Post-op, 18 and 19 weeks

Well, the pain in my knees and ankles has pretty much leveled off to a very uncomfortable state. I've had to return to full doses of percoset to keep it in check. I saw my PM Doctor today and he basically informed me that there is good news and bad news.

Good News - the burning on the top of my feet is an indication that those nerves are finally healing. He said I probably have a couple more months of the burning before it settles down all together. Unfortunately, nerves do not heal quickly and this is just a new stage in the healing process.

Bad News - the knee and ankle pain is also nerve pain. Because these symptoms are new, he thinks it may be some scar tissue forming in my back causing the problem. I'm gonna have to wait it out and see what my body does for the time being. He told me that I'll probably have to do an MRI and an EMG in February once everything has a chance to run its course and settle down. In the mean time he prescribed Lyrica for the nerve pain.

My back has been doing great lately. I get a little sore if I sit to long and after a long day. When they say recovery for this surgery is 6 months to a year, they aren't joking.

Post-op, 17 weeks

Everything has been going pretty good this week except for the last couple of days. I've been experiencing an increased amount of burning/ache/pain in my ankle and knee joints the past couple of days. I was kind of chalking it up to the crazy weather being warm then cold.... This evening the symptoms are a little different and I have noticed that both my ankles and my knees are slightly swollen. Not a lot of swelling but the stupid pain is spiking at a very high level right now and the percs aren't helping. The funny part of this is that my back seems to be holding its own. Its a little more sore than usual but thats about it.

My routine hasn't changed, so I really don't understand why this is happening. I'll be contacting the Doctor tomorrow to find out what this new development means.

Post-op, 16 weeks

Anti-inflammatory meds have been making thinks much better lately. Knees and ankles don't hurt as much in the evening. Feeling came back in my right foot briefly on Saturday while I was driving. That really hurt. Every nerve in my big toe fired at one time. Numbness is back but the fact that it came back briefly gives me hope that it will eventually come back all the way. Went to the dentist today and survived sitting in the dreaded chair while I got a temporary crown. Now my face feels like my left foot.

Post-op, 15 weeks (3 1/2 months)

Had my follow-up appointment with my Doctor today. All the screws are in the same place, the implants between the vertebrae have not moved, and I'm showing signs that fusion between the vertebrae is taking place. Merry Christmas to me !!!!!

All physical restrictions have been lifted. I got a script for anti-inflammatory meds today, so goodbye inflammation. I've also been given permission to start working on my short game, I'm sure it needs a lot of work. I'm on schedule for my first pain free round of golf in the spring.

Post-op, 14 weeks (3 months +)

Only 1 week left till I find out the status of the fusion process. I'm confident that I will get good news next week and will be told that I am growing bone.

Post-op, 13 weeks (3 months +)

Nothing out of the ordinary to report except that I tripped down the stairs the other day. Wrenched my back a little. The only thing hurt was my pride for being such a spaz. Prior to my surgery that kind of fall would have had me in excruciating pain for at least a month maybe longer. Guess you can say I'm definitely getting better.

Post-op, 12 weeks (3 months)

Nothing out of the ordinary to report. I've been feeling quite chipper at work and Physical Therapy is having a positive effect. I've started detoxing from the meds being that I no longer require them except in the morning when I first get up. I'm coming off them slowly so I don't disrupt my life anymore than I have to.

Post-op, 10 weeks (2 1/2 months)

1.) Right foot still numb on the top of my foot and my big toe is partially numb. Foot drop almost completely gone.
3.) No change in the left foot, still numb.
4.) Back still sore when I first get up in the morning but has been better than in past weeks.
5.) SI Joints and hips are starting to calm down finally. Physical Therapist has been loosening up my hips which reduces stress on the SI Joints.

Continued water PT on my own. Still walking 2 1/2 miles a day during the week and 5 on the weekend. Continued land based PT.

Feel a lot better this week. Started to scale back the meds cause they just aren't needed anymore. I still have discomfort but its not that intense pain that I used to have.

Post-op, 9 weeks (2+ months)

1.) Have no idea if the right foot is improving anymore. It's still numb on the top of my foot and my big toe is partially numb. Still have some drop foot but I think it has improved.
3.) No change in the left foot, still numb. I think this is as good as this foot will ever get. Been like this for 5+ years except for the big toe being numb which is new since my surgery.
4.) Back still sore when I first get up in the morning. Adjusting of my sleep number to 50 has helped ease the pain a little in getting out of bed in the morning.
5.) SI Joints and hips are still acting up.
6.) Actually have been sleeping a little better this week.

