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2 Level lumbar fusion

edited 06/11/2012 - 8:51 AM in Recovering from Surgery
Hello, it's been a long time since I've been on the forum but glad to be back. I used a lot of advice, opinions etc...from people here and want to say to the creators of this tool - thank you.
3 1/2 weeks ago I underwent a two level (L4/L5 and L5/S1) fusion. Im not going to be dramatic but man, it was awful the first few days. I was on the table over 7 hours which had it's own complications. Plus my doc - who is awesome- said he had to cut through 6-8 inches of back muscle. Going through the front was not an option for reasons too long to explain. So he went through the back, the incision is 10 or so inches long and they made 3 layers of stitching coming up on their way out to sew all of that muscle back together. I'm 40 yrs young, 6'4, 275 lbs - former athlete, not overweight. Well, yes, I'm overweight but that depends who you talk to and that's a whole other weight/height chart. Let's just say people don't think I'm chubby.

So now you have the background on the surgery, I am walking fine, doing stairs, wearing the brace non stop, doing the spine bone growth stimulator, basically everything I am supposed to. I'm fine during the day. I'm cutting back on my meds. But why can't I get a decent night sleep. Everyone (my docs) are encouraging to take my meds to be in less pain but I was on Norco 10 for 18 months in between my last surgery and this. The point is, i did this fusion so I could get off meds - period. I know, it takes a while to ween off the strong stuff but I'm taking 1/2-1/3 of what I was taking in the hospital during the day, but at night I wake in wicked pain so I have to take the strong stuff - which I hate.

My doc is saying 8-12 week recovery but he also said a 4 hour surgery. I know, there were complications in the OR etc... But Im doing so good during the day, why is it so hard at night. Plus I still can only stay in the bed for 4-5 hours at night then have to move to the couch. I just need a different sensation on my back etc...

I guess I'm looking for encouragement or someone to tell me to toughen up and don't give into the pills. But the docs say that for a long recovery like this people recover better when they are in less pain. Some days I do too much and I pay for it I guess.

Well, sorry for taking your time if you took the time to read this ramble but if anyone has been through this I'd appreciate some comments. Thanks in advance.


  • I hate to see that you are in such an predicament. I am facing a similiar procedure of a two level fusion so I'm still preop and a newbie to this forum. I have had other reconstructive surgeries and delt with sleep and sleep pain issues. It becomes so that night and day mean nothing and you sleep when you can. And there is really nothing but crappy TV on in the middle of the night. Hang in there and I hope someone can give you the advice you need.
    Weight room accident at 18. Had compression fracture and was paralyzed for month until ruptured spinal column healed. At 37 did all the epidurals/blocks. At 38 had two level open lami and Discectomy. At 39 (Sept 2012) had two level ALIF L4-S1 fusion.
  • I get it I do.

    I am 31/2 weeks post 2 level fusion. L4-5 fusion revison due to non-fusion and fusion at L5-S1. They also did some clean up work and trimming at L3-L4, freed up many nerves that were caught up in scar tissue and of course there were complications getting the old hardware out. It seems they were quite rough on me. Still, silly me, by now I had so hoped I would be done with the majority of these drugs.

    Since then if I have heard it once I have heard it 100 times and will share with you what everyone is telling me. "Are you crazy? You just had major surgery a major trauma to your body. Give it some time." As you said yourself, If you are not in pain you will heal faster. Rest is so important to your recovery. You cannot rest if you are in pain.

    I too was on a pain mgt program for a long time before the surgery and my main goal was to get fixed and get off the drugs. I think that makes it harder for us. When we are in chronic pain we push thru the pain. Now we are faced with all this surgical pain and our first reaction is to push through it. Unfortunately that is the worst thing we should do with surgical pain.

    My plan? Hang in there, use the meds only as needed and prescribed for relief and ride this surgical pain out while I do everything I am told to make sure I fuse this time.

    As to the pain itself. I have found on the days I do too much during the day I pay the price at night. When I take it easy and slow during the day my pain level is easier to handle at night.

    I wonder if you are experiencing "break through" pain at night? Is it possible you are putting off dealing with the pain so long that it is getting out of control...

    I have no idea if my experience helps any at all but I hope you get some rest and some relief. Not only from the pain but from the stress of worrying about the use of the drugs.

