ALIF L5/S1 Impossible0ne

ImpOssibleOne · #1 (**permalink**) 02-13-2009, 07:10 PM

Hey,

I finally bit the bullet. Had an ALIF on Tuesday at Stanford and all went well.
Took about 90 minutes and the surgery itself was a breeze (for me.) They wheeled me into the OR; one minute I'm chit-chatting being introduced to everyone and the next Dr. Carragee was smiling and saying "You're done!"
The pain was manageable, courtesy of a morphine pump and the nurses couldn't have been nicer. My husband stayed all day with me and that was a godsend emotionally. He simply set up camp; computer/phone/newspapers and stayed till I went to sleep at night. Not that I slept well, the Dr's and vampires from the lab were disturbing me all night long but it was all fine.
By Wednesday afternoon I was only using the pump recreationally so they yanked it and switched me to Vicodin. It works but it's definitely not as much fun.
On Thursday the doctors stormed into my room at 6:20 and said, "You're doing great. Your chart doesn't even look like a surgical patient's. No fever, no blood loss, no nothing. So after a forced march around the nursing station, I was given the boot. It was actually my choice; I really wanted to go home as there was nothing the hospital was doing for me at that point.

I'm still in pain, obviously, but it's not unbearable and I can putz around the house with relative ease. In fact, I made my husband his morning toast today. :-) I'm still a little gassy, eating gingerly, but I don't think that's a reason to remain hospitalized. I'm sure it'll be fine soon.

My surgeon happens to be of the get-up-and-do-it persuasion so I've no brace and few restrictions but when my body begs to differ it has no problem letting me know. All well so far.

Adrienne

treefrog · #2 (**permalink**) 02-13-2009, 07:33 PM

I hope your recovery continues to go as well as it has so far. It sounds like you are doing really well.

mmglobal · #3 (**permalink**) 02-13-2009, 07:53 PM

YAHOO.... great news. I'm so happy to hear that you tolerated the surgery so well.

DON'T OVERDO IT WHEN YOU START TO FEEL BETTER!!!!

All the best,

Mark

dshobbies · #4 (**permalink**) 02-13-2009, 08:50 PM

Adrienne,

You sound like a surgical poster girl. What a great story. Please remember that as you feel better, your body is still healing. Take it slow.

Sounds like you have a great hubby too!

All my best, Dale

Terry Allen Blackburn · #5 (**permalink**) 02-14-2009, 05:08 AM

WOW. Everything sounds good so far. Hang in there, listen to your body about what you can and should not do, enjoy the; "Getting better, every day, a little at a time" scenario. If anything pops up, please ask as, many of us have been down the same road and can normalize the experience for you.

Terry Newton

ImpOssibleOne · #6 (**permalink**) 02-14-2009, 07:21 PM

Thanks everyone.

Well I hit my first bump today which probably had to happen at some point. Maybe all the nerves have finally noticed that the neighborhood has changed and are having to rearrange themselves accordingly.

I always hear you guys talking about the ups and downs so I'm not worried. It also think there's a post surgical euphoria that has worn off. You know..you wake up whole and able to walk, everyone around is relieved and happy. Everyone still is for sure, but now I'm only looking at weeks and months of pain. Plus it's raining.

One question: How do you think Vicodin compares with Percocet? I'm taking the Vicodin but I don't seem to have much tolerance. 1 pill and I'm looped, and not pleasantly so.

Thanks for listening.

Justin · #7 (**permalink**) 02-14-2009, 08:38 PM

Adrienne,

Congrats on being on the other side! Vicodin is acetaminophen and hydrocodone, whereas percocet is acetaminophen and oxycodone.

The percocet is stronger than the vicodin. Everyone reacts differently to different narcotics. I would discuss this with your physician.

Keep your head up and remember it is very early days. We're pulling for you...keep us posted.

mmglobal · #8 (**permalink**) 02-14-2009, 08:49 PM

Amen about the ups and downs.

I'm always frustrated when people post their immediate euphoria, then they don't want to post the negative side of their recovery. I'll call them up and say, "Hey, you are missing an opportunity here... post the negative so people can see what it's like and they won't be so scared when they have a setback!" (They still tend not to post until it's long over, then it's all softened and the fear is gone.) THANKS for posting.

