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1wk post op L5-S1 Discectomy, laminectomy, foraminotomy

Hello Fellow Members-
I am 1 week post op from a discectomy, laminectomy, & foraminotomy on L5-S1. I was part of the August Surgery Buddies group, but felt that a new thread in Surgery Recovery would be appropriate, since it is now September. I found it very helpful, before and after surgery, to read about other's experiences. That is why I'm sharing mine; in hopes that it will help somebody else.

A brief history (I'll try to make this short): I'm a 43 year old female. I hurt my back over a year and a half ago. The first MRI showed a bulge at L4-L5, a 3mm herniation at L5-S1 with an annular tear, and DDD. From that time up until August of this year, I tried every conservative tx available, from chiro (made it hurt worse) & PT to ESIs (x5) & Rhizotomies (x2). In July/Aug, I also did a tx package of acupuncture, homeopathic injections, moxibustion, & cupping. Since my ins did not cover this kind of tx, it was not cheap, but I had to know that I had tried everything. Last Aug/Sept, I had a surgical consult with a NS before my first rhizotomy. At that time, I was told to exhaust all conservative measures because if he took me to the OR, it would be for a fusion, as he found that I have instability in my L5 vertebrae. The word "fusion" scared me to death, so I avoided surgery like the plague! Around June, of this year, my pain seemed to increase significantly & continued to worsen, it seemed, with each passing day. The pain was from lower left back, thru hip & buttock, and down length of leg into my foot eventually. The last ESI was around mid June. All ESIs were done under local anesthetic & were just a little uncomfortable. Until the last one, which was excruciating. Just the needle placement caused me to yell. When he pushed the med, it felt like someone had stabbed me in the lower back and then tore the knife all the way down to my ankle! The Dr & nurse had to help me down off the table afterward. So, each day, my pain got worse and worse. I started to need help going from sitting to standing bc the sciatic pain in my left leg was so bad. I ended up becoming dependent on a cane & sometimes had to use a walker. My lowest level of pain, the last couple of months, was an 8 & frequently throughout the day & night, I would have pain that was off the charts. There were some episodes of pain, when I went to stand, that were so bad that it would take me several minutes to move 20-25 feet with a walker. During the episodes of off the chart pain, I could only move by using the cane or walker (or holding on to someone) & slide my left foot slowly across the floor. Those of you, who know this kind of pain, know there are no words to adequately describe it.

I finally asked for & got a new MRI bc I knew something was wrong. A temporary flare up should not have lasted this long, with pain only worsening. The new MRI showed that my herniation had tripled in size, was crushing my left s1 nerve root, causing moderate to severe spinal stenosis & narrowing of the neural foramin. It was time for a new surgical consult. My Dr & I knew I couldn't avoid this any longer. Truthfully, I would have let someone cut me open that day, just to have a chance at some relief. I had my consult on 8/19 & surgery was scheduled for 8/28. It was changed once to 8/29 (I cried), but on 8/27 I got a call, saying it was changed back to 8/28. This NS felt that a fusion was not necessary at this point, but warned that the disc will likely give me px in the future. I had also had a friend, who is a NS out of state, look at my images & he had 4 of his colleagues (2 NS, 2 OS) look at them as well. They all agreed that I needed a microdiscectomy, not a fusion yet. Surgery was supposed to be outpatient, but they could not get my pain under control in recovery, so I was admitted. The surgeon told my mom & boyfriend that it was much worse than he expected or the MRIs had shown. I took myself off the morphine the next day (I was also being given Percocet, muscle relaxers, & anti-inflammatories) bc I just wanted to go home. The hospital bed was so uncomfortable & I couldn't get any sleep with nurses coming in all the time for blood work, checking vitals, and changing IV bags. That's not to say all my nurses weren't great; they were all very nice and very compassionate!

