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3 days post op c6/c7 ACDF

I am a 36yo male, healthy and am on my 3rd day post op of c6/c7 acdf with instrumentation...have read so many different things about recovery and instructions from my surgeon and none of them seem to be the same...so here are a few of my worries and questions:

Incision- do I keep it covered? I am in a hard shell neck brace I was told to wear 24/7 for one week, was told I can uncover the incision but doesn't seem feasible with a hard brace rubbing against the wound...anyone have experience with this? When can I shower?

Swallowing- I can only swallow half way comfortably when on the pain meds...how long does this sore throat last?

Bowel movement- been taking stool softness since I've been home but still no movement, no sensation of even having to go...should I worry?

Sleeping in a hard shell brace...any tips are appreciated...this seems impossible...I have no recliner, I'm typically a side sleeper, been trying the best I can on my back and propped up on pillows.

Returning to work- they released me from the hospital the same day as surgery even though I was told before hand I'd have to stay overnight. I don't have a very physically demanding job, but I do have to move..bend..lift at times. Also, I work in NYC and getting to work involves bus, subway and walking. Ideally I want to return to work no later than 2/3/14. Does this seem feasible if I limit my movement at work?

Any other advice is appreciated. Thanks all!!


  • LizLiz Posts: 7,832
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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
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  • Hi PDentrone,

    I am now at four weeks post-op ACDF C5-C6 and can provide some insight to the questions you've asked.

    First, your surgeon should have given you a post-op instruction packet. Mine gave me a 3 page form which I've read many times to ensure I'm adhering to his instructions.

    The incision should be kept covered for the first week. It should be kept completely dry. Showers are okay, but only if you take precautions to ensure the surgical coverings over the incision do not get wet. I had a technique of using surgical tape to seal saran wrap which I layered around my neck.

    After one week, you can remove the outer bandage. The wound should now be closed where it can tolerate getting wet. However, no immersion in water, bathtubs, pools, hot tubs, etc., for three weeks post op. If you have steri-strips underneath, these will eventually begin to fall off.

    At three weeks, it is recommended to begin using a silicon-based scar creme. Kele Coat, available on Amazon, has worked well in addition to silicon gel scar tape, a translucent cover you can place over the scar. The scar creme will greatly improve the recovery of the scar tissue.

    Regarding swallowing, it is normal to have discomfort for the first few days after surgery. All of the muscles on the surgical site were moved out of the way and have become inflamed. I recommend lots of yogurt, kefir, soup and other soft foods during this period. In addition, drink plenty of water. I recommend having a jug and glass in easy reach of your bed so you can rehydrate during the night without getting up (which can be painful first week or so).

    Your bowels are impacted from the painkillers and will take a few days to catch up. No worries there unless the situation continues a few more days. I took Colace which solved that problem.

    A note on painkillers. These only help to reduce pain and serve no other function. They are addictive and have mild psychoactive effects. As you had a single level ACDF, you should have a tolerable level of pain. To get back to a functional life, your career, etc., I recommend weaning yourself off of these as soon as possible.

    Sleeping at first can be very difficult with the cervical collar. Surgeons use of these post-op varies. Mine requests I wear mine until fusion occurs, and is seen in XRay, usually at the 6 week mark. I took a combination of Benadryl and Melatonin (both OTC) to help with my sleep while I was adjusting. I'm also a side sleeper and benefited from having a body pillow (available on Amazon) to help keep my spine supported. Also, learned to sleep with both arms extended to ensure I don't roll over into a position that could damage my healing neck.

    Recommend getting a good scarf to wrap around the cervical collar. With a bit of color coordination, no one will even notice the collar when you're out and about.

    With regards to returning to work, I was given clearance by my NS to return 3 days after surgery. I had my surgery on December 23rd, so I had the holidays for recovery, but began catching up on email several days after surgery. I returned to work on January 6th. That said, mine is a work from home position with no commute involved, except for client site travel which I've postponed until after the 6 week mark. My first week back at work was a bit rough, but I've had no problems since. I just have to remember to take breaks each hour to rest my neck.

    Good luck with your recovery! Remember, Peyton Manning had this same surgery in 2011, and then broke the all time QB touch down record at age 36. He's now headed to the Super Bowl. You're young, in good health, and should look forward to a full recovery.

    How did the surgery do in terms of reducing your pre-op symptoms?
  • thanks so much golsf! I have to say my pre-op symptoms feel so much better but it's hard to tell without laying normally and being so immobile, still a bit of tingle in the fingers but the sharp pain in the shoulder blade and neck is gone! Swallowing pain has certainly gotten better but the hard collar is still an annoyance. The next week I'm going to try to step up my activity level, walking a lot more, taking less pain killers and try to be ready for a full day back at work a week from Monday. Might have to adjust my commute a bit, spend a little more money for cabs but might be worth it instead of fighting into over packed trains, jarring around.

    Made a bowel movement yesterday and it was like I hit the lottery!! Haha

    Was just great timing to get this surgery done as Peyton makes his way to the Super Bowl in my backyard no less. Seen a few stories on TV now about his multiple surgeries, recovery and his come back, makes me feel much better :). Needless to say I'm a Bronco fan next weekend.

    Thanks again for the tips..looking up body pillows now! Good luck with the rest of your recovery.
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