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Rough L5/S1 ALIF Recovery

Hi all. My husband just had his first ever surgery last Wednesday, March 20 which was an ALIF for a slipped disc in his L5/S1. He woke up from surgery in intense pain but with the pain medication was able to improve steadily and only stayed in the hospital for 3 days/2 nights. His first two days home were OK but we are day 7 after surgery/day 5 at home and it seems like he hasn't gotten any better and quite possibly has gotten worse. He cannot do anything on his own - sit down/stand up/lay down, pick up his feet to put them on a foot stool, etc. He has found comfort long enough to sleep in our recliner with a heating pad under hos back brace but as soon as he wakes up he is in excruciating pain to the point that he is crying and screaming out in pain. He uses a walker to get around the house and is now saying his whole left side below his waist feels like it's going out on him and his arms are incredibly sore from supporting himself to walk. Is this normal? There have been countless times we've debated calling 911 because he's in such incredible pain and I can't help him. He was prescribed 10mg Percocet for 10 days, 7.5mg Percocet for the next 10 days, and 5mg Percocet for the final 10 days before his appointment with his neurosurgeon but he's only on day 5 and he's already halfway into the 7.5mg Percocets. We have called the doctor office and left voicemails for the nurse but have yet to hear back. I'm just looking for some sort of insight because we both had higher expectations for his condition going into his second week after surgery. Any information is greatly appreciated.
The Sextons
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Comments

  • Call the surgeon's office again and insist you speak with someone.. I had a 2 level ALIF in December, and although it was a tough recovery the type of pain and issues really seems out of whack. I had some new sciatica pain down my left leg and groin and numbness in my left thigh about the 2nd week. They suspected inflammation impacting nerve(s) and gave me prednisone. It really helped and within a few days at least the new sciatica pain really went down. Be careful with the heating pad because you can possibly get a burn.

    You have to use your gut feeling about calling 911 or going to the ER. A lot of ER visits are due to uncontrolled pain,

    I hope you have some relief soon.
    KarenD
    4 level ACDF C4-C7 5-2-11, laminectomy & discectomy L4-L5 1/26/12, ALIF L4-5, L5-S1 12/10/12.
  • bmbutlerbbmbutler Posts: 90
    edited 03/27/2013 - 4:00 PM
    Keep calling his office! If no one will help, ask for the office manager and demand a call back. Go to the emergency room if you don't get help.
  • LizLiz Posts: 7,892
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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • HopeInBraceletsHHopeInBracelets Posts: 73
    edited 03/28/2013 - 2:37 AM
    I had a 2 level ALIF in 2007. (L3-L5). I was sent home with morphine. There is no way Percocets would cut that post surgical pain. The first 2 weeks were EXTREMELY painful and I remember ice packs (NOT HEAT) and tears. 8 days after surgery my pain was still so bad, they put me on Fentanyl patches WITH the morphine. Now I am no sissy....I broke my back in 2006 and waited til 2007 for surgery because it was hockey season for my boys and school. You need to callyour husbands surgeon ASAP and demand to speak to someone. Your husbands pain needs to be controlled or he will not progress.

    Oh....and there will be some days that it will feel like he is going forward with recovery and some days it will feel like three stepsback.....all normal.

    Michelle
    DDD 2 level ALIF L3-L5 in 2007. 4/11/13 posterior fusion w/decompression on L5-S1.
  • flowerpotsfflowerpots Posts: 379
    edited 03/28/2013 - 5:26 AM
    I had ALIF L4L5S1 3/13 and i have the same pain as your hubby. I was in hospital for 5 days on morphine pump. I told my surgeon before surgery i had a high tolaranse for pain meds.He sent me home with 4 mil morphine plus 2 tylanol every 3 hrs.I finished the pills and he gave me 90 more. I dont sleep at night because i get bad nerve pain down both legs and back pain.He told my husband ,he did alot of work and it takes time.I have a 10" insision on belly and 2 2" insisions on back.I only get up to go the bathroom and i use a walker and my hubby has to help me.I see my surgeon tomorrow for postop checkup.I have alot of questions for him. I will let you know how i make out.Its obvious the pills he gave your hubby arent working.You should be able to get in touch with your dr.He should be getting back to you. My dr always gets back to me ,or he has his surgical nurse call me.You have to speak up for yourself.We are in the pain and we know when its not enough.You can pm me if you have more questions.Good luck.Oh i use ice packs everywhere i have pain. It really helps.I got alot of the gel ones in the freezer ,so i always have them.stay strong Kathy
    Kathy B
  • scinmyheartsscinmyheart Posts: 78
    edited 03/28/2013 - 6:04 AM
    "He was prescribed 10mg Percocet for 10 days, 7.5mg Percocet for the next 10 days, and 5mg Percocet for the final 10 days before his appointment with his neurosurgeon"

