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4 weeks post-op and having issues with the anterior incision

I had my single level ALIF/PLIF on 10/29/12. Everything after surgery everything seemed to be going well. I spent 3 days in the hospital and then went home. My mom stayed with me for the rest of the week until she had to go back to work. I was up and walking on the second day and had all my staples removed 11/07/12. At that time my doc said everything seemed to be going well and that I could go back to work. I just needed to make sure I stayed active by walking. Within 3 weeks I was walking a mile a day and feeling great. At about 3 weeks my anterior incision started to get red and painful. There is also a goobery looking discharge from 3 different areas and I was running a low-grade fever (highest it got was 100.0 but I normal run about a 97.4-97.6 temp so for me this was a pretty good fever).

I went to the ER on 11/17/12 with severe pain around and underneath the incision that began to radiate outward, a fever, sweat "attacks", nausea, and the goobery discharge. They did lab work, a CT scan, and gave me IV pain meds and antibiotics. Nothing showed up in the bloodwork but a "pocket" of fluid was seen on the CT scan. The ER doc admitted me for a possible infection. A hospitalist came in about 4 hours later, asked a couple of non-specific questions, and left without even looking at the incision or asking me how I was feeling. About 6 hours after I was admitted a PA from my NS office, not his PA, came in and said there was no sign of infection and that she was discharging me. I went home with some antibiotics and some major frustrations.

I saw the vascular surgeon (the doc that did the anterior incision) about 2 days later. He poked around, ordered some more bloodwork and another CT. He said he didn't know what was going on but that I should be having the discharge that I was/am 3.5 weeks after the surgery.

I was back in the ER on 11/22/12 with the same symptoms. Bloodwork and a CT were again ordered. Bloodwork came back fine and showed the fluid pocket was larger. This time the doc gave me the choice on whether or not to admit me. After discussing the options with him, a nurse, and my mother I decided that I would be more comfortable at home. I left with a prescription to get me through to my appt on Wednesday.

I just don't understand how I was doing so well and then all of the sudden it was like I hit a brick wall. The back part of the surgery (which is the important part) seems to be doing really well. However it has been hard for me to walk and stay active with the pain and nausea that I have been experiencing.

My question is has anyone else out there in SH land had a similar experience? I am at a loss and my surgeon seems to be as well. Right now I am grasping at straws in hopes that someone else has a similar story.

Single level L5/S1 360 fusion with 6 screws and a rod (10/29/12)
Diagnosis: Grade 1-2 spondylolithesis, Pars Defect, L5/S1 disc tear anterior and posterior, DDD, spinal stenosis


  • I'm sorry that you are now having problems. :-(
    My lumbar fusion was a PLIF, so not the same as yours, but I did get an infection after surgery.
    My incision opened up at the top, while the staples were still in place.
    I then got an infection, but it was diagnosed by a swab test.
    I had antibiotics and daily cleaning out and dressing changes. I had to wear the dressing for 6 weeks, but eventually I did heal (although had over granulation tissue that had to be cauterised). My scar is thicker at the top where all the problems were, but it is fine now.

    Your problems are more complicated, but I wanted to give you hope that all will resolve and be fine in the long term.
    Right now though, I am thinking of you and hoping that you will get some answers on Wednesday and that they will have a plan to deal with things for you, to get you back on the straight and narrow.

    Gentle hugs >:D< >:-D< :hug:
  • About a month ago, I had ACDF C3/4 and C4/5. I did not have exterior sutures. I had surgical strips and gauze over the area for one week after being released from the hospital. My surgeon changed the gauze the second or third day I was in the hospital.

    I had commented to the nurses and my surgeon that the area (not the area of the adhesive, but under the gauze) was warm and itchy. They told me that it was just the healing and the fact that gauze was covering a large area of my throat.

    I HATE things around my neck - always have, always will. No turtle necks, no necklaces, no scarves. I joke that I must have been strangled in a former life.

    So, I endure the itching for one week while at home. I had no temperature, but my blood pressure while in the hospital went from 127/72 to 211/117 (something like that) - something completely abnormal for me. The hospital kept me an extra day because of that. It went down to about 140ish/82 - so they let me go home.

    So - the itching persisted. I was NOT doing any exercise, as I am also in a Miami J Collar - so there is absolutely no movement (or very little) of my neck.

    I go in for my one week post-op visit to remove the gauze and as the nurse is removing the gauze, I can see the look on her face is not pleased. I asked her what was going on and she said she was going to get the surgeon. I went to look at it - and it looked like Carpaccio - red, raw, inflammed, My surgeon came in and had the same look on his face as his nurse. They apparently had not seen anything like it before. It looked like someone took a sander to my throat.

    I was actually relieved to know that it was, in fact, SOMETHING and not just my mind. They think that I had an allergic reaction to the gauze, but I have had gauze on me before - I think it was a simple heat rash gone out of control because of lack of air circulating in the area. Once removed, I could feel and immediate difference, but, I had a new problem - the collar made my throat warm AND we had a fluke heat wave of 85 degrees the last week of October and first week of November, which DID NOT help. So, I sat a lot with my head against the recliner and opened the collar and held a small electric fan there.

    Heat and perspiration made it worse. I wonder if it contributed to blood pressure issues (in conjunction with the normal anxiety of being in a hospital, although for me it wasn't that as much as not being able to swallow easily and knowing I was mostly going to be on my own when I got home.

    I am wondering if your working out and perspiring was creating a similar reaction, but yours going to different levels? I am guessing not, but I was amazed at how quickly mine started clearing up when I was able to keep that area clean, dry and exposed to air. I did happen to have steroidal lotion at home (from something else and I kept it), so I put a little on the area, except the incision) - just one time - and what a difference. The swelling and rash and redness immediately started going away. Now, I just have some residual pinkness at the healing skin.

    Just thought I would ask if it was possible that sweat might be contributing, if not causing it?

    I wish you well and hope you post what you find out!
    10/26/2012 ACDF C3/4 C4/5 surgery
    No pain; no pain meds - thank goodness!
    04/01/2013 - 5 months + 1 week - FUSED
    Doing some physical therapy for even better range of motion
  • Because I have had so much stomach pain. I did see my vascular surgeon today. He drained a bunch of fluid and packed it with iodoform (gauzy-like material with betadyne in it). Part of the problem is that part of the incision has not healed at all. He stuck his little tool in there and it went straight through to my gut. So basically I have been walking around with a hole that goes from my skin to my gut. The good news is that he said the fluid he took out doesn't look like it is infected but he sent it off to the lab just to make sure. My incision area doesn't look or feel as swollen as it was so hopefully this is the answere.

    Single level L5/S1 360 fusion with 6 screws and a rod (10/29/12)
    Diagnosis: Grade 1-2 spondylolithesis, Pars Defect, L5/S1 disc tear anterior and posterior, DDD, spinal stenosis
  • It doesn't sound like that doctor might have found the cause for it either, but I hope that this solves it. It would be nice to know what it is in case it is something you can prevent reoccuring.

    I wish you well.
    10/26/2012 ACDF C3/4 C4/5 surgery
    No pain; no pain meds - thank goodness!
    04/01/2013 - 5 months + 1 week - FUSED
    Doing some physical therapy for even better range of motion
  • I hope that now the surgeon has drained off the fluid, the tissue will be able to heal and close up the hole.
    I hope that you feel more comfortable now.

    Take care and get plenty of rest to allow your body to heal.
    Gentle hugs >:D< >:-D< :hug:
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