Saturday, June 27, 2015

21 days Post Spinal Fusion L4-S1

So today is 21 days post surgery.....I hate to even type how things are going in fear of jinxing the recovery process. After the double Laminectomy I felt great immediately upon waking with the nerve pain gone but felt some left hip pains that were pretty sharp. I walked and did the EFX and some stationary biking during the recovery and had a total amount of stepping miles of 146 for the month of March.  In january I had a step count of only 126 miles and that included 3 marathons and a 5K so you can tell how debilitated I became.
In April my step mileage count was 137 miles...when I did stationary biking it doesnt register as steps so I did have some other forms of exercise as well. It was in April 6 weeks after the first procedure when the nerve pain returned but to the opposite side....nothing as severe as before but would have advanced to that over some time. Knowing I would be having surgery on June 6th during the month of May I pushed myself to walk and hike and get myself nice and strong in hopes that it would be an advantage in recovering. I walked and hikes 161 miles during the month of May.
Surgery was June 6th and 3 days prior I went and walked a half marathon in northern ohio so that I could be surrounded by my running family and have a little bit of mental therapy before the big day. I was incarcerate from Thursday the 6th and was released Sunday the 9th.  The first evening was the worse where I didn't even have the strength to move my body...actually all 4 days were horrifying but each day did get a little easier. By saturday the 8th I was walking around the floor of the hospital 3 times and did that 3 times during that day. I never pushed and one time I cut it short and did only half a loop because I was tired.  When I got home it was still tough getting up and down but I have always felt better when I moved rather then the pain from sitting or laying on the incision area and then the initial movement causes some pain as well. After I was home for a couple days I began some short walks outside. They started with a couple .25 mile 3 times a day and they rapidly increased each day...again I have not once pushed myself...I have paid close attention to how I feel and if I would get the slightest feeling of discomfort I immediately turn around and head for home.  It was day 11 and I was out walking and things just felt so good that instead of turning where I had been for a 1.50 mile total walk I just kept going...nice and slow. I ended up going 3.2 miles. I was concerned and called the doctors office to see if this was bad even though I wasn't pushing at all. The nurse said to listen to my body and that was a lot for someone that isn't even quite 2 weeks out and to absolutely not do anything else but walk...No bend lift or twist and no other forms of exercise.  The next afternoon and evening I had more of the hip sharp pains that I had been having so I decided to back down to my 1.5 mile distances for the rest of that week. I still went and did a walk every couple hours but just kept them shorter in distance. By Saturday I was feeling ok so started to bump them back up again and I could feel my pace getting a little faster....still I AM NOT PUSHING myself.  This week now I have been averaging about 15,000 steps a day,,,Tuesday thru today I have been doing in excess of 7 miles each day...with the longest walk being the 3.2 mile route when I wake up and then I follow it with distances that range from 1.5-2 miles a couple more times during the day. I can say today my hip pain is starting to disappear. I still have incision pain when I sit back or lay down on it but I feel the best when I am moving and walking.  My pace is getting much faster too. I managed this mornings 3.2 in about 50 minutes but I wasn't going for speed just walking comfortably. I also stopped during this 50 minutes and talked to some people I say.
I have no intentions of trying to run or jog until the doctor tells me I can. I know the titanium has to heal in there and make my spine strong again so jarring things could really mess things up....but the way I am feeling I believe some speed walking and some longer distances will be there much sooner then I ever dreamed! I think running will be there much sooner then I ever dreamed but I would guess its going to be still at least 4 or so months out...but thats a lot better then 1-2 years as suggested before the surgery!!
My first follow up will be this Tuesday and I believe he will X-ray and see how things are looking and then give me a plan of action.

Wednesday, June 17, 2015

11 Days Post Spinal Fusion L4-S1

So Im 11 days post op and I start to feel like I am some sort of medical marvel...first with the knee years ago being told I can't run or would need a knee replacement within 2 years but then year and half later decided to run and did 88 marathons/ultras and now don't have any swelling or bruising of the knee? I feel like I should be hurting more but my walking get longer and stronger everyday.