So here I am, 1 week post op. I am going for my post op appt on 9/9/14 & I am hoping I get to talk to the NS, as it was his PA who came to see me & discharge me the following evening. I have to say, the post on Post Op Must Haves was very helpful, especially the idea of having a little Tupperware container that you can keep some essentials in on your bed, in arms reach. In mine, I've got the tv remote, a phone handset, little package of tissues, life-savers, Chapstick, a back scratcher, a mini flashlight, a pen & small pad of paper. How am I feeling? Well, I have good times & not so good times. I say "times" bc I can't say "days" yet, as far as "good days." The first couple of days were tough. There was improvement right away in the sciatic pain in my hip/buttock & upper thigh (back of thigh), but the Charlie horse feeling behind my knee & in my calf & the pain in my feet (both heals) persisted. I did order and have been wearing compression socks & those seem to be helping. There have been a couple of days, where if felt ok in the morning (after taking meds-pain, anti-inflammatory, & muscle relaxer), but then felt bad the second part of the day. I have also gotten up from a chair wrong or made a wrong movement, without even thinking & paid the price for it. Today, my legs are feeling better, but my back still hurts. It's a combination of disc pain & incision pain (oh, & the incision itches like crazy). I have had continued battles with constipation. Just when I think I have conquered it, it is back the next day. I am taking stool softeners every night, but also have to watch what I eat & take a laxative every couple of days. I am fearful that I will reherniate from straining, but I am trying to be careful. I am trying to find the right balance between walking & resting. I definitely feel it, if I over do it! I had hoped I would be like one of those, who wake up from surgery pain-free, but that has not been the case for me. While I still struggle with some pain & still use a cane, I definitely think my surgery has been a success so far, as the pain I have now, I can deal with. If this was the pain I was having over the last few months, I wouldn't have had the surgery. I'm hopeful that I will continue to improve & I will keep you updated on my progress.

I hope that my story has helped somebody. I am very thankful for other's sharing their stories & I continue to read about how others are doing. Also, the support that I have gotten from this community (& there are a couple that have really been there for me--you know who you are) has been so great! I am very grateful for that support & I hope that you will find the same. Best wishes to any of you who are suffering or on your road to recovery!
Lauren
8/28/14 Discectomy, Laminectomy, Foraminotomy L5-S1
9/15/15 Surgical Debridement of infected surgical incision & drain seroma; wound vac applied
10/21/14 L5-S1 Osteomyelitis & Discitis; 10/23/14 Bone & Tissue Biopsy = MRSE
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Comments

  • Lauren, it sounds like you are making slow but steady progress after a bit of a rough start. I'm happy to see a positive update. The itching from the incision is nuts, but thankfully it doesn't last too long (maybe a week or so). Hang in there!
    Christina
    Left leg radiculopathy/sciatic pain
    L5/S1 microdiscectomy - May 30, 2014
    L5/S1 microdiscectomy - Aug 14, 2014
    L5/S1 TLIF - Sept. 24, 2014
    Left-side screws/rod removed along with bone fragment Dec. 29, 2014
  • Thanks Coltsfan! I'm trying to stay positive. I admit, sometimes that is very hard. I had my friend change my dressing earlier tonight & it looks a little suspicious at the bottom part of the incision. I've kept it very loosely dressed because it has continued to leak, but only a little bit. When she changed the dressing tonight the leakage on the gauze looked a little bit wet. When she checked the incision, it looked a little funky at the bottom of it & has a little bit if red around it too. She cleaned it (very gently) with some Betadine and put a tiny bit of antibiotic ointment on it. I go for my post op on this coming Tuesday (9/9), which is just shy of the 2 week mark.

