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2 weeks post C4-C7 ACDF

jailajjaila Posts: 16
edited 06/11/2012 - 8:50 AM in Back Surgery and Neck Surgery
Hi everyone. I am new here and simply looking for some tips and some folks that may understand what I am going through.
I will try to make my story as short as possible.
Starting approximatley last May while training for a sprint triathlon I started having left shoulder pain. It initially felt like a stinger. Progressively this got worse causing a deep ache all the way down left arm and numbness to thumb, forefinger and middle finger. At times it would feel as though my shoulder itself was going to dislocate. Over this time I noticed muscle atrophy and my left shoulder now sits approximately 1/2" to 1" lower than right shoulder. My MRI showed : moderate to severe spinal canal stenosis, bulging discs, osteophytes, congenitally short pedicles, and severe foraminal stenosis. My neurosurgeon made a major point of letting me know in no uncertain terms that without this surgery I was at a increased risk for severe and permanent spinal cord injury with what for most people would be a nothing incident. I immediately worried about the what ifs for my husband and daughter. I am only 39 and pretty healthy. Needless to say 1/5/11 I had C4-C7 acdf with cages and titanium screws...no plates. I stayed in the hospital only 1 night...they let me go home after the drain was removed. I was only given a soft collar with instructions to wear it when up walking around, in crowded places, in the car, and while sleeping if I wished. I do wear it while I sleep because quite frankly my husband is a bit of a thrasher in his sleep so I feel safer with it. While just at home taking it easy I don't have to wear it.
I am currently taking Norco 10/325 & Robaxin 750.
I have found the Robaxin to be the most helpful because I am experiencing incredible muscle spasms in my upper back between my shoulder blades. At least I am assuming it is muscle spasms. This pain from spasms is much worse come afternoon and can be unbearable at times at night. I really thought I would be doing much better by now. I am out of work for a minimum of 5 weeks due to the type of work I do. He had said that some people go back as early as 2 weeks depending on their job. I follow up with him beginning of Feb for xrays and will find out at the time if I am released to work. I have to go back to work full duty as there is no light duty available at my job. At this point I am thinking I must be a wimp because I don't know what kind of a job I would have that I would feel I could currently do at this stage. I never thought I was a wimp before and in fact declined any pain meds pre surgery just anti-inflam & telling myself I needed to toughen up. I tried to cut back my pain meds a week after surgery and was in misery so I started them back at regular intervals. I am again trying to taper the meds back and have decreased the Norco to every six hours and only 1 Robaxin every six hours. My daughter accidentally bumped the back of my head (relatively lightly) last night and the pain was awful! My voice is mostly normal at this point. Minimal difficulty swallowing although sometimes out of the blue things get stuck in my throat. It does still feel as though I am swallowing past something (still swelling in there I am sure). My incision is healing nicely and there is minimal discomfort there. It does feel strange with any movement of my neck and I can only describe it as not only limited, but it feels thick & doesn't feel like me. I was prescribed a bone growth stimulator and received it yesterday. Per post op instructions I am allowed to drive at this point although I haven't yet. I have read some of the posts on here but a lot of them were from folks having 1 or 2 level fusions...

Am I just being wimpy? some people with 2 level per there posts seems to be a lot farther along than me by now.
Does it take longer to recover from a 3 level vs 1 or 2?
Is it too soon to try to cut back my meds?
Is this pain between my shoulder blades normal? or could I have already screwed something up?
At what point do others not sleep with the soft collar on? I do have a tempurpedic bed & pillow.

Any help, insight, suggestions, or advice would be greatly appreciated.



  • I think your beating yourself up girl! You just experience a major surgery on your neck no less...it's okay to take med for pain. Recovery time Varys from person to person. I'll be 3 months post op on Feb 3rd, I started feeling more normal after one month...but I've got new issues that I won't moan about. I wore my collar to bed for the first month and I took it off only to shower. After I had my first post op appt, I took it off and only wore it for another week at night. To answer your questions:

