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not sure what I did but feel awful. 4 months post PLIF one level

nelnnel Posts: 402
edited 06/11/2012 - 7:41 AM in Back Surgery and Neck Surgery
Hello again,
I am 4 months out from PLIF on L5S1. I have had some ups and downs in my recovery mostly from "doing too much".
Well I didn't think that what I did on Thursday was "too much" but now I am in horrible pain again. I appreciate that it is not nerve pain and is "only" muscle pain but it hurts!

So thursday I worked in the morning (teacher - senior school)after my usual morning swim then walked the dogs in the afternoon (so far nothing that I don't normally do) but then in the evening I had to do a parents' evening. I left home at about 5.30 drove to school then sat from about 6pm till 8.10 pm. I had a fairly decent chair, although there was no lumbar support. I started aching 'round my hips almost immediately so I took the only painkillers I had - ibuprofen. That helped and after that I mostly just had that squashed together feeling in my tailbone. When I stood up to leave I was definitely stiff.
During the night I woke up in pain and felt like I had jolted awake. The pain was in my hips and across the bottom of my back.
The next morning I tried to swim as usual but gave up because it hurt too much. Then I had to work the morning but took it easy and sat down for both lessons. I was hurting quite a lot and felt really stiff. I can't take the narcotics in the day because they make me feel sick and giddy so got by on paracetamol.
I did not go for my usual walk on Friday and slept a bit instead. That night I woke at about 3am in loads of pain and had to take co-codamol. The same thing happened saturday and sunday nights. I am now not taking more than two doses of paracetamol in the day so that I have one to take as co-codamol at bed time and a spare for when I wake in the night.
I really hurt when I get up and am so stiff. I really just want to sleep but when I lie down it is really painful to get back up. I seem to have that velcroed to the bed thing back again.
I tried walking on Saturday but think that might have been stupid. I hoped that moving about would make me feel better. I haven't walked since.
I just don't get how the 2 hours of parents' evening can have knocked me back so far. It is now my half term holiday and again I can't enjoy it! I just don't know what to do to get past this. Is it just a waiting game? Or is there something I can do to make the pain go?
I do have a few valium left - should I try that? Should I just try and push through the pain? Should I rest until I feel better? I knew I was in this for the long haul but I didn't expect to keep getting poleaxed like this!
Sorry to go on again. Any help/solutions would be sooo gratefully received.
Helen
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Comments

  • I'm pretty sure i heard someone mention here recently that you aren't supposed to take ibuprofen post fusion....did your doctor mention anything about that? Maybe it's only for a few weeks post op, not sure.
    I'd give the valium a go, at least it will give you some much needed sleep and could relax those muscles that sound like they're in spasm.
    Are you having PT? What home exercises/stretches have you been given?
    I had an ALIF Aug last year and I can't sit for more than 5 minutes, but it does sound like you're sitting for too long without a break.
    If you're concerned you should call your doctor.
    Take care and let us know how you go.
    Kylie
  • take it easy ..your fusion is not a miracle! you are doing far too much ..carry on as you are and you risk permanent pain and no way to control it ,i talk from bitter experience
    STRAKER

  • I haven't had surgery, so am definately not an expert. I wonder if sitting for so long is the culprit. Lots of people on here say that they are unable to sit for long before they have pain.

    If I get bad pain that comes on, I usually find that ice helps it. Have you tried that?

    I hope that this set back is just short-lived, and that you quickly return to your healing, and can enjoy the half-term rest.

    Take care, and don't do too much!

  • I'm sorry you are having a little setback, but I think it is fairly normal. I know we've "talked" before where I indicated that I thought you were trying to do too much too soon...but it seems to be working OK for you.

    It is frustrating to realize how little it can take to ruffle things up again. I had a one level PLIF two years ago. I am always surprised when I bend over one too many times that I still get pain.

    I don't know what caused your flare. It may be that while you were sitting, you were using some of those muscles that have not yet re-strengthened after surgery. Perhaps there was some stress associated with the conferences which fed into you tensing your back in a way you have not been doing since surgery.