I had my staples removed last friday afternoon - there was 23 of them...I had my mom take a look at it and it looked like a couple places where the incision was pulling apart some and I called my family doctor who removed them and sent a photo to his text but didn't hear back so I had mom go ahead and get some butterfly's and try to close the gap. It seemed to work then my son saw a gap in the middle where the incision was really deep and he did the same and the next evening it seemed to have gotten much better.  There is some itching where it is healing and when I sit or lay there is some surgery pain in the center right side of the incision....kinda feels like a burning sensation when it hits me. My right hip still has some pain and I have some itching in the left upper hip. I am not sure which side he took part of my bone out to use as a harvest bone and I am assuming some of this itching and hip pain is probably from that.
Walking feels great! Its so hot and humid outside but it feels good to walk. I started last week with just walking up the street and back 3 times a day and then by the weekend I was up to half mile 3-4 times a day. When it was too hot and humid I got on the treadmill at a 2.5-2.8mph walk for half mile. Things really don't hurt much when I'm walking...seems to hurt the most when I am laying and then have to roll or move positions.  Nighttimes are still a little rough and I have to take pain medication at bedtime to help sleep and lighten up that pain of laying on my back or side and then having to move some.  Yesterday it got pretty hot and humid so I took to the treadmill at a very slow pace and things felt so good I just kept going....I stopped at 1 mile and felt as though I could go more without any issues but chose not to.
I woke today and had to go to work for a few to get a deposit together and a couple other things then when I got done I headed outside for a mile walk...but when I got going I decided that I would go on to Kinneys lane and back and I know this is 3/4 of a mile each way. It was 100% humidity but there was a little breeze and wasn't hot hot hot.  I really felt good that it was almost scary.  My mind started questioning if I will mess things up by walking too much but the doctor said the more I walk without pain the faster things heal. If it hurts stop...that simple. I know I am strong willed and stubborn and I can block pain very easily so i then question myself and wonder is it hurting and I just have blocked it??? But really it feels much better when I am moving. Steps are very easy, I am NOT lifting anything more then 5 -10 pounds and that is one area that I will not attempt. That area is one that I know can make things worse and there is no reason nor need to attempt to lift anything. I am able to do laundry and when it's finished Tanner brings the basket upstairs for me...even though it most likely isn't 5-10 pounds I will not risk that.  I am not using the sweeper as tempting as it is when I see dog or cat hair laying around it is not worth it. I was glad Moxie (the cat) got her hair cut yesterday as that will keep down some of that.
Most people who go into this surgery are older then myself and are not nearly as active. Last year even with the pains before surgery I averaged 250-300 miles a month of walking/running then after my surgery at the end of February I still averaged 150-176 miles of walking each month. I didn't run but stayed walking. Even when the laminectomy didn't work as we hoped I still stayed active knowing this recovery would be less painful the healthier I was going into it. I had stopped the pity party that first part of May and stopped eating all the ice cream and junk and took 10 of the 30 pounds I had put on since last year and 20 some alone since Jan off.  I had a couple bad days this week but when your son makes you a homemade banana cream pie, crust and all then banana bread from scratch whats a mom to do :)
I have already started thinking of new goals.....I know in November I will do just the half at RnR Vegas and walk it....but I am thinking I will be able to start back to running a little at a time by then and get training for RnR Nashville in April. I also am signed up for RnR NOLA in Feb and the full there has a 7 hour time limit so walking with little bits of jogging shouldn't be a problem if all goes well.  I don't think I will be able to do California International the first of December since it is a 6 hour time limit and I don't think I will be running enough by December to get me there in that time but I have not written it off yet. I was signed up for several events when we hoped the first procedure worked and had no idea I would be having major spinal surgery. California International allows for deferral but heck its $49 just to defer so I am not sure what I will do and have till the middle of November to decide what I will need to do.
My spirits are high and I have received so many cards from friends all over the place. I pick one randomly each day to read - my dream is to have one a day each day of my first the doc said I would be 1-2 years with no running so I took it as 1 year....after the surgery he felt it was a realistic goal to look forward to possibly doing RnR Nashville as my comeback marathon.

