Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

advertisement

Quick Start Forum Video Tutorial

    Forum-Tutorial-Screenshot
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

Notice
All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

The main site has all the formal medical articles and videos for you to research on.
advertisement

I've had my fusion - where do I go from here?

I have been thinking about the road ahead for a long time now. My neurosurgeon is amazing, and although he will order a yearly MRI, I'm assuming he's not going to be the one seeing me on a regular basis. I've been healing well enough. Still no obvious signs of fusion at 3 months post-op, and I'm still taking Norco 3x day if needed. On a bad day, I will take all three. On a regular day, maybe 2. So I obviously still need someone to prescribe the medicine.

Do patients like me have to go to a pain management doctor, or do some of you post-surgery patients still see your GP's? What is 'allowed' now? I mean, I will still be seeing my neuro once a year, but will he be considered my new primary? I'm so confused who I need to go to to talk about flare-ups, or the ups and downs of the post-surgery world, and do any med adjustments. I have my 3 month post-op next week and then I won't see him again until 6 months.

I don't want to do anything that is not permitted, but I feel like I need to get a plan in place. Advice?
2015: Thoracic protrusions C7-T1, T3-4, T6-8
Dec'13: 360FusionL4-S1 w/bone graft
2013: 3x2-level disc injections: 12mo surgery postponement
Dec'12: DiscogramL4-S1
Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
advertisement
13

Comments

  • dilaurodilauro ConnecticutPosts: 13,271
    First thing is to continue progressing the way you are post surgery! Its still not that 'long' ago that you had your surgery and coming to the point where some days you dont need as many Norco is good.

    Surgeons are great and having one that you really have confidence in is even better. But unfortunately, the 'affair' between surgeon and patient starts to dwindle after the 3 month time period. Their job is done, they did everything they were suppose to do, now its in your hands. So, the surgeon slowly starts to walk away in the sunset.

    Ok, so now are you stranded alone? do you fend for yourself? - no. I started this by saying there are options. There are three that I always think about.

    Primary Care Physician Your basic generalist. One that can spot things that many specialists can not. They are the ones to carry you to the next level, the specialist. Still after surgery, they can play a key role.

    Pain Management Doctor The one who can generally prescribe the various medications you need and perform various conservative treatments (ie ESI). They look at you as the patient and want to understand your pain and how to control it.

    Physiatrist These are the 'Rehab' doctors. Once you have passed the post surgical stage and are doing fine, they are the ones that also can prescribe the various medications you need. They do not perform procedures but instead work with you to schedule them. Be it a MRI, CT-San,ESI, Bone scan,etc. They look at your as the person and want to understand all situations regarding your health , why there are problem areas and how to resolve them.

    Maybe I am a bit biased (but I am), to me the best post surgical route is the physiatrist. I've been with mine for over 8 years now and she understand my body better than I do. She monitors all of my medications, prescribes the narcotics and others. She works closely with me to regulate my medications to make sure that they are helping me the best. She would easily write a prescription for Oxycodone 5mg, see how that works, if not, write one for 10 or 15mg. She looks for feedback from me. I see her every 30 days ( now as the surgeon/patient affair, this one grows! )
    Honestly, my physiatrist has been by my side all the time , she will make recommendations for treatments. Some not always the traditional. She was the one that sent me to that Thai master of deep/soft tissue massage, she has sent me to Yoga instructors that specializes in spinal patients, she has recommended DOs for osteopathic treatments, for cranial massage therapist and even to professionals to help with mediation. The complete package.

    So, Sarah, for you, you should look for the complete package. It could be anyone of the type of doctors I describe above.
    The key, is to find the doctor that is going to treat/monitor Sarah and not just another patient.
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • Hi Sarah, do you have a bone growth stimulator? If not, you may want to ask your surgeon about getting one since there aren't any signs of fusion yet. Are you getting routine x-rays to determine your not fusing?

    After my surgery I was able to wean off of Lortab and went down to Darvacet. After surgery, I was never once again ever off all pain meds. The pain I had before surgery was gone, but a new, worse kind of pain set in. Since 2007, I've gone from Tramadol to Darvacet to Hydrocodone to Oxycodone now to Oxymorphone (which works better than any other med I've ever had). Sprinkled occasionally with Lyrica which was also good, but my short term memory was non-existent on it and I had to drop it. If you require meds on a continual basis, it's best to start with the lowest strength med that will work for you. You appear young so getting on strong stuff now may be an issue down the road as your meds acclimate to your body and stops providing relief.

