New with Recovery questions

[SandyAZ]

Hi, I have been reading the posts and gotten a lot of good information over the last few weeks and decided to join the forum to ask some questions. My son, Sam, had posterior spinal fusion surgery on July 24th and the surgery and the recovery in the hospital went really well. He had no problems with nausea and did well with the PT. We came home on Saturday the 29th. He had his postop appointment on Aug 1 and the surgeon said the X Ray and the incision looked fine.

I've been giving him his pain meds every 4 hours around the clock like they said. The first few days I was also giving him the Valium every 4 hours and the surgeon said to back off on that and only give it when he had the spasms. So we did that but he has a really hard time telling me what kind of pain he has - he really doesn't know if it is a spasm or not. Today he seemed to have more pain and when the Percocet didn't improve it I gave him a Valium and he said that helped some. The Percocet I gave him was the last of that and now we have Vicodin from here on out. I don't know if that is going to be less effective or not. Also part of what might have made his pain worse today is the combination of the trip to the surgeon on Tues and yesterday having his first bowel movement (that was an ordeal for him!). ANy suggestions on how to describe to him the difference between the pain from spasms and the regular pain would be helpful. Also, how long til the pain starts to ease up? Right now he has no energy/desire to do anything other than watch TV or sleep. We get him up a couple times a day to walk around the house and to sit up to eat but otherwise he is in bed. We've tried getting him comfortable in a recliner so he can have a change but he says it hurts too much. Sitting is still really painful - to the point where he would rather not eat sometimes if he has to sit up to eat. (We tried letting him eat laying down a few times because we were concerned about him not eating but then he got indigestion. This kid was 5'9'' and weighed 112 before the surgery so eating is a concern).

When we left the hospital they had him sitting up 20 minutes twice a day. It's a struggle for me to get him to do 10 minutes twice a day. And the amount of walking he is doing at home is less but I am getting him to do it twice a day. I know it is important to get him sitting up and moving, but is this enough at this stage?

Any ideas on foods that are easy to eat at this stage?

Sorry this is so long and rambling but it is so hard to see him this miserable and not be able to "fix" it. This week is more dificult is some ways than the week in the hospital.

Thanks
Sandy

[flowerpower]

Hi Sandy,

Glad to hear everything went well with your son's surgery. I also have a teenage son who had surgery a while back.

I can't answer your question about how to distinguish the "regular" pain and pain from spasms, my son didn't seem to be affected by any type of muscle spasm.
He stopped his pain meds about 7-10 days after coming home. He was still feeling sore, but he didn't like taking the Lortab. As hard as it is, getting your son up and walking is the best thing, the more he is up and around & gets his body (slowly, easily) working, the more his pain will diminish. The more he lays around, his body will stay sore when he does have to get up. I know it's not easy and you hate to see them in pain and discomfort, but it is the best thing for them.


As for sitting, we bought a lumbar cushion (around $10 at Wal-Mart) and also a couple of body-length pillows/cushions from Costco (also around $10). He will us a body pillow at his computer-desk chair and it gives him good, comfortable support.

As for the bowel issue, is he on any type of stool softener? My son was started on Colace soon after surgery, and stayed on it until about a week after coming home. He had no bowel problems.

I remember my son didn't have much of an appetite when he came home and he seemed to want to stick with "soft" foods. He ate scrambled eggs, oatmeal, soup or just chicken broth, toast, applesauce, jello. I also made him alot of fruit smoothies. That was one of the best ways I found to get a little more nutrition into him. In addition to the fruit, you can add yogurt, a protein powder or wheat germ. He really loved those, too!

Hope this has been somewhat helpful. I hear you on how it is somewhat harder the first week home than being in the hospital - hang in there, usually by the three-week mark the kids just really seem to turn around, and it just gets better from there

Feel free to contact me if you have any other questions or just want to chat - it's always nice to talk to another mom of a boy who has been through this.

