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Spinal fusion recovery (Page 14)

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October 14th, 2010
Quaver...yup...if you got the kudos, that was the message, and I did see it up. Funny...as if there were anything sexy about back pain....
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replied October 15th, 2010
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Dear Bad foot,

I find your sense of humour to be quirky and accurate. Back pain is actually the antithesis of an aph..disiac... (note the caution applied to the "a" word in case I too have a post removed!) My pain levels are well up tonight. I'm certainly paying for my wonderful holiday. I wish I could see a way out of this ghastly cycle of less pain - optimism - do more - serious pain - do less - depression - gradual easing - optimism etc! Sometimes it feels like a life/death sentence. Perhaps I'm paying for the misdeeds of a past life. Well I suppose I could have been Lucretia Borgia! Keep smiling everyone. I am here for every one of you if you need my support. I am after all an old hand being 2 and a half years post op, with a shining career of 11 previous years of chronic back pain which led to the spinal fusion. On that cheerful note, I shall wish us all a comfortable weekend! .

Quaver
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replied October 17th, 2010
Hi everyone. I'm new to this forum and have been reading a lot of your posts. I have to keep reminding myself that hopefully everyone on here is on here BECAUSE they are still suffering, and that those people that have done well and have gotten relief just don't feel a need to use a site like this.

I've had terrible low back and left leg pain since 2005, and had a laminectomy done (at L5-S1) in December of that year. It worked great...I would still have a little pain occasionally, but nothing too bad. Then last autumn (2009) I started having the pain daily and knew something was wrong...went to see the neurosurgeon and ended up having a fusion done at the same part of my back this past June (after trying meds, PT, injections, etc.)

Most days, I don't feel too bad. I stopped taking pain meds a while ago, cause my body is VERY tolerant of any kinds of medication, so if I need pain relief, they don't help anyway. I've seen the surgeon twice since surgery, and he says that my x-rays look good, although they don't yet show the fusion, so I still don't know if it has worked.

I'm very reluctant to try to ask for medication that might help (if there are any), because he says I seem to be doing well. I also don't want to give out a drug-seeker vibe or anything. I just want something that will help me feel better. Although I don't feel too bad most of the time, sometimes it can be terrible. He cleared me (when I saw him a week ago) to look for a job if I can find one that is a desk job and part-time. Unfortunately, I've been off of work for so long now that I've lost my job. I'm an RN, and there really aren't those kind of jobs out there right now (that don't require lifting, which he says I can't do). Even if I am able to find a job, if I'm on medications, I'm sure I won't find something I can do while on meds.

At this point, I'm just very frustrated and want to get back to a normal life. I'm only 28 years old, and have dealt with this for a long time and now am out of a job because of it. I used to always be on-the-go and fairly active. I currently am able to do more than I was doing for a while before the surgery, but feel as though I've had a good deal of recovery time already and should be getting back to normal.

I don't really have any specific questions for anyone...unless you have suggestions regarding meds or any kind of therapies that might help. The surgeon doesn't want to send me back to PT for rehab yet...says it may hurt me. So, I'm trying to walk a lot as I'm able just to be doing something...

Thanks to anyone taking the time to read this. I wish you all the best of luck in your situation and recovery.
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replied October 18th, 2010
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Hey Sam8,

I am so sorry that at such a young age you have to put up with this sort of pain and disability. The most important thing for you to do is to take charge of your own situation and your own pain. Only you know how you feel and what your pain levels are. No medic can tell you. It sounds to me as if you could be depressed? There is no shame in that. You don't say whether you are in US or elsewhere? I am in the UK and if you were over here I would say visit your GP, hopefully you have a good one, and tell him/her how you are feeling. Don't do what I used to do which is make the best of it and end up in tears later. You may need antidepressants and you certainly need help with your pain.

At your stage post op you are still healing and need to be comfortable. There are many things that should help you. Basic paracetamol and codeine and/or an antiinflammatory such as diclofenac. Ask your GP or equivalent. Once you are comfortable then you can try withdrawing pain relief gradually. If all goes well that should be possible quite soon.

Any exercise in the water is best. I spent many an hour just walking in the pool. I also held onto the side and swung one leg back and forth, turned round did the same with the other leg. Then I drew a figure of eight with one foot, turned round, did the same with the other. You always hold the side and exercise the leg not against the wall. The water should be between waist and chest height to support you.

Once you get back to work make sure you have a good chair and that you get up and walk around roughly once every half hour, sooner if the pain comes on.

