Posts Tagged ‘minimally invasive spinal fusion’
I know this comes directly on the heels of the last one but I found an additional paper with question I haven’t covered yet so here’s my attempt to get caught up on my writing…
Is there muscle tightness after ACDF? Yes. That’s the short answer. How long it will last depends on different things. First, how much you are willing to do physical therapy is the biggest factor. I’ve now been doing rigorous neck, throat and upper body exercises since my surgery 7 months ago and I’m still not completely over it… the more I work with it and the more I use it, the better it feels. Keep at it! There may be some underlying issue going on and in that case talk to your doctor, that discussion will be invaluable in deciphering the intensity of the tightness and if more intervention with physical therapy might be needed. TALK TO YOUR DOCTOR! He’s on your side!!
XLIF and spasms… Well, since that’s all that was typed in, I can assume that the person has already had the XLIF procedure and is still having back muscle spasms. I did for a while, like for maybe four months…that was, until I got the muscle strength back into them so they settled down. There were certain triggers for the spasms too. If I sat too long in one position, if I was exposed to a direct draft from the air conditioner, if a room was too chilly, if the swimming water was too cool… are you getting a picture of the theme? My body temperature needed to be regulated too. After a major surgery like mine, it’s not uncommon to have the sweats or the chills at the oddest times. The rest of the world is functioning normally and you’re sitting there shivering and in spasm! Keep yourself as warm as needed. In time, it should pass. I found the more active I was, the less it went into spasm. I’m not talking over the moon type activities, I’m talking just getting up and doing everyday tasks. Keeping the blood flowing is a big help to regulate the sweats and chills.
Retirement due to cervical pain… I’m sorry to hear you have so much pain you had to forgo your livelihood, especially in the current economic climate. I wish you could talk directly with me about your pain. I would tell you that having the ACDF is a real game changer, and, depending on what you do for a living, could take you further to garner a bigger retirement pension or money for the everyday until you are eligible for full retirement benefits.
Recently, I was approached by the wife of an anesthesiologist asking about the ACDF surgery. It seems her husband has had to curtail his practice to part time because he can no longer bend his head over patients in the OR without severe pain in his shoulders and neck. I don’t know what happened to the doctor, but I hope she was informed enough once she spoke with me that he would seek out a remedy for this debilitating condition. Remember pain is universal, it knows no socioeconomic status, no race, color or creed and it certainly doesn’t know when to stop. It doesn’t have to be the end of what you do… it helps you get on with getting on!
One of the most magical things I’ve discovered about the doctors who perform these operations is that to a lot of them are often doctors without borders. Meaning, the villager in a third world country has access to the same cutting-edge treatment I had to make me a whole person. To me that is beyond amazing to know the world has access to this life changing treatment, not just the wealthy or those fortunate enough to have good health insurance as I was. I envision an elder of a village who worked all his life being a hunter and gatherer for his family and village and has suffered a fall or blow in some way that has debilitated him to the point of him becoming frail and listless. To know that this treatment is available to others less fortunate than myself gives me great comfort that one less person will be suffering the way I once did. I want the world to know about its power to change lives! That’s why I do this website!
Cervical spondylosis & swimming… I can only guess what this person wants to know, and that he/she has been diagnosed with the condition but has not had the ACDF surgery. A question on this person’s mind might be, “am I furthering the condition by swimming?” Maybe, depending on what kind of swimming you are doing. If you are doing a freestyle swim with your head in the water, you’ll be doing more movements directly related to the neck area as you take your breaths. If you are swimming a backstroke, you lessen the activity of the neck but still use some neck muscles to keep your head above water even though you may not realize it. I am able now to do all the strokes to swim as I once did years ago since my ACDF surgery. Recently I swam a mile in 1 hour and 6 minutes all freestyle, something I haven’t been able to do in 24 years. It was absolutely exhilarating! Bear in mind that I have to roll my whole body to breathe because of my additional XLIF surgery, this was some adapting to not damage my lumbar region. I don’t feel that either of the surgeries, XLIF or ACDF, have limited me in my desire to return to swimming as my choice for exercise. I have great range of motion in my neck but I will tell you that I am limited to bending my neck from side to side as in when someone may want to hold a phone on their shoulder. That’s what probably got me into the condition I was in the first place. It got to the point I couldn’t hold my head upright, and would hold my head tilted to one side or the other when not laying down. It was like I was an alive bobble head!
Decorating my neck brace… The hard collar neck brace was not the most pleasant experience I’ve ever encountered. To offset that, I decided to embrace it full-on knowing it was only going to be a part of me for a short while. After looking at all the nooks and crannies the brace had, I decided on the area where the logo was placed for my personalizing for my brace, front and center. It was shaped like a medallion so I just made a rubbing of it on a piece of paper, attached the rubbing to some ribbon I had and cut a small piece out (actually several in case I screwed up) and then ran it through a little device I have for card making that puts adhesive on the backside of it to make a sticker out of it. I left the back peel away on until I was done with my decorating which I did with rhinestones that were sticky on the back (you can get them at a craft store). I made my initial in a capital letter and then designed a simple flower to the side. When I went back to see Dr. Smith he noticed it right away and busted out into a belly laugh, shaking his head. I’m sure he thought I was nuts, but, it was my way of dealing with the negative aspects of the brace. I decided to have fun with it and embrace it instead of complaining about something that would eventually give me a broad measure of relief!
