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Multilevel ACDF

adkpeglegaadkpegleg Posts: 7
edited 06/11/2012 - 8:50 AM in Back Surgery and Neck Surgery
C5-7 ACDF pending. Can anyone tell me the earliest one can return to work on limited duty? I work as a nurse, so I know that returning to work without restrictions at 4 weeks would probably be an unrealistic goal. I don't smoke, drink and my normal routine includes Bowflex home gym and treadclimber and Power 90. I live an active lifestyle of kayaking, golfing, fishing and enjoying all life has to offer in the great Adirondack Mountains during all seasons. How long does one have to wear the neck brace and when is the soonest PT can start?


  • I had same surgery on 12/9/2010. I thought I would go back to work as a teacher in 4 weeks, no such luck. At 6 weeks I was not cleared for work due to muscle spasms and limited ROM in my neck.I am not nearly as active as you, but I am not a couch potato either. NS and OSS all have different views on neck collars. They range from hard collar for 4-6 weeks then a soft collar for he same, to a soft collar for 4 - 6 weeks to nothing at all. What did you surgeon tell you? I am still restricted to no more than 5 pounds to lift. One thing I can tell you is look at the threads about what to have at home prior to surgery. My favorites were: bendy straws, stool softener and soft foods. Let me know if you have any other specific questions. Also stay on top of the pain meds take them at a regular intervals don't let the pain get the best of you and no need to be a hero.

    12/9/2010 2 level ACDF C5-6 C6-7
    cages with BMP, plate and screws
  • I had the same surgery and was released to drive after one week and back to work after two (or as soon as I felt up to it). I chose to do the bulk of my work from home (lucky that I could do that) so that I didn't have to haul files and computer back and forth to the office, but I did start going back to the office for a few hours each day and seeing customers after two weeks. I was not prepared to stay 8 hours at that point and needed my pillows and heating pad a lot for that first month.
  • Forgot to say that my NS does not believe in using the collar so I didn't have to worry about that part. There were times I wished for one! Your head is heavier than you think! I also was not allowed to lift more than five pounds for at least a month (if I remember correctly...it has been almost 3 years since my surgery). And I was not ordered any PT after surgery, although I did have it about a year after surgery because of some continuing pain.
  • Hard collar 4-6 weeks. Return to work based on 1 month follow-up appointment and X-ray results to track fusion. Lifting is restricted to a gallon of milk...10 lbs. No bending, pushing, pulling, twisting, raising up arms for 1 month...AKA no living. What's another month!!??? LOL. The end is near...the final curtain. If anyone tells me I have a lot of nerve...I can honestly say.."not anymore" !!! Have things been going well for you post-op? Thank for your reply.

  • Not only is every patient different in their healing and perception of pain, but also each surgeon is different in his advice for post-surgery recovery.

    The best person to listen to is your surgeon. He knows what the internal condition of your spine was, and what action he took to deal with it.

    I know that there are some cautious and some not so cautious surgeons out there, but there is no one else who has taken a look inside to see what was going on. Surgeons do sometimes get a surprise, with things being worse than shown up on the MRI or other tests.

    If you follow the surgeon's advice and get worsening problems, then make sure that you contact them to ask if they need to see you again, or if you should ease back on what you are doing.

    Hope that all goes well with your multilevel ACDF and that you will soon be feeling much relief from it. :-)

  • I agree with jelly hall. every patient and NS or OSS is very different. It is very important to follow your specific surgeon's orders. But you need to be proactive and ask questions and be prepared. There are great threads with what you should have prior to surgery. My favorites are bendy straws, stool softener and soft foods along with a helpful spouse or friend. Good Luck :)
  • Each person is different, I went back to work a week after surgery, but remained in a hard collar for 8 weeks, started driving 2 months after surgery, still wore hard collar intermittently through December of that year. I am a very active person and trained a lot in gym. My muscle density I believe wreaked havoc on trying to calm my neck down. 5 months after surgery, I became pain free and remain so until 2 weeks ago. Hindsight is 20/20, we're not the same after surgery and I evidently was doing too much running and lifting. When the flare-up returned I did not shut it down immediately and further I was doing squats which I will never do again, promise.

