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Post-op report - posterior laminectomy/foraminotomy w/o fusion

SwedishFishSSwedishFish Posts: 57
edited 07/20/2012 - 12:23 PM in Back Surgery and Neck Surgery
I had a lot of trouble finding information on the surgery that I had specifically although at the last minute I did get some great help in these forums. This will be lengthy but hoping it will help someone having a similar procedure done!

I had laminectomies done at C5, 6 and 7 and foraminotomies at C6 and 7 on July 12, 2012. I had no fusion and I am not required to wear a cervical collar. Official recovery time is 2 weeks. I am one week and 1 day into my recovery. I am 46 years old and in moderate shape. Other than neck pain my primary complaints were nerve pain from my shoulders to my fingers - anywhere from electric shocks, to numbness, tingling, and achy/crampy feelings. The hands/fingers were by far the worst for me and as a teacher the most noticeable.

Pre-op: get your house ready for your return. You will be able to bend your elbows at about shoulder height, so you can't reach anything above the top of your head (you will be able to wash your hair w/o assistance) or anything below your arm reach without bending your neck. So I put for example in the bathroom everything that I needed on the counter. I put all of my things into a basket so that I could pull it towards me if necessary - toothbrush, toothpaste, face cream, lotion, comb, hand mirror - anything like that. This was really helpful. I bought a grabber at Target for less than $10 that has little suction cups on the ends and it works great. I have even been able to pick up a pill off of the floor before my dogs could get to it! Very handy to have. I also had some help and my dad installed a handheld shower head (which honestly I haven't held in my hand and have done just fine but nice to have the option) and then a corner shelving bath unit with adjustable shelves. 3 of the 4 shelves were within my range of reach so I had shampoo, conditioner, bath puff, shower soap, razor there. In the little space where you can hang a washcloth (I have a shower-tub) I had a long-handled bath puff and brush that I slipped in there upside down. If you can hang something like that in your shower it would work too. AWESOME for washing your feet! I did not need a shower stool but I think this will depend on you. I was able to shave under my arms no problem. I did shave my legs by lifting them up against the shower stall a week after surgery but I didn't do a great job. It could be a falling hazard too d'oh. ;) I had to have people dry off my feet/toes because I couldn't do it. I did buy a bed tray and used it once so it wasn't a must have. Have a variety of pillows - most of us do anyway in search of the "perfect" pillow or combination thereof! I have one of those reading pillows (you know that have the little arms on the sides??) and then 2 pillows on top of that when I'm on the couch. First couple of nights I was propped with 2 king pillows in my bed. Last night I was on my back on my buckwheat hull pillow and got a great night's sleep. This has been a hard transition for me because I'm sort of a side/tummy sleeper where I'm on my side but with one leg drawn up. So I've been working on sleeping on my back as that's one of the worst positions for your neck long-term!!

There will be certain meds that you have to stop taking 2 weeks prior to surgery and then another group 4 days prior and then depending on your surgery for a certain number of days after.

If friends offer to help - accept it! A friend came over one day for 4-5 hours and helped my boys clean up a lot of the house so that they only had to do "maintenance" type stuff around the house to keep it neat after surgery! It honestly made an amazing difference for me. She also took me shopping for the last minute items that I thought I might need.

Stock up on groceries, paint your toenails, get your hair trimmed - anything like that so that you won't have to worry about it. Pre-make some meals or have easy prep things available if you don't have someone to help you with that stuff.

I had pre-reg at the hospital 2 days prior to surgery after my pre-op appt with the PA (she described the surgery more in detail and I was able to ask questions) when I had to have intake stuff done, pay my co-pay, have bloodwork done, an EKG, talk to a nurse there and sign a bazillion papers and have a chest xray. Took about 2 total hours I think.

My parents were here for the surgery and a little less than 1 week after which was very helpful. Since I still can't drive it would have been nice to have had them for a few more days but I'm grateful for the time they spent here! And I have 2 kids who can help with most household things so that helps.

