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golfnut
07-18-2010, 10:23 AM
Does anyone know the reason that some surgeons don't have you wear a brace following surgery????

I don't think Dr. Lenke usually requires one, but when I've been practicing the logroll getting out of bed and when I toss and turn all night, I keep thinking that it would be easy to accidentally twist. I'll ask Dr. Lenke in Nov. at my pre-op, but I can't think of a reason for not wearing a brace. I'm sure he has his reasons. I would gladly wear one if it would prevent me from doing damage following surgery. I asked one other time and no one seemed to know the answer, so I'm trying, again. Thanks!

Back-out
07-18-2010, 11:05 AM
Great question! I've been wondering the same thing forever (well, since the surgery started seeming real). I was hoping I'd have a surgeon who insisted on a brace. And yes, though there are other reasons, the night-time damage possibility was uppermost.

In this connection I'll note two real-life examples.

1) AFAIR JenM's neck problem began sometime after surgery after she reports having slept on it badly.

2) I noticed a few months ago that I was occasionally doing weird things to my left thumb in my sleep. This was important because I had a very delicate operation on it in January (basal joint was reconstructed using tendon graft). To protect it, I resumed using the custom splint .

It sure caught my attention though, looking forward to the much more extensive surgery on my spine. I don't even know how many times I was doing hijinks to my thumb joint, as it only occasionally woke me with pain (but I noticed it was aching the next day and I seem to have permanently lost some dexterity).

Yep, how indeed can we prevent ourselves from doing damage to our fragile spines after surgery? We could be dreaming anything and act it out a little or a lot. This is more likely to happen when we're in pain and our sleep is disturbed because of it. For that matter, going on and off pain medications changes a lot. Withdrawal can produce nightmares. Tossing and turning are more common. When I'm utterly exhausted and finally sleep, that sleep is abnormal.

We could even fall out of bed! I haven't done that in a LONG time (I guess we train ourselves to stop short sometime in infancy), but it does happen once every few years. The consequences after surgery would be catastrophic.

Why then, aren't BED-RAILS required too? I think I'm going to try to arrange for a bed that has them (I see they're available on line).

One of the only questions I did get to ask my last consult was about braces, and no - he only uses corsets. I see this as a drawback! (Don't even know if I could put it on alone).

leahdragonfly
07-18-2010, 11:35 AM
Hi Amanda,

I think the answer to your question is that the instrumentation that is used is so rigid and secure that a brace is not necessary in many cases.

For complicated, long fusions and revisions, I think the brace is used to protect against bending-twisting-lifting, as a reminder. Also I have read it helps support the muscles at first and keep the person more comfortable because it rests the muscles. As far as I know the post-op braces are not worn in bed. I doubt you can harm your instrumentation during sleep.



Gayle

LindaRacine
07-18-2010, 11:46 AM
Does anyone know the reason that some surgeons don't have you wear a brace following surgery????

I don't think Dr. Lenke usually requires one, but when I've been practicing the logroll getting out of bed and when I toss and turn all night, I keep thinking that it would be easy to accidentally twist. I'll ask Dr. Lenke in Nov. at my pre-op, but I can't think of a reason for not wearing a brace. I'm sure he has his reasons. I would gladly wear one if it would prevent me from doing damage following surgery. I asked one other time and no one seemed to know the answer, so I'm trying, again. Thanks!

Hi...

If you want to wear a brace 24/7, I suspect that could be arranged. ;-)

I can tell you that after surgery, your nighttime movements will be far less active than they are now. Everything changes. I can't remember ever hearing that someone's movements during sleep caused a problem with the implants.

Many surgeons have stopped bracing because they feel it causes atrophy to the core muscles. The newer implant systems are so secure in the hands of a really skilled surgeon that the amount of movement to dislodge anything is beyond what a normal postop patient would even attempt. Also, some of these surgeons are using a brace for just a few months,

I think it's really rare that a surgeon tells a patient to wear a brace 24/7.

Regards,
Linda

Pooka1
07-18-2010, 11:51 AM
The newer implant systems are so secure in the hands of a really skilled surgeon that the amount of movement to dislodge anything is beyond what a normal postop patient would even attempt.

Yep. I think the only reason adults are braced post op is because of Ti Ed threatening to ski through powder up to his neck. :D

golfnut
07-18-2010, 11:53 AM
Linda,

That makes total sense about the core muscles atrophying if one relied totally on a brace instead of tightening the abs. I guess it surprised me that some surgeons still brace following surgery while others don't. Naturally, I'd rather not wear a brace unless it's necessary.
Thanks for your answer.

Susie*Bee
07-18-2010, 12:29 PM
I was one who wore a brace-- for 5 months. My understanding is that my surgeon does not brace very many of his patients, but I was told I might be a candidate and to bring some men's white t-shirts with sleeves that fit snugly with me to the hospital, to wear underneath a brace, just in case-- snugly, so there wouldn't be wrinkles to irritate my skin. My fusion was a long one, and there were other procedures, I have arthritis, etc., and he must have felt I just needed the extra support. The brace was molded for me there in the hospital, probably about day 5, after some of the swelling had gone down. It was adjusted later on a little too, as it was rubbing under my armpits a little also.

