FMLA for ALIF? Edited-now having MIS TLIF can you share your back to work times?

FMLA for ALIF? Edited-now having MIS TLIF can you share your back to work times?

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techgurl1988
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FMLA for ALIF? Edited-now having MIS TLIF can you share your back to work times?

I just found out today that I have an L4/L5 grade 4 annular tear. Back pain started in 2009 but initial MRI showed nothing (later I learned I was misdiagnosed, they missed a tear that second opinion found)

So because "nothing" was found I was sent to land PT for 6 weeks and them home PT. nothing worked so I went back to same doctor and he literally told me to lose weight knowing I could barely move. He didn't even offer injections or a pain therapist and only would give me ultram for the pain.

Well fast forward to 2011 and I have had 3 ESI's, facet blocks, and left and right side rhizotomies. Pain doctor thinks something else must be wrong and so sent me for a second MRI Dec 2011. This one finds a high intensity zone/ tear so pain doctor refers me to neuro surgeon.

I see Neuro doc in December, he orders aqua therapy but believes surgery is needed. So we try one last time and 6 weeks later I am worse so he ordered a discogram April 3.

I just got the results today that I have a grade 4 annular tear. One of the surgeries we discussed pre tear findings was an ALIF. I need to know or at least have an idea about what I should do for my work as far as leave/ PTO.

Currently I work from home (have since 2010) as a software engineer so I do not have a physical job. I know everyone's recovery is different but I am looking for a range so that I can plan whether or not to use short term disability or if 2 weeks PTO is a "are you kiddin me?" option. I figure I need the short term disability but wanted to get some opinions.

Again, I know everyone is different but what I am looking for here is an average of what maybe your doctor told you or personal expience after this type of surgery.

Thanks and sorry for the long post!

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backache99
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as for the FMAL i can't tell you anything but

on the 29th of dec 2011 i had ALIF L4/L5 and from a surgical point of view my consultant tells me its gone text book .but from a patient point of view its been hell .this is my 3rd operation and i am 45 male .i am still in awful pain and on loads of oxycontin and unable to do much .movement is difficulty sleeping is a distance memory {mind you it was before the ALIF.}.if you have any spinal surgery be prepared for a long recovery .for the fist 6 weeks i was zombied at home on my recliner unable to do anything ..even showering i needed help with and at the end of it i would end up crying i was so tired and defeated .thankfully my wife is a nurse and was able to switch to nurse mode as and when needed .i am still unhappy with the result of my operation .i thought by now i would be able to do much more.but my consultant did warn me that it could take up to 2 years to heal fully .and pain relief was never the main reason for the surgery .the main reason was to stabilize the spine ..and my consultant has done a brilliant job of that ...things like bending say if you drop something like your razor its so hard to pick it up and cleaning certain parts of your body ...well i will leave that to your imagination ! ..ALIF is preferred by most surgeons because they can gain better access to your spine .but believe me its no fun for the patient .you will be in pain ....good luck in whatever you decide
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

SueD
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Hi Techgurl

I had 2 level PLIF operation in July 2010 and my surgeon said I would be off work for at least 6 weeks. Ha! If only that were true. I didn't return to work until about April 2011.

Everyone recovers at different rates and obviously your overall health, age, core strength, weight, positive thinking, family/friends support network etc. etc. all have a bearing on your recovery rate. If it's your first spine operation that makes a big difference too (because, from my experience, the more you have the longer it can take to recover from).

I will say that from about 4 weeks to the 6th week I was feeling amazing - like I could conquer the world, but when I drove for the first time at 6 weeks, I felt a very sharp pain in my back whilst turning around to reverse the car and basically the pain levels have steadily worsened since then.

I did have revision surgery in December 2011 to have the hardware and 3 screws replaced, and unfortunately the pain has persisted. I now have pain from sacro-iliac joint dysfunction (as a result of the fusion, I don't know) and a couple of other health issues going on, which have increased my pain levels too. Also, my surgeon has warned me that the job I do could be preventing further recovery and increasing the pain - but that's a different story that I'm trying to deal with at the moment!!

I cannot give you a rough estimate of recovery time, and can only speak from my personal experience.

Will you be having further tests before being scheduled for ALIF surgery (like a discogram)?

If you follow ALL the surgeon's advice to the letter and avoid bending, lifting, twisting, excessive pushing, pulling and stretching, I am sure he/she can advise you in more detail of what recovery you can expect to make if all goes according to plan.

SUE
2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!

EMS Guy
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FMLA

IMHO FMLA is the route to take. It protects your job for up to 12 weeks.

Even though I was a WC case, I still had to go on FMLA. Be sure that if you're not ready to go back to work at the end of 12 weeks that you stay in communication with your employer. Right before the expiration of your 12 week period you are required to make notification to them about your status. If you don't and the time frame comes and goes, they may be able to take action against you.

In most states, you can call your State Dept. of Department of Labor and they will explain the FMLA to you.

Hope this helps!

Keith

Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2

techgurl1988
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Thank you bachache99! Wow I

Thank you bachache99! Wow I am sorry for your pain! I am at the point where I am exhausted from the pain. I can't wash myself very well either in certain areas so I know exactly what you mean! It's no fun. I have to get my hubby to help sometimes and I am so blessed to have him! Thanks for sharing your experience. I am currently taking 10/325 Vicodin and 50mg tramadol. Since my discogram on the 3rd, my pain has been worse and I have gone from taking 2 Vicodin a day and 4 tramadols to 3-4 Vicodin and 4-6 tramadols for break through pain. I am very nervous about all the acetaminophen I am ingesting but that is another topic!

