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TLIF L4-L5 Post op Day 6 - Needing some Hope!

Hello everyone,

I’ve been reading this forum for the better part of 2 years now, and decided to join the conversation. I had a work related injury in early 2016 that lead to a herniated disc with a severe annular tear. I was 34 at the time, and all of my other discs were in perfect condition. Fast forward, has PT, ESI (ended up with a spinal fluid leak), a laminectomy/Discectomy a year ago and after failing to improve, I had a 1 level fusion last week. I have been realistic about the slow process of healing, but I am just looking for some input and hope!

Right now I am still mostly in bed, walking often, and sitting for meals (painfully). I had a lot of issues with muscle spasms in the hospital and still am struggling with that as my main source of pain. I am at the point where my hips and low back are sore from being in the bed, but I can only tolerate so much walking due to spasms. Collectively I am walking about 0.5 mile a day broken up according to my Apple Watch.

Of course my pain meds have completely backed me up, so I’ve been aggressively working on that too. Any advice on safe ways to stretch or keep from getting too sore while resting? I overdid it on POD 4 and realized I need more sleep and rest than I was getting. Seems to be a fine line between walking enough and walking too much. I wish I could just soak in a nice hot bath! Ice has been helping with muscle spasms between meds and when it seems to flare up. My incision looks good other than some swelling.

Feeling already bored of feeling blah! Any tips for sitting comfortably or relief of spasms and constipation!


SJ

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Comments

  • Hi SarahJade4

    Welcome to Spine-health

    There is definitely a fine line between too little and too much walking but you will find your own level in the next week or so. Brilliant you are doing everything you can to mobilise.

    The sitting thing was a no go for me for a while, so I would perch for meals, use chairs with arms or use the table for some support, by resting my elbows on it. I have to be careful with this though and somebody had to help me get my chair right into the table, so I didn't end up bending my back forward.

    I had to get help in hospital with constipation, two attempts at enemas and then sent home with laxatives and stool softeners. I also eat dates, prunes, orange juice, bran and drink a large spoonful of golden linseeds soaked in a glass of water. I found this a little less aggressive than some laxatives and used this once I came of the morphine and stepped down to just Tramadol.

    It is all trial and error to start with, so don't lose hope, things really do improve as you settle into recovery.

    There are no medical professional on this site so we cannot advise you on exercises but you could call your medical team and ask about this or check any paperwork you were sent home with from hospital from the Physio department.

    We also have Surgery Buddies groups under 'Forum Topics' you could join. Just click on the month and introduce yourself and have a read. I found these groups so helpful during recovery.

    I have added two links below to help new members with information and these also contain the forum rules. There is lots of material to research that will give you the power of knowledge.

    Welcome to Spine Health


    AJ


    AJGormit
    Spine-Health Moderator
    ---------------------------------------------------------------

    L5/S1 herniation Apr 2013
    nerve root injections Oct 2013
    L5/S1 discectomy Jan 2014
    L5/S1 nerve roo &, facet joint injections & edpidural Jan 2015
    L5/S1 revised discectomy, L4/L5 discectomy & Wallis Inswing Stabilisation L4/L5 May 1st 2015
    L4-S1 TLIF with decompression June 2017
  • Thanks for the encouragement, AJ!


    Things are going. I am happy to say my bathrooms woes are full swing in the other direction now. Ha! That fine line again.

    Still dealing with a lot of spasms, but much better than a few days ago. The most painful one is on my right side (the cage spacer went in through the right) so I’m assuming that’s just where most of my surigical trauma is. My right side has been my more painful side all along with the most narrowing and bulge on the right. That muscle aches down into my leg which makes laying in bed uncomfortable. But, this too shall pass! I’m very grateful for this site. It’s helped me in many ways and it’s nice to come here where I know others understand.

    Hope everyone’s had a great holiday!


    SJ

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  • Hi again SJ

    Wow, on the bathroom woes!!! I think this is why I started relying on the golden linseed soaked in water, as it has more of a natural approach and less of the 'aggressive' outcome :-). As you say, a very find line!

    I found the first two weeks after surgery were just about letting the body settle after surgery. Your body has taken a huge amount of trauma from surgery, so hopefully these muscle spasms will settle soon. If you have any concerns at all or feel something isn't as it should be, just put a call into your medical team and report what is happening and they can advise if they expected this as part of your recovery. They are there to help, so use that support. They want a good outcome as much as you, so use their brains and experience, if you are worried.

