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2 weeks post-op 4-level ADCF

Hello all, newbie here;

I am only 2 weeks post op for a 4-level ADCF, and recovery has gone absolutely beautifully until just a few days ago. I'm afraid that I've messed something up!!! (eeeeek!). Like many of you I had a highly recommended and renowned orthopedic spinal surgeon whom I've been seeing for 3 years for neck pain and various parenthesis, from my face down my arms, primarily on the right. 2009 MRI showed severe degenerative disc disease with multiple spurs and nerve impingement on the C5-6 level. After a few rounds of PT (which didn't do anything except exacerbate the situation), and nerve root blocks, surgery was discussed. However, my pain and tingling was intermittent and I didn't feel like I was ready for such a huge procedure. My criteria then became, if the pain got out of control or there was a threat of permanent nerve damage from compression, then I would have it. At the time, in 2009, there was no compression or stenosis and only a one level fusion was recommended.

Fast forward to 2012, pain and numbness increased in frequency and intensity. MRI now showed stenosis and cord compression in 3 places - time for surgery. But now it was a 4-level ADCF that was needed. So I has the surgery after consulting with a neurologist and another orthopedic surgeon, both of whom confirmed that surgery was necessary.

Recovery, especially the first week, was typical - hoarseness, difficulty swallowing, pain of course, and had to be propped up on many pillows and/or recliner. The worst part by far was lifting my head unsupported to get out of bed, etc. After a week I was doing better than anticipated. I was fitted for my stimulator, which I west everyday for 4 hours, and even when the PT came with the stimulator he couldn't believe I just had a 4 level. I came home with a hard collar and have never had to wear it. Difficulty swallowing, almost totally off of pain meds, driving, walking, everything after a little more than a week. Awesome right?

Well, I think I must've pushed myself top hard when I took my daughter (2) shopping. I'm not sure if the weight of my purse on my shoulder caused it or what. But now if I do anything physical, such as drive for awhile, wear a purse, or do any activity for longer than 30 mins I get this excruciating burning in my shoulders (mostly my right but sometimes both) and in between my shoulder blades. And I should add that it only happens when I'm doing some activity for longer than 30 mins to an hour. It doesn't hurt at home or washing clothes or anything like that.

My question is: have I done something wrong that might be permanent? I'm scheduled to go back to work in 2 days; thankfully I have a desk job in finance. But I also have to sit for long periods of time and use the computer constantly. I'm afraid if this happens at work I won't be able to take pain pills. I also have a 100 mile round trip to work everyday. Will this go away? Have I just pushed myself too hard in such a short amount of time that I've pinched some nerve? Or could this be permanent? I'm scared to death because the pain is horrible!!

Any advice would be greatly appreciated!
4-level ADCF, C3-C7, 9/25/12


  • LovetrotravelLLovetrotravel Posts: 296
    edited 10/08/2012 - 8:38 AM
    I am just shocked at how much you are doing at only two weeks from a 4 LEVEL fusion!!...

    I just can't believe your Dr. is allowing you to drive so much or at all at this point....carry anything like your purse....or even start PT...

    And going back to work in 2 days full time???? Especially with that round trip of driving and all that computer work???

    That just sounds crazy to me....It's one thing to be feeling great and recovering well...but it's another to not let your body heal properly and ruin everything the surgeon did...

    I still don't see what was the exact reason for them fusing 4 levels...but obviously this Dr. is not like one I have ever heard of before if they are allowing you (encouraging you) to do all this so soon....

    I recognize that different Drs. have different thoughts of when to "ride" in a car...but for doing the driving yourself so soon and so much is just not something I have read a patient doing.

    PT is not usually done until a month out as you want to get the most out of it and wait until the nerves/muscles have calmed down...and this was after a two-level fusion.

    Anyway...sorry for rambling but I am just taken aback with all of this and can only say that you need to be extremely careful....An actual fusion takes close to a year to take place...the best long term recovery and patients who have the best success in the long run are the ones that go day by day....steady as she goes.....GRADUALLY moving and doing more.

    I am very concerned for you.....
  • I am also amazed at all you have been doing so early on after a 4 level ACDF.
    I think your body is trying to tell you that you are overdoing it!

    I am facing a 2 level ACDF and have been told that I will need 3 months off work in my teaching assistant job.
    I won't be able to drive for 6 weeks.

    Please do be careful!
  • welshladywwelshlady Posts: 121
    edited 10/09/2012 - 10:25 AM
    i just want to add, the first week after my op (a three level) i was brilliant, no real pain just uncomfortable swallowing and getting up and down. but after the first week..... things really did start kicking in, it seems that i had lots of pain killer while i had the op and that took a week to get out of my system... it is now 5 MONTHS later and i am just going to start a slow return to work and i hope to drive by the end of the month, but only short journeys to start with. please be careful and dont expect too much too soon....... you know the saying..... if you think the offer sounds too good to be true then it probably is..... well same goes for your recovery. (i thought i was some sort of superwoman to be feeling so great so quick... how easily fooled i was!

    good luck
  • I was surprised about being allowed to return to work so quickly myself. But when he said two weeks I jumped on the next available. My husband went back to school so I am the sole income and we also have a 2 yo daughter. It seemed as if all the stars aligned with work, the length of time off and finances, I was able to get help from my sis in law for a week, etc. My doc said that the fusion will be so stable that when I feel like I can drive and I'm off pain pills, to go for it. I took it easy, stayed in bed, etc for the first week and then slowly started trying to ween myself off the Meds as soon as possible so I could take care of my little girl while my husband was in school.

