Thursday, December 27, 2018

Lumbar Discectomy - 10 things I learned in the first 4 weeks post-op

I've now happily reached 5 weeks since my surgery and I thought I would share some things I learned. If you are contemplating getting a discectomy because you have a ruptured disc and it's not getting better with conventional means, I recommend you do (read my success story). For me, the pain during the 4 weeks post-op was way less than the pain pre-op, plus, it decreased day after day and I was getting better week after week. Just seeing this progress, which I hadn't seen for three months, was so thrilling. Anyway, here are a few things I learned during the past 5 weeks:

1 - Memory pains feel so real
I didn't have any memory pains the first week post-op, but one day in week 2, I was lying in bed and moving my left leg (the one that had suffered from sciatica pain for three months) and trying to relax it. I had my knees up, and was letting my left knee fall as close as possible to the mattress, (which wasn't far, since my left muscles were so tense). Still, the memory pains started from then on. I called the surgeon's office and they thought maybe the movement had allowed the disc to extrude again, so he sent me for an MRI and it was clean! PHEW! In any event, I was feeling memory pains from then onwards. As much as memory pains are scary (Did I do something wrong, is my disc protruding again? Am I going to need fusion surgery? Oh no!), I learned that they are just natural. The nerve has been pinched for so long that it just remembers the pain. I asked my doctor about Lyrica (Pregabalin) and he prescribed me some. That worked really well to radically decrease the nerve pain memory but I only took 1 tablet because I felt really dizzy and light-headed in the morning and I didn’t like that feeling at all.

2 - Handy tools: grabber - sock aid - bottom buddy
Since we can’t bend for 4 weeks after a discectomy, a grabber is essential. Find one that is firm at its mid section if it has one (some are floppy). I actually dropped my grabber quite a few times during the 4 weeks. Luckily, at the beginning, my husband could pick it up for me. Later on, I managed to find a way to grab it with my feet and pull it up. If you live alone, getting two grabbers could come in handy every now and then.

A sock aid is also very helpful if you live alone and nobody can help you with your socks. I only used mine a few times. I only recently found out about a bottom buddy, which would have come in handy in the first 2 weeks, but I seemed to manage on my own :)

3 - Kitchen and Bathroom
I made sure that everything was in reaching distance. Some kitchen things needed to be moved to a higher drawer or cupboard, other things needed to be moved down a bit. This is temporary but it really prevents you from trying to reach too low or stretching your back by reaching too high. After 4 weeks, I was back to normal, and everything returned to their original place.

4 - Brushing teeth
Ok. So you’ve brushed your teeth. But you can’t bend over. Now what? I brought in 2 glasses from the kitchen. I use one for sipping and bring the second one up to the level of my mouth for spitting. Easy-peasy and no bending involved. I’m still using this system now as my physiotherapist says that I will only start bending in week 6 post-op.

5 - Walk, walk, walk
I had spent three months lying on the floor because both sitting and standing were so painful. On day three after the surgery, I went out for a 40-minute slow stroll. It was fantastic. After that I dropped the time a bit as I didn’t want to overdo it, so I started at 20 minutes, then built up to 30, then 40, etc. I have been walking every single day. Some days were hard, my feet and legs would feel exhausted after only 30 minutes. Sometimes I would push myself a bit and walk 50 in those cases, but once back home, I would always lie down to rest my back, legs and feet. Remember that building up strength after surgery is not like preparing for a marathon. Slow and steady is better. If you feel any pain in your back, you might be pushing too hard. Don’t do too much too fast. There is no room for the “no pain/no gain” approach when recuperating after a surgery. Take it slowly. Your body needs rest too. I’m now able to walk up to 90 minutes a day and I’m going to aim to walk 2 hours a day soon.