Operation: I arrived 2 hours prior to my surgery time. They do all of the typical surgery prep stuff and you have to talk to the pre-op nurse, anesthesiologist, surgery nurse (in my case it was the Physician's Asst), neurosurgeon, prior to surgery and answer the same questions over and over lol. I had to wash certain areas with a sanitary washcloth thing and then put on the gown. I was able to wear my underwear but took everything else off. I had an IV put in, bp, and those leg sleeve things that inflate to help prevent blood clots. My mom went with me and was able to stay with me for the entire pre-op time. The surgery itself took 30-40 mins. I remember nothing after being wheeled into the operating room and having a couple of words with the nurses and the anesthesiologist and I was out. They put in a breathing tube, put the halo-like head holder into place (I had 3 scab areas that were closed over with glue, if they bleed too much they might put in a stitch or staple) while I was completely under, put me face down on the operating table and then undid that all without my knowing a thing.

Post-op: The surgeon went and talked to my mom when I went to recovery. You are in recovery for 1-2 hours normally, and they told me if it was longer than that it would be waiting for a room which proved to be the case. This is if you're staying in the hospital - I'm sure it varies if you have it done and go home the same day as some do. So I think I was in there for 3 hours before I had a room. You can have ice chips here but that was it.

I went to my room where my mom met me. I got hooked up to a bazillion things. I still had the leg inflate things on - (kind of like a nice leg massage lol) until the next morning. For many hours I could only have ice chips and water. The first trip to the bathroom was not easy. NOt only having to unhook anything but I was very sore and unstable from the meds. They brought a chair next to the bed which well wasn't easy but worked. After that I was able to walk to and from the bathroom on my own although had to have a nurse there. They put an alarm in your bed so that you can't get out without the nurses knowing lol. I stayed overnight - my dad and kids (10 and 13) were able to come visit. I slept off and on, watched TV, chatted with nurses. If you're in pain don't hesitate to ask for pain meds. That afternoon/evening I was visited by the neurosurgeon, PA, and my internist. And for dinner they brought me a regular meal. I didn't eat a whole lot honestly though at any of the 3 meals that I had there and mostly wanted the softer foods. My throat was sore for maybe 4 days post-op from the breathing tube.

In the morning I had visits from PT and OT - the PT showed me how to get up out of bed safely. I can't remember what else but there might have been a couple of other things. The OT took me for a walk and I was fine so that was it. Told me I was his easiest patient of the day. :)

I didn't know what to wear to the hospital. You won't be able to lift your arms over your head so remember that. However, if you have something that buttons up the front or that is stretchy so that you can put your arms through and have someone stretch it over the top of your head (I can do this now on my own). I wore an elastic waist skirt and had a stretchy t-shirt with a tank under it and was fine. Oh and for the women - I can do my own bra but you will have to fasten at the front and move it around if you're used to doing that from behind. I wore the same thing there and back and just had an extra pair of underwear. Shoes need to be easy to put on. I live in Vegas so flip flops were perfect. In my closet I also have a number of pairs of flipflops lined up on the floor so that I can put them on easily. Your eyes can look down but you can't really look up or down with your neck. Another hazard is small pets! My dogs are just under my range of vision so I walk sort of "shuffling" in case they get under me like they do all the time!

My release was delayed slightly because my BP stayed very low - at one time it was 80/57 or something like that. It wasn't until it was 100/72 that I was sprung. I haven't had to take my high bp meds since although I have a home bp machine and am keeping tabs but I'm supposed to follow up with my internist.

I have an incision that's about 2 in long maybe. It is slightly lower than I expected and more on my upper back than my neck. I have 7 staples in it. I was able to shower the day after surgery - you just let the water/soap drip over your back, you can't scrub and no baths, pools or anything like that for weeks. Pat dry or I actually have used a blow dryer to dry that area on low. I had a bad reaction to the surgical tape (and duh told them that I was allergic) and so have had to use Benadryl gel on the areas around the incision (not ON the incision!!!) that has helped tremendously with the itching! Oh and in the hospital for the first night you will also have a small drain in your back. There's a tube in your back lower down than the incision with a little bulb at the end. It fills with saline, blood, fat, ick from your surgery. When I went to the bathroom I put it into my gown pocket lol. Oh and they shaved a small inverted triangle of hair on my ne k - took me a week to figure that out lol. It's completely hidden by my hair.