    Keep us posted.
  • Good you came out of your surgery well but sorry you're having pain at night. I heard one member here who had to take slow release meds to help her after the surgery to sleep at night but I hope it gets better for you as time goes by. You may want to run it by your Surgeon that you're awakening in pain and see what he says. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Hy Frog,
    Thanks for the message . I'm going to keep on keeping on. I'm going to push through the pain, I have confidence the surgeon did his job, so now its time for me to do mine.

    I hope your recovery goes well and let's keep pinging each other as we travel down this path.
    I'm seeing my PM tomorrow and want to start cutting the meds in half if possible. I'll keep you posted. Thanks for the post.
  • Hy Frog,
    Thanks for the message . I'm going to keep on keeping on. I'm going to push through the pain, I have confidence the surgeon did his job, so now its time for me to do mine.

    I hope your recovery goes well and let's keep pinging each other as we travel down this path.
    I'm seeing my PM tomorrow and want to start cutting the meds in half if possible. I'll keep you posted. Thanks for the post.
  • Hi Charry,
    Thanks for the post and encouragement. I will talk to my doc and see what he says.
    Be well.
  • Hi Rob M,
    You got that right where day becomes night and vice versa.

    I wish you luck with your procedure.
  • You have heard it over 100 times because its true! :)

    3 1/2 weeks post-op of a 2 level PLIF (I've had one, and a 2 level ALIF) is sooooo early in recovery time. Pleas speak to your Dr. and tell him/her that you are "pushing through the pain". As a Spiney/Neckie for 9 years I can say that it is not a good idea to do this. Your body needs to heal and that takes time. Pain meds are there for a reason. It could possibly be that you are waking at night in pain because you are cutting back on your meds.

    Just my 2 cents. Also, remember that now the discs above and below you fusion will be taking on more force and are prone to deteriorate. Learn from my mistake: treat your back kindly.

    With time your pain will hopefully diminish.

    Take care,
  • Hey ICar,

    Maybe I didn't make myself clear. I know you want to push through this surgical pain but my experience says DON'T. We are not talking about the Chronic pain here. This is surgical pain. It must be allowed to heal. 31/2 weeks is nothing.

    Activity should be "as tolerated." If it hurts that means stop. Use the pain meds to keep you active and to allow you rest. If that is not working talk to your Pain doc maybe you are not on the right thing. I am using a slow release pain med and have not had to use a single Break Trough drug in 9 days.

    Do keep me posted on what your pain mgt doc said. Please be honest with him about your activity levels and your pain levels at night.

    Hey it's been this long. A bit longer on the meds to allow your body the full benefit of a complete heal isn't gonna hurt much is it?

    I look forward to hearing from you.

    What was the date of your surgery anyway? Mine was 2/24.
  • Hey Frog,
    My fusion was 2/21, so wer're kindred spirits. The first thing my PM said was I looked great. Which is good, but I did take an Oxy 30mg before I left home (ha). We came up with a plan. They're taking me off the Norco and just using the Oxy. Doc said if I have any withdrawal symptoms to call and we'll get back on Norco - since ive been on it for 18 months. But she said that coming off the Oxy will be easier if I can transition to it OK. They can cut it either by going from 6/day to 5 to 4 etc... Or they can cut the mg in half. Which of course could be done with Norco but she felt the tolerance is so high with the Norco. I mean 1 30mg Oxy helps the pain significantly better than 2 10mg Norco. Of course the dosage is higher but as you both say, it's time to heal.

    I keep a log next to my meds to make sure I'm doing right by myself.

    I was truthful about nightime issues and she said I cut back my Robaxin(sp) from 6 a day to 4. It is a strong muscle relaxer which make day night etc... She said to time it to take 2 at night with the Oxy and that should help. But it's a matter of still not being able to sleep on my side since I had radiculopothy - Neurontin. The nerves are starting to heal but the numbness and pain still keep me on my back so moving to the couch and changing positions and support help a lot.

    The way I see it, at the end of the day I could be in Lybia or Japan. I pray for those people even after all the history.

    Frog, I hope you stay in touch.
  • Thanks for your advice. That is what this is all about. Sounds like you are a good individual to give it. I appreciate your thoughts. Patience is not my strong suit but I will stay the course.

    Best wishes to you.

  • Oh my goodness you MUST give your body time to heal! I had an L5-S1 ALIF on 2/22 and I am still basically laid out from it. I do walk short distances, sit several times during the day, and try to be very careful with movement. If I try to overdo at all my presurgical pain returns with a vengeance. It's going to take a long time for my nerves to heal. Before my injury I was a very active type A striver. Telling me to relax & take easy was just hard to accept.
    Hang in there and take the time!
    Pat Gibson
    L5S1 ALIF 2-22-11
    Now L4 Retrolisthisis
  • Good news you are reporting ICAR,

    Sounds like you have a plan. I love it when a plan comes together. What your PM said makes since to me.