Wednesday, June 10, 2015

Recovery Starts Here

I only had six weeks pain free after the double Laminectomy on Feb 23 then the left glute area started with stage one of the nerve pain...I call it stage one because it was the same nerve pain that left me debilitated about 6 months prior when that began on the right side and wouldn't go away.  I had plans a week later (first week of April) to spend a week in southern Utah where I was planning on do the ZION 100K again...I already knew I would be unable to do that but I love the area and decided to volunteer at the event and then spend the week with my friend Amber checking out places I didn't get to see the year before.  The doc had  put me on a steroid pack a week or so before going to Utah hoping it was just inflammation but that didn't help. Once I got to Utah I knew it wasn't going to be a good outcome since the steroids didn't help at all so I hiked and enjoyed every minute I could. I had to take some rest breaks but it was all worth it! About week 10 I went back to the Doctor and had another MRI.....I had the MRI locally on a tuesday and that evening the Doctor himself called me at 6:30 pm.....I knew that probably wasn't a good sign. Sure enough I was still a complete mess and one of the disc were completely gone. When I went back in to discuss it with him he asked me to be honest about my prior recovery since the one disc was completely gone and I told him...I was good...I only running at all.  I told him about my hiking in Utah the week or so prior and he said that wouldn't have done anything as it was already done before I left for there so he didn't mind at all me doing what I love. I did have to shovel 18 inches of snow off my roof less then a week after the first surgery since my roof and flat and my drains were completely iced over so nothing could drain. A couple days before the big snow some water had started coming through and I got out there then to get the ice off while I waited on someone else to come up and help. They finally showed up and took over and I had made arrangements with them knowing that this big snow was coming to come out and shovel it for me. The day of the snow he was suppose to come in the evening but didn't show and said he would be there by 11:00 the next day since it was going to get to the 50's so it would start melting and i could lose the entire back room if that happened....11:30 came and I called...said he got tied up at another job but would be right out....1:00 comes...nobody and its getting warmer...I call no answer. Tanner was still in college so I had no choice and I had to get out there and do it myself. My doctor was aware but said you had to do what you had to do and then said it may not hurt anything that some do things by the book and still have problems so do something they shouldn't and don't have problems. We don't know if that played a factor and at this point it doesnt matter why and he knew the spinal fusion was going to inevitable anyways but we were hoping for a couple years down the road.
Being such a major surgery it took time to get insurance to approve and with my age it took a little more since most people don't have this type of issue at my age. I was scheduled for June 6th.
The Procedure that was done was
1. L-4-L5, L5-S1 laminectomy and facetectomy
2. Posterolateral theses L4-L5 and L5-S1
3. Transforaminal lumbar interbody fusion with preparation of interspace L4-L5
4. Placement of 10X20 mm Crescent PEEK intervertebral biomechanical device L4-L5
5. L4-S1 segmental pedicle screw instrumentation with pedicle screw system
6. Harvest of local bone through same incision
7. Use of Porgenix and Magnafuse moralized allograft for inter body and posterolateral fusion
I was unable to eat of drink after midnight the night before and surgery was scheduled for 12:45 with an arrival time of 10:45. I took a xanax before leaving as I was very nervous. I arrived and found he was running late and my time would now be 2:00. My IVs were attached and the things on my legs so they would be able to monitor how close to the nerves he was during the procedure. My mom took me and was allowed to wait in the pre op room with me...poor thing couldn't stay awake.
The doctor came in to talk with me and then the anesthesiologist and shortly after I was headed back to the surgery room. As I approached I started getting more scared- I am glad he started the anesthesia right away because I was almost in tears with fear...what if something went wrong..this is my spine
the back bone of my entire body and well being.  It didn't take long and I was off in my happy place and had no idea what was going on.  When I woke up in the recovery area they called my family to let them know but I was only able to lay there. After about 2 hours and no room for me to go to they allowed two family members to come back....Tanner and my dad had arrived by then so they came back. Tanner snapped this pretend it doesnt hurt like hell picture and we visited for a few and then the waiting game for a real room began again. It was almost 4:30 hours till I got into a room.  