Tracy,

Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
SI joints "messed up" not sure if I will get them fused at a later time
Had Open PLIF L4/L5 5/28/13
Woke up to permanent nerve damage in legs and feet.

techgurl1988
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Hi Sue,The last test was

Hi Sue,
The last test was the discogram on April 3rd which is where I got the grade 4 annular tear diagnosis along with some minor bulges. The CT report stated " L4/L5 Grade 4 annular tear, 3 mm broad based soft tissue protrusion with left greater than right foraminal narrowing, L5/S1 2mm central focal soft tissue bulge". The Second MRI i had in Jan 2012 before the discogram said " L3/L4 2 mm bulge, L 4/L5, 2mm bulge, 3 mm high intensity zone left lateral posterior annulus, L5/S1 2mm bulge"

So I am just looking at all the surgery options since I have been dealing with this since 2009. I have already been through PT which didn't help. Then went through 3 ESI's, facet block, and left and right side rhizotomies-but mind you those were all done before the second MRI results above. My first MRI showed nothing but "maybe a little arthritis" and my original ortho saw that and apparently thought I was faking so he didnt try any other tests despite me going back and begging for something else. He said "you need to lose weight" and that was that. I felt dismissed but determined to have pain relief so i sought a pain clinic. So my pain doctor was trying all these things based off of the first MRI, not even aiming at the real problem it turns out. when he realized nothing was working he ordered a second MRI from another facility...and that was when they found it. He referred me over to my current neuro who ordered the discogram.

Now I am doing aqua therapy and while I am glad I can get in some movement, it is making me worse on land. (while in the pool, I am able to do my exercises with little pain, the minute I step up and the water is below my waist, the pain is back with a vengeance!)

Thanks for your response and sharing your experience. My gosh you have been through a lot! It's discouraging to not have pain relief after the surgeries! I will keep you in my thoughts and prayers!

Tracy,

Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
SI joints "messed up" not sure if I will get them fused at a later time
Had Open PLIF L4/L5 5/28/13
Woke up to permanent nerve damage in legs and feet.

techgurl1988
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Thank you Keith! I

Thank you Keith! I appreciate your opinion. This has helped me a great deal. I think you are right, I need to look into FMLA and my companies policies. Since I am a remote worker I don't know if there are different rules? So I will be doing my research!

Tracy,

Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
SI joints "messed up" not sure if I will get them fused at a later time
Had Open PLIF L4/L5 5/28/13
Woke up to permanent nerve damage in legs and feet.

oonamilk
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Hey, 12 weeks was not long enough for me

12 weeks FMLA was not long enough for me and I ended up losing my job.

It's rough. I had an ALIF at L5-S1.

If you want to PM me, go ahead. The recovery pain is pretty unbeliveble.

I'm a techie too, and so far haven't been back to work, although I want to. I can't find a work from home arrangement.

Good Luck, and Take care! My Doctor's advice, which was correct: Plan for more time off than you think you will need.

I wish you the best of luck.

techgurl1988
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Oonamilk

It turns out since posting this that my surgeon wants to do a MIS TLIF. Was your surgery minimally invasive? I understand that the ALIF is sometimes a tough recovery and takes longer..but that is just what I have gathered on this board.

My doctor said 6-12 weeks just depending on how I heal and how quick I can get back to PT.

Can anyone share their MIS TLIF leave from work time?

Tracy,

Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
SI joints "messed up" not sure if I will get them fused at a later time
Had Open PLIF L4/L5 5/28/13
Woke up to permanent nerve damage in legs and feet.

oonamilk
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Nope, had ALIF

I had an ALIF. I hope your recovery is fast!
Do FMLA regardless. Also, depending on your State, there may be more job protection or benefits. I am in CA, and at least CA gives state paid disability. It's nowhere close to full salary, but it does help quite a bit.

My unsolicited advice to you is to try not to hold yourself to a time frame for recovery - it just makes recovery harder. I have been beating myself up for not getting better fast enough or 'on schedule'. If you can help it, try not to do that to yourself, just focus on healing.

Good luck. My thoughts are with you.

techgurl1988
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I was told...

My HR person said I would get 60% of my pay, but I would still have to pay my health insurance coverage. I pay around $340 a month for just my husband and I. We had United Healthcare, but we were switched to Aetna Jan 1st. However my employer uses a separate insurance company for the short and long term disability. They are the ones covering the 60% of my pay while I am out for up to 12 weeks. After that it turns into long term disability and I haven't looked at the coverage there.

I live in Texas. My HR person said that I had to use up all of my PTO first before I could use FMLA. I think that is wrong but it's what it is. My company doesn't have separate vacation time, the PTO is for vacation and sick days all rolled into one. So I will use up all of my PTO and not be able to take a real vacation for another year.

Thanks for the thoughts and well wishes!

Tracy,

Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
SI joints "messed up" not sure if I will get them fused at a later time
Had Open PLIF L4/L5 5/28/13
Woke up to permanent nerve damage in legs and feet.