    A few questions for you?

    Do you have a Brace? do you find it comfortable? Are you driving yet? How much are you walking? I am assuming you have the No BLT restrictions. Do you have the no sitting more than 30 minutes restriction? Can you sit comfortably? You sound like you are getting around so well.

    Honestly, I am walking around my house and have gotten outside for short walks the last week or so. Of course the weather here is less than cooperative. (Winter storm warnings again tonight and tomorrow.)

    Even if the weather were cooperative I don't think I would be doing much. Like Pat mentioned, I am still experiencing considerable surgical back pain as well as leg pain that I had pre surgery which now the nerves seem even angrier. I have all those restrictions and can barely sit even if I wanted too. I was assured it's all going to take time and I am still a very short time out of surgery.

    I was actually going to talk to my PM when I check in at the end of this week. I can't decide if its just the meds or me coming out of surgery but all I want to do is sleep.

    Just as I told you, I have every intention of doing things just as instructed but I do want to get off the drugs as soon as I am able. I know what he will tell me. Sleep. It's good for you. But we shall see. I would like to see if I am on a lower dose of meds if I would have more energy.

    Either way, like you, I take a look at all the devastation around the world on TV and I think maybe I should just suck it up and be thankful for what I've got.

    Thanks to the media it can all be brought right to our doorsteps all most real time. I find that amazing and a bit unsettling.

    Keep in touch

  • Ok, yes I have a brace and i don't go anywhere without it. The surgeon cut through 8 inches of back muscle - and he he made 3 levels of stitching on his way out. So definitely using the brace.
    Yes, no bending, lifting but not sure what T is?
    My doc said no sitting for 20 minutes for the first 3 months. I doubt i could anyway.

    The way I look at walking is a few things: 1) it is good to get out of the dang house, 2) even when you don't want to do it, do it. I know the meds make you tired but if you're stable enough to walk and have someone to walk with (spouse or friend) then try as much as your doctor and body say you can. And 3) walking helps the bowels. Man these meds can mess with you. Just be careful lowering the dose so soon from surgery. I understand you want to get off, but give it time.
    It is going to take time, but know you'll be better off 6 months from now.
    Heck, my wife is due with #2 in a couple weeks. I'm terrified. Hang in there Frog
  • ICAR,

    T = twisting. No bending lifting or twisting.

    I hear you loud and clear on the sitting.
    I have the same restriction on sitting for the first 3 months. Fine with me. Right now it's too painful. I have determined there is not a comfortable seat in my entire home. I have tried to use this as an excuse to get new furniture. So far Hubby is not buying it. What's with that?

    I am walking everyday. Many times a day. Short walks but I am walking. Mostly in the house. We'll need new floors at this rate too.

    I have been getting outside at least once a day weather permitting. I don't dare in the snow and ice. What's with that too? Enough already!

    Besides I have to climb stairs to get in and out of my house. I was told I could climb stairs up once and down once a day. I am using that restriction up just using my bedroom upstairs everyday. I'm trying not to push my luck by adding the stairs getting in and out of the house several times a day. I really don't want to aggravate the muscles anymore than I have to. Once the weather breaks I'll be out there.

    I am looking forward to 6 months from now. Heck, I'm looking forward to 3 months from now. I made the mistake, in the begining, of trying to measure how I felt each day. Big mistake. I know I have to look at it in larger time frames or the disappointment will be overwhelming.

    Congratulations on #2. Woo Hoo, How exciting. You are getting your life back just in time. It is terrifying! The fact that you are terrified means you care. I can't wait to hear all about it. I am sure you have heard this a million times but "Don't Blink" buddy. Enjoy every minute. Before you know it they are "adult" children. (And I do use that term adult very loosely.) But they will always be your children.

    Take Care

  • At 3 1/2 weeks I was still on oral morphine. I underwent 2 level fusion (same as you) Dec 2010. It was about 8 weeks out when I really started to wean myself off pain meds but still needed them at night. I am 3 1/2 months out now, still use Tramadol if necessary, Alleve mostly works. I still get backaches, and thigh pain and hip pain. This is my third surgery, I know it is going to take at least a year.

    You will get there, be patient, you have been through a lot of surgery.

    good luck to you
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