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ALIF COMPLETE


Hi all! Just wanted to touch base. I had my L5-S1 ALIF on 2/5. Everything went as planned surgery wise. My pain has not been well managed and I’m having major issues sleeping or getting comfortable enough to do anything. Laying on my side causes incision pain like it’s going to bust open. Laying in a recliner or on my back kills my hips.  I’m wearing my brace and taking Oxycodone and Zanaflex or Flexeril as needed around the clock. I am also using ice. Nothing is helping me. I wander the house at night testing out different pieces of furniture. If I happen to get comfortable it’s for 1-2 hours max. I am trying to be patient. It’s not working.   Just wondered if anyone has any words of wisdom to help. I feel like I am getting very depressed on one hand but it could be sleep deprivation idk. My surgeon got snippy at the hospital. Thought I was taking too much medication and made a comment that I just needed to quit all pain meds cold turkey because I’m Dependent on them. This started my downhill slope. Yes, I have taken Flexeril 2-3 times a day for years. Norco 10/325 veryoccasionally for 2 years. So, when you have to stop the only 2 things that help (Ibuprofen and Prednisone) naturally you increase Norco....but I take too much....Really? This has ruined the good rapport I thought I had...another reason I’m upset and rambling. Any advise? Words of wisdom? 

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1

Comments

  • I think it's time to find a good pain management doctor, they will be the best to control your pain, also you didn't mention taking any nerve specific medications and it sounds like you are having a good deal of nerve pain to go along with incision pain. If your surgeon is not willing, talk to your PCP about a referral to pain management. 

    challenger
    Spine-Health Moderator


  • Nerve medication has not been mentioned by my surgeon. It was discussed a long time ago by my PCP I think. Gabapentin/Neurontin I think. My response was I am afraid to take it because weight gain is the biggest side effect. That’s the last thing I need now. How have others on here done on Gabapentin? Any other meds in that family you recommend or have had success on? Thanks for the suggestion I will definitely reconsider this as my current situation is not doable long term. 

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  • CPinkstonCCPinkston Posts: 49
    edited 02/11/2019 - 9:43 AM

    I am 3 weeks post op from ALIF AND PLIF  L5-S1 fusion and VERY MUCH relate to some of the things you said.  once I was home from the hospital I had a VERY difficult time getting comfortable in my recliner or in my bed...sleeping on my side causes pain, but I still try to to relieve pressure from my back when I sit or lay on my back.  I have found my recliner to finally be the most comfortable to sleep in at night....I put a pillow behind my back in the recliner which gave some extra support when I laid it back....have you tried this? I also put a pillow under my knees. I don't find the bed very comfortable, but at the recommendation/urging of the OT she said I should use the bed for naps and sleep on my side. It does provide some pressure relief. For pain meds, I was prescribed gabapentin after surgery.  I have found it to be very helpful for any nerve pain..I have had minor nerve pain.  It would be worth talking to your neurosurgeon or PCP about starting on it.  I think finding a good pain management dr is key as well.  I have been blessed that after surgery my "old" pain that led me to have surgery is completely gone.  I only have the surgical pain which I know will take some time to go away. 

  • dilaurodilauro ConnecticutPosts: 13,168
    edited 02/11/2019 - 9:44 AM

    Just do a search on Neurontin or Lyrica here and you will find dozens and dozens of member discussions dealing with those nerve medications.

    As with any medication, there are always potential side effects.   I was on Neurontin for several years and it did a fair job of controlling my nerve pain.   

