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L4-L5-S1 Posterior Fusion - unrealistic expectations?

CandyTXCCandyTX Posts: 5
edited 07/27/2013 - 9:36 PM in Recovering from Surgery
I'm sure this is asked all the time. I did read through here, but I guess I just need some personal "it's going to be okay" words. I'll try to keep this short... but, yeah.

2 years ago, I had weight loss surgery. I've lost 225 pounds (that's not a typo) and now weigh 150 pounds. Yeah, it's been wonderful. Truly.

In April 2012, I came home from a conference with this worst pain running down my left arm and shoulder. I thought it was a pulled muscle, but my primary sent me for an MRI telling me she thought I did something to my neck. 2 days later, she called me back after a frantic 3am email to her saying that the meds weren't helping and I was in bad shape. She sent me directly to the ER because, after talking to me, she realized I was in shock from the pain. At the time, I thought she was overreacting, but I now realize that she was very wise. I was NOT in good shape at all.

I've had back issues for many years. MANY years. My weight was a huge contributor, obviously. As I've lost weight, it's gotten steadily worse. Chiro work has helped, but it got to the point that I would be okay for a week and then be on my way back there for another adjustment to at least get me through the pain. It wasn't pretty.

Late Spring, I ended up with severe pain in my sit bones. I thought maybe I'd bruised something (are you seeing a trend here?), but my primary said... um, no. Go for an MRI. I have bulging discs and degeneration in my two lowest levels. My other levels look REALLY good, according to my spinal surgeon.

I'm scheduled for a double fusion this coming Wednesday. I've never been all that good at accepting how things are going to be. Denial is my middle name. LOL! I own my own business. I've done everything I can to prepare my employees. I work at home (as do all of my team) and spend most of my day in front of a computer screen (it's a bookkeeping business). After my neck, I had it in my head that I'd be fine after a week. Ha! It took a good month before I was able to really communicate well enough to work again. I said all kinds of weird crazy stuff during that time because I was out of my mind. It took another two months to get off of all medications and drive and get back to real life again.

My surgery is going to be posterior. L4-L5-S1. My surgeon uses minimally invasive techniques EDIT - I feel very lucky he was on call when I had my neck fusion, he was wonderful!). Although I could be sent home the same day, I'm opting to spend one night in the hospital. I guess because my neck was a week in the hospital (it was over the Easter holiday and the insurance company insisted we try injections, but I couldn't come off of the pain meds because I was in BAD shape, etc etc). So, I guess I have it in my head now that this recovery is going to be a breeze.

I keep seeing differing things online about recovery. My surgeon said it will be like my neck. 4-16 weeks. At this time, my plan is to take most of a month off and then get back to part time for a month after that. I have a few things I'm hoping to be able to do in front of the computer after two weeks. Takes just a few hours.

Am I totally being unrealistic? Do I need to plan to basically fall off the face of the Earth for four months?

My husband is a teacher and goes back to work 2.5 weeks after my surgery and my kids go back to school 4 weeks after my surgery and I have to be able to drive. Do I need to fly my sister in to be with us for a month so she can deal with the kids, driving and mail runs and things that have to be done from this location? Do I wait and see?

I will talk to my surgeon more, but I'm really just kind of freaking out now. I'm not sure if I'm being completely unrealistic and stubborn or what. A friend of mine had a similar surgery and said she was using a walker for a few weeks (!). I don't think I'll be jumping up from the hospital bed and doing the mashed potato or anything, but...



Post edited to remove specific doctor's name. Please read the Forum rules

Candy in Austin, TX
Single cervical fusion April 2012 through ER
L4-L5-S1 lumbar fusion 7/31/2013


  • LizLiz Posts: 7,832
    edited 07/27/2013 - 9:36 PM
    I am sure that you will find your time on Spine-Health very rewarding. This site is a powerful and integrated system that is dynamic and continues to grow.
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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
  • jlrfryejjlrfrye ohioPosts: 1,110
    edited 07/28/2013 - 12:20 AM
    I just had l5-s1 fusion on the 15th of july. I see my surgeon on the 30th to remove the stitches. I feel good enough that I am going to be asked to be released for work. I don't know if he will but I am going to ask. I may be rushing it but I have a desk job and feel as if I can handle it. good luck on your surgery and keep us posted
  • First off, congratulations on your huge weight loss and your life style change. I too went through lots of problems when I lost a lot of weight... which was frustrating because you think loosing weight and exercising will make your spine better, not worse. And I'm not saying the weight loss and exercising made your (or my) spine worse... but these spine issues arising when they do is frustrating.