    Thanks for your reference to holidays and hope you were able to enjoy as well, considering your post op recovery.

    AJ

    AJGormit
    Spine-Health Moderator
    ---------------------------------------------------------------

    L5/S1 herniation Apr 2013
    nerve root injections Oct 2013
    L5/S1 discectomy Jan 2014
    L5/S1 nerve roo &, facet joint injections & edpidural Jan 2015
    L5/S1 revised discectomy, L4/L5 discectomy & Wallis Inswing Stabilisation L4/L5 May 1st 2015
    L4-S1 TLIF with decompression June 2017
  • Had a setback. Woke up feeling very off with a bad headache and generally feeling unwell. Saw the NP who wanted to proceed with caution, but not jump to any conclusions. Have had a low grade fever for several days as well. After getting home from the NP office, I took a nap and woke up to new draining from my incision site. It had been dry for over a week. So I called my doctor’s office and they direct admitted me to investigate in case I had developed an infection. Happy to report all worse case scenarios were ruled out, but I definitely have a seroma (fluid filled pocket) that found a way to the surface and is the cause of the drainage. Cultured, MRI, and started on antibiotics to ward off any potential infection and sent home. Thankful I only had to spend one night on that rock hard hospital bed. I had been taking for granted the true comforts of home! I have been able to drastically reduce my pain meds and muscle relaxers to where in trialing just Tylenol this afternoon. Fingers crossed! Happy new year!


    SJ

  • I had TLIF L5/S1 on 12/20. I spend most of my time in my recliner or in my bed all propped up by pillows. I get up and walk as much as I can. It’s been really unusually cold here down south so walking outside isn’t happening much. My hips are sore too. My doc prescribed Valium to help with the spasms and the tightness. I’ve been only taking one a day and taking tizanidine the rest of the time. I’m really wanting off all meds. Only I’ve also developed two large pockets of fluids under my incision which is causing extra pain and pressure. I think i had get off or drastically decrease all the meds if it weren’t for these pockets of fluids. My surgeon has been out of town so i went and had it looked at on Saturday and they did ultrasound and said it was fine and that while it causes extra pain it’s not harmful. There’s no sign of infection, it’s not oozing or draining, and I’m not running a fever. They said my body should absorb it on its own. I see my surgeon tomorrow for a follow up so I will see what he has to say about it. I haven’t been able to wear my brace because it’s too painful pressing up against this lump on my back. It’s about the size of my hand. I also want to ask him about what stretches i can do. I feel like I need to stretch.

    Glad to know there is no infection. That’s great news!

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  • Star, we had surgery on the same day! It’s unuaully cold here too and I’m in the south. I think it was 16 degrees today! So my trial off of my pain meds and muscle relaxers was great for...6 Hours and then I was literally suddenly in horrific pain, tears and all. Gave in and took half a pain pill and a muscle relaxer. Guess I’m not ready! I think my expectations are just a little off...I’ve heard that fusion heal on their own time and there’s truly nothing but supportive care that we can do to hurry it along. Maybe this is my lesson in patience! Let me know how your follow up goes! I am so sorry about your seromas! I’ve heard if they’re causing a lot of additional pain, they can be drained. Just hate to open a spot up for potential infection if your incision is dry now! I will be relieved when mine stops draining. It’s very minimal now but I suppose it makes me a little paranoid knowing it’s not closed off completely. You may want to ask your doc about heat for the seroma. I feel like I read somewhere that can help, but there’s a delicate timeline with heat an fusions, so I wouldn’t do anything without asking your doc. Of course, ice will help the pain if at least temporarily! Will be praying for you! Thanks for your post!

  • Oh and Star, my procedure was a TLIF L4-L5, with a cage and pedicle screws with rods. :)

  • Yes, my TLIF was with cage, rods, and screws as well.

    I woke up early this morning in a ton of pain. I got up, put my robe on, and came sit in my recliner. When I went to get up and refill my coffee cup, I felt something very wet on my back. The seromas are definitely draining now a lot which is relieving a lot of the pressure.

    I see my surgeon this afternoon for a follow up.

  • Aww, keep them clean and covered. If you have any bandages from your surgery, I’d clean your back and put one on...I’m glad the pressure is relieved but I’m so sorry you’re draining. Let me know what the doc says. I’m waiting on a call from mine - can’t tolerate my antibiotic...

    Thinking of you!!

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