I had surgery StALIF L5/S1 Activ-L L4/L5 Zeegers, Alphaklinik

[fuzzy]

I recommend Zeegers and the Alpha Team highly.

I had surgery at Alpha 5 days ago Nov 9. Dr Zeegers implated a STALIF fusion at L5/S1 and a Activ-L at L4/L5. The hospital has been superb and Zeegers and his team have been very thorough from beginning to finish. I had many meeting with Zeegers the week before (come early!!!), when I woke up I was starring at an xray of the Active-L and some screws in my back and a smiling Zeegers. He visited several times in my room and took his time to explain what he had done, It took me 3 days to realize what he did and it feels very good. His detailed written report gives a very clear insight in his careful methodical approach. There is no pain in my back and my feet feel better every day. I can highly recomment him and his team. And the best way is to go and visit and check out the Klinik. I did this in July and was very impressed. Zeegers believes in personal communitcation and called my several times in the US, very late in his day. I feel that this greatly improved his understanding of my problem and what to look for during surgery.

Now I need to get my self in shape and get moving again.

[dshobbies]

Fuzzy,

My heartiest congratulations. Good for you!

Keep up the good work... but remember to take is slow.

Best wishes for a great recovery, Dale

[mmglobal]

Fuzzy... sounds like you are doing great. Where are you staying? Call me when you can or let me know when I can call you. I'll be there in a couple of weeks... will you still be in Germany?

Mark

[fuzzy]

I stayed at the Sheraton Grand but have now moved to my place in Hannover. Zeegers gave me thumbs up to move at the 1 week follow up. I was glad to get out of that hotel. Nothin for long bearded fellas, too many stares. I will be back in munich dec 6 for 4 week follow up. Due to my osteopenia he is VERY interested in the personal follow up as he tried VERY HARD to ensure no subsidence which allready seems to be less of a problem with Activ-L. He used a very careful somewhat unconventinal technique for distracting the disc space very carefully to ensure no fractures tohe endplates. He documented this with a slideshow of flouroscope pictures made into a movie.
No bone cement was used (!).

Now day 9 since surgery I am slowly thawing out and the painlevels are dropping. My feet are still doing all kinds of wierd things but it seems to be improving. I have a light line of pain running down my left leg, before surgery it was my right leg. I hope it goes away. There is NO pain in my back.

[joemonfl]

Great news fuzzy. why did Zeegers determine to do a fusion at L5/S1 versus the ADR at the level?

And I've had the same experience with Zeegers on the phone. Multiple conversations with him lasting 30-60 min to me in Florida.

I'm scheduled for a 2-3 level adr 12.14.07 and daughter and xwife will follow the week after for support.


[quote=fuzzy;2841]I recommend Zeegers and the Alpha Team highly.

I had surgery at Alpha 5 days ago Nov 9. Dr Zeegers implated a STALIF fusion at L5/S1 and a Activ-L at L4/L5.

[fuzzy]

When I showed up he spotted a shifting of L5 on flexion. Retook the xrays, same thing. He says that by putting ADR there I might end up with more or new pain or possible device pailure in the future. Highly adviced to accept the STALIF if he finds confirmation in the OR. He said if all ok he would implant ADR so I did not know what I would end up with when I went to sleep.

[joemonfl]

great explanation thanks fuzzy. How are you doing on pain meds and where did you stay in Munich? How was the flight back?

[fuzzy]

Day 10. I am on iboprofen 400mg ( 2 pills) as needed and am trying to take as little as possible and control the pain by taking breaks and not stayin in one position too long (works). Don't take pain meds while lying down but when going on extended walks with sitting periods (like those horrible seats in a subway), then the pain builds up, even with ibo's. The muscle pains in legs and butt (and surgery pain, bonegraft site) are starting to go down. The only thing coming from spine itself seems to have to do with the fusion site. Exercise HELps tremendiously and it is getting better every day. Still have this problem of the cold right foot and I can't tell that it is cold! But before the surgery both my feet were numb and on fire etc when ever I stood up, right more then left so there is a big improvement that was obvious right after surgery. Right foot has not problems at all now. No stiffness in low back, I have watch out, even with brace.

