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fierceliketiger
02-23-2009, 12:29 AM
Hi guys...
It seemed like I was recovering fairly well...but I am still on a fair amount of pain meds (vicodin) at nearly 3 months out (3 months on the 2nd), as well as muscle relaxers. I don't really know if this is normal or not. It seems more and more like I am getting further behind instead of ahead in recovery. I am up to 8 miles on the treadmill now...but not everyday. I just seem to get SO MUCH pain after I walk that much. I make sure to at least walk 3 to 4 miles, but its a real challenge most days.
I had a major meltdown today because I am just so frustrated with myself. I try to walk, and I do all my PT religiously (and have thus been cleared because I have muscularly surpassed the exercises I can do without twisting or bending), but the pain and exhaustion are really getting to me. My doctor says not to worry about the pain meds, that I am not ready to step them down to a lesser medicine yet...which I would assume is correct since I am not really managing the pain right now, and to keep trying to get to that 10 to 15 mile mark. But GEEZ. For a while I was adding a mile a week, now I'm lucky if I progress one every 3! I also have to worry about "eating enough" apparently, because I am burned 2000 plus calories between physical therapy and walking everyday. So I am trying to stay on top of that, and I have to take supplements to make sure I am not burning up all my nutrients...
How long was it before you all were off your meds? And was anyone else told to walk this much? I havent seen anyone post that...

Susie*Bee
02-23-2009, 05:09 AM
Hi firece-- I'll try to answer from my own experience, but I can't remember the extent of your fusion and how young you are...

I was on pain meds (hydrocodone and also gabapentin) for 5 months, then could take a milder med (darvocet) if needed after I was weaned off those. I was told that walking was very good-- but there is no way I could ever have walked like you have been. I walked for half an hour to maybe an hour. It sounds like you are pushing yourself too hard to me. Did your doctor actually say to walk that much???

I hope things settle down so you feel better about yourself and your progress. You have come soooooo far so I hope you can be pleased with that. Hang in there-- and maybe back off a little bit with the walking. I think it's always wise to listen to your body. It knows how much you can take.

debbei
02-23-2009, 05:58 AM
Hi Fierce,

I stopped pain meds completely at almost 3 months and had a week or so of really tight rubber-band type feelings in my back. Then I was doing pretty well. At that point I was doing PT 3x a week, and would do my treadmill about 3x a week, but not on the same days as PT. I would go between 3 and 4 miles. I was doing pretty well.

Then a few weeks ago, we had a lovely spring-like burst here in NJ. I walked up a storm outside; 3 days in one week I walked between 4 and 5 miles outside. I got a little carried away walking pretty fast, my arms swinging to the music...I was having a great time and enjoyed the outside. One of these days I also had PT and had worked pretty hard. 2 days later BAM I was out of comission for over one week. I really think I overdid it and I had this horrible stabbing pain in my left shoulder through to my chest. The PT helped me figure out that I had strained the intercostal muscles (between the ribs, which wrap around back to front), which prior to that I never even heard of.

It's a little over a week now and I'm much much better. The stabbing sharp pain when I breath is gone, and now it's back to that rubber-band feeling of tightness on the side that I strained. During that week I took 2 pain pills and was for the first time given muscle relaxants. I really think that I initiated this setback myself by doing too much. I've been told this happens and I should expect it, but I had been feeling so good that I forgot what a trauma I had put my body through not even 4 months earlier.

8 to 15 miles a day seems like so much, even for someone who hasn't had this surgery. Do you do this all in one session? I know that 4 miles on the TM for me takes about an hour; I can't even imagine going longer! Maybe you could back down a little until you're starting to feel better. Remember we're not what we used to be right now. Doesn't mean that you can't get there, but maybe take it a little slower?

Like Susie said, listen to your body. Our bodies are smarter than our brains sometimes. At least in my case it was!