Can an XLIF fusion break? I would imagine that all bones can break no matter if they’re fused or not, but it’s my understanding that the bones below or above my XLIF procedure will break before the fusion will. That being said, it all depends too on how many levels are involved with your XLIF fusion. In my case, I had a 6 level fusion and would probably be more likely to break under the right conditions, but most people have 4 or fewer levels of fusions done which would give it strength just by it’s short length. It also depends on if the fusion was done with rods alongside the fusion or if plates were in position too. I also did not have rods or plates used so, yeah, maybe mine could break under the right pressure, but my daily activities don’t include anything that rigorous to be cautious about an injury of that magnitude. No time soon will I be slammed to the floor in a choke hold by, say, a cage fighter! LOL I was told that my everyday life activities would never warrant that kind of injury.
Reasons to have an ACDF surgery? It has taken me a lot of this website to explain in pretty graphic detail what life has been like without my XLIF or ACDF surgeries. I don’t have a capsulated list of reasons, but I will invite you to read several of my other posts which try to indicate what life was like before and after the surgeries. I welcome you to read those entries and decide for yourself just what reason would fit you and your condition. Each of us has our own crosses to bear, with their own little twists and peculiarities about them. I would be remiss if I didn’t tell you that your case is as unique as you are, although there are some that are a classic textbook specimen; however few and far between. For that reason, I can only speculate what reason you might have for seeing a physician to have an ACDF done. I will tell you that in my particular case, I sought a neurosurgeon for the procedure. You can find a listing of surgeons on the NuVasive website or by calling them directly or calling the 1-800-475-9131 number for THE BETTER WAY BACK, an affiliate program designed to reach out to people in need of such information and to connect with people like myself who’ve gone through the procedure and are willing to speak candidly with you about your expectation and fears about the procedure.
In the next few days, I’ll be attempting to get back to writing about the last few days of my class reunion… I have some interesting writing assignments just ahead of me but I want to finish up all my lose ends first.
In the meantime, you know what to do… take care of you and yours!
Here’s round 5 of questions and answers about the XLIF, ACDF, and Total Hip Replacement surgeries. Remember the statements I make are general and pertain to my direct experience with them. EACH CASE IS DIFFERENT and you should seek medical advice from a medical professional. This is merely an extension of the questions I’ve been asked on my website but my responses are not medical advice.
Do I need a walker after my XLIF? The short answer is YES. The reason for that is so you don’t loose your balance. Your surefootedness is not stable right after surgery and trust me, you’ll want something to lean on for a few weeks. (4-6 actually) And most of all you don’t want to screw up what your doctor just did to fix you. It’s only for a short while, so just suck it up even if you don’t want one, and live with it… you’re not going to be using it for long!
XLIF and airline security… I just got back from traveling east and I assure you it was no big deal. Even with my total hip implant. I told them I had surgical metal in me ahead of time and the TSA just asked me to go through the x-ray instead… no pat downs, no hassle, nothing, quick pic and moved on through. It was no big whoop and I never set an alarm off.
- How long does it take to heal? Well, since this person didn’t specify which surgery he/she was referring to, I’ll tell you what I know about each one… there are some general statements that can be made for ALL surgeries…
1. it’s standard that after a major operation, it takes up to six weeks or so for the wound to close completely from the skin. HOWEVER, you have to keep in mind that wound is still weak and can take as much as 6 months to feel like it’s OK. By that I mean there’s nerves that have to reconnect and your scar will be sensitive for a while. I’m now 16 months post-op with my surgical site still numb somewhat, and I can still feel the nerve endings they cut through are reconnecting by the twinge every once in a while, it feels like I got poked with a needle for a second. The wound also still itches. That’s a good sign.
- 2. it’s not unusual for a surgical site to take upwards to 2 years to fully regain it’s prior status. If feeling is going to come back to the surface of the wound site it will be within that time frame. That being said, I had breast surgery 11 years ago for a tumor and it took I’ll bet every bit of 7 years to regain all the feeling at that surgical site, but I did get it back. I’m thinking that too, it was because of the sensitive area of the body it was at. Every body is different!
3. each person heals at their own pace. General rules apply as just that. No doctor can pin-point a day and time you will be deemed “cured” from your condition. The longer you are post-op from your surgery, the better you should feel, keeping in mind your share of the responsibility for physical therapy and recovery… YOU have to take control of your aftercare. Don’t blame your doctor that you’re not feeling well (unless other problems arise) if you haven’t done the prescribed aftercare diligently. He’s not God. The surgery he performed may well have been successful but you need to look at yourself and ask if you’ve done ALL you could to aid in your recovery.
