Saturday, December 31, 2011

OUTLASTING THE DAY

I made it!! Yes, I did my entire two-plus walking miles tonight without having to make a pit stop for an energy recharge! All that on top of going to Winter Park (Florida) this morning to view an exhibit at Polasek Gardens, have lunch at Panera Bread with my dear husband of almost twenty-six years and to walk about ten blocks doing some after Christmas shopping. Yeah for me, I was able to sit for about 45 minutes in one of those high padded stools at a table while eating...and I had no pain!! I even had a somewhat comfortable thirty mile ride to our destination...and back. Seems like I'm ending the year on a good note. Not to say that the year has been bad. It hasn't. I'm still healing very well from my October 2010 back surgery fusion and I'm on the road to healing from this current surgery. There have been some serious downs during the past fourteen months, but they, thankfully, don't outweigh the ups.

I did buy a new pair of walking shoes today. Doesn't seem like a big deal to those who have not had back surgery, but it's a major thing to me. I've been wearing a particular type of walking shoe for nearly eight years...not the same pair of course. I love the brand, comfort and price. But, woe is me, they are no longer made...so I stopped at my favorite shoe store on the way home from Winter Park and was able to find a comparable pair. They are comfortable, but they are different. Different enough that they did cause a bit of muscle pain in my low back as I was walking this afternoon. I don't think, though, that they will cause an permanent problem while walking. Hopefully I've found my new 'favorite' walking shoes. If so I'll be going back and buying several pairs.

As with last year, I've noticed that there are times throughout the day when I literally feel no discomfort or pain in my back. It's a good feeling to not be constantly reminded of the surgical trauma and resulting titanium screws and rods that have invaded my body. Sometimes I almost feel 'normal'. The new normal though. I know that eventually I will have back to back days that there won't even be a twinge of anything in my back to remind me of the surgery. But until then I do pray for the strength to mentally and physically get through all the tough times.

At the advice of a friend, I tried Tylenol PM (a generic form) last night to help with sleep. I only took 1/2 of a pill along with 1 extra strength Tylenol (a generic form). I did sleep very well and was even able to sleep for a bit on my left side with a  pillow between my legs. That is a milestone for me!! Of course this evening, with all the early New Years revelers lighting off all sorts of illegal fireworks well into the new morning hours, sleep might be elusive regardless the sleep aid.

Stay safe this night...see you in the New Year.

Wednesday, December 28, 2011

MOVING ON UP

Well I made it six hours at work today even though my sleep is still not good. I did feel I had a bit more energy, which is a good thing right now. My walking routine is continuing gangbusters, as is the stationary bike at the YMCA. The improvements are small increments, but improvements nonetheless. I am grateful.

If you are getting ready to have spinal fusion I truly hope you are both mentally and physically prepared. You must committ yourself to the physical therapy, whether it is self-directed or doctor scheduled. Having gone through this twice I know that my attitude towards the therapy/exercise part has been what has helped me heal and remain somewhat flexible and able to eventually do just about everything I was able to do before both surgeries. Yes, you'll change the way you do those things, but you will still be able to do them. So please don't get discouraged if you begin to feel that you aren't making headway in your recovery. It happens to all of us. I will continue to take two steps forward and one step back...this I know from last year's experience. But it eventually did work out. I know it will again. It IS hard. I promised to tell you the truth, which I feel I have done to this point. You deserve to know what to expect, not just what a doctor/surgeon tells you to expect. Let's face it, your surgeon probably has not been through the surgery. He can only tell you what clinical information he has learned. There is no fault in that. It just is. My hope is this blog will continue to help you as you face this surgery...and as you recover....successfully.

Sunday, December 25, 2011

MERRY CHRISTMAS

Incisions five weeks post surgery 12/25/11
If you're still with me I wish you and yours a very Merry Christmas. Didn't think I'd be spending my second Christmas in a row recovering from back surgery...but that's the way it goes.

Overall the past few days have been pretty good. I went to work for almost six hours on Friday (23rd), then grocery shopping, which was quite a harrowing experience. Everyone running around paying no attention to other human beings...and those of us with back surgery on our mind and body. I almost left the store because I was so afraid of being knocked into. Sounds very high-falootin', doesn't it? But you'd understand if you were in my position. Those little bumps magnify to your back and are quite painful sometimes.

Yesterday (24th) was my best day yet since surgery. Literally no pain or discomfort for most of my waking hours. I was able to 'work' in the yard for a couple of hours. That work consisted of picking up sticks/twigs with my handle Grip-n-Grab and putting them in the trash can. And I did some supervising of my dear husband as he weeded one of the flower beds. Yes, it is still in the 80's here in Florida and things are still growing gangbusters. Also used my lightweight (bought after last years surgery) leafblower to get the leaves off the front porch and driveway. It felt good, both mentally and physically, to 'get back in the yard'. Of course, I ruined a great day by trying to max and relax, as my husband says, on the living room couch. I honestly thought my back was ready for the cushy couch...it wasn't...and in a bad way. I barely lay down for ten seconds and knew it wasn't right and tried to get up. Had to leverage myself on my side and  push off a chair at the edge of the couch. My husband was right there in case I rolled off the couch. That set off a chain of events in my back that led to a lot of pain at the new fusion level and in my right hip. I hit my bed after two extra strength Tylenol...getting up two hours later to take a Vicodin. Ugh...one step forward, two back. On a bright note, I had a fairly good night's sleep. Maybe I was knew I had to sleep because Santa wouldn't visit if I was awake.

Five weeks post surgery I am slowly getting back into a normal daily routine, even making a full dinner the past two nights. I'm walking a minumum of two miles a day, doing at least sixty stairs daily and keeping up with all my leg lifts and stationary marches. I've added a hamstring stretch against the wall and that feels really good. I'm still having a hard time putting on my socks from either the standing or sitting position. My back muscles get quite tense and sore after I've been moving for a few hours. My legs get quite weak after walking for a period of time, although my cardio is just fine. I'm trying to figure that one out. It's something I'm going to ask my surgeon about during my January 9th follow up. Otherwise I feel I am progressing at a decent pace and am so thankful for this.

Wednesday, December 21, 2011

PUSHING THE ENVELOPE

Tried work again yesterday morning. At least I'm trying. I was able to get in a good 4 1/2 hours before my body revolted. My head wanted to stay, but I thankfully listened to my body. Slept a couple of hours at my in-laws while waiting for my husband to finish work. Did I mention we both work at the same place and for his parents? This fact has made the recoveries from both these fusions so much easier, as I don't have to worry when to go back to work, I can set my own hours and I can get to all the after care appointments with ease. I am so thankful for this situation. We did go for a walk last evening. Can't miss my walk. However, after doing half the normal stair climbing and not really resting after one mile, I was one low-energy, weak-legged fusion patient. My cardio is just fine...my energy still highly sucks. I tried to put on a happy face, as I told myself that at least I accomplished something by going to work...but by early evening I was in so much pain I broke down and took 1/2 Percocet. My right hip was on fire and my low back was aching the worst since the day after surgery. It feels like a setback, though I know I just overdid it. I'm still having extreme trouble with the whole sleep process...maybe it's the pre-menopause thing going on too along with this recovery. But I am not able to get a decent  night's sleep. It's that simple. I do not want to take any type of sleep aid, as those highly interfere with anti-depressants. However I am also unable to really work out hard in order to get that exhausted feeling for a really good night's sleep like before the surgery. It's a catch-22. I guess if that's my only complaint at this point in my recovery then I am lucky. My sleep clock will reset itself once all this mumbo-jumbo with recovery is on the wane. Until then I'll continue counting sleep....err.....sheep.

Sunday, December 18, 2011

FILLING THE TANK

I'm sitting here watching my husband through the back sunroom...he's cutting down palm fronds on our three huge Queen Palms in the back garden. I want to cry. I want to be out there with him helping. The garden is my domain, my piece of heaven. There's a part of me that feels he is invading something private. He won't let me help with anything to do with the yard or garden. And, sigh, he is right. He is so right. You will find there are many things you just have to wait to do again. It will be hard, very hard, to temporarily give up the things you love to do, those things that make your soul feel alive and your spririt sing. But the sweetness of slowly going back to those things truly does make the wait, the patience reluctantly tolerated and learned, quite satisfying for your being.

My experiment went badly this morning. I tried to 'sleep' on my right side, very carefully positioning myself to be in perfect shoulder/hip/ankle alignment with a slight bend in my knees. It was not uncomfortable...until I turned over on my back ten minutes later. The pain in my right hip was sharp and throbbing, the post surgery/recovery room type of pain. A full half-hour later, which the time was spent trying to calm myself and apologize to my body for trying to do something I shouldn't have tried so soon, I gingerly got out of bed and started my day at 9:30 a.m. At this point the pain has subsided and I made a promise to myself to wait awhile before I try the new position again.