Home: You will be very very tired. One activity can make you feel exhausted - so be prepared for the exhaustion factor. I was able to be up and about pretty much right away and that has increased over the days. My post-op directives included walking 30 mins a day in 3-6 time periods. I just went around the block with someone however many times I needed to. I was able to sleep in my bed starting with night 1. It took some propped pillows to do so comfortably. Some can sleep on their side but I can't seem to do that. So propped to almost sitting has been the best. In retrospect wondering if I should have purchased one of those wedge pillows - might have helped. I had the dressing on my neck until the following day when I took my first shower.

I do spend a lot of time on the couch. I haven't really tried the recliner as it's a couch recliner and a little hard to get out of, but facing the TV with pillows propped behind me has been the most comfortable. We pulled the coffee table close where I keep my phone, iPad, laptop, water, meds, etc. close at hand. The first 2-3 days be prepared to take your meds to stay ahead of the pain. After that it just depends on how you feel. I am still using meds 1 week and 1 day after surgery. One thing that was "overdoing" it for me was sitting in an upright chair for a few hours watching kids swim. Then I had a hard night sleeping and yesterday was just on the couch with pain meds round the clock. Today I woke up feeling much better though and have had no pain meds at all since getting up. So be careful - simple things can be too much! I have been able to fold a load or 2 of laundry and small household things like that. But I have spent a lot of time reading my Kindle, playing on my iPad (to use my laptop someone has to put it on my lap and put it back - it weighs over 6 lbs and you won't be able to lift anything over 5 lbs), napping and watching TV lol.

Feeding pets: luckily my kids can do this as I can't reach down. Someone gave the idea of putting it on a long handled dust pan and pulling them up to put the food into. But something to plan for!

The indentations on my head from the holder are healing well but still sore to the touch.

My range of neck motion actually isn't that far off side to side from pre-op surprisingly. I have not been able to drive yet and the 2 requirements are range of motion to see and being off of pain meds for at least 8 hours (hoping I might reach that milestone today - yesterday was a bit of a step backwards). Oh and advice was to take a short drive first and see how it goes and gradually make longer trips. Again, that sitting up position is very wearing on your back/neck muscles. So hoping to drive to my dr's appt on Mon but not counting on it and I do have someone to take me which I think I'll do anyway since having the staples out might create some short-term increase in pain I would think like when you have stitches out (I haven't ever had staples).

When I first woke up I immediately noticed NO nerve pain in my hands!!! I will say that I've had some off-and-on nerve pain in my arms/hands/fingers but it's easily an 80% reduction from what I was having prior to surgery so in my case it looks like the surgery was the right choice. The post-op info does say that that is expected and possibly some numbness (although shouldn't be NEW) for a few weeks. i'll see what they have to say on Monday about mine.

My follow up is this Monday so about 1 1/2 weeks post-op. So I will get my staples out then and know more and can update. I still have pain to the left and right of the incision site, some pinching feelings and pain in my neck (I think a lot of it is muscle tension) at this point but at least today it's tolerable without meds. We'll see how that goes as the day progresses!!

I hope this helps someone - I tried to answer all of the questions that I know that I had prior to my own surgery. I'm happy to answer questions if people have them!

And thanks again to all who were thinking of me for my surgery - your positive thoughts helped!!

Carmen :)



  • jellyhalljjellyhall Posts: 4,372
    edited 07/22/2012 - 11:41 AM
    I have just found this. Thank you so much for taking the trouble to post this, I know it will be very helpful to many others. I am due to have a 2 leve4l ACDF, but I think this will help me too. I haven't read it all yet, but have printed it out and will read it thoroughly, highlighting things that I want to remember or act on.

    I am pleased to hear that you are now into your recovery, and hope that it will go smoothly and give you much needed relief.

  • SwedishFishSSwedishFish Posts: 57
    edited 08/25/2012 - 10:55 AM
    Well I'm glad that at least one person found this helpful! I took the time to try to include all of the things that I know that I really wondered about and never got answers for.