Having said all that, there is a difference between riding out a setback and ignoring something major. If you have a sudden onset of severe symptoms or if your symptoms change dramatically.... it's a question for the doctors if you need to be worked up. I

I hope your setback is short lived and that you can avoid the activities that caused it. I love your attitude that seems to say, "hey what's a few more days, weeks or even months... I'm on the other side of the surgery and on the road to recovery." A year from now it won't matter if you came around at 3 weeks or 3 months or even more. Long term is the only thing that matters here.

I think that the base opiate in Vicodin is hydrocodone while it's Oxycodone in percocet. 10mg oxy = 15mg hyrocodone (Somebody correct me if I'm wrong here! You'll find conflicting information on the internet... take this with a grain of salt and don't look to the internet to tell you about your meds.... talk to your doc!)

runner · #9 (**permalink**) 02-14-2009, 11:49 PM

Adrienne,

I would second that about asking your doctor about the pain meds.
One internet site you could use for information about medications is Drugs.com | Prescription Drugs - Information, Interactions & Side Effects, I found information on there about my medications.
You have to understand that everyone reacts to medication differently, so one person may get relief from one drug and not another. Or the side effects may not be desirable.
Before surgery, I was on percocet as a short-term drug and then oxycontin as a long term medication. So one was short-acting and another long-acting to cover the pain. As soon as I could, I weaned off one drug at a time and didn't have any withdrawal symptoms that I noticed because of getting off of them slowly.

Before I took any medication, I always cleared it with my doctor first. It didn't matter if I had some "extras" in the medicine cabinet, I phoned the doctor first and cleared it with the doctor.

I am allergic to Vicodin and I can tell you that the doc's physician assistant once asked me to take Norco, which is the same drug. I knew that but not everyone would.
So always be alert to what you are taking.

runner

ImpOssibleOne · #10 (**permalink**) 02-15-2009, 03:37 AM

Thanks everyone, for your replies.

How true Mark, all that really matters is the final outcome.
It's like when you're seasick: If you keep your eye on the horizon, far away, the rolls and tosses seem small and you maintain your balance.

I'm beginning to see the bumps will come frequently, maybe many times a day. I think it has to do with the pain meds which don't agree with me. I just find them depressing. My husband (and many of our friends) are ER docs and deal with back pain, though acute as opposed to chronic, all the time. So I'll try different meds out to find the least objectionable.

I'm fine on nothing if I'm doing nothing, but unfortunately rehap requires moving so I have to find something that works.

Terry Allen Blackburn · #11 (**permalink**) 02-15-2009, 04:10 AM

Vicodin is a short acting opiate and tolerance develops quickly where it requires more of the medication to produce the same results. Percocet is the time released ingredient in Oxy-Contin, which has been called; "Hillbilly Heroin", as it has been linked to several overdose deaths from the IV usage of a medication that is supposed to be a long acting opiate. This is all wonderful medication for relieving pain and, sometimes, a double-edged sword. Please discuss the issues, with your medication, with your physician as soon as possible, as it sounds like you are experiencing a reaction to the drug.

Terry Newton

phylly · #12 (**permalink**) 02-15-2009, 05:54 PM

Hi Twin,
I am not doing as well as you yet but I'll be there soon. Your recovery sounds fantastic. Having been through this before I would say to take is easy the first few weeks. Walk and rest a little. Have those around you cluck over you a bit. About the meds, i like the pecocet because it is stronger. I was on a lot of meds prior to surgery so it helps the breakthrough pain. I agree with the others to check with your Dr. before changing the meds. WhAt were you taking before? You might need something less potent. Gotta go PT is here.
Phylly

ImpOssibleOne · #13 (**permalink**) 02-16-2009, 07:49 PM

Day 6

I'm in a lot less pain but the leg numbness continues with a vengeance. I'm finding that if a split a Vicodin in half and take it at 2 or 3 hour intervals, it works much better for me. I can actually follow a movie plot or read a book which makes the time more pleasant. Tried a percocet yesterday and spent the day staring at the ceiling. Bambi meets Godzilla.

I haven't taken a walk outside yet but would feel confidant to do so. It's raining and cold so I just tromp down my hallways. I also think, Vicodin aside, I'd also be good to drive. Can't imagine where I'd go though, I'm still walking very quite slowly and still feel a little too vulnerable to be out by myself.