Singer
02-23-2009, 07:15 AM
I was on Oxycontin for almost 8 months, and I needed it.

I cannot imagine trying to walk as much as you are. If you're exhausted, slow down. Your body is still trying to heal and it needs more rest than exercise at this point. I think you're overdoing it.

fierceliketiger
02-23-2009, 12:14 PM
Susie Bee, sorry I forgot to say my age and fusion level, I really should put that in my signature. I think I will after I write this.
I am 23 and my fusion is from T-10 to the pelvis, they also did a spinal osteotomy because I had an incomplete vertebrate that grew to the side and was pushing on everything, so they removed it. When I talk to the surgeon he says that I am probably experiencing a lot of pain from the osteotomy as well as the fusion because they removed so much bone.
Today I slept so late, but I was up all night in pain. I took hydromorphone twice throughout the night, and didnt fall asleep until 4:30am. I also didn't wake up until 11am. I feel like such a lazy bum. lol Yup, my doctor said he wants me walking 10 to 15 miles a day and to actively work towards that. Apparently increasing the blood flow that much to the area (especially with the osteotomy) will really help it heal.

Debbei- I generally have to do it in two sessions, I can do about 5 miles at once, but then have to take at least a 30 minute break.

Thank you all for your replies. I know I am exhausting myself, but at the same time I feel really bad whenever I don't walk as much as I can.

sueRRT
02-23-2009, 01:06 PM
I am 20 months post-op of a T4 to L5 fusion with instrumentation and I'm still on pain meds. Right now I'm taking Darvon twice a day and Darvocet at bedtime but neither is really working. I can't imagine walking as much as you are. I really think your DR. is pushing you too much too soon.

LynnMarie74
02-23-2009, 04:13 PM
Hi guys...
It seemed like I was recovering fairly well...but I am still on a fair amount of pain meds (vicodin) at nearly 3 months out (3 months on the 2nd), as well as muscle relaxers. I don't really know if this is normal or not. It seems more and more like I am getting further behind instead of ahead in recovery. I am up to 8 miles on the treadmill now...but not everyday. I just seem to get SO MUCH pain after I walk that much. I make sure to at least walk 3 to 4 miles, but its a real challenge most days.
I had a major meltdown today because I am just so frustrated with myself. I try to walk, and I do all my PT religiously (and have thus been cleared because I have muscularly surpassed the exercises I can do without twisting or bending), but the pain and exhaustion are really getting to me. My doctor says not to worry about the pain meds, that I am not ready to step them down to a lesser medicine yet...which I would assume is correct since I am not really managing the pain right now, and to keep trying to get to that 10 to 15 mile mark. But GEEZ. For a while I was adding a mile a week, now I'm lucky if I progress one every 3! I also have to worry about "eating enough" apparently, because I am burned 2000 plus calories between physical therapy and walking everyday. So I am trying to stay on top of that, and I have to take supplements to make sure I am not burning up all my nutrients...
How long was it before you all were off your meds? And was anyone else told to walk this much? I havent seen anyone post that...

Hey Fierce...me again. WOW oh WOW on the 8 miles a day & extra super WOW oh WOW (how is this possible everyday) on burning 2000 calories everyday!!!! You must be skeletal woman! lol Ok, being serious now...mathmatically speaking...as a general rule of thumb, here is how a human burns calories by walking: Take your weight x distance = "energy" used walking. (Obviously energy = calories) For the sake of the post & not knowing what you weigh..(Im going to just assume that you are pretty thin) if you weigh 120 lbs & walk 8 miles a day, you are buring 960 calories...a day. You say that you also have your PT everyday(?) I obviously dont know what you do in your sessions, but I will have to guess its streching, maybe some light weight lifting, etc. I cant imagine they've got you buring 1000+ calories then too?! If so, I really truly think they are WAY WAY WAY too hard on you & also, perhaps your Doctor is simply just expcting too much from you as well. I think some one else said that was alot...even for some one w/out the fusion surgery. I think we are all just concerned for your overall well being & health. You have to remember (trust me - I need to be reminded all the time myself) that you are still early on in the healing process...even tho 3 months seems like a long time, in the grand scheme of things, it's really not. I (we) dont want to see you hurt yourself or jepordize your fusion & healing. Please consider slowing down a little, wont you? Again, Ive learned this myself too, listen to your body & trust what it tells you. We are all proud of your progress & how "determined" you are to get back to your normal self. Just knowing that you are this determined so early one will only help you when are you truly ready to do all of this "work"