    To be straight up, it sucks because I have the mentality of a triathlete but the spine of a gingerbread. In the last year I was lead into a false perception of where I was. I felt great and so therefore I kept adding to my workout routine.

    I so badly now at my age of soon to be 37 just want a quality of life where I do things non-invasive and moderately. I don't want to go through this again. My job doesn't care about my extracurricular activities and nor does my family. I need to be there for them and producing so I've got to know my limitations far better. Easier said then done. Good luck and let me please be your lesson to live in moderation.

  • I had the exact same surgery 2 level ACDF C5-C7 on 12/6 - thought I would be out of work 6 weeks and at my 1 month post-op appt my NS cleared me for PT 3x per week but no work yet.
    I agree with everyone else's advice - everyone heals different and all Doctor's are different in their recovery requirements. I had a hard Collar for 2 weeks and then nothing ... and it was already said but you won't believe how heavy your head feels after this surgery! I was in excruciating pain prior to the surgery that was impacting my life severely so I have no regrets on the surgery as the pain was immediately relieved but the recovery is much slower than I expected. I am an on the go person - very demanding job with long hours and a family so I now have put into perspective that I will do what I need to do so that I don't go back to work too soon and end up back in the operating room!
    I will say the hardest part is that there are days I feel like I could have made it thru a day at work and then there are day I know I could not have... Anyway when is your surgery - well wishes your way and just take the advice of your surgeon as he is the best person to tell you what type of recovery you need. Just be prepared they may tell you at first 4 weeks and then extend that at your 1st Xray appt - that is what happened to me...
    Hope all works out and keep us posted on how you are doing!
  • I had ACDF C4-7 on 1/5/11. I too work as a nurse...although this spinal stuff I will preface is definitely not my area of practice or expertise! I definitely agree with what was said earlier about not letting the pain get ahead of you...stay on top of those meds. I tried to cut back too soon and paid the price. My NS gave me a soft collar. I have to wear it when in a car for 3 months, when I am up and about in crowded places, etc. Wearing it while I sleep was my option, but I do simply because my husband sleeps a little rough around the edges so to speak. When I am just sitting and taking it easy I don't have to wear it. I started driving about a week ago. Checking my blind spots is tough. My ROM is better to the left than to the right. I am not able to turn good enough to check right sided blind spot...well really either side, but the right it worse. I had my husband get me some of those small mirrors that paste on to my side mirrors and they are great! As far as return to work goes I don't know. I have read some people go back quite soon...but I suppose that depends on type of work and how many levels you have done. There is no light duty at my job and I am nervous to see if I will be cleared to return to full duty. I feel pretty good for the most part but do notice that after being up and about during the day if I have errands to run or such I am still quite sore later. That in mind I wonder if I will be ready to return to my 10 hr shifts. I am also really looking forward to starting PT. I will find out at my follow up appt on 2/8/11 re: my return to work status, if I am ready for PT, and will have first set of post-op xrays. My pre-surgery symptoms are gone! No more shoulder, arm pain, or numbness!!!:) I am still occasionally having food or pills get stuck in my throat. My voice is back to normal. My biggst problem continues to be muscle spasms across upper back between shoulder blades.
    When is your surgery scheduled for?
    I wish you luck...keep us up to date with your progress
    Good Luck,
  • Are you taking any muscle relaxers for your spasms. I had them severely and was taking Robaxin and did nothing. Now I take Valium at night only and I think the relaxing night sleep has helped my muscles and only get a spasm every now and then when I did too much. Just wanted to offer my experience. Hope you are doing well. Funny how your DR gave you a soft collar and I asked my DR if I needed one and she said no ... all so different.. take care!
  • Glad you are doing so well. Driving does get easier. I still have to ask my son or husband to check to make sure it is clear or I have to turn my entire body. Tough seeing over the high snow piles. Depending on how swollen you are - the lump can last for a while. I am at about 7 weeks and it is almost gone. Still have problems every now and then. Good luck with your follow up appointment. My advice is to start writing down and concerning symptoms and questions so you don't have to worry about trying to remember them. A 10 hour shift is quite long. Don't push yourself. I have found out the hard way it will take longer to recover than anticipated, but since I don't want another surgery I am taking off . You onlky have one neck.
  • SpineAZSpineAZ WiscPosts: 1,084
    I purchased a panoramic rear view mirror that can go off/on the mirror easily (hubby removes it when he drives my car). It has been VERY helpful
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Panoramic review mirror?? What does it look like? Easy on and off? Where did you get it?
  • Surgery went GREAT. Loving my right arm again...minimal discomfort. Walked throughout hospital for over 2 hours post-op. So glad to have had this done!!!!!!!! Too bad you have to wait in pain for so long before getting done what needs to be done.
  • So happy to hear that things went well for you! The relief from the pre surgery pain is great!! Just remember to take it easy post op and don't try to do too much too soon.
