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.