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What Can I Expect?

Gunny 1GGunny 1 Posts: 12
edited 06/11/2012 - 8:43 AM in Back Surgery and Neck Surgery
Hello Everyone,
pretty new to the board here but so far have been extremely impressed with all of the knowlege i have gaines so far. Any way here goes. Over the last year it has been the worst of my life. I own a gym and have been a competitive bodybuilder and very athletic all of my life. Always in perfect shape until now. Alittle over a year ago it was as if someone had turned a pain switch on from my belt line to my feet. The pain in my back was and still is unbearable. In my small town with only a handful of doctors trying to get someone to listen and help is like trusting in todays economy. After a year of testing... X ray, MRI, PT, Disc O Gram ( what a treat that was ) and 6 epidural steroid injections by 2 different docs, i had no relief. All testing has revealed ddd from S1 up to L4. I saw 2 different surgeons in Reno Nv. who both said that the surgery on me was out of their league due to the shape and relation of my sacrum and pelvis. They said the angle of the sacrum was 2 steep to give them the access they needed to fuse me correctly and both said no way! The 2nd surgeon recommended me to a surgeon in Santa Monica who now is in Cedars Cinai. When i met with him he said he was 100% confident he could get me some relief. He said of course there are no guarantees but said after doing thousands of these things he said he can help. i asked him about the whole angle thing and he said that yes i am tricky but still feels he can get me good results. I ma scheduled for surgery to fuse S1 to L4 on May 27th. I have heard and read both good and bad on the site here but would love to hear comments to my specific case. I just know that i am at the point where this pain thing has become all consuming and i pretty much cant stand it any more! I want relief. Have been on narcotics as well for over a year and am not even looking forward to that whole drill when that roles around. Please feel free to comment or suggest. Doc says 3 days in hospital and then another week in a motel close by because i live 300 miles away from the city. Also would enjoy hearing what i can expect while in the hospital and after i get home? Thank you for taking the time to listen and hopefully comment.


  • Wishing you the best with your upcoming surgery.

    I am recovering, 9 weeks post op, from a L4-5 anterior and posterior fusion. I can't comment specifically on your L4-S1 fusion but I did have a recommendation re the hotel you will be staying at for a week post op.

    Try to find a hotel by the hospital that specializes in housing people who are recovering from surgeries. The L.A. area is big and you should be able to find one. You want to be able to rest comfortably. Some people are comfortable in bed, some aren't, some in recliners, etc.

    Who will follow you after surgery? 300 miles is a long way to travel for follow ups, so hopefully you have someone close to home.

    Good luck and feel free to ask questions as they come up. There is a wealth of knowledge and experience on this board.

    The 3 days in the hospital is an average, but it can be longer, so you want to be sure your reservation for the hospital can be changed.

  • I am now 3 weeks post op from a decompression and interbody fusion of L5-S1. L5-S1 had a grade 2 slip and were bone on bone with partial fusing already taking place on its own. I had fractured pars that allowed the slip to occur and pulled the nerve with it, mangling it pretty bad. I had bone removal at back of vertebrae to make room for the nerve and two disc placed in between L5-S1 after they had to cut L5-S1 apart to allow for the decompression. In my situation they did not bring the 2 vertebrae back into perfect alignment, only half way. So, I have a slight slip still, but all will fuse with room for the nerve now. I don't think this is common, but not sure. I don't know if your doctors are trying to force all levels back to perfect alignment or if your situation is not even relevant to mine. Too have forced the 2 vertebrae into perfect alignment would have put to much strain on above levels. At least that is the way I understand it. So, again this may not apply to you. But the vertebrae don't always need to be perfectly realigned.

    I never could make a 300 mile drive, even now. So, I would find somewhere local for a week or two. I rented a medical bed (we have steps), but either way it allowed to me to set the right height and angles for my best comfort.

    Pain was bad for the first 3 weeks, but I can see progress now. Will have to deal with the left leg pain/sciatica for a few months if not longer due to its mangled condition. Without the severe nerve damage, I would be doing real good. I waited too long on my decision, but would do surgery again.

