After Surgery - Fusion

 

 

Scoliosis surgery - in whatever form has a very long & slow recovery timeframe.  In relation to fusion, the spine takes approximately one year to fuse and during that time there should be no impact sports or heavy lifting, or really anything that could damage the fusing process.

 

Recuperating at home

 

When leaving the hospital and enduring any journey the answer is lots of cushions, big & small.  Remember also that you will be taller, and however weird it sounds, you have to get used to suddenly being taller.  Things will be lower i.e. the sink for cleaning your teeth, the kitchen cabinets may be closer to your head height now etc.

 

There are also a number of things that you may want to have lined up to help you with your longer term recovery at home, such as:

 

  • A chilly bin in your room to stock up on ice packs, water, juice and other essentials.

  • Ice packs.  Ice is a valuable pain reliever.  Applying an ice pack to numb the painful area will go a long way

        to easing pain and discomfort.  An ice massage can be really soothing.  

  • Of course your devices, having them handy with easy access to chargers and additional power is essential :-).

  • Some equipment that you might find makes your world more comfortable.  i.e. a fold away table e.g. The Tablemate from TWH, 

        and a straight backed firm chair.  

  • A grabber.  You will likely be told not to bend over or reach up for anything for a while.  A simple grabber can help you pick up items off the floor and reach for things from an upper shelf.  Again, The Warehouse is great for these at $5.00 NZD.

  • Heating pads.  Starting about two days after surgery, the doctor may allow you to use heating pads to alleviate local pain and discomfort.  You may also want to apply to the areas of your body that wasnt operated on; for example, if you had lower back surgery, you may want a heating pad for your neck - it can be soothing and help keep your neck from getting stiff.

  • A squeeze bottle.  After a fusion surgery, it's tough to twist or reach, even just to clean yourself after a bowel movement.  You can use a squeee bottle filled with warm water together with moist wipes work well.

  • Extra pillows.  A few well-placed pillows add much needed support.  Try placing one under your knees whilst lying on your back or in a reclining position, this takes the stress off your lower back.  

  • Shower mat.  So you wont slip in the shower.

  • Shower brush with long handle.  These will help you get clean without bending, twisting or reaching.  You can pour liquid          soap or liquid moisturiser on the brush.

  • Just sitting can be painful, so perhaps an inflatable donut pillow or hemorrhoid pillow can make sitting more tolerable.  

  • Shower seat and handicap rails in the shower.  Not everyone needs these, but it is something you may want to discuss              with your doctor.

  • Toilet riser.  This will help immensely with going to the bathroom, especially if youre a woman and drinking all the liquids that you are supposed to.  Risers with hand rails to lean on are most helpful.

  • Cane or walker.  You may feel more comfortable walking with some added stability for a while, and if so, discuss getting a cane or walker with your doctor.

  • Fall prevention. It is best to remove anything that may be a tripping hazard, such as loose rugs or clutter.

  • Have lots of bendy straws on hand making drinking in awkward positions easier.

 

Tips & Tricks

 

  • Pop things on shelves higher up e.g. clothes - so you dont have to bend down to pick up your clothes from the floor :-)

  • Keep on top of your painkillers at all times.

  • Bendy straws are essential for the first few days at home.

  • Essential to keep moving.  Try walking a little further each day.  You'll be exhausted from very little exercise so be careful and take it easy for the first few weeks.

  • You will feel new pains and the odd twinge or "electric shock" type pain, which are usually the nerves and muscles "waking up" and its normal to experience these after this type of surgery.  Your body just needs time to recover.

 

Exercise 

 

Keep moving is the biggest tip.   Regular short walks, doing simple leg exercises and drinking plenty of water are the main tips for getting your body back to normal.

 

 

What to Expect After Your Surgery

 

From Day 1 to Year 1

 

To help you understand the recovery process you are beginning, below are the main steps in the recovery process.