Meanwhile I have folks coming over with entertainment of all kinds: books, DVD's, games, and GREAT food. In fact my family has never eaten so well. They'll probably want me to do this more often!

ImpOssibleOne · #14 (**permalink**) 02-19-2009, 07:20 PM

Day 10

Yesterday morning was nothing less than hell; I had pain beyond my breaking point, which I've never had before. But by last evening, I was up making dinner for the family. Not really cooking more like arranging the food and heating it. Still it was a big improvement and it goes to show you that the downs do end at some point.

Switched to Percocet in divided doses and that's working better than the vicodin as the vicodin was making me a little anxious. I'm walking (shuffling) 15 minutes twice a day and, more or less, making the best of things.
The weather looks acceptable so I might take a little power mosey outside today.

But for donning socks, I can generally care for myself. Fix a simple meal, shower, dress, etc. I'm even picking up a little around the house, very gingerly of course. I live with men and, as wonderful as they have been through this, the place looks like a frat house.

The best news comes from my cat. She is pleased to note that my incision is healing quite nicely and that she is once again allowed upon her favorite stomach.

mmglobal · #15 (**permalink**) 02-19-2009, 08:31 PM

Isn't it amazing how tender the abdominal incision can be??? I'm glad to hear that you are making progress. One of the ways I knew I'd get better was that the setbacks were quickly recovered from. Before my surgery, when I did something that hurt, I always wondered if this would be 3 days, 3 weeks or 3 months. After the surgery a few hours rest and I was up again. If you had a horrible pain episode in the morning, things must be looking up (our you were REALLY hungry. Maybe medicated? Hopefully, just better.)

Thanks for keeping us posted... all the best,

Mark

phylly · #16 (**permalink**) 02-20-2009, 01:00 AM

I had a similar day today. I think it was overdo from yesterday. Nerves do get inflamed and irritated. Have you tried ice? It really helps me to calm down the area. I hope that you are not tackling too much even rearranging food on a plate sounds like a lot to me at day 10. Try to rest a little.
Phylly

ImpOssibleOne · #17 (**permalink**) 02-24-2009, 06:30 PM

The pain an numbness continue and are still worse than it was pre-op, though the location of the pain has changed. Yesterday my surgeon, though he didn't come out and say it directly, said that my pain should be less than it was pre-op at two weeks. I don't know about that one. Since my irritation was chemical, there were no nerves being impinged, and it's not simply a matter of removing the pressure. It's just a matter of taking out the leaky disc and waiting for the nerves to heal. I think my time frame is going to be different but I walked away thinking I was expected to be playing tennis by two weeks.????

Meanwhile I'm walking an hour/day, in divided moseys of 15 or 20 minutes. Popping 2.5 Vicodin + 1 tylenol every four hours or so and this seems to damp down the pain somewhat. If I take an entire Vicodin, I'm out on the couch.

Otherwise, all well. Got the staples out yesterday, which is nice and I'm enjoying an abundance of bad TV.

phylly · #18 (**permalink**) 02-24-2009, 09:18 PM

I am so sorry that your pain continues at such a high level. I have my stitches out tomorrow and have some questions to ask about the fusion. I wonder if you are taking enough medication right now to help the pain? What about some nuerontin to help with the nerve pain. Are your legs or feet numb all the time? What did your Dr. say about that?
Walking an hour a day is a lot. Do you think that is causing more pain? I count walking around the house walking at this point and then one 15 minute walk outside but I think I will get instructions to walk more.
I can't wait to shower when the stitches are out and I won't need help to cover the incision with waterproof bandages. Hang in there, and I hope each day will be better and better.
Phylly

ImpOssibleOne · #19 (**permalink**) 02-25-2009, 08:25 AM

Yeah, I think the hour/day may be over doing it too. The blurb from Stanford says one should be doing an hour/day at 6 weeks, although my particular surgeon seems to think I should be doing that now. Phily, I'll be curious to see what they recommend for you at this point. There seems to be a wide range.

Tomorrow I'm just going to putz around the house, give the nerves a day off, then go to 15 minutes twice a day for a while. I also need to up the pain meds, i think. I'm hardly taking anything...the equivalent of 2 Vicodin/day at most.