For healing from my XLIF, I didn’t feel the same pain I had just hours prior to surgery and for the last ten years, that pain was gone immediately post-op. However I did have surgical pain and the reconnecting of nerve endings that for so long were being pinched. This is an altogether different kind of pain. And the good news is…. it eventually goes away!
By my 3 month checkup I was feeling good. The nerve endings were still reconnecting so I was still dealing with that, but overall, much better. By then I was able to drive and able to resume a more normal life. By my 6 month checkup I was pretty much good to go. I was out of my back brace in 4 months although the Dr. Smith originally wanted me in it for 6. Dr. Smith is an amazing observer. He realized I must be spending more time out of my brace than he had told me to be. I know why he took it off me at 4 months was because he saw how much stronger my back was, that I was standing well on my own in the office and my movements were more fluid not so rigid. He slyly asked me how many hours a day I was out of my brace in an upright position and I said maybe 2 or 3 but he knew human nature well enough to know that it was more like 4 or 5… I guess that was good enough for him. But, it showed that the grafts took, and that my spine was fusing nicely. A fusion of my size, 6 levels, is most unusual and it will take ever bit of the two year mark to be completely healed… that being said, I’m doing things I haven’t done in years! I feel terrific in that part of my body!
As for my ACDF healing, I am now just shy of 7 months post-op. I’ve had my share of difficulties throughout those months and have shared them with you in previous posts on this website. Each day I feel my neck getting stronger, and my throat muscles are coming back slowly. A little slower than perhaps I expected or would have liked, but nonetheless, they ARE coming back. The surgical site is still somewhat numb but that will just take time to dissipate. My neck overall does get tired yet and the muscles when I first wake up, have to be stretched to get the blood flowing properly into them. It takes all of maybe 5 minutes to do that by some simple stretches. I feel confident more now than ever before I will regain full use of my singing voice and of the range of motion in my neck without the stiffness and aches at present. IT JUST TAKES TIME… BE PATIENT! I know that’s hard to do, trust me!
Lastly, my total hip replacement performed by Dr. Crovetti is a marvel! I’m now days away from being 5 months post-op. I still have some latent stiffness if I sit at the computer too long, and I do sleep with a pillow between my knees if I’m on my side. Other than that, I even had a pleasant surprise at mass the other day when, I never even stopped to think about it and, I did a partial genuflect before getting into the pew! I can’t tell you how many years, or decades it’s been since I’ve been able to do that! My PT doctor, Amanda Scott, taught me how to do a lunge, which is basically a genuflect! IT WAS AN AWESOME FEELING! I walk with a normal gait and stride. I don’t have a waddle to me either. When I walk I feel I stand tall and straight for the first time that I can ever remember. I still have a slight numbness around the incision on my leg and just below it but it’s a small trade off when I think of what I’ve gained in return. I understand that it too will go away in time. I AM A NEW PERSON IN SO MANY WAYS!
I want to add something here. This comes from Amanda Scott, my Doctor of Physical Therapy at mattsmith Physical Therapy. She was overjoyed when she saw how much effort I put into my recovery because so often she sees people who’ve taken the time, and, spent the pain and money to have an operation, just to come to physical therapy and not take it seriously. “You can lead a horse to water but you can’t make him drink,” comes to mind. These are the people you see half-heartedly doing the exercises, the ones who don’t remember them from one visit to the next because they aren’t doing them at home enough to remember them. They are the ones who only want to come one time a week, not getting the biggest bang for their buck by doing several days a week to jump-start their body again. These are the people who want to be pampered at all costs. I have a newsflash for you… your therapist knows without you even saying it if you’ve been doing your therapy at home! They can tell by your range of motion progress, and the pain levels you complain about! They KNOW what you are and are not up to! And I’ll let you in on a secret, the more effort they see you put into your therapy, the more apt they are to help you become more confident in your movements. The bottom line is…. IT’S ALL UP TO YOU!
Yes, the physical therapy was boring, and sometimes grueling, especially at first. Then I hit my stride, and I enjoyed going to PT, I felt better, and the better I felt, the more I wanted to go… I knew I wasn’t always going to be there and I wanted to make the most of the time we had together so I could take that knowledge into the future. I haven’t been near as diligent as I could be since leaving the physical therapy sessions, but at least I have all the exercises written down. I do them more often than not, and my body is constantly thanking me for it. So, I guess this is the long answer for how long does it take to heal… it all depends on how much you’re willing to put into it.
What’s the best exercise for XLIF 6 mos post-op? Well if you don’t want to do anything else to help your body heal, at the very least, WALK! And I mean every day…. the use of many muscles when you walk will be beneficial to you if you walk. You can also do water walking if you have a public pool that they don’t keep too cool, 83-85 is a good temp for water walking… and by water walking I don’t mean putzing!!! I mean vigorous walking, pushing your limits just a little each time in. USE YOUR MUSCLES!!! The thing I love most about water walking is that it takes away all the gravity. You feel so much lighter in the water and therefore are more apt to do more exercise. Stand on the side of the pool and do some leg lifts, but know your limits! You want to be able to come back the next day too! You can’t do it all at once, and pushing yourself too much will only lead to a setback because you’ll stop what you were doing to rest and heal the soreness, putting you at risk for not wanting to go back because you’ve gotten out of the habit of going…DON’T DO THAT! A good rule of thumb for recovery is when you can do your exercises, have pushed your limit slightly and wake up the next morning knowing you can do em all again without aching! And it DOES happen that way!
