I LOVE TO RIDE MY BICYCLE, I LOVE TO RIDE MY BIKE.

I spent a week in the Outer Banks of North Carolina on a family vacation at the beginning of August. We stayed at my Aunt's beach house, a beautiful property close to the beach and other fun places to visit. The house is equipped with about a dozen bikes, most of them simple, gear-less beach cruisers to give visitors an option for traveling to the beach or the nearby shops.

Because of my surgery and that the synthetic bone is in the process of fusing the vertebrae, I am not supposed to ride a bike that requires me to bend forward at the hips, like a mountain bike or a cycle. I can, however, ride a bike on which I can sit up straight with a flat back. I took the opportunity to try out one of the cruisers and was addicted immediately.

I rode it almost everyday, to the beach, to the shops, to the local bakery. It was exhilarating to feel the sense of speed, and the exercise was great. I had so much fun with the cruiser that I wondered if I should get one for home.

After some thought, I bought a beautiful Raleigh Venture (I have no ties to Raleigh folks - just did a ton of research to find the best fit). It was difficult to make this choice: I have a gorgeous K2 T-Nine Series Vista mountain bike that Bolted Bionic Husband gave me for Christmas shortly before my back took a turn for the worse, and it has not been used very much. I felt a bit guilty buying a replacement, but knew this bike would get a lot of use. Someday, after the bone has fused, I may be able to ride the Vista again. Maybe.

Just this week I started a graduate degree program at our local university (more on that story to come). The campus is relatively large and I have significant ground to cover to get to my campus job and to classes. While vacationing with the beach cruiser, it occurred to me that I could ride a bike around campus, not only getting to my destination faster, but also doing it with less impact to my fusion than I could by walking briskly. Since campus is about 20 miles away from home, I've been loading it into my truck, driving to campus, parking and unloading, riding to class, and loading it back in the truck when class ends for the ride home. And riding my bike on campus has been fantastic, despite our oppressive triple-digit temperatures.

The other night after class, after the sun had set and the air had cooled, I rode my bike around campus just to look around and take in the breeze. By the time I got home, my legs felt like jelly and I was totally relaxed, my body buzzing with the post-exercise endorphins that are so addictive. I slept like a baby.

Most importantly, I feel like I have yet another accomplishment under my belt. I am riding a bike!, something I could not consider doing last year. It feels good to push my body to do new things and have it actually cooperate. And I can't wait to push it a little farther with my new bike with longer rides, just as soon as the temperature drops below "broil" in this white-hot desert.

AxiaLIF: NEW SURGICAL TECHNIQUE FOR SPINAL FUSION.

I still spend a significant amount of time reading whatever I can about spinal treatments. It started before I visited my spine surgeon, when I was trying to gather enough information to make an educated decision about whether or not it was time for surgery. After my initial visit with my surgeon, I spent hours and hours on the Internet researching spinal fusion surgeries: what happens during surgery? what is the surgery designed to alleviate? what are the success rates short term and long term? what are the risks? (I still find it interesting that in all this research, I never did find "the scoop" on spinal fusions, the non-sugar-coated story of what it is REALLY like).

In my latest scan of the most recent news on spinal fusions, I came across this article in the Daily Press of Newport News, VA. After reading it, I reflected on how invasive my spinal fusion was, how there were times in those first few days after surgery when I thought I made a huge mistake, where the pain was so severe that I wished someone would pull the plug (I didn't have that kind of "plug" but you catch my drift). I look at my 4-inch bumpy, ridged abdominal scar that looks like a mini Grand Canyon when I look down towards my toes. And I think about the three weeks I spent in bed after surgery, and the months of recovery afterwards.

It makes me grateful that there are people out there who continue to look for better ways to do these procedures. And I am thankful for those people who are willing to try them so that the rest of us may benefit. Twenty years from now I hope that my scars look antiquated, and that they become obsolete like appendectomy scars.