I hope you can find some useful tips in amongst that lot. Only you can decide what is right for you. The doctor cleared you to look for work. If you don't feel ready and aren't desperate for cash then leave it for a while. Not even the best doctor can look at a back patient and say what they are ready to do. They can merely look, listen to what we tell them and hopefully make an informed judgement. You are your own best doctor!

Take care, look after yourself, listen to your body.

Good luck,

Quaver
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replied October 20th, 2010
Hi Sam,

You sound like a positive person. I know how debilitating pain can be and how quickly one's positiveness can be diluted but I urge you to hang in there and keep searching for alternative pain relief strategies.

I agree with Quaver, exercise in water is a wonderful means of strengthening the core muscles. Some Pilates groups do it in the water and belonging to a group can help with motivation but I guess if you're out of a job, that becomes difficult.

Good luck and keep chatting. Basil60
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replied October 21st, 2010
Hi Sam and all,
I will be 3 months out of a triple L4-S1 fusion with cages/pedicles this Saturday. So far, the best, and only thing I have been capable of is swimming. It really has made a difference, and has given me more strength and endurance. Quaver's post is spot on, and it was that same advice given to me when I joined this group right after surgery. From that point on, I started to fight for what I needed, as my aftercare really fell through the cracks. it was only then, I started to get some relief from pain, answers from the doctors, and really on the road to recovery.
To Quaver,Pete or Basil...I have a question for you regarding my own recovery: I had my 12 week check up on Tuesday. The neuro said the x-rays looked great, and that he was pleased with everything he saw. When I disussed what aches/pains were remaining, he told me to stay on the Lyrica, as the nerve pain in my right foot would take the better part of 6 months or longer to go away (which I knew ahead of time from this group that it was the last to go), and that the pain in my right hip/leg is caused by when pulling my spine back (I slipped forward 1 inch) into place, it is now sitting on a nerve. A one time shot into the area with dye and under an x-ray, they will shoot a steroid into the exact space. I think I am explaining it correctly, but please forgive me if not. Anyone ever have this? What are your thoughts? I am looking for all the info you have. He says it will absolutely banish the pain, and that it is a one time deal.
And lastly, Michael...we have not heard from you and I am assuming you have had your surgery and are in lala land...hope all is well.

Paula (Badfoot52)
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replied October 21st, 2010
Hello all,
My apologies for not keeping up. I have been busy with work. I am fortunate that I work from home. I am only able to do so much each day so being quite busy I tend to run out of gas. At that point I do not think very clearly so writing a post becomes onerous instead of therapeutic.

My surgery is November 17th. I have just finished e-mailing with the hospital about pre-authorizations, etc. I am now ready to go get cut open. Yahoo!!! To be honest, I was desperately depressed when told I needed more surgery and it would be more than double my prior two surgeries together. Another yahoo. I have made peace with it now (which wasn’t easy). I then went and got a couple of 2nd opinions. In total I had 5 people review my MRI and CT. They all came up with the exact same opinion. This has helped assuage my fears. In the time from being told I need more surgery until now my condition has worsened. I was quite upset that these are the same scans that my old surgeon had and the radiologist reading them did not see that the fusion did not work. Do not be afraid to get a number of 2nd opinions.

With the new medication I have not been in as much pain but our bodies adapt to the opiates quite rapidly so I need more for less relief. The one common theme I keep reading over and over is that we all reluctantly take our pain meds but do not want to. We seem to balance the amount we take with our max ability to handle the pain. Since I am having surgery next month I have been a little more accepting of taking increased dosages. What I have learned is it reduces to pain a bit more for a little while then my minimum needs are higher. Badfoot, you are absolutely correct using the “S” word in describing oxycodone. Unfortunately, it is a necessary evil.

Though I’m not in lala land yet I will be soon. I will write some posts from the hospital. You should all have a good laugh when you read them while I’m heavily medicated. Last surgery, it seems I was sending out mass e-mails at 3am that were most humorous. My friends are all excited to get more medicated drivel next month.

Quaver, a thought. I would guess from your posts that perhaps your pain is increasing ever so slowly. Have you gotten an MRI lately? The nice thing about technology is you can get extra copies of the CD’s for your MRI and mail them to other doctors for review. Like you, I was very fond of my first surgeon but that doesn’t make him right. I was reluctant to see anyone else. At the gentle (like an elephant) urgings of my wife I did and was told the complete opposite story from my first surgeon. All I know is my pain is getting worse and now I know why. At least I have a plan and not wallowing in pain everyday with no hope.

