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Several questions on a lumbar fusion, trying to put all in one post ...

AnonymousUserAAnonymousUser Posts: 49,512
edited 06/11/2012 - 7:34 AM in Back Surgery and Neck Surgery
Okay, I am having a fusion on L5-S1 on August 13th, so the surgery jitters have set in, and so please excuse all the posts ... this forum definitely helps ease my concern as I read everyone's comments on here.

Few questions, and I put them all in this one, to keep the forum a bit cleaner :)

1. I am in a rough situation where I work for a bank and the job situation is not as solid as I would like it to be. I am trying to be back to work by September 1st. I work on a computer and would be working from home, so I am not sure if that will be possible or not. I am allotted four weeks of Short Term Disability, however, with our consolidation with our parent organization, September 1st is when the combined organizations jobs are going to be posted. Obviously something long term I want to try and be online for. Thoughts? Anyone have good news to share :) When I had a lumbar discectomy on L4-L5. I was back to work on the 10th day of surgery. I was going crazy doing nothing and the pain was lower than pre-surgery.

2. Has anyone purchased one of the chair back cushions like the one advertised on the forum - "Contour Freedom Back"? I spend all day in an office chair, so anything to help make it less painful is preferred.

3. Staples or stitches? Which did you get? I have read pros and cons on both, and just wondering what you ended up with? (yes, another pre-surgery jitters annoying question).

4. Anyone have a bad reaction to morphine? I spent the night in the hospital after my discectomy (my dr prefers to keep a close eye on patients the first 24). Around 4am when they do the vitals check they found my BP down to something stupid like 80 over 40. Did this happen to anyone else? One thing to note is I met with my anesthesiologist on Friday for a pre-surgery consult and he said he noted this when reviewing my chart from the last surgery and was something he was going to make sure they were aware of during admittance. I thought that was cool!

5. How many days in the hospital? The doctor says 3 to 5 days, and I know everyone is different, just wondering what yours was :)

6. I have been searching for videos of the procedures as it gives me a better understanding and level of comfort with the procedure. Has anyone found any good videos of a lumbar fusion? I have not really found the greatest ones.

7. To cage or not to cage. When I talked to the surgeon he said he was going to use the bone materials from the laminectomy to put around the hardware and in between the vertebrae to facilitate the fusion. I watched a surgery video yesterday where the doctor was in there and found the disc ruptured and then opted for a cage. Is that only when the disc is ruptured, or preference, or??

Okay, told y'all I was getting nervous. Too much time on my hands counting the days/hours/minutes/seconds.

Sorry for such a long post and appreciate everyone's responses.


Jason

... just a slight bit nervous
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1

Comments

  • I had ALIF on 7/13 (3 weeks ago)
    1. I don't work so sorry I can't help here.
    2. Not purchased one of these..sorry
    3. I had staples. My incision was rather larger..10". I didn't have any problems with the staples. I just got them out last week and I think the healing is going very well. Right now my incison looks really good. Just a thin pink line. It does have all of the little hole marks form the staples as well...but they are very faint.
    4. My BP went way down with Morph as well. At one point is was like your 80/40. They switched me to Dilaudid (mush stronger than morph) but I didn't have a reaction with it. But after the second they had me on my old percocets. I felt much safer on these. I am not a huge fan of any meds.
    5. Originally I was in the hospital 4 days. But on day 6 I started throwing up and landed back in the hopsital for another 4 days. (my intestines are really upset from being shoved aside during the surgery) I am still having some issues with nausea/diarrhea (sorry if tmi)
    6. Not really found any videos. I too searched before my surgery.
    7. If I am thinking correctly...a cage is just the thing that holds the bone fragments. It's a given for the fusion to take place I think.
    I am sure you will do just fine with your surgery. It is a major surgery and a long recovery process with some things happening that you might now expect. I never thought I'd be back in the hospital because of stomach issues. But I was lol. But I would do it all again. I still have some back and leg pain. But is less than before surgery and I think it us just the normal pain from surgery and the nerve relearning to work in it's correct position.
    Best wishes for a safe and speedy recovery.
  • the nerves are completely normal. I went in for my pre op physical and my heart rate was 122. Needless to say the doc gave me some ativan to make it through the next week and a half. But just knowing I had them I guess calmed me. I only took maybe 2-3 that 9-10 days before.
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  • It is normal to be a bit nervous and I think it is great that you are asking questions!

    Wanted to comment on the morphine and BP issue. Morphine is not the only thing that drops BP. Valium can, Zanaflex, residual anesthesia, and laying on your side. If I were you, I'd make sure I was really awake when they take your BP and NOT laying on my side and that the blood pressure cuff was the appropriate size. You WANT all the pain meds you can get and still breathe after fusion. Too many staff members don't even know how to use the proper size cuff(i.e. too big cuff gives too low reading, too small cuff gives higher reading.) If you are really awake, then your heart rate will be thumping along and make your BP more normal. If they give you a low reading, ask them to retake it again in 5 minutes. If it is too low, they may hold your pain meds and you don't want that.