  • So happy to hear your surgery went well. I had the same experience immediate relief post-op - it was already said - and just advice to take or leave - go slow and let the healing begin. Don't do too much too soon! It is hard because you have less pain than before surgery but have to let the inside heal and the bones to fuse! Anyway Best Wishes to You! Keep us posted on how you are doing!
  • Feeling good post-op day 2. Definitely taking it easy. Percocet, Robaxin and Neurontin around-the-clock. Real comfy. Slept 11.5 hours last night. Missed some dosing of pain pills but took only 20 minutes to work. The shoulder massage by my sister between the shoulder blades felt great too! My 2.5 hour surgery was 4 hours! My NS referred to my neck as having "significant disease" and cleaned everything out...THANK YOU!!!!! No regrets whatsoever...watch out spring, here I come!!! Can't wait to kayak,golf and fly fish....yabba daba dooooooo!!!!!!!!!!!!! Over the hump and in the home stretch...it's great to love my arm again...I called it so many nasty names the last 3.5 months! Thanks for all the support. Miralax in coffee works wonders...beat the heck out of Colace and Senna! Well...nap time. :)
  • Well..11 days post-op and Robaxin is doing little for the muscle spasms between my shoulder blades and posterior neck. Robaxin 750mg three times daily...took 2 tablets at 9pm and the increase did nothing. :( Called the MD..to continue Robaxin and Neurontin 600mg three times daily...asked for an increase but they prefer to push the use of narcotics (Percocet) on you. No go on that, I won't use it anymore. I'll be unable to work as I drive to patient's home as a public health nurse. SO...looks like sucking it up is the answer. I may as well get used to it now. It's "nerve wracking" ( pun totally intended) that nerve regeneration pain is similar to nerve compression pain. Great...I guess the optimistic way of looking at it is that it is "good" pain and that there are people worse off than me. I look through my pictures of the time I spent in Haiti volunteering after the earthquake and I realize that I don't have it THAT bad. So..I refuse to be a cry ass about it and am almost done with putting together my weight training and aerobic workouts for when the NS clears me to do so. I hope to be able to do the Adirondack Canoe Classic this fall...in a kayak again or maybe a 20 pound canoe. A 90 mile paddle over 3 days with 5.2 miles of portages. Hoping when the ice goes out of the lakes that the kayak will be going in. I've lost so much...yuck..flabby in the arms and belly...got a lot of training to do to get ready. My 30th HS reunion is this July too...definitely need to be in the shape I was. Goals, goals, goals. At this stage I'll just be happy to get back to work, the boredom is driving me nuts.But I am studying French via the Rosetta Stone learning language series so that, combined with learning Creole, will make my return trip to Port Au Prince better as far as my ability to communicate with my patients. I've stayed busy but getting back to my normal life can't come soon enough. FUSE bones...and make it quick!!! :)
  • Robaxin did nothing for me either - few weeks after my surgery - could not sleep muscle spasms were so bad - got a script for Valium and worked so much better .. I only took 1 at night to relax and sleep and once I got a good couple night of sleep the muscle spasms subsided - still get them but not as frequent! I stopped my pain meds too at about 10 days - my stomach could not take it anymore and just took Extra Strength tylenol and the valium as needed. Worked for me .. I agree with the worst part of the recovery for this surgery is the boredom. I am still not cleared for work and in PT 3X per week ... hoping to be cleared in early March... I can say even now over 2 months post-op I feel good but do have bad days like yesterday - got my hair cut - went to dentist and then eye doctor and was in pretty bad pain last night - neck and shoulders - not sure if it was because I was laying back on those Chairs several times all in 1 day - don't know .. took a flexeril before bed and much better today .. kind of resigned that those days will happen for months as long as those bones are fusing and all will be eventually as normal as possible!
    Take care and hope you continue to heal well .. just wanted to share what worked for me!
  • Hey Adk...hang in there. I totally understand your frustration, muscle spasms, boredom, wish to return to old body and work. But, that said, it is a new you-- and your body, muscles, and discs above and below fusion are learning to move in a new way so to speak. Healing takes time. I am certain with your degree of determination that you will be back to doing everything you love in good time. Just remember this is no minor procedure and the amount of healing your body needs will take time. You don't need to try to do too much too soon...a set back would be really frustrating. I am a little over 6 weeks post op and I really, really, really get where you are coming from. Pt is helping, but even that is a slow process..and I feel my muscles have gone into the uber weanie state of being....but it will get better. I so look forward to returning to work (March 8th) :). I am trying to get away from what I have often lived as a nurse..."do as i say, not as i do"....give yourself time. Hang in there!
  • I went back to work as a teacher (4th grade)on 2/14 (Monday). There have been many ups and downs. After school each day the recliner was my best friend for the entire evening other than dinner. I was exhausted, sore and achy a few days but in excruciating pain for 2 of the days. Not sure what I did to cause the pain. Those 2 days I was not sure I was going to go back the next day, but I did. I was so glad when Friday arrived. Now I have a week of to recuperate. Not sure how I will be when we return after the week off as the next break won't be until the end of April. I have a great bunch of kids and additional staff that was willing to come in and help out. I did sit at my desk with a high back wonderful chair that I bought early in the school year many times during the day. I showed my kids the xrays with the hardware and they were intrigued and asked wonderful questions.
    Hope everyone is doing well and taking it easy.