    I can't speak of a two level fusion because I've not had that surgery, and its so true that everyone heals differently. I was told 6 months off of work yet returned 7 weeks later... but I returned looking very sexy with my three braces and stylish walker... I was able to get on the computer and "work" for an hour or so at probably week 5... a lot of this will depend on the amount of pain medicine you need afterwards. I was on some pretty strong meds (for me anyways) which hindered my mental concentration and made me very tired. I was so happy to be able to decrease and come off of them! Anyways, best of luck. Obviously my life is forever changed due to my spine issues... but it is what it is and I still live a very happy, full filling, active life career, family and all. Best of luck to you. I hope surgery and recovery runs smoothly for you.
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • And I meant to add, I think I'd "wait and see" about flying in your sister. 2.5 weeks with your husband's help, you will be able to take care of your self after then (or should be assuming you don't have any complications)... and then to also have some help with your children even after that will be great. (assuming your kids are helpful for you ie old enough to help you around the house with light house work etc.).

    You *probably* will be able to drive in 4 weeks, not long distances or for long amounts of time, but short distances. However you might want to ask your surgeon about this specifically as he might have a general "rule" for surgeries such as yours IE no driving for 3 weeks or 6 weeks etc.)
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • Thank you so much. My kids are 10 and 12. My middle schooler walks to and from school and I can always get a neighbor to take my elementary kid to and from school. I should have said that, they are pretty self-sufficient.

    I'm really really not looking forward to this. My neck recovery was kind of a breeze in comparison it seems like. I think we'll go with the wait and see approach.

    I probably AM being a little unrealistic because in my head I'm a tough old broad and I'll just bounce back. LOL, I'm 38. I think the weight loss probably sped up the issue. All that tissue went away/decreased which probably was helping in some odd way to cushion the issue. I'm sure I would still end up here, just a little later, with a lot more weight on me and a bigger badder recovery. At least that's what I'm telling myself! :)

    Sorry to the mods, I missed that in the rules :) xoxo
    Candy in Austin, TX
    Single cervical fusion April 2012 through ER
    L4-L5-S1 lumbar fusion 7/31/2013
  • Hi I am new to the forum, and now in Week 3 of recovery after L5-S1 fusion.
    Junf a few things. Driving a car for first 6 weeks is a No Go. You can go with someone else driving, but only short distances.
    After 2 weeks I was getting along quite well, walking far distances. Only problem is staying on your feet for too long, like when you cook food, shower etc. This caused some pain in my case and I have a mild case of nerve pain in my rigt leg, which I had never before the surgery. Exercising is important, focus on stretching and walking.
    My kids help a lot, bu they are16 and 17 already (I am divorced) and we are coping fine.
    Good luck.
    Stephen 45M
  • There is a good article on the website about 2 level fusion vs 1.
    I had a L4/L5/S1 on 07-02 but it was a 360. I had and ALIF and a PLIF.
    Thee was no way I would have been able to do anything work wise at 2 weeks.
    But again, 360 is more invasive than just a TLIF etc.
    Read some of the monthly surgery buddies threads and that souls give you a good gage too!
    Hope everything goes well!
    99/00 L4/5 & L5/S1 herniation
    2001 L5/S1 microdisectomy age 25
    severe DDD at surgery level
    2011 pars
    2012 RFA L/3/4/5
    7-02-13 L4/5 l5/S1 360 fusion ALIF PLIF
    DX spondylitis , DDD, scoliosis, and slight kyphosis
  • My surgery was 7/23. Doing very well. Leg muscles get VERY sore. Tylenol doesn't touch it. If I take one Percocet it does. Going to talk to the doctor on Monday. It is like I have run a marathon. Muscle but not nerve pain. At least I don't think it is.
    Staples came out last Wednesday. Not the most pleasurable experience. Been out for short drives and done very well.
    Very pleased with the outcome and expect a full recovery. I believe it comes down to doctors and I am so thankful to mine.
    My dogs have been great. Dog walker comes each day during the week to give them a long walk. Took each for a short walk yesterday and going to try again later today. Try together in another week.
  • Chris77CChris77 Posts: 135
    edited 08/10/2013 - 12:27 PM
    I had plif L5/s1 6/12/13 and was cleared to drive and off pain meds at 2 weeks. My fusion was just one level. I have a 10 and 12 year old also. They were a big help. Feeding and cleaning up after the pets and so on. I had a great outcome and my back feels great. Good luck with surgery and recovery! I found the people here supportive and this site so helpful.
    PLIF L5/S1 fusion 6/12/13
    ACDF 5-7 7/17/13
    44 year old Mom of 10 and 12 year old girls, full time veterinary technician.
  • after debating for over a year weather or not go have a ALIF eventually when I decided that enough was enough I went for it the surgery was awful I woke in a pit of fire I was so ill I spent the night in recovery unable to be moved {because they thought that if I went off they could get me back in theatre ASAP ]after the night of hell I ended up on the spinal unit where I spent the next week it was awful when I was discharged home I spent the next 6 weeks zombied in my recliner unable to do almost anything for myself due to extreme fatigue and pain its been 18 months now and I am worse that before as soon as I stand I am in more pain I only sleep for 2 hours again pain wakes me .and now I have developed some bowel problem due to the anterior approach of the surgery ??.all I know is pain rules my life .the operation was the worst thing that I have ever done .the last 18 months have been hell and I don't see it getting any better ..by the way its 6 weeks to be legally able to drive ..its is in the uk I don't know what it is where you are .remember its big surgery and everyone is different .I wish you good luck with it
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • CandyTXCCandyTX Posts: 5
    edited 08/11/2013 - 6:34 AM
    So an update. From my phone because meds aren't kicked in to get to computer. Surgery wednesday 31st went textbook. Recovery was over 3 hours because they couldn't get my pain controlled. The plan was to send me home Thursday. I spent days in uncontrolled pain. We couldn't get a handle on it. I think the five months of narco use didn't do me any favors. While I'm the hospital we finally got it with one and a half dilaudid and Percocet and valium. I don't remember how often but it was pretty often. I was still in a level six pain but only crying the last fifteen minutes before the diludid was due. It was ugly. Yr morphine magic button did nothing. They finally released me Monday after trying to release me Saturday and Sunday. Hubby was an awesome advocate and Was one hundred behind me when I refused to leave. The PA was all "well your discharge paperwork is done" and then said the insurance might not pay after he's done discharge. I told them I didn't give a crud. We needed a good pain management plan for home or I wasn't leaving.