I stayed at Sheraton accross the street from Alpha. I am still in Germany but moved on elsewhere and will be here for another 3 weeks. I am glad I am not flying home yet but would be fit to fly at the 2 week mark I am sure.

[joemonfl]

I read 2 iboprofen and laughed, I haven't been able to take just that for years. Good for you.

I"ve heard about the leg and butt pain, do you think stretching would help, even before surgery?

Would you be able to site see between day 5 and now? How long can you walk or stand? My exwife wants to know if I'll be able to take a tour with them post op.

Did you stay at the ArabellaPark or Grand? oh and my daughter wants to know are there any TV shows in english?

Keep up the good progress.

[fuzzy]

2 to 3 levels is a big surgery. I was not ready for any bigger outing until about day 9. Now at day 12 I can go for several hours, with breaks all day.

I stayed at Sheraton Grand. Don't know about english shows I only watched german and french ones (I am trilingual, so is Zeegers, more like quad lingual). But at least BBC, CNN and, I think, Comedy channel.

Don't know about the pains after surgery, I am sure it varies with everyone. A lady who had surgery the same day (single level) with me seemed to be in much better shape then me at day 4. I was pretty fit going in. Exercised till the day before. Seems the anaestethia meds really got to me, I was seriously dizzy for days.

Ibo's, Stopped the Alphakillers at 2 days. I got pretty high pain tolerance, right now the pain tells me when to be careful, slowdown or stop.

[Maria]

Hey Fuzzy,
Thanks for the report/update on your surgery and how you've been doing. I'm really interested in hearing about outcomes w/ the StALIF fusion and glad to hear you seem to be doing so well to date.

Please keep the updates if you're so inclined. You do have interested readers here! Loved hearing the glowing report for AlphaKlinik and Dr.Zeegers. He sounds like a great guy and wonderful surgeon~ as well as the facility and staff as well.

take good care and well wishes for continued good healing/recovery!

thanks, Maria

[joemonfl]

Just a quick hi fuzzy to see how you are feeling?

[fuzzy]

Tomorrow I am 3 weeks out from the surgery and I am continuesly improving

My back does not hurt at all when I am not pushing it. It only hurts after a 2 hour hike things start getting pretty darn sore, passing well past the iboprofen level. But breaks help as they take off the pain quickly, I think a lot of that is the muscles. I still have leg pain in left leg that comes and goes, particularly at night, lying "wrong" triggers this pain real strong. The darn bone donorsite is a real pain sometimes. I still have quite a bit of burning in my feet and my right foot is consistenly cold but contrary to before I can now feel the coldness more often then not. Lying down resolves these problems faster then before. Sitting endurance is improving. I would develop pain quick and now it takes a little longer. If there is any pain in my back then its right at the fusion level, it seems.

My body is still over coming the shock from surgery but i feel much better now an can't wait to go on some long walks, like the tiger in the cage.
Next week I will see Dr Zeegers for a 4 week checkup.

[sharman]

I'm so glad to hear that you're improving. Just three weeks after a hybrid surgery, that's very good news.

Can I ask a question? Why did Zeegers choose autologous bone graft?

[fuzzy]

I don't have an intelligent answer as this question didn't even come up. But I'd rather use my own bone then something else and will make it throught the discomfort. I try to remember to ask the question thought at the next visit.

[mmglobal]

Zeegers uses autologous bone because that's what he gets excellent results with. There is motiviation not to use BMP, growth factors and other fusion accelerators in hybrid procedures because you don't want to risk causing fusion at the ADR level.

The downside of using autologous bone is the potential serious pain at the donor site. Read AlanK's story on the GPN page... he did have substantial pain at the donor site, but at 10 months out, he was reporting functioning at 100% with zero pain, zero meds.

I've never gotten strange looks at the Sheraton Bogenhausen... I guess my beard is not quite as long as yours! Maybe I'll see you next week.

