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Thread: What is the point of post-surgical restrictions really?

  1. #1
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    What is the point of post-surgical restrictions really?

    If I feel like bending to pick something off the floor, what can it hurt? I may be a little sore after, so. . .? Am I messing up my fusion to do things like that? Will it make me less straight? I don't think it will pull anything loose. Just wondered. Need a little fear to keep me in line I guess. I'm 4 months post surgery now.

  2. #2
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    Hi there,

    as someone who suffered broken rods and a huge revision surgery to fix them, I am absolutely open-mouthed reading your post.

    After going through this huge surgery and difficult recovery, how can you have such a careless, defiant attitude about your doctor's restrictions? You apparently fail to realize that your doctor gave you the restrictions for a good reason (so you don't harm your still-healing back and mess it all up), not just to be mean or annoy you. Yes, you can potentially pull things loose, or disrupt the fusion process. That's why your doctor gave you restrictions in the first place.

    So yes, to be very clear, you must follow your doctor's orders unless you want to mess up your back and risk jeopardizing your healing from the surgery. If you do not respect the activity restrictions, you definitely should. It's that simple. You need to find some fear and respect your doctor's instructions.
    Gayle, age 49
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    5/10 VBS Dr Luhmann Shriners St Louis
    5/16 6 yrs post-op, 24*T/ 22* L, mild increase in curves, watching

    also mom of Torrey, 12 y/o son, 16* T, stable

  3. #3
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    May 2008
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    Amelot

    It sounds like you are doing great.....and at the 4 month stage many of us feel like we make huge leaps in improvement.

    Healing time can be a confusing thing....especially when you get hit by a truck,(surgery) then heal, it feels like you are doing pretty darn good and you are ready to push the limits. These limits we all hit at some point and create pain.

    Text books will say 12 months for “bone” to fuse. This is plus and minus many months, and they REALLY DON’T KNOW at what rates bone heals at. In a child, I could imagine extremely rapid rates, and in an adult these rates must be at a slower rate.

    Fusion material, or the bone that’s healing can be like stone or cheesecake....this is how this can vary, and it only makes sense to give it the time it needs to heal. If the integrity is compromised for some reason, your rods will eventually break at some point. If they break, you will need more surgery.....revision surgery.

    If it takes a year, and you are at 4 months, and me being lousy at math, that leaves a long way to go.....(smiley face)

    Bending produces and incredible amount of force in the spine. Its extremely high, and you don’t want to take that chance right now. Do the one leg squat, with one hand on your knee and go down with your spine vertical with no bending.

    Build your leg muscles by practicing squats. Do this at the kitchen counter with one hand on one knee and one hand on the counter.

    Left hand on counter, right hand on right knee, left leg bends back. Go down and reach without bending.

    Walk like a model on the catwalk. Head up, spine straight and erect. Keep this thought in your mind. Your in catwalk training......and stay on the catwalk.

    We are all models in our recoveries.....remember Right Said Fred? “I’m so sexy, it hurts” That’s our theme song you know. LOL

    Keep up the good work!
    Ed
    49 yr old male, now 58, the new 53...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  4. #4
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    Until fusion really gets started, you can definitely pull screws out. And, often, if you end up with a screw or screws pulling out, you may need to have your fusion extended up or down. That's a risk most of us aren't willing to take.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  5. #5
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    Quote Originally Posted by amelot View Post
    If I feel like bending to pick something off the floor, what can it hurt? I may be a little sore after, so. . .? Am I messing up my fusion to do things like that? Will it make me less straight? I don't think it will pull anything loose. Just wondered. Need a little fear to keep me in line I guess. I'm 4 months post surgery now.
    Oh my goodness! Very important to follow directions! I have a short fusion and am cautious to follow all my doctors instructions to a tee! I work daily with feet and when we do surgical proceedures such as a bunionectomy and we say no weight bearing, we mean no weight bearing! I have had patients not follow directions and messed the pin up which caused their foot to go back to looking deformed and then massive infection follows. Be careful and do what your told!

    Tamena

  6. #6
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    Oct 2011
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    That's exactly the kick in the pants/encouragement I needed!