To those of you out there awaiting surgery: research, research, research. Being informed is one of the best ways to ensure that you choose the right procedures and therapies. Listen to your doctor, but most importantly, listen to yourself and do what is right for you.

GUEST BBW BLOGGER: BOLTED BIONIC SISTER

As part of a little experiment on BBW, I had a guest blogger, Linda, write about her spinal fusion surgery and recovery (thank you so much, Linda!!!). Continuing this experiment, the post below was written by another guest blogger, my younger sister, who I will refer to as Bolted Bionic Sister (a.k.a. Mama Mia Maria!).

Unlike Linda and me, Bolted Bionic Sister has a totally different perspective on spinal fusion surgery and recovery: she was a family member watching the chaos of surgery and recovery from the outside. I asked her to write about her perspective in the hopes that it will help family members understand what to expect during their loved one's surgery and recovery. I have to admit, however, that I have been procrastinating posting her piece; it is difficult for me to read what my family went through to help me. I hope it helps you.

BOLTED BIONIC SISTER'S STORY

Even before my sister's spinal fusion surgery, she was working on the Bolted Bionic Woman blog. I mentioned in passing that people might find it helpful to read about the surgery from a family member's point of view: I thought family members should know what they may experience so they could prepare themselves for it, as our family was not prepared at all for what we saw. So here is my account of my older sister's spinal fusion surgery and recovery.

I thought I had already seen my sister, Bolted Bionic Woman, at her worst, wincing in pain as she tried to walk and participate in the smallest and simplest activities of daily living. I remember her telling me how her leg would often go numb while walking at work so that she was limping and could no longer feel her feet, and what a bizarre feeling it was. I thought it could not get any worse than watching her hobble around with one of her hips at least 4 inches higher then the other one, not being able to straighten herself out and walk fully upright because of all the pain. As bad as all of that was, nothing could have prepared me for seeing her in the recovery room after her spinal fusion surgery.

I was accompanied into the recovery area with my mom. As I walked through the double doors I must have audibly gasped and froze on the spot. I vaguely remember hearing my mom say that she was pretty swollen. Pretty swollen was an understatement, as her face was perfectly round with little slits for eyes, but it was only the beginning of what I was about to see. She must have been hooked up to every machine and tube possible. I can understand the need for an IV and oxygen, but the catheters in her neck took me by surprise - I was aghast at the way they looked.

I grew up in a medically-oriented family (Dad is a physician and Mom is a nurse), and my career as a social worker took me on a path where I saw the very sickest of sick children, but when it's your family, your flesh and blood, your sister, it is a completely different experience. The image of her in the recovery room is ingrained in my mind so vividly that I don’t think I will ever forget it. As I approached her bedside, she said she was doing well, asked where her niece and nephew were, and we had a few fun minutes talking about the hottie of an anesthesiologist she had, and how having him that close during surgery was well worth going through it. Unfortunately, those few minutes in the recovery room would be the best I would see my sister look in the weeks to come.

The hospital stay was an absolute nightmare. The first night, a few hours after surgery, they moved her upstairs to a private room. I got a call early the next day from my mother saying she had been crying in pain most of the night and had not been able to get any relief. When I came to the hospital I was still surprised she was so swollen. I expected to have somewhat of the same light-hearted conversation as we did in the recovery room, but she could only mumble a few words, and when she wasn't crying, she would lay quietly. Her pain was completely uncontrolled, and to find a nurse on her floor to get any kind of attention was close to impossible. At times my sister would turn and hold onto the bed rail with white knuckles and cry. The nurse call light was useless - it either could not be found or would not been answered.

