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Thread: The hours between anterior and posterior fusion surgery

  1. #1
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    The hours between anterior and posterior fusion surgery

    Hi everyone:

    I would like to know what the hours/days between the anterior surgery and the posterior surgery were like for everyone. How long was this period? Did you have decent pain control? If so, to what do you attribute it to? If no, then do you have any suggestions? Were you alert or knocked out? How aware of your thirst and dry mouth were you? How was your stomach pain from having the muscles and intestines moved over and how was your incision pain? Were you laying prone during this time or sitting up? Were you catheterized. Which surgery was the most painful, the anterior or the posterior? Please speak freely because it will help me and others to be mentally prepared. Many people read this forum but few respond, I'm not sure why. I would like to hear from as many people as possible so I can get a broad idea as to what to expect.

    Thanks everyone. Hope no one is in as much pain as me...

  2. #2
    Join Date
    May 2008
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    reno,nevada
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    I just lost a great post for you and in windows 8, there is a button on the left side that will delete your work, and I have not figured this out yet. Does anyone know which key it is? or how to retrieve it? Its either FN or ALT or CTRL.

    I had a 2 day stage T1, Anterior on 01/29/2008, and 2 days later the posterior on 01/31/2008. I was out the whole time.....

    Yes, they will cath you...better to be knocked out, Iíve done it both ways. The easy way, and the hard way. All medical related tube related stuff is always easier when you are knocked out. (smiley face)

    I will add later....gotta run

    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

  3. #3
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    The prone (face down) position for full fusion patients is a difficult position. This position jeopardizes the neck laying on a regular bed when you are fused all the way up to T2.

    After surgery, you will wake up in a supine position (face up). Usually with the bed laid down flat. I didnít like the nurse lifting the head of my bed, itís not something that makes any sense since you are bending the spine inducing kyphosis immediately after surgery....I wanted my bed to be dead flat and my spine straight.

    Pain is a complicated subject. Since my meds were high strength, I couldnít feel a thing after surgery.....Its when they lower the dose on the IV meds that the pain sets in......no matter how you look at it, its hard to dodge the pain bullet......and I did have pain while on injectableís and IV meds, so weaning to orals was a surprise. The first 6 weeks are the hardest and after you heal some, things do quiet down some as far as pain goes....I took many hot water soaks for pain. A deep tub is best for this since you float, and 106 degrees does work well for nerve and bone pain. Drink plenty of water if you do this otherwise you will get dehydrated and cause other problems. Sip on water all the time.....

    I had a huge anterior (14Ē) and a resulting ileus. I was extremely bloated, (9 months prego) and my ankles were the size of footballs. Edema and ileus levels vary between patients, they use medications for ileus, and use the squeezing socks to stim your feet each morning. Believe it or not, this is when getting up and walking is extremely important because of DVT. They wanted me up all the time, multiple times per day. I didnít have a problem with this since standing was actually my most comfortable position. When you have 2 huge bandages front and back, you sleep half way between a supine and a side position. I had a L1-Pelvis anterior with 5 cages or spacers made from PEEK installed. PEEK is a type of plastic.

    My pelvic anchors ached.....they are huge, and they ached. You cant drill big holes and insert big bolts and expect them not to ache.....Imagine what it would have felt like with a new set of Monroe shocks installed. (smiley face) Sitting is almost impossible right after surgery......2 minutes max and only on a regular type of chair.

    In time this all passed and the pain subsided. It was many months....

    My pain levels were out of control before my surgeries. Nothing I did to combat pain or stay semi comfortable was working anymore....and didnít want to take meds on a daily basis so surgery was the only answer. There was no choice in my mind and shots didnít make any sense to me having my lumbar spine in the extreme degenerated condition that it was in.

    I had to take the chance....my quality of life was 0. I was also skiing in MAJOR pain...which you cant drink that pain away....believe me, I tried.

    Stage dates vary per patient and surgeon. My testimonial is about a 2 day ALIF/PLIF stage.

    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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    Quote Originally Posted by Tableone View Post
    Hi everyone:

    I would like to know what the hours/days between the anterior surgery and the posterior surgery were like for everyone. How long was this period? Did you have decent pain control? If so, to what do you attribute it to? If no, then do you have any suggestions? Were you alert or knocked out? How aware of your thirst and dry mouth were you? How was your stomach pain from having the muscles and intestines moved over and how was your incision pain? Were you laying prone during this time or sitting up? Were you catheterized. Which surgery was the most painful, the anterior or the posterior? Please speak freely because it will help me and others to be mentally prepared. Many people read this forum but few respond, I'm not sure why. I would like to hear from as many people as possible so I can get a broad idea as to what to expect.

    Thanks everyone. Hope no one is in as much pain as me...
    Hi! I had 3 days between my anterior and posterior surgeries. I had lots of drugs, so do not remember much pain. My favorite lyingosition is on my L side, so it was somewhat painful to do so, but I did anyway and relied on an ice bag for additional pain relief. I was drugged....so, semi alert. No problem with thirst or dry mouth. My incision in abdomen was painful, but tolerable ( great drugs....). Yes, to the urine catheter. The posterior surgery was WAY more painful mainly because the curves were reduced.

    From what you said, I don't think that I was in as much pain as you were. We are all different.

    Hope that this helps. I am on my third rodeo now.....hoping that it is my last!