Enough preaching...Im sorry...again, we are only concerned for you & probably just very shocked to read your post,given the BIG surgery you just had. Take care & have a great week! :)

fierceliketiger
02-23-2009, 04:41 PM
haha, Lynn, I wish I was skinnier. I actually am not very thin at all. I am about 170lbs. I have a heart rate monitor that I wear during walking and during pt. I think my heart rate goes up (thus burning more calories) because of the super hot brace.
I've actually lost quite a bit of weight in the last year...about 65lbs. Which is why I was pretty shocked with the really high calorie burn.
I do my PT two times a day, every day. All of the exercises end up taking about an hour and a half each time. fun stuff.

Nancy Joy
02-23-2009, 07:19 PM
I too wonder about your mileage!!! I have friends who have not had surgery training for marathons that have to work up to 8 miles a day. I do not know anyone who does this on a regular basis unless in training. I have the same fusion as you and I do 30 minutes a day. Anymore than that and I pay big time. I even have to watch my arm swings and speed. I can do one mile in 15 minutes and then slow it down for the 2nd 15 minutes. Suffering is a sign to look at a readjustment. I am still on Hydrocone as needed at 4 months out from 1st and 3 and 1/2 from second surgery. I take anywhere from 1-3 a day. My best wishes are out to you as you figure out what works best for you.

asccbodypro
02-23-2009, 08:42 PM
Fierce,

First and foremost you and only you know how you feel. You need to listen to your body and clearly I think it may be trying to tell you something. I know others have given their opinion on the walking. It does seem to be excessive, where you this active prior to your surgery? If you had no pain than that would be a different story. Maybe you could try doing 30-40 minutes a day and see how your body responds and go from there, and once you start feeling better again you can slowly increase your mileage. Give your body a little TLC and also make sure you are getting enough protein!!! Your body definitely needs enough protein to not only continue to heal properly but also to keep up with your activity level. I hope you start to feel better soon.

Susan

txmarinemom
02-24-2009, 09:03 AM
... I am still on a fair amount of pain meds (vicodin) at nearly 3 months out (3 months on the 2nd), as well as muscle relaxers. I don't really know if this is normal or not. It seems more and more like I am getting further behind instead of ahead in recovery. I am up to 8 miles on the treadmill now...but not everyday. I just seem to get SO MUCH pain after I walk that much. I make sure to at least walk 3 to 4 miles, but its a real challenge most days.

FLK, there's nothing abnormal about being on meds at 3 months (although no idea what you deem "a fair amount"). I can't believe your surgeon is pushing you to walk 10-15 miles like that at 3 months - after fusion to the pelvis and an osteotomy/hemivert excision.

I will echo what Singer said ... if it hurts, and you're exhausted, slow down. A few miles a day is PLENTY of activity for you at this point, and what your surgeon is demanding miles is ridiculously excessive. You need to use some common sense here and listen to your body ... if it hurts, don't do it.


... the pain and exhaustion are really getting to me. My doctor says not to worry about the pain meds, that I am not ready to step them down to a lesser medicine yet...which I would assume is correct since I am not really managing the pain right now, and to keep trying to get to that 10 to 15 mile mark.

Hell, no, you're not "managing the pain" ... you're exaccerbating it. And remind me ... what's so magical about the 10-15 mile mark?