When I arrived my folks and Tanner came in and it was rough. I had major hip pain going on...they thought from the position I was in during surgery as well as nerve damage and the position after surgery. I felt like if I could just stand up for a few it would feel a little comes the most frustrating and scary part. I tried and tried just to raise my butt and hips off the bed and I had no strength to do that at all! I was scared I was so frustrated and I tried so hard and just couldn't do it. I said again I really need to stand up and move and so they had someone come in and teach me to try to bend the right leg then roll it over to the left...try to much and lift my hips up so my body would lay on its side using the bed railing and the bed and this was so hard!!! I finally got to a side step was to let my legs roll over the bed and then push my upper body erect....again very difficult and painful but I finally made it up. They put a walker in front of me and I pushed and they helped to get me to stand upright. I asked to try to walk and they went with me a couple steps into the hallway to the nurses station and back...that was enough and it helped with the pain that I was having in the hips.  My folks left and Tanner and my dad went on home...Mom was staying with my brother so she was close if needed but it was also my nieces bday weekend so she got to spend some time with them shopping and enjoying a visit. Im not one to ask for help and why come sit and stare at me in the hospital.  Once I got settled into my room and bed they gave me an ice pack because the hip started to hurt again as well as my quads and every muscle and nerve in my lower body. I honestly felt so weak in the legs that I thought I had ran a Hundo!  They started me now on stronger pain medication through IV and that would last about 3 hours so every 3 hours or so they would come check on me. Night one was rough and around midnight the new nurse on duty came to empty my drainage bags and my catheter - about an hour later I had so much bladder pain and the urge to pee that it almost had me in tears....I reached over to see what was up with the catheter and the nurse that changed it had it draped over my hand rail so all my urine was draining back into the bag.  I called for help and finally someone came and fixed and got it going correctly but after that the bladder pain and pressure never went away. Morning came around and this same nurse told me I need to order breakfast at 7am...gave me a menu and left. About 6:45 I called and said I was told to order breakfast but have no clue how to do it because she gave me a menu and left? She came back in and said I need to call this number 3663.....I said ok...but how do I call that number with what??? She then reached way back behind me on a wall and says oh here is the phone.  I ordered some raise bran and hard boiled egg. The nurse then came in and took my catheter out and did some charting and I told her I had to pee and she said no you don't you just feel like it because i took the catheter 15 min goes by and the nurses are changing shifts...I start to try to get myself up when they both were in there and they said what do you need and I said I need to the nurse from hell said we can help..all you have to do is ask...I said I did...I told you I had to pee and you said I didn't. I finally got myself up and used the walked to get to the bathroom and I peed!!! I had to then have a bladder scan the next 3 times I went to be sure my bladder was getting empty or close to empty each time.  The doctor came to see me and I told him about the nurse from hell....he said all went well but he wants me to have a bone scan when I am healed to see if it may tell more about my bones and what type of Arthur I may have. He said he was so surprised how weak my bones were with my activity level and that the 78 year old man before me in surgery had stronger back bones then me. He then said it is something congenial which the only person that had arthritis was my dads mom and she passed away very young so nobody really knows what kind. I don't have joint pain as would be expected either. He felt the surgery will be successful and we started talking running.  I had walked a half marathon 3 days prior to the surgery...It was one of Mainly Marathons series of 7 states 7 marathons in 7 days and it was starting in Northern Ohio...about a 4:30 hour drive and the RD gave me a free entry and was sharing a room with a friend.  It wasn't about doing any distance and I didn't care if I did half,full or just a couple was mostly for mental therapy as I needed to be with members of my running family before I would go under this major surgery and would be off for quite a long recovery. I am so glad I got to go...I stopped at the half and got an extra medal to give to my Doc....signed the back with a date and gave it to him after surgery and told him to keep that so if at 92 years old I break Harriet Thompson marathon record she broke the weekend prior he would have this from me :) He has done only one full marathon and he said he would like to do another but he cramped up around mile 20-22 and had to walk some and stretch...not that there is anything wrong with that but he really wanted to be able to run without walking...I told him he should do the RnR Nashville with me in April next year and that it is part of St Judes so he would have a medical connection and really think he would enjoy that moment he said that will be our goal for me to be able to do that marathon in April! I loved this goal since at first he has to tell all patients that they should expect to not be running for 1-2 years. Of course we don't know how the healing and recovery process will go but hey its a goal and its a great goal!!!
OT came in and taught me how to put my socks on and took me around the hallway. We started with the walker and when i got in the hall she asked if I wanted to try without the walker and I said yes...she had a tie around me for safety that she held onto but I managed a loop with out the walker.  Mom Allison and the girls came over after bday shopping and stayed about an hour and the girls walked the hall loop with me once. I was not allowed to walk without someone being with me. PT was suppose to come but never showed up that day.