I lasted a full five hours at work on Friday (16th). Yeah for me. Pain was minimal, nothing a couple of extra strength Tylenol couldn't take care of. I was actually able to concentrate on the tasks at hand and got a lot done. My stubborn streak was saying "just stay until the day is over at 3:30 p.m." The learned, post/past surgery experienced part of me said "STOP! Go have a rest at the in-laws house." The latter voice won out and I am glad it did. I had enough energy in reserve to stop at the nail salon on the way home and get a long overdue pedicure. It's the little things that keep me on the right side of the human experience.

There is still a fair amount of achiness in the general area of the surgery. The muscles around the top of my butt crack (for lack of a proper medical term) are very sore at times. I'm guessing the insides are trying to get used to the invasion of the screws and rods and the fact that what little movement was there pre-surgery is no longer available due to the fusion. Sitting is becoming less of a problem, though the car ride in our particular vehicle (2001 Ford Explorer Sport) is still not as painless as I would like it to be. Most chairs are okay as long as there is not too much of a cushion. I can attest to the fact that if your hips are lower than your knees the pain will come....I've read that several places. I was actually able to have breakfast with a dear friend of mine yesterday morning. We even did a bit of Christmas browsing afterwards and enjoyed sitting outside Starbucks for nearly forty-five minutes enjoying our festive, over-priced drinks. You see, little by little you will get back into 'life'. It will happen slower than you wish, but it will happen. You must, though, keep up your exercises...walking, stationary bike, stair climbing, leg lifts. Even on the days when I've been at my lowest, in both spirit and energy, I have done ALL the recommended exercises, therapy, rehab....whatever you wish to call it. I cannot stress this point enough. Now, go out there and do one thing for your soul today....

Thursday, December 15, 2011

THE LIST

I am blessed with and grateful for:
-my health
-my sanity
-my loving husband
-my friends
-my faith & spirituality
-my job
-my home
-my sight
-my hearing
-my mobility
-my sense of humor

Incisions: 12/15/2011
Four  weeks post surgery
These are all I need to continue on my healing path after these two surgeries barely more than a year apart. Today marks one month since fusion surgery of my L5-S1. It has been up and down...honestly, more downs than ups. But this seems to be the normal m.o. for these types of procedures. This year I am in much better mental state. I suffer from depression and anxiety....to a degree where it can be debilitating to live a normal life. Right before last years' procedure I was once again getting back on my anti-depressants. For anyone who's taken that road you can relate to how hard it is to get on these types of meds. Long, short: I've been on and off Lexapro for four years, thinking, when I was 'well', that I didn't need the med. Once off, the cycle of depression would begin again...the elevator heading to the bottom floor. As you know I am very anti-med of any kind...however I have totally given in to a death-do-us-part dependence on anti-depressants in order to maintain my sanity, my life. The whole story is fodder for another blog...but I'll leave that to others. Suffice it to say, my recovery last year was much prolonged because of my mental status and frequent severe anxiety attacks. This year, thankfully, has been much easier on the mental front. Yes, I've still had some minor episodes of frustration (depression?) over the length of time it takes to 'get on with it'...my regular/normal life as it was/is. But even those folks who don't suffer from clinical depression also go through issues post any surgery. It's in my handbook and a common acknowledgement when you are hospitalized, as they do offer mental counseling services as part of recovery/treatment. This is why 'my sanity' is listed as one of my blessings. I don't think the other items in my list need any explanation.

Wednesday, December 14, 2011

ASSUME THE POSITION

Credit: TBWA, Paris
How many times have you slept through an entire night and never changed sleeping positions? This is a problem after back surgery and is why I am having such a hard time maintaining a deep sleep. You see, when you have active dreams you actually do physically react by, well, moving in your bed. Simple. Right? I'm no scientist but I can attest to the fact that my brain is constantly 'on' when I am sleeping....in a subconscious sort of way. It will not let me move in reaction to any dream/stimulus or in an effort to get my body into a more comfortable position. I usually fall asleep on my back. That's been my normal position all my life. More often than not I wake up on my right side, hugging a pillow. I get there without knowing when, how or why. It just happens. However, now as I 'sleep' I am fighting myself to not react normally in my 'sleep'. This constant fighting is what is keeping my real sleep to a minimum...and it's damn frustrating! You might be saying, "Why don't you just turn over on your side?" Folks, you can't just do that...the low back is not sturdy enough yet to support that type of involuntary turning without a great deal of pain (I've tried). Next time you toss around in your bed try to make a mental note of how many limbs and muscles you are using to make the moves. The low back muscles are highly involved...mine are too darn sore and weak yet to be of any help. Sounds like a minor whine to you...but I had to post so that other back surgery patients know this is normal. This non-movement during sleep also happened after last years fusion. I have re-read my daily notes from that time and did not notate when I was able to finally sleep on my side...but it did eventually happen. I was sleeping/turning/moving/running away from monsters right up until this years surgery November 17th. Sweet dreams.

Monday, December 12, 2011

NO CAFFEINE...STILL NO SLEEP

Sleeping is way overrated. I say this because it's becoming an elusive thing in my life. It's not the meds, as I am only taking one Vicodin at around 6:00 p.m. every night, two calcium suppliments, one B-complex vitamin and my 10mg Lexapro. And, no, it's not the anti-depressant causing the insomnia, as I've been taking that for almost four years. I was able to sleep quite well last year, even with occasional severe anxiety attacks. This year, though, is just a total mess. Overall I'm trying to keep 'active' all day and not nap at all. It is hard to sit in a chair for any length of time, so I have to resort to my bed when I am not up walking, doing dishes, piddling around the house, etc. I read when I am in bed or watch some type of cooking show. And, yes, I do make a daily pilgrimage downtown to the local coffee shop for a small decaf, which I take an hour to drink while I read whatever newspaper is available for public perusal. Still, falling asleep, even with some type of Steve Halpern cd in the background, is just not happening. It's beyond frustrating!

I'm still having a lot of discomfort all around the surgical area. I can say that I've had many bouts of impatience this weekend. Looking at last year's log after my L4-L5 fusion I see that the discomfort went well into the three month post surgery period. So, I'm guessing this is normal. I did thirty minutes on the stationary bike yesterday at the gym. IT FELT GREAT!!! I was sweating and had NO PAIN during or after the session. I walked a little over three miles also and did all the stair climbing and stretching exercises as outlined in the post surgical handbook. Of course, by evening I was aching a bit....about a 3 on the 1-10 pain scale. To top off the day...yes, ladies, you will agree with this...I was finally able to shave my legs!! It's been nearly four weeks since the last shave and it wasn't pretty. My husband had to put the shaving cream on my legs, but I used the handy tool he made for me, propped my leg up on the toilet seat and...you know the rest. What a great feeling it is! It's these little things that get you to feeling more and more human the days following surgery. I have to keep reminding myself, and you, that this recovery is long term...at least one year. Seems like forever...

Friday, December 9, 2011

NO OVERTIME

Four-and-a-half hours. That is as long as I made it today at work. The forty minute car ride is not included in that time. I ran out of energy very quickly and ended up napping for a couple of hours at my in-laws home which is only four miles from our work. My husband finished out his day and we came home. I am trulyl hoping that car rides will become more comfortable as time passes, as it was an extremely painful ride home. The very end of my tailbone, where the new screws are, just ached and I got several jolting 'electrical shocks' to that area while riding home. We still went for a two-mile walk and I did the stairs and other therapy exercises. But I barely made it home. I had a few muscle spasms in my mid-left back. I do feel a bit discouraged. I know there are ups and downs with this. But I felt as though I was making rapid advancement and just like that I feel like it's only been a couple of days since surgery instead of three weeks. I would like to see some kind of study that explains why your energy level(s) wane so much after surgery. And truthfully this really isn't a major surgery in my book, as it is done on an outpatient basis. Maybe it's my impatience that makes this so hard to accept. I am so car ride shy that I even begged off going to the gym for bike riding tonight. Even though it is only four miles from our home I just am not in the mood for that kind of pain right now. I'm headed for the shower and an early bedtime tonight, as I only slept about five hours last night. Goodnight...

