PHYSICAL THERAPY: PART TWO.

Physical therapy has been going great. Doing Pilates exclusively on the reformer. I have developed some solid muscle, especially in my legs. People with lumbar spinal fusions have difficulty bending forward, so the best way to pick up something I dropped is by squatting. Thank goodness for those quads and hammies!

I am taking much less medication than ever before. Still taking Cymbalta everyday and Tramadol as needed, but that's it. Things are clearer now, and I notice things I never noticed when I was in a drug-induced stupor. I am also doing 30-40 minutes on the treadmill (not running though) and the elliptical three times a week. My quality of life and health have definitely improved.

I still have some physical goals beyond what I am doing now. I really want to ski next season, and I figure if I stay on the groomers, stay cautious, and maybe wear my old brace to prevent twisting, I can. I want to start cycling, not just riding my mountain bike on paved trails. The drawback of cycling is that the position itself does not allow for a flat back, but I figure if I get really strong and build my abdominal corset, it may be a possibility. We'll see what happens but this is my hope. For now, I am so happy to be walking without pain and doing Pilates.

I have received a handful of emails on my Facebook account from people who are contemplating a spinal fusion or have already had them; sharing their stories with me or telling me that what I have written has given them important information they have not heard from their doctor; has made them feel less scared and hopeless about having this surgery. Thank you so much to all who sent emails: this is the reason I started this blog and I am so pleased that people are reading it and taking something from it. I wish you all the best and will continue to update with new information and my status.

Remember: it takes 12 -18 months to fully recover from a spinal fusion and I plan to document it all.

PHYSICAL THERAPY: PART ONE.

About six weeks after surgery, my surgeon said it was time to start physical therapy. I had been done some basic leg stretching exercises given to me by the home health physical therapist, but this was the big show.

I did quite a bit of research about where to go. I wanted to go to a clinic that had Pilates equipment; my last round of PT three years ago included Pilates and it was extremely effective (until I stopped). I also wanted to go to a clinic that was privately owned by a former physical therapist - these clinics tend to be more patient focused and more invested in your treatment and recovery than PT clinics that are operated by large health systems focused on volume. Just a personal choice.

I was fortunate to find just the clinic I was looking for, even though it is a 30 mile round trip. I started PT in January when temperatures in Las Vegas hovered in the 50s. My sessions always began with 1o minutes on a big heating pad (my favorite part of therapy!) The PT would then come over and do some mobility exercises, then assign me various exercises to do in clinic. Each visit started with heat and each visit built on previous exercises along with new exercises. I noticed that some of my stamina and energy was returning and that I was feeling stronger. At this point, I was faithfully attending PT three times a week while still doing exercises at home and 20 minutes of the elliptical at the gym.

About four weeks later, my PT recommended I start the physical therapy version of Pilates, a thirty minute session using a Pilates reformer to further strengthen my core. As the physical therapist described it, I want my abdominal core muscles to form a corset that will hold my spine in place and prevent it from moving when I move. All of my movements should engage those core muscles whether I am emptying the dishwasher or braking when I drive. I was pretty excited to get started.

I arrived for my first official session and met Shane, a lovely former Las Vegas showgirl who has been a dancer since she was two. After tiring of dancing on the strip she delved into Pilates study and became a certified instructor. The combination of Shane's knowledge of Pilates, her understanding of the limitations of my condition, and her incredible personality was an instant match.

I cannot stress the importance of finding physical therapists and other people involved in your recovery that you click with. These people will see you on good days and bad, and need to inspire and motivate on the bad days and celebrate the good days - if your preferred method of motivation is bootcamp style, know that, and the same goes for those who prefer a more nurturing form of motivation.

Do what works for you - a good relationship with your "partners in recovery" helps you get to the clinic on days when you want nothing more than to settle in on the couch with a couple extra pain pills; days where the pain is worse than it was yesterday and you distinctly remember being told you would feel "so much better" after surgery; days where you just don't have any extra energy to face your recovery and would rather reflect on life before your body became your worst "frenemy." Shane has been that person for me and I owe much of my recovery to her. Her optimistic attitude and wonderful sense of humor made me commit to never complain during therapy and to push through the soreness and fatigue. I was lucky to be here so this is a No Bitching Zone.

We started off with very basic reformer exercises and the importance of breathing, scooping the belly button into the spine, and pulling in your pelvic floor (which has other benefits, ahem, I might add). These movements train you to stabilize your core, that all-important cluster of muscles, with every movement. Although the sessions were 30 minutes three times a week, it was a quick thirty minutes. I realized I LIKED this kind of exercise! And I felt muscles I didn't know I had after each session, slowly feeling stronger and more aware of my body, a body that had turned its back on me (for lack of a better word) a long time ago, a body that was finally deciding to call a truce.

POST-OP: WEEKS TWO THROUGH FOUR.