My legs were numb before the surgery but now they're number. Everyone seems to think it's just a reaction to the surgery and that when everything simmers down, the numbness will too. Hopefully.

phylly · #20 (**permalink**) 03-06-2009, 04:22 AM

Hi Adrienne,
How are you doing I have not heard from you. I have continued to walk about a mile each day and then around the house and up and down the stairs. I will up that amount as soon as I can drive and go shopping to help the economy. I don't want to mess this up so I may be aiming a bit low. Are you feeling any better? Please post so we know how you are doing.
Phylly

ImpOssibleOne · #21 (**permalink**) 03-06-2009, 07:29 PM

Phily, I'm glad to hear you're doing so well. I'm doing pretty well too. Walking 25 minutes 2x/day...probably 2ish miles total but maybe less. This is more of a mosey than a walk. I do have pain but I'm taking nothing but Tylenol and very little of that because it doesn't work. I would take the pain meds but I can't stand them and the pain is semi-manageable. I can't wait until I can take NSAIDS. I'd kill for a celebrex.

The really good news is that the leg weakness/numbness is going away. It waxes and wanes, which I guess is part of the program, but last night my left leg felt completely normal for the first time in two years! They're itching like crazy, which hopefully is a sign of healing but at any rate they feel 'better connected' now, which is great. Hopefully the trend will continue!

I drove a little bit the other day, just around the neighborhood to see how it felt. I even gave my husband and son the OK to leave for the weekend as I feel conficent to take care of myself now, though I did send my 70lb dog,with a tendency to over-zealousness, to the kennel.

All well, so far.

ans · #22 (**permalink**) 03-09-2009, 05:09 AM

Wonderful news! Keep it up and Phylly, my best to you. - ans

ImpOssibleOne · #23 (**permalink**) 03-17-2009, 09:53 PM

Nothing much to report. Same ol', same ol'. I seem to have hit a plateau in the recovery and am biding my time. I'm walking an hour/day, but it's really more of a forced march. The one improvement is in sitting, which I can do a lot longer now so it must mean some of the swelling is going down.

I had been feeling some new weirdness on the front of my lower thighs and, naturally, thought it must be another disc level gone bad. They were going over like dominoes! Took me a few days to realize it was caused by the heat given off by my laptop.

In other good news, they say I can start taking NSAIDS at six weeks and I am X'ing the days on my calendar. I so can't wait! Tylenol does nothing and I hate the narcotics...so I'm probably in more pain that I should be right now.

All in all, I'm making progess....albeit slowly.

phylly · #24 (**permalink**) 03-18-2009, 01:03 AM

Good job for you on the walking. Today is Judge Judy and Dr. Phil for me. I cannot get going. I did 1/2 hour on the treadmill yesterday and probably walked too fast but I am determined to try two walks per day after my vacation today. You are inspiring me to get my butt up more. I guess we all have days like this.
I have noticed the sitting getting better also. Are you wearing a brace? I will be happy when I get to stop wearing this. I know it would be okay to run to the bathroom without it but I have the fear of messing something up if I don't put it on whenever I am up. I am glad to hear that you are doing better all the time. Keep up the great recovery and less pain when on the NSAIDs.
Phylly

ImpOssibleOne · #25 (**permalink**) 03-18-2009, 07:26 AM

Hi Phily,

Can't quite stomach Dr. Phil; my thing is Desperate Housewives. Actually I have a lot of 'things' with so much time to fill but even I was stranded on a desert island where the only cable channel is the Dr. Phil Channel, I couldn't watch that man.

No, I'm not wearing a brace and every time I hear about someone wearing one I sit up a little straighter. I wonder if I should have. I think my body lets me know if I'm doing something really stupid but you never know. Sometimes I think I should wear one at night. Each night I fashion this elaborate pillow construction designed to keep my spine aligned and every morning I wake up with the pillows all over the floor and me twisted up, all comfy, the way I like to sleep.

How nice you have a treadmill. I either have to pace my house or trudge the hills. Ick.

ImpOssibleOne · #26 (**permalink**) 04-10-2009, 10:23 AM

I flew to Seattle (2 hours) from the Bay Area with my son. He got into a couple of great colleges up there and there was no way I wasn't going with him to help him decide. I didn't check with the surgeon, I figured I'd just bite it and spend a few days on ice when I got home.

