It is common for patients to feel run down when first getting home from the hospital. To help ensure a smooth transition home, it helps to know what to expect and get help with basic necessities from friends, family, or a neighbor.
Activity Restrictions After Spinal Fusion Surgery
During the early stages of recovery from spinal fusion surgery, some basic activity restrictions must be followed:
- No bending. Bending at the knee and hips are fine, but no bending the back (spine).
- No lifting. Lifting anything that weighs more than a gallon of milk—about 8 pounds—is not advised.
- No twisting. Even though many routine activities involve twisting the spine, doing so is to be avoided during this period.
- No driving. Due to drowsiness and reduced coordination in the days following major surgery, as well as the side effects of opioid painkillers, driving is not allowed. Car rides should also be limited during the early recovery period.
Chores that involve bending or lifting—such as cooking, cleaning, washing laundry, grocery shopping, and caring for pets—are better avoided in the initial recovery period. It is advised to arrange help with such chores before the surgery. It also helps to have some easy meals on hand ahead of time, such as pre-prepared or microwavable dinners.
Pain Medications After Spinal Fusion Surgery
Pain is likely to continue after discharge from the hospital. Prescription pain medication will probably be recommended. If an opioid is prescribed, the patient should not drink alcohol or operate a car, because this type of medication may cause drowsiness and/or impaired judgment. Ice packs or heat wraps may be used to supplement pain medication, but applications should be limited to 15 or 20 minutes with at least 2 hours of rest in between to protect the skin.
New regulations may make it more complicated than before to renew pain relief medication prescriptions, such as opioids. As opioids will be prescribed for a limited amount of time, the doses taken should be diminished daily, with the goal to off opioids by 4 weeks after surgery. To avoid a delay, it is best to clearly understand the process for obtaining pain medications with the surgeon and/or staff before the operation.
Getting Sleep After Spinal Fusion Surgery
When recovering from lumbar fusion surgery, the spine should be kept straight even when getting into and out of bed. This process is accomplished by the log-roll technique, which involves keeping the knees together and maintaining a straight back while:
- Sitting down on the edge of the bed
- Lowering the head down to the bed while lifting up the legs
- Rolling onto the back
Other sleep tips include:
- Ensure the bed is not too high or too low for the log-rolling technique
- Try different pillows to see what feels most comfortable
Some people may also find that sleeping in a reclined position is more comfortable shortly after surgery.
Caring for the Incision
The surgical incision site needs to be cleaned daily and checked for signs of infection. Possible signs and symptoms of infection at the incision site include:
- Increase in redness, pain, or discharge
- Fever or chills
Showers or applying a gentle, wet sponge can help keep the incision site clean. Being submerged in water is not permitted at this stage, so no baths.
Adapting the Home Environment
These items may help make recovery at home more comfortable:
- A “grabber” device. Bending and reaching up can be avoided with this lightweight tool used to pick things up off the ground or shelves. They are sold at pharmacies and discount stores.
- Toilet and shower equipment. Adding a shower mat, toilet riser, and a shower seat makes the bathroom safer and easier to use. Home health equipment may be covered by insurance.
- A cane or walker. If more stability is needed or wanted for moving about, a medical professional may recommend this option. Additionally, canes and walkers can be bought at some pharmacies and medical supply stores without a prescription.
- A mini-fridge or cooler. Keeping cool drinks and ice packs close at hand is more convenient and may help patients reduce moving, bending, or climbing stairs more than necessary.
- A recliner or extra cushions. The seating position in a recliner takes some pressure off the lower back. Sitting on a cushioned surface is also likely to be more comfortable.
- Fall prevention. It is best to remove anything that may be a tripping hazard, such as loose rugs or clutter. Some people also install handrails as needed, such as on stairs or in the shower.
These changes can help the patient recover at a safe pace. Trying to do too much too quickly can increase pain and slow recovery.