    Have you tried using heat and then very gently stretching? I would suggest trying something like that several times a day, and some gentle walking to keep the blood flowing. If you have a muscle relaxer, I don't think it would hurt to try that.
  • I am wondering if the sitting is the culprit - thing is I don't have a choice about working these parents' evenings. Thankfully there aren't any more long ones for a while now. That is the problem with teaching - it is so all or nothing. And of course work haven't given me any support since my return to work six weeks ago. I am pretty fed up with work right now - can you tell?!!

    I have been walking around the house the last few days but don't feel up to a walk in the "real world" again today.

    I really don't fancy using ice - I am a heat pack user. I don't like being cold. It makes me tense up. I think that is a horses for courses thing! I think I might have to try heat again.
    I have used small amounts of ibuprofen since my op - over here it doesn't seem to be the same deal as in the US. My 3 month x ray did show some fusion so I guess it is ok. I only take it when the paracetamol alone isn't working.

    Gwennie - I am trying to do less, honest! I have been making a concious decision to say no - like on friday no walking and I only stayed in the pool for 5 minutes! I am planning to rest up this holiday even though my heart is screaming that I should be pushing to get "back to normal" while I have the time away from work.

    I will try some heat and stretches and might take some valium tonight. I have a spa day booked tomorrow (felt I deserved a treat!)so maybe the warmth and relaxing generally will help?

    Straker - you have scared me now. I just don't know how to do much less and still get better! I know that swimming is a bit of a contentious issue but my surgeon and physio both say I should do it and I am only doing a bit. Also it is always the thing to go when I hurt. I am supposed to walk so I do some each day (except for the last two when I have hurt too much). And I have to go to work. It is so difficult to get the balance right. Which things do you think I should drop? I just don't know what to do for the best. Last time I saw my surgeon he pretty much said that the reason I hurt is because I am not doing enough exercise etc. But then in the next sentence he says don't do it if it hurts. Then he says that things will hurt! I am so confused!!!!
    I am being pretty lazy at home - still hardly do any housework. I have cleaned the bathroom a few times and cleaned the kitchen worktops but have not hoovered or swept the floor or anything that really needs me to bend. I don't make the bed and don't really do laundry.
    What I really want to do is the right thing so that I get past this pain, don't get any more days like these and keep improving. Until this all hit me on Friday I was starting to feel better. I had bought a memory foam mattress topper so was sleeping better and hardly had any pain in the day at all. So I suppose what I am asking is what is the right thing to do?? I am all out of ideas!
  • Although I haven't had my fusion, I can so understand your frustrations. It is such a struggle trying to balance all aspects of life. I think as women we struggle with that, then add major back surgery on top of that. I watch my husband and he just doen't seem to struggle with balance. When he is tired or sick, he stops and sleeps or rests. At the end of a long day, he goes into the study, turns on the TV and rests. It doesn't seem to work that way with me and maybe not with you also. I envision my day as a list of things that "must" be accomplished and I don't stop until everything has been completed. My struggle is how to stop , and begin to put myself on top of the list! I love that you are going to the spa! I wish I had more to offer! Sending prayers your way from Texas! Hang in there!xxxx Shari
  • Thank you Shari! Everything you said is sooo true. When my husband has been off work sick I get home from work to a bombsite. When I am off he gets home to a cooked meal! Haha - more fool me!
    I have definitely been taking on board Gwennie's advice and really have stepped back from a lot of stuff. The house is a mess. I only cleaned the bathroom and kitchen out of self defence because I hate trying to get clean in a dirty room and who wants to eat food from a filthy kitchen! The floors can just stay dirty - after a few months it doesn't get any worse! ;)
    I don't really do anything other than go to work and my exercise stuff. I haven't been out for a meal, to the cinema etc. I thought the spa day was the best way to relax and perhaps loosen some of these tight muscles. Plus, I desrve it LOL!!
    So I suppose I didn't think I was doing too much. Just that parents' eve has pushed me over the edge.

  • Have a wonderful 'you' day tomorrow at the spa. Enjoy every minute of it, knowing that you really deserve the treat.

    I'm in the UK on half-term too. I have developed a bad head cold and sore throat, so am going to take it fairly easy. It is so annoying how often we become ill as soon as school holidays come along.