What if I’m still having headaches 6 months post-op after an ACDF? TALK TO YOUR DOCTOR!!! There might be some underlying issues that still need to be addressed! That’s not something you should just accept. At any post-op measurement! Your doctor should be investigating other causes for your headaches until he’s satisfied that it could be just a negative side effect which is rarely seen in ACDF post-ops. HAVE THAT CONVERSATION WITH YOUR DOC!!!
Will another disc go bad after I have my surgery? That’s hard to answer. There is definitely the “risk” of that depending on what type of activity you resume after your operation. But I wouldn’t get all doom and gloom just yet. Our bodies are marvelous organic machines with many capabilities to heal from the abuse we deliver to it each day. Could it happen, yes, will it happen, maybe, can my doctor say for certain that it won’t, NEVER! Our body is aging all the time, and with that comes the throes of arthritis and degeneration through either no fault of our own or through the abuse we continue to pummel it with, totally disregarding cautionary advice from your doctor, ad campaigns about food, alcohol, drugs etc., or chiding from your loved ones who can see the toll your poor choices have taken on your body; things you can’t see for the simple reason you’re so close to the situation. We must all be our own best advocate, because, everyone else is worried about their own self, so much so they aren’t going to invest more time in you than themselves… it’s human nature!
I hope this segment has again, informed and inspired both the patient who’s already gone through the surgery looking for additional answers and for those in fear of the unknown. The “old school” method of back surgery where the doctor cuts through the back muscles and damages more than what he fixes are fast coming to an end as newer and more innovative techniques for accessing the middle of the body are invented. My best advice to anyone in need of these types of surgery is to be your own best advocate by being informed. I love to hear patients when they come in talking about their condition in medical terms because they’ve done their research. And still I love to talk to those who haven’t got a clue about what’s going to happen to them. It lets me help them through the often confusing process of surgery by giving them a lay person’s understanding of what’s about to happen to them. They walk out of the office feeling they have been heard, their concerns are addressed and they have someone to lean on should more questions arise. I offer myself to be available to them at any step of their healing process.
I will be adding more to this website in the way of sharing my healing as well as answering question I get. I also plan to post some exercises I did for the different conditions. Make no mistake, you MUST CHECK WITH YOUR DOCTOR FIRST BEFORE YOU ATTEMPT TO DO ANY OF THEM. Each persons’ condition is different and what the doctor had to do to fix your problem. Only he’ll know which ones will be good for your body.
In the meantime, remember to take care of you and yours,
Well, it finally happened…. someone’s tired of hearing me talk about my surgeries and my doctor and in a negative way! So here goes…. here’s what I’ve got to say to them…
It’s been brought to my attention that I may sound like I’m sugar-coating everything I talk about while writing on my website. I was told there are plenty of other really good doctors in this world that perform just as many successful surgeries as Dr. Smith. I agree, there are a great many good doctors that regularly have successful outcomes like Dr. Smith. However, after seeing three doctors and being turned away from two, one of which said I was so deformed he wouldn’t touch me, it was Dr. Smith who took the chance with me.
Until one walks in the shoes of someone who suffers from severe back and leg pain along with hip and shoulder and neck pain, one can’t even begin to place the value on what Dr. Smith did for me. When the dust settled claim-wise from my insurance company, I was appalled at the price the hospital took in comparison to the amount my doctor received. I really feel it was upside down. He is so underpaid for what he gives back to people!
So my thought has been two-fold, give back to others and help Dr. Smith get the word out in a positive manner. There are so many horror stories about botched back surgeries. So many so, that the insurance industry now wants to deny most back surgeries. Herein lies a HUGE problem… this comes on the eve of a VERY large number of successful minimally invasive back surgeries. The procedure is so new, that a lot of the insurance companies are still skeptical about it’s place in the industry and are looking at ways to restrict even the most successful minimally invasive procedures. It’s just absurd!
Some have suggested I have an ulterior motive for offering my time to Dr. Smith’s office to be an in-house patient advocate. And they’d be right. Yes, it is all about helping others make that final decision to change their life and free themselves from the hideous pain they suffer, but there’s more to it, some of which is self-serving.
It’s been eleven years since I’ve been in the workforce. Eleven wasted years of productivity, of my family’s lives being so different because I wasn’t able to contribute financially but rather only as a homemaker. And often shoddy work there at best. I’m in the “black” years, those that put me really unemployable because of my age, and yet too young to collect social security. But then there’s the issue of the economy. In a few years when I reach 65, will it even be available to me? And what about Medicare and Medicaid? What price will I be paying along with those benefits? Not to mention the fact there are so many people much younger than I unemployed and eager for gainful employment. What possible chance do I have if you really look at the BIG picture of the global economy?