... For a while I was adding a mile a week, now I'm lucky if I progress one every 3!

This isn't rocket science, hon ... you've reached the limit of what your body can handle. People that *haven't* had surgery can't expect to add a mile every week forever and ever. Really ... think about that. At some point everyone plateaus.

Do you think a 100 lb woman, lifting weights (let's just say curls with a single bar), adding 5 lbs a week for a year, would be curling > 2.5x her body weight at the end of that year? No way. At some point, she wouldn't be ABLE to add another 5 lbs.


... I also have to worry about "eating enough" apparently, because I am burned 2000 plus calories between physical therapy and walking everyday. So I am trying to stay on top of that, and I have to take supplements to make sure I am not burning up all my nutrients...
How long was it before you all were off your meds? And was anyone else told to walk this much? I havent seen anyone post that...

LynnMarie, while the general rule of thumb you quoted comes into play, there are other factors (basal metabolic rate - BMR and active metabolic rate - AMR) that come into play.

The 2000 cal's a day is entirely possible.

All my life, except during pregnancy, I fought to stay over 100 lbs.

My BASAL metabolic rate was over 2100. These are the calories you burn just eating, breathing and sleeping.

My *active* rate (factoring in the 10 games of softball a week, and all my other activities) clocked in at about 4400 calories a day. Do you realize how hard it is to EAT that many calories a day? People would tsk-tsk, and do the whole "I wish I had that problem!" thing (Trust me ... You. Do. NOT).

I resorted to tricks like choking down double Ensure shakes (with all kinds of crap added into them) and eating a humongous bowl of instant mashed potatoes every night before I crawled in bed.

(side rant): It used to infuriate me people think they have every right to ask a skinny person "Don't you *ever* eat?" ... but you ask a larger person "Don't you ever STOP eating?" (mind you, neither has food at the time ... it's based on assumption) and *that's* rude. It's never okay to comment on anyone's weight, period!

Everyone (including Wolpert's book) had me freaked about losing weight after surgery ... there was just no way I could afford that. I managed to bank about 7-8 lbs. ... and ... then ... I woke up starving in the hospital. I never lost my appetite, and still haven't lost those lbs I so furiously worked to pack on (thanks, Dave - LOL). My metabolism took the surgery as a shock, I suppose, and has slowed down for the first time ever.

That was me, pre-op, however, FLK. Right now, if you aren't taking in at *least* 2,000+ calories a day over what you're burning, you're depleting your body of what it need to fuse and to heal.

I've made the comment before to people "Even when you go through a period in recovery where it seems like nothing's happening, it is. Your body is quietly repairing itself, getting ready for the next visible burst of progress."

If your body has nothing to draw on, how is it going to repair itself? Fusion and healing alone take a LOT of energy, and you're not leaving yourself enough. Personally, I'd drop back to a few (no more than 5 at the HIGH end - and only if it doesn't HURT) miles a day.

In answer to your question, NO, I've never seen anyone who was forced to walk that much. Who IS your surgeon, anyway?

Sorry if any of this sounds harsh, but you need to use your head, kiddo: Listen to your body ... it's very obviously screaming at you.

Regards,
Pam

LynnMarie74
02-24-2009, 09:43 AM
Pam.....& FLT....I stand corrected & I apologize. I didnt realize this...it just seems soooo incredibly extreme is all...in all ways. And of course, I would never intentionally be *rude* to anyone on this site. I think I was just taken back by the post is all....just like everyone else was...and was concerned w/her/your well being...and I just had enough "courgage" to type it I think! :) But again, I will stop preaching & keep some of my thoughts to myself. Hope everyone is having a good day...3 days til Friday! Ohhh wait...Im not working now, so everyday is Friday!

