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ACDF C4-5 & C5-6 on 12/3/12, so many little things...

Pangea250PPangea250 Posts: 15
edited 12/26/2012 - 10:57 AM in Back Surgery and Neck Surgery
I had my ACDF for C4-5 & C5-6 on 12/3/12, so I'm just over 3 weeks post op now. It was such a painful thing to go through...I woke up crying in the recovery room. I spent a good 10 days medicated around the clock, & I still need a narcotic pretty much daily at this point. Not happy about that. :-( And I feel like a drug seeker if I need to ask for more pain meds. My arm pain & headaches are gone, but neck pain remains & it seems to move more down my back to one side a bit more and more. Honestly, it feels to me like it's related to poor posture because of post op muscular weakness.

I wore a hard collar for several days, but found it very difficult to tolerate, so weaned myself off by about 7 days post op. I think that any more time in that torture device might have created permanent injury, if it hasn't already.

I saw my surgeon for my first post op visit at 2 weeks. I brought to his attention what feels like a LOT of scar tissue directly under my incision. It's so hard under there, felt like a deck of cards. My surgeon reminded me that he encountered existing scar from a previous thyroid operation 9 years ago. Makes sense. He was ready to send me off with a follow-up appointment at 7 weeks post op when I asked for a script for PT. He said he usually doesn't do PT so soon, but I told him I'm afraid of things freezing up in my neck. I mean...it already feels that way, particularly from how my head would sit nestled inside the hard collar. So I've had 4 PT visits so far. Not much improvement seen from that yet, but I know I must learn to be a more patient patient, so to speak.

My biggest concern is 2 tendons (I think they are tendons, anyway, though I suppose they could be ligaments), 1 that originates on the edge of the left side of my jaw near my left ear and another that originates halfway between that edge and my chin. Both go (somewhere) down my neck and I think they are now frozen, in a non-extended state, to the scar tissue in my neck, due to being immobile in the (expletive) hard collar. I can barely extend my neck backward if I keep my mouth closed. If I open my mouth, lowering my jaw, I get much greater extension.

With mouth closed and extending my neck, I can physically palpate the tendons from jawline to incision line, stretched tight, unable to budge further. Note: there is no problem on the right side of my jaw, and the incision exists more to the left side than the right.

I read in another post about post op depression. I'm relieved I'm not alone in that. I'm also concerned that I return to work tomorrow, a desk job with mostly sitting. I tire so easily now doing almost nothing, I don't know how I'll make it through the day. I feel like a wimp. And a big baby.

Somebody please tell me this is all normal & to be expected. My gut tells me no, though. I'm beginning to become afraid that I'll need some kind of additional surgical procedure to release this scar tissue.

Edited to add: I also have complete numbness of my skin from my jawline to the incision line on the left side. It hasn't improved at all in 3 weeks & I'm beginning to think it might be permanent?

- Pangea
status post ADCF C4-5 & C5-6 12/3/12
- Pangea
ACDF C4-5, C5-6 on 12/3/12
Bone growth stimulator 4 hrs/day
Follow up 1/21/12 - growing bone, still in pain though. Working desk job but still not cleared for volunteer EMS :-(


  • Hi there, Pangea:

    First, I think you are correct - that you are not being patient. 3 weeks is nothing! It's frustrating to be down for the count, but patience in healing is going to be the only thing getting you through this. Lack of it is going to make it feel impossible. All of what you are describing IS normal. You have been through a lot and your body has to heal. It won't heal in just 3 weeks, unfortunately. Don't rush it. My attitude is that you get one shot to get this right. Surrender to the healing process (as woo woo as it sounds) because there are no shortcuts to healing.

    I am now 8 weeks post ACDF C3/4 C4/5 and I have a collar, too. The Miami J Collar. I hate it, but I have never been in pain since my surgery, so that is a difference between ours. Sorry to hear you are in so much pain. I am constantly amazed that I had none, even while in the hospital. I had them, take me off of pain meds the second day because they made me nauseous and I wasn't in pain.

    Second, for the scar and the scar tissue - I went to the health food store and got some scar oil. I massage it in every morning and every evening and without a week or so, I felt the scar tissue softening. My sister had some surgery and her surgeon told her to use olive oil. So, if the wound is closed and healing, you may want to try some of that to help with the softening of the scar tissue. Just a suggestion.

    The collar is frustrating, I agree, but especially those first 3-4 weeks, I cannot imagine being without it, especially while sleeping. I just have no room/time for the fusion to get messed up. I saw my surgeon at 6 weeks and to my disappointment, he wants me in it another 6 weeks to make sure that the fusion works and works well. The fusion has started, and he knows that I have blocked out this window of time to heal, so he wants to make sure it goes smoothly and well. I get that and I am willing to play. He has seen far more of these than I, so I want to defer to his expertise, with my slight fudging of the rules in play. So, I will endure. For example, when I am sitting in the recliner and my head is resting against it, I open the collar so air will circulate.

    It does throw off my posture - BIG TIME. I cannot sit or stand for long periods of time - but mostly because of fatigue. If you are going back to work, make sure you get up and walk around the office a few times and then resume sitting for a period and repeat the process. During the holidays, I was doing a lot of prepping and helping and after about 10 hours, I could barely stand. But, I knew all I needed was to lie on my bed and stretch - that made a world of difference.

    I massage the back of my neck often and I use a microwaveable heating pad that drapes over my shoulders. That has really made a big difference, too. Bring that to work, if you are able. I have been working from home and I use that heating pad often.