    The two big negatives for me were

    • Weight Gain
    • Loss of Short Term Memory

    Once I did stop that, those type negatives slowly turned positive.  (but  always remember, not everyone has the same negatives)

    Take a look at these articles, they go into more detail   All about Neuropathy

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • I have been fortunate with Gabapentin, I have not suffered weight gain or any memory loss, tried Lyrica for a short time, did not have a good experience with it, but like Ron said everybody is different. The one thing that I do not like about Gabapentin is that it makes me sleepy which at this time would be good for you.

    challenger
    Spine-Health Moderator


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  • Hello all, 

    Welli decided to listen to all of you and call the surgeon. The PA called me back to discuss symptoms. Of course she suggested Neurontin. I told her about my concerns (weight gain, swelling, memory changes). She said she’s never heard of weight gain as a side effect of Neurontin. Really? I told her she better look it up. Anyway, I am so miserable I decided to go ahead and try it. She started me on 300mg three times a day but has me gradually increasing the dose. (I think this is a high dose to start, but who am I) I do not plan on staying on this long term and hope to wean off ASAP. I have taken 3 caps total and am not noticing much yet. I hope it provides some relief. I plan to discuss pain management doc at my follow up on 3/6/19. Wish me luck. Any other thoughts or recommendations are appreciated. Thanks. Nikki

  • Joel1QJJoel1Q Posts: 259
    edited 02/16/2019 - 3:41 AM

    When I started Gabapentin it was rough with those same reactions, plus some.  When I finally wasn’t getting much relief 2 months post op my PM insisted I try it, it then took 2-3 weeks before I noticed any affect and that was at 1200mg/day.  900mg/day is considered a low dose, I ramped up to 2400mg/day by end of month 4 post op and have just dealt with (accepted) the side effects ever since. My neurologist suggested cymbalta, I’m on week 4 and am noticing no difference.  I was also told I had a b12 deficiency, a booster shot from my PCP seemed to help short term, I am on supplements for that plus anti inflammatory. Nikki, it’s so important to maintain that good rapport with your doctors!  Also patience is such a virtue post op, but you must be patient and positive and it can help some to talk to someone professionally about/through your pain, if you have that option. There are good people here too that listen and will help as much as possible.  good luck. 

    L3-S1 ALIF Feb 2018 and 

    L3-S1 PLIF Laminectomy and Fusion March 2018

  • nikcanrn- As Joel said your Neurontin dosage is considered low at this time, you will probably increase over time, it does take time to get in your system, usually 1-2 weeks. I also agree about the relationship with your doctors office, remember the PA is usually the gate keeper to your doctor, I may not always agree with my PA but I always try to stay cordial, I realize when you are in pain that can be very hard. Talking about a pain doctor is a very good idea, in the meantime do some research of pain clinics in your area. Remember you are still very early in recovery and it takes time for the pain to calm down after surgery, nerve pain is usually the last thing to go away. Take care and keep us posted 

    challenger
    Spine-Health Moderator


  • @nikcanrn Getting a pain management doctor is an excellent idea. I've been seeing mine for several years and he was the one who referred me to my neurosurgeon for surgery when spinal injections stopped working.

    I'm also on Gabapentin and it's working for me. Just got my dosage increased to 2400 mg per day.

    What's helped me to get as comfortable as possible has been an adjustable bed and a power lift recliner. Both were found on Amazon for very reasonable prices. I also have to sleep on my side to keep the pressure off of my back. I had a PLIF on L4-5, L5-S1 in December and I am still in recovery with some complications, but I'm hanging in there. Life does start to get better after surgery.

    Take care and hope you start feeling better soon.

  • Thank you all for the reminders that I need to have patience.  I just get so frustrated with doctors being so judgemental about all people being drug seekers because they are on opioids.  I have a great PCP and she has been supportive to me.  So, I will reach out to her if things do not go well with my surgeon. All I ask from them is to listen to my concerns and not treat me like I am stupid or as a drug seeker. This is a hard recovery and I am trying to cope best I know how. The hardest part for me has been I really need to be resting more, but when your legs burn and you are coming out of your skin it’s hard to sit or lay down for any period of time. I’m in pain and Need support, not to feel chastised.  I am now up to 900mg of Gabapentin and not noticing much yet. I will see how I adjust over the next couple weeks. Again, if it needs to be increased I will try to roll with it.  Didn’t realize this was a “low dose”. Seems high.  I have also been looking for in network pain docs. On top of all this joy I found out 3 days before surgery I was 1 of 180 people being laid off in April.  I am sure this is adding to additional stress/anxiety. Thanks again all. Nikki

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