It hurt needless to say. The flight, the long car ride, Seattle to Portland, etc. First day was OK; I hobbled in and out of cars and across campuses. The second day found me lying in the back seat, on campus lawns and admission office couches. I hurt in places I didn't know I had body parts. I thought I had blown a gasket. There were even a couple of toes I couldn't feel. Went back to the hotel that night, downed a couple glasses of wine (the size of Lake Superior), iced my back, went to sleep and woke up....fine. Better than fine, in fact. The last campus in Portland was hilly, damp and huge. I hurt some but I was at the front of the tour group, attentive and happy the entire hour and a half.

Sometimes it seems that if I have a really bad day, the next day is better than baseline. Maybe the body's natural pain killers kicking in?
I still hurt for sure; the recovery is slow, but it seems like the setbacks are shorter than before surgery.

I see the surgeon Monday and am slated to go on a trip to Hawaii on Tuesday. (Husband's medical conference) But I'm a little leery of a five hour flight....and even more leery about leaving my high school senior home alone. On the other hand, Mai Tai's are very theraputic. I will get the surgeon's opinion on this trip however.

Anyway, at two months post ALIF, I was able to travel and came back no worse for wear...except for the pain of finding out how expensive college will be.

Cindylou · #27 (**permalink**) 04-10-2009, 01:07 PM

Good for you. Glad you were able to make the trip with your son to look at colleges, even through the grit of pain. You know, you may look back one day and only remember what a rough day it was for you, however, when your son looks back one day........and he will, the only thing that will really stand out in his memory is the fact that you were there. He won't have a clue how much pain you were in, so God bless you for bucking up and making that lasting memory with your son. And big bonus that you actually felt pretty good the next day. I do believe precisely what you said about the bodies natural pain killers kicking in. Absolutely. I'll be curious to see if you do the Hawaii trip! Hang in there.

My best,

Cindylou

dshobbies · #28 (**permalink**) 04-10-2009, 05:27 PM

Glad your trip didn't do you in. Now you know that ice, both on your back and in a glass help a lot... when you go to Hawaii, see if you can find some of those cold pacs that have the chemical reaction. You break them or shake them and they get cold??? Bring a lot of them with you and use often. They might just do the trick.

About leaving a teen-age son at home alone

. Can't help you with that one. Damned both ways.

Happy flying, Dale

ImpOssibleOne · #29 (**permalink**) 05-14-2009, 07:08 AM

I am better than I was pre-op but I really can’t say whether it’s because of the forced marches et al. my surgeon made me do or the surgery itself. While I can do more than I did before in terms of walking, sitting and such, there are times when I feel every bit as badly and in the exact same way as I did pre-op.
But those episodes don’t last as long as they did pre-op. I don’t know if it’s because that when I have a bad episode, I just keep going now rather than succumb to the couch or because I can go on now because something is ‘fixed’. Just don’t know.

So anyway, at three months post ALIF, I’m walking 2 – 3 miles/day but at about a pain level 3. I ice afterwards and recover quickly. Leg strength is better but the numbness remains as before. Bending, twisting, squatting still set me off and my hips hurt like hell.
The xrays indicated I’m fusing quickly, months ahead of schedule in fact, so I’m taking a few Advil per day. Also a 2.5 Valium at night to sleep but nothing else unless you count a stiff chardonnay with dinner.

I could probably work, as long as I had a lot of physical flexibility. My energy level is fine but it really took all three of these months to feel that I had completely regained my it.

Anyway, I’m better and more active but the jury is still out as to exactly why. If I had to put money on it, I’d say the recovery was due to the rehap, my ‘it’s now or never’ attitude and feeling post-op just HOW painful back pain can be and realizing mine maybe wasn’t so bad after all. The most important component is that I don’t have the weakness now. Now it’s just pain so I keep going. I don’t fear losing my legs and that makes all the difference.
A few years ago, I was very active running miles a day and lifting weights, etc. So when my back went out I reasoned that I should do the opposite and sat down. And I stayed there for two years. I probably should have walked or done whatever to my capacity. There’s probably something to be said for keeping your muscle tone up and staying as active as you possibly can.

All for now. Maybe I’ll have something more definitive to say next month. Or maybe I’ll never know why I got better. Maybe it doesn’t matter.