    I think that a 3 level would take longer than 2 and 2 longer than one. I started cutting back on my meds 7 days post op. I only took muscle relaxer at night and the loritab at night only when needed. Unless I was really hurting...it's okay...thats what the pain pills are there for.
    I slept in a recliner for the first 2 weeks. Only by my H's insistence did I return to our bed. I used 5 pillows in order to get comfy. Pain between shoulder blade is normal. My aches/pains moved around from week to week. It does get better I promise.
    I'm not sore anymore...apart from turning my neck and working on my Range of Motion. Turning to the left hurts more than the right. My left side was the problem to begin with...so thats expected. Your doing good...just take it easy, walk as much as you can tolerate and listen to your body when you need meds.
  • I agree with cgm. You just had major surgery and need to give yourself a break. I had a 2 level and I think the recovery time and pain may increase with additional levels. I still took pain meds at 2 weeks, although it wasn't around the clock. At 6 weeks I still take a muscle relaxer or prescription pain meds when I feel it is necessary. I am and you are not a WIMP. we have been through an ordeal and our body is telling us to take it easy. So do yourself and your neck a favor and take it easy. Surprised that you had cages, but not plate. I had cages with BMP, plate and 6 screws. I recently requested a copy of my medical records so I would have them. It was interesting to read. I also have a copy of my x rays. My son thought they were cool and showed them to his anatomy and physiology teacher. I do not think you could have screwed anything up. At 2 or 3 weeks I tripped up the stairs and thought I did major damage, I had a huge bruise on my leg and my neck was killing me. I also had a 24 hour stomach bug. No damage either time. My surgeon is liberal and I wore a hard collar for a few days at my instance then a soft collar full time for 2 weeks. Since then I wear it when I am out, in a car, when I am in pain and for sleeping. I hope that you are doing ok. This is a great support site.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,385
    Then I am a super wimp ... the king of wimps!

    Did you have any posterior work done?

    You really need to pose these questions to your surgeon as he/she knows the extent of the work performed and what kind of time frames you should be expecting.

    Each of us are different.

    And yes IMHO the more levels .... the more potential pain, meds, and time to convelese is warrented.

    I am over 3 years since my last procedure ... but that was after a failed 2 level. I now also have stenosis at the level above my construct.

    Will keep you in my thoughts and prayers,


    Spine-Health Moderator
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  • My surgeon did not give me specific time frames because he has always said that each person is an individual and their healing is based on the condition they were in before the surgery, how long they had the condition, extent of damage and work that was done during surgery along with an negative side affects that may have occurred. I am trying to be patient, although I am not a patient person. I just know that I do not want to have another surgery.
  • Thanks you guys! I appreciate your insight....I have really been feeling like a wimp....I will try to be better about that.
    Metal- I didn't have any posterior work done and from what I have read I am very happy about that...from what I read its awful.
    This is the first surgery I have ever had and it scared the hell out of me. Now I am just worried to screw up the work they have done. The stories I have read about people not fusing and having additional surgeries makes me nervous.
    I am so grateful to have found this forum and such nice people to communicate with. I guess it comes down to a case of if you haven't walked a mile in someone else's shoes then people tend not to really understand. Ofcourse it doesn't help that I tend to try the "cowboy up" method of life.
    Thanks again...your replies mean a lot. And I hope you are all doing good and wish you well.
  • Jaila, I spoke to my orthopedic spine surgeon on 2 occasions because I thought I screwed things up. Tripped up the stairs and had a 24 hour stomach bug. They reassured me that I would be in pain or uncomfortable for a few days but could not have damaged the hardware. They said falling down a full flight of stairs or a car accident could do damage. But they said if I wanted to come in get x rays I was welcome any time. They really treat me as a whole person. I agree that I have concerns about non fusion and needing another surgery. Those 2 items are what keeping me at home and behaving myself otherwise I would push myself to go back to work now. I am not a patient person. :( Wish I could find something to do to enjoy the time off. I can't even get into reading a novel or watching movies on tv. Oh well. I do look forward to reading posts and the support here.
  • Jalia,

    First let me say welcome to spine-health. I will echo in large part what everyone else has, your not a wimp. Take a deep breath and just know you need to relax now and work on healing. The muscle spasms for some can be out of control, has a lot to do with the positioning during surgery. Don't compare your recovery to someone else, as it is true while the procedure may have been the same as far as the name goes they may have done different things on each person. One thing I have that helps with the spasms is a tens unit. Also when you see your surgeon again let them know about the spasms and maybe they could see about some massages to help with them. But just know everyone is different in the healing.

    Another thing to keep in mind is for the number of ACDF's being performed the failure rates aren't that high. The recurrent surgeries around here are not as common as you would think. Most members whom have done well are out and about back to normal busy every day life.