The above questions will be decided for me by powers far out of my control. But I can in some small way take stock of my situation and realize I am now in a position to do something about it. Since I no longer spend my days preoccupied with the “white noise” of pain underlying everything I do, I’m able to concentrate on things of importance. Things like writing my memoirs and figuring out how to help others. I don’t get paid for what I do right now, but someday I may, and in the meantime, I’m gaining new insight to help expand the emerging developments in neurosurgery. Without patients to operate on, a surgeons skills are not used to the fullest.
I hold a pretty unique position in the fact that I’ve had three very debilitating conditions which have been corrected successfully. My willingness to discuss these conditions can bring hope to the tens of thousands still suffering from these conditions and who are unaware of what relief may be available to them. I’d like to think I can show my humanity to others, by sharing with them my experiences and what they can expect and hope to achieve through their personal surgery. As is always the case each patient will have a varied outcome for several reasons, but the most important is the level of commitment they dedicate themselves to the physical therapy for their recovery. A doctor is only one part of the equation in the healing process. It’s imperative each patient dedicates themselves in order to achieve maximum results.
That being said, it’s harder than you can ever imagine. These prospective patients will need help. I’ve been told a lot of people aren’t as strong willed as I am to face this type of a challenge. Or atleast they think they aren’t. They just need a boost of confidence to know they can handle the surgery and recovery which will make their healing go much easier. That confidence can translate into lesser time in a brace or on the sidelines until they gain their strength back. That’s where I come in. It’s my personal experiences rich in human frailties that can guide others to know they too can do what I did.
It’s been awkward finding a rhythm, getting back in the groove of going to an office and being somewhat creative for a purpose. I haven’t hit my stride yet, but I keep plugging away at it. I trust that one day, soon, things will start to click and feel I’m finally back in the groove. I may not be able to do the job I once did, but I’m certainly not ready to keep myself out of the game any longer. I was a family mediator by degree; an architect of lives. It was very rewarding work to see people so far apart on the simplest of issues come together through what I said, and how cool it was to craft their lives in such a way they became civil to one another and could deal with the negative issues that made them angry. To some degree, I understand how Dr. Smith feels when someone comes into his office downtrodden in a wheelchair and in a short time comes back walking upright with a smile on their face. It’s a gratifying feeling.
I don’t know that I’ll ever be able to mediate again, but I can be an architect of lives, helping others, coaching them to transform their own lives, to be productive, and active once again. We have but one life to live, we better give it our best shot!
So I can say to those who’ve called my intentions into question, yes, I am just slightly biased. Not just for Dr. Smith, but for the treatment and technology he used to transform my life. It can be that way for so many more. Especially if insurance companies don’t put more stringent guidelines on people, tying the doctors’ hands and limiting them to band aid treatments instead of fixable procedures. Also, these doctors, not just mine, need to have a larger cut of the pie. I was in the hospital 3 days, not weeks or months. My doctor got paid only one tenth the bill the hospital charged. It’s insidious to think they have to be willing to save lives and maintain their training and teaching just to get paid pittance in comparison to the amount the hospital raked in. I might add too, that the care I got at the hospital was less than stellar.
I might have been on morphine, but I still know what good hospital care is. The most outrageous act committed by a nurse who came into my room, put down a blood draw tray, walked over to the bathroom toilet, flushed it with her bare hands, then walked back over to me without washing or sanitizing her hands, and wanted to start feeling for a vein. I stopped her, asked her if she was going to wash her hands before she touched me, she looked at me and asked why. I said because you just flushed the toilet and didn’t wash. She got indignant with me, left the room and sent someone else in to do my blood draw. I understand that was only one nurse, but she does represent the hospital. Each of us represents where we work, as a part of the whole. Therefore, it’s no real stretch for me to assume that there may be more like her where she came from, in that very hospital. If she hasn’t got enough pride in her job, that by her attitude, she could cause more harm than good by her presence, she should not be there.
I was defensive when I was called out about my attitude towards my doctor and the procedures performed on me, but I hope you all can see a bigger picture now and have a deeper understanding about what is really in play here. If you don’t get it now after this explanation, you never will. Most will, some won’t and I really don’t feel like wasting my time on those who want to bring into question my motives. I simply want to get on with my life in a more meaningful, positive way than ever before.
As always, remember to take care of you and yours,
Sorry it’s been 12 days but I’ve been a tad busy… I’ve been making final arrangements to go back to Ohio for my 40th class reunion! When I first met my doctor, Dr. William Smith, I told him he had a year to get me well enough to attend my reunion and I wanted to wear 3 inch heels. Well here it is almost time to go and he kept his word! I tried on my heels the other day and I’m good to go!!! A while back I took in my 2 1/2 inch heels to my physical therapy doctor who taught me how to walk in them again… I’m pretty excited to be able to fulfill another thing on my bucket list. And on Thursday I start my first dance class. I bought myself some lessons as incentive but couldn’t use them til now… I’ll let you know on Thursday how it goes!