Lynn

LynnMarie74
02-24-2009, 09:46 AM
haha, Lynn, I wish I was skinnier. I actually am not very thin at all. I am about 170lbs. I have a heart rate monitor that I wear during walking and during pt. I think my heart rate goes up (thus burning more calories) because of the super hot brace.
I've actually lost quite a bit of weight in the last year...about 65lbs. Which is why I was pretty shocked with the really high calorie burn.
I do my PT two times a day, every day. All of the exercises end up taking about an hour and a half each time. fun stuff.


HI! Im sorry....I was out of line & I apologize.....we are all just a little worried about you is all. And what an amazing weight loss----congrats-thats SUPER!!!! Have a nice day........

JoAnn5
02-24-2009, 11:36 AM
Yup, my doctor said he wants me walking 10 to 15 miles a day and to actively work towards that. Apparently increasing the blood flow that much to the area (especially with the osteotomy) will really help it heal.

.

Gosh, hon, Not to be condescending, but are you SURE he didn't say 10-15 minutes per day rather than miles??? That sounds counter-productive to me. It's no wonder you aren't able to sleep for the pain! Don't worry about the meds at this point!

fierceliketiger
02-24-2009, 01:15 PM
Lynn,
I didn't take it as condescending or rude at all! I know the basics of calorie burning and was SHOCKED when I strapped on my heart rate monitor for the first time while walking, I figured I was somewhere in the 600-700 range...not close. Frankly, I'm not "Not" trying to lose weight, so I am not too worried about not eating enough to stay at the weight I'm at, but more worried about not eating enough to stay out of "starvation mode", which my body seems to love going into every so often. In either case, I wasn't insulted. I was actually kind of flattered that you thought I was skinny. haha

Pam,
Thank you so much for your reply. I do realize now that I am pushing it. I think I got it into my head that if I wasn't walking 10 to 15 miles a day I was being "uncompliant" and would not recovery as quickly. The last 3 days I havent really been able to walk AT ALL, because I am sore, stiff, exhausted, and in A TON of pain. As far as how many pills I take (or a fair amount), I take anywhere from 2 to 6 hydrocodone a day. I am supposed to take 1 to 2 pills at a time, but the pain is bad enough still that if I take one (Believe me I have tried it) it just doesnt do anything yet. I am always weary of taking pills, and even though my pain before surgery was pretty awful I refused anything stronger than tramadol and tylenol, when the doctor kept offering me much stronger drugs (and my blood pressure/other vitals indicated I needed something). Then, along comes this surgery, and frankly, there was no way NOT to take pills.
My surgeon is Dr. Sergio Mendoza at the University of Iowa Hospital.

JoAnn,
Yup, positive. I asked every time I went in to make sure that is what he wanted. Before the surgery he had me walk 10 miles a day just to get "ready".

Susan-
Thanks for the reply. My surgeon is making me drink two protein drinks everyday (especially after the marathon walking) to make sure my protein levels are up. Also, I am having all kinds of problems with my iron levels, so I have to take 3 doses of that each day as well. I just switched protein drinks (yesterday) because the one I was using "changed their formula" and added creatine...and now tastes like cat pee. haha

For everyone I missed-
Thank you all for your replies. :-) I think it took someone else (besides my fiance and mom) saying that I was overdoing it to get it through my thick head. I can reasonably do about 5 miles a day before things go completely to crap, so I think I will back down to that for a while.:o

txmarinemom
02-24-2009, 01:16 PM
Pam.....& FLT....I stand corrected & I apologize. I didnt realize this...it just seems soooo incredibly extreme is all...in all ways. And of course, I would never intentionally be *rude* to anyone on this site. I think I was just taken back by the post is all....just like everyone else was...and was concerned w/her/your well being...and I just had enough "courgage" to type it I think! :) But again, I will stop preaching & keep some of my thoughts to myself. Hope everyone is having a good day...3 days til Friday! Ohhh wait...Im not working now, so everyday is Friday!