Thursday, December 8, 2011

GLUTEUS MAXIMUS WAS NOT A ROMAN CENTURIAN

Slept in until 10:30 a.m. this morning. Ugh!! Makes me feel like a slug...a sore slug. I guess I needed the sleep. We hit the gym (YMCA) last night for this first time post surgery. I tried the stationary bike for twenty minutes at a very low resistance. Got a pretty good heartrate going....I really love a good cardio workout! Figured I would try a mile or two on the treadmill....NO GO!! Extremely painful even at a snails pace. I was unable to do the treadmill after last year's surgery for about five months. I could/can walk all over town, even the sometimes challenging hills, but the treadmill is just plain painful right now. So, I abandoned that after one-and-a-half minutes. We came home and walked about two miles in the neighborhood instead. No problems. Overall I did almost four miles yesterday. However, this morning my butt muscles and deep down in my hip bones, for lack of a better description, were very sore. I'm guessing it was the stationary bike. It's amazing to me how quickly one falls out of shape when not doing a normal exercise routine. I don't mean gaining weight (which I haven't, lost four pounds) but just the overall fitness that goes so quickly. I know I'll build back up to an hour-and-a-half workout over time, but it's still a bit hard to accept right now. I promised myself and my husband to NOT push it too hard this year...let nature take its healing course as it always does.

The day wasn't a total waste even after having awaken at such a late hour. I did some computer stuff, ate breakfast (at 11:00 a.m.), wandered downtown for a cup of decaf, read a great deal of the New York Times, hit the post office, did the stair climbing exercise at the park, watered some yard plants, showered, cleverly wiped up some cat yack off the floor, read for about two hours, watched some television, ate dinner and am now posting. We're going to walk a couple of miles after I'm done here. I'm still doing one Vicodin late afternoon...the pain just builds up over the day to a point where I need instant relief, not only for peace of mind, but in order to help me sleep pain-free. I need a good night's sleep tonight because tomorrow morning I will head to work for a few hours for the first time since surgery three weeks ago. The forty minute ride to work will itself be quite a challenge....

Wednesday, December 7, 2011

YOU'RE SUCH A TOOL

Thought you'd like to see how well the scars are healing. I am so thankful the swelling has reduced so quickly this year. One of the most painful parts of this surgery is doing the log roll in and out of bed and the pressure that occurs on the areas that are swelled up. Your bed is not as soft as you would like to think and those swollen pressure points are the worst part of trying to get comfortable in bed. The surface bruising appears to be gone. I do feel a lot of deep tissue pain at times. There area at the L5-S1 fusion level is very sore at times...deep down sore. It did not hurt at all until a couple of days ago. I will guess this will pass too.

You will have to make a lot of adjustments to your lifestyle after this type of surgery. It is inevitable. You just have to accept that. Ladies, even with adding a routine of flexible stretches I will contend you will not ever shave your legs the same way again. Luckily my dear husband is a machinist and man of many design talents. I described what I needed in order to shave my legs and in about an hour or so he made this holder for me out of aluminum tubing. The one end is slightly crimped in order to accept a rubber handled disposable razor. It's a friction fit that works just great. He painted it with rough textured black paint and put grooves in the end for a better grip with wet hands. I intend to use it the rest of my life, as I want to put as little stress on my low back as possible in all areas of activity. I've used this several times and it works just great.

A tool that you should have around your home regardless if anyone has had back surgery is something like this Grip 'n Grab. I bought this last year before my previous surgery. They are about $25.00 and are available at Lowe's and other stores of that nature. The ones advertised on television are twice as expensive as this one and they both do the same thing. I use it for everything! When I go back to working in the yard I will pick up sticks with it...again. I can lift the food bowls for refilling for the cats, the towels off the floor, position my shoes for putting on...everything. The rubber tips help to keep the heaviest (about 5 pounds) objects from slipping from your grip. Please get one of these before your procedure. You will use it. Why not make your life easier while you are recovering.

Tuesday, December 6, 2011

LOOSENING UP

So yesterday I totally overdid it. Period. My fault. My pain. Period. I am someone who has to do something everyday. Can I sit around and read all day? Well, yes, if I have to. But more likely than not I like to keep moving. So you can clearly imagine how this surgery puts so many restrictions on me and my daily routine. I post this because I want you to realize this is what you will face if you are an active person who is scheduled for this type of procedure. I can't speak from the viewpoint of a someone who just likes laying around all day. So, if that's you then you probably don't want to read this post. I also have a creative vein or two running through my body. The outlet for that has always been my garden. But since I am unable to do any type of yardwork for at least three months, I fell back on my other outlet....baking. Which I did for six hours yesterday. Yes, six hours on my feet on top of walking nearly three miles. I ignored the pain until I finally broke around 6:00 p.m. I took a Vicodin and Robaxin and cried. I went against all I know to be right, all I know the surgeon told me not to do and paid dearly for it. There is a bit of solace in this mindset though...I am normal. That was proven by this series of YouTube videos by Dawn Underwood. These are excellent and she's a fellow patient after my heart. She, too, overdoes it and pays the price like I did/do. I highly recommend her series. I have watched most of them and can say they are as close to the real experience of spinal fusion surgery as I've read or seen.

As for me, I will be okay. I spent most of the day reading in bed, did some dishes and walked almost three miles...not all at once. I am in a bit of pain as I write this tonight. It feels like a few inner things are loosening up and I have some muscle pain in both buttocks and upper back. I'm actually going to a city council meeting tonight for the first time in over a year. I quit going last year before my surgery and was just not in the right frame of mind or physical condition to go again until now. Plus, I was a fiend with my workout schedule post first fusion last year and didn't want to miss one night. Hopefully, I can sit there for a while without screaming in pain....not from the surgery but from the idiocy that occurs in government at all levels.

Monday, December 5, 2011

SLOWING DOWN...CATCHING UP

Certainly I must be getting better by now. Yesterday, though, really whacked me hard and I honestly don't know why. I did a couple hours of work work for my job, a bit of reading and went grocery shopping with my husband for the first time since surgery. And, damn, if I wasn't totally out of energy by 3:00 p.m. I did take a Vicodin at noon...just couldn't hold out any longer. But otherwise it was what I would consider a slow, lazy day in my book. Yes, yes, I know I am recuperating and there is a reason why they tell you to take six weeks off from work. There is also a reminder in the surgery handbook that states something like 'just because you are staying home that does not give you an excuse to engage in home chores and regular activities.' Yeah, I know. But I gotta be me...and that just sucks sometimes because I am such a go-go-go person. My mind is running but my body can't keep up right now. It's a hard compromise to make. We did eventually walk downtown late evening in order for me to do the stairs in the park. For the first time since surgery I honestly thought I was not going to make it home. My legs were like jelly and I had odd pains everywhere: my buttocks were sore, my right side was going into muscle spasms and there were all sorts of 'electrical' twinges around the incision areas. It was quite scary and humbling. The body will tell you when it is done. It will tell you to slow down. It will shout at you to give it a rest. Sometimes I'm just hard of hearing and my body makes me slow down to give it a chance to recoup. When we got home from the walk I took another Vicodin and a Robaxin (muscle relaxer), cleaned up and hit the bed. Ahhhhhh...never more happy to be in my own bed.

One of my favorite authors Michael Perry states in his best selling book Truck: A Love Story: "We are in possession of a machine that is set on self-destruct." That, my friends, is our body...plain and simple. Those of us who have gone through any surgery need to be aware that as with any machine we must treat it with kindness and try to get the most miles out of it. It is up to us to listen to the doctors orders...to heed them fully and not rush the natural healing process. I have to write this to myself so I can read it and it will sink just a bit more into my hard head. My husband stated the obvious last evening; "Yes, the doctor said you could walk all you want....but I don't think he meant all at one time."

Saturday, December 3, 2011

PARADE MARCH

Pain minus a narcotic pain killer really does suck! Does this mean I'm an addict? Well, I know I'm not, but I do know this much...it's nice to have a stash of the good stuff just in case you really need them. As I mentioned before I had a lot of Percocet left over from the last surgery because I had been given two separate prescriptions...one at the emergency room two weeks before surgery and one after surgery. Total number of pills was 160...yes, 160. I eased myself off Percocet last year by extending the time interval between doses and finally taking smaller and smaller doses...until, ta-da, all was okay. That took about four weeks. I had dozens of pills left over that came in real handy from time to time the few months following the surgery when I would really overdo it and have severe pain that extra strength Tylenol just wouldn't take care of on it's own. Right now I do not have enough Percocet to ease off like before (even though I had begun to schedule longer intervals between doses a few days ago as part of easing off) and I can say I am in a slight panic mode. I truly thought the surgeon would give me another prescription. Can you just stop these things cold turkey or do you need the easing off? Trust me, I am getting pain now in areas that were before void of pain at all. It is not fun. And, trust me again, the extra strength Tylenol is NOT taking care of the pain. My husband said that maybe having the pain to remind me I am still recovering is a good thing because I have a tendency to overdo it and could do damage to a fragile surgery that needs time to fuse/heal. I know he's right, as I did overdo it today by walking downtown, doing the stair climbing exercises (5 times) and standing on my feet for nearly two hours to wait and watch the Christmas Parade. Then I came home and did some much needed edging around the lawn....just overall a bad day with pain as the cherry on top. I know I'll get past this pain problem. I did last year, but have to admit it was much easier with the narcotic pain meds. The plus for today is...no pain in my right hip at all!!! Yeah!!!

