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?

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.

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.

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.

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.

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.

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.

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.

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

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...

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.

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.

'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...

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.

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.

I'M NOT A DOCTOR...OF ANY KIND

Ninety-six hours from now I will be getting a pedicure, shaving my legs-all the way up and all the way down-picking up the throw rugs around the house, washing my bedsheets, wrapping the toilet seat with towels held down with masking tape (more on that later) and making sure all the stuff I will need most are at waist level.

Aside from the pedicure and leg shaving, the other things are what you will need to do to prepare yourself and your home for your return after spinal fusion surgery. This I know because of a wonderful booklet put together by the CELEBRATION ORTHOPAEDIC & SPORTS MEDICINE INSTITUTE (Celebration, Florida) & given to spine patients to READ BEFORE their surgery. My husband & I read it thoroughly...several times. I don't know if you will receive something like this before your surgery, but I would almost bet that if you called or wrote to the Institute they would probably mail one to you for the cost of postage. It's worth it.

As I noted before, I had my L4-L5 fused last year due to a slipped disc (SPONDYLOLISTHESIS). I was not in the right frame of mind to post to a blog at that time. Little did I know I was to have this same procedure done just over a year later at the next level down, L5-S1. I felt that maybe I could help someone else who might be thinking about having this surgery done. No, I am not a doctor...just an average 47-year-old female, standing 5'8" (actually gained 1/2" in height after last year's surgery), 164 pounds (lost 17 pounds last year too), very active...and have been told I am big-boned. No that's not a denial term meaning I'm fat...anything but. I am in shape and have maintained my weight for over twenty years after losing 65 pounds. I don't 'diet'. I eat right...no red meat, no fried foods, as little fat as possible...and I don't smoke. I do love a Russian River Valley Merlot or an Alvarino from Spain once in a while, but other than that I am as clean living as one can get. Why do you care about this? Well, you probably don't. I'm just trying to paint a picture for you for comparison...yeah, we're all uniquely individual, hence we all will react and heal differently after a surgery such as this. I'm just giving you my baseline...my basics. I'm not better or worse than you...I'm pretty average, wouldn't you say?

The photo posted on this entry is that of the scars from last year's surgery (October 14th). It's a minimally invasive procedure. Hell, you go home the SAME DAY...as long as you take a few steps on your own and can pee on your own (hopefully not at the same time). Bye Bye...insurance companies are watching their bottom line. You're breathing, you're leaving. Anyway...I promise to do my best to add a note or two each day after surgery. And, trust me, I will be brutally honest. I truly want you to know the REAL story. Otherwise why in the hell waste my time  posting and your time reading.

SOME 'BACK'GROUND

Huge debate in my mind as to whether anyone would want to read a blog about back pain. Then I look up 'low back pain' on a search engine and come up with 358,000,000 hits. Yes, that's three-hundred-and-fifty-eight MILLION. So, I narrow it down to my particular condition: SPONDYLOLISTHESIS, and am revealed 832,000 pages. Great, we're narrowing down to what I want. Finally, SPINAL FUSION--2,080,000...whoops, we're going the wrong way. But it was what I wanted to know about.

As with most medical searches on the internet you are bound to come up with a doctor/hospital perspective and tons of advertisements promising you 'instant relief from back pain'. I truly wanted a personal  account, someone who had gone through the surgery I was facing. When I did find comments on forums nearly all of them were negative and the few positive ones weren't long enough for me to fully understand what I had to look forward to. 

So, last year, on October 14, 2010, I underwent fusion of my L4-L5 vertebrae. (L=lumbar) The photo on my profile is of the final results...kinda personal, but the closest you'll get to seeing who I am. I have now been afforded the chance to undergo a SECOND spinal fusion. This time the L5-S1. (S=sacrum). Don't freak out...the first fusion was/is a total success...the second is a the result of a birth defect called SPONDYLOLYSIS, no, not SPONDYLOLISTHESIS or SPONDYLOSIS. Yeah, those Greek have a great sense of humor beginning all these back problems with 'spondy' and trying to confuse us primitives. I read somewhere that 'spondy' means bony or bones. So, I guess that works out... 

The first fusion was a result of a slipped disc between the L4/5. I had actually lived with this condition most of my life, utilizing chiropractic care for over twenty years as a stop gap measure to keep me standing upright until surgery became the only option to relieve EXCRUCIATING pain. I would literally go months without an adjustment, doing things that a 'girl' shouldn't do...heavy lifting, construction, cutting down and hauling trees, playing full touch football as a youngster with the 'guys'. Basically hard physical stuff that I thoroughly enjoy(ed). Well, all hit the fan last June 2010 when, while I was sitting on my settee, I reached under it to retrieve an ill-behaving cat (is that an oxymoron?). And, *POP*...yep, that's the beginning sound that leads to three months of unbelievable pain. Total, miserable pain that allowed me to do NOTHING that I loved. Long-short...after nearly $1200.00 in chiropractic co-pays I finally INSISTED on an MRI. As no adjustment was providing any relief I knew that something else was going on. And the MRI revealed the 'big slip' had finally taken place. October 2, 2010 I spent nearly twenty-four hours in a  pain that can best be described as 'the devil's inferno'. Nothing provided relief...nothing.

The emergency room visit resulted in two demerol injections, copious amounts of vomit from my reaction to those injections, a bottle of Percocet (oxycodone) and Ondansetron (anti-nausea med) and Cyclobenzaprine (muscle relaxer). Yeah, I was a dulled basked case, but at least I could open my eyes without seeing the stars of pain that had taken over my universe. Thankfully I already had an appointment with an orthopaedic surgeon for Monday, October 4th. Surgery was scheduled for the 13th....me being somewhat of a signs or superstitious person, I asked for it to be moved to the 14th. Done.