I spent three evenings at the hospital to make sure that my sister got her last dose of pain medication for the night before I went home; if I knew I could stay overnight I definitely would have. One night in particular is seared into my mind about the lack of pain control and the totally inattentive nursing staff. It was past her time for more pain medicine so I tracked down a nurse who gave the standard reply of "I will be right in." After a half hour, I tracked her down again, and got the same line, "I will be right in." When she finally did arrive, my sister had tears running down her cheeks. The nurse said, "her eyes are closed and it looks like she is sleeping." I told the nurse that she is in severe pain, and she has tears coming out of her eyes. When the nurse woke up my sister and asked her if she was in any pain, she said she was and the nurse finally gave her some medication. Everyday was a constant battle with the nursing staff to attempt to manage her pain. And I say attempt, because they never did get it managed.

On day three at the hospital I was so impressed with my sister. Even with the lack of pain control and the disastrous nursing care, she did a great job working with the physical and occupational therapists. During the first session, it took all her effort to sit up in a chair and have help putting on her back brace. The next day she had help with her back brace and was able to stand and walk a few steps down the hall. I knew watching her walk down the hall that once we could get her out of the hospital and at home, she would do so much better.

After her week long stay at the hospital she was finally discharged, a process that was also a nightmare. The entire staff kept blaming another department for why she could not be discharged yet. First it was because of the physical therapist neglecting to do something, then the blame shifted to the nurses, then to the discharge planner and then to the doctors. After a long day of solving problems we should not have had to solve, my sister finally got to go home to the comfort of her own bed, the familiarity of her own things, and the loyal companionship of her dogs.

For the first week-and-a-half at home, she needed help to shower, dress, prepare food (for what little appetite she had), and to take care of three back incisions, a long vertical stomach incision, and three neck and back wounds from drainage tubes. She had my help as well as the assistance of our mother and one very worried five-year-old nephew. He would carefully examine his aunt's incisions daily, and rub Vitamin E oil on them while giving his assessment of how they were healing that day. (He still does this, almost 10 months later. He will ask to look at her "marks," rub them a bit, and tell her they look much better). Her three-year-old niece was a constant source of entertainment and soon became her aunt's little walking buddy when it was time for my sister to start moving more. Her niece would hold onto her aunt's walker as they first mastered walking to the driveway, and little by little, walked to the neighbor's house, then the mailbox, and finally around the block.

Through all this, I am so happy to say that my sister has done very well. She has been faithful about attending doctors appointments, going to physical therapy and Pilates classes, which she still continues to do. I am proud of all she has accomplished in this period of time. She thoroughly researched all of her treatment options, endured numerous painful procedures, and had a great attitude through the worst of this surgery and its subsequent recovery. I am so glad she is out of the pain she was in, and she now seems to have a new lease of life.

However, I do owe her an apology. As I mentioned before, we had discussed doing a family point of view post for this blog a while back, and I offered right away to write about the experience. I procrastinated and procrastinated, and now 10 months later I have finally done it. It is not that my sister's surgery was in any way unimportant in her life or mine, nor was it something to be brushed aside; but I knew that writing about my experience with her surgery and recovery would bring up emotions that are still very raw and vivid. I finally told myself that after all she went through, not only physically but emotionally and mentally, I owed it to her to sort through my feelings and emotions and write this account, as she has endured more than I will ever know to get to where she is now.

I wish I could conclude this post with some articulate words to describe my thoughts about my sister through this ordeal, but PROUD TO BE HER SISTER sums it all up.

Bolted Bionic Sister is a licensed clinical social worker (L.C.S.W.) who works with parents and children on behavioral and emotional issues. As a Supermom to two awesome children, she epitomizes patience and grace, and is one of my favorite people in the world.

GUEST BBW BLOGGER: LINDA HANDEL

LINDA'S STORY.

July 13, 2009. Today I had my four month doctor’s evaluation.

On March 11, 2009 I had a spinal fusion of discs L3-L4-L5 posterior. The surgery was 4 1/2 hours long. The surgeon was sure about fusing L4 and L5 but said he wouldn’t know until the actual surgery if he was also fusing L-3. Dr. Lucas said that the nerve roots were pretty tangled up with ganglion. The nerves were very inflamed. L-3 was involved and fused as a result.