Mark

[fuzzy]

Yes, the bone site has some real pain potential. The first few days was very bad and literally stopped me from walking much. It felt like someone to a big hammer to my hip.

I stayed at the Grand but went over to the Bogenhausen a few times. the folks at the counter there allmost swallowed their own tongues, haha, I think they were wondering wheather I should really be there but on the other hand they must get to see many strange folk all the time.

Mark, will you be in Munich next weekend? If so stay in touch and lets meet up!

Pain update: 6 hours on my feet yesterday and the biggest pain genertor was... the bone graft site. Pain in the spinal area was nil and the other pains were a good general ache in my legs, sore feet and the usual minor tingely stuff in my feet but improving.

[Tim]

Fuzzy
Great to hear your doing so well!
Apologies for hijacking your thread but I just want to pick up on Marks comments regarding autologous bone graft vs BMP.

Mark
I know we spoke briefly about this recently but I just want to ask a quick question following on from your comment that "There is motiviation not to use BMP, growth factors and other fusion accelerators in hybrid procedures because you don't want to risk causing fusion at the ADR level".
Do you feel then that the use of BMP is positively contraindicated in any hybrid surgery be that a combined ADR + fusion primary surgery or a later secondary fusion surgery above or below an existing adjacent ADR? As you know this is an issue I am currently very much trying to understand.

Again Fuzzy apologies for utilizing your thread. In my humble opinion a combined procedure with fusion at L5/S1 and ADR at the more mobile L4/5 sounds like a great combination which should give you years of hopefully pain free activity. I look forward to hearing of your recovery going from strength to strength.

All the best
Tim

[sharman]

Thanks, Mark, that makes sense. I have read that autologous bone has a higher chance of success than allograft, and certainly can understand why BMP might be a risk in a hybrid.

The hybrid sounds like an excellent approach to an L4 - S1 two-level. Apparently a more difficult recovery, but good long-term prospects. Wish you luck with it, and look forward to reading about your progress, Fuzz.

[fuzzy]

Now at 4 weeks.

Everything has improved a little. Left leg pain is becoming more of a good ache but my right foot is still anoying at times. It does the ice cold number the moment I stop moving and now it sizzles....but I sat in the car for a good part of the day today. The bone graft donor site does not hurt except sometimes there is a twitchy neve at the incision site that gets iritated by wearing the brace and or the band of the pants. My walking endurance is improving and my back stays painless longer now then last week before I need that 15 minute rest, and it seems that left leg is causing me more problems now then anything in my back.

I met Dr. Zeegers today for a 4 week check up and the xrays show the implants to be in their original locations still, no subsidence into my soft bone. I am relieved. So is Dr. Z. who looked downright emotional to see me walking and in good spirits today. I will surely be back in 3 to 4 month for a personal checkup as its well worth the airline ticket if I can handle coach class which I am pretty sure I can by that time.

[mmglobal]

AHHHH... I missed you... I was there. Are you staying in Munich? I'm here till at least Sunday....

I'll have to come back for the questions... grueling trip... gotta run.

Mark

[fuzzy]

Yes, I am here till sunday.

[Maria]

Fuzzy,
Sounds like you're having pretty amazing progress! The pain at the donor site sounds pretty familiar from other's posts I've read over the years. The OSS I've been seeing for the longest time has said in the past he would not want to harvest a bone graft from my hip. Said I was too slim. It may have been to do with my bone density levels as well though he did not say this.

I'm happy that you're able to walk for such extended periods of time. I love to walk and on low level Methadone (and Neurontin) I find that walking is easy for me in the last few years and actually makes my back feel better and often I can stay on my feet the whole day with very little down time.

It is the projected sitting that you think you may be able to do that really impresses me (based on where you're at now). If I could sit to fly in one coach seat again vs. 3~ wow, that'd be most amazing. Oh to travel again, go to movies, sit in a library for hours on end, take a train and actually sit in one seat vs. draping myself across two.. on and on ad nauseum...