    Maybe a flight would be better than driving?

    Good luck,


  • Hi Gunny

    Your second surgeon sounds like he's done lots of difficult fusions. I can't comment about your situation because we're all different.

    It's so important to have a surgeon you have confidence in. My surgeon aims for 80% - 90% recovery for his patients, and so far, I'm in that range. It will be a BIG surgery and recovery will be SLOW. There are bending, lifting, twisting restrictions post-op which will apply for several months, and you'll always be aware of the need for good posture and core strength, but being a bodybuilder and owning a gym, you'd be aware of this. You'll have to be very careful with your back for the rest of your life.

    I'd recommend you have a look at Gwennie's post on what to expect during recovery under the Recovery section of this forum.

    At the top of the page there's a sticky with heaps of info on what you'll need for the hospital and afterwards.

    I'm sure you'll get top care at the hospital - I'm in Australia and I've heard of it. You'll be on a pain pump for the first couple of days and then you'll be changed over to oral meds. If you have nausea, they can add a med to the drip. You'll probably have flow-trons and stockings, as well as an injection in the tummy at night to prevent blood clots. You may or may not have a drain in your back (my operation was done from the front, so I didn't have one). I had a catheter for a few days. Initially you'll be on a liquid diet and then change to a light one.

    A physio will visit you in the hospital and get you walking again and give you a special exercise program.

    You'd be on top of good dietary principles but once you get home, you'll need to develop loads and loads of patience because healing takes a long time and you can't hurry it up. Initially you'll want to rest most of the time with small walks around the house, and then progress to outside, but always taking care not to do too much at any one time. So it's rest, walk, rest, walk ..... Pain meds should be taken as prescribed so that you keep on top of the pain.

    Will your surgeon refer you to another surgeon closer to home for the first couple of check-ups? As others have said, 300 miles is a long way to go and will be very hard on you in the initial recovery phase. However, don't let this put you off going with this surgeon. I was very nauseated on the short drive home from the hospital.

    I'm 6.1/2 months out and am fused. It'll take at least another 6 months for the fusion to become strong. Fusion has been a godsend to me because I can now walk without pain and join in and enjoy life again. I've had lots of ups and downs during recovery and at times have been really frustrated, especially with not being able to sit for too long, but that's improving. I had to work on my attitude but it's all been worth it.

    Wishing you all the best for your surgery on the 27th and do keep in touch.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
  • I am just over 6 weeks post L4/L5 laminectomy and fusion with cage and screws and rods.
    My recovery has been very good regarding pain levels but I have had all sorts of complications which have meant lots of medical appointments and visits back to see the surgeon. One week, I had three trips to three different hospitals and three trips to the doctor's surgery! I certainly wouldn't have wanted to travel far.

    After surgery there will be routine appointments, even without the complications I have had. 10 days to 2 weeks after surgery appointment to remove staples/stitches, 6 week check for x-rays etc; 3 month check; 6 month check.
    Would you be able to have any of these locally?

    Wishing you well with your surgery :-)
  • Thanks for the reply. We have found a motel to stay in that has a kitchenette with all the pots and pans and stuff needed. As well as a couch. My wife will be with me the whole time so she will have the unfortunate task of not only taking care of me but getting to drive us the 300 miles back home.
  • Hi Ken,
    Yeah if I could fly there I would. I live in a small town in California with a tiny airport. Nothing commercial. So thats one of the small dis advantages of small town living, no doctors, no major surgeons, no airports. But other than that it is awesome place to live. Just a bummer when something like this comes up. I am not sure about the vertabrae alignment but hopefully he just fixes everything that he sees that is wrong!
  • Hi Trish,
    It was nice to have my surgeon be so confident. He was not arrogant just confident. That works for me especially after hearing the other 2 say no way. My surgeon says he will do all of this going through my stomach which is what you had. How was the incision on your stomach after surgery? I understand I will have to be patient for the healing to take place. I am not very good at being patient but I am definately learning my lessons on that one. As far as i know all of my follow ups will be with him and his office as we have no major surgeons where i live of any kind. So i will get good at spending time behind the windshield. how long were you out of work? I am not sure yet on mine but i do plan on doing what ever it takes regardless of time. I want this to be a one time deal!
  • Hey Gunny, sounds like you are doing a good job of lining things up.:)

    I had a 360 fusion, which is both anterior and posterior. My anterior insicion is horizontal, about 6 inches long, but I think that yours will be vertical. The biggest difficulty for me was GI issues. Most surgeons tend to go through the left side, so your GI trac gets pushed around. The swelling of the soft tissue, plus the insicions cause the intestions to be irritated. So as you begin to eat, the gas and movement through the intestines can be painful.