Yes, your muscles do atrophy-- and it is very hard when you stop wearing the brace. You can't stop "cold turkey"-- but have to wean off. By the end of each time period, your back just aches from holding itself up! :eek: It took me a month. There are different types of braces. We had a show and tell thread awhile back-- I'll try to attach a link. It actually was a thread about a lot of questions on an upcoming surgery, but part was about bracing. Posts #9 and #11 show pictures of two types of braces. #11 is mine, and shows the glorious "boob cut-outs" I had... ;) http://www.scoliosis.org/forum/showthread.php?t=7308&page=1&pp=15

I wore mine when I was "up"-- standing, sitting, etc. It came off when I was sleeping or showering. When I was sleeping, I was always on my back, and believe me, there was no thrashing about or rolling over in my sleep. Things change with your surgery. I had always been a tummy sleeper and have never done so since. I don't miss it.

titaniumed
07-18-2010, 01:21 PM
Sharon

It wasn’t the powder skiing... It was the horizontal bungee jumping that changed brace protocol....

Next time your teenager is sleeping late, tell them that this just crossed my mind. LOL

http://www.youtube.com/watch?v=z8bVx43qlHo

Ed

Pooka1
07-18-2010, 01:44 PM
Ti Ed, that is crazy!!! Doesn't look safe!

titaniumed
07-18-2010, 01:47 PM
Karen

The one thing that surgeons are worried about is a sudden impact like a fall. Falling down or a car accident would exert forces not acceptable in the immediate weeks after surgery.

I only wore mine when leaving the house in the car for the first 2 months.

Best to fit after surgery, mine had to be refitted since I grew 4 inches, and was 9 months along from my ileus.

Here is a picture, this sums it up. The smoke is from constipation.
Ed

Pooka1
07-18-2010, 01:51 PM
Karen

The one thing that surgeons are worried about is a sudden impact like a fall. Falling down or a car accident would exert forces not acceptable in the immediate weeks after surgery.

I only wore mine when leaving the house in the car for the first 2 months.

Best to fit after surgery, mine had to be refitted since I grew 4 inches, and was 9 months along from my ileus.

Here is a picture, this sums it up. The smoke is from constipation.
Ed

:D:D:D:D:D

Excellent.

Susie*Bee
07-18-2010, 01:59 PM
Thanks for the comic relief, Ed, as always... I tend to plod along and answer and forget to lighten up. :) BTW-- did you get that heart you wanted? Or is that in yet another surgery???? You are such a cool guy, yet you look SO "HOT" in that pic! ;) Take care!

Pooka1
07-18-2010, 02:01 PM
Thanks for the comic relief, Ed, as always... I tend to plod along and answer and forget to lighten up. :) BTW-- did you get that heart you wanted? Or is that in yet another surgery???? You are such a cool guy, yet you look SO HOT in that pic! ;) Take care!

Ti Ed once remarked that his house is such a cool contemporary that once a woman enters, she never wants to leave! I wonder where he houses all those women!!

titaniumed
07-18-2010, 02:08 PM
I use the inlaw quarters, where else?

Pooka1
07-18-2010, 02:09 PM
i use the inlaw quarters, where else?

lol!!!!!!!!!!!

titaniumed
07-18-2010, 02:23 PM
They keep calling all the time, and I sometimes run out of room, due to limited space...

Ive aged a little. LOL
Ed

rohrer01
07-18-2010, 02:25 PM
Ed, you're too funny. You really do make this forum, eh em... entertaining! :D

Thanks for the smiles!:):):)

naptown78
07-18-2010, 02:30 PM
Hi...

If you want to wear a brace 24/7, I suspect that could be arranged. ;-)

I can tell you that after surgery, your nighttime movements will be far less active than they are now. Everything changes. I can't remember ever hearing that someone's movements during sleep caused a problem with the implants.

Many surgeons have stopped bracing because they feel it causes atrophy to the core muscles. The newer implant systems are so secure in the hands of a really skilled surgeon that the amount of movement to dislodge anything is beyond what a normal postop patient would even attempt. Also, some of these surgeons are using a brace for just a few months,

I think it's really rare that a surgeon tells a patient to wear a brace 24/7.

Regards,
Linda

I wore a brace 24/7 after my revision surgery for about 3 months , yes even while sleeping! I got used to it after awhile...I think the reason was because my surgery was so complicated, and I had a hx of an area of non-healing from the first surgery. It did help with pain control too.
Amanda, Linda is right, your sleep movements after surgery slow down. I padded myself with so many pillows, there is no way I could really move much! A bed rail is really unecessary...don't buy stuff you don't need.
Ed...I'm upset I didn't get a cool brace like yours!

titaniumed
07-18-2010, 02:35 PM
Thanks.

I have a very fast laptop, but working off an air-card. In order for me to respond quickly on a roll, I cannot make any mistakes!

I also have a million icons on my desktop, which is insane. You guys are lucky Im not posting engineering specifications. At work, the computers are lightning fast, but Im not there today, and dont usually post from work if Im busy.