Continued water PT on my own. Still walking 2 1/2 miles a day during the week and 5 on the weekend. Started land based PT this week. Got an award from my therapist for having the tightest hips he has ever encountered. He says that this is my biggest problem right now, so we're gonna work on loosening me up. Sure was in a lot of pain this afternoon from being loosened up.

I'm sure I improved a little this week but its barely noticeable. I get a little frustrated at times because I'm just not where I thought I'd be. I'm not complaining (maybe a little) cause I do understand that it takes a long time to heal. A friend of mine is going in for knee surgery and their recovery is supposed to be about 4 months. Completely recovered from major back surgery after 9 weeks is probably a little over optimistic.

Post-op, 8 weeks (2 months)

1.) Sitting is not a problem anymore, but I limit how long I do it.
2.) No improvement on the right foot this week, still have the drop foot.
3.) No change in the left foot, still numb.
4.) Back still sore when I first get up in the morning. Can feel some swelling at the incision site. Doctor says this is good cause we want the inflammation. More like he wants the inflammation, I want it gone. Have been adjusting my sleep number on my bed in hopes of helping the problem.
5.) SI Joints are still acting up and hips are now joining the party.
6.) Meds still interfere with my sleep.

Continued water PT on my own. Still walking 2 1/2 miles a day during the week and 5 on the weekend. Mowed the lawn again this week which resulted in a lot of pain the following two days (little bit of morphine fixed this right up). Medication combinations (Percs in the morning, and 1/2 dose during day topped off with Robaxin before bed) still seem to be working.

I'm still improving little by little each week. Don't see any marathons in the near future but the reality of it was I wasn't planning on running one anyway.

Post-op, 7 weeks

1.) I'm able to sit beyond 30 minutes now, but I limit how often I do it.
2.) Right foot is a little better this week. I can finally walk on my heels for a couple of steps.
3.) No change in the left foot, still numb.
4.) Aches and pains aren't as bad now, must be the calm before the storm (i.e. start of land based PT).
5.) Back still sore this week, especially when I first get up in the morning.
6.) SI Joints are still acting up.
7.) Meds still interfere with my sleeping.

Continued water PT on my own. Still walking 2 1/2 miles a day during the week and 5 on the weekend. Medication combinations seem to be working now. The goal is to be off the meds and have limited pain.

I can definitely tell that I'm improving. I'm really trying my best to follow my Doctors orders (NO BLT) and live my life at the same time.

Post-op, 6 weeks

1.) Sitting beyond 30 minutes is still a NO NO.
2.) No improvement in the right foot this week.
3.) No change in the left foot, still numb.
4.) Ankles, Knees, hamstrings, and hips are bothering me at the end of the day.
5.) Back still sore this week, especially when I first get up in the morning.
6.) SI Joints are still acting up.
7.) Meds still interfere with my sleeping and still have been waking up from soreness in my back.

Lost 1/2 pound this week. Continued water PT on my own. Insurance Company has authorized an additional 5 sessions. PT still seems to flare up the nerve in my right leg. Still walking 2 1/2 miles a day during the week and 5 on the weekend. Added Percoset back in during working hours but have cut out Robaxin to see what that does. I'm gonna figure this med thing out eventually.

Post-op, 5 weeks

1.) Sitting beyond 30 minutes is still a NO NO.
2.) Right foot may have a little improvement, not sure.
3.) No change in the left foot, still numb.
4.) Ankles, Knees, hamstrings, and hips are bothering me at the end of the day (the list is growing a little).
5.) Back has been a lot sorer this week, especially when I first get up in the morning.
6.) SI Joints are now acting up. Physical Therapist says that I'm transferring some of my fused joints functionality to the SI Joints and their not happy.
7.) Meds still interfere with my sleeping and have been waking up from soreness in my back now.

