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12 wks post-op...pain meds...work!

FarmgrrlFFarmgrrl Posts: 146
edited 06/11/2012 - 8:43 AM in Back Surgery and Neck Surgery
Hi all,

Long time, no chat. I'm 12 weeks post-op from a subtotal discectomy at L4-L5 (this was #2 for me). I just completed my 6 weeks of PT last Friday. I had some questions about meds...and working.

I'm currently taking Aleve 2x/day. As the day goes on, I notice breakthrough pain and take 8mg of Zanaflex every hours as needed to help with the discomfort in my left leg. Usually that works for about 2-3 hours and then I need to take a Percocet (10/325) (at that point its not just my leg but then my back bothering me as well). That usually does the trick for me. I write down my meds religiously (I have since I got home from the hospital) and I see that I need my Zanaflex and Percocet at least once a day and I'll take it twice if its pretty bad (usually the weather has a lot to do with it). I know that the burning and piercing pain in my leg is par for the course because of the nerve healing but I also get really sore muscles like I've been running or lifting weights (I'm doing nothing of the sort! LOL) but only in my left leg and particularly in my calf. I talked to my PT about it before I finished and he just kind of shrugged me off. Anyone notice any of the same sx?

I'm kind of concerned about the Percocet as well. Initially, on discharge my NS rx'd me 5/325 Percs to take 1-2 every 6 hours as needed. At my 1 month post-op visit, he refused to let me taper down to Vicodin since I was only taking "50% of the normal dose" of Percocet (I was trying to only take 1 pill per dose). I told him I needed a refill and he rx'd me 10/325 Percs to take 1 every 6 hours as needed (he was being a little sneaky with that one!). So I've been taking Percocet now for 3 months and I'm concerned about withdrawals. I notice go too long without one I start to feel "yucky"---sweaty, nauseous, hotflashes etc. I know my pills are big doses but I'm not taking them very frequently. Does this make sense?

Next week I am going to visit the NS (a new guy, my guy retired 3 weeks ago) for my 3rd post-op visit. I am still not working but I expect that they will release me back to work. I have to re-apply for my job and I will be required to submit a urine sample for a drug screen. How is that supposed to work if I'm still taking narcotics for pain? My former employer is anxiously awaiting for me to reapply as they have a position open for me...I don't want to mess this up.

Never mind how anxious I am at the prospect of running around for 12 hours shifts at this point in time. I'm still having issues with stamina. I'm doing much more around the house...I finally managed to use the Swiffer Wet Jet yesterday to clean the kitchen floor (I was quite proud but still sore afterwards...)

If anyone can offer me any insight into these issues, I'd greatly appreciate it!

I'm sorry I haven't been on too much since surgery. I've been trying not to get too depressed about the whole thing so I've been distracting myself with other things as much as possible.

Christine :)


  • It sounds like you have a physically demanding job. I don't know the laws/rules are pertaining to that. I will tell you that I am in a similar situation in terms of time since surgery and still taking Vicodin for pain. I was concerned about going to work while on pain medication, but my HR department said that as long as it is prescribed, that I am allowed to take it while at work (as prescribed). I have a desk job, though, so there is little risk of injury. My concern was my ability to think clearly and to meet expectations. If I started making bad decisions or was communicating incoherently due to medication, I suppose they could tell me to go home. I am almost certain, though, that they couldn't fire me because this is a disability and a necessary accomodation for me to function.

    I welcome someone with better legal knowledge to explain the laws, but I wanted to respond because I know that I was cleared to take medication while at work (again, for my type of job, with my prescribed medication).
  • As long as you have a prescription you can legally take your meds as long as you aren't operating a motor vehicle. That's all the law says.

    But it becomes a question of ethics. Can you safetly (your safety and that of others) do your job on the medications you take? Most of us have worked while taking muscle relaxants and neuro drugs which can make you drowsy or slow your reactions. Many have also taken different types of pain relievers that can have similar effects.

    There are all kinds of laws that protect you against discrimination at work. If you search the forums you will see a few good posts on this subject. Do you tell your employer or not?

    My feeling is that this is a decision that your concience has to make. Are you able to safetly work taking the meds? Only you know the answer.

  • hi farmgirl!

    I have been keeping an eye out for you! How are you? well I guess I know since you just updated.

    Sounds like your doctor has been even more cautious than my doctor. I am glad to hear things seem to be going fairly well for you. I wish I could help you on the pain med question but I don't think I'm the right person.

    As for drug test, you bring your prescriptions with you to the test, I think (or ask them) b/c it is ok as long as you have a prescription. The only challenge is will they realize you are a 'liability' from a health perspective....just some things to consider.