    Thank you so much for your responses! I don't mean to be a wise (insert your own word here) but I really needed to hear that from patients. I have new twin grandbabies and a special needs grandbaby and it's very hard to overcome the maternal (grandternal?) instincts to help out, but your responses have strengthened my resolve to behave myself. I really appreciate you taking the time to respond!

  7. #7
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    Oct 2011
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    Is it too personal to ask how your rods broke?

    [QUOTE=leahdragonfly;145363]Hi there,

    as someone who suffered broken rods and a huge revision surgery to fix them, I am absolutely open-mouthed reading your post.

  8. #8
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    Quote Originally Posted by amelot View Post
    Thank you so much for your responses! I don't mean to be a wise (insert your own word here) but I really needed to hear that from patients. I have new twin grandbabies and a special needs grandbaby and it's very hard to overcome the maternal (grandternal?) instincts to help out, but your responses have strengthened my resolve to behave myself. I really appreciate you taking the time to respond!
    Your investment today and for the next 8 months or so....and forever in doing some things will pay off in the future when you are healed and finally totally fused. It will be a shame to undue some of the hardware and suffer an injury that gives lifelong limitations and pain being cavalier and reckless about limiting yourself now. Sounds like you are feeling pretty good physically, and while that is GREAT, it makes you want to do more and take more risks. Sometimes damage from too much activity and not restricting yourself will give longterm changes that cannot be undone. I have not had surgery, but am a medical professional who has seen some damage from people who don't listen to restrictions advice postop. Sometimes, it's really ugly.

    So, bite the bullet and restrict yourself. Your grandkids will always be around to love and you to help them. Help out how you can...remembering that it is an investment in your FUTURE.

    Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

  9. #9
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    Where to find the blog on Gayle's broken rod

    [QUOTE=amelot;145384]
    Quote Originally Posted by leahdragonfly View Post
    Hi there,

    as someone who suffered broken rods and a huge revision surgery to fix them, I am absolutely open-mouthed reading your post.
    I am sure that Gayle will reply soon, but she has details about the rod breaking on:
    12-15-2011, 11:12 AM#1
    "The pop that was hear around the world". Go to Surgical Revisions and type in "leahdragonfly" in the box on the upper R corner. The blog is about 1/2 way down the page.
    Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

  10. #10
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    Oregon
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    Hi amelot,

    here is a link to my posts about my broken rods and revision surgery:

    http://www.scoliosis.org/forum/showt...ound+the+world

    Basically, the first rod broke when I was just standing still, barely leaning forward a minimal amount. The break was undetectable on imaging. A month later I was changing into my work scrubs and dropped my shirt on the floor. I bent over to pick it up and felt/heard a tremendous and painful pop. I had x-rays again, and this time both rods were clearly and visibly broken.
    Gayle, age 49
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    5/10 VBS Dr Luhmann Shriners St Louis
    5/16 6 yrs post-op, 24*T/ 22* L, mild increase in curves, watching

    also mom of Torrey, 12 y/o son, 16* T, stable

  11. #11
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    Indianapolis area
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    Okay, I agree with everything everyone has said about following doctors' orders. But, just an FYI, Dr. Lenke told me at 5 WEEKS post-op that I could begin to lift restrictions. I have since often wondered if he forgot how far along I was (or wasn't) when he said that. But that's what he said. Also, the booklet they give all the patients at Barnes says the BLT restrictions are for four months--not one year.

    However, having said all that, I am constantly worried that I screwed up something in the S1 area early on. I was on the phone one day and, not thinking, started to sit down on my bed by hiking my leg up like I would have before surgery. Ouch!!! Not long after that I started experiencing the hip/butt/leg pain that I still have at 9-months postop. Moral of the story: I wish I had been more careful!!

    Evelyn
    age 44
    80* thoracolumbar; 40* thoracic
    Reduced to ~16* thoracolumbar; ~0* thoracic
    Surgery 3/14/12 with Dr. Lenke, T4 to S1 with pelvic fixation
    Not "confused" anymore, but don't know how to change my username.

  12. #12
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    Oct 2011
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    18

    Very helpful and VERY scary!