Sam, if you haven’t, read this whole forum if you want answers. Someone here has experienced whatever you are going through at one point or another. This has helped me more than any doctor. One point of admonishment, (not to be too patronizing) you said,” I also don't want to give out a drug-seeker vibe or anything”. Do not give a rat’s butt what anyone else thinks. Take care of yourself first. Don’t be in pain unnecessarily because of someone else’s opinion of you.

Badfoot, are you talking about a spinal injection? If so, my feeling is they are hit or miss. As far as your foot, my brother in law had an L4 S1 fusion 2.5 yrs ago. He is the perfect success story but had the foot problems. In one year it was 75% better and in 2 years it was gone. I think this is what we’re all shooting for.

I am off to the couch for some playoff baseball.

Best wishes and thought for you all,
Michael
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replied October 22nd, 2010
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Hey Everyone,

Badfoot, I think you should take heed of what Michael is saying and give your foot longer to recover. I have had 4 sets of injections. The first lot really helped, the second made no difference and the third and fourth made me hugely worse. I have been told that it's possible that I'm allergic to the medium that the working components are in. That's possible, but also, if your nerves are jangled and aggravated then sticking needles and fluids into an already irritated area could perhaps also cause an adverse reaction? Is you pain diminishing at all? I too have an L4 S1 fusion and haven't had major problems with my feet. (Here pause to take an oxycodone)

Michael, you think my posts suggest that my pain is getting worse? Well yes it did get worse after my long flights but is not so bad now. It simply depends how I treat it, if I'm careful, go to bed early, don't walk too far, stand too much, sit too much, lean forward too much, live too much...!! It isn't too bad.

I haven't consulted another surgeon since my fusion but have seen rheumatologists, physios, osteopaths, pain consultants. I am under the London Spine Clinic and my MRIs and X rays are reviewed by at least one other surgeon. They don't consider my back to be in need of clinical intervention at the moment. I have to say that when I had discography before my surgery, when he injected my L4 L5 disc I screamed a bit and when he injected L5 S1 I screamed the place down. I think my pain is mostly coming from the L5 S1 disc, despite the fusion. It was in tatters and becoming bone on one side before the surgery. As my own surgeon I wonder why that disc wasn't removed and whether I should push for that now. Has anyone any ideas?

Enough for now, must go. Michael, keep your chin up and your sights on the future. We all know what spine surgery is like and we all understand your fears. We're here for you and personally I'm having trouble managing to type with every finger crossed for you!! Smile

Hugs,

Quaver
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replied October 25th, 2010
Hi Guys,
The name of the procedure is a S1J Injection. I googled it, and read mostly medical jargon, and it is a clinical read. Anyone have 1st hand knowledge of this? Eager to know plus and minuses that only those who've undergone this procedure would know. Have started the process of weaning myself off the Oxycodone, and it has been painless. Down to 2 5mg a day, extra if needed. I truly am feeling better each day, and I will be patient with the neuropathy. Pretty soon I will be changing my name to "Not Bad, Foot"!
Cheers!
Paula
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replied October 25th, 2010
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Dear Not so Badfoot,

I have had this injection and I am sorry to say it was this that left me in a worse condition. I can't decide if I should tell you but think I should be truthful. I could hardly walk a fortnight after this procedure... As I've said on previous posts it's possible that I was allergic to something in the injection but the fact remains that this procedure made me worse. Of course you would probably not react like this, but I would make jolly sure that you absolutely have to have the injection. You say your foot is better, well in my opinion you should leave well alone for a while longer. Every procedure carries some risk. Your body is desperately trying to heal itself. Be patient, give it time.

Good luck,

Quaver
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replied October 25th, 2010
Paula,

Quaver has a point. I have had 4 of these. 3 were pre-opeation. One post. All of them caused much more pain for 2 to 4 weeks due to the trauma of a needle being stuck in an already damage spine. One of them really helped me for about 2 month. The other 3 perhaps 1 weeks. I am not sure I would do it again at this point but I was willing to try anything to abate the pain.

Good luck, Michael
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replied October 25th, 2010
Quaver & Michael,
After speaking with the Lab Tech at the Diagnostic Imaging place, she was also in agreement that 12 weeks might be too early in the recovery process, and unless I was in extreme pain, it was always better to let the healing process take whatever time it needed. I am going back to my neuro on 11/2, and I have decided to wait. Like I said, I am no longer at a pain level 5 or higher, I do feel the aches and pains getting better daily, and most of all, I don't want to put more steroids in my body unless I have to. I can always have this procedure later...I don't want overkill, and I can be patient. All I can say guys,...THANK YOU, THANK YOU!. I felt confident enough talking to the lab tech, and saying I would wait. I really felt I wanted to wait, and having someone to bounce it off really helped. Thanks again, guys.
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replied October 27th, 2010
Hi Paula,

The SI J injection you refer to is an injection into the Sacroiliac joint. This is the joint between the sacrum (bottom of your spine) and the iliac which is the upper part of your hip. The needle is inserted under guidance of fluoroscopy (X ray) so there is no "hit or miss" about it.