    ...oh h### no...he would have had to call security as I would not have left with "aspirin"...please know I'm not taking a shot at you...I'm just fired up at that surgeon...I'll call him for you!..but being your husband's first time, you just don't know what to expect. I had a L4'L5 PLIF and went home with Oxycotin 20 X3 and Oxycodone 10/325 X 6...that was for the first two weeks, and I still hurt

    please call back and get hold of someone and refuse to hang up until you speak with someone who can do something...I hope your husband feels better!
  • Hi everyone, just wanted to give an update. After another morning of not being able to get ahold of my husbands doctor, he finally caved and we called 911 around 3PM and were taken to the hospital near our home (differently hospital than his surgery was at but same network of facilities). He was immediately given 2mg of Dilaudid and taken for an X-ray. In the 8 hours we have been here he has been given a total of 9mg of Dilaudid (4 of which were diluted by saline and put in an IV drip to be distributed over 4 hours) and his pain has been somewhat managed but he still have severe spasms. He was just taken for an MRI around 10PM so I am waiting for him to get back and for the doctor to let us know what he sees in the results. Although we are still in the ER, the doctor on duty already said my husband will definitely be getting admitted they just have to see if they want to admit him at the hospital we're at or have him transferred to be admitted at the hospital he had his surgery at. I'm really hoping the MRI will show the doctor the problem so they can decide what they are going to do as far as his medicine regimen to help him control the pain once he makes it home and is off the Dilaudid.

    Thank you everyone for your advice and well wishes. I will keep everyone updated as I can.
    The Sextons
  • I am so happy to hear your hubby is in the right place to manage his pain. Shame on that dr for not calling you back though. I wish you good results on the MRI and new pain meds for home!