Lost 1 pound this week. Continued water PT. Didn't get approval from Insurance Company to extend PT beyond 5 sessions. Authorization will come but is delayed cause I didn't follow the rules. Water PT will have to continue on my own. PT still seems to flare up the nerve in my right leg. Only walking 2 1/2 miles a day during the week and my normal 5 on the weekend. Work is going well and am now back full time. Cut back on the Percoset during working hours, so I'm only taking Tylenol and Robaxin. What a difference, I can think again but the pain is WOW, almost a 5. I've worked like this before so I just have to get used to it again. I take the good stuff when I don't have to think. At least I know where my pain is so if the Doctor asks me I can tell him. Kind a sucks when you have to plan your life around what medication and how much pain you can tolerate.

Post-op, 4 weeks

1.) Sitting beyond 30 minutes is still a NO NO.
2.) Right foot is starting to show some improvement, Water PT must be working.
3.) No change in the left foot, still numb.
4.) Knees and hamstrings are still bothering me at the end of the day.
5.) Back has been sore with the increased activity.
6.) Meds still interfere with my sleeping.

Lost a 1/2 pound this week, funny how you gain weight fast but take it off real slow. Continued water PT and actually made it to the pool twice on my own. PT really seems to flare up the nerve in my right leg. Last night the leg was fine after PT so maybe more progress is being realized. Had to cut my walks down to one 2 1/2 mile walk a day. The reduction of walks is due to time constraints. I'm gonna have to find a way to work in the treadmill now. Just not enough hours in the day. Work is going well. Have been going part/full time over the last week in the office. This has been a real pain in the butt, so no more half day stuff. I'm full time in the office from now on.

Post-op, 3 weeks

1.) Sitting beyond 30 minutes is still a NO NO.
2.) My right foot went back to the way it was when I first came home from the hospital. Can't have everything be perfect.
3.) No change in the left foot, still numb.
4.) Knees and hamstrings are still bothering me at the end of the day.
5.) Back has been sore with the increased activity.
6.) Drugs really interfere with my sleeping.

Started back on my diet since I've gained all this weight back. Mowed the lawn last Saturday, that was lots fun and felt great to just be out there. Had my first water PT appointment yesterday, which was a drop in the bucket compared to the walks I do twice a day now. Went back to work yesterday. It was nice to be doing something productive with my day rather than sitting on my butt.

Post-op, 2 weeks

1.) Sitting beyond 30 minutes is definitely a NO NO. I've done it a couple of times and the pain that follows is not worth the few minutes of extra comfort.
2.) My right foot woke up a little this morning. Some of the feeling came back to the top of my foot. It smarted a little at first, but now its seems to be back to normal. Still have some numbness left, but the prospects for that going away are looking up.
3.) No change in the left foot, still numb. I have manage to build up some strength into my foot from walking.
4.) Knees and hamstrings are still bothering me at the end of the day. It's kind of a good/bad pain because I know their sore and tired from having an active day.

It's much easier now to roll from side to side in bed now. The incision hurts less and in fact is now starting to itch which is a sign that it's healing. I'm now walking 5 miles a day again. Definitely need the exercise being that I've already gained 11 pounds since my surgery.

With the exception of one bad day, week 2 has been very productive as far as healing goes. Tomorrow is my first post op appointment with my surgeon and pain management doctor.

Post-op, 1 week

Thought those that are thinking of going down this road of fusion might be interested in knowing where I stand after 1 week. For starters, don't expect to much. If you do, you will be disappointed.

1.) When sitting, it hurts a lot when you sit back for obvious reasons. My back is very bruised and sore where the incision is.
2.) The entire top of my right foot is numb and I have drop foot. This is most likely because of the nerves being moved around in my back. It's a weird feeling but doesn't hurt.
3.) Left foot is almost completely numb. I have next to no strength in this foot. Some of this can be attributed to nerves being moved around during surgery and some of this was permanent damage that I already knew about. I sure hope my foot gets back to the way it once was, otherwise I'll never be able to trust my footing again. I'll cross that bridge when I come to it.
4.) Both knees and pelvic area are extremely painful. Not sure why, but this is the source of most of my pain by the end of the day.
5.) Back pain beyond belief if you do anything bad, bend or twist. My back is extremely sore by the end of the day. I hate to think how it would feel if I actually did something all day.

It's very difficult to get in out of the sitting position for me. I can only sit for about 30 minutes per stretch and walk/stand for about 5 minutes. Lying down is by far the most comfortable position. I permit myself to lie down once in the afternoon and then in the evening before bed.

This surgery was my last option to return to a somewhat normal existence. Prior to going this route, make sure you have exhausted all other options. You can not change your mind once its done. In fact, I must now fuse my vertebrae because the discs between them have been removed.

