Possible L4-S1 Fusion, some questions

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10sox

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I am facing a possible fusion. Basically, if my disc herniates again for the third time, I have no choice but a fusion. It has herniated 2x in the past 2 years. I have no idea what i did to make it herniate. Last time I was in physical therapy doing VERY light leg stretches. I also have DDD. have a 2 and 3 yr. old at home to take care of and no family closer than 1500 miles. My husband does work from home, but has a stressful, demanding job and works long hours.

So, I am just trying to prepare myself of what to expect if the disc does rupture again. My surgeon said he would go through my stomach first, then turn me around and go through my back. He said my nerves are already too damaged to risk doing it entirely from my back. He said the recovery would not be bad, and due to my age (35), I would heal quickly.

I know everyone's surgeon will have different ideas about my questions, but just trying to get a sense of what I am in store for:

How long is the typical hospital stay?
How long are you bed ridden (meaning most of the day in bed)?
How long before you can drive?
Do you need someone to help with personal care? If so, how long?
What are the lifting restrictions?
And last, what would you do if you had a 2 and 3 yr old at home to care for and no one to help you? Is this even going to be possible? Will I need to hire someone to come in the house to help? For how long?

Thanks so much!
10sox
 
Hi 10Sox,

I'll try to answer some of your questions. As healing is such an individual thing, I'm sure others will respond with variations on my info!!

First, I would suggest that you start trying to train your kiddies to become more independent...i.e., no demanding to be picked up by mom, and no lifting into chairs, etc. by mom. Start planning now on how you could do things in an alternate way so you do not lift them. Try to figure out ways to make it into a game so they'll want to try, even if it is difficult.

Would your surgeon do the 360 fusion in one surgery? Sometimes they will do one part, wait a couple days and do the second part. I was going to do mine this way initially, and I think I was told I would be in the hospital about 3 days.

I wouldn't think of it as being "bed ridden." They won't let you go home until you can walk stairs, if you need to, walk to the bathroom, dress yourself, etc. When you get home, even if you are still on strong painkillers, you can get up to go to the bathroom, and that is the time to take whatever little walk you can do. I was pretty lazy and this period for me lasted about 10 days. People brought me my meals, fed the dogs, etc. My job was to lay in bed and recover.

Driving really depenRAB on your doctor and how long you take painkillers. Will you be in a brace? If so, you won't drive for quite awhile. Some people drive at 2 weeks, but I would think with a 360 you'd be at least 3 weeks, if not longer.

Most people do not need help with personal care. Be sure to get an elevated toilet seat and a shower bench is also helpful.

My surgeon did not give me lifting restrictions, but everyone on the board said no more than a gallon of milk...and I even found that to feel heavy at first. It is REALLY important to not lift as this can do a lot of damage...that and bending...obviously two things you do a lot with little kiddies!!:dizzy:

I think I would hire a babysitter for the first two weeks you're home...and then maybe part-time for a couple more weeks unless the kiRAB are gone part of the day. Otherwise you'll never get the rest you need at the beginning.

Hope others in your situation will reply soon. I can barely remeraber what life was like when my kiRAB were that young!!!

In the meantime, if you put some of these restrictions into practice now and really give that disc a chance to heal, maybe you can avoid another herniation. Let's keep thinking positive thoughts.

xx M:wave:M
 
Thank you so much for taking the time and responding to me. I am just trying to prepare myself in advance if this does happen. Because I have no family in town, I really need to start preparing and I really didn't know what to expect. My mom said that she might be eligible for a "Family Medical Leave" and could fly down and help me if need be. I really hope that will work out. Her place of employment does not have the best management and you just never know what they'll do.

I am meeting with my orthopedic surgeon on Tuesday and I a gazillion questions to ask him. I will add all the ones I posted above to that already large list.

Thanks again. The kiRAB are in bed and I am wiped for the day.
 
10sox, I just wanted to add that we're really not trying to scare you away from this surgery. For MANY people, it gives them back their lives. There's about a 97% success rate with this surgery, and the success stories from "our crowd" here on the boarRAB doesn't hang around much. They're out at full time jobs, taking kiRAB hither and yon, having a social life, etc.

You just need to know what to expect, especially since you have little ones who can't watch themselves. If you need this surgery, go for it! It was the best thing that could have happened for me for my back problems. But be prepared for a long recovery time. I've heard it compared to open heart surgery for recovery. It is one of the hardest surgeries as far as recovery. But there have been people here who have said it was a lot easier than we told them it would be. Admittedly, I think I had a harder time than most, possibly because of the nature of my problem and the extent of my fusion. Realistically, expect it to be harder than your doctor is saying and easier than I'm saying. :) But definitely try to line up some help for your kiRAB.

Blessings,
Emily :wave:
 
Hi 10sox, and welcome to the back board!

M&M gave you some great answers!

You might want to read the sticky at the top of the page called "post surgery tips." It has a ton of great suggestions that will make your recovery easier. You'll also get an idea of what recovery will be like.

I had a 360 almost 2 years ago (wow, it seems like I just had it!). I was in the hospital for 8 days, but most people are in for 3-5. I had low blood pressure issues and ended up in ICU. Once you're home, you're not going to be up to doing anything except resting, watching TV, doing a quick wash up, and making sure you do a little walking whenever you can tolerate it. The pain meRAB tend to me you groggy, so you will sleep a lot. I was mostly in bed for the first 2 months, being up maybe a total of about 4 hours a day altogether. I gradually was able to be up longer and longer, but there's no rushing recovery from this surgery. It's a big one! I had 8 levels done, though, so your recovery might be easier than mine was.