I have titanium rods, spacers made of my own bone material and screws that are drilled into the bone. There was also a bone graft taken from my left pelvic bone. Some people get donor bone material rather than a bone graft. In retrospect, I may have preferred the donor material. The site of the graft was tender for a long time and added unexpected discomfort.

Like many who need this surgery, I did everything possible not to!! I got temporary relief from cortisone shots…meaning just a few hours of relief at a time. I took ibuprofen and went to my chiropractor who gave me e-stim with cold packs, cold laser, and ultrasound for temporary relief. He was very supportive of the surgery.

Since the surgery, I have zero pain in either leg. Before surgery I doubled over walking up stairs, was exhausted from managing the pain, and unable to work out, which is a big part of my life. I do not regret having the procedure and I’ve stopped blaming myself for needing it to begin with. I’ve always followed a good workout and diet routines. I go for chiropractic treatments, take my vitamins--what went wrong? Dr. Lucas said it could be from anything…an injury from my more sporting days or from being rear ended in a car accident, to crashing around in the ocean. Whatever the incident or groups of small incidents, it doesn’t really matter. There is nothing I regret nor do I think… “I shouldn’t have carried my kids in a front pack, I shouldn’t have done weight lifting or I shouldn’t have played field hockey.” The damage to those discs was going to be the way my body finally gave in to the stressors of my everyday life.

Apparently, the L4 and L5 take a beating. Happily, the surgical technology has changed dramatically from when patients had to wear a “turtle shell” brace for many months and remain immobile. Dr. Lucas said that the rods and spacers in my back are actually a brace and I didn’t need to wear another brace when I left the hospital. I did get one at his suggestion in case I felt I wanted to wear it to feel more secure. I never did!

I wasn’t fearful of the surgery itself. I had full confidence in Dr. Lucas who is a gifted man with a big heart. I was concerned how I would feel after. While the surgery was smooth, my hospital experience the first night was not too great. I read blogs about post surgery experiences so I hoped to be prepared.

My experience does not mean yours would be the same. Individual physiology is different. I had low blood pressure after surgery most likely due to anesthesia and the number of hours I was in recovery. As a result, the pain medicine my doctor expected me to receive was not in place and I wasn’t dosed by my pain level but rather the number of hours between IVs. I had to receive the three units of blood that I pre-donated at the blood bank. Dr. Lucas came the day after surgery and insisted that I be dosed according to the pain I felt, not the hour of the day. This made a huge difference.

Post surgery was painful but not the kind that made me cry. For me, it was the kind of pain that was immobilizing. I was afraid to move. I couldn’t move. I was sure the rods would come poking out of my back! The searing pain was from the surgical site and before the pain meds were administered by need. However, I noticed immediately that there was no other pain…my legs were already pain free from the moment I woke up and could assess my status.

The first day after surgery my inability to get up on my own was discouraging. What was I thinking? I just had major surgery, was not conscious for twelve hours...Did I expect to get up and dance? I had no pain in my legs but I couldn’t move or roll over without help. I was not patient with myself. Instead of rejoicing, I started counting the seconds to get this healing business over with. Thankfully my roommate was a chatter box filled with hilarious stories. How could I not laugh with her? Nonetheless, I was a grump, stubborn and wouldn’t walk when the physical therapist came by to get me up. I was groggy and out of sorts and agreed only to “roll and sit up.” My family was happy to see my stubborn personality was still up and running!

The second morning I let myself be coaxed out of bed for a walk down the hallway. By the afternoon I was sitting in the chair. Hospital politics became interesting as various nurses and patients came and went. Day three I used the walker for about 5 minutes then realized I felt good enough to go up and down the hall without it. I waved at my family taking a break in the lounge. I climbed the little stairway and was ready to leave.