    Numbness under chin to the incision - I have that, too - and that is to be expected. Nerves were cut and it takes time for them to reconnect. 3 weeks is nothing. Don't panic. I started getting a little bit of sensation back just under my jaw bone about 4-5 weeks into it and my surgeon and his nurse say that it can take up to a year for full sensation to come back, but it usually does.

    I did have swallowing issues the first few weeks and I do still have some tingling down my arm, which may or may not correct itself, but I knew that going in.

    I did have a terrible reaction to the gauze, coupled with the fact that we had a fluke heatwave at the end of October of 85-90 degrees and it caused severe itching to the point at which it looked like someone took a sander to my throat. I was patient, though and at the end of the week when I went in so the surgeon could remove the gauze, he and his nurse were both shocked. Once the gauze was off, I knew it would be better.

    May I make a suggestion? I know you are frustrated and anxious. I get that. One thing I did - and if you knew me you would know that it was not in my character - but I decided to download a guided imagery audio. There have been studies done that have shown that those who listen to guided imagery audios heal faster and pain is lessened. I have no idea if this helped me have zero pain, but if it did - WOW. I know that I put the audio selections on my smart phone and brought that with me to the hospital. I listened to it a few days before going into surgery and then while in the hospital, it was the first thing I asked for along with my ear buds. I listened to it many times, especially during a few anxious moments in the hospital when I awoke at 2am and my mind wandered. I continued listening to it at home when I went to bed and when I would awaken at odd hours. I downloaded one on Amazon for $9 - Preparing for Surgery. For me, it really helped. Email me, if you would like to know more.

    It might help with your pain and anxiousness, you never know.

    Again, 3 weeks is nothing, even though it feels like an enternity, I know. I can't wait until this collar is off, but I really, really, REALLY want to make sure the fusion takes. I don't want to be one of the 'failed fusions'!

    Sorry this is long. I hope it is helpful.
    You're doing fine - DON'T RUSH IT!
    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
  • Thanks, Francine. :-) I'm a bad bad patient, I know. I just want my life back. It's hard on the kids (I have a 17 year old & 11 year old) & it's hard on me too.

    I was back at work for 2 days last week, & it was tough. I sit mostly, office work. I hurt more now than before I went back. I tried to get up & move around, which helps, but I work in insurance with homeowners, flood, auto, etc. I live at the Jersey shore & we are still feeling the devastating effects from Hurricane Sandy. The timing for my surgery wasn't optimal. :-o So I'm super busy & now playing catch up from the hurricane & from being out due to surgery. Life gets in the way.
    - Pangea
    ACDF C4-5, C5-6 on 12/3/12
    Bone growth stimulator 4 hrs/day
    Follow up 1/21/12 - growing bone, still in pain though. Working desk job but still not cleared for volunteer EMS :-(
  • Pangee,

    Francine gave you some good advice above. Let me add that you don't want to do this rodeo another time. If you think this time is hard, let me tell you from experience the second go around is much harder. If you trusted your surgeon to do the surgery then trust him/her in the post op care department. Personally there is no way I would have taken the brace off, if they requested I wear it. I have worn one once for 12 weeks and another time for 16 weeks, yes it takes time to get used to, but then again, I just wanted to get this behind me and move on.

    When you return to your surgeon on the next appointment ask about some massage therapy, that will go along way in getting things loosened up for you. They obviously don't want to do anything to soon as the hardware needs time to setup. Trust me when I say you don't want to go through this again. So hang in there be patient and hopefully before you know it this will all be a thing of the distant past. Keep in mind a full recover can take up to a year, which seems like a long time, but in the grand scheme of things not really. Your body needs to adjust to the new way your neck works with the missing joints you don't have any longer, so it is going to take some time.
  • ...and although it was a painful experience going back to work, it was probably what you needed to experience to see that you're still at the beginning of the process.

    I agree with TamTam - talk with your surgeon or nurse to see if there are things you can do, like massage therapy, that will help you out. I try to do a ton of SLOW stretching so that my back doesn't tighten up because of the awkwardness of how I THINK I am standing. It's just not normal, even though friends tell me they cannot see any outward difference.

    I am sooo looking forward to the time I can get a deep tissue massage. My neighbor even gave me a massage certificate for the holidays so I can celebrate once I am ready.

    I can only imagine how busy things are for your work because of Hurricane Sandy - and, having said that, your health really needs to come first. Also, luckily, your kids are not infants or toddlers. While they need you, they probably do or can start doing a bit more than they are used to when they are relying on you! LET THEM! This is good for them. They will survive, I promise. :)

    I just recently started driving (with the collar) - and although especially during the holidays I am staying off the roads as much as possible because of the insane holiday drivers, it is nice to know that if I need to run an errand, I am now able to do so. I am cautious and am not driving freeways with this collar, at least right now.

    Hang in there. I am not used to being 'down for the count' either. This is a new experience for me, too. But as TamTam said, trust your surgeon and the recommendations s/he is making. They are not doing this to be sadistic, I am pretty certain. :)

    Have a wonderful New Year!
    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 appreciate everything. The doctor did say I could take the collar off, so I am following his orders. It does seem strange, though, that I don't think I've read any other account here of my surgery where people didn't wear it for 4+ weeks. And everyone seems shocked at how fast I'm back at work. I'm trying to figure out why my doctor has me moving forward so fast.
    - Pangea
    ACDF C4-5, C5-6 on 12/3/12
    Bone growth stimulator 4 hrs/day
    Follow up 1/21/12 - growing bone, still in pain though. Working desk job but still not cleared for volunteer EMS :-(
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