    adkpegleg: Sounds like you are doing GREAT and have such a POSITIVE outlook. You seem to be a very active person. Do not push yourself too much too early. Listen to your body. I remember doing too much too early and really regretting it.

    jaila: As a nurse it must be very difficult for you to be on the other side of the fence sort of. Just remember that if you do not feel up to going back to full duty on March 8th ask for an extension. I am sure you will have alot more physical situations to deal with along with the driving . Both of those situations will add to you muscle spasms and pain.Glad that you feel PT is helping.

    Everyone else on this thread: Hope that all of you are recovering according to plan and not doing too much and re-injuring yourself. Be safe and take care of your neck. You only have one. :)

    12/9/2010 ACDF C5-6 C6-7
    DDD, severe arthritis
    4 hours a bone stimulator
    no bone growth yet
    PT starts Monday had eval (painful)
    Went to work as a teacher 2/14/2010
    DDD, severe arthritis
  • I'm also very frustrated about the nerve regeneration period. I'm 7 days post-op and feel a different kind of pain - hope that's a good sign! Currently I'm on Flexeril only and occasional Tylenol. Honestly, I can't deal with the side effects of narcotics: nausea, dizziness, sleepiness, etc.

    How's your throat and swallowing? I still have a lump in my throat and it is quite annoying, since I have to crush my multivitamin and supplements into powder and mix it into applesauce. My husband says that I'm like an infant.

    Can't wait to drive next week! My doctor told me to practice driving in an empty parking lot to check ROM before getting on the roads. I'm only allowed to drive locally initially.