    One other thing to keep in mind is some members will get that oh I am feeling better now and go out and do to much. Then you have the set backs and the additional pain. So just be sure your following all the surgeons orders. The most important thing I ever did for recovery was walk and when you think you have walked enough walk some more. You can find some walking programs on the net such as 10,000 steps which will give you goals to obtain.

    Just thought I would stop by and welcome you to spine-health. Take care.
  • Let's put things in perspective:
    1. every ones threshold for pain differs.
    2. the more muscle you have the more muscle the surgeon must cut through.
    3. consequently the more levels the more tissue was disrupted, the more pain you will have.
    4. every day is better than the day before
    5. there are no awards for enduring pain - in fact studies show that pain slows recovery.

    I just had (jan 18th) a two level foraminectomy c7/t1 &t1/t2. My best friend has been ice, ice and more ice. Yes the muscle relaxer does help with the spasm (so does magnesium)and I'm taking the pain pills (less today than yesterday) until my post OP visit. There is plenty of time to detox from the meds and time to do physical therapy. Right now the best thing you can do is not irritate the surgery. Give it the best possible chance to heal and you won't have problems with it latter on.
  • Yes, everyone had a different pain tolerance and the manner in which they deal with pain meds. I know I am able to function on certain meds that other people fall asleep with. But I do differ with you that everyday is better than the day before. I have had some days that we worse than those prior. It sometimes matters how much you push yourself and what you do. I am not sure what a foraminectomy is, but if is is similar to a ACDFD then you should still be on pain meds around the clock. But at 6 weeks, hopefully they are only every now and then. Everyone is an individual and must truly listen to their body as to what they should and should not be doing and when to take pain meds. Especially in the beginning it is important not to be a hero and let the pain get ahead of you.
  • SpineAZSpineAZ WiscPosts: 1,084
    Be sure to take the norco and robaxin on schedule. Don't miss a dose. What that does is get a therapeutic level into your system and you don't have the ups and downs. As you heal you can reduce this to the times when you really need it. I had C5-C7 and I too needed the muscle relaxant more than pain meds at that time. Robaxin doesn't do much for me, so I use SOMA. If you find that it's not working don't be afraid to ask for something different.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • I agree with SpineAZ. Especially in the beginning you need to take the pain meds, muscle relaxer and anything else prescribed on regular intervals to stay on top of the pain and give your body a chance to recoup.
  • My doctor prescribed a time release pain medication called Avinza. It forms a baseline to control pain - no ramp up and crash. I also have Norco for break through pain. He explained that this combination is not only most effective but the easiest to cut back on after the pain subsides. Another thing I have are "Lidoderm" Patches, which is a topical patch for muscle pain. Although the muscle relaxants (Flexeril) works well I find it too dehydrating and strong - so I break them in half. These pain meds and the anesthesia have me constipated and that's another problem I need to deal with now.
  • Welcome to SpineHealth and I wish you the best for a successful recovery - I echo all of the others and will tell you everyone heals in their own time. I had a 2-level C5-C7 ACDF and I am 41 with 4 year old twins and did not know how we were going to do this with me out of commission. My NS advised me same thing that I was at serious risk to permament cord damage that scared me to death. I understand about being afraid to do additional damage and I think this was previously stated too .. but my NS said I really can't do damage to the hardware with everyday normal activity. I was cleared at 1 month to start PT 3x per week but not cleared for work yet and they said at first no work til March but if PT goes well then they will re-consider allowing me to return. I also can only return full time and have a very demanding 10hour per day job ... so I have resigned myself to do what I need to do to be 100% so I don't end up have any more surgeries. I also wear a bone stimulator and got mine 2nd day post op and do wear it diligently everyday for 10 hours - some are different... It does get better and just let yourself heal and keep us posted on how you are doing and/or if you just need to chat with us friends who understand!
  • Thank you all!...Mary I am glad to hear you are doing so good. What kind of things does PT have you doing at this point?
    JHR...I won't give you tmi, but I second your complaint re: the constipating effect of meds. I currently may take out stock in prune juice...lol. I have tried many things unsuccessfully but the prune juice really seems to do the trick...now if they could only make it taste good.