Friday, December 2, 2011

DAY TRIP

Two weeks post surgery! I've made it this far and went even further today than I have in two weeks. My follow-up with the surgeon was this afternoon. I was a bit apprehensive about the car trip, as it is a forty mile ride. It was quite difficult getting into the car and took me a few minutes to properly adjust the seat and my 'quilted blankie' that I use to support my back while traveling. But, we made it with minimal pain, even though they are doing major road work on the highway out to the hospital....and you know what that means; lots of bad road to bridge transitions and rough paved detours. Yeah, those little bumps that the rest of you take in stride are like lightning bolts in the backs of those of us who have had back surgery.

Three x-rays were taken of the newly installed hardware. All looks quite good according to the surgeon. I trust him implicitly, as he's been doing this for thirty some years. The only thing I could discern from the x-rays was a 'lump of coal' in my intestines. Anyway, he was pleased with the results. We showed him and his assistant the blisters and the areas that had blisters that already burst and were healing. They both agreed that I reacted to the Dermabond and the full skin adhesive that was applied. Otherwise there is no sign of infection and he was pleased at the healing advancement of the incisions. I can say that the swelling has gone down significantly and very light bruising is all that remains. I showed his assistant the photo of the bloodied gauze post surgery and she stated that that is normal is some circumstances. The pain in my right hip should go away in time according to the surgeon. I know that it did last year, but I am always on alert and state the problems so they are notated in my medical records. He stated the obvious, which is there is a whole lot of internal swelling and pinching going on all over and near the surgical area and it takes time for all of this to slowly go down, hence pressure will back off certain nerves/muscles and pain will be relieved. This photo was taken this morning and does show improvement, don't you think? The best news I heard, though, was he cleared me for riding the stationary bike and for swimming. And he said I could also walk as much as I like..which I've been doing anyway, pain/discomfort allowing. That is my early Christmas present and the only one I need this year.

I did ask for another prescription of Percocet and the doctor stated that I can now switch to extra strength Tylenol, saving the remaining Percocet to aid in sleeping on those nights when the pain might be elevated. I actually felt good enough to stop and eat lunch with my husband at Panera and I did a bit of walking across the parking lot to the Best Buy to purchase some laptop accessories. This is the first full day out for me since surgery November 17. I did get a bit achy on the way home and was nearly out of energy upon arriving home around 4:00 p.m. It was a long day for sure and did reinforce the fact that I am still recovering and my energy level is still not near 100%. I should sleep well tonight.

Wednesday, November 30, 2011

STREET WALKER

Missed posting yesterday due to intense pain in right hip. Could barely sit for any period of time and standing just sucked. I was able to walk downtown and wander for a little over two miles, do some window shopping and do the stairs at the city park. I am looking forward to the two-week follow-up appointment Friday in order to ask about this right hip. It doesn't hurt all the time, thankfully. However, it does catch me in mid-stride with a severe 'jolt' and leaves me breathless for a moment...then my heartrate increases and I freak out a bit. While reading last years daily notes I noticed I was have the same problem with my left hip/leg for at least two weeks. So, here's to hoping this is transient.

I've cut back on the frequency of the Vicodin. It's been almost 48 hours since this change. I am taking a Vicodin every six hours and a Robaxin (muscle relaxer) every twelve hours. Seems to be working out okay. I did, though, just get a major twinge at my right low back when I tried to push myself away from the table after dinner. Felt just like an electrical shock!!! Has me a bit freaked....everything has been going so well. Maybe I am taking things to fast and trying to do too much. Yes, this is major surgery and, yes, sometimes I do forget that. Here's to hoping I didn't do any damage with the chair pushback. I know these seem like trivial things to someone who has not undergone this type of surgery. I hope you never have to find out just how much your back is involved in everything you do every day of your life. For those of us in this temporary position, we must remember we can't do normal until we get back to normal, whatever that level of movement or flexibility will be. We will never be the same as we were before surgery. But, trust me, your body and your mindset does adjust to the new norm. We are an incredible miracle, aren't we?

Monday, November 28, 2011

RADIATION OVERDOSE

It's late afternoon and very grey outside. The first rain we've had in quite awhile. I was ablel to get in about one mile walking today before my right hip began to hurt. It truly seems to be a tendon related thing, as the pain is only there when I plant the foot while walking, then take the step. The pain is when the leg is in motion. As with last year, I have a different stride because of the different mechanics now in my back. People I work with actually told me last year that I was walking differently. Now I guess I'm going to have to learn a new stride all over again. That is fine with me as long as there in no pain involved.

I feel I am finally in a normal sleep pattern for right now. I do NOT nap during the day like I was doing for the first few days. My husband went back to work this morning for the first time since my surgery. I was actually a little apprehensive about that last night. Although I would like to think I am okay on my own and fully mobile...well, the first thing I did this morning was lock myself out of the house when I left for my walk. Like any good exacting person with anally retentive tendencies, we have a hidden key outside the house. Now, I won't tell you where it is, but I did have to McGyver my way to getting it up to my level, as bending is a no-no not only for now, but for the rest of my life. It took me a couple of minutes, but I did it!!! After a VERY careful shower out in our garage...yes, we live in an old home that actually has a full bath in the garage and even is air conditioned and heated...I proceeded to be 'helpful' to air out the bathroom by trying to move a low floor fan in to dry the shower enclosure. I now have a nice bruise on my right big toe where I dropped the fan that I was trying to carry with my 'fingers on a stick'. There is a reason it says they are rated for five pounds. But I persisted like a bad Monty Python sketch...and that fan got nudged and bumped all the way into the bathroom...I put 'repaint scratch on door jam in garage bath' on the honey-do list. Don't ask.
Here are the pre and post operative x-rays of my back. The first shows the L4-5 fusion from last year. The great thing is that you can see some fusion taking place in the implant disc area. The other two are the posterior and lateral view after the L5-S1 fusion hardware is in place. You can barely see the rods in the first picture, as they were PEEK (Poly Ether Ether Ketone) plastic, a medical plastic that is now a norm in fusion surgery. The latter two photos show that the PEEK rods were removed, with one solid titanium rod now running continuously through the two levels of the fusion. There's just something in my head that keeps telling me I am more solid right now with the titanium. Yeah, it's probably just me, but I do feel better about the changeover. There are folks that have had the rods/screws/hardware removed for various reasons. Of course, there is no way that can be done until a FULL fusion is achieved. I truly believe that the fusion bone will continue to grow and become stronger for the rest of your life. Do I have evidence to back that up? No, that's just me. I never plan to have this hardware removed...one caveat to that statement is this: if it is evidenced that they are causing some type of unbearable pain, then we'd have to talk. Otherwise I love being the "Bionic Woman". This will make my trip through the airport security scanners much more interesting next time.

I switched over to Vicodin (hydrocodone) 24 hours ago. No, the doctor did not suggest it, but, yes, they are prescribed to me for the back pain I was having before surgery. There seems to be a bit of a difference in consistent pain relief with the Vicodin, which I am taking every four hours, as I did the Percocet. I am still on the Robaxin (muscle relaxers) every eight hours. I do plan to slowly wean myself off the meds by early next week.

As soon as this rain lets off I'm going to hit the roads for another one mile walk with my husband. I haven't gotten on the scale yet, though I do feel I may have gained a pound or two. I do hope the doctor releases me this Friday to start the stationary bike along with the walking. I'm not so sure he'll release me for swimming yet, as the incisions are still 'angry' looking and one of the blisters we popped now has some blood in it. There is no funky smell at all and the general redness is less today. With everything going so well, I certainly don't want to risk an infection from a public pool right now.

Sunday, November 27, 2011

SCRUB THE MISSION

Yesterday afternoon I charged my husband with cleaning around my incisions. The areas still look a bit 'angry' and have many teeny blisters and a few large blisters. This did not happen last year. Though I will say my incisions were very small (four each 1" long), I would like to think things about my skin did not change that much in a year. I've been cleaning the area in a general manner, but as I am not able to feel the area because it is still numb, I didn't go gangbusters. I don't want to scrub the dermabond off the tops of the incisions. My husband hopped in the shower with me and used my washing gloves (you know the ones that have a texture to them to help exfoliate your skin) and some very gentle moisturizing cleanser. I told him to dig in until I said 'stop'. He managed to wash right up to the incisions and was able to remove a bit of adhesive that was still stuck to the skin. Overall the area has lost some of its redness and is less itchy. We're going to repeat the procedure tomorrow.