    Take care and hope that you get back onto a straight path in your recovery very soon.
  • I think you're doing about the right amount now. I was not enthused about you swimming laps at the same level of intensity that you did prior to your injury/onset of pain...at this point. I think you need to build up a bit more gradually than it sounded like you wanted to do early on.

    I just think that the sitting at the meetings took its toll and it will take you a bit of time to recover. The muscles are not yet back into shape and your endurance is not what it was either.

    One problem with recovery is that once we start having more than one or two days where we are feeling better, we get lulled into a sense that recovery will continue and we will just continue to feel better and better. Maybe there is someone out there for which this is the case...but everyone I know and know of has gone in fits and spurts. So don't be discouraged. Just recognize it for what it is and keep doing what you are doing...remembering that walking remains the best exercise for those of us with lumbar surgeries.

    Did I tell you already about my traction exercise? If you are able to get down on the floor, and back up, this is very beneficial.

    Lie on your back, knees bent, feet hip-width apart and flat on floor. Arms should be close to your sides, palms facing up. Pelvis should be in "neutral" position. If need be you may put a very small pillow under your head, but it is more in alignment without. Tuck the chin ever so slightly.

    Now all you do is breathe deeply from the belly, so it rises and falls with each inhale/exhale. Just lie in this position and keep breathing and relax.

    This position is a natural form of traction. It allows the discs to unload. It allows any muscles that may be "guarding" a stressed area to relax. It allows soft tissue to fall back into alignment.

    I have been known to do this in a quiet corner of an airport corridor and a department store dressing room when I felt I could not walk another step! When I am having what I think of as an acute flare, I do it three or four times each day.

    Another position is similar and accomplishes the same thing. Lie flat on the floor with your hips snugged up to the edge of a couch or chair. Lift legs, bending at the knees and place them on the seat of the couch...so from the knee to the feet, you are resting on the seat of the couch or chair. Again, arms to the side, chin slightly tucked, deep belly breathing. I do this when watching TV or taking a little nap. You have to relax while doing it -- just let yourself go and feel your muscles sinking into the floor.

    Hope one of these positions offers some comfort to you.

    Gwennie (the Nag)
  • Hey Gwennie - I don't think you are a nag at all. You have given me plenty to think about and if I didn't want answers the I wouldn't ask!
    I just tried your traction thing and it was ok while I was doing it (except I found it hard to have palms up and close to my side, either palms down and close or palms up and more spread out) but when I came to move it really hurt! It does seem to me that my worse pain happens after I have relaxed lying down. If I sit I can get up fine, and from lying on my side it is not too bad but from lying flat on my back it hurts like mad. I think that perhaps I don't remember to engage my core after fully relaxing and that is why it hurts. If I think really hard and concentrate on my core then I can get up with no pain. Can I do it on the bed rather than the floor? I find it quite hard getting off the floor.
    Jellyhall-I intend to have a fab day tomorrow! Sorry to hear you are getting a cold - it's true the holidays are when I always get ill too! Hope you feel better soon. x
  • Do you roll onto your side first before getting up from lying on your back?
    It's the best way for your back to get up, you should never sit straight up from lying flat, always roll onto your side first then (if on a bed) lower your legs and raise your torso in unison.
    hope this helps.

    Kylie
  • Oh yeh I do do that. I find that rolling on to my side is the most painful thing when I have a bad day. Once there it is much easier!!
  • Hi Nel,

    Just wanted to share that my job requires sitting and
    although, I make a point of moving around a little and standing rather than sitting...I end up sitting
    alot. I do not feel the pain until I am up and walking around. It is definitely accumulative and
    towards the end of the week I'm in even more pain.
    I end up coming home and lying down. Similar position to what Gwenny suggested. Only I remain this way through the evening. it is very
    frustrating. I don't really have any answers. Just
    wanted to share my experience.

    Oh, also, it does not seem to make a huge difference
    how many hours I work. After 2 1/2 hours of sitting,
    moving, standing, the result of pain is the same for
    me no matter how many hours I work.

