No Bending at Waist for 4 months?!

[conmay]

My 15 y/o daughter had her surgery on June 10th, so we are almost 6 weeks out. She has done remarkably well. She has a restriction of no bending at the waist for 4 months. When I asked, the doc said she could bend enough to wash face and brush teeth at sink. Now that she is feeling so good, she says "she just wants to get back to normal." She has been doing plie's to get down to reach things with a mostly straight back. Luckily she has strong legs from horseback riding. When her friends ask when she can bend, she says "October" and they ask "what about your locker? OR say OMG".

Anyway, did anyone else have this restriction? Why does she have this restriction? She was fused T5 to L1. I can understand that the fusion needs to heal, but bending at the waist isn't where the fusion is. How will she/we survive until October? Our next doc visit is in October as well.

Connie

[Shelgrl66]

The reason why she cannot bend at the waist is because it is putting stress on the area that needs to fuse, therefore putting stress on the hardware as well. Back when I had my first surgery at 15 back in 1981 (T9-L5), we had no bending at the waist (only at the knees) for 2 yrs. Back then, we were told that that was how long the fusion takes to be solid. It was a pain in the butt, as well as the knees, but it wasn't worth having to go back in for another surgery right away either. Whether or not the fusion is in that area or not, it still creates stress on the rest of the spine. It is best to bend at the knees in general anyways. Good luck and all the best to your daughter.

1981-Harrington/Luque instrumentation T9-L5 for 30 degree thoracolumbar curve.
1990-Revision surgery-Broken hardware/flatback deformity/pseudoarthrosis-Cotrel Dubousett instrumentation with extension into sacrum.
1995-Revision surgery-Severe flatback deformity/kyphosis-Moss Miami instrumentation (T5-sacrum) with titanium cages (back/front/back procedure), thoracoplasty, total reconstruction with osteotomies. (surgeon did surgery while coming down with chicken pox and developed encephalitis with brain damage, etc during 14 hr surgery)
2005-Car accident-spinal cord injury/myelopathy from top of rods/hooks at T5. Decompression surgery to remove hardware, with exception of cages. Permanent damage.
2008-5th surgery pending for severe stenosis in cervical spine, as well as lumbar spine because of prior surgeries.

[vndy]

Conmay,

That's a very typical restriction. I found that after a month or so I got so used to squating down instead of bending over. Since the restriction was lifted, I often still squat just out of habit. There is a difference, also, between bending at the hips and bending at the waist - I was told (although you should always check with your own doctor) that bending from the hips was fine, but bending from the waist was not. Like Shel said, bending from the waist will strain the area that is trying to fuse, and make it more difficult for the fusion to occur.

In the scheme of things, 4 months is not a terribly long time. While the first weeks (even months) after surgery seemed to crawl, the past few have flown by. October will come faster than you expect, and bending to touch toes will feel so wonderful when it can be done safely I kept telling myself that, for me, the restrictions and recovery were a (much needed) lesson in patience!

Best wishes to you and your daughter!

[danceISlife]

Wow, I didn't realize how common this restriction was and now I'm starting to get a little worried lol. My doctor didn't tell me this at all. I didn't bend at the waist for about six weeks, and then when I went to my appointment he actually encouraged me to bend at the waist. I mean, he's an experienced doctor and I trust him completely. Maybe it just depends on a doctor's preference? Hmm...

[txmarinemom]

danceISlife,

It is a very individual call by surgeon and by patient: I was released to bend, lift and twist (with discretion, i.e., "if it hurts don't do it!" at ±2 months) - and am released from ALL restrictions now (5-1/2 months post-op - and have been for a 1-2 months).

My surgery and vndy's (we originally thought) were equal. She has since learned she's T4-T12, and I'm T4-L1. We both had BMP, and she had a bone growth stimulator (I didn't). Our surgeons, however, were very different when it came to restrictions - and when they were lifted (overall, Hanson is just less conservative than most surgeons I see described here). 4 months is pretty typical for no bending, and my case (being released from that restriction so early) isn't that common.

Like vndy, I still find myself squatting vs. bending from the waist to pick up things. It's not a conscious effort, it's just habit now.

Even *after* restrictions are lifted, there are healthier ways (even for people with "healthy" backs) to perform common activities. People are just generally tough on their backs - and kind of take things for granted until they experience a problem. Small modifications to the way we perform everyday tasks can greatly minimize the risk of issues down the road.

Since surgery, I've changed the way I do a lot of things ... first out of necessity, and now just to avoid undue stress. Among the more simple changes:

I always try to set task heights (and work surfaces) at a non-stressful level. For example, I moved last weekend, and now I'm unpacking boxes: When I unboxed my china this morning, I sat on an ottoman in front of the china cabinet - and placed each box on an identical ottoman. I never had to bend over while emptying a box, nor while placing items in the china cabinet.

Also, I packed for the move using MUCH smaller boxes than I would have before surgery.

My grabber still sees quite a bit of use. I got one of those "Gopher" (or something like that) grabbers (they had them in the "As Seen on TV" section of CVS for $10), and it is SO handy. Unlike other grabbers (that cost several times more) it has suction cups that squeeze together when you pull the trigger ... and the load capability of the thing is pretty incredible. Among other miscellaneous tasks, I use it for laundry: It's strong enough to remove wet clothes from the washer, and then I use it to pluck items from the dryer.