6 - From walking stick to trekking poles
I had already purchased a walker while I had the ruptured disc as standing was so painful and walking was difficult. After surgery, I used my walker again for a while, not because I needed it to walk but more to send a message to other people: be careful around me and please don’t bump into me or push me. I really didn’t feel like falling or getting pushed in my lower back. Also, it was great as a stabiliser if ever I tripped over something. After a week or so, I switched to trekking poles (I bought some Leki’s - great brand!). I used only one to start with and I was able to walk twice as fast than with the walking stick. Now I sometimes use 2 trekking poles as that’s quite a workout for both arms and legs. I love them. People still think they are a walking stick, so it’s like parting the water when arriving in a place full of people, they just let you pass, or make sure their dogs don’t get too close. Really a great way to walk safely. And once, I did miss a step — there was a hole in the ground. Had I not been able to lean on my trekking pole, I might have fell and God knows what could have happened to my back at that point. Needless to say, I am keeping those trekking poles close to me for quite a while.

7 - Pain meds
I had been taking lots of 5 mg Oxycodone pills as well as 30mg Codeine tablets for 3 months before surgery as the sciatic pain was unbearable. After the surgery, I continued to take Codeine during the day and 1 Endone at night as well as Paracetamol for the underlying post-surgery pain. I took an Endone at night because I really wanted to get a good night’s sleep. I think that’s essential for healing after surgery. Little by little, I dropped to only 1 Codeine during the day and 1 Codeine at night. By week 3, I was taking only 1 Codeine at night and by day 25 or so, I was able to drop all pain medication. Since my dosage was so low in the last week (1x 30 mg Codeine per day), I was able to stop without any side effects whatsoever.

8 - Pillows
I used so many pillows everywhere. I had a wedge pillow covered in a plastic type material that worked great to get in the car (passenger side, as my surgeon said I couldn’t drive for 4 weeks). I would face the rectangular wedge pillow outwards, sit down on it, and then pick up my legs and turn them into the car, and the pillow would rotate with me because of the slippery fake leather material. Another option is to put a pillow on a plastic bag, so that the pillow will also turn with you. This is important at the beginning as you really don’t want to twist your back. Little by little, it gets easier to get into the car as you grow stronger after surgery.

I also had pillows in bed. I had a long half circle one for when I slept on my side. I would place it at my back, so that I wouldn’t unconsciously twist my back in bed. I also had a smaller pillow to put between my knees as that decreases the pressure on the lower back. I only took the longer pillow out of the picture just a few days ago, and I’m in week 5 post-op.

Lastly, an Occupational Therapist came over and introduced me to this amazing lumbar support pillow. This is so comfortable! It really provides strong but soft back support and it’s customisable in the back, thou can change the level of tightness just to suit your needs. It is so helpful to sit again with this comfortable support!

9 - Physiotherapy
After 4 weeks of home rehab, the surgeon gave me the green light to start physio. I’m so thrilled to work on my core, leg and back muscles again! I’m really enjoying moving and working. The physiotherapist has given me some exercises to do at home as well and they really help. Physio is great because I never want to go through this again.

10 - Sit/stand desk
Because sitting is really not good for the back, I bought a sit/stand desk that is really easy to use . I love the gas lift mechanism as it lifts all by itself without any strength needed. I also purchased a Topo anti-fatigue mat, which I love because it’s not flat and I can change positions to relieve the pressure on my feet. They have standard and mini sizes. I took the mini and it’s perfect for me (I’m 1m60). I asked other people who own a sit/stand desk and many of them say they sit 50% of the time and stand the other 50%, that it’s good to switch every hour or so.

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Well, these are just some things I learned along the way. I hope these help you to figure out what you might need in your particular case. Feel free to comment if I have forgotten to mention anything.

P.s. DON'T READ THE HORROR STORIES ONLINE!  Everybody is different. Every situation is different. Every injury is different and everybody will recuperate differently after surgery. Some people might not heed their surgeon's advice and therefore re-herniate their disc, but they might not say so online. Trust your surgeon and your needs.