Well, additional questions have come up as I’ve gone through my website. Important questions I feel qualified to continue to answer. The more questions asked, the more informed you will be in making your final decision to have your life changed. As with all surgery, there are complications beyond the control of the doctor or that could not be seen at the time of your surgery. Just remember one thing, your doctor is acutely aware of the risks involved, therefore, it’s in his best interest to make sure everything he does is in your best interest. I say this because some of the questions asked seem to want to lay blame on someone. Surgery has it’s risks. That’s why you should be as informed as possible going into it.
HOWEVER, the surgery is only one small part of the healing process. YOU are the one in control of the final outcome. If you are a smoker and the doctor asks you to quit, THEN QUIT. The only person you are hurting is yourself AND the doctor can only do so much. Smoking is one of the biggest roadblocks to recovery. It limits your blood flow and slows down the healing way more than you can imagine. If your doctor tells you to go to physical therapy, THEN GO. During your operation, no matter which one you’ve had, your body goes through a severe trauma. The muscles he had to cut through to get to the area to be fixed need help so they can function at full capacity once again. It isn’t going to be forever, but after your surgery, you need to know you must make every effort to help yourself. THE DOCTOR CAN’T DO IT FOR YOU! One more thing, in most cases, your condition deteriorated over a long period of time. YOU ARE NOT GOING TO HEAL OVERNIGHT.
I spoke with one woman who told me she was planning on going across country as soon as she had her surgery. When I informed her she would have at least 6 months in a back brace she told me she didn’t have that kind of time. Her husband had retired the week before and they had always planned that as soon as he no longer had to work they were going to tour the country. It truly is a great plan for those who want to do that type of thing. But the reason she was going to have the surgery done was because she couldn’t step up into their RV due to her pain. I tried to reassure her that she’d be able to do all she wanted after the surgery but just not RIGHT after the surgery. Your body needs time to heal, and sometimes the healing is slower than we expected or wanted.
I temper what I tell perspective surgical candidates about my experiences not because I don’t want to scare them or not tell them the whole truth. My circumstances were very unique, and I was far more willing than most to comply with ALL of the recovery process. Some people are not so diligent and I’m OK with that if they are. Again, the only person they’re hurting is themselves. As for me, I’d been in pain for so long, I wanted to do everything possible to insure I had a complete and successful recovery. I lost an entire decade of my life to several disabilities and I needed to get on with things as quickly as possible and by doing the recovery necessary I was able to do that.
For most people, recovery can be totally and completely successful if they are willing to put forth the effort, unless of course, there are mitigating circumstances or complications. When a person does, they feel better about themselves. I had to give up my job because of the severity of my pain and succumb to a sedentary life for an entire decade. Because I wasn’t able to move as well as I once did, I put on weight. That in turn put more stress on my conditions. Which made it more painful, which made it necessary for more over-the-counter pain relievers. Those in turn, have an effect on your kidneys and liver because you’re taking so many a day just to get through. That makes you depressed which then makes you want to eat more and be less active. It’s a vicious circle with no real way out. That is, until you come to surgical relief. So it really does become a no-brainer that surgery is the best option, unless you are so terrified of surgery it’s impossible to overcome that fear. I don’t make light of that but let me address it head on. Would you rather be on drugs that change your personality, don’t really take away the pain for good and often times leave you “hooked” on them and still be limited with your mobility? Or would you rather know that after a time spent with surgery and recovery you can be drug free, and free to be as mobile as you once were.
Right out of the gate I want to answer a question posed to me online. “What kind of doctor performs the ACDF and XLIF? My doctor is a NEUROSURGEON. More importantly he is a doctor affiliated with NuVasive, the company instrumental in the development of the minimally invasive spinal fusions. NuVasive trains orthopedic surgeons as well as neurosurgeons to perform the ACDF and XLIF along with other minimally invasive techniques. Depending on the type of condition you have will dictate what type of technique your doctor will use. If this procedure is something you’re wanting to explore further, go to the NuVasive website where they can connect you with a NuVasive surgeon in your region.
Let me address the surgery itself. Minimally invasive ACDF, XLIF or even the hip replacement I had done puts less stress on your body. I’ll explain in simple terms. Because of HOW your doctor gets to the area needed fixed, he is able to do this by no longer cutting into as many layers of muscles and tendons. In years past, a surgeon had only one method to reach the affected area, through all the layers of muscle and tendons. In doing so, they caused as much or more damage to your body just to reach that area. That’s why so often you’ve heard of someone’s brother’s, uncle’s, cousin who had back surgery and swears it was the worst thing they ever did. IT DOESN’T HAVE TO BE LIKE THAT ANYMORE. More and more doctors are being trained in the minimally invasive procedures giving rise to a very high number of success stories. Another very HUGE plus of the minimally invasive procedures is that a patient isn’t on the operating table near as long as the old method. The XLIF procedure I had done was three hours and twenty minutes. Normally, with any other doctor, it would’ve taken about an hour per level. Since I had six levels done, it should have taken at least six and that’s not including opening and closing. Dr. William Smith is exceptional and world renown. I am very blessed to have Dr. Smith as my doctor.