The morning of the fourth day I was mobile on my own, and with my mood lifting, I finally rejoiced at being pain free from the throbbing pain down my legs---I was released by my surgeon to go home. Dr. Lucas often suggests his patients go to local rehabilitation facility but he was impressed with my mobility and determination. I also have family who helped with meals and keeping the house peaceful. I was pretty tired and slept a lot the first week! However, I could climb the steep stairs to my room and look out of the windows into the yard. I could go downstairs and rest during the day. I was totally amazed at my mobility. No more one leg at a time and pulling myself upstairs by the rail. No more one leg at a time to get down. I went for slow walks around the block with my partner’s help. I knew that healing was going to be a function of time but actually experiencing the healing process is quite different then just thinking about it!

I have to say, being physically fit paid off post surgery. Dr. Lucas suggests to patients who are not fit to attend physical therapy prior to surgery. Recovery is faster if you have a strong core and have a routine in place for post surgical care. I went to physical therapy the second week after surgery. It was a shocking experience for me. I couldn’t even lift my leg, do a bridge - nothing. I was very emotional as I realized the path of rehabilitation was going to be months long. I was stiff, sore, and tired. I needed help with my socks, couldn’t carry the laundry basket, and couldn’t work. It was overwhelming but I had no choice if I was going to get my life back. There is a women’s soccer league with my name already in place… but clearly not this year.

Four months post surgery my pt and I are parting ways. I’ve gone through all the stages of physical rehab and can do pushups along with the stretches. My stamina was nonexistent at first but I was back to work in three weeks part time. I’ve gone from two pound weights to ten pound weights for some exercises. I was determined to do whatever it takes to get strong again.

Whatever you do - please do your physical therapy homework every day. By the third week of going three times a week I was strength tested, exercises added and having scar tissue massaged to the point of tears. I was on the recumbent bike for 10, then 15 then 30 minutes. At first I was doing goofy exercises like the “swimming bug” and the “knee march.” Goofy, maybe, but I could hardly do them the first time or the second. Now when I see others in the workout room doing this little march on their knees I realize the squats and planks I’m now doing were hard earned over these last four months. I am reminded, as I watch new patients with my old struggles, not to be discouraged. Collagen formation needed to heal the site takes about a year to sixteen months to complete the fusion. It’s two years for the bone to actually finish forming. And there is Absolutely Nothing You Can Do To Make it Go Faster Then Nature Intended….period.

Do I test this beyond my limits? Yes. Am I sorry? No. Did it hurt? Yes. And I backed off and tested again but less so.

Today was my four month exam with the surgeon. I have lost some flexibility but this doesn’t deter my daily living routine. I am still stiff but less so each week. I thought I could feel the rods on the right side of the surgery. Dr. Lucas explained that it is the muscle not the rod I feel. He retracted the muscles to do the surgery so they are still swollen and tender and still healing. I have various aches and pains but I was told that month four is still the beginning stages of the healing process. The aches and pains I feel will continue to diminish. Just go about living and start slowly to build back core, stamina and strength. Walk every day!

Good luck with your surgery. I hope this small piece helps you make the best choice to be pain free. Stay positive. There are so many stories on the internet that are disheartening. We, as patients, have to take responsibility and do our part in staying in shape, keeping our weight in control and doing physical therapy. Get more than one opinion and research your surgeon. Find others who have had similar surgery. I was amazed at the number of people I know who either had lower back disc surgery or had a parent, a friend, or a relative that did and who are pain free and as active as ever after many years.

I am very grateful to BBW and her blog. I felt her successful experience could also be true for me. I somehow knew, after reading BBW's thoughts and feelings, I would get through surgery and someday I would also write something of my experience in support of others.

Linda Handel had a spinal fusion March 11, 2008. She is a licensed psychotherapist in private practice for 25 years, the founding director of the Blackstone Shelter for abused women and their children, and is the recipient of the Charles Potter Award for Public Service. She is a mother to two married children in their early thirties, and a grandmother of a wonderful granddaughter.