    Rose
  • Hi Nel,

    Just wanted to share that my job requires sitting and
    although, I make a point of moving around a little and standing rather than sitting...I end up sitting
    alot. I do not feel the pain until I am up and walking around. It is definitely accumulative and
    towards the end of the week I'm in even more pain.
    I end up coming home and lying down. Similar position to what Gwenny suggested. Only I remain this way through the evening. it is very
    frustrating. I don't really have any answers. Just
    wanted to share my experience.

    Oh, also, it does not seem to make a huge difference
    how many hours I work. After 2 1/2 hours of sitting,
    moving, standing, the result of pain is the same for
    me no matter how many hours I work.

    Rose
  • Hi Nel,

    Just wanted to share that my job requires sitting and
    although, I make a point of moving around a little and standing rather than sitting...I end up sitting
    alot. I do not feel the pain until I am up and walking around. It is definitely accumulative and
    towards the end of the week I'm in even more pain.
    I end up coming home and lying down. Similar position to what Gwenny suggested. Only I remain this way through the evening. it is very
    frustrating. I don't really have any answers. Just
    wanted to share my experience.

    Oh, also, it does not seem to make a huge difference
    how many hours I work. After 2 1/2 hours of sitting,
    moving, standing, the result of pain is the same for
    me no matter how many hours I work.

    Rose
  • Hi Nel,

    Just wanted to share that my job requires sitting and
    although, I make a point of moving around a little and standing rather than sitting...I end up sitting
    alot. I do not feel the pain until I am up and walking around. It is definitely accumulative and
    towards the end of the week I'm in even more pain.
    I end up coming home and lying down. Similar position to what Gwenny suggested. Only I remain this way through the evening. it is very
    frustrating. I don't really have any answers. Just
    wanted to share my experience.

    Oh, also, it does not seem to make a huge difference
    how many hours I work. After 2 1/2 hours of sitting,
    moving, standing, the result of pain is the same for
    me no matter how many hours I work.

    Rose
  • Thanks for sharing Rose. I had noticed that generally I am worse by the weekend so maybe the fact that this parents' eve happened on a Thursday was just the straw that "broke my back"!
    I have to say that I am not feeling much better a week later. I haven't even bothered to try swimming (although part of that is because swimming happens in the morning and I have needed to lie in!). I have been waking earlier and earlier with horrible throbbing pain in my hip. I am taking co-codamol at bed time and a second dose when I wake (or later if it isn't 4 hours later). If I stand for even a short time I start to ache in my back and hips. Last night I tried tramadol but it seemed even worse. :(
    I am seeing my GP tomorrow to see if she has any helpful ideas. If it hadn't been half term holiday this week I doubt I would have gone to work. I am worried about going back next week now. Lets hope this clears up before then. I really hope this is just a muscle thing. I was so worried in bed last night (while I was awake from 2-4.30)that I have done something bad.
  • I'm sorry to hear you are still having problems. I had hoped you'd be better by now. Some vacation.... :(

    Please post and let us know what your doc says tomorrow.

    Gwennie
  • I'm so sorry you are going through this bump in the road! Hopefully, you will feel better when the sun rises~it always does eventually! Hang tight! Shari:-)
  • As I suspected it is just put down to doing too much by my GP. She also said that I need to make sure I space my physio exercise throughout the day rather than clumping them together. That is one thing I find hard to do because first thing I am stiff and too sore to do them and then I am at work. So I have been tending to do most of them in one bigger session in the evenings rather than lots of small sessions through the day. I am not so sure it will make much difference though - I am fairly sure this flare up is just down to the parents evening and not the exercises.
    Funnily enough when I am feeling good I do tend to spread the exercises out more as there are more times in the day when I feel able to do them!!
    Ah well I will just try and spread them out, gently increase my activity level and see how I go.
  • Ha...I know exactly what you mean about doing to much in a short period of time. Yesterday I told my physical therapist that if you just cut me in half, my top half is good to go!! I'm 12 weeks out, and Gwennie and others told me not to do to much, and had to back off PT for a month to recovery. I'm going to take it easy this time, and it sounds like we boh have been given good advice.

    Wish you much success in your recovery, Nel!!

    Lisa
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