    Thanks for the encouraging words! I hope you are doing well too!
    Lauren
    8/28/14 Discectomy, Laminectomy, Foraminotomy L5-S1
    9/15/15 Surgical Debridement of infected surgical incision & drain seroma; wound vac applied
    10/21/14 L5-S1 Osteomyelitis & Discitis; 10/23/14 Bone & Tissue Biopsy = MRSE
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  • L333777LL333777 Posts: 109
    edited 09/07/2014 - 12:53 AM
    Besides the fact that I'm continuing to have so much trouble sleeping, my incision is definitely infected. Took a picture, after taking dressing off before shower last night & there was definitely puss filled drainage leaking out. Just standing & waiting to get in shower, yellow stuff kept dripping out and down my lower back & butt (sorry, if it's TMI). I texted the picture to NS friend (the one living in another state, who evaluated my MRIs while I waited for my surgical consult appt) & he said definite incision infection. While I did not want to bother NS over the weekend, friend said, if he had operated on me, he would want to be told about it. Called service & PA called back. She said that, unless I'm running a fever of 101.5 or more (I'm not), the incision looks to be opening (it doesn't), or there is a whole bunch of puss, then to just keep an eye on it, change the dressing 3x/day & apply bacitracin to it. The incision started to look funky at the bottom of it on Friday night, we cleaned it with Betadine & alcohol (ouch) & put neosporin on it. When the dressing was changed yesterday afternoon, it looked a little worse (the dressing was more wet & the leakage that was a clear yellow discharge the night before had turned to a more puss filled discharge) so it was cleaned again with the same stuff & then dressed with Bacitracin. PA said no more alcohol or Betadine, just go back to how I was cleaning it before, which was by letting soapy water run down my back in the shower (using Dial) and let the water hit it to rinse it off. If any of the worsening symptoms occur before my post op appt (late afternoon on 9/9/14), then I'm to call back. This surprised me, as I told her, in addition to the puss draining, the incision is red around it & puffy, but I guess there is a reason why they are Drs/PAs & I am not :) . My back definitely hurts more since this started, both incisional pain & the deeper disc pain. Getting up from sitting or getting vertical after laying produces increase in pain.

    On a side note, I'm having some increase in shooting nerve pain in legs (both, whereas prior to surgery, it was mainly left-sided pain). I just leaned back in the chair I am sitting in & holy cow did that hurt the incision area! So, that is my update at 1 week and 3 days post op. I can't help but think that I might be healing better if I was getting more hours of restorative sleep. You know, that whole body/mind connection. I think I'm definitely sleep deprived at this point, as I'm only able to sleep 2 hours at a time during the night before waking up ( and I'm not starting my night time sleep until late, like around 2:30am or 3:00am). I usually am up for the morning by 7am, but today was just before 6am. I am lucky if I get one 1-2 hour nap during the day! I would be over the moon, if I could crash for an uninterrupted 8-10 hours! With all this being said, I am trying to stay positive until and if the NS gives me reason not to be.

    I hope you all are doing well & sleeping peacefully :)
    8/28/14 Discectomy, Laminectomy, Foraminotomy L5-S1
    9/15/15 Surgical Debridement of infected surgical incision & drain seroma; wound vac applied
    10/21/14 L5-S1 Osteomyelitis & Discitis; 10/23/14 Bone & Tissue Biopsy = MRSE
  • I had a L4/L5 microdiscectomy on Friday got home from hospital last night,,, had bad back for few days then pain shooting in my buttocks leg and foot and numbness also developed a foot drop,, got all this 2 months ago went a and e but didn't send me for mri straight away until 2 weeks later when I demanded to be seen again by someone,, I was told on week 8 what was wrong with me by my surgeon were I got transferred to that my foot was now paralysed and won't recover has my own hospital had left it to late to sort it all out,,,,, had surgery to relieve pains in leg,,, went well was in pain and still am but morphine is helping a lot also on meds for nerve pain in foot, still no use in my foot but early days,, hoping my surgeon was wrong about it being paralysed and to late to save it only time will tell,,, have to have rehabilitation in future on my foot and start to wear a splint have to use crutches,,, I was so nervous about surgery my first time,, it was more being put to sleep than the surgery itself, but I had nothing to worry about they were great,,,, I haven't worked since I went to a and e but I can't walk proper and far without pain,, let's see if this surgery helps in the next couple of moths, but I can't see me being v
    Back at work till at least another few more months yet,, see how I go,,,,,
  • I am sorry to hear about the prognosis for your foot & I hope your Dr is wrong about it. That has got to be really scary. It's a good thing that you demanded to be seen again. I'm still in pain as well & now the infection in the incision has stemmed to increase that pain. The hospital said I could not be sent home on Morphine, so I took myself off it, but continued with the Percocet they were also giving me (that was also my medication before surgery) & have had to continue it at home as well. We are both in, what is considered, very early days of recovery. From what I hear, it can take a long time for nerves to regenerate. Right now, they are still recovering from the trauma of the surgery. I did order some compression socks & they seem to be helping with some of the sciatic pain in my calves, ankles, & feet. Let me know if you want me to send you the name of the brand I got, as I'm not sure if we are allowed to post that in the threads, but is could send you a private message.