    I apparently caused some problems because hubby must have talked to the right people. I had floor and hospital managers in my room at various times. Eventually the doctors and PAs realized I want making this up so I'm home now with two 10-325 Percocet every four to six hours and valium every eight and oral dilsdid twice per day for a week and one per day for a week.

    They are all worried about addiction. Me too but frankly if I get addicted I will have to deal with that after. Controlling this pain comes first.

    It's been eleven days and I'm only slightly better. The valium helps a lot with the spasms. The Percocet dulls the pain and the dilaudid is getting me through the night and worst of it.

    My sister flies in wednesday. My surgeon follow up is the 19th.

    I'm mobile with a walker. Short distances without if my pain is okay.

    My pain hovers at four to six and up to eight or nine at times. Worst is the nerve pain in my legs and rear.

    Trying to keep spirits up but I'm pretty broken. Hubby is out from work for another week, teacher, and we already know I am going to need more help so my sister iscoming for four to six weeks. She works for me so makes it easy.

    I don't know if what I'm going through is typical but it's pretty sucky.

    Oh, they did do a CT while I was there and said all looks well.

    I hope to have s less downer post later but for now. It is terrible and buyers remourse. Lol
    Candy in Austin, TX
    Single cervical fusion April 2012 through ER
    L4-L5-S1 lumbar fusion 7/31/2013
  • 64pvolvo1800664pvolvo1800 Posts: 250
    edited 08/12/2013 - 12:36 AM
    I remember 7 years ago, I had RNY surgery and dropped 111 lbs down to 165. Immediately after surgery I woke up thinking to myself "couldn't I have just pushed myself away from the table instead of this pain?" But, I became grateful as the days grew by and I knew it was just buyers remorse and I had tried everything else to no avail. I'm still 165 and very grateful I shose that path.
    I had ACDF on C456 9 years ago and it was a blessing almost immediately after surgery, still is.
    I had ALIF L5/S1 almost two years ago and this time it was a crapshoot but I was crippled and in enough pain (nerve and low back) that I had to do something. The surgery was rough and the recovery much worse than the neck or RNY. My low back pain resolved to a large degree but the leg/hip/foot/butt pain got worse and has continued to worsen over the years :(.
    I am scheduled for a spinal stimulator on 8/20 and hopefully it works. It seems to be a 50/50 shot again but I have to try something again or else the "early retirement 9mm style" is an option.
    I feel foryou and I hope you see favorable results soon. The only advice I can offer is to NOT overdo anything. Walking is good for you but not a mile a day or a mile a minute! Just easy walking. Good luck with recovery.
  • buyers remorse ?? its not a saying we use in the UK
    Tony {UK}
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • Second thoughts about whether you've done the right thing or made a mistake out of sheer hope for relief.
  • CoolChangeCCoolChange Posts: 1
    edited 08/18/2013 - 4:13 AM
    So sorry to hear of your troubles, Candy. I'm 47 and 8 weeks post-op of same MIS 2 level fusion surgery you had. Like you, it was a last resort since epidurals, meds & PT failed to help in past year. I am having a much easier time of it then you are, evidently (am in process of weaning off vicodin - now need 1 every 10-12 hours.) My husband required heavy narcotics for years due to chronic health issues, and although I agree that addiction shouldn't be your first concern at this point, please be sure to address the Rx dependence w/your doctor. Withdrawal isn't pretty, and you'll want your Dr's assurance that he will assist you in weaning off the meds when your pain is under control. He might also consider adding an anti-depressant since long term pain & use of pain meds often contributes to depression. Personally, my biggest concern is that I'll inadvertently do something to mess it up, and if I do, how will I know? On a positive note, I noticed the biggest improvement in pain-relief and flexibility between 4 & 6 weeks after surgery. I also had/have some intermittent nerve pain in my rear & thighs, but it is easing up & very bearable now. Look at it this way, as I do...you were miserable before the surgery, so you really didn't have a choice. Now all you can do is think positively & be patient. :-) Wishing you well and hoping you'll keep us updated!