BTW, your beard appears to be a tad longer than Mark's beard. Somehow I can't see him sporting a beard of that length in the OR tho I like that ZZ Top look!

[fuzzy]

Hello Maria, I have read about you buying 3 seats to travel by air. I have tried that and it was simply not enough. I need to lie totally flat, legs straightened out to get relief and refuel for more. That is still that way but I recover much faster. 15 minutes flat really gives relief to make it some longer in a sitting position. Impossible before, needed 1 hour then lasted 30 min.. So luckily I got business class (frequent flyer miles)for this flight over and back and can confirm again I am so glad I managed to to that rather then buying 4 (in the middle !!) seats. By turning the seat all the way back and then padding the foot rest and then laying my legs *on top* of the foot rest with my feet hanging over the end of the foot rest I managed faily well coming over as I was basically flat. Still I am worried a little about that flight back in 2 days but I think I will be fine but I am so glad I did not have to make the return trip at 2 week!

The bone graft. I am very skinny and my bone values are not so good at T-2. It seems Zeegers had no concerns with that and actually the upper hip area turned out to be pretty good density wise. By feeling along the top of the hip bone I can clearly feel a hole in it, where the bone was taken but the pain at this site is very low now, just need to keep pressure of it sometimes.
My back pain is 0, nil there is only the leg troubles whcih seem to be improving and I am not stiff at all, unlike before. I have to be downright careful. Before when standing the pain would rise fast and my back would get really stiff to move to a new position weather to sit or worse getting up. These problems are much less now.

I don't remember if I wrote this but I drove a car for 1.5 hours. This was impossible before. Now the pain was stable and not increasing and my feet were much better with the strong pain in my right leg gone. Quite a bit of discomfort (main be pain 3 to 4) in my lowerback but manageable. After the drive I had to get out very carefully but was moving fine with no after effects after 5 minutes, pain in low back went away right away after getting out of the car! This was on NO painkillers, at 4 weeks post surger.

I really do feel lucky this is turning out so well and Dr Zeegers is a magician.

[Maria]

Fuzzy,
I'm fortunate at 5'2" that I can lie across 3 coach seats and be comfy however not all seats are the same size it seems as the Delta 747 I was first on before we all got bumped off this flight for supposed mechanical reasons was downright killing my hips as I laid there for just 15 minutes pre flight.

So we got bumped as I stated and the next plane had more comfortable seats and I could lie comfortably on my side or back. With bent knees my feet don't hang over anything.

May I ask what pain medication you were on prior to your surgery and how often you took it for how long (# of years?). Just wondering. It's a rather personal question so you don't have to answer if you prefer not to.

BTW, my last bone mineral density was t-2.2 in lumbar spine (2 years ago nearly) and then t-2.8 in one of my hips. I'm supposed to be taking Actonel but stopped nearly a year ago and don't take Calcium either as I have stomach probs with all forms of Calcium I've tried taking. I must return to the ingestion of Actonel or some such thing soon as I realize I'm ony hurting my own bone density!

Good luck w/your flight!

[mmglobal]

I'm still here in Munich. It was great to meet fuzzy and some other clients who were there. I was very impressed at how long of step he was... seeming pretty dang spry... but he is 4 weeks out.

We got together in the clinic with a client who was only 2 days post-op. When I picked up Sam... we bumped into Zeegers. It's great for him to see the patients together laughing and smiling. There are 11 devices between the 4 of us. Left to right... 2 Charite's; Activ-L and STALIF; 2 Activ-L; 2 Activ-L, 2 Coflex and Mobi-C (Almost forgot a partial knee in there.)