    I am now I think 6 weeks post-op and doing very well. I go back for my follow up with the neurosurgeon on 9/5. I saw a PA for the initial follow up when they took out the staples. I can say that once the staples were out (they let my 10 year old remove them lol and he did a very good job! And yes, he was supervised!!) the pain level diminished dramatically! The first 2 weeks I was very sore, very tired. I was driving 2 days before I went and had the staples out and the cautions for short trips first was a good one to follow. My scar is healing nicely - I had not only a reaction to the adhesive on the tape (told them I was allergic) but also to the STAPLES themselves! So I was using a lot of bendryl gel for a few weeks no joke after the surgery.

    I had my parents here for the first 6 days post-surgery which was great. My boys are 10 and 13 so they were able to really help a lot although since I couldn't drive I did have help here and there. AND I learned to let people come and HELP. I'm never good for asking or accepting help. One friend flew from Seattle for 3 days, got the boys in gear and totally organized my laundry room! Another local friend helped get the 10 year old's room organized which is a much bigger task than you might imagine.

    I haven't been prescribed PT but I assume I will when I see the neurosurgeon on the 5th. I can tell you that holding my head up some days is PT enough! I had to sit through some all day trainings recently and there was a point where I just felt done every day. I did tell the instructors that if I put my head down, my eyes were open and I was listening - just need to rest my neck from holding my head up!! And over time I've just been able to do more and more "normal" things gradually. My weight restriction for lifting post op was 5 lbs for 2 weeks, then 10 lbs for 2 weeks and now 15 lbs for 2 weeks. I am very careful about lifting things though and when in doubt, have someone else do it!

    I am on NO pain meds at all and haven't been regularly since I started driving. I occasionally need ibuprofen and sometimes a heavier muscle relaxer at bedtime, but other than that no narcotics or anything. I would say for the last couple of weeks I'm more sore than in pain if that makes sense! I'm a teacher and the last 2 weeks have been really hard on me though - lots more than I'm used to doing in a day and LOTS of sitting which is awful. So lots of just general muscle/joint pain just adding to the "normal" stuff. I start with students on Mon and I know this week will be exhausting but I will do my best to sit when I can at school (I stand probably 90% of the time when I'm teaching) and just make students help a lot! (high school!) I also got a note from my PT to have a small fridge/freezer in my classroom (they banned them because of energy costs) so that I can keep an ice pack on hand at all times. I imagine once I start PT I will be needing it a bit more often again. We have 4 mins passing periods and there's no way that I could get downstairs to the other side of the building to the workroom freezer AND go to the bathroom (very important particularly with 90 mins classes!) in that 4 minutes. So that's a relief.

    I still get very tired very quickly. I should walk more which I know would help but well it is what it is. I was very good the first few weeks post-op walking the required 30 mins a day, but as I got busier it has gone by the wayside.

    I still have some off-and-on nerve pain in primarily my wrists and hands. I think I mentioned the PA said it would be normal for awhile and it would take 3-4 months for my brain to catch up and stop misfiring and know how much relief I've gotten. I can tell you that easily even though I still get symptoms I've had a good 70% reduction in the nerve issues. My nerve issues in my legs/feet seem to have eased a bit as well - PA said there was a possibility that the neck procedure might help. But I know that I don't walk around as much as I did before and so hard to tell until I'm back to normal activities how much it has helped the legs/feet. BUt definitely some so that's good. I know that I have lumbar issues and probably SI issues but hoping they've been eased enough to keep me going at least for a few more years before I have to deal with them. I get thoracic pain too...dang arthritis anyway!

    Anyway, I hope that helps. And I know that having no fusion makes a DRAMATIC difference in recovery for sure. I truly could have been released to go back to work after 2 weeks with restrictions. I wouldn't have loved it but I could have depending on overall job requirements. But glad that I had a full 5 weeks before I had to go back to school (the other things 2 weeks ago were added later so not planned for).
  • At 6 weeks, it sounds like you are doing really well.

    It is so encouraging to hear of a successful surgery. So often we hear stories that start of with great trauma and then don't end in the way that the surgeon and patient hoped for.
    With the successful surgeries, we just hear that things went well and then the person moves on. To read of your story and how well you are doing in so much detail is great and very encouraging for those of us who are facing cervical surgery.

    Thank you again, very much.
    Take care and keep up the good healing.
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