Post-op, Day 3

Climbed two stairs this morning and given thumbs up by PT to go home. Also went on a walk without the walker. I've been feeling real cocky all morning thinking this recovery isn't so bad. Got released from the hospital after 1:00pm. Arrived home around 2:00pm. I need to write the Virginia Department of Transportation, cause these roads suck. Here are my rules laid out by my doctor and my wife:

1.) No sitting for more than 30 minutes.
2.) Walk around house at least 10 times a day.
3.) Do not go up or down stairs on my own. Already got in trouble for this one.
4.) Take pills on time.

For the most part, my pain is associated with the surgery. I expect this to be the case for several weeks maybe longer. Right now, I'll take it day by day. This is by far the most painful surgery I have ever experienced in my life. I am very weak and walk using a cane to support my self (I don't trust my legs, especially my left one). I don't know if this surgery was worth it. That will be a discussion for another time.

Post-op, Day 2

Today was pretty uneventful. They pulled out the epidural late this morning and replaced it with a morphine pca pump which I controlled. Over did it a couple of times and literally put myself to sleep. Once the effects of the epidural wore off, they pulled the catheter out, now that really hurt for a minute. Went on two walks today, both with the walker. Got to go a little further each time.

Post-op, Day 1

Got to walk 20 feet at 11:30am with the PT folks. They're like Dave, you can't feel your legs so you can't go on a walk. I show them that I have motor control and pass all their tests. I tell them, my left leg has been numb for 5 years, nobody told me I couldn't walk then. I finally win the argument with my wife shaking her head at about how stubborn I am. Did my 20 feet, 10 feet to the door, 10 feet back to bed, my ass hanging out their in all its glory. It felt good to get out of bed. Not to mention, the young lady from PT calls me a young man and says that I'm the first patient she has ever seen walk with an epidural. Rest of day was uneventful till around 2pm when new PT Girl comes in. She says no you can't go for a walk with an epidural. PT Assistant (huge burly man) arrives with walker and tells her he's already been out once today. So, I get to go on another walk halfway down the hall this time, I'm thinking maybe a 100 feet. Now they're talking once the epidural is gone I may not need a walker. I guess those 5 miles a day pre-surgery is paying off.

I paid for my little walk and had to increase the pain meds accordingly.

Had some visitors this evening, my two girls and mother in-law and father in-law stopped by for a couple of hours. My father in-law and I now have a lot more in common. He already is fused at the same two levels and I'm on my way to being fused. We both have the same doctor.

Day of Surgery

Real nervous right now. We're waiting for my Doctor to arrive. The anesthesiologist is real inpatient and is eager to get started. I've already talked to my doctors PA.

My doctor finally arrives, 20 minutes late. Anesthesiologist pops in a minute later, gives me a shot in the IV to make me drowsy. I kiss my wife and they start to wheel me out, next thing I remember is I'm in the PACU and I have lots of pain. My wife tells me later that surgery last 4 1/2 hours and I was in the PACU for two hours. They headed my advice and brought me out of the anesthesia real slow. It didn't seem like a very long time once I woke up before they wheeled me to my room where my loving wife's concerned look greeted me. I sure am lucky to have married her. She is and always will be the light of my life.

Didn't get to see the doctor for the rest of the day, but my wife talked to him after the surgery. He ended up doing two levels instead of just one. L4/L5 just wasn't stable enough to take over for L5/S1. He also performed a Hemi Laminectomy and Foramintomy at L3 but other than that, L3/L4 has the right stuff but I'm gonna have to work hard to help it out.

Got a Fentanyl epidural with button to bump delivery every 10 minutes. Like an idiot, been hitting the button every 15 minutes all day. Pain hasn't been real bad today, mostly at a 4 (with spikes to 6 or 7). I've been nodding off all afternoon while my poor wife has been sitting there straining her neck to see the TV. There is nothing worse in the world then sitting / laying in a hospital room watching the time pass by.

My wife went home at 8pm when visiting hours were over. I finally took an extended nap for 45 minutes at 9pm. Here is why I am an idiot, no button pushes during nap resulted in increased amount of pain. It took an hour to get everything under control again pushing the button every 10 minutes. To top everything off, I now have my worst migraine of the year and I'm unable to take aspirin for it. Around 1 am the pharmacy sent some tylenol up but it's to late now, this ones here for the duration. My nurse convinces the pharmacy around 6:00 am in the morning to order some Fiorcet for the migraine. After 4 hours of waiting, Fiorecet arrives at 10 am. I really hate the pharmacy now.

