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What to expect: L4 - L5 Fusion

My wife (age 51) had L4 - L5 fusion Tuesday morning. Tuesday evening was able to get out of bed and go for a short walk without a problem. Wednesday was taken by PT/OT out for a longer walk and up/down stairs. Little to no pain other than muscle fatigue and out of breath; she could have run if had a chance. Unbelievable compared to the last 10 months of scrutinizing pain, trying this and that before submitting to the inevitable titanium supports....

Thursday stubbornness was victorious over reason and she convinced hospital staff to discharge her in the afternoon. Since that evening and through this minute, my wife has been in horrible pain on her left buttocks and down the leg. She is using a walker to provide all of her support to the extent she would probably fall if she had to put all her weight on both feet. She is moving so, so slow and calculating every movement in and out of bed. This is a completely different person pre and post op at the hospital. Right now, someone needs to be near her at all times when getting in/out of bed and walking with a walker.

A call to the neuro nurse practitioner yielded nothing more than, "give it time...he had to clean around the nerve, so it may have been irritated..."

So, is this extreme drastic change from day to day post op "normal and to be expected?" How much "time to give?" Should there have been more PT/OT recommended and/or other home support.

Thanks for any insight you may be able to provide.
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13

Comments

  • I think nerve pain is to be expected. I rarely had any prior to surgery and 8 days post op I got it down both legs, it was horrible. My Dr prescribed Neurontin (gabapentin) I takes away all of the nerve pain for me. Did they give her anything like that? I know for me once they took me off the IV meds the pills didn't take away all of the pain, it was an adjustment. Once I got home and settled I was able to control the pain. Something about bing home was settling.
    Herniated discs & DDD at L4-L5 and L5-S1; ALIF L4-L5 & L5-S1 on 1/10/2014;
  • RubyTuesdayRRubyTuesday Posts: 195
    edited 03/01/2014 - 2:30 PM
    As the previous poster asked...was she given a prescription for gabapentin/ neurontin or any other type of nerve med? It's happened to virtually all of us who have had a lumbar fusion. The surgeon has to touch nerves, move them, scrape them, etc to get the job done. We get to our room and even a day after, feel great because the anesthesia and good meds are in our bodies. We get home and get on oral meds, and things aren't so rosy.

    If she's not on meds for her nerve pain, call and ask for a script. I'm a little surprised the nurse didn't offer one when you called. Also, is she on a muscle relaxer? I had some pretty bad muscle cramps when I got home from the hospital.

    Good luck and please let us know how she's getting along.
    Synovial cyst removal in 2008. L4-L5 facet joint.
    Lumbar fusion at L4-L5 in December 2013. TLIF posterior entry
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  • RubyTuesday said:
    ...

    If she's not on meds for her nerve pain, call and ask for a script. I'm a little surprised the nurse didn't offer one when you called. Also, is she on a muscle relaxer? I had some pretty bad muscle cramps when I got home from the hospital.

    Good luck and please let us know how she's getting along.
    Thanks for the words of wisdom and support. She is on Neurotin....and Valium to address muscle spasms--which really have not developed. The other pain meds include Norco and oxycodone. She also has to wear a corset brace.

    Its hard to see her in so much pain and so "incapacitated" when she could practically walk normal post op and now can barely take a step.

    According to the feedback from you guys so far, what she is experiencing is "normal." Tomorrow is the day we're cleared for a shower, which I'm sure will help.

    I'll keep you posted.
  • Is it unusual for physical therapy not to be recommended?
  • My Neurosurgeon didn't order PT for me. They're all different and have different beliefs about it I guess.

    As for the pain meds, advise her not to try and tough it out. Take the pain meds on a regular schedule in order to stay on top of the pain.