Ed

golfnut
07-18-2010, 05:05 PM
Ed,
Loved the tinman picture! I cracked up and then went one to see the next picture where you house the women of your life. I'm so glad this forum has people that have a sense of humor!

Back-out
07-18-2010, 06:08 PM
Amanda, Linda is right, your sleep movements after surgery slow down.
My God, even my SLEEP movements are going to be slow? Egad!!:o Is that because pain wakes us up subliminally and we stop rustling around? No kidding. What's the mechanism?

leahdragonfly
07-18-2010, 07:57 PM
Amanda,

I'm guessing it's a combo of pain and the effects of narcotics (rather than exposure to rhBMP).

Confusedmom
07-19-2010, 05:15 PM
For those of you who have had surgery + a post-surgical brace as well as wearing a brace as a teenager, does it feel kind of like the teen-age brace?

FWIW, I have had 2 docs recommend full-time bracing post-surgery for me and one (Bridwell) saying it's not necessary. Dr. Gupta in Chicago said he prefers to brace long fusions even though "it is a bit old-fashioned." So, I guess the surgeons are just deciding whether it's more important to give every possible protection to the fusion or to preserve the muscles from atrophying. (Mine did atrophy with the adolescent brace, so I know what that's about. It's not a totally bad thing--I had the smallest waist back then because it was literally skin and bone. Hmmm, maybe I'll ask for that brace again! :p )

Evelyn

Back-out
07-19-2010, 05:44 PM
For those of you who have had surgery + a post-surgical brace as well as wearing a brace as a teenager, does it feel kind of like the teen-age brace?

It's not a totally bad thing--I had the smallest waist back then because it was literally skin and bone. Hmmm, maybe I'll ask for that brace again! :p )

NON small waists are that way because of an excess of muscles? I think NOT. ;)

Never mind. I think I know what you mean. Recently was examining some gravures of corseted females from way back when. Talk about hideous spinal (and breathing and other) problems induced from wrongly managed postural problems! We have it easy today. No wonder middle and upper class women then had a much shorter lifespan than working class. Giving birth was like forcing the baby through a funnel! :eek:

kennedy
07-19-2010, 06:16 PM
Ed your so funny you make me laugh:D

LisaB
07-20-2010, 08:32 AM
I'm having surgery with Dr Bridwell Aug 31 from T3 or T4 to my sacrum. He said that I won't need a brace. As Linda said in her comments the new hardware they use is very secure apparently. I'm just glad I won't have to wear one.

Susie*Bee
07-20-2010, 09:39 AM
Ed-- after seeing the pic of your little place... I'm kinda glad it didn't work out for you to stop by that time you were out this way for a wedding. You might have felt uncomfortable at my house by comparison... http://farm1.static.flickr.com/219/493613881_1fba56bc88.jpg?v=0 ;) BTW-- Is your last name Hearst? (not that I would recognize that place...) Of course, you know it would have been fun to get together and chat if that had worked out. Hey, do you remember seeing the pics of Ginger's brother's place, in her blog??? When she hosted Dr. Boachie for breakfast that one time? Pretty classy! Take care, mon ami!

Susie*Bee
07-20-2010, 10:30 AM
I'm having surgery with Dr Bridwell Aug 31 from T3 or T4 to my sacrum. He said that I won't need a brace. As Linda said in her comments the new hardware they use is very secure apparently. I'm just glad I won't have to wear one.
Lisa-- that's great. I'd be willing to bet you are fairly young too, with a good strong spine, even if it's scoliotic. You'll be that much ahead of some of us, so that's great. I bet you're anxious to get your surgery over with and be on the road to recovery! Best wishes!

LisaB
07-20-2010, 06:27 PM
Thanks SusieBee, but I'm actually one of the more mature girls. I just turned 56 in June. I probably need to add that to my signature. And I have to start on Forteo because actually my spine bone density isn't so good even though the my hip and wrist/forearm are normal. Dr B doesn't seem to think that's an issue as long as I go on Forteo and stay on it for the 2 year time period. So I'm working on getting that set up. But at this point they are still saying no brace. We'll wait to see what happens in surgery.

golfnut
07-20-2010, 08:01 PM
I'm another "mature" girl and will be 60 when I have the surgery. Dr. Lenke's office has said I probably won't need a brace, so it must not be based on age. I will also have a long fusion, so that must not be a major factor either. That's fine with me as long as I don't make a wrong move getting out of bed or forgetting when doing something and accidentally twist or bend . . .. Apparently the pain helps remind you not to make those moves! Not looking forward to the pain, but it's to be expected. I started this post and I appreciate the answers. It just seems weird that some surgeons currently require braces post surgery while others don't recommmend it at all.

mbeckoff
07-21-2010, 10:06 PM
I have been wearing my brace since May 4th all day except for showering and sleeping . It helps with the pain. My surgeon has not said when he feels that I will start weaning myself down from wearing all of that time. I do not really mind wearing it. I have gotten used to it for the most part.It does not bother me. He said that he wanted me to wear it as I have such a long incision and I am over 50 years old.

Melissa