Two miles was my limit this morning. My right hip just starting aching and each step with that leg was very painful, with the pain eventually spreading down the top of the right thigh. It did not feel like a nerve pinch, as it did not continue hurting when I was motionless. Maybe a deep muscle or tendon. Considering that it only happens on long, uninterrupted walks, my husband is guessing, and most likely correctly, that I am overdoing it. That sounds just like me.

Tomorrow will begin week two of no work for me. I have a very fortunate work circumstance and can take off as much time as I need. I will, however, be doing some of the bookwork from home this week...at my leisure. I would hope that if you do commit to this surgery you will make sure you can take the FULL SIX WEEKS off from your job. Sometimes we don't have the back-up finances to do this. But a positive outcome, in my opinion, of your surgery longterm will be greatly enhanced if you are able to take the time to heal. I was able to ease back into my job responsibilities over a period of a month, working half days here and there. If you are going to go through so much pain to have this procedure done, why not ensure a successful outcome by following the time off work guidelines.

Essentially today was okay...this is the first day that I actually felt totally 'blah' about everything. I know there will be good and bad days. Fortune has allowed me many good days post surgery than bad. Last year was a totally different story...too long to tell here, and besides this blog is about my current situation. I do hope you have many good days after your surgery.

Saturday, November 26, 2011

RAN OUT OF GAS

Yep, I officially hit the wall this evening. Just got in from a post dinner walk of 7/10 of a mile and am forcing myself to write this post. The every four hour meds dosage seems to be working okay. Of course I woke up naturally at 1:00 a.m. this morning to take my meds...hello, brain, time to reschedule. The four hour interval was set for 2:00 a.m. Oh well, I'll get used to it soon. The sleep was good. Woke up at my normal 'work day' time of 6:00 a.m. and did a little reading, then listened to my relaxation cd and promptly fell back to sleep until 8:30 a.m. when a chorus of kitties let us know it was past feeding time. Yes, they too have an inner natural clock.

Had a light breakfast then headed downtown for a cup of decaf, something I have been depriving myself of for nearly two weeks. It's quite busy downtown as our little village is having their annual 'Light Up' festivities all day and into the night when it all culminates with throwing the switch on well over 2 million lights throughout the city and main public park. There were already gads of folks in town. Don't be surprised if you get nervous around crowds of people when you are out after back surgery. Last year I was literally terrified to go downtown, afraid of being accidently bumped or jostled by others. You also can't move out of the way as fast, so you tend to really guard yourself, making very stiff moves and tensing up all your muscles...hence that brings on more pain. This is a natural survivor reaction, but should not take over your life by any means. It will take months, yes, months, to feel 'normal' again, a time when you will loosen up a bit and be more natural in crowds. And your new 'normal' walking and movement pattern will more than likely be a bit different than that of pre-surgery.

I'm an observant person to the point where I map out the emergency exits whenever I am in a public place. Period. No exceptions. It's just something that I do. Fourteen weeks post surgery last year (February 2, 2011) I had the opportunity to attend a rare Florida concert by one of my favorite singers/pianists, Diana Krall. By this time I was totally off all meds, with only an occasional 1/2 Percocet. The three hour car ride there was fine. The hotel was topnotch. Ruth Ekherd Hall was glorious...if you aren't recovering from back surgery. Oh, the chairs were plush. The access in was well marked. However, as we sat in the middle seats, thirty rows from stage, with well near 50 other seats either side of us and no middle isle...I noticed the emergency exits. Even in the best of circumstances, no panic, no visible flames/smoke, it was sure to be a miracle to get out of there in one piece. I was still moving at a slower than normal pace and was still a bit guarded around others. Yes, I did enjoy the 90-minute concert, even though I was wondering in the back of my head why I hadn't booked a handicap seat. Never occurred to me that I would need to, as I was certainly going to be the one who held someone up during an emergency.

I did do some cross posting on the Spine Health forums, hoping to direct some folks to this blog and answering some general questions from folks who will undergo or have already undergone any type of fusion surgery. The forums are very well moderated with a lot of good information. Of course, I still suggest you take everything you read on them with some caution, as everyone is different and most of us aren't medical professionals who post on the forums.

My pain level this evening is edging up a bit. The alarm just went off for my 6:00 p.m. pain pill and I actually said out loud, "Yeah!! Pain pill time!!" Trust me folks, I need it right now...so I will sign off, brush my teeth, do some reading and a bit of mindless television watching.

Friday, November 25, 2011

PUSHING THE LIMIT

Decided this morning that I need to change my dosage time interval for my pain meds. I have been doing the Percocet every 3 hours and the Robaxin every 6 hours. They coincide with each other four times a day, which is great. I use the alarm clock feature on my cell phone to wake me up to take the meds during the night. The past few nights I have been sound asleep when the alarm has gone off. I take my meds, reset the alarm for three hours and have a bit of a hard time falling back to sleep. Of course, when I wake up to take the dosage(s) I am in little to no pain. I do want to keep the pain meds in my system constantly for at least the first two weeks, so I don't want to go LONG periods of time without taking a dose. Last year I tried to wean off the pain meds at day 10 post operation. HUGE mistake. But, I figure I could go longer during night hours without the pain meds...possibly a 4-hour interval instead of three. I also think this will greatly help me get a better night's rest...I am going to try this time schedule tonight.

I bit the bullet today and decided to take the long walk downtown to a set of stairs I'm very familiar with  to begin the stair climbing rehab part of recovery. I say long walk with tongue in cheek, as it is only 3/4 of a mile...piece of cake for me. It was slow going to the park that has the stairs, but we made it. My patient handbook suggests do three sets of fifteen stairs per day. You have to take each step ONE AT A TIME and not walk them normally...making each step a 'landing' with both feet. Sounds easy, huh? It's actually harder than you think because you have to THINK about each step...up and down...and, it is also a bit painful because you are stretching some muscles/tendons/ligaments, whatever, that have become quite tight after surgery. The surgical area will also tend to pull and twitch with some minor pain around the incisions. Of course, I did 5 sets of up and down, with my marching in place exercises in between each set. I do twenty of those each set. Things felt good at the time...

After a little bit of Christmas window shopping, we picked up the mail at the post office and headed home. It took every bit of my remaining energy to take a shower, brush my teeth and ease into bed. I was totally wiped out and my right hip was just aching to no end. Yes, those who know me are reading this and nodding their head, they know me well and I always push the limit...that's just me. And I pay for it. And I paid for it. Learn from me, double the recommended exercises has a tendency to double the pain and exhaustion. I actually took a 1 1/2 hour nap...something I'm trying NOT to do during the day in order to have a regular night's rest. The morning walk was just under two miles...and this evening we did a slow 7/10 mile walk, with some mild pain in my right hip.

Everyone will be different when it comes to exercise and rehab after this type of surgery. If you are scheduled for a spinal fusion and DON'T have any exercise routine in place at the time, I would highly suggest you at least try to start taking walks, pain permitting. The folks I've heard of who feel their back surgery failed seem all to have something in common; they did not have ANY type of exercise routine in place before surgery...of course this made it near impossible to get into exercise when you are in such PAIN after surgery. You will make excuse after excuse to remain 'motionless'. IT WON'T WORK! You will end up blaming your surgeon for the 'failed back surgery' and, dare I say, you will be in more pain for life after the surgery. One thing I truly wish back surgeons would do is to screen patients more closely about their activity lifestyle. You are responsible for your recovery...why not make it easier on yourself and commit to an exercise routine...not only will it help your general health, it will certainly increase the odds of a successful outcome for the surgery longterm.

Thursday, November 24, 2011

APPROPRIATE DAY

If you had told me one week ago that I would be eating Thanksgiving dinner at a restaurant with my husband with little to no pain...well, they used to call the places loony bins, and that would be where I would have said you belong. Yes, I have more than my fair share to be thankful for not only during this time, but throughout the year, throughout my life. So what possibly could I complain about on this day of thanks!?

All I can do is give you an update as to the goings-on today. I had a really tough time falling asleep last night. Not so much the pain twinges here and there, but more, I believe, the fact I've been resting too much. As I am unable to walk my normal 3-5 miles a day, or bike at the gym 10+ miles, or swim a half-mile or so, or generally have a good workout for an hour or so at the gym...well, I'm restless. For me my day is not complete without a great cardio workout. I crave it, yet know deep in my gullet it is impossible to luxuriate in at this stage of recovery. I did walk, slowly walk, two miles today; one in the morning and one just an hour ago. I feel like the foal who desperately wants to fling her new-found, spindly legs in the surrounding air of the paddock. She knows she has the ability, while ignoring the sensible fact that she could trip at the least imbalance and find herself flat in the dirt. My normal walking pace is three miles an hour...I'm barely doing one-and-a-half miles an hour now. But, I am thankful that I can walk with little to no pain to speak of. I am thankful there is no snow on the ground and I am able to enjoy 76 degree weather for the coming week.