Friday they also came in and changed my bandage and took one of my drains out. The hook looking things on that photo are where the drains are. Throughout the night I had to pee so many times and its such a huge process just to get myself up. My ab muscles even feel like that have pulled away from my skin due to the stress of trying to maneuver my body and then I use everything in me just to push myself to a sitting position then on to stand.  I do a count to three then deep breath in my nose and blow out the mouth before each movement.  They giggled once and said they have never heard anyone count to 3 before but it works!!  That evening I had a surprise visit from Tanner and his friends....It was nice because I was ready to walk the hallways but you hate to push the call button because they workers are so busy with other people you don't want to bother them to come walk around the hallway with you. They brought me a cream horn from Schmidts and I only ate the top off it with some cream - I was afraid too much sweets would cause some bowel issues and I think the body heals better with less sugar. The 4 of them took me two laps around the hallway, we looked like someone very important with a good looking posey around them.
A big storm came through and they hung out for about 90 minutes and then I went to sleep for a bit. Sleep is very tough...I only needed the IV pain medication Friday night and stopped that in the early Saturday am but Saturday night about 1:00 it was unbearable again...I kept pushing the call button on both sides of the bed and nothing happened....the call button and remote was on the table but I must have forgotten to bring it closer to me during a potty time. I did some breathing and managed to get myself to sleep for another hour then tried all the call buttons again but those don't work....I managed one more time to breath myself to sleep and then the gal came for vitals and I told her the buttons on the bed don't work and i couldn't reach the controller...she got my nurse and the pain had gotten too far out of control that she had to do the IV meds to get me back to a manageable level...then I started back on the oral doses and things seemed to be fine.
Saturday mom stopped over and brought me some chipotle...I ate a little but don't have much of an appetite still. She stayed for about an hour or so and told me about my nieces bday presents (they got her an electric guitar!!) My niece has been learning guitar for awhile and is really good...she is also super artistic...she just turned 14. She was excited to open her other presents and had to wait till grandma got back so there isn't much to do but sit and stare at wall in a hospital room so mom headed back after an hour or so. She checked to be sure PT would be there today too.  We were hoping my other drain would be removed on Saturday but there was still enough drainage that they needed to keep it in.  PT did come and taught me to do steps since I have steps in my home. She also walked me around the hallway walker free!!! She let them know that I could now walk the hallway with out assistance as I chose. I had another great surprises on Saturday...that afternoon my old Pastor that got reassigned Pastor Kym James and her husband Frank brought me balloons and he brought his guitar and they played and sand me a couple songs. We all prayed together and it was very refreshing.
Sunday morning came and I got the ok at 5am to take out the drains but the nurse was busy and had to check in a new patient. Then at 7 am the shift changes so I had to wait till the new nurse got situated....finally an hour or so later she came and changed the dressing and removed the drain. It thought removing it would be like a sigh of instant relief but it wasn't.  I got released and we got home around 1:30 in the afternoon and got settled in. It felt good that night to be in my own bed and I really worried about not having the rails and such to pull on to get up but I found it easier getting in and out of my own bed. It is now Wednesday and I have been home for about 72 hours and things are improving. I am a little concerned with the top of the incision as it looks like a big sac of fluid and almost feels that way too. I iced it last night and today it seems to have gone down a little but I did call the docs office to let them know. She suggested it could be scar tissue forming and she would let him know and get back with me if I should be alarmed. I walked outside today about a total of 300 goal was to make it to the end of the street but I came up short and decided to turn around. As of around 9 pm last night I haven't taken any pain meds but I think I will have to after while. I had a headache and was allowed to take tylenol and that has helped.
My son when he first saw my incision was like OH WOW....i said what is it draining or something wrong and he says just looks like you have a giant extended butt crack half way up your back.
I managed another walk this evening and the total steps for it were 585. I have no need to push myself as I want things to recover the way they should.  I have had a strange smell in my nose all day. Years ago I was told I had Ol Factory hallucinations where people smell a smell that is not there and I really haven't had them to to bad the past couple years but maybe being in there with all the nerve has brought it back on...lets hope it is temporary because its very annoying!! One smells something but can't even describe what it is...its not foul its not pleasant its just a weird ass smell!
The first part of May I started tracking again with Whale Watchers since I had gained over 20 pounds since the first of the year. I was so depressed and the comfort food really did before the first surgery I couldn't even stand without crying for longer then 30 seconds so ice cream and junk became my go to. I lost about 8 pounds that month and the week since surgery I lost 3.5 so Im in the right direction. Trying to eat lots of protein so the muscle and such will heal quicker.