    Keep posting and let me know your progress!
    2011 ACDF C5-6 for Spondylosis with Myleopathy
    2012 L4-5 herniated disc and hernated disc at C4/5 2013 Taking Amitriptyline for headaches
  • Lili...just a note on the swallowing issue. From what I have read on different posts swallowing issues for most are resolved by about the 4 to 5 week mark. For me it has been a bit different. At just over 6 weeks out from surgery swallowing is mostly improved...but I do still feel the "lump" in my throat. It is worse at times than others. I think I am attributing the lump being worse at times when I have had a busier day. Occasionally food will still get stuck and I need that water to chase it down. This does continue to improve.
    7 days post op is early and I hope you are doing well. What did you have done? levels? hardware?
    french...I wish you continued good healing as well. I am sorry to hear returning to work was rough on you. You are so right....only one neck. (doesn't seem fair) :)
    Best wishes to all of you
  • 7 days post op is really early. I had major issues for more than 2 weeks. At 6 days I was put on steroids in order to reduce the swelling which caused major swallowing issues. Couldn't take a pill at all for 4 days, needed shots while in the hospital because swallowing was so painful. Ice cream was an issue. After the dose of steroid was finished I still needed water to chase down all foods except liquids. I am now 10 weeks out and still drink alot of water because certain foods still seem as if they get stuck or take longer to go down than I would like. I saw my 6 week x rays and could se the significant swelling that was still there. When I use the bone growth stimulator the swelling and swallowing gets worse. I still do not eat bread products, meat, pancakes or bagels unless I cut them in thirds and toast them almost like a cracker. My feeling is that I may always have a lump in my throat. I can seat more than enough at this point so I am not concerned. At 6 weeks there seemed to be a marked improvement.
  • Thanks for your replies! I had a single level ACDF at C5-C6 with allograft anterior plate and screws. I know people who return to normal with their swallowing by 10 days post-op, so was hoping since mine is a single level fusion, I would be like one of them. :S Did either of you feel like the muscles spasm, especially when you are about to burp: when gas is pushing up?

    Honestly, I can't complain too much because so far things have been improving slowly. The burning on my deltoids is the worst, but at least the pain is not constant.

    Tomorrow I start the bone growth stimulator. I will let you know if I get the same side effects. :)

    2011 ACDF C5-6 for Spondylosis with Myleopathy
    2012 L4-5 herniated disc and hernated disc at C4/5 2013 Taking Amitriptyline for headaches
  • Hey there...been a few days since I checked this post. I did notice belching was very uncomfortable especially in the first couple weeks.
    Hope you are hanging in there and doing ok!
  • I'm exactly 2 weeks post-op! Yesterday was tough, since my daughter was home with me the last 2 days with the flu. I'm desperately trying fight the virus. Have been coughing a lot and worried about the pressure on the incision. She's been waking up every night with either a fever, vomiting and last night she had a bloody nose!

    I started driving yesterday! Seems like my ROM is the same as pre-surgery. Swallowing issues are almost gone. I can swallow pills, although sometimes gets stuck half-way down and eating all types of food.

    jaila, how are you doing? :)
    2011 ACDF C5-6 for Spondylosis with Myleopathy
    2012 L4-5 herniated disc and hernated disc at C4/5 2013 Taking Amitriptyline for headaches
  • Lili, i was one of the lucky ones regarding swallowing. I dove right in and ate steak, veggies the day after my surgery. my swallowing was bad for 4 days then poof...It was good. I will tell ya'll one thing that I still do to this day. ICE!!!! ice when your taking that muscle relaxer at night...try to ice at least 3 x's a day. I will be 4 months on 3-3, I over did it, dancing, falling up the stairs, and moving some furniture around that I should not have. i felt like i was @ 3 weeks post op. Don't over do it! You are not a burden....Don't do like me an apologize for asking for help. You both are newbies, take good care of YOU.
  • Good to hear from you! :) Yes, I do consider myself relatively lucky that I've been eating pretty much whatever I want for the last 4 days with minimal problems.

    When you say ICE, do you mean you are icing the muscles, incision, or the spine where surgery was performed? I never did well with ice for muscle pain - heat was better for me. I understand that ice will decrease inflammation where the incision is, but does ice help with the nerve regeneration or does it hinder the healing?

    It's hard not to overdo it, especially on days when you feel awesome! On Sunday, I was feeling so good that I was running across the street, when my DH screamed at me to stop. He is constantly reminding me to slow down.

    How has your dizziness been? Mine is absolutely coming from the neck muscles. The dizziness has been coming and going, depending on how much muscles are spasming.
    2011 ACDF C5-6 for Spondylosis with Myleopathy
    2012 L4-5 herniated disc and hernated disc at C4/5 2013 Taking Amitriptyline for headaches
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