    Do you think the surgery worked?
    I'm about 11 weeks out and am in the midst of PT. My next follow up is May.
    I have not gone backward and would have to say I'm doing better each week...very small progress but progress. I just wanted to say hello.
  • SpineAZSpineAZ WiscPosts: 1,084
    Unless your job requires driving or machine operation or heavy duties - then therapeutic amounts of medications in the blood are usually okay. HOWEVER, I say usually. Your company could have a policy that bans these type of medications in any drug test. I once did disability claims for a mining company. They had an across the board ban on evidence of these type of medications in any drug test...even for the secretaries, not just for the miners. We did occasionally negotiate a return to work for people using these medicatinos if they did not have jobs involving driving, machinery, etc and they would consider these on a case by case basis. So some companies are looking to see if there are illegal drugs in your system and/or excessive use of medications (i.e. abuse of meds like percocet).

    If you are on some type of WC, STD or LTD from work be sure to make sure you would be permitted to return to work. One of the reasons my LTD has continued is my job required driving and since I can't do that on medications I continue to be considered disabled from doing my job.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • I'm not worried about taking my meds at work because I am a registered nurse and I ethically couldn't do that (nevermind what my employer has to say about it)...I couldn't imagine making an error because I was a bit fuzzy in the head from my meds. (Though I've built up quite the tolerance...)

    I worry because I'm 99% sure I'm going to need to take my meds after my shifts are over just to get comfortable to go to sleep. Heck, I was taking Vicodin and Zanaflex before surgery and that was not a problem? (As well as many co-workers, we're nurses, everyone's back hurt at one time or another!
    I am on STD right now. If I reapply and am rehired within 90 days of being terminated (I lost my job on Feb 24th), I retain my seniority and all of that good stuff without having to go through a formal orientation. Right now I'm feeling the pressure to beat that clock. I almost fell over when I saw that my NS wrote on my STD forms that he expected me to return to work in JUNE! My fingers are crossed that this new guy has better news than that (today is my appt)

    I'm sorry for the late reply but I appreciate everyone's responses!

    DNice! How are you? Are you back to work? I know how you feel on the slow progress. I'm still dealing with weird leg sensations (creepy crawlies, burning, stabbing pains...they're all over the place!) as well as back pain that is better some days and worse on other days. Right now, my left foot feels like its on fire but I'm told this is normal(?). Really, looking back, its way better than it was but still not "perfect" LOL I'm headed back to see the NS this morning for my 3rd post-op visit. I try to keep up with my PT exercises but sometimes they just hurt! My left hamstring is still particularly unhappy with me, apparently its been doing a lot of compensatory work and doesn't hesitate to let me know that when I'm doing my exercises. Overall, I'm comfortable with decision I made but some days that little voice in my head wonders if I should have just gone ahead with the fusion (especially if I rotate my pelvis/hips the wrong way, I get a hell of a shock in my back). Keep me posted!
  • I am suprised and then not so suprised at how many nurses are on this website. The type of injury I had to my back usually comes from impact sports such as gymnastics or football..(I have done neither) I think it came from my profession. I started out early as a CNA after high school..that was hard work but I was young and strong. I did that for several years then went to school and became a LPN..after doing that for 8 years I decided to go back and have been a RN for several years now. All of that lifting had to take a toll. You know what the proper body mechanics are, but when you find another human being lying in their own filth and there is no one to help you...you move that person yourself just to clean them up and give them some dignity.

    I love my job very much and can no longer do floor nursing in the hospital...Even though I have a bad back I would never go back and pick something different to do.
  • Nursing is such a self-less profession...giving of yourself from the physical standpoint, to help others. I'm not sure if I am going to be able to return to work either (my doctor said that I may never be able to go back to my job), but I have no regrets, and am so proud of the work that I have done, as I'm sure you are also!!

    With our back issues, it is difficult to contemplate another career either. Pounding the pavement trying to find a job in this economy, or sitting in a classroom learning another trade is impossible with my back. My sister in law just got a bachelor's degree, and is unable to find work...and she is healthy.

    I'm still holding out hope that I can return to my career someday. At 22 weeks postop, I know I'm still early out since the job is so strenuous.

    Take care,

  • Thank you on behalf of all patients! :D
    Over the last week, I have been to so many medical appointments at 3 different hospitals and twice at my doctor's surgery.
    Absolutely everyone I have met along the way has been wonderfully caring and helpful.
    It must be a very rewarding career, but must take a lot out of you both physically and emotionally.
    Thank you again for being so caring :-)
  • Thanks Tonya & Lisa,

    Nursing definitely takes its toll over the long run. I started having back problems in my teen years but managed to do OK. Then I was a waitress before becoming a nurse...I slipped and fell a few times (with trays full of plates of course!) but was always OK. I had back pain and all of that before becoming a nurse but my beloved profession has betrayed my body exponentially! I couldn't imagine not working with kids but after explaining to the NS what it entailed he shook his head and agreed to release me to work on May 20th but with restrictions...no lifting over 15 lbs and no "severe" lifting (after I described the bending we often have to do especially when "wrangling" toddlers in their cribs). He told me he wants me to find a position in a clinic or doctor's office. I'm going back in 3 months to re-evaluate my need for restrictions and to follow up on the surgery.

    As a side note, he told me that if I had come to him for an evaluation (remember he's just filling in for my NS that retired) that he would have fused me because I had a repeat herniation (to him that meant I have instability in my back). He also felt I might have more of an issue with L3-L4 now because of where my numbness is in my foot on his physical exam(I didn't realize it now includes the inside/arch of my foot).