I've seen it done and it's quite easy to reach. This procedure is a type of "block", which as you probably know is a cocktail of anaesthethic drugs whose aim is to reduce the inflammation in the joint. The Sciatica nerve runs over this joint and can be affected by the inflammation. As you know, the sciatica runs all the way down to the foot so I suspect the goal of your clinician is to attempt to treat your foot condition conservatively.

The result can be either partial or complete relief but I haven't been able to determine why Michael experienced worse pain after his injection except to say that his was into a part of the spine whereas the SI joint is not. You may experience some discomfort immediately after the procedure but this usually goes away quickly.

Quaver wants you to give the injection a miss but unless we know for sure that Quaver is talking about an SI joint injection, I would definitely go for it. It cannot make you worse for long if it does not work.

Holding thumbs,

Basil
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replied October 27th, 2010
Hi Quaver,

In your post of 22nd Oct, you queried why the L5 S1 disk was not removed. I can only pontificate (love that word) that your surgeon is being conservative and following good clinical practice, which is "if you don't need to remove it, leave it".

Replacing a disk is major surgery and done as a last resort. You indicated that you have been 2 1/2 years post fusion and 11 years in suffering. As your doctor I too would be hesitant to subject you to yet another major procedure unless it's life threatening.

Strictly speaking, the disc replacement should perhaps have been done before the fusion as this procedure is intended to maintain movement in the affected area. If it doesn't work, then a fusion could be indicated. I'm sure your doctor would have warned you that a fusion places additional stress on the upper level of your vertebra and for this reason, they wait until the last moment before doing it. You waited 11 years. That's impressive and a good example to others reading these posts.

I think you should repeat your experience of relief from exercises in the swimming pool. I'm a big advocate of this type of alternative treatment, which is strengthening the core muscles. All patients can benefit from this particularly large people. By the way, if you are reading these posts and you are an overweight person you owe it to yourself to reduce your weight as this probably one of the major causes of your pain in the first place.

Here's a challenge to all overweight readers; tell us about it, commit yourself to a target weight and let us provide encouragement via our posts to help you achieve your goal.

Luv, Basil
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replied October 27th, 2010
Basil,
Thanks for the info regarding the S1J injection.That is exactly what neuro ordered. Since my pain is easing daily and with the help of swimming 3x a week, PT 3 x a week, and of course Aleve TAD (440mg per my neuro), almost all the pain is gone. In your best opinion, do you think waiting will cause a problem? Right now, I am so fatigued with any additional treatment, Dr's, pills, etc. Is there a chance that the remaining pain will abate by itself with time, or is this a small byproduct of surgery that needs this procedure to get rid of pain that will not go away without intervention? Have you had this shot? Couldn't agree more about weight/exercise/core strength...before surgery when I could no longer exercise, I put on close to 15 lbs, in a year's time which I definately could feel in my back. After surgery, lost it all and then some because the pain meds took away my appetite.I would like to lose another 5lbs, and the swimming, which has been a new addition to my workout has made all the difference in the world, and I will keep that in my routine.
Thanks for reply...hope everyone is doing well.
Paula
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replied October 27th, 2010
Spinal fusion surgery October 13, 2010
I recently had decompressive laminectomies at L3-4 and L4-5 and spinal fusion from L3-4 to S1 with rods and screws. I had spondylolisthesis at L5-S1. My surgeon said he had never seen so much irritation to nerves. I had suffered from the spondylolisthesis for a long time, but controlled with good body mechanics and an avid swimmer and athlete, and ideal body weight. Chiropractics have been helpful for the flareups over the past 20+ years. However, I suffered a freak accident at work and herniated the discs above the spondylolisthesis and this created more pressure and weight on an already compromised area. I had severe pain in my left thigh, left hip and pain in the left knee cap. I lived on pain medications and could not even drive. Formerly, about once every 5 or 10 years I would have low back pain with right-sided sciatica and the chiropractor always got me out of it.