    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

  5. #5
    Join Date
    Apr 2012
    Location
    San Jose, CA
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    570
    I had one day between the surgeries - 3/5/13 anterior and xlif and 3/7/13 posterior. I was semi-alert too. I hallucinated, but I understood that these were hallucinations. I remember that nurses helped me to sit up for a few minutes on the day between the surgeries. My mom was in the room and she said: "Your back is straighter already" and I was really surprised to hear that after the anterior because I thought most of the correction is done during posterior.

    Posterior surgery was way more painful. But the worst pain 10/10 was from my complication - abdominal hematoma. That pain was worse than any post surgical pain... After that was taken care of, my recovery was smooth and steady.
    I am stronger than scoliosis, and won't let it rule my life!
    45 years old - diagnosed at age 7
    A/P surgery on March 5/7, 2013 - UCSF

  6. #6
    Join Date
    Aug 2012
    Location
    San Francicsco Bay Area
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    Thank you everyone for your comments. I feel like the regular posters here are my personal friends! However, I wish some others would chime in, too. Also, if anyone cares to, please go into some more detail. For instance, what is a "ileus" and the incisional hernias I keep hearing about? How do I know if a hernia is coming on, what do I do when it does, what do I do about the number 10 pain from it? etc...etc... Do you feel your spinal implants/spacers inside your stomach? Also, if we're not allowed to eat or drink for several days after the anterior, what do I do about that? I have horrible memories of my first posterior-only surgery and the thirst...can't face it again. I would also like to hear from any nurses on the forum with suggestions about communicating with the nurses. We're all familiar with the usual scenario: you need your pain meds, so you buzz the nurses station (if your call button even works and you can reach it) and the desk clerk answers the buzzer. You state you need your meds, and the clerk answers that your nurse is busy, (and I'm sure she is) and the message will be delivered. This can go on for hours. I do plan on getting in-house pain management like I did twenty years ago, (If such a thing is still available) but I still have to rely on the nurses to deliver it if I've used up the quota in the IV. I read that Susan woke up with the tube still down her throat and couldn't get anyone's attention. I get upset, angry, and worried when I read that stuff like this is still happening to patients. I am a single woman and will be going through this alone. I have friends but they all work full-time. Linda will understand because she is also single, also Ed.

    Sorry if I'm asking too many questions. Perhaps I need to get back with the Scoliosis twitter group and try to get some more answers there. I'm in agony over here; my spine is literally crumbling from my facet disease, but I am TERRIFIED of everything that can go wrong because I KNOW what it's like to wake up in hell as it's happened to me before twice before.

    Also, I am very jealous of Ed for having a hot tub because I could never afford such a thing.

    Thanks for listening everyone.
    Last edited by Tableone; 04-29-2015 at 11:11 PM.

  7. #7
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    758
    I know about going through this alone. It will not be easy but I do think your surgeon can arrange for better pain control. At first it will be IV that you self administrator. Also you can have the pain control experts help. I don't recall being thirsty but the IV's help with that also. A wet cool cloth helps. It does sound like you have friends that can at least check in. Maybe someone can spend the night with you in the first few days. It does seem as if the nights are the worst. I know how hard this is alone as I am single also.
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  8. #8
    Join Date
    Mar 2005
    Location
    east coast
    Posts
    359
    I was kept intubated overnight after my fusion and I was only vaguely aware. I mean I was apparently was alert enough at the point when my BF walked in visit me in ortho intensive care unit to finger spell to him in american sign language (knowing he wouldn't know what i was saying b/c I didn't teach him any before surgery) and shook my fist at him when he said he doesn't know sign language.

    I was told by the anesthesiologist I'd be kept sedated and intubated over night so I knew to expect it. Didn't bother me at all, and only parts I remember being 'awake' is the being smart-ass to the boyfriend and my nurse swabbing my mouth with a wet sponge through out the night. I never felt scared or concerned, and no pain either.

    Never had any trouble with nurses bringing me pain meds or for any other need -- They were always there with in minutes of me buzzing the call button. There was one night when my bowels finally gave it all up and I was calling them every 30 minutes. My night nurses were awesome and actually preferred them to one day nurse I didn't like.
    Last edited by green m&m; 05-01-2015 at 07:24 PM.
    30 something y.o.

    2003 - T45, L???
    2005 - T50, L31
    bunch of measurements between...

    2011 - T60, L32
    2013 - T68, L?

    Posterior Fusion Sept 2014 -- T3 - L3
    Post - op curve ~35



  9. #9
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    Quote Originally Posted by Tableone View Post
    what is a "ileus" and the incisional hernias I keep hearing about?
    Ileus is failure of peristalsis. The intestines stop. Not a physical block, but can happen after abdominal surgery. If this happens, you bloat up and after meds and time, you get through this..
    https://en.wikipedia.org/wiki/Peristalsis
    https://en.wikipedia.org/wiki/Ileus

    Incisional hernia is an incomplete surgical wound. If you donít heal for some reason.....The sewing work the surgeons do as they ďback outĒ is time consuming and detailed.
    https://en.wikipedia.org/wiki/Incisional_hernia

    Your spinal implants are not in your stomach, they are screwed to your spine and spacers are between your vertebrae which turns to solid bone. I donít feel my rods or any hardware, but some do.

    I had great nurses.....and they kept an eye on me as I was right by the nurses station. I didnít have a PCA because I couldnít work a button because my shoulder was broken, but chances are you will have one. Thatís the button with the happy juice. I could use one down at work by my desk when too many e-mails come in. (smiley face)

    If you are a scoli with big curves, a hot tub is a good thing.....My accountant told me to buy it. You know ďAccountantís ordersĒ LOL Getting a doctors note for IRS is easy....

    I spent a ton of money on scoliosis. Well over 100K through all the years.

    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

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