    The reason for the 4 level fusion, which even he said he doesn't usually recommend, was because my cord was compressed in 3 areas and causing me lots of nerve problems and the possibility of permanent paralysis was real, at least in some areas of my face and arms, even my legs would buckle because of sudden and severe weakness.

    I can only go by what my doc says, you know, and trust that he's telling me, you know? He was rated by post surgical patients 5 stars across the board from more than 50 patients on independent sites. He publishes articles, does Doctors without Boarders, board certified, Chief of Spinal Surgery at Baylor Hospital. He's never had any sanctions or complaints filed with the Texas Board of Medical Examiners. He has the credentials so I feel confident he knows what he's doing.

    Anyway, I'm back at work today - hard collar, stimulator, comfortable chair, ice pack designed for shoulder (which seems to help quite a bit), and a travel pillow if needed. But the doc told me he would approve as much time as I need off from work up to 5 weeks, but he said I should be ready for my kind of work in two weeks, even with my 100 mile commute. I have nearly all range of motion so I don't have any trouble looking around me to change lanes, etc. We'll see I guess :( I just want this should pain to get under control because it is disabling. So far so good today. Fingers crossed!!!

    Thanks again everyone. Any other advice or suggestions for relieving the shoulder pain is certainly welcome. :)
    4-level ADCF, C3-C7, 9/25/12
  • I think that you just need to give those nerve time to heal up.Nerves don't heal quickly,it can take up to a year after surgery for them to get as healed as there going to get. Also maybe your purse is just to heavy yet for your shoulder. I was told my by neuro. that my purse should be small and light and i had a 3 level.
    Your recovery so far is amazing, good for you. If that shoulder of yours is that bad then perhaps you still need to be taking more of the pain meds. that you have. Perhaps you weaned off them too quickly. Just talking from experience. lol I did the same thing. My pain wasn't that bad until i went off the meds. then it just seeped back in. Good luck getting back to work, just don't overwork yourself because it will bite you in the ass! LOL
  • Gav_73GGav_73 Posts: 3
    edited 10/10/2012 - 10:34 AM

    I think you hit the nail on the head for me. When the pain started in the shoulders it was my first real day off ALL pain meds, and I took my daughter to the mall to "shop" for an hour, which turned into a 5 hour walking and waiting period for a walk-in eye exam and glasses. I didn't have a lot of shopping bags or anything, but my purse was heavy and just full of unnecessary junk. The purse, the couple of bags, a tired baby who wanted me to hold her all the time (she was actually laying down in the eye doctor's office telling me she wanted a nap), was all TOO MUCH! I felt like I was being constantly stabbed with hot pokers in my right shoulder, which would some times radiate to the left. I was helpless and stuck right in the middle of the mall and there was absolutely nothing I could do. It was horrible.

    So the first thing I did was get rid of that awful purse and get back to the basics. I only take pain pills at night and bought this awesome ice pack that wraps exactly around my shoulder from my neck across the middle of my back. It's great! Then when I get home I take it totally easy. But I can see your point. The pain started not only when I got out and about so soon, but when I quit the pain meds. What's interesting is that I recently had my tubes tied, a hysterscopy and D&C for endometriosis on a Friday. By Sunday I felt great and came into work. Well, during the work day I thought I was going to die from the pain, and realized - WOW, this is the first time the pain pills have had time to wear off! LOL

    I also had kyphosis pretty badly (a deformity from degeneration that straightens the natural curvature of the cervical spine). It was at a negative 5 degrees before surgery (meaning all curvature was gone and was even starting to go the other way), to a positive 23 degrees. So I'm sure the posture adjustment and all that has something to do with the shoulder pain too. Who knows?

    But I did finally call my doc about the shoulder stuff and he said it's very common, nerves are waking up and shoulder pain is something almost everyone experiences and I didn't do anything wrong. That it was temporary and it would eventually go away. I sure hope so. I had them call out an extra month's worth of Norco and Valium tho and I have no problem about taking them. LOL

    Thanks again!
    4-level ADCF, C3-C7, 9/25/12
  • Gav, I am sorry you are having some issues but also I am especially glad to read how well you have been doing. I have 4 level ACDF scheduled for January and been researching . Very few seem to have so many levels done at one time. I am very apprehensive about the whole thing but I really need to have this done, the pain and fatigue are just too much. Thanks so much for posting. I guess the lesson learned is don't stop the meds too early and don't overdo!
    4 level ACDF completed on January 3rd.
    I developed an infection which required reopening the wound on January17th
    Looking forward to life without as much pain!
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