    I think I am doing a little better the past few days. Continue with the muscle spasms, but I am hanging in there. I have improved I think in part by taking my muscle relaxers and such routinely to stay ahead of the pain and spasms. I frustrate myself with this because I know its true...the need to stay ahead of the pain...but for my own stupidity thought somehow it didn't apply to me :(
    I am anxious about what I will find out at my post op visit on 2/8. Curious if they will see some progress with the fusion, if I will then start PT, and if I am cleared to return to work. I also work 10 hour shifts on a graveyard schedule.
    Mary..giving up smoking is very hard I know (trust me I know where you're at),..but you can do it!
    Thanks again,
    Wish you all the best
  • I was given the OK to start PT at my 1 month visit - they did show bone growth on the xray and all hardware was in place. My PT is 3x per week and has consisted of an initial assessment of my range of motion and mobility. My ROM was about 30 - 35% turning head each way and the expectation is to be about 70 - 75% painfree. So I do very lite weights started at 3 lbs and dropped to 1 or 2 lbs with about 5 different arm shoulder strengthening, ride a bike where the arms move back and forth with the bike for 10 minutes with a heat wrap on it - start out that way .. then end with conditioning and massage by the therapist. This past week I moved the weights up 1 add'l pound ..have to say it is exhausting and I ache the whole day from it but it feels good to be doing something. I am not sure when they will add stuff or re-assess. I get nervous some days that it was too much because there have been days I could have taken a pain med after it but refused ...
    And boo-hiss on the prune juice - try stool softeners (not laxatives) just take one every day you are taking the pain meds - they help ...
    Take care and good luck at your appt .. let us know how you are doing! Hang in there!
  • Hope that the PT is helping. I have been doing some simple neck stretching in each direction, not sure if it is helping or not. I try and complete 5 stretches in each direction 5 to 6 times a day. I also use my son's 5 lb weights. I can only do 2 or 3 lifts with my left arm, but 5 with my right. I only do that 2 to 3 times a day. I agree that it is exhausting. Glad to hear that you are doing well. I agree with you that stool softeners are the way to go. Continue to feel well.
  • Hope you are well too.. be real careful with the weights ... my PT started me out on the lite weights but have to 10 tricep lifts each arm - 3X and 4 different ways so that is why they started with the 1 and 2 lb weights .. by the 3rd round of 10's I can barely lift the 2 lb weight .. the hardest thing still for me is posture. So I must have had bad posture for my 41 years of existence because everytime I am standing talking to my PT guy he is reminding me in a very nice way to straighten up. I asked him how do you stay conscious of that. I can tape stickys on my computer but when I am just standing or sitting immersed in a conversation or watching a TV show I forget and there goes the slouching - no AHA answers on that one!! He said it is the slouching that is the worst thing for the neck and lifting anything heavy over your head - which is what I did that got me into tbis mess! He said unless it is urgent I should never again lift or even reach anything over my head .. get a stool .. that is hard - just the other day found myself reaching for a bowl on top shelf - not sure if that is not OK - forever! So do I have to get a stool just to get a bowl out of the cabinet when I can get it if I reached on tippy toes. I think they mean anything heavy but will ask again!
    We got clobbered with a foot of snow here yesterday into today so really got cabin fever ... Hope you are doing OK ..
  • Maybe I should switch to the lighter weights and complete more units of each exercise. It is difficult to make those decisions since I am doing the exercises by myself with PT. I wish they would have given me a script for PT. I tried. Can you describe all of the exercises that you do. Maybe then I could be more productive. It finally went above freezing today. All the way up to 36*. I seized the moment when it was sunny and took a 45 minutes walk. Now I am pooped, but not in any pain. We got clobbered also a good 15 inches of snow plus about 2 inches of small hail or sleet. I guess posture is something we must all think about. Thanks in advance if you can describe the exercises in detail. You may be in for the same future snow. (coating to 2 inches tonight, then more on Sat into Sun and again on Tuesday.) WHen will this stop. The snow is also making me put off trying to go back to work, besides the lack of ROM. Have a good day. Did the twins make it outside to play in the snow or build a snowman?
  • Sent you a PM on the weights and excercises .. Twins are loving the snow to a point where I can't get them inside ... we got about a foot and looks like a bigger storm brewing for next week .. ugh!
  • How are ya doing? I'm one of those posters that has stuck to my one major thread to update. I was on re-reading my post from when I found this place. Funny to go back and see how far i've come...on most days. Whiny on some too. Anyhoo...journaling kinda helps, so update on here when you get the hankering to do so. Be well and take care Jaila
    cgm :D
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