After the party broke up, Fuzzy and I had a beer at the Queens Hotel... (holiday inn for the newbies). Not only is he long of step, but he can sit. He may look like a Texas rocker, but he's got a lot of interesting and unusual hobbies... VERY interesting guy! One of the things I love about my job is getting to know so many interesting people. It's especially rewarding to see so many of them do so well. Fuzzy... keep it up and take care of yourself. When you are up for a ride... Chuck and I will meet you in No. Cal and we'll go for a ride. (To give you something to look forward to... here is 3-level Bertagnoli ProDisc under 2 years out. He's still doing great at 3 years... rides 7 hours from So.Cal to Santa Cruz)

[Maria]

edited as necessary

[fuzzy]

Maria, take a look at Suzuki Savage LS 650. Low rider, good for small rider (my wife) low weight, bullet proof and fun. Reasonably priced, bargain used. Only down side, not as comfortable as a larger touring bike on long trips. Trust me I know as I had many bikes and this one is the one I keep for the better days... and for the first attempts to see if my back likes to ride.

[fuzzy]

Mark, the meeting was great. I really enjoyed that rare opportunity to meet you all just before I left back home!

[joemonfl]

Hi Fuzzy,

Heard you were already back, sorry I missed you. I had a flight get cancelled which put me a day behind.

How are you feeling back in the states?

I ran into Mark yesterday during my pre op session with Dr Z.
Wating now in one of those rooms for my turn, a 3 level Ativ-L.

Dr Z is as nice in person as on the phone and the staff is very helpful.

If you are an American in Germany, I do suggest learning some German. first it is polite and second you won't have a total vacant look on your face when others are speaking in German.

I'll copy this into a clean thread and update as i go.

[fuzzy]

Good luck, Joe! I am feeling very very good, considering I am only 5 weeks out. I made the trip back to the states ok and I forgive Zeegers and crew all the pain and discomfort I am still in as it is getting better by the day.

Yesterday I felt a warm comfy right foot the first time. I layed down and my foot warmed right up. The funny stuff in my feet is getting less and less and the leg pain is an ache unless I push it. Stopping the activity the pain drops down quick.

I had to know so I stopped taking the ibuprofens 2 days ago, even at night. I have one sore body but no PAINNNn. Lying still in bed (good nights sleep) the pains drop to 0 but quickly come up when I start wiggling arround. I might stay with the ibuprofens at night for a while but after 2 days I got an idea where my body is at. It still needs to heal.

[Maria]

For the bike recommendation~ will check this model out~ I like to window shop even if I'm not buying

[fuzzy]

Its been 7 weeks since the surgery.

I am doing very well. There is no pain to speak of in my back. I am more flexible then before surgery *even though* there is a fusion in my back. I am sill relearning new posture. Sitting I can tell things are different down there especially sitting in cars. The leg pain has steadily improved to were it is very low now. The strengh in my left leg is improving. What I am still struggling with is lots of fizzle and sizzle and buzzing in my feet. When I angle my legs, like sitting, folding my legs in bed etc it causes buzzing in my feet. After having been on my feet a while and then lying down there is a lot of spasms in my left leg. Toes twitch. My right foot still goes cronically cold. This starts as soon as I get on my feet and take a while to go away when I lie down. Warming the foot up once lying down will speed up the "recovery a little" Hope this goes away one day. Anyone have this kind of thing?

Iboprofen sometimes, thats it for meds. I am so glad I a not on anything else. My back feels great! I really have to make sure I dont overdo it as it feels that good.

[joemonfl]

Hey Congrats, you hit that magic number for us, 6 wks and the implant and bone should be permanent now.

I had my knees scoped and a lateraly release done where they change the way the patella tracks and it took a good year for the muscles, nerves etc to adjust to the new weight bearing. That is what I think we have ahead of us.

I did my first long walk yesterday but boy did I feel it last night in my muscles.

Still sorry we didn't get the chance to toss a beer or two.
Joe

[sahuaro]

Fuzzy:
I am just now reading your story. Congratulations on a successful surgery! I hope you continue to progress, losing those foot symptoms.
Love the beard but I guess you're lucky you didn't have cervical surgery because I bet they would have shaved you!

[fuzzy]

I will stay away form the cervical surgery as long as possible, for more then 1 reason. one of which is not looking forward to the beard trim but luckily it grows an inch a month