An added benefit of the minimally invasive procedures is, there is less blood loss. I had a patient speak with me about his pending operation. I told him that I was in the hospital three days and was amazed. But he was opting for the conventional procedure because he liked his doctor and the surgery would be closer to home. As it turned out, he spent five weeks in the hospital. During the first eight hour operation he started to “bleed out” and the doctor had to stop the operation. This was NOT an minimally invasive XLIF procedure. He closed him to let him recover from the blood loss. Three weeks later they went back in to finish the job they started. It was a long, painful, grueling process. One he said, he never wished anyone would have to go through. I feel really bad for him, but in the end, it came down to him choosing the wrong procedure for the wrong reason. He is getting better and more mobile every day. He did say that he was very frightened by the whole ordeal and wished he’d made a different decision. Hindsight is always 20/20.
Someone asked, “how strong is a lumbar fusion?” Well I’ve been told that if I was in a car accident, the other unfused portions of my back would break before my fusion would; taking into consideration you are more than six months out from the operation and all things went well. My doctor takes x-rays at different intervals of my healing post-op to see how well the fusion is “taking.” The x-rays will clearly give him a measure of what’s happening in my body. The more successful the fusion is the more solid the spine looks in the x-rays. Dr. Smith has always been pleased with my progress.
Another question was asked about the swelling of my legs post XLIF. I suppose it all depends on many circumstances. One, how active are you post-op? Activity and movement are important during the first phase of your recovery. I’m not talking about walking around the block, I’m talking about just doing the passive exercises prescribed to you while in bed, like moving your feet up and down and bringing your legs to a bent position while laying down and moving your legs from side to side. And then there’s always the trek to the bathroom. I’m glad I live on one floor so I could walk to the bathroom.
A family member was recovering from a hip replacement and had a portable potty brought to her bedside. She got no real exercise at all and she never did really recover from the surgery. I have to add she also refused to do any of the physical therapy exercises at home on her own. Keep remembering… your recovery success is up to you! No one else. Swelling can also happen when edema occurs, which is often treated with medication. As you become more active post-op, your swelling should subside, unless of course there are some other medical issues you need to deal with.
“There’s pain in my shoulder after my lumbar XLIF surgery.” Yes, there will be some pain in your shoulder on the side you were operated on. Remember, instead of the doctor cutting through all your muscles, his assistant “pulled” them aside so he could work on your affected area. By pulling all those muscles aside, they’re stretched from their attaching points, often farther away than you may think that they are attached. I’m grateful to my doctor for explaining that I would have that pain afterwards so it came as no real surprise when it did. It should subside within a couple of weeks post-op, at least mine did.
Yes, there will be pain the length of your leg for a short while. This too will subside as the nerves reconnect that your doctor had to work on. Actually he probably released the nerves from being pinched and you may have a feeling like someone is poking a needle into your skin in a hundred different places. That’s your nerve endings reconnecting. Each person will experience this a little differently and the length of time it takes for your nerves to regenerate will be different as well.
One of the coolest things about minimally invasive surgery is the fact that you have very small scars in comparison to conventional surgeries. I have three, two-inch scars on my right side. Dr. Smith also needed to go into the back, so I have a one-inch scar on my spine at waist level; which has almost disappeared. Prepare yourself to wear very loose, comfortable clothing for a few months until you can put a pair of pants or skirt on with a tighter waistband. The incisions are usually made right at the waistline. I have a propensity to keloid so I had to work on my side scars with some Vitamin E oil. I got the 40,000 IU’s, but for most people the 10,000IU’s should do the trick. (you can find this in most drug stores or health food places such as Whole Foods) When you rub it on your scar, push with some degree of pressure. You’re not looking to reopen your wound, but you are wanting to break up the scar tissue forming underneath where the doctor actually cut. Mine was flat and comfortable within a few months.
One parent was concerned about picking their child up after surgery. Whether it’s the XLIF or the ACDF or for that matter even the total hip, you should probably avoid doing any lifting until you’re cleared from your doctor to do so. Make arrangements for someone to do those kinds of activities until you are more able. One trick would be to sit in a chair or on the sofa and either have the child brought to you or to have the toddler climb up to you. Lifting in the first couple of months of any surgery should be avoided unless otherwise specified by your physician.
OK, so I’m four months post-op from my ACDF and I have a few bits of wisdom for those who have just had it or are thinking about it. Let me preface this by saying…I WOULD DO IT AGAIN IN A HEARTBEAT!!! The relief I got from the pain was immediate.
The surgical pain is a little bit different. One has to understand that within a little less than 8 weeks after I had my ACDF, I had to have a total hip replacement. This meant I had to have another airway put down my throat, allthewhile healing from the neck surgery. This posed some interesting problems for me healing from the ACDF. It was four days after my ACDF hard brace came off that I found out I’d have to have a total hip replacement.