Take care,

Renee

[Cakedec]

May need some different medicines

Hi Sandy,

I can relate to your son's pain because it sounds like mine. I had my posterior surgery done the 24th also T5-L5 and had bad pain and spasms once they stopped the morphine. The meds they gave me only lasted 2-4 hours and did not help. The pain with this really is a muscle spasm-tightness of sorts, it's hard to separate the 2 out, but the dr. said they need to treat both. The pain was bothering me so much that I was also in too much pain to sit up, walk, move without morphine the 5-7th days. I told the dr. about it and they changed my meds to both a muscle relaxer (Flexeril) and a long lasting (12 hour) pain killer (Oxycontin). This did the trick for me so that I am now able to get up and down and move around without shrieking in pain; also my appetite came back.

You may want to contact the dr. again if things do not calm down for him
soon. Good luck.

Deb

[Carmell]

Sometimes pain meds work different for different people. Braydon (age 11yrs) does better on Valium than other narcotics like Lortab, etc. I think for Braydon its because of the anti-anxiety effect. When you are uncomfortable/in pain, you tense your muscles making the pain even worse. When you can relax with meds like Valium the pain is less intense (does that make sense?). I know the doc doesn't want him to be on pain meds for a long time (understandable, but sometimes not do-able). I would talk to the doc again and tell him/her that your son is not tolerating the Percocet as well as you'd like. Maybe they can come up with a combination of meds that will help.

I also agree that he still needs to be taking stool softners (at least) until he's completely off narcotics. His bowels will contribute to him not eating well and other pain issues. The pressure from the bowels being immobile on the incisions is painful. Gotta keep him "moving".

Another thought I had... is the pain he's having nerve-type pain? Does he describe the pain as being like pins/needles? or tingly? or stingy? Maybe some of the nerves in his spine are overly stretched and causing some discomfort.

Most teenage patients (and parents) say that the 3rd week post-op is a turning point. Your son is not even 2 full weeks out of surgery. Time and consistancy (walking, sitting, etc) are the key. Baby steps. Hopefully for him that 3rd week rule will ring true.

Take care and keep us posted.

[SandyAZ]

I really appreciate the quick responses. Thursday Sam was at the end of his prescription for Percocet and he started on the Vicodin. It actually seems to be working better even though the doctor said it wasn't as strong a pain medicine. Could be coincidence and that his pain is just easing up - whichever it is he is doing a lot better as far as the pain management. He says its not been too bad today. It also seems to be making him less "druggy" - he has been awake more yesterday and today which is a good sign.

I talked with the doctor and he said that if the pain med doesn't take the pain down to a 2-3 level then it might be spasms and to try the Valium in addition. We did that a couple times and that really helped as well. I think you are right, Carmel that the anxiety makes them more tense which in turn causes more pain.

Unfortunately, he is now having nausea and a dramatic loss of appetite since we switched to the Vicodin. Just called the doctor and he is calling in a prescription for Zofran that is supposed to help.

His mood took a dive last night - feeling like this recovery will take forever and discouraged that even the walks around the house tire him out so much.
I've told him what you have all said about the third week being a big turnaround - of course being a teen its hard for him to see beyond how he feels today. But it helps me keep from getting discouraged and keep a positive attitude with him knowing this won't last too much longer. He hasn't showered yet - he was just about ready to do that the other day when he started having the nausea issues and now won't even consider it. I'm hoping the Zofran will help his stomach and then he'll be more willing to try the shower. I think that will help his mood to get cleaned up.

He's been taking Colase since he's been home and when he had his first bowel movement Wednesday he had really intense cramping and diarrhea. I was expecting him to have the opposite - so I stopped giving him the Colase. Is that normal and should I still be giving him the Colase while he is on the pain meds even with the diarrhea. Wish I would have thought to ask the doctor about that when I had him on the phone!

Deb, it's interesting that you had your surgery on the same day as Sam. Are you up and about much or do you still spend a good amount of time in bed? I know you said you were able to get up better with the switch in pain meds, but does it still hurt to sit up and walk? I know they say it is harder for adults to go through this surgery. I think adults have the advantage though of knowing from experience that things do get better. I hope you're feeling good and your recovery is still going well!

Renee, were there things in the 2-3 week time frame that your son enjoyed doing to help pass the time? So far all Sam wants to do is watch TV or movies. He is getting bored but has no interest in things he liked before like X Box or MySpace - partly I'm sure because he hasn't been able to be comfortable sitting up. Although again maybe once we get the nausea under control he will be more willing to try things.

Anyway, I appreciate the comments and the contact with other moms!!

Sandy