    Yes, if she's anything like I was a few days after surgery, she's walking around like a zombie. But it will get better. Good luck!
    Synovial cyst removal in 2008. L4-L5 facet joint.
    Lumbar fusion at L4-L5 in December 2013. TLIF posterior entry
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  • My Dr didn't recommend PT. Just walking, walking, walking. I increased a little more each day and still am, I am 7 weeks post op. He did say last week I could start swimming and using an indoor bike.
    Herniated discs & DDD at L4-L5 and L5-S1; ALIF L4-L5 & L5-S1 on 1/10/2014;
  • I have had 3 spinal operations the last was ALIF at L4/L5/S1and unlike your wife I was ill from day one I was unable to get out of the hospital bed for three days even on loads of painkillers ..when I eventually did my legs were like jelly and I had groin pain and awful back pain ..its been 2 years and 3 month and I have suffered like mad .I still have awful lower back pain that never goes away and more worryingly I have leg problems that were not there before the ALIF my legs swell and so do my feet I have altered sensations all the way down both legs but the worst one is my right one .some of the sensations are just numb but the other bits hurt like my feet and my toes feel like they are on fire as do the lower half of my legs ..fusions are a massive operation and many people suffer post op with other complications ,good luck it sounds like you're in the same boat as myself ..I do find that a TENS and many painkillers make the pain just about bearable ..morning pain is about the worst
    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
  • Thanks again for the supportive feedback so far. Backache99, I'm so sorry about the complications associated with your surgeries. This is my wife's/our first time with a spinal surgery. I think I'm going to need to be cautious and selective as to how much I share from your post; she is feeling a bit discouraged and tearful in the last day or so.

    I'm finding through my research that there are almost an infinite number of surgery side effects, results, complications, etc. While its horribly unfortunate what Backache99 has had (and continues) to endure, I appreciate the reality associated with real life experiences of others.

    I appreciate those of you that have responded so far. I understand there is a wealth of information on this forum on just about anything related to spine health, and so I should use diligence as a forum member and do my re-search. However, I am so busy as a caretaker that I sometimes only have seconds to review the board and your responses, let alone exhaustive research. So, I apologize in advance if the answers to my questions reside somewhere else on the forum.

    I am also leaving for an out of town conference Tuesday and won't return until late Friday, so I'm trying to learn as much as I can and decide what supports need to be in place before I go.

    Along with the questions I've asked, I'm open to suggestions on how to get in and out of bed, as well as maneuver from side to side while in bed. We have a walker by the bed and prefers to lie on her left side, although the most painful leg is the left.

    1. Should she wear the corset brace while making all movements on the bed?
    2. Any other ideas on moving in and out and around the bed?

    Thanks
  • Gardens17GGardens17 Posts: 39
    edited 03/02/2014 - 3:41 AM
    I know it takes a lot to care for your wife right now. I was lucky enough to have my mom take care of me for the first month. In terms of getting in and of beg, the log roll works best. Did they show her how to do that prior to leaving the hospital? I only wear my corset brace when out of bed or sitting in a chair. I am just really careful when moving around in bed since I don't have it on. It's not comfortable to wear when laying down. I've hears that silky sheets or PJs helps maneuver around in bed.. I also used my walker to help get in and out of bed as my bed is high, also needing a small stool or adjust myself when sitting on the bed.. Try different things, she will get the hang of it.
    Herniated discs & DDD at L4-L5 and L5-S1; ALIF L4-L5 & L5-S1 on 1/10/2014;
  • romeroom said:
    My wife (age 51) had L4 - L5 fusion Tuesday morning. Tuesday evening was able to get out of bed and go for a short walk without a problem. Wednesday was taken by PT/OT out for a longer walk and up/down stairs. Little to no pain other than muscle fatigue and out of breath; she could have run if had a chance. Unbelievable compared to the last 10 months of scrutinizing pain, trying this and that before submitting to the inevitable titanium supports....

    Thursday stubbornneswas victorious over reason and she convinced hospital staff to discharge her in the afternoon. Since that evening and through this minute, my wife has been in horrible pain on her left buttocks and down the leg. She is using a walker to provide all of her support to the extent she would probably fall if she had to put all her weight on both feet. She is moving so, so slow and calculating every movement in and out of bed. This is a completely different person pre and post op at the hospital. Right now, someone needs to be near her at all times when getting in/out of bed and walking with a walker.

    A call to the neuro nurse practitioner yielded nothing more than, "give it time...he had to clean around the nerve, so it may have been irritated..."

    So, is this extreme drastic change from day to day post op "normal and to be expected?" How much "time to give?" Should there have been more PT/OT recommended and/or other home support.

    Thanks for any insight you may be able to provide.
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