My husband has noticed several small blisters right next to some of the incision areas. Kind of an odd thing, something we will be sure to point out to the surgeon next Friday during my two-week follow-up. They are a bit hard to see in a photograph. They do not hurt, though the whole area that was covered in bandages post surgery itches like crazy and still has a slight rash.  As you can also see, there is still some bruising and quite a bit of swelling, a lot more than last year. The two spots you see at the upper right and left of this photo are the remnants of huge blisters that formed when I very loosely covered the oozing incisions after we removed the bandages on Monday, November 21st. The adhesive tape I used was the normal type of white stuff you buy at your local pharmacy. Apparently I am either allergic the to adhesive part or the adhesive part reacted badly with something left on my skin from surgery...but, anyway I ended up with what I would call a 'chemical burn'. I'm more worried about these becoming infected than I am about the surgical incisions. I've never had this reaction before to this particular type of wound tape. It is now in the trash.

I got up the courage to take a look at the photos taken during surgery that my surgeon gave to my husband when he spoke to him post-operatively. I should have access to a scanner next week and I'll be sure to post them here. They aren't as graphic as I thought they would be. Wishing all a great night...as I didn't nap at all today and tried to keep busy, I do hope that sleep will come with ease.

Wednesday, November 23, 2011

KEEPING UP WITH YOURSELF

The diamonds are coming at a somewhat 'normal' basis, though the miners are straining a bit to bring them into the light. My surgeon stressed to me to not strain or push during a bowel movement for the first few weeks. Hence, the regular doses of stool softener and a mild laxative. Don't go overboard, though, because there is absolutely no way you'll beat the miners to the surface if you wake up in the middle of the night and the canary is singing. Get my point?!

I was proven right about one of my previous posts (It's All Uphill) about pain meds. As noted, I've been trying to get a higher narcotic dosage of the pain med without increasing the acetaminophan dosage. I would have to physically show up at the doctors office to get a written prescription to turn in to the pharmacy. They cannot just call in another prescription. Something that is nearly impossible right now as any long distance car travel is not only restricted by the rules of the surgeon, but quite painful. We only know that this is no doubt due to the over-prescribing of these types of meds to folks who really don't need them. I was even willing to meet them at the pharmacy and give back the meds I still had left. Something else I learned is that once you buy the meds they're yours. The nurse said I could take one and a half pills of what I had here. Yes, that does technically increase the narcotic dosage, but subsequently increases the acetaminophan dosage, something I'm much more worried about. She stated that it was safe to do as long as I did not take more than 12 pills in a twenty-four hour period. It seems the medical community no longer can see us as individuals when it comes to these types of narcotic pain killers. We are all lumped into the category labeled 'suspicious'. If I were truly a pill popper or pill shopper would I still have thirty pills from the original prescription of eighty left over from last years surgery sitting in my cabinet? They wanted no explanation...we're all suspects. Guilty until proven guilty.

As someone who is used to getting up at 6:00 a.m. and beginning my day, you can imagine how hard it is to linger in bed until 8 or 8:30. I will read a bit in the morning, then get up and have a protein drink and small breakfast. As I am the one who handles the money in this household, I had a few bills that needed to be paid and posted this morning. You can see the feline ac'cat'ount help I had. This is the third leg in the triumvirate, BeBop. I felt really good and decided to take the 'long' walk, a one-half mile square down by the lake on a little travelled road. Even though you may feel great and strong, I urge you to bring your caregiver, whomever that may be, with you. Period!!! No, a cell phone will not catch you when you are in mid-fall. No, a cell phone cannot call an ambulance on it's own when you are lying in the middle of the road unconscious. It's that simple, walk with a partner. My husband is trained, for lack of a better word, to notice all the little dips and rises in the road and warn me about them. Those will SO throw you off balance after this surgery and they have the potential to 'shift' the implant if you step on them awkwardly enough. You will be walking with your head down for quite a while as you assess each and every step you take in order to avoid any misstep that could lead to very painful and irreversible damage. Remember, you are being held together with screws and rods. The cushioning disc is gone. Yes, there is an implant, but there is no bone growing as of yet. And even though it may feel like a solid juncture it's everything but. 

I've been asked how long the incisions are, as it is hard to judge from the photos. They are a little over 4" long. I fully expect them to heal properly and 'disappear' by this time next year. They are no longer oozing and the swelling around them went down quite a bit from last night to this morning. I was quite surprised, because I was having a hard time positioning myself in bed last night due to the half-golf-ball-sized swelling at the top of the incision on my left. Well, it's time for the evening walk...now, just where is my husband.

Tuesday, November 22, 2011

I'M RICH...!!!

Is there anything else I need to add to this? Honestly, I hate associating my bowel movements, or lack thereof, with one of my favorite movies, but if you've followed this blog you will note I've been waiting for the diamonds to be mined...and indeed they have. Yes, diamonds are a girls best friend. In fact, the nurse at the surgeons office called right after the big event and asked if I had had a bowel movement yet. My husband stated with all the proudness of a new parent recognizing the first bowel movement in the nappy of their newborn, "Yes!." As there is a nerve in the area of the surgery that can be pinched if you are full and constipated, the pain I had been having could actually be somewhat attributed to that nerve being pinched because of the lack of the diamonds being mined. Do I feel better? Yeah, a bit. I'm also relieved to know a bit of 'normalness' is creeping back in.

We swallowed the gopher last night and decided to go ahead and take off the left side of the bandage. This was the side that was covered/soaked in blood, that eventually leaked the pooled blood all over my bed and generally caused a bit of apprehension in this household. To both of our surprise...the entire thing came off without so much as a stitch sticking to the incision area. The worst of the whole thing is a slight rash below the sticky covering bandage that had covered the area. And, yes, we smelled the bandages for any type of funk which could indicate an infection. The only smell we could both decipher was a musty/sweaty one. There is still a pinch or two of oozing from the incision areas, otherwise all is clear. This photo has some line marks across it because it was taken right after I got up from bed. Without the additional bulkiness of the surgical gauze and all that other crap, the log roll manuever in and out of bed is a lot less painful because less point pressure is being placed on the sensitive incision areas.

Did a one-half mile walk this morning after breakfast. My energy level still really sucks. It was all I could do to mine the diamonds, shower and update my meds log....and, bam, I was flat on my back again for a mid-morning nap. If you do plan to go through this surgery please commit yourself whole heartedly to the rehab. The self-directed rehab should be fully laid out for you by your surgeon and his office before you ever decide to do this surgery. This is not a couple of stitches and we'll see you in two weeks thing. Some surgeons will insist on a structured, scheduled rehab for you. A good friend of mine who had this surgery done by my surgeon four years ago had to go twice a week for six weeks to her local Florida Hospital branch and participate in exercises to help her regain her balance when walking. I am thankful that I don't have to do that. Maybe the surgeon saw in me a very self-motivated patient, determined to succeed. Last year I followed the patient booklet without fault, even doubling up on the exercises some days. I want to make sure you know the whole picture...this is at least a one-year commitment on your part towards overall healing. A solid fusion can take two years to occur. Keep this in mind through all the pain you might now be in while trying to make the surgical decision.

Monday, November 21, 2011

IT'S ALL UPHILL

The miners are still working on the diamonds...in the meantime, I've been doing my daily 1/10 mile walks up and down our deadend street. My highest count so far is five times in a 24-hour period. Folks this is torture for me because I am so used to coming home from work and hitting the gym for at least an hour a night...I love hard cardio workouts on the treadmill and stationary bike. We through in limited weight machines twice a week, which have really helped me build my upper body strength over the past year. That has been immensely helpful log rolling in and out of bed after this procedure...something I recommend doing for the rest of your life to relieve any back stress upon getting in and out of bed. I also love to swim and would do (wait, I will continue to do when I am up to it) at least one-half mile twice a week. So, these measely 1/10 mile jaunts really suck!! Believe me, though, they are about all I can do right now, so I am thankful for the gradual hill on our deadend street. I talked to a neighbor a couple of days ago and apologized for my appearence, especially the long, fluffy teal robe and medusa-like hairdo and his jovial response made my day..."That's what deadend streets are for."

