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some post-ACDF questions

BuelaBBuela Posts: 67
edited 06/11/2012 - 8:58 AM in Back Surgery and Neck Surgery
I'm having a 2-level ACDF in 3 weeks on 1/3, and I have some questions that I need answered before my pre-surgical appointment a few days before my surgery. The pre-surgery checklist has been a wonderful resource, but I'm not always sure what pertains to cervical verses other types of surgery.

My doctor said I'll be wearing a hard collar 24/7 for at least 4 weeks. Can you shower, soak in a tub, or get into a pool while wearing the collar? I presume it's probably different for the first week or two because of the incision, so whatever perspective you can give on how easy it is to wash up or wash my hair - I know I may need to use dry shampoo for a bit, but UGH, I can deal with sponge baths way longer than I can deal with unwashed hair.

Is there anything that you had (or wished you'd had) that really helped with your basic personal hygiene?

On the "how to prepare" list a few people wrote about needing help wiping, but it wasn't clear what surgery they'd had - - please tell me that's only an issue with lumbar surgery.... :S

I see lots of recommendations for a recliner after ACDF. We don't have one, and the ones I seen that friends have offered to loan me are really difficult to open and close, so I'm serious considering renting (for $90/month) a recliner that has electrical controls for both lying back and getting up out of the chair. Would something like this have been valuable for you?

I'm also considering investing in a stand that can hold books or my ipad or kindle, even flat facing down so that I could read it even if I were lying all the way down. If you are an avid reader or internet-cruiser, would you have appreciated having something like this as you recovered? How limited was your ability to reach up or out as you recovered?

How soon were you able to feel up to doing things like cooking? I know I can't lift anything heavier than a half-gallon of milk, but I could still cook with an assistant - I just don't know how soon I'll feel up to doing that.

How soon were you feeling up to socializing? shopping (with someone to lift things)? going out to dinner?

Would you have realistically felt up to attending a 1 hour work meeting just 2 weeks after your surgery? It's something I REALLY need/want to attend, but I don't have a clue as to whether it's realistic to consider it.

Did you have (or wish you'd gotten) a temporary handicap permit for when you needed to go somewhere (with someone driving).

If you're a parent, any specific suggestions?

Anything else you'd suggest that you wish you'd known sooner?

If you've read this far, I'll reward you with what at least gave ME a good laugh -- that my 16yo granddaughter (who we're raising) very sincerely offered to drive me around since she'll get her permit about a week after my surgery. :loll: Ohhhh yeah, that will make me feel confident - NOT!!


  • I think I can answer some of your questions, from my experience only, though.

    I was allowed to take my hard collar off to shower only. They put some sort of waterproof strip on the incision that stayed on when it got wet, so it wasn't a problem. I used a shower chair and sat in it while my hubby washed my hair and the rest of me. However, I wasn't allowed to do this until 4 days after I got home. Hopefully you'll be able to do that. The reason for the chair and having my hubby do it was that I didn't feel comfortable standing on my own in the shower and also I didn't want to tip my head back to wash my hair. This way, I could just cover up my face with my hands while he did all the work. We did this for the first two weeks.

    I love having the wet wash wipes that come in a package to just spot-clean between showers. It seemed that showering was so tiring the first couple of weeks and I didn't get a lot of exercise, so those made me feel clean and I could do that myself.

    Wiping isn't bad with an ACDF, especially with a hard collar. That's mostly a lumbar issue.

    My recliner was my savior. I have one where you pulled a little button on the side to raise up the leg part and then I have to push down to close it again. That didn't seem to be a problem, but some days I had someone push it down for me. I slept in it for the first couple of weeks and that was fantastic. It's very difficult to sleep flat in bed for most of us at first. Mine really wasn't that expensive - just over $100 and is very cushy.

    I also have a rolling table next to my chair to hold the computer and other things. 1/3 of the top of the table stays flat and the other 2/3 can be tilted and has an "edge" at the bottom so books or other things won't slide off. They're fairly inexpensive at the larger stores. I also used it as my eating table. My caregiver just put the food on it and I rolled it over in front of me. I still use it.

    Reaching up is not easy after cervical surgery and out is ok, but not to lift anything. It uses to much of your cervical muscles.

    For me, I started walking short distances after about 5 days, but didn't really feel up to doing a lot for a couple of weeks. I have doubts about attending a 1-hour meeting two weeks after surgery, but you'll have to see how you feel. You'll probably still be on medications at that point, also.

    I'd say that for me, it was about the 2-3 week mark before I felt I could get out for very long. I did go out to see friends after 2 weeks, but got tired very easily, so it was short. The walking helps get your strength back, though, but it takes time.

