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.