    Quote Originally Posted by leahdragonfly View Post
    Hi amelot,

    here is a link to my posts about my broken rods and revision surgery:

    http://www.scoliosis.org/forum/showt...ound+the+world

    Basically, the first rod broke when I was just standing still, barely leaning forward a minimal amount. The break was undetectable on imaging. A month later I was changing into my work scrubs and dropped my shirt on the floor. I bent over to pick it up and felt/heard a tremendous and painful pop. I had x-rays again, and this time both rods were clearly and visibly broken.
    Is there no way they could have told you that you weren't totally fused?

  13. #13
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    Oct 2011
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    18

    So is there any specific thing you especially should avoid?

    Quote Originally Posted by Confusedmom View Post
    Okay, I agree with everything everyone has said about following doctors' orders. But, just an FYI, Dr. Lenke told me at 5 WEEKS post-op that I could begin to lift restrictions.
    Evelyn
    At 2 months, I thought he told me to try things and don't do them if they hurt. (My husband didn't hear it that way.) That's why I posed the question. Thank you! Someone else told me that I could bend "at the hip," but not bend my back.

  14. #14
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    Quote Originally Posted by amelot View Post
    Is there no way they could have told you that you weren't totally fused?
    No, I had a completely positive one-year check-up and x-rays just about 6 weeks before the first rod broke. You really can not tell if fusion is complete from x-rays apparently.

    Every surgeon gives differing advice/restrictions, based on the individual and the surgery. I would recommend you contact your surgeon's office and ask for a clarification about your particular restrictions.

    I misunderstood the restrictions about bending---I knew it was not ok to bend my back, but I thought it was ok to bend forward from my hips (such as to lean over the sink while brushing my teeth, for example). I thought as long as I held my back itself straight I was within the restrictions. This was simply a failure on my part to fully understand the restrictions. I also did not know I shouldn't bend forward more than 90 degrees in a sitting position. I learned these things later from reading posts by our moderator, Linda Racine. These restrictions were not really made perfectly clear to me. So I will always wonder in my mind if I harmed my fusion, or if I would have had broken rods anyway. I had surgery as a teen to fuse L4-S1 for spondylolisthesis. It was in 1984 and at that time they did a fusion without hardware, and I had to wear a body cast for 3 months. I felt well afterward, but came to learn at age 40 that the L4/5 level had a pseudoarthrosis and never fused. So my surgeon said that for some reason maybe I am not a great fuser!

    Sorry if I sounded harsh in my first post to you, but as you can see, I have been through a lot with my back, and I would hate for anyone else to have to go through a major revision like I did if it can be avoided in any way.

    Best of luck, and before you know it, you will be able to legally bend and lift those grandbabies of yours.
    Gayle, age 49
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    5/10 VBS Dr Luhmann Shriners St Louis
    5/16 6 yrs post-op, 24*T/ 22* L, mild increase in curves, watching

    also mom of Torrey, 12 y/o son, 16* T, stable

  15. #15
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    Jun 2011
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    So. Calif., near Palm Springs
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    Quote Originally Posted by leahdragonfly View Post
    I misunderstood the restrictions about bending---I knew it was not ok to bend my back, but I thought it was ok to bend forward from my hips (such as to lean over the sink while brushing my teeth, for example). I thought as long as I held my back itself straight I was within the restrictions.
    I haven't had surgery, and I've wondered about this. Maybe this is a dumb question, but while you're under the restrictions, how do you manage things like brushing your teeth, washing your hands, or washing your face at a sink without bending forward at all? I can't wash my hands without bending at our bathroom sinks. I just tried it at the kitchen sink and I think I could do it, just barely.
    Age 44 (now 48). "Mild" curve (and pain) at age 16.
    No x-ray, brace or followup as a teen.
    Told curve wouldn't progress or need treatment.
    Chiropractor said I had a 22-degree TL curve, at age 20.
    Non-SRS surgeon said curve is 46 to 51 degrees, at age 44.
    SRS surgeon thinks curve is 42-degrees thoracic, 39-degrees lumbar, age 44.
    Also have bilateral pars defect at L5.
    Considering surgery due to pain.

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