    I wasn't hungry for several weeks after surgery, yet it still hurt. Be very cautious of constipation, it can be a VERY difficult situation and several people have been in the ER because of it! I was so scared, so I was very cautious. I used miralax when needed and it's great! Absolutely no taste, and it doesn't upset your stomach.

    The other GI issue can be a side effect of the antibiotics~diaheria (?sp). Eating Yogurt or taking the probiotic supplements the pharmacy can give you will really help.

    During surgery, regardless of how your surgeon makes his incision, he will have to cut through a nerve: the ilio~inguinal nerve. Everyone is different, but I found this to be difficult. Essentially it just takes time. Pain meds and meds for nerve pain ( 2 different things/meds) help.

    Do you have assess to physical therapy? If you do, great! Because it is an important part of your recovery.

    If not perhaps your surgeon could help set you up with one, that you could see during the week you are in the hotel and then for consultation visits when you come back for your follow ups. Not ideal, but....

    Do you have assess to a pool?

    Wishing you the best and we are here to support you.
  • See your point on airports. If you spend some time were you had the op, say a week and take a lot of breaks while driving, you should be OK. I still feel every bump at 3 weeks post op. If the roads are smooth you might be OK without spending so much time before heading home. Ask Dr. But, YOU WILL FEEL THE BUMPS.
    We are all different, so it may not be as bad for you.

    I lived 8 years in California, near Santa Maria. That was in the 70's. But, I know what you mean about the beautiful landscape and small town advantages.

    Good Luck,

  • SpineAZSpineAZ WiscPosts: 1,084
    Not sure if you said but will you be having any kind of brace created for you for after surgery. I previously was fused L4-S1 and had a custom brace made for post-surgery (recently had L3 added, but that's due to my own weird physiology and anatomy).

    Understand that your plans should be flexible. You may be in the hospital an extra day or two or may need an extra day or two in town at the motel. And, don't be too brave to say, on the way home, if you want to stop for the night just for the need to lay down comfortably.

    If they are going in only from the back you will have pain from the surgery, but given the right pain meds and taking them religiously as prescribed will help. Especially in the first few weeks you don't necessarily want to take meds on an "as needed" basis. If you keep them in your system at a certain therapeutic level you are likely to feel better (especially for the period during which you are at a motel and traveling home). Call the hotel in advance and tell them you may need many extra pillows if possible depending on what it takes to make you comfortable. See how accommodating they can be in that and even if they have a "disabled" room that will have grab bars in the tub/shower and in the bathroom.

    One item I found very helpful in the immediate recovery is a toilet seat riser. It can hurt to lower yourself all the way to the height of a standard toilet seat. It's something you can usually get at the big name pharmacies and should take with you for your time in the motel (and don't forget it on the way out). I did not need a walker but some people are comfortable using one. We borrowed one but if the hospital feels you need on they can often prescribe one. For when you get home get a grabber (24-36" device that helps you pick up stuff off the ground or anywhere out of your reach).

    You won't need much entertainment besides a TV remote but your wife may. And I find I am up all night after surgery, so short of getting adjoining rooms (if you can, consider this) your wife may want to bring ear plugs if she wants to sleep while you watch TV, etc.

    How long you'll be out of work depends on how heavy your job is but also significantly on how well and how quickly you recover. Even the healthiest most fit person can have setbacks or recovery delays so pace yourself and listen to your body.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Gunny, can you send me a pm with the name of the surgeon?
    rugmankc said:

    I lived 8 years in California, near Santa Maria.
    Hey Ken, guess where I am currently living?