When I grocery shop these days (since the kids left home I actually have to DO that again - LOL ... they used to have "store duty" ;-), I have the sackers pack fewer items in each bag (more bags, but less weight). I keep a rolling cart in my trunk (it collapses down to briefcase size) and use it to bring groceries from the car to the house. That thing rates near the top of my "The Best $10 I Ever Spent" list (along with my grabber!): I use it in the house any time I'm moving more than a handful of items, and it's hauled everything from bricks to trash to potting soil outside.

Susie*Bee ( I think it was?) suggested a simple tip a while back to remove things from the oven: Instead of bending over to lift out a heavy pan, remove the item while sitting in a chair.

We could probably all think of dozens more ways to be more kind to our backs!

Anyway, back to the restriction, tell your daughter to hang in there. 4 months really is a drop in the bucket, and not to say it isn't *always*, but it's especially important those first several months post-op to listen to your surgeon .

Regards,
Pam

[Snoopy]

My daughter started p.t. at 3 months post-op with no bending at the waist until that time. Jamie is fused from T3-L2. It seems like a long time, but time goes quickly!

Mary Lou

[txmarinemom]

Mary Lou ...

Funny you should mention PT: I was thinking after I posted last night , that's yet another area where doctors vary. There were never any plans for me to do PT (pre-op), and I never did any post-op.

Regards,
Pam

[Snoopy]

Pam,

I sometimes wonder why things vary so much from doctor to doctor. I've read where some kids (and adults) are released from all restrictions at about six months, yet Jamie's doctor was VERY strict with her and most of her restrictions lasted for a full year. When she asked if she could go hunting two weeks before her one year mark, he outright told her no. Not until one year. What's two weeks? She didn't go hunting that year at all because we figured her doctor had his reasons and who were we to risk messing something up for a few days of hunting?

Jamie had p.t. about a year before surgery, while wearing her brace. Her doctor wanted to keep her back muscles strong. A lot of the p.t. after surgery was for tight hamstrings.

Mary Lou

[Mel McG]

Dear Conmay,

I had surgery about 13 years ago now. I was fused down to L4. I did not have this restriction at 12 years old. LIke the others have said, it might be because of her fusion down to L1. I would suggest after she is well enough to get her some physical therapy. I got none, and suffered muscle spasms badly when in college. I had little to no muscle fascia in the lower back. It's important to stay physically strong and build muscle to support the back. Swimming is great.

Best of luck to you.

[txmarinemom]

When she asked if she could go hunting two weeks before her one year mark, he outright told her no. Not until one year. What's two weeks? She didn't go hunting that year at all because we figured her doctor had his reasons and who were we to risk messing something up for a few days of hunting?

Yeah, Mary Lou, I'd be pretty puzzled by the "not for 2 more weeks" stance ... like you, I have to wonder what's the big deal. I'll say this - I'd be a lot more willing to say "Yeah, whatever ... it's been 50 weeks - I'm doing it" if it were me than my kid. As a fused adult I probably am a LOT less cautious than I'd be as the parent of a fused child. In addition, overall, my doctor is much more liberal than a lot of surgeons.

I think he released me to shoot my shotgun at 8-10 weeks post-op. I'll have to look back and check for sure, but I know it was early. He was also well aware I'd been shooting for 30+ years (since I was old enough to hold one), and I'm sure that played a factor. Just like you wouldn't take up a new sport during pregnancy, it's ill-advised to do in surgical recovery. It seems you've mentioned Jamie has been shooting for a while, so that doesn't sound like the issue ...

Jamie had p.t. about a year before surgery, while wearing her brace. Her doctor wanted to keep her back muscles strong. A lot of the p.t. after surgery was for tight hamstrings.

Yet another difference - LOL! Aside from the fact I had no PT pre-op (and really didn't need any with all I was doing), I do know I was told to keep the back muscles *stretched* but not to *build* muscle (I even dropped actvities that did that for a few months before surgery). Supposedly, it makes things tougher by creating more muscle mass to cut through.

I can understand PT after for hamstring lengthening with a fusion into the lumbar area (even though Jamie's just one level lower than me, you know how significant each lumbar vertebrae is).

I'm only fused to L1, and didn't have a problem just stretching on my own. It's a REALLY important area to keep limber as tightness in the hams will *definitely* be felt in the lumbar region. Even people without scoli (and low back pain) don't realize if they'd work on their hamstrings, they could help their back pain tremendously ...

Best regards,
Pam

[Snoopy]

Pam,

I agree with you completely! It it were me who had fusion surgery, I probably would have gone hunting. I know I couldn't live with the guilt if I had let Jamie go hunting and then something went wrong. You're a mom, you know exactly what I mean.

Can you come to my house and expain to Jamie how important it is to keep her hamstrings loose? At almost 17, she has other more important things to do than stretches. I worry sometimes that she's going to pull a hamstring muscle and I worry about how her hamstrings will affect her in the future if she doesn't keep them loose.

When you figure out why each doctor does what he/she does, please let me know, okay? Then I'll have a much better understanding of doctors.

Mary Lou

[sparklegirl59]

dear connie,
i will pray for your daughter...
i hope that everything goes well.
she will also be in my thoughts.
i know that HAS to be a tough boat she's in!