What to ask 6 months post op fusion

[kangaroo]

Hey everyone,

I will be accompanying my Father this Thursday for a L5/S1 posterior fusion 6 months post op appointment (orthopaedic surgeon).

We are hoping the fusion has now started (did not show up during the 3 months appointment) and that the instrumentation is alright.

Dad is definitely not getting that much better since the past few weeks. Flexibility and strength are still quite lacking and most things he needs help with. He hasn't been able to work for a while either.

The only positive is that his pain levels are quite stable even after stopping Endone (stopped it 2 weeks ago). He still takes Lyrica 75mg twice a day. We'll ask whether that needs to be tapered down or not.

I was wondering if there are any tips and pointers on what to ask and look out for during this 6 months post op visit. We will be taking the pain level chart that Dad has been filling out as well.

Thanks for the help everyone.

[Maria]

I think what I'd want to do is make sure the surgeon knows your father's progression to date physically. All to often it seems older patients and often men seem not to want to complain to much (even if not really complaining rather just stating the facts).

If your father has kept a pain journal and/or activity journal that'd probably be helpful although often visits don't allow for too much reporting but at least it reminds the patient to say something to the surgeon re the progression to date.

I'm sure there will be films to see how the fusion is progressing. I don't know if your father will be recommended to have any physical therapy. My personal feelings about PT is that it should be very tailored to the individual's recovery yet I myself have only experienced that a few times in my many PT therapy sessions for whatever condition I was rehabilitating from.

I often think that passive therapy is helpful if one cannot really tolerate the active therapy (where the PT puts the involved extremity or body part thru a passive range of movement and there things involved like ultrasound etc).

How's your Dad doing with walking and mobility in general? The important thing I think is to make sure that whatever your father's most needed "complaints" as we used to call them in Nursing are heard and if none that his questions whatever they may be are answered as best the surgeon is able.

I always write questions down and check them off at the visit. I've not had a fusion and others here might be able to be more helpful with exactly what to ask however I would google fusion recovery questions at the 6 month mark and then ask whatever basic questions that are standard for anyone recovering as well as those questions that most apply to your Dad with how he's progressing to date.

It does sound great that your Dad has been able to stop the pain medication and I'd not worry about the Lyrica if it addresses the reason he's using (neuropathies?) it however no harm in asking about tapering dose however I'd want a script written so it's my (the patient's) decision re the taper meaning not cut the dose significantly vs. write maybe Lyrica (and dose) bid -qid (twice to 4x/daily) for pain as needed (as long as highest dose is within normal limits). That way if your father tries to decrease the dose and finds it bothers him too much he can just bump back up as needed).

Best wishes for a continued good recovery for your Dad! Maria

[mmglobal]

Kangaroo... I'm so sorry I didn't see this before your appt. How did it go?

Mark

[Maria]

I see that I was too late in replying.. I'm sorry. I do hope it went well and sorry again for being late with my reply.


Maria

[kangaroo]

Originally Posted by Maria

I see that I was too late in replying.. I'm sorry. I do hope it went well and sorry again for being late with my reply.


Maria

It's fine Maria and mmglobal. Thanks for replying.

The good news is that fusion has begun! Union is still not there but it's making its way there. I did notice a slight curve in the spine that I saw only when we got home. I feel a bit concerned that the doctor didn't show us that. Perhaps it wasn't an issue?

Anyway the appointment was quite rushed. I had my questions and only got to ask half of them before he rushed us off. He's never done that but I think they were all in a hurry since they had an emergency case later and/or it was nearing the holidays.

Originally Posted by Maria

How's your Dad doing with walking and mobility in general? The important thing I think is to make sure that whatever your father's most needed "complaints" as we used to call them in Nursing are heard and if none that his questions whatever they may be are answered as best the surgeon is able.

He's doing quite good. He can walk about 5km per day. Plus he does a lot of housework and helps Mum out even though we tell him not to. It's been hard to get him to settle down as to not agitate his fusion.

The main issue is his mental state. Not being able to work is really eating at him and the slow recovery is not helping either. I am sure many other people here experience the same. He is seeing a psychologist but I think he would benefit more with a pain clinic or someone who can teach him cognitive behavior therapy.

[Maria]

Yes that wanting to get back to an active life be it work or whatever can sometimes be a downfall or a stumbling block, setback etc. with healing so please do try to get your father to not do anything that's heavy or aggravates his fusion if possible. He will want to be ready for release to return to work when that time comes and it does if one continues to progress well and feels they can handle returning to their previous line of employment. I'm glad to read that your father is doing as well as he is and perhaps he could benefit by some CBT or just talking with someone (psychologist) that will assure him what he feels is normal however he is actually working right now.. working to heal well and working towards a long term goal and that involves being in the now and doing the work on a progressive and continual basis. Of course having been there I get it.. although didn't have a fusion tho did try to rush things.. it did not work well in my favor and in fact worked very much against me.

As Alastair used to say "slow and steady" (I believe that's what he said).. and hopefully your Dad will get there as he seems well on the path to a good recovery! Maria