    Good luck with your recovery & I hope you start feeling better very soon!
    8/28/14 Discectomy, Laminectomy, Foraminotomy L5-S1
    9/15/15 Surgical Debridement of infected surgical incision & drain seroma; wound vac applied
    10/21/14 L5-S1 Osteomyelitis & Discitis; 10/23/14 Bone & Tissue Biopsy = MRSE
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  • As the day has progressed, the pain in my lower back has intensified. Also, I am having clear right sided symptoms, whereas my surgery was focused on the left (the herniation was crushing my left S1 nerve root). To say that I am disappointed, is a real understatement. The pain in my back is now shooting to the right and nerve-like pain shoots through the side & front of my hip & down the side/front part of my right thigh, thru my knee. I can now stand no longer than a few minutes before the pain & leg weakness gets so bad that I have to sit down. I'm not sure if this is related somehow to the infection at the incision site, but I'm really hoping it is so that it will resolve once the infection is cleared. There is still yellow pus & clear yellow fluid draining from the bottom of the incision & it soaks thru the dressing with a few hours of being changed. The incision is very, very sensitive. While my boyfriend was applying Bacitracin, with a cotton tip, during a dressing change tonight, he said he was barely touching it, but it felt like someone was digging their finger into the incision. A dressing change is how long I can stand before I have to sit/lay down. I also cannot sit very long either, so I need to go back to bed now. I'm writing these updates in hopes they will help someone else, but now it's also for me to keep a journal of what's going on for when I go for my post-op appt on this Tuesday. At any rate, thank you for reading. I could use some positive vibes & prayers right now.

    Lauren
    8/28/14 Discectomy, Laminectomy, Foraminotomy L5-S1
    9/15/15 Surgical Debridement of infected surgical incision & drain seroma; wound vac applied
    10/21/14 L5-S1 Osteomyelitis & Discitis; 10/23/14 Bone & Tissue Biopsy = MRSE
  • smartens162smartens162 Manitoba, CanadaPosts: 449
    I'm sorry you're having such a difficult recovery so far, but I do believe it's too early to tell if things you're suffering right now are signs of permanent damage. So much swelling tissue, disturbed nerves, other nerves maybe 'coming back to life' (i'm no dr, just relaying things I've been told or read). The nasty incision site would concern me too, hope you can have that looked after soon! Question: how much sitting are you doing? I was advised to do very little sitting in the first few weeks...just curious what your dr advised? My surgery is coming up at the end of October, also L5/S1 discectomy. I spend alot of time praying these days, as I can't 'do' a whole lot... believe I'm moving mountains from my bed, so I'll be praying for you, Lauren!
  • I've been trying to monitor myself not to sit to much & to get up and move around often when I do sit. The PA didn't address sitting at discharge. At this point, it seems nothing is comfortable. Up until tonight, I could go lay down and get some relief, but even that has become uncomfortable. The infected incision definitely has me concerned, but I am also very worried bc this pain shooting down toward the right & thrust rt side is the opposite side of my herniation & surgery. I had very little rt side symptoms before. Thank you for the prayers & I'll be praying for you too!
    8/28/14 Discectomy, Laminectomy, Foraminotomy L5-S1
    9/15/15 Surgical Debridement of infected surgical incision & drain seroma; wound vac applied
    10/21/14 L5-S1 Osteomyelitis & Discitis; 10/23/14 Bone & Tissue Biopsy = MRSE
  • I'm not sure if anyone has any ideas or can give any reassurance if this has happened to them. Yesterday, the increased pain in my lower back, hips, buttocks, & leg really defined itself as primarily right sided pain, which was my good side. By the time I tried to go to bed for the night (about 1:30 or 2:00am), I was pretty uncomfortable. I couldn't stand for more than a few minutes before I was overwhelmed with pain & my legs would feel weak. Laying down, which usually gives me some relief, had also become uncomfortable. I finally fell asleep in the only position I could sleep in during the last few weeks before surgery, which is on my back, with 1 pillow under my lower back & 2 pillows under my knees. I woke at 4:30am in severe pain & could hardly move. I think I was also afraid to move! As I had to go to the bathroom, I forced myself to do the log roll to my side,using the headboard bars & it was excruciating. After going to the bathroom, I was up (alternating between sitting and standing/walking with my cane) for about an hour. Finally, so exhausted, I went back to bed and fell asleep for an hour on my side with a pillow between my knees. I had taken my pain med at 4:30am, along with a Methocarbanol. When I woke again at about 6:30am, I was still in pain, but not as severe as it had been earlier. I was up until 8:45am, took my pain medication again & Mobic, & laid back down. I dozed in and out until about 30 minutes ago.