    I didn't feel the need for a handicap tag with the ACDF. When other people drove, for the first week or so they just dropped me off at the door and went and parked. After that, you should be walking anyway, so walking from a parking spot to the store should be considered part of your walking regimen.

    Walking is very good for recovery and you should start with small distances as soon as you feel able and work your way up to longer distances. However, stay on stable ground and no going up or down hills, flat surfaces only.

    As far as needs, be sure to get a grabber to pick things up off the floor, a nice warm blanket for comfort, lots of pillows, bendy straws and things to keep your mind busy. There'll come a time when you'll feel you're up to something that you shouldn't really do, then you'll do it and set yourself back a day or two. I think it happens to all of us. We may feel like we can do something, but you have to adhere to restrictions and realize that it takes time to heal. The hard collar, though, is a good reminder of that. I'm glad I had one.

    I hope I answered most of your questions, if not keep asking. A lot of us have been through an ACDF, but not many at those levels.

    That's funny about your 16-yo granddaughter driving you. Mine was just opposite - after my lumbar surgery, my 80-yo mom-in-law drove me to my first post-op appointment and in the parking lot, didn't see a speed bump and went over it without slowing down. Oh, ouch! I hate to say I screamed at her and then she was very uncomfortable and scared to keep driving. LOL She did fine after that.

    Take care and feel free to PM me if I can help you in any way.

  • Hi Buela,

    Living alone following my surgery, things were a bit different. I was able to shower right away, actually the first thing I did, when I came home. Being a modest person, trust me I was the only one in that shower and had no real issues. Just be sure to set everything you need up before hand. Now the swimming deal, most will tell you it is a no no, not for fear of getting the incision wet, but actually for fear of what is in the water. I think I could return to the pool at the 6 week mark.

    As far as walking my surgeon gives all his patients a walking program that is to begin the day you return home. That walking is above and beyond your normal daily living activities. You can google walking programs, and there a few out there such as 10,000 steps. As Cath said you don't really want to be reaching out or up will put strain on your muscles.

    As far as the bathroom issues, I am a self cather and did just fine, so I think you should be good to go.

    The recliner I didn't have one either, so used the couch with some pillows set up. The hardest part was getting up, but that had to do with the hip incision from the illac crest harvest.

    AS far as letting the grand daughter drive you, let her practice her driving skills on someone else, with a healthy neck. Just my advice, though. As much as she wants to help you and it is very exciting time for her, well this might not be the time for you to be involved. Heck I taught my niece to drive with no neck issues, and needed nerves of steel. actually the one thing you want to avoid is any additional stress.

    Ask away with any questions you have, as you can see we all have different experiences. But sounds like your getting there in the preparation department and it is always helpful in your recovery.
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  • So I've spent a ton of time reading this site, but didn't join until today. I had C6-C7 ACDF on Fri Dec 2, 2011. It came out of the blue and I have no idea what I did to cause it. I do travel (fly) quite often for work (I'm a consultant) and it could be all the lifting of my luggage that did it, but who knows. All I know is I returned home from a trip on a Friday night, and woke up in AGONY on Saturday.

    Went to a chiropractor 2x (Sat and again on Mon), then gave up as it seemed to get worse. Made an emergency appt with a spine surgeon (one of the best in the area). After the MRI he told me I needed surgery urgently (and he's extremely conservative - surgery is the very last option he usually recommends.) But apparently my herniation was very bad and was compressing my spine.

    The procedure went fine (he said mine was a "textbook" procedure) so there were no issues and I spent one night in the hospital. During my recovery at home I slept on a (push button) recliner (we have a mini home theatre in our basement and it was perfect) for the first 7 days. I didn't do a lot of reading, mostly watched TV, surfed the web, slept and ate jello pudding and fruit smoothies. Swallowing was pretty painful the first 3-5 days. I'm also fortunate to have a husband who babied me the entire time. <3<br />
    Today is about 11 days post surgery for me. I've been up and walking for pretty much the whole time I've been home. I stopped the pain meds and the spasm meds a couple days ago (the constipation was the worst and the meds also seemed to have affected my taste buds). I'm back on solid food and the awful feeling in my throat when I swallow is mostly gone. I'm wearing a soft collar and have my 2 week appt with my surgeon this Thursday and he should hopefully be removing the steri-strips and the stitches (no idea why I got stitches when so many on here seem to have ones that dissolved, but oh well.) I will have an xray that morning then he'll hopefully tell me that all looks well ... I'll be honest I've been doing things that I shouldn't so I'm hoping it doesn't end up biting me in the rear. :-/

    I was told not to shower for 3 days post surgery, so I used baby wipes. I have not washed my hair since Thur Dec 1st because I didn't want to risk bending my neck. I usually only wash it once a week (because doing my hair is a production) so this is a stretch, but because I've been basically immobile and in the house, it's not been an issue.