Pre-Fusion Surgery

I've had a bad back for most of my adult life. 2001, just before Christmas, I was washing the car and stood up. My life changed dramatically from that point on when I ruptured, more of an explosion, my L5/S1 disc. Did the PT for several months and on my last day one of the fragments from the disc severed a nerve. Long story short, had a discectomy and basic cleanup work done two weeks later. Lost partial feeling in my left ankle and toes permanently. It's like walking with your sock folded over in your shoe all of the time, really annoying.

After six months of normal life, pain started to set in again (not as bad this time). Did the shot thing for about six months, never really helped. I don't recommend having a steroid injection in the Doctor's office without a fluoroscope. My Doctor finally told me that I just had to live with the problem cause I had weak facet joints. Pain was about a 3-4 most of the time. It's amazing what you can block out if you set your mind to it. In 2005, went to a new Doctor, who also told me to just live with it. Turns out he assisted in my surgery in 2002 which I didn't know. They did an MRI, showed disc herniations up and down my entire lower lumbar with L5/S1 50% collapsed. I went on my merry way and lived with it. The hardest part of living with it is showering and getting dressed in the morning. Life is supposed to be an adventure, right? I rarely complained about my back, so on the really bad days I might be able to garner a little sympathy and TLC from my wife and 2 girls (ages 14 & 12), one can dream ok.

My wife finally convinced me to see yet another doctor in the spring of 2007. They did all kinds of wonderful tests, XRAYS, MRI, Discography (this one really hurts), EMG. Turns out that living with it is not such a good idea. L5/S1 didn't even show up anymore (nothing but air) and L4/L5 was now 50% collapsed.

The following is my diagnosis as of the spring of 2007:

1.) DDD L1-S1.
2.) Left L3 foraminal stenosis.
3.) Left L4 foraminal stenosis.
4.) Bilateral L5 severe forminal stenosis.
4.) L5/S1 vertebral deformity.
6.) L4 spinal stenosis.
7.) L5 severe central and subarticular stenosis.
8.) Failed L5 laminectomy (FBSS).
9.) Severe facet joint arthropathy.
10.) Bulging / mild herniated discs L1/L2, L2/L3, and L3/L4.
11.) Severe disc herniation at L4/L5.
12.) Collapsed disc and severe herniation at L5/S1.
13.) Sacroiliac (SI) joint dysfunction.

Considering my long laundry list of problems, I can never expect to pain free in my back again. Regardless of the facts, I have opted to have another go around with the knife in an attempt to put my body back together. My plans are to be able to horse around with my kids at the pool without fear of hurting myself, ride a roller coaster and not feel like my back has just been crushed, play golf and not spend the following week wishing I hadn't, or just living life like the rest of the world. My goals seem pretty lofty at this moment and I know that after lunch tomorrow I'm not going to be a happy camper.

Here is the list of procedures that they will be doing:

1.) Lumbar posterolateral fusion L4-5.
2.) Lumbar posterolateral fusion L5-S1.
3.) Lumbar transforaminal interbody fusion of L4-5.
4.) Lumbar transforaminal interbody fusion of L5-S1.
5.) Left L4 far lateral laminectomy with foraminotomy for foraminal stenosis.
6.) Bilateral L5 far lateral laminectomy with foramintomy for severe forminal stenosis.
7.) Posterior vertebral osteotomy with the bilateral sacral dome osteotomy of
S1 for spinal mobilization and reduction of deformity.
8.) Left L3 hemi laminectomy and foramintomy.
9.) L4 decompressive laminectomy with bilateral foraminotomies for spinal stenosis.
10.) Right decompressive laminectomy of L5 with foraminotomy for severe central and subarticular stenosis.
11.) Placement of inner vertebral body mechanical device at L4-5.
12.) Placement of inner vertebral body mechanical device at L5-S1.
13.) Placement of segmental spinal instrumentation.
14.) Harvest of autologous cancellous and critical cancellous bone graft.
15.) Use of infuse, RHPMP 2. sub muscularly.
16.) Left L5 revision laminectomy and foraminotomy.