  • So, 19 days out now. I ended up moving my follow up to Friday. Went as expected. Wrote me a new RX for Percoset. We're hopeful to move to Narco after that one is over. The pain is still there, but I'm managing to have them only every five hours instead of four, still on 8 per day, but we're going slow. The leg pain is better, but having quite a it of weakness. I overdo it sometimes and pay for it, but it's who I am. LOL. Percoset gives me terrible reflux so Tums is my friend. LOL.

    We've talked at length about addiction and they have drugs that can help me come off of them and will wean me as needed. Last time I was able to cold turkey it with no problem, but we just had Narco that time, this time, we have more stuff going on. It won't be pretty if there is an addiction issue. I'm not exhibiting any addictive behavior (not taking them just because I want them), but we all agreed that, at this point, controlling the pain comes first.

    Dealing with any addition issue will come second. I kicked a major addiction to food (I've lost 220 pounds in 2 years - yes, with surgical help) so between whatever medical help they have and my therapist, I feel like we can kick it if it comes to it. I think it helps that I'm not exhibiting drug seeking behavior either. They do track all of that stuff and watch to make sure I'm not taking too many based on what they prescribe. I realize it will be ugly if I have to deal with it, but I'm trying to not worry about that and focus on pain relief.

    The Valium is my god right now. The muscle spasms are the worst of it at this moment. We'll see what happens.

    I'm already on Zoloft. I went through a bout of depression after my weight loss and neck fusion surgery. Funny, I was just thinking of talking to my doctor about weaning down the dosage earlier this year, but I think we need to wait on that. My primary doctor is simply amazing.

    I'm only using the walker for longer distances. I can go into a store without it if there's a cart I can use for support.

    I'm doing better for sure. I suspect this will be a slow healing. Next follow up is in four weeks. I hope to be much more mobile by then but I'm trying to just take it one day at a time.
    Candy in Austin, TX
    Single cervical fusion April 2012 through ER
    L4-L5-S1 lumbar fusion 7/31/2013
  • CandyTX said:
    So an update. From my phone because meds aren't kicked in to get to computer. Surgery wednesday 31st went textbook. Recovery was over 3 hours because they couldn't get my pain controlled.
    So sorry to read about your hospital problems. My hospital was not perfect but it wasn't that bad. All the nurses were so young and inexperienced. I was on a morphine pump drip that they placed in my hand as soon as I woke up. Once I was moved out of intensive care and into the neurosurgery wing, they added Percocet and Valium. Had to remind the floor doctor about the muscle relaxers. For me, the most excruciating pain was when I woke up after the 10 hour surgery and when the therapist came to make me sit up on the side of the bed doing the leg roll. Almost fell off the bed. After that, I guess I kind of got used to it since I was in a lot of pain prior to surgery.


    ALIF/PLIF L4-L5-S1 (2 cages, 2 rods) 6/10/13

    Isthmic Spondyliothesis Level II - III
    ALIF/PLIF L4-L5-S1, 2 cages, 2 rods, 6 screws (6/10/2013)
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