    Because I am able to work remotely (and as a contractor I don't get paid if I'm NOT working), I only took 1 week off. I went "back" to work remotely this past Monday and plan to work this week and the next and take the last week of the year off. I really am praying for a swift fushion - if I can't fly for 6 months, I doubt that they'll keep me on this contract. :(

  • good luck with your surgery, for starters. :)

    I had a 2 level ACDF on September 26th. So about 2.5 months now. These are just my experiences with what i could manage afterward, and what my doc said was ok.

    I only wore a soft collar for a week after the surgery. (I am one of those people who can't even wear a turtle neck sweater, so i'm not sure if this was less than he would have normally done, but i barely made it through the week as it was.) Really, the collar wasn't that bad, but it got annoying at night when i was trying to sleep. I did continue to wear it when i was in the car for a little while longer. Figured the extra protection it offered couldn't hurt, and i took some pressure off my neck.

    I did not sleep in a recliner, although i might have been more comfortable. getting the pillows in the right location was a little difficult, and i found trying to turn or move at night to be painful. (i still have some pain moving around at night, even now... but compared to before surgery, its quite livable.)

    I use a laptop, which i keep by my bed. i had no problems using it once i was home after surgery.

    I was allowed to drive 1 week post surgery. (i cleared it with the doc multiple times... at first i thought he was nuts.) Well, i did try driving about 1.5 weeks post surgery, and the pain i had the following day was bad. i waited until after the 2 week mark, and i did much better. It was difficult, still hard to turn my head quickly side to side, but for short trips i was ok. now, 2.5 months later, i still find it difficult to turn side to side, and find i rely more on my side mirrors, and turning at the waist as opposed to the neck more than i used to. But i can spend a significant amount of time in the car, and have just the muscle aches, no nerve pain shooting into my arm, like i did before surgery.

    I'd say, it was probably 4 or 5 weeks after surgery where i was getting back to a somewhat normal routine.

    I did start swimming again 3 weeks after the surgery. (again cleared by the doc first) i do breast stroke so no major head turning. and no pain from it at all.
    I was not allowed to start PT until about 2 weeks ago. (should have been at 8 weeks, but closer to 10 because of the scheduling of follow up appointments)

    I can tell you two weeks after surgery i spent an hour in the car each way to go to a birthday party with my kids (hubby drove) I spent a couple of hours on my feet following the kids around, and while, by the time we left to go home, i was not a happy camper, i thought i had done pretty well just being up and moving. I was walking with a friend of mine probably less than 2 weeks after the surgery. I didn't have much stamina, but getting out and getting some fresh air was great. i let friends drive for those outings though.

    And if you can get a permit, get one. this way you have it in case you need it. i've got a permanent one now, but i've also got a herniated disc in my lower spine that i've already had 2 surgeries on as well. (And working up to number 3 there.) i don't always use the permit, but there are days i am very glad to have it.

    i also have 2 young kids at home. one is 8 and the other just turned 4. definitely makes life more challenging, but we do the best we can.

    feel free to PM me, if you have any other questions.

    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • Quick update. Stitches out today; steri strip on wound for the next week (or until it falls off). Doc says todays xray looks good. No need to continue wearing the collar (although to be honest I'm almost scared not to :p its become somewhat of a security blanket).

    I can drive short distances, but no swift neck movements.

    Next f/up in 4 weeks. Still not cleared to fly because he doesn't want me lifting >10lbs. The wound itself looks god-awful but he tells me it will vastly improve.

    No regrets that I had the surgery done, and I'm wishing you all the best with your procedure and recovery.
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  • Im a Mother of a 2yr old and am a incomplete quad so i cant lift much BUT not lifting him (i can usually bear hug him to move him)

    having my son understand that the boo boo was under the neckbrace and wasnt the initial brace was a big thing
    another thing is with how big my acdf was and having children its harder you have to be prepared and dont over do it with caring for them

    when i do my daily living activites it hurt my neck but can make little things

    bending my head when bending my body hurt

    i felt up to doing things about 3 weeks later
    the surgery caused me alot of issues so i was in the hospital longer

    I use regular chairs and can do most things normally but getting dressed and i have found adadptive equitment to help pull over my shirt from the collar
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