I am two weeks post surgery and immediately after the surgery I did not have any leg pain and was so relieved. Surgery was Wednesday and I was sent home Friday. I think this was way too fast. I was ordered a rolling walker and a bedside commode which we placed over the master bedroom toilet because it has handles to assist me in getting up and down. I had prepared well for coming home, i.e. cleaning my house, placing things at waist level where I could reach them and stocking up on groceries for several weeks because I still am not permitted to drive.

I am trying to wean myself from the Percocet, but am not successful as the burning in the left hip and thigh has returned. It appears from reading other patient's comments this is normal and due to "angry nerves." My surgeon said he had never seen such irritated nerves and that mine were bright red instead of gray.

My question is, if these nerves were freed up, how long does it take for them to stop hurting or burning on an average? I am walking daily and trying to avoid bending, lifting and twisting and I must say that is a huge challenge and I pay for it the next day if I do the wrong things. With rods and screws and donor bone, how could I have pressure on these nerves? Why did the pain go away for a little while?
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replied October 28th, 2010
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Hi Basil and Paula and everyone,

Firstly, yes Basil I do know the terminology and I have had the sacroiliac joint injection, at least twice .I had facet joints and possibly sacroiliac injections 12 years ago. I can't remember if it was just facet joints or if it was sacroiliac as well. I received considerable relief 12 years ago. The subsequent two sacroiliac injections made me considerably worse. The latter one leaving me almost unable to walk. This last procedure was sone by a top surgeon from the London Spine Clinic. It's possible that I am allergic to something in the injection. I have also had two epidurals. The first made no difference and the second was at the same time as sacroiliac injections so who knows! I have received radio frequency treatment on both sides. it was hideously painful and inflamed everything (which it was supposed to do) but never settled down and relieved (which it was supposed to do)

As I said to Paula (and I'm pleased she agrees and that my words helped her make the decision) I should leave Nature to take its own course and continue to attempt to heal before embarking on this procedure. In my opinion there can be nothing to lose by waiting.

Dlain in answer to your query about recovery from nerve aggravation, in my experience they take a while, but I'm sure it varies from person to person. Certainly, a year and a half post the infamous sacroiliac injection and two and half post my fusion, I can walk, for about a mile at a slow pace. I built it up gradually, starting with walking a few houses along in my road, but
I am still in chronic pain. I am of ideal body weight and play a wind instrument which requires huge control of the abdominal muscles. I have spent hours on core body strength. In fact I have followed all the medics' instructions to the letter, so at low moments I demand of fate to tell me why I am still in the state I'm in!

Good luck to all of you!

Quaver
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replied November 1st, 2010
Hi Dlain,

I'm in agreement with Quaver, it can take a long time for the recovery but you have to hope that yours will be quicker and more successful than poor Quavers. Our bodies differ from each other and we respond differently to treatment from one another so what I'm trying to say is that while poor Quaver is still in chronic pain, it does not mean you will automatically experience the same thing.

The fact that your nerves are freed up does not always mean instant relief especially if they were inflamed. They will need to heal in their own time. At least you took donor bone so that removes the usual pain experienced from the harvest site (usually your hip).

Keep the chin up and follow your doctors instructions.

Holding thumbs.
Basil
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replied November 2nd, 2010
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Hi Dlain,

Of course there is no reason you should end up in the same condition as me! All I mean to say is that your body needs time and rest to heal. Do the prescribed exercises and try to chill out! That way you'll give yourself the best chance of an excellent recovery. So basically I think Basil and I are in agreement. In fact I am sure I went back to work too soon and pushed myself prematurely, so take as long to recover as you can afford!

I am interested that all of you non UK patients receive either donor bone or bone harvested from your own body. In the UK we are given artificial bone. My surgeon even trained in the States and he still used artificial bone.

Another matter which interests me is whether Basil is part of the medical profession? Basil please ignore the question if you don't wish to clarify this one way or the other!

Dlain try to relax and allow your body to continue healing. Also remember to keep smiling!

Take care all of you,

Quaver
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replied November 10th, 2010
Hi Quaver, I am related to a pain doctor and frequently probe him for answers, which stimulates me to do my own research. I have managed to avoid surgery thus far but must confess, I do not have the severity of stenosis that some of you poor guys out there suffer from.

I recently read about TMS (Tension Myositis Syndrome) and I reckon this applies to me in many of my spasms, particularly when I can't even stand up straight.

Quaver, I checked with my cous. and it seems that artificial bone is the latest technology, developed because of the problems experienced when using ones own bone or donor bone. It is however very expensive, recovering research costs I guess, and each doctor has his own philosophy about which bone he uses. They apparently get quite emotional about it when challenged.

Basil
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