 

 

During your stay:

 

DAY 1

 

The first day after surgery is mostly a day of rest. Pain medications will be adjusted and blood tests will be performed as needed. The therapists will allow you to stand up and walk as tolerated with their help. A (PCA) Personal Analgesia Pump is often used to allow you to control your own pain medication.

 

DAY 2

 

Small drainage tubes are often placed in the incisions. These are removed on the second day. The PCA pump is also slowly decreased and replaced with oral pain medications. Dressings are changed. Physical therapy is continued with more walking, sitting and education.

 

DAY 3 to 5

 

The priority is more rehabilitation as required. The patient should be working towards a regular diet and voiding normally at about this point in time. The decision as to when you are ready to go home is made during this time. It is based on all of the issues already described as well as clearance by the Physical Therapists. 

 

DISCHARGE

 

The day of discharge brings a flurry of activity. Prescriptions are provided and discharge instructions reviewed. These are all provided in a written format as well. You will need to arrange for transportation home. You are allowed to ride in a regular car but make sure it is one that is easy to get in and out of. You of course, will not be allowed to drive your own vehicle home. 

 

 

 

THE FIRST WEEKS AT HOME 

 

During these first few weeks, you will find yourself to be very tired. As such, you will be spending half of your time resting in bed and the other half, up and around. You will certainly be able to go to the bathroom and manage your surroundings without additional help. You will most likely be using pain medications on a routine basis. It is a good idea to have someone available to help you for the first two weeks or so at home.

Activities at this point should include a progressive walking program. Use of a stationary bicycle or treadmills are also allowed, although it may be too early to begin this program as of yet. Do what you feel you can do, but be conservative and safe. In any event, no lifting of greater than 10 pounds is allowed. Also, no stooping, twisting, lifting, housework, or yardwork are allowed at this time. 

 

During this period of time, the wound must be kept clean and dry. It is recommended to keep a dry 4x4 inch gauze over the incision at all times. This dressing should be changed on a daily basis. Cover the wound with a cut piece of Saran wrap, secured with tape, for showering purposes. This will keep the incision dry during this process. Change this to a dry gauze once again after the shower. Place no lotions, powders, or ointments on the incision unless instructed to do so.

 

Keep track of your prescription medications. Write down a schedule as to when they may need to be taken. 

 

As the weeks progress, you can gradually increase your amount of activity however, your restrictions do not change at this point. Returning to work is based on your type of surgery, type of work, level of energy, and general comfort. Fusion surgery may require up to two or three months of recovery prior to returning to work. Discuss the specifics of your situation with your doctor for a better prediction of your particular needs.

 

ONE MONTH AFTER SURGERY

 

Your next checkup will be at about six weeks post surgery. And an increase in your level of activity may be allowed. This may include progression towards a basic exercise program. Again, the magnitude of your particular surgery will influence this time frame. In any event, with exercise, excessive motion of the lumbar spine and pelvis is to be avoided. Physical therapy may or may not be initiated at this point.

 

Going back to school is normally recommended after 6-8 weeks (part-time).

 

THREE MONTHS AFTER SURGERY

 

Another check up at three months after surgery is the norm. At this time, a more vigorous physical therapy exercise regimen will be initiated. X-rays will usually be obtained as needed. This is done to check the healing of the fusion. 

 

SIX MONTHS AFTER FUSION SURGERY

 

X-rays will also be obtained to further assess the fusion process. It is expected, that most fusions will be approaching maturity at this point. As such, most all restrictions will be lifted at this time. Understand however, the fusion is not as strong as it will ever be until closer to one year after surgery. It is therefore one year before it is expected that your recovery is totally complete.

 

ONE YEAR AND BEYOND 

 

A routine check after a major spine surgery is recommended on a yearly basis. At this time, your exercise program will be reviewed and recommendations made to maximize your strength, agility and endurance. X-rays will also be obtained as needed to monitor the fusion and adjacent areas of the spine. Tips on lifestyle improvements to further help your spine throughout the years will be a major focus as well.