    Michelle
    DDD 2 level ALIF L3-L5 in 2007. 4/11/13 posterior fusion w/decompression on L5-S1.
  • The MRI results were read by a resident doctor who says there is a small amount of fluid around my husbands new disc but nothing that looks infectious or that should be causing him this much pain. The doctor at the hospital his surgery was at requested he be transferred to the ED at that hospital so they can look at him and said specifically that as of now he doesn't plan on admitting him. After 10 hours in the ER my husband has been given so much Dilaudid (9mg) that the nurses that are coming in to administer the medication keep talking about how they've never seen someone be given so much and still be coherent. My husband is not only coherent after that amount of pain medication, he is still having severe spasms in his back that cause him to yell out in pain. There's no way we can get to the other hospital, they run some tests, and say everything looks how it's supposed to so cya, right? There is absolutely no way we can make it through another day at home. My husband relies on me 100% to pull him up to a standing position from the couch, move him around on the bed, etc and I'm to the point where I'm helping him with tears streaming down my face because my 125lb body is so sore from pulling around all 170lbs of him that feels like dead weight. I'm so scared they are going to get us there, run some tests, and say "everything looks normal so there's nothing we can do" and then being sent home. My husband is to the point where he's literally crying to the nurses and doctors here saying "If I knew it was going to be this bad I wouldn't have done this, I would have just dealt with the pain I has before surgery becaue it was nothing compared to this." Any words of encouragement would be great right now...
    The Sextons
  • What about rehab!!!!!
    Kathy B
  • flowerpotsfflowerpots Posts: 379
    edited 03/29/2013 - 7:01 AM
    Hi everyone, I went to see the surgeon today.Hes very happy with my insisions!!! The nerve pain he thinks is from lifting the vertabra back in place and all the work he did.He wants to see me in a mth.He said if the nerve pain gets worse call him right away and he will take a ct scan. He gave me Gabapentin 300mg 3 times a day.He says I will have my life back in full after the recovery period!! Im feeling incouraged!!!!!Hope everyone is doing good.Stay strong everyone!!!!!! Kathy
    Kathy B
  • The last two days have been completely insane. At 3AM we got transferred to the hospital he had his surgery at so they could assess him for themselves but they let us know ahead of time they had no plan on admitting him. We sat in the ER (much poorer quality than the hospital we were taken to by ambulance earlier in the day) until around 10AM and then he was officially admitted to the hospital and coincidentally enough he is in the exact same hospital room as he was in directly following his surgery (lucky for me it's a single patient room with a pull out couch/bed). They have him hooked up to a patient-controlled pump of Dilaudid which allows him 0.4mg every 10 minutes plus he is on a regimen of steroids, muscle relaxers, and anti-inflammatory medicines for what they believe is swelling causing nerve pain. He has been told he will be here for at least the weekend, if not longer based on whether he starts to gain strength and feeling back in his left leg so they can assess his muscles to make sure it is just nerve pain, not something more serious. Luckily they are done with all of the tests that were ordered and his pain is controlled. After two doses of the steroid there is already a big difference - he has been able to get up and walk to the bathroom with no help other than his walker, move from the bed to the chair to sit and eat comfortably, and he has regained almost all control of his left leg. The physical therapists have suggested inpatient rehabilitation but won't decide between that or outpatient until they see how he progresses this weekend.
    The Sextons
  • So happy things are moving in the right direction for you guys.I say rehab would be great because you cant keep lifting hubby. Hope things continue to move in right direction for you.Happy his pain is controlled finally. stay strong and get your rest.kathy
    Kathy B
  • sextons911ssextons911 Posts: 8
    edited 03/30/2013 - 8:20 AM
    Well, my husband is getting discharged today. After a total of about 43mg of Dilaudid in a 36 hour period they stopped the PCA pump this morning and started him on 20mg of Oxycodone every 4 hours. Also, he had four doses of the steroid to knock out the inflammation in his back. The doctor only wrote a prescription for 5 days worth of the Oxycodone and my husband isn't due for a follow-up for another 2 weeks.. any idea why he wouldn't be given enough to last until his next appointment? The doctor knows he took all of his 10mg Percocet and half of his 7.5mg Percocet so what is he supposed to do between the time he runs out of the 20mg Oxycodone's and his appointment? Also, the steroid changed his condition drastically and allowed him to walk and do basic functions on his own (thank goodness since I feel like at this point I'm in need of pain medicine due to carrying him around for a week, lol) but now that he is no longer taking that, will the swelling and inflammation come back? I'm just trying to make sure we don't have a replay of what happened last time he was discharged because I honestly cannot physically help him as much as I did before due to my back, arms & legs just throbbing with pain. He is being sent home with 5 days worth of 20mg Oxycodone every 4 hours and 5mg Flexeril every 8 hours. Is this going to be enough? After 5 days should he be at the point where he needs no pain medication? Another thing is won't he have withdrawals from the Oxycodone since at this point he's been taking Percocet/Oxycodone for nearly a month and he'll be taking 120mg per day for the next 5 days and then stopping?
    The Sextons
  • GEEZE they go from one extreme to the next. They should of given him what was working for the pain. Have you seen or heard from your surgeon in all this?Im sitting here boiling. He should of talked to you by now.I don't know what to tell you. You have to speak up to these people.Hope you can manage , im thinking of you. Kathy
    Kathy B
  • The surgeon is on vacation until next week - how convenient, right? The doctor filling in for him stopped my husband's room both Friday and today for a total of maybe 60 seconds each time. Friday to basically tell my husband there was nothing on the X-ray or MRI to account for the amount of pain he was in or the numbness in his left leg so he needed to talk to someone from pain management because had been "medically cleared" and "the hospital is no place for healthy people." Jerk. Every time someone suggested going home I made sure to make it very clear that we could not go home until my husbands pain was under control because unlike last time we got sent home, this time I don't have the strength to help my husband around like last time so the first time he's in so much pain he can't get around on his own, I won't hesitate to call 911. We've been home for about 5 hours and so far so good but this is how it started last time he was discharged. My husband has been able to get around on his own with very little help (he did take his muscle relaxer and at one point needed me to help guide him in getting comfortable laying down on the couch but other than that, his condition from 4 days ago to now has changed completely.
    The Sextons
  • Happy hes more comfortable,maybe he just needed the morphine a little longer. Pillows ,ice, and rest. hoping for a painfree night hang in there kathy.
    Kathy B
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