Last night was a terrible night, filled with intense leg muscle pain and general right leg weakness. I did find out something interesting when I was reading my pain med bottle. The dosage is listed in two increments 5mg/325mg. The former listing indicating the narcotic element, the latter the acetaminophan dosage. I noticed this time around that the pain level, even after taking the pain med every 3 hours, was always hanging around a 3/4 level, something that did not happen last year. When I took a pain med last year the pain would be nearly wiped out for the duration of time between dosages. Since I weaned myself off pain meds last year at the earliest comfortable time, I still had about 12 or so left in the cabinet. And, voila, last years dosage of the same type med (Percocet) was 7.5mg/325mg. That answered my question as to why the pain was never truly at bay these past three days, especially at night. Remember when you had a fever as a kid? It would always spike in the evening and throughout the night...that's what's going on with the pain. So, we made a strategic decision last evening...we are using the higher dosage pain med for the 11:00 p.m. & 2:00 a.m. dosing. Trust me...it made all the difference in the world. We do have a call in to the doctor's office to get the higher dosage pain meds from the pharm. Nothing yet...but at least I know I have a few nights of somewhat painfree sleep coming.

Let me say this about pain meds. I am actually a very anti-meds of any kind person. I won't even take headache meds until I am in a severe state. I do realize, however, that after a major surgery such as this pain meds are needed in order help your body (and mind) heal, so I do take them and am very grateful for them. I have never abused a drug of any kind in my life. Period. If you have, that's your business and has nothing to do with me...until you screw it for the rest of us. By abusing prescription meds and having a pain clinic on every corner who's willing to dole out oxycodone, hydrocodone, etc. to relieve the slightest paper cut....this scenario puts the eye of scrutiny on ME. I actually felt weird even asking my husband to call for the higher dosage until he pointed out to me the three things listed on the discharge instruction that need to be called in immediately--the 101 fever, oozing/smelly incision discharge and NO RELIEF FROM PAIN.

Speaking of incisions...we took the plunge this morning and per instruction removed the bandage on the right side. My husband used some alcohol soaked gauze, as instructed by the wonderful nurse in the recovery room, to make the process easier. It still hurt like 100 bandages being removed from 100 blisters at the same time...with the adhesive parts on the blisters. As you can see, he did extend the incisions from last procedure, which he told me he was going to do during the pre-operative consult. But this year we noticed a lot of bruising, something that was non-existent last year. There were a couple of spots still oozing a little bit. Thankfully we have a lot of non-stick steripads and medical adhesive tape leftover from one of our cats who passed last year from mast cell cancer. Although you are instructed to NOT cover the area, we did not want the shirt or bedsheets sticking to the incision and pulling off the dermabond, so we are loosely covering it until it dries out a bit. I might get the courage up to remove the other side tonight. I can do my scream song.

Finally, there is something about also healing your spirit along with your mind and body. I strongly feel all three of those things have to work together for complete healing to take place. I can recommend a couple of cd's that I always have in my bedroom player. I turn them on very low before sleeping, not just during this whole recovery process, but throughout the year. This may be something that will help you. Maybe not. But, I just wanted to throw these in the mix in order to cover all the bases in case you need an extra boost during your own recovery from any surgery. Steve Halpern, Music for Healing
Steve Halpern, Effortless Relaxation

Sunday, November 20, 2011

WHO CARES?

The temperature has come back down to normal, though it did scare us last evening by jumping back up to 100.1 for a little while. We haven't hit that magical 101 yet, so I guess I'm okay. The nights sleep was not the best. I am still having sharp, intense pain in my right hip that radiates down the outside of the thigh to my knee. I realize there is a lot of swelling going on in my low back around the surgical area, so it shouldn't come as a surprise to me that a nerve or two is being pinched. I did find a sweet spot last night where I was able to sleep without pain in that leg. Of course, nature called and I had to pee and was unable to find that position upon returning to bed. Folks, you will be laying (or is it lying) on your back for quite a long time after this procedure, especially if you have hips that are wide, like mine. You just can't get enough support into your waist area to make you comfortable when you lay on your side. Last year I thought I would never be able to sleep on either side again, but after about seven months I was sleeping normally, without waking up for every position change.

A strong support system, and no not the one we were just talking about, but the human one is needed in order to get through this months long ordeal. Yes, you can hire a nurse if need be. But there is something about a total stranger wiping your ass and taking care of your most basic needs that...well, somewhat dehumanizes the whole experience. And what an experience it is. My husband of twenty-five years is, well, for lack of yet being cannonized, a saint-in-training. This year we had access to the Nextel walkie-talkie/phone system through our place of work. It has made it a lot easier on him. He is able to be out of earshot, but can be by my side in less that fifteen seconds once I 'beep' him. He can sleep in his own bed instead of the uncomfortable chair in my bedroom. Yes, the sleeping is in increments of three hours to coincide with the meds schedule, but at least I feel better knowing he is more comfortable. You truly need a go-to person who can take care of your every whim and not be embarrassed by your offensive bodily odors, your bad breath, your mussed up hair, your gas passing and your strange request for a Gatorade run at midnight. You have to trust this person to hold strong to you as you take turtle-slow walks up and down your dead-end street in your nappy bathrobe. This person might be your significant other, your child, a dear friend...but whoever it is they will be your rock and need to know how much responsiblity they will be taking on. It's not just for a day or two...it's a minimum eight week daily committment. Thank you, my love, for doing this a second time.

I got up at 5:00 a.m. this morning to take my round of muscle relaxers and oxycodone and felt that I needed to take a walk. It was such a beautiful, peaceful morning. Clear skies with every twinkling star reaffirming the fact that I made it through the operation. I am so grateful. Yes, it's a long time recovery; as long as two years for a solid fusion. When we got back home an owl whoo-whoo'ed his primitive greeting and I fell back to sleep promptly when my head hit the pillow. God, I love these meds.

My appetite is actually much better this year than last. I craved a biscuit and egg sandwich this morning. I actually made one for my hubby too. In between 'meals' I'm eating jello, drinking a LOT of water (really want to get all those nasty anesthesia drugs out of my body) and Gatorade. Still haven't produced any diamonds yet. I just finished eating 1/4 of a sub from our favorite grocery (Publix) that they make only this time of year. It's black forest ham, smoked turkey, smoked gruyere, cranberry/nut relish all on a hearty seven-grain sub roll. Warm that puppy up in the microwave for a few seconds and...damn...it's autumn in my mouth. As a side I have a half-dozen baked Ruffles chips and my go to drink when I am sick....7-UP with tons of ice. So, I think I'm eating okay....need nutrition in order to help the body heal, right?

Our little secret....I really do miss the gym every night. Soon enough...

Saturday, November 19, 2011

COMING CLEAN

Day two after surgery. Really rough night sleep with incredible pain in right hip and down my right leg. Could not, for the life of me, get into a comfortable position in the bed. Had a few scary hours because of a slowly rising fever. It got to 100.3. The discharge papers from the hospital mentioned that if it got to 101 I would need to call the doctor immediately. I don't remember having any fever last year. I looked over my daily notes and didn't see anything about that. My dear husband zipped out and picked up my prescription for nausea and some Gatorade, which, under normal circumstances, I just can't stand to drink. However, it really hit the spot last night. I strongly stress trying your best to get something in your belly....anything for that matter. There is a dish of strawberry/banana jello in the fridge that I nibble on throughout the day and night, plenty of those protein meal bars and Special K protein drinks that are really filling and provide lots of vitamins. Vanilla is my favorite flavor.

Still haven't released the lump of coal yet, despite stool softener and laxatives. That is certainly causing a lot of discomfort! I have resorted to putting ice on the surgical area. It was not recommended last year, but this year my husband said the surgeon specifically mentioned I should do that. The bandages are supposed to come off Monday. Really wondering what it looks like under the bloody one. Was able to take a shower by myself this morning, though my husband stood right outside the shower door. The luxury of this is that he always puts my towels in the dryer so I have warm towels to greet me when I get out.

I have lots and lots of bruises all over my body this year. Especially my upper arms and butt area. I know the nerve monitor doctor told me that I really had to be firmly in place on my stomach for the surgery to take place. I just can't imagine what they did. The sides of my breasts are also extremely sore and tender. Who knows? I am going to ask the surgeon why this is when I go for my first follow-up in two weeks. I do remember being wheeled into the operating room and it was something a little like a sci-fi set. Actually freaked me out a bit. The surgeon did give my husband several photos that were taken at the end of the endoscope during surgery. That was a surprise. However, I haven't looked at them yet...I just don't want to know right now.

Will be nice to be able to sleep through the night in a few weeks. Right now, between the pain and having to wake up every three hours to take my pills...well, you can imagine that no sleep is being had.