    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • Gunny 1 said:
    Hi Trish,
    It was nice to have my surgeon be so confident. He was not arrogant just confident. That works for me especially after hearing the other 2 say no way. My surgeon says he will do all of this going through my stomach which is what you had. How was the incision on your stomach after surgery? I understand I will have to be patient for the healing to take place. I am not very good at being patient but I am definately learning my lessons on that one. As far as i know all of my follow ups will be with him and his office as we have no major surgeons where i live of any kind. So i will get good at spending time behind the windshield. how long were you out of work? I am not sure yet on mine but i do plan on doing what ever it takes regardless of time. I want this to be a one time deal!
    Hi Gunny

    My incision looked a bit gross for a few weeks but now it's healed to about a 5" hairline scar. Once the stitches dissolved, I used Bio-oil on it for several months. Any oil or cream for healing scars and stretch marks can be used, should you feel like doing this.

    I'm recently retired, so didn't have to go back to work, but if I'd had to, it would have been very hard because up until the 5 month mark, I wasn't able to sit at my computer for longer than half an hour. My core muscles are much stronger now and I'm pretty good for a couple of hours. When you get well into your recovery, you'll just know when your back will be able to take the stress of going back to work. It's different for everyone and most go back part-time initially.

    When you do have to make that long trip back to your surgeon, make sure you're up on your pain meds and perhaps you can lie down in the car or have your seat reclined as much as possible. You will have someone driving you?? If you are driving yourself, then have lots of breaks and walk a bit to take the stress off your back. I think it was between 6-8 weeks before I was driving again, and that was freedom!!

    All through my recovery, I had the mind-set that this it was a one time deal too and I was self-indulgent and didn't push myself too hard. Of course there were ups and downs and not too much good sleep, but that's normal.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
  • Hi Trish,
    Thanks again for the reply. I will have my wife with me. There is no way i could be going through something like this with out her. Especially the drive home. It has really been great getting all of this awesome information from everyone. Hopefully things go as smooth as everyone else seems to have gone. I know there are the ones that have compications, I just hope one of them is not me!
  • Thanks Jayhawk,
    What is that nerve you are talking about? I have never heard of it. What is it function? It sounds like it made you pretty sore or something after surgery? As far as physical therapy goes I am lucky and have a really good friend who is a therapist. He specializes in spines and continually keeps up on seminars and training so I should be in good hands there. I hear you on the constipation issue. I have no desire to go through something like that. This surgery will be plenty for me to handle so i will be sure and stay on the fiber or laxatives or whatever it takes to keep things moving.
  • They plan on going thru my stomach. That seems kind of freaky but oh well. I think he said that i would have a brace as well, and that does not sound to comfortable at all but one again not much of a choice. The plan is to just do what ever they say and heal up as fast as possible. I'm sort of a high strung hi energy guy that is very active. The down time will probably drive me nutz, and since I dont like oprah i'll just have to channel surf till i am happy.
  • One thing I might have missed, but just in case no one else has mentioned it -

    on your drives - TAKE BREAKS! Get out, walk, do whatever - you should NOT be sitting that long post-op. I wasn't released to sit more than 45 minutes until after about the 6 month mark. Even then it was still agony to sit beyond 20 minutes.

    Best of luck!
  • Yea, I wouldn't plan on sitting for long periods.

    As far as braces, the hospital gave me (Retired Military)an Aspen Quickdraw Brace. Here is their website. http://www.aspenmp.com/ It has a video in lower center of webpage.

    Not promoting them just think it is very comfortable with multiple draw strings for a good, firm even fit. Mine is black and they have different styles.

    I think this website shows the one I have, the RAP style with a removable panel. http://www.dme-direct.com/quickdraw-quick-draw-aspen-brace-back-medical/

    I will wear the panel for a month then it comes out and the brace is now thinner and less noticeable under shirts. It has soft material on inside that touches your skin, although I wear over a T-Shirt then outer shirt over brace.

    I hope posting the sites is OK, I have no affiliation with them, but love the brace.

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