.
    -Be aware of your back position with sitting and standing activiies
    -Do not bend forward at the back during activities such as brushing your teeth or shaving. Use a small basin as needed and bend forward at the hips.
    -Do not do any heavy housework - vacuuming, cleaning windows, laundry, shoveling snow, moving the lawn,.
    -Do not drive until cleared by your doctor. Always wear a seatbelt. Avoid long car rides.
    -Take showers standing or sitting on a shower seat. Use a long handle sponge to reach your feet. Avoid bending over (shaving legs). Do not get down into the tub or submmerge yur incision.
    -Avoid going into a full squat, or getting things off the floor. Do not lie on the floor. (Those pickup grabber things are great for picking stuff up off the floor. Hope you have one).

    -Walking is the best form of exercise. Slowly increase your distance and time. Let your arms swing naturally at your sides, relaxing your shoulders down from time to time. Consult with your doctor s to when you can progress your exercise routine.

    Julie, remember that I'm not a doctor and am just giving you some items I was told and gave you some of my experiences. You really need to have a nice talk with your doctor at your post-op. In any case, I hope this helped calm you down some or at least answered some of your questions.

    Take care and let us know what happens Thursday.
    Cath
  • It sounds like you need a pep talk on the reality of recovery from fusion. Some surgeons are rather "optimistic" in what they tell their patients regarding the timeline for recovery. There really is no standard when it comes to healing. Each patient is different, each surgeon has his own way of doing things, and nothing is really "typical."

    You are very early in recovery and what you are experiencing is very common. Many people take pain meds for many months after fusion. Some do not need them, but many do. I took everything that was prescribed to me, around the clock, for the first eight weeks, and I just had a one level fusion. I did not have a brace. This is completely a matter of your doctor's training and experience. Some swear by them. Others think it causes the muscles to further deteriorate...so again, it is a matter of preference.

    Braces used to be the norm when they did fusions without hardware. Then they served a purpose as it was several weeks before any signs of bone growth and the brace helped to hold the patient together in the meantime. But now with the use of pedicle screws and rods, the bones are secure during the time it takes for bone to knit together.

    At four weeks out, most people walk as their major exercise. Walking is very important and should be continued even when you are able to move on to gentle stretching and PT. Walking is the best exercise as it stretches out the spinal nerves which helps to keep scar tissue from attaching to those nerves.

    I also had a doctor who provided little information or instruction. He always told me "If it hurts, don't do it." This was not terribly helpful in that you only found out AFTER the activity that it was going to result in more pain!!

    Since you are still very early in recovery, you should be limiting the amount of time you spend sitting. Fifteen minutes at a time is all you should be doing, and then just when having meals. Otherwise take a number of short walks rather than one long walk. Walk on level pavement and adjust your stride if walking causes pain. A shorter stride will put less stress on the spine. And it is not a race...go at a speed that is comfortable. When you can do a particular distance without causing increased pain, then gradually go a little further and a minute or two longer. Give yourself a chance to get used to that, and then gradually make increases.

    It is especially important to remember the NO BLT.
    Avoid activities that require bending, twisting, reaching up overhead or to the side, and do NOT lift anything heavier than a gallon of milk. Do not bend at the waist for any reason, and these restrictions will be in effect for the first three months...and you should still be careful after that point.

    Activities such as sweeping and vacuuming are very hard on your fusion, so avoid them.

    There's no magic to this. You need to learn patience and to listen to your body. If you are wondering about a certain activity, think through it and analyze what movements are involved in doing it. If it involves bending at the waist, do not do it. If it involves any kind of vibration or jolting action, avoid it. If it involves sitting without being able to get up and walk around after 15-20 minutes, avoid it.

    The first three months is the most critical time in recovery. Try to be very mindful of these restrictions during this time period. Fusion can begin at about 3 weeks, but it will be a year before the new bone is strong.

    And finally, along with patience, a positive attitude is very important. Expect ups and downs as you move through recovery. Don't get in the habit of "taking inventory" of every little ache and pain every day. You will not see much progress from day to day. Rather, look week to week if you must do anything. Recovery is often measured in baby steps, and often it is two steps forward and one back. Expect this, and you will not be overwhelmed when there is a little setback.

    Ask your surgeon what took the extra two hours. But two hours is really fast for a two level fusion -- three is more realistic from everything I've heard and read. Sometimes small things happen like there is a problem with low blood pressure. Only your surgeon can answer this question. Be sure to ask the hospital for the operating room notes. You will want a copy for your records.

    Goota run -- I'm off to see my alternate med. guy --

    Good luck to you....and remember to walk and rest. And give yourself permission to recover at your own pace.

    Gwennie
  • Thank you guys so much! what you guys wrote both helped me much more than any thing the dr said or i have read. i am printing both your replies and re reading them again and again. i know i have more Q's so i am sure you will be hearing from me very soon ..oh one was do either of you have kids? dogs? i have 4 large dogs and my husband cannot always be home (tho he works from home which is great) but i am very nervous to go home -I have been staying at my moms since i left the hospital and i am going home this week-how do you guys handle that stuff? and work? I am not working right now but i had a dog sitting business b4 all this got worse and was plannig to start it up again but im thinking it would be close to a year b4 i can handle all that??
  • hi and welcome to the forum! :H we are here to offer you support and answer what questions we can. you have been given some good advice and i hope it helps you get through your recovery a little better. :D your doctor should always be there for you though!!! good luck and feel better soon! :D Jenny :)
  • Gosh I feel so bad for you and hope your follow up will be benefitical. Is it possible that his nurse or his pysician's assistant could answer your questions? What about writing your questions and e-mailing or faxing them? You really need to be able to get your question/concerns answered. Let us Know how your follow up went. Keep taking your pain meds, you need them, hang in there amd be careful of your dogs. If they are well trained you can relie on that, giving them their commands and establishing boundries. If they are not, you will need to keep them away from you, if one of them jumps on you whether you are standing, sitting or laying down, they could really hurt you and damage your fusion. Take care!
  • they are somewhat well trained. post op kind of helpful but he just wants me off the meds so fast it seems to be all he cares about. i am thinking of going to my reg. dr and telling him everything and seeing if he will help me taper in a good way because my surgeon has alreay made it clear he is a surgeon and does not give out pain meds but i am less than i amonth out of surgery!!!! is this a bad idea? i dont know what reg. dr willl say but he was the one giving em to me b4 surgery so hopefully!!
  • another Q is i started feeling better about 2.5 weeks after being home. haaving not had my post op and really no clue at the time of what i should be doing as far as how long i should stand,walk,sit and lay i just really think i started doing to much. well i went to post op feeling ok but he didnt seem to care about anything other than he did a great job the xrays were perfect and now its up to me but still did not tell me what that meant. YES i asked he simply doesnt answer with actual answers. he wants me off meds now. thats insane and i am not willing to do so. am i wrong? he said i will be and should be in pain or the surgery is not done right. also he did say i should stay in bed lying flat 10hrs a day is that right? for 8 weeks. with lots of walking but its icy outside so i cannot go out and my house is tiny so i will literally be walking in circles-how much of teh day should i be walking,sitting etc...can i cook,drive? he didnt mention this stuff and when i told himi had a list of questions he said oh no questions that just means you dont trust me.huh? no it just means i dont know what hte hell to do and i am so nervous of messing the fusion up. i am doing alot of normal walking thru the house-the only thing i dont do is bend over and twist that causes pain.however my left side is shooting paints in my leg and hip. is this normal for it to start up again?
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