Friday, November 18, 2011

DON'T LOOK IF YOU'RE SQUEAMISH

It's over. Now the real fun begins. My surgery went off on the scheduled time...and this go round I was terrified. In pre-op they hook you up to all sorts of nerve monitoring devices. The guy who did that was Dennis and he was traned by the Navy to become a doctor who specializes in this...I forgot what it is called. This time I was awake all the way to the operating room.

Upon waking up in recovery I can't tell you the level of pain I was in. It was off the charts. Yes, this is normal, but it still sucks. A shot of demerol and the pain went down a bit, but then up came the nausea. Apparrently I don't take well to pain meds. Having been someone who's never done any drugs in my life, I'm guessing that's the reason. I went in to surgery at 7:15 a.m. and was out by 10:00 a.m. If you plan to have this done please know the pain is real bad for the first hours after the procedure.

I finally threw up a lot of water and that actually helped me feel better. You have to walk a bit and pee before you can leave. They let me decide how long I wanted to stay. And unlike last year where I was totally drugged up and couldn't leave until 9:00 p.m., I was walking out in the 85 degree sunshine at around 3:00 p.m. I live about 40 miles from the hospital and it was not a fun ride home. The potholes and rough roads are so exagerrated with this procedure.

Upon arrival I had a look at my back and, yuck, here's a photo. I really hope that the dermabond they used is working on the left hand side. My husband said the nurse looked at it and said it was fine. I had very little leakage last year. This morning at 4:00 a.m. I felt something wet in the bed, got up and noticed a huge blood stain on the sheets and my back where this incisions are. There had been a pocket of built up blood under the clear bandages and it managed to leak out a small crack. Of course, I freaked out. But right now, about 36 hours post procedure, only a couple of spots have been left on the bed. So hopefully everything that was going to leak out has. I also need to warn you how difficult and painful it will be to get in and out of bed, even using the log roll technique they tell you about. It will HURT where the incisions are. Period.

I'm taking my Percocet and Robaxine (muscle relaxer) every 4 and 6 hours respectfully and am thankful for these drugs. I've been able to walk about 1/4 mile outside today and will probably do another 1/4 mile before bedtime. Yes, I'm weak and have absolutely no appetite. I did make myself some bland scrambled eggs and piece of bread with hummus. My biggest problem right now is trying to have a bowel movement. Pain meds are notorious for binding you up and I have a lump of coal that is sitting in my descending bowel that is sure to turn to a diamond soon if it remains. I am taking stool softener and a gentle laxative, both of which I started before surgery. Well, eggs are getting cold....time to go.

Wednesday, November 16, 2011

'CUZ I'M WORTH IT

Getting ready to hit the hay tonight after a relaxing pedicure. I even shoved off the gym tonight, something I don't ever do. Had a couple slices of vegy pizza and a low fat yogurt expresso chip cone. My last meal, so to speak, before surgery tomorrow morning. Have to be at CELEBRATION HEALTH HOSPITAL by 6 am for the 7:30 am surgery.  


I did some quick calculations regarding the cost of last year's surgery. The total cost for hospital, doctor visits, three aftercare followups, progress mri's, cat scans and x-rays was $150,135.24. The negotiated amount that the insurance company paid out of that total was $47,396.80. Are you still breathing? My total out-of-pocket last year (and this was all for back related issues) was $3500.00. Yes, it is expensive and would be nearly impossible to pursue without insurance. Of course, as I am sure those of you with chronic back pain can agree, there is no price that can be placed on living a pain free life. I strongly urge anyone who is in the cycle of physical therapy, steriod injections and oral medication, epidurals and even having a morphine pump directly implanted in your back, please take matters into your own hands. Many insurance companies will not approve spinal fusion until after you have spent countless months, and sometimes even years, playing their game. Meanwhile, your quality of life erodes while you wait to finally reach the level of pain that a faceless corporation feels is needed in order to approve this costly procedure. There is something a lot of us forget when dealing with insurance companies and doctors....WE ARE THE CUSTOMER...they work for us. I've had to insist on a couple of things the past two years in order to get the correct diagnosis. I know my body and knew that I was not getting relief, so something else had to be done. I did tons of research on spinal fusion, made sure all my questions to the doctors were written out before each office visit and made sure they were answered. I'm paying for these visits, I'm the customer. Please don't accept something you don't understand. Don't accept an insurance company representative telling you you haven't reached their level of 'disability' yet so they can't approve a surgery. I have been so fortunate to not have these two fusions questioned by the insurance company. I have United HealthCare and they have been wonderful. I've had only a couple of issues that were resolved quickly and not even worth detailing.

I will do my best to post something every day during this whole recovery process. If something I write helps even one person who faces this type of surgery then I feel this will be worth it. Please feel free to post any question. I promise to answer it honestly. Good night...

Monday, November 14, 2011

COVERING THE GREY AREAS

The nausea waters are much calmer now, even though it was a restless night's sleep. My guess is that it is normal to feel a bit apprehensive before any major surgery, even if you'd already been through the same thing a year earlier. Last year, though, I was so messed up on pain killers and muscle relaxers the two weeks leading up to surgery that I cannot remember much of what happened during that time. I didn't have the wherewithall to get nervous about anything. Maybe that was a good thing.

Keeping your spirits up and your humanity in focus after any surgery is a challenge in the best of circumstances. This surgery adds an additional element because of a lack of being able to move much at all. I am a very independent human being, who, in the blink of an eye, had to rely on another human being to take care of my most basic needs. It was hard. I know it will be hard to go back to that state once again. I know what I can do this time to at least keep my spirits up and I am doing one of those things as I write this. My hair is brewing with hair color, specifically Nice & Easy No. 112 Natural Dark Auburn. Even the cats have abandoned the room due to the ammonia fumes, which are a formidable opponent to the litter box smell. Last year I didn't even think about taking care of these little things, the little things that make you feel good, that make you feel a bit more human, not like an unkempt, knotty-haired, chipped-nailed knuckle dragger. The grey hairs shimmering in the mirror last year seemed to enforce the old-age stiffness I was feeling from the back surgery. A stiffness that, with time, went away. And now the grey hairs are going away...at least for a month.

Don't feel bad about primping yourself before this surgery. It may be a while before you'll be able to get out (remember you can't be in a car for at least two weeks). Get your hair trimmed, your nails done, your legs waxed...trust me, those little things will make a huge difference in how you look at yourself while recuperating.

Sunday, November 13, 2011

THE PUSSY POSSE

Sitting next to me as I write this is a plastic pink vomit basin...just in case. I've never seen a 'how-to' paragraph on cleaning up vomit from a keyboard in any computer handbook. There are clearly written side effects on the pamphlets that come with pain medication, specifically Percocet (oxycodone). Nausea & vomiting are the two that scare me most. As this is my last weekend before my scheduled spinal fusion surgery on the 17th, I spent the day trying to get things in order around the house and yard. Clearly, as evidenced by the pain in my low back, I overdid it...once again. I also hit the YMCA pool for one last time, as I am not going to be allowed to swim (or take a bath, for that matter) for a month or so. Don't fret, though, you can shower. They just don't want your incisions soaking in water.

After a shower and some pasta I decided that I needed to take one Percocet, as the pain level was beginning to increase slowly. About an hour later the nausea has hit like a tidal wave. Inbetween keystrokes here and there I took an anti-nausea pill (Ondansetron) that I had left over from last years emergency room visit. It helped a bit, but I'm still fighting with my stomach in the hopes of not returning my dinner. I intended for this post to be longer, but more than likely will have to cut it short.


Leo and Chester
 I want to mention how important it is to prepare your home for your return. Especially if you have pets. As we don't have children,  I can't comment on the prep for them. We have three cats who are all very vocal and people-loving. They tend to get under foot a lot, and in our tiny home (1000 square feet) it can be a problem. They love to hang out at the bedroom door while we are sleeping and 'escort' us to the bathroom at night...actually ANY time we go to the bathroom. In even the best of  circumstances, we've both come real close to tripping over them. Knowing that I'll be shuffling along to get from place to place, we learned real quick last year to leave a light on in the kitchen and a nightlight in the bathroom to aid in making sure I didn't trip over a furball. Furthermore, I can say that you will be VERY sensitive to the SLIGHTEST touch or jostle to your bed. It will send a shockwave through your body, elevating your pain. This fact made it impossible to allow our felines into my bedroom. I hated denying them access, but knew that any type of fall immediately after fusion could have dire consequences. My husband was also banished from the bed...that's just the way it had to be for me. In fact, as I write this, he is installing his little flatscreen television from his garage workshop in my bedroom for my viewing pleasure as I recuperate.

Will close for today, as another nausea wave is beginning to crest and I am not a good surfer at all.