I had an appointment with my surgeon during Week Two and to the left is my X-ray. He was very pleased with the placement of the hardware and how the rest of my vertebrae looked. I was still using my walker and easily fatigued, and sitting in a car was very uncomfortable. But by this time, the severe pain the accompanied that first week after surgery had subsided significantly. What was left was much more bearable and was minimized with pain medication.

I was already off the Percoset and the antibiotics and taking Tramadol and Soma as needed. I was finally able to sleep through the night with the aid of a sleeping pill. I was really hopeful and was able to stay awake a little longer throughout the day. And my incisions were healing perfectly - my home health nurse made a funny comment that they were the cleanest sutures she'd ever seen!

I have to give all the credit to Nurse Mom, a real Registered Nurse, who observed and monitored my incisions like a hawk. Trust me folks: you do not want infection to further complicate the pain stemming from holes in your vertebrae accommodating screws and bolts (giving the phrase Drill Baby Drill a whole new meaning) and the perpetual sting from the incisions you already have. Take care of them like you would a newborn baby or cashmere sweater and do EXACTLY what your surgeon and your home health nurse tell you to do. Don't make an already sucky situation suckier by allowing infection.

Things continued to improve through these first four weeks. I put on a little more weight but not so much where my brace was uncomfortable. I would wear a tank top underneath the brace and a shirt or sweater over it. (I actually bought a few maternity tops and sweaters from Target that fit over the brace perfectly!) The average observer could still tell there was something going on under there but at least it was totally obvious in public. During week two I was visited by a physical therapist at home who taught me three basic exercises to do everyday to keep strong until I could go to outpatient physical therapy sometime around week six.

By week three I was moving around without the walker and showering without supervision (I still used the shower chair though). I even took my first non-medical-related trip out of the house - Bolted Bionic Husband took me to see Twilight on opening day, and I was able to sit through the two hour movie fairly comfortably. I remember being so excited to get out of the house that day (as well as shocked that Bolted Bionic Husband would even set foot in a crowded theater to watch a just-released movie about teen vampire lust). The only drawback is that I had lost quite about of strength in the first few weeks and had lost alot of stamina. By the time we got home from the movie I was exhausted, but I was out! In public! Walking without assistance!

By week four, per my surgeon's instructions, I started exercising on the elliptical machine 20 minutes a session three or four times a week. For those of you unaware of this exercise machine, it simulates the action of running without the impact. It is very easy on the joints and with a spinal fusion, impact is your worst enemy. The benefits of starting exercise were clearly gaining stamina and strength and keeping weight down, but the best benefits for me included keeping the depression at bay that had been hovering over me for years.

Things were getting better every week and I had more hope than I had had in years that things were going to be OK.

POST-OP: WEEK ONE.

The first four weeks after the spinal fusion are a little fuzzy due to the large volume of medications I was taking - Percoset, Tylenol, Soma, Lunesta and antibiotics - but I will do my best to describe those brutal weeks. (This picture is the abdominal incision that was required to perform the anterior fusion - the scars on my back in the picture below are from the posterior fusion. Take note: the abdominal incision develops significant scar tissue and leaves a solid bumpy ridge down the belly that will eliminate the possibility of that flat, sexy stomach for the rest of eternity. Sigh.)

My first week home was miserable, but I was so happy to be out of the hospital. I am so fortunate to have a mother who is a registered nurse, a father who is a physician, a sister who would do anything for me (and is also a therapist - score!) and Bolted Bionic Husband, who takes no prisoners when it comes to solving a problem. While I was assigned a home health nurse to perform daily evaluations of my incisions (all four of them) and the area on my neck where three catheters were inserted and removed, my mother and sister were truly the ones who took over my daily care. I could not do anything on my own - I needed help showering, getting dressed, brushing my hair, using the bathroom. I needed all sorts of tools to make these taken-for-granted activities possible including a raised toilet seat, shower chair, a grabber tool and a walker. I needed the walker to move anywhere, and anytime I was not showering, I was required to wear the brace. I owe my family a debt of gratitude for all their help in my recovery.

The first week was difficult. The pain was constant and often kept me awake at night despite the medication and sleeping pill. I could NEVER get comfortable, and every couple of hours I would elbow Bolted Bionic Husband who, without really even waking up, would bring me more medication.

I spent most of my days sleeping after having a shower because that minimal amount of activity was exhausting. My mother would change my dressings, which were weepy and draining the entire first week, and then I would fall asleep until mid afternoon when my home health nurse would visit to examine my sutures. After that I stayed awake enough to visit with my family in the evening, and was usually asleep again by 7pm. There was never a comfortable position to be in that first week, and everything hurt. I had dropped 15 pounds and all my clothes sagged, although the up side was having more room for the back brace which was worn almost 24 hours a day. I was generally very weepy alot of the time, but hopeful I would feel better soon.