Lynn

Lynn, I didn't in any way mean to indicate you were rude - or anything of the sort ... you're like the antithesis of rude ;-). I think everyone posting here is doing so out of concern - and I agree, it does sound extreme, and potentially dangerous (at the least, unnecessarily painful!).

Happy Friday(s) - LOL ... I actually preferred to call them Saturdays: The whole day open, and another free one right behind it! ;-)

Pam

txmarinemom
02-24-2009, 01:57 PM
Pam, Thank you so much for your reply. I do realize now that I am pushing it. I think I got it into my head that if I wasn't walking 10 to 15 miles a day I was being "uncompliant" and would not recovery as quickly. The last 3 days I havent really been able to walk AT ALL, because I am sore, stiff, exhausted, and in A TON of pain. As far as how many pills I take (or a fair amount), I take anywhere from 2 to 6 hydrocodone a day. ...

For everyone I missed-
Thank you all for your replies. :-) I think it took someone else (besides my fiance and mom) saying that I was overdoing it to get it through my thick head. I can reasonably do about 5 miles a day before things go completely to crap, so I think I will back down to that for a while.:o

FLK, I think the most reasonable approach (and maybe it is 5 miles, who knows?) is find a distance you can consistently walk and not be in pain. I'm glad you're wearing a heart monitor. The general published guideline of aerobic exercise isn't even measured in miles:

"The American College of Sports Medicine says you should exercise three to five times a week in 20- to 60-minute sessions intense enough to raise your pulse to between 60 and 90 percent of your maximal heart rate." (from straightdope.com)

Assuming you walk at a 5 km pace (not all that fast, but brisk enough), you're still doing 3.1 miles per hour. I really think anything more than that is excessive - especially if it hurts so bad you require pain meds (beyond your normal intake).

You mentioned metabolic starvation mode just before I was about to post that ;-). If you're consuming 2000 calories a day, and expending 2000 calories, you *will* eventually stop burning them. This is why so many people who diet - and don't eat, or eat very little - trash their metabolism ... often for life. Scientists are finding out that yo-yo dieters who repeatedly go into starvation mode, especially over years, never really recover their normal metabolic rate.

For anyone not familiar with this, say you drop down to 600 calories a day (when your recommended intake is 2000). You may lose weight initially, but your body eventually thinks it's starving - and your metabolism slows or stops to conserve stores. When you go above 600 calories a day, you're going to gain weight because you've taught your body to live on that ridiculous amount.

The best approach for keeping a healthy metabolism is to eat a little something throughout the day every hour to match your daily required intake. If you know you're burning "x" amount, are pregnant, or know you're using extra energy to heal, adjust accordingly.

FLK, I'm glad you took everything everyone said into consideration: I really do think you'll have a much less stressful, and definitely more healthy, recovery. It just *still* blows me away your doctor would put you on that kind of regimine ... that's just insane - for ANYONE.

Best regards,
Pam

LisaMS
02-26-2009, 12:55 AM
I agree with all those who've posted saying that the amount of walking sounds REALLY excessive! Surgeons are human too, and they don't always know everything. He probably has a theory about the blood flow to the pelvis, etc., but you have to go by whether this really seems to be helping. I walk 2 to 3 miles in my neighborhood (which has steep hills), about 4 times a week. I do PT exercises (and I've also been "graduated" by my PT) about 4 times a week. I saw my surgeon for my 12-week check, and he told me to still take it easy! He thought I was doing plenty. My energy is great, and I'm back to working half time and cooking, doing housework, etc.

I am 3 months out and don't take any pain meds, but that's because I don't have any pain! I do take muscle relaxants once in awhile for the spasms. Everyone is different, and if you're having pain, you need pain meds. I work for a hospice, and two patients with the same cancer diagnosis will take vastly different amounts of pain medicine, because there are just so many factors affecting pain.

I hope that you can find a good balance between strengthening and letting your body heal. I also hope that your pain gets better. Good for you for being so diligent! Makes me feel like a lazy butt!