    I called the NS office to see if they have an earlier appointment, as my post op is tomorrow at 3pm. The back, hip, buttock. & leg pain (on my good side prior to surgery) is pretty bad, but I can't take anything for about 2 more hours. I'm tempted to try some Ibuprofen, but worry that I shouldn't take that in case the NS decides to open my incision to clean out the infection, which started on Friday evening. Despite following orders to change dressing 2x/day & apply bacitracin, there is still yellow puss at the bottom of the incision, with clear yellow fluid dripping out of it. It is also puffy and red around the incision.

    My question is: has anyone, post surgery, have pain set in on the opposite side? If so, what was the determined cause & how was it addressed? I'm freaking out a little because the pain on my rt side is pretty bad & more toward the front of my hip & side/front of leg. The pain in my lower back is as bad as it was pre op, just directed to the other side now. Thank you for any help. I am going to post this message as a new thread in this forum, in hopes that I may get some additional feedback.

    I hope everyone else is having a smoother recovery.
    Lauren
    8/28/14 Discectomy, Laminectomy, Foraminotomy L5-S1
    9/15/15 Surgical Debridement of infected surgical incision & drain seroma; wound vac applied
    10/21/14 L5-S1 Osteomyelitis & Discitis; 10/23/14 Bone & Tissue Biopsy = MRSE
  • and a lot has happened. I went to post op appt & the NS found a mass under the incision. I was sent immediately for an MRI to make sure there was no infection in the bone or disc space. There was not, however there is a seroma. A small central disc protrusion was also noted & these are causing deformation of the spinal canal. No one has addressed the disc protrusion & I'm not sure why. I've seen the images & it's pretty clear. Could this be due to post op inflammation or disc material that is displaced because of the seroma? I have not talked to my NS since the MRI was done, as he sent me right to his "Wound Dr," who I discovered when I arrived is a practicing plastic surgeon. He is supposed to take me back to surgery on Monday to open incision, clean it out, drain seroma & fill pocket, & sew back up. It will then be dressed with a wound vac dressing. Something is just not sitting right with me as I think more & more about it. I asked the "Wound Dr" if he was going to culture the wound to make sure there is not staph or MRSA & he just said that he will be cleaning everything out in surgery & then will culture area to make sure nothing is there at time of closing. I am not a Dr, but shouldn't we be making sure there is nothing there already? My surgery was on 8/28. A week later, I started having increased incision pain & leakage. There has been a thin yellowish clear liquid draining for several days. There has also been a thicker, white substance at the bottom of the wound, which I though was pus, but was told yesterday (by wound dr) that it is liquified/necrotic fat tissue. I have felt flu-like symptoms about 4 days with body aches, fatigue, & just generally feeling sick. I've gradually been spiking fevers (yesterday was 103.2, but I was overdue for medication, took it, and broke the fever). The wound dr said, if I continue to spike fevers btwn now and Monday's surgery, I have to go to hospital and be admitted for IV antibiotics. I had thought I was being sent to a infectious disease dr, but no, he is a plastic surgeon. Who should be doing surgery on me at this point? Should it be a plastic surgeon? And why has my NS not addressed the certain, disc protrusion noted on my post op (just shy of 2 weeks) MRI?
    8/28/14 Discectomy, Laminectomy, Foraminotomy L5-S1
    9/15/15 Surgical Debridement of infected surgical incision & drain seroma; wound vac applied
    10/21/14 L5-S1 Osteomyelitis & Discitis; 10/23/14 Bone & Tissue Biopsy = MRSE
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