Post-op bending and twisting

[LorDon]

Hi everybody,
Can somebody explain the guidelines for post-op bending and twisting? I'm a little confused about this.

Thanks,
Lori

[MATJESNIC]

Lori,

Basically, they are not to bend or twist until fusion takes place because of the hardware. It would be like bending a paper clip over and over again until it breaks. That was one example I read. Of course, the occasional bend or twist will probably not do harm. But it is easier to just say no bending or twisting. As you get more and more x-rays post op you will say when the fusion has taken place. Usually around a year. Nicole keeps saying she misses bending.

[LorDon]

Thanks for the explanation Melissa. How long does complete fusion take? 6 months to a year? I can't imagine not being able to bend or twist for such a long period of time. When you drop something, your natural reaction is to bend over and pick it up. Does it hurt when they bend or twist? Is this something that you constantly need to remind Nicole about?

Lori

[flowerpower]

I believe it does take anywhere from 6 mo. to a year for fusion to take place. If BMP is used it may even be sooner, but for the 1st year you want to be very careful-too much bending and twisting and the fusion may not take hold. If one needs to bend to pick something up, bending at the knee (not the waist) is better. The hardware may restrict this a little anyway. You may need to remind them at first, but they get used to it.

Renee

[emma12]

I think 6 months to a year is normal for fusion to take place. And, I am constantly reminding my daughter not to bend or twist. Not so much bending over to pick something up, the hardware does affect that in her, but twisting and bending sideways. Once she felt better, she "forgets" that she is not supposed to do that. Lifting things also, needs constant reminders with her, she carried out too many binders from school on Thursday. I've weighed them and shown her what her limit is several times. I hope she gets used to it soon-----

[MATJESNIC]

I never have to remind Nicole because her biggest fear is doing something wrong and having to get surgery again.

Anyway, Emma12, what did your doctor say is the weight limit for them to carry? Renee, anyone else?

I believe some say 5 lbs, some say 10 lbs.

[flowerpower]

Our dr. didn't want Joe carrying anything over 5lbs for at least the first 3 mos. That was kind of hard, because even a gallon of milk weighs that much. After that it was up to 10 lbs until 1 yr. post-op. When we went camping that summer he was allowed to carry a 1.5 liter water pack on his back, but didn't really want him carrying any more that that. He had a lot of vertebrae fused though, others might not be so restricted.

Renee

[LorDon]

Thanks for all your responses. Melissa, you asked my next question - how much weight can they carry! I think Chris' history book weighs at least 5 lbs.!! Thank God the XBOX controller is only a pound......

[MATJESNIC]

We have been very strict with Nicole. I have been taking out any juice and milk from the fridge.

It is easy to get a second set of textbooks for home. But you have to be careful about the weight of all those binders. They really add up.

Nicole is back at school part-time and is a little overwhelmed. This will be her last week of tutors.

[Carmell]

After fusion surgery, most surgeons say "no BLTs" - no Bending, Lifting, Twisting. I love food, so a food comparison is good to remind me what they can and can't do.

This plan is to protect the spine and to prevent the fusion material from being disrupted. If the material (bone chips, etc.) covering the metal rods is somehow disturbed, it can lead to failed fusion (pseudoarthrosis). An area that has a failed fusion can cause a curve in the future. It can also cause other problems like pain and imbalance of the spine. This is NOT a good plan. The BLT plan is hard to remember, and often patient feel like they are "all better". Until you get the CLEAR from the ortho via xray (they can see if the fusion is solid) please follow this BLT plan.

Done with my lecture/soapbox...

[emma12]

At our post op (which must have been about 4 weeks), the doctor said she could lift a little more than she had been (original restriction was a gallon of milk, 2.2 pounds). When I asked him for exact weight, he said 10 pounds was probably too much, my daughter asked if she could pick up our cat, he's 6 pounds, and the doctor said I guess that's ok, but limit the number of times you do that, and definitely don't bend over to pick him up. Not really an exact answer. Also, no back packs or shoulder book bags for the entire school year.

I've been trying to limit her to about 5-6 pounds coming home from school. During school, it's not an issue as she goes to her locker between every class. We have the text books at home, and they have some in her class for her to use, for the entire year. Really watch the binders, they do add up. She can not carry all of her binders and her trapper at the same time, it is too much weight. And, I went through everything so that instead of 20 blank pages in each, she has just a few, and needs to add more when needed. Also, saw that she was carrying about 25 pencils and pens in her trapper, ugh!!! Rather frustrating!!! I have told her repeatedly that she must be more organized so as not to carry things home when not needed. If it takes more time, it takes more time.

I have stressed the importance of following these rules, over and over with her. Now, she wants to go to a Halloween dance at the school this weekend. This would be her first real outing with kids since the surgery. I've told her again that you can't be bending, twisting, at all, or dancing. Do I trust her to do this??? I hate to say no and be the bad guy, but... She feels great, and seems to frequently forget her restrictions. Is it an age thing (she just turned 12 in June)?

I'm sure Nicole is a little overwhelmed with returning to school, and she still has tutors coming in. We did 1/2 days for a whole week, then slightly longer part time days for a second whole week. If she's staying up with the rest of the class, maybe she should do something less than full days for another week? Just a thought, I know when my daughter went full days last week, she was very tired at the end of the day, but still had tons of homework to do. My daughter actually wanted to go full days the second week, but I told her no, she should take her time. Her school was very understanding and accomodating to her. She is really glad to be back in a "normal" life now.