The hard brace, I’m not gonna sugar-coat, was the most unpleasant thing I’d experienced so far. We have a natural tendency to twist our head in a certain direction of sound, or to look down when we drop something. With the hard brace I tried to do all that but my chin was caught making it immobile. Each time I did this my jaw had extra pressure on it from trying to look a certain way. My teeth hurt a lot from that pressure. I was uncomfortable most of the time. The only relief I got was if I went to lay down or at night because I was able to wear a soft brace if I was laying down. But I knew it was only for six weeks. My back brace was on for four months, originally being told I’d have to wear it for six months.
I don’t know if it was a combination of being in the brace for six weeks and having to have another airway put down my throat, but the healing of my neck has been slow for me even though it’s only been four months. I just feel I should be further along than I am. It’s felt like someone is choking me, not enough not to breathe, but still choking me. What it really is, is the muscles they stretched to get to the area of the spine to fuse, relaxing. The right side of my face is still slightly puffy, but I’ve never had my jaw go completely out of place afterwards. I did have some clicking, but my doctor of PT gave me some mouth exercises to help with that. A few weeks of doing those and my jaw felt much better.
Early-on after surgery, I did have some real muscle tightness but as I did my physical therapy exercises, that subsided. I had a lot of breathing and swallowing issues right after my ACDF but it was my own darn fault. You see, I refused to take the steroids the doctor prescribed while in the hospital. It wasn’t until he was out of town five days later that I realized I was in trouble and had to call his PA, Joe to have a script called in. Joe said they’d take a couple of days to kick in but I should be OK. They did and I was, but not before it gave me a real scare! A really stupid move on my part! Hindsight is always 20/20!
I didn’t have any face pain after my ACDF, except right afterwards, but that subsided quickly. It was from them pulling those muscles aside to get to the vertebra. It was really weird for a while because when I tapped on my neck it sounded so hollow. All the muscles and inner-workings; voice box, esophagus, etc were so far over and they needed time to work their way back. It took almost a month for the tapping to not sound so hollow! Before my ACDF my arms were constantly going numb and my right fingers were numb as well. As soon as the ACDF was done, the numbness went away.
Right before surgery I asked Dr. Smith if I’d be able to sing again. He answered, “Most people recover nicely getting their voice back and have no problems. A small percent end up with a rasp in their voice for a good while and an even smaller percent will have the rasp permanently.” Well, that didn’t really answer my question, but then again, it did. What he was telling me was what I could hope to expect, but that each person’s recovery is different and he wasn’t going to predict anything.
He did advise me that I shouldn’t put a strain on my voice until I was like at least four months out to allow everything to work back into place and then I could start to do singing warm ups and vocalizing a little. I’ve started the warm ups and the vocalizing and I’m here to tell you it still feels like there’s a lump in my throat. I’m wondering if I should get my throat stretched. The more I use my throat and neck muscles for talking and singing the less I feel like someone’s choking me, it’s still there, but less and less as the days go by. I imagine that by the six month mark I should have my voice back completely with no discomfort in my neck at all. Just in time for rehearsals for Christmas Choir. Now my singing voice will be a different story. I don’t know how far up the scale I’ll be able to go, but from the preliminary exercises….well, let’s just say, I’m very hopeful! The more I get control of the muscles the better the sound is. I’m starting to do some things I didn’t do before so I’m treading on mighty uncharted territory. More along the lines of contemporary singing rather than the opera type that I was trained to sing. That’s OK, I like a good adventure!
I’ve had some unique experiences because of me having an XLIF and a total hip. I am glad however that I didn’t have the total hip any sooner. If I had, I don’t think it would’ve rendered the same positive results. By that I mean, my back had to pretty much completely heal before Dr. Michael Crovetti, the hip surgeon, would know how to set my hip so I didn’t have to wear orthotics any longer. He did the final “tweaking” so to speak to my structure. Even though Dr. Smith had stabilized and straightened my back to a degree, my shoulders were still visible crooked. One was higher than the other. It wasn’t until Dr. Crovetti replaced my hip that I now stand with both shoulders even.
I had a picture taken at the NuVasive Cheetah Ball in San Diego with Bill Walton and Nate “Rock” Quarry. Standing between the two of them made it really obvious how crooked I still was, but that was before the hip surgery. I’d love to have another picture taken between the two of them again just so I can hang them side by side to show the comparison. With each surgery I’ve become a better person! Physically and mentally. If anyone is facing the same dilemma, to them I say, have the back done first, wait and heal completely from that and then have the hip done. You won’t regret it. I’D DO IT AGAIN IN A HEARTBEAT!!!
So as I close for now, I hope this has opened your eyes to some of my experiences. Do your research and make sure you fully understand what it will take to heal. And whatever you do, remember that your doctor can only do so much, it’s up to you to do the rest! Choosing a minimally invasive procedure is a step in the right direction… enjoy your journey.
As always remember to take care of you and yours,