    I had a two level lumbar fusion and stayed 4 days including surgery day.

    Back to work that soon? Gosh, I don't know, my brain was so foggy from the meds I couldn't have done it. However, if it is from home and you're not taking a huge amount of meds, you might be able to do short times on the computer. You might have to set a timer to remind yourself to get up and not sit for long or you'll be sorry!

    Good luck to you, please let everyone know how you are doing postop!!!
  • I had an L4-S1 fusion on 22 Jun. I am active duty military which allows me ample time and resources for recovery. Tomorrow is the 6 week anniversary, but I am unfortunately still trying to get a handle on pain management. My right side is 110% better than presurgery, but my left side has been problematic. My lower leg and foot to be more specific. I still have some pain at the surgical site, but it is nothing in comparison to my foot/leg. My calf regularly feels completely engorged and on the verge of exploding. My foot constantly feels like it is on fire. If it touches ANYTHING, regardless of how lightly, it creates an intense heat/pain that can last from a few seconds to several minutes. If it happens at night, it instantly wakes me up. I have had very few full nights of sleep as a result. I am three weeks into physical therapy, but have obvious limitations. As a combat arms officer, I have led a rather physically active lifestyle. Not being able to run or lift is killing me and impacting me as much mentally as physically. I am still very optimistic that things will continue to get better, I just have to realize that a change in lifestyle is required. I hope for your sake that you can return to work that quickly, but I know that I could not have. I have started going into the office once or twice a week and learned that sitting at the desk checking email is about the worst thing I can do to my back. Sitting upright (with good posture) just causes me a lot of pain. This is all my personal experience and yours very well may be much different. I am certain that the decision to have the surgery was the right one. I am also optimistic that in the end, my body will be better for it. I think my biggest mistake has been trying to be a tough guy instead of aggressively persuing pain management. I was on a rather high regiment of oxycontin and percocet for two years prior to surgery resulting in a high tolerance to both. After a fusion is certainly not the time to ween yourself off of them. Now I'm trying to get the pain under control and I can worry about stopping the meds later. Best of luck and again, this is just 1 experience, every one is different. Just keep a positive attitude and you will be well.
  • I had the surgery on June 10th. I could probably have gone back to a desk job within 2 weeks, at least part time.

    I bought a back support on Amazon that is a "Mckenzie" product and it works well.

    I was in the hospital 2 nights. No reaction to morphine. The surgeon used Dermabond (superglue) to seal my incision. I also had a cage with cadaver bone and BMP.

    There's a video on spine-health, and also one on videojug.com.

    Since I've been home I've followed the post-op instructions, and have very little surger-related pain.

    Rusty

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  • I had some bad stomach issues after the disc, I ended up with some bleeding which landed me a colonoscopy ... not the funnest thing, especially trying to lay down and roll around post op :)

    Thanks for the info.


    Jason
  • Yeah, mine was a bit high too for my pre-surgery. He said that was completely normal and if it wasn't elevated he would be more concerned :)
  • But career wise, it will be bad if I can't. But, on the flip side, I am not going to do it if it is unbearable. that would just be stupid.

    I took two weeks off when I had the disc surgery and so I only have 20 days left of paid disability. That's my really drop dead date. Fingers crossed.

    I appreciate everyone's response ... making me feel a lot better off.
  • Sorry to hear about your pain!! That really bites. At least you have the positive attitude. I am trying to go into this saying it's going to be a walk in the park ... mind over matter right :)
  • sjcollier said:
    I am in a rough situation where I work for a bank and the job situation is not as solid as I would like it to be. I am trying to be back to work by September 1st. I work on a computer and would be working from home, so I am not sure if that will be possible or not. I am allotted four weeks of Short Term Disability, however, with our consolidation with our parent organization, September 1st is when the combined organizations jobs are going to be posted. Obviously something long term I want to try and be online for. Thoughts? Anyone have good news to share :) When I had a lumbar discectomy on L4-L5. I was back to work on the 10th day of surgery. I was going crazy doing nothing and the pain was lower than pre-surgery.

    3. Staples or stitches? Which did you get? I have read pros and cons on both, and just wondering what you ended up with? (yes, another pre-surgery jitters annoying question).

    Jason,
    I just don't know if returning to work so early is realistic. I honestly understand your reason for doing so but even under the best circumstances this is an accelerated schedule. What kind of procedure are you having? ALIF, TLIF, PLIF? I hate to even post because I am not a success story but for what it is worth I am 6 months post-op MIS-TLIF on L5/S1 and I cannot sit for more than an hour. Fusion outcomes seem so variable. A guy I know had the same procedure from the same doc on the same level and he is skiing bumps, running. He feels absolutely no pain. He did say that he returned to work part-time 1 month after surgery and he felt in hind sight that was pushing it.

    I did not have staples or stitches. They used glue.

    Best wishes for a thorough and speedy recovery.
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