I was not allowed to drive for 6 weeks, but even at that point, I really wasn't up to it. I only drove when I absolutely had to, such as for doctor's appointments or getting kiRAB where they needed to be. My kiRAB are older, teenagers, so they were actually a big help to me. They brought me breakfast and lunch in bed everyday and kept me company. You will definitely need help with little ones! Do they have frienRAB who can take them for part of the day for a while, or someone who can spend time at your house, maybe even a teenager to be a "mother's helper?"

I did not need help in the bathroom at all. It hurt getting up and down from bed, but once I was up, I was okay. It wasn't easy, but I did everything without any help. It might be a good idea to get a raised toilet seat. That really made things easier, as it's very painful to get yourself back up once you've sat down. Being higher up makes it easier. I had some days that I didn't shower in the beginning, as I was prone to blacking out because of the low blood pressure business. On those days, I cleaned up the best I could using those packs of personal wet wipes. Just to wipe down my arms and torso made me feel so much better (and probably smell better, too! :)) But everyone is different. There have been people here who have needed someone to help them every step of the way.

If you belong to a church, you might request that they provide you with meals for a while. That was a great help to us.

I hope your doctor isn't sugarcoating this surgery and its recovery time. It's no walk in the park! You'll be told no BLT's (bending, lifting, or twisting) and you'll have sitting restrictions, too. I was told no sitting for longer than 15 minutes at a time for the first several weeks. No worries there: it hurt to sit for that long!

I hope I haven't scared you. I'm trying to be honest and help you be as prepared as possible. Do I regret having gone through this surgery? Not for a single nanosecond!!!! It was definitely the best thing for me!

If you have other questions, we'll do our best to answer them from our own experiences.

I wish you the best as you make your decision.

Blessings,
Emily
 
Thank you all so much for your thoughts and opinions on this. I am just really freaking out and trying to prepare ahead of time as much as possible. I am already on pretty heavy restrictions that include, no lifting my kiRAB. But I can honestly say I lift them numerous times throughout the day. When your child is hurt, or scared of the monster decorations at Sams club and won't move...you have no choice but to pick them up. If I go through this surgery, I need to be prepared and find some help so I won't be in these situations alone with my children.

I have an apt in one hour with my Orthopedic Surgeon. My husband is coming along for the first time. I need to tell him how much pain I am in and how this is really affecting the quality of my life. I was told before that the fusion will only give me 50% chance of relieving my pain. I need to discuss this further with him.

At this point, I am willing to do just about anything to get my life back. My kiRAB are only 2 and 3 and I want to do so much with them. I realize when I look back and remeraber when they were even younger, I remeraber more about the pain I was, than the actual event. (like at my daughters baptism, I remeraber how many pills I had to take that day). I don't want all my memories to be based around my pain.

Thanks again everyone. I am sure I will have a lot more questions if I do in fact need this procedure. Like I said, my disc has gone 2x and it is already buldging again. I feel like I am playing with fire here.

10sox
 
Hi 10sox,

I had a L4- S1 s/p Fusion done on October 31st 2007. I am still not back to work. I really hope your doctor does not sugarcoat this for you as Blue said. My Dr. told me 6 months. Here it is almost 1 year later.
Although everyone is differrent, but age sometimes factors in and sometimes doesn't, I am 30.
You will be in the hospital for 3-5 days, unless complications keep you there longer. When I woke in the hospital after surgery the pain was pretty bad. You wont want to move much, but you have to get up and walk. I started walking the day after my surgery, and let me tell you those first steps were very painful.
When you get home, you won't be allowed to much of anything, lifting over 5lbs is a very big NO. Also there is 3 things to always remeraber: NO Bending, No Lifting, No Twisting!!! I was in a brace for the first 3 months, I was not allowed to drive for at least 2 months as far as I can remeraber.
You will be on some very powerful painkillers so you will be drowsy alot.
There will be lots of Therapy as well. My Therapy started 1 month after surgery, the Therapist came to my home 3 days a week.

Just don't think this is a walk in the park, and dont let your Dr. tell you that it isn't bad. Spinal Fusion is the top dog of spine surgeries. There really isn't much that can compare with it.
Hope this helps alot,
Kevin
 
Yes, I was going to write a similar sentiment...and I was one who was really expecting the worst from reading on this board for 3 years prior to agreeing to fusion. But Emily really had me prepared. I was expecting a much more difficult surgery than it turned out to be! ;) Most people have a successful outcome and are out and about.

That being said, there are several important points to consider:

1. You need to know that this is a BIG surgery (my doc's expression) and recovery does not happen overnight or in a week or two.

2. This surgery will not return you to 100% perfection. You will never return to your pre-injury condition. You may come close, but you will never be restored to the way you were earlier in your life, "pre-problems."

This is an important point as we are conditioned to think if we have something wrong, we go to the doctor, maybe we need surgery, we have the surgery and we are "fixed." After we recover from the surgery itself, we never have to think about the problem again. This just is not true with back surgery.

3. Unless there is bladder or bowel involvement (cauda equina syndrome) or severe nerve damage like foot drop, this surgery, and almost all back surgeries are considered "elective."

4. It is very important to get several opinions.

5. It is VERY important to go to a fellowship-trained spinal specialist -- either an orthopedic surgeon or neurosurgeon who has additional training in the spine and back, and devotes all or almost all his practice to issues of the spine and back.

If you have covered all these bases and have done your research, you will be ready to make an educated decision.

If you decide to proceed, I hope your MIL will be able to come and help you. Could your husband take family leave to help you out if she can't come? I think you will mostly need "mother's helpers" to occupy the kiRAB....rather than nursing care for you.

take good care,
xx M:wave:M
 
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