    I really wish my experience with a Physiatrist was as good as Ron's is, but mine was absolutely horrible. He was a 5 and out (5 minutes with each patient and he moved on to the next). I went to him for almost a year and on my last appointment I asked him a question about my back and come to find out, he didn't have my chart with him, nor could he remember anything about the "treatment" plan he put me on. I fired him from my care at that point and found a PM!

    I was blessed to find the PM I have. Even though there have been some bumps in the road with his office, I can go in and explain how things are going and they listen. If I have a sudden increase in pain they order a new MRI and we go from there. They also recommend certain procedures to see if I could benefit from them. It's the best professional relationship I've ever had with a doctor's office.

    So in a nut shell, you will need to see which type of doctor will work best for you. Which ever doctor you choose to use, don't be afraid to ask them questions about your care. I believe that what Ron has with his doctor and I have with mine comes from the knowledge that we can speak with them about anything and they will listen and respond. Sometimes it takes a while to develop that kind of patient/physician relationship but it makes the whole "pain cycle" much easier to handle when both sides understands each other. I sincerely hope that the fusion process kicks into gear for you and your pain level will drop!

    Keith
    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • advertisement
  • My surgeon will only handle pain medications for 3 months post-op, after that he requires you see a pain mgmt doc. I saw a physiatrist years ago, and the guy was a complete clown and wasted my time. I don't require any pain meds now and haven't for months, but if I did, I would be going to my pain mgmt doc. I still see him periodically for SI joint injections, which I've been having done for years. I last saw my surgeon in January and won't see him again until next month for my 6 month xrays, but if I have any questions, I can give him a call and his nurse or PA will call me back within 30 minutes normally.
    10/28/13 - ALIF, PSF, decompression at L4/L5 and L5/S1
  • Do you still have a lot of pain Sarah?
  • SarahLindeauSarahLindeau Posts: 766
    edited 03/17/2014 - 5:20 AM
    Yes - I have more pain than I was anticipating. I try not to let it get me down, but I have this little voice in my head that is whispering words of doubt. I'm still taking norco 3x a day. I have to have it, or I cannot do the full time working out of the house and mom job that I signed up for.

    If I try to forgo a dose, I am miserable. Mostly stiffness and pain that is radiating upwards towards my shoulder blades. My bone graft is still giving me a tough time too - it hurts to wear my brace.

    I'm also afraid I'm not fusing.

    I just want to know that I'm not going to be forgotten about. I suppose I'll go back to my PAC who I've been seeing for 5 years. She works in the same practice where my neurosurgeon works, so they'll know what each other is doing.
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • advertisement
  • Tell me more about the bone growth stimulator. How does it work? Have you had one?
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • SarahLindeau said:
    Tell me more about the bone growth stimulator. How does it work? Have you had one?
    I have one, my surgeon feels they are a must for anyone having a mutli-level fusion. Basically you wear it directly over your surgical site and it sends an electromagnetic signal to promote bone growth. I have the CMF SpinaLogic by DJO Global and have to wear it for 30 minutes a day for 9 months, unless I fuse before that. Your surgeon would have to order it and most insurance companies approve them no problem. The company rep came to my house to get me set up and show me how to use it.
    10/28/13 - ALIF, PSF, decompression at L4/L5 and L5/S1
  • I'll have to put that on my list of questions for my surgeon for Wednesday. I'm worried about the lack of fusion so far, but I will certainly know more after Wednesday, and hopefully, there will be some good news to be seen on the x-ray.

    I've been letting my demons get the best of me lately. I feel like I've stagnated and I'm trying to get back the positivity that I've had through all of this. A little voice keeps whispering to me, 'what if...?' and I'm doing my best not to listen.
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • You're only 3 months post-op, right? My surgeon doesn't even bother with xrays before then because that's generally the earliest you'll see any signs of fusing. At my 3 month appointment in January my surgeon said he saw some signs of fusing but I still had a long way to go. At that point I only had the bone stim for about 2 weeks though because things got botched with my insurance. My surgeon has a local distributor he uses but my insurance wouldn't approve the bone stim unless it was billed direct from the manufacturer.
    10/28/13 - ALIF, PSF, decompression at L4/L5 and L5/S1
  • I hope it goes well. I don't know what Norco is. Is it strong? Can you mentally focus? Gosh, I loved reading your posts as you were so hopeful and positive. I hope this is only a blip in the road. I'd say don't think negative but I can't seem to do that myself at times. I guess it's only been 3 months for you; it's only gotta get better I hope.
advertisement
Sign In or Register to comment.