    Driving home I almost had an anxiety attack thinking about everything he said. The decision of whether to fuse (3 levels!) or not was a big one for me and I thought I had done the right thing. I know that I made the best choice I could but now I think I might have just delayed the inevitable.

    My goal right now are to really working on dropping some of this weight. I was already overweight when this debacle started in the fall but I have gained a good 25 lbs between all of the steroids & stress. My 2nd goal is to quit smoking because I know its absolutely terrible not just for my back but the rest of my body as well. I know this sounds like an excuse, but after the friggin' horrible sucky year I had in 2009 I couldn't manage to let it go. 2 surgeries in 7 months really is tough in many, many ways. After spending 6 days in the hospital after this surgery, the first thing I wanted when I got home was a cigarette which was probably the biggest mistake I could have made.

    I'm going to stop my whining and try to get some sleep. I appreciate all of you reading this. Thanks :)
  • I suppose I've already spent too much time feeling sorry for myself that my recovery from my one-level fusion hasn't gone very well. I can't even imagine the challenge that you are facing. I admire your courage in recognizing some important first steps. I wish I could tell you there was a non-surgical way to alleviate your pain because I'm not sold that my fusion was even necessary. In any case, my prayers are with you as you sort all of this out. It isn't easy.

  • Thank you nurses for all you do and all you sacrifice! We so appreciate you!

    I was just reading an article in my OT Monthly that all stated OT/PT's as having a high rate of back dysfunction....In my early years, I specialized in working with peole who have had strokes, spinal cord injuries ie paraplegics and quadraplegics. It is very physically demanding work. After the birth of my daughter who spent her first 2 years in and out of the hospital. I switched to pediatrics and now specialize in babies ages birth to 3.

    I spend my days on the floor helping to strengthen muscles, normalize muscle tone and facilitate developmental skills. I carry large peices of equipment, portable scales, laptops, printers etc.

    I have spent a lot of time with my surgeon and PM doc to figure out how to perform my job with the least amount of stress to my body.

    The thought of not being able to return to my job is frightening.....I am thankful every day to have found a profession that I love! I absolutely love what I do! I hope and pray it can return!
  • Hi Graham,

    Yes, I'm still here...

    I finished up my 6 weeks of PT 2 weeks ago. It did help but really it opened up my eyes to how tight I was. I definitely increased my flexibility (or rather loosened up those hamstrings) and we did the core exercises as well. I also realized how creaky my knees are! By the end they had me lifting a 15 lb box off of a shelf and placing it on the floor and back to the shelf x20 and my knees would pop so loud that the other PT's could hear it across the gym and laugh but really ask if I was OK. It hurt too which should be another reinforcement that I need to drop some lbs. (Also, if I don't I'm gonna need knee replacement surgery!) I have a little bit of a suspicion that I am compensating with my back for what my knees can't do...on top of still needing to strengthen my core. Oh vey!

    You're right what is done is done. There's no going back now. At least my family hasn't given me grief with the "I told you so" comments. My mom didn't completely agree with my decision but we all know that fusion doesn't mean you're problems are solved.

    One of my nursing school classmates has been following my progress from my posts on FB and she sent me a message. She now has been out of work for over a year due to back problems. We're getting together soon so we can compare notes (and cry over a beer LOL). Its just crazy.

    I was watching all of the PT's during my sessions and I also wondered how they managed not to hurt themselves. All of them (seriously 90%+ of them) are fitness buffs but we all know that doesn't guarantee that they will be free from back problems. Also, I can appreciate what PTs do with kids. I used to see them lugging mats and toys all over the place working with my patients.

    Thank you so much for your support. I'm sorry to hear that your recovery isn't going as expected. I too was caught off-guard with this surgery. I expected my 2nd discectomy to go like my 1st and nothing was the same. From the post-op pain levels to the length of my hospital stay to my recovery. I too try not to focus on the bad but the good as well. I'm trying to see what doors open for me...who knows, maybe I'll find something I love even more than working at a hospital with the little ones!?!

    Thanks again to all of you for your support. I was long overdue to post on here. Nobody quite understands like a fellow Spiney!

    (BTW Graham, I didn't TOTALLY ignore your comments re: smoking, its still on my mind :) )
  • Thinking of you this week and wondering how it is going for you returning to work. I hope you are having a good week and are able to handle it. Let us know how you are doing.

    I am so worried about returning to work. I went on my first road trip this past weekend, 3 hours in the car, stopped once, reclined my seat during the trip, gone for 2 nights.

    I slept for almost 2 days straight when I got back! I couldn't believe it!

    Looking forward to hearing how your week is going!
  • Stop second guessing yourself and questioning whether you did the right thing. You weir options, made a decision. You are where you are. feel a 2nd micro


    is off the inevitable. That is personal opinion. Medical fae answer is "it depends"... Don't you love that answer ;-) if it delays things a year or


    so. Better medical answers arconsider mimprovement overional fusion. It's just part of the evolution. Thmuch better.

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