What are bending limitations post-op?

[Mojo's Mom]

Okay, I just read David Wolpert's book and am thoroughly depressed ;-)

Here are some questions relating to the early weeks, perhaps three months, post-op:

I'm not clear: if I am fused from high in the Ts to the sacrum, will I not be able to bend my neck to look up or down?

What are the limitations on reaching? I get the impression I will not be able to lift my arms much? Can anyone describe this for me in detail?

Can I not bend from the hips? Is there some miminum/maximum angle I will have to keep between my torso and my thighs?

I just can't get a clear picture of what I will and won't be able to do in the early weeks, with the long fusion I will require.

God, this all sounds like total Hell.

[Susie*Bee]

Steph-- don't despair! How high in the Ts are you going? I'm fused from T2 to L4... at first you may not feel like looking up or down a whole lot, but you can do it some. I definitely can look down and see my feet. And my tummy sticking out. Things like that. I do have a harder time looking up, but get along ok. I can't "down" the last few drops of a can of soda, but now I'm taking a medicine that makes all carbonated beverages taste like trash, so it doesn't matter. I'm not drinking any anymore. I can see most of what's above, just not directly above. As far as reaching goes... it may bother you some-- it varies with people. I could put my shirts on ok. I think I needed a little help putting my t-shirts on that went under my brace, while I was in the hospital, but by the time I got home, I was able to do that. Just slowly. Everything was slow. I would take my shower (using a shower seat) and wash my hair. And then have to rest for awhile. That part is no joke. It is tiring to do those things. The hospital may issue you a reacher (tool) or you may buy one. They are very handy, helpful devices. Everyone agrees you need at least two, in case you drop one.

You should be able to bend at the hips. I wasn't fused to the sacrum, so someone else may correct me if I'm wrong. But that is how you sit down, etc. The main NO-NOs are the BLTs-- no bending, lifting (usually over 5 lbs. for awhile), and no twisting.

Your fusion is just a little longer than mine. You'll be ok. It is difficult, but you will manage. Hang in there.

[LindaRacine]

Hi Stephanie...

My fusion starts at L4, and I have no problem looking up, or draining the last drops out of a soda can.

The limitations right after surgery are usually no bending past 90 degrees, no twisting, and no lifting of more than about 5 pounds. The restrictions will get lifted gradually. You should check with your surgeon's office to know what your specific restrictions will be.

Regards,
Linda

[kennedy]

hi stephaine my fusion is from T4 to L2 if the fusion is under L1 bending is limited i can olny bend under my surgeon supervison

[KathK]

Hi,
My fusion starts lower (T9), so I did not have to wait long before I could comfortably raise my arms over my head (at about 3 weeks). I have never felt limited in my neck movement.

My fusion does extend to the sacrum. I was told to keep a 90 degree angle or larger between my spine and my thighs for the first 3 months. The add-on to this is that the spine is not to lean forward. So although, the angle between your spine and your thighs would measure 90 degrees if you were standing and your spine was horizontal leaning forward, that it NOT an ok position!

You can recline while seated. In that position, the angle between your spine and your thighs is greater than 90 degrees (remember the "obtuse angle" from geometry?).

What has surprised me is the number of items that are JUST out of reach without a LITTLE bend (such a temptation). I have started to use several pairs of salad tongs to grab those items that are just out of reach. For example, our bathroom sink is a little low and I can't reach the faucet handles without bending forward. So, I leave a pair of salad tongs on the sink and I'll turn the water on and off with those.

I'm wondering when we are allowed to "stoop" to pick items up or to go down on one knee (while keeping the back straight) to pick items up. That will be heavenly .

[Mojo's Mom]

Thanks all of you, and particularly Kathy, because you are fused to the sacrum. I can't imagine that I'll escape that.

Kathy, you aren't allowed to bend forward from the hips AT ALL? I'm thinking of your bathroom sink here. I understand that you can't bend forward 90 degrees, but can you lean forward from the hips toward a sink, say, at 45 degrees?

Everyone says no bending, or limited bending, but what does that mean? I could, when in my Milwaukee brace, darn near fold my body flat onto my legs, I was that flexible, and still have a lot of that. Of course, when I do that now, I can't be sure what part of that movement is truly hips only.

I've been experimenting seeing how many things I can do while keeping a straight back, and it seems there are so many ways to get things done, but I gather you can't go down on one knee, even? What about bending your knees while holding a counter or something so that you can lower yourself down to things near the floor?

Can most of you eat at a table in the early weeks without a problem? Read a book in bed? It seems that if you have your neck movement these things shouldn't be a problem, but maybe I'm missing something.

[ADMoul]

Hi Stephanie, It was about this time last year that I read the Wolpert book and even though it's very informative, it can scare the heck out of you.

I was basically told no "BLT"--bend, lift, twist for the first few months. My fusion starts at T4 and I had no neck issues or trouble lifting my arms over my head. I was in a brace during waking hours to give me a little more stability and obviously that limited movement. It wasn't horrible and honestly, it gave me a sense of security esp. when I was out and about. Like Susie said, everything is "slow" in the beginning and taking a shower is a major event during those first few weeks! I used those grabbers (you can get at Target) a lot to reach things and still use them occasionally. I can tell you that I sang 3 choral concerts (better part of 2 hours standing) at a little less than 3 months post-op and was just fine. I was very fortunate to have the entire semester off from school plus the summer to recover so psychologically, I wasn't stressed about being strong enough to get back to work in a hurry. Yes, there were some rough nights early on, but for me that time was short-lived and I am just amazed at how the body adjusts to having it's main "support system" totally reconfigured. At almost 8 months post-op, although I am still careful about doing certain things, I do not in any way feel limited by the surgery. It has had the opposite effect of allowing me to do what I enjoy and live my life without chronic pain.

[Snoopy]

hi stephaine my fusion is from T4 to L2 if the fusion is under L1 bending is limited i can olny bend under my surgeon supervison

Kara,

It doesn't matter if your fusion goes down to L1 or not. Everyone is given restrictions on bending regardless of how long or how low your fusion is. The surgeons want everything to have time to heal and start fusing before you start bending or lifting.

[jrnyc]

hey Steph
i know that surgeons try to end the fusion as high as possible in terms of preserving flexibility...no matter what anyone says, that is the plain truth...thus, for kids/teens, surgeons so often don't want to fuse really low!

i questioned my surgeon repeatedly, spoke to one of his (successful) post op patients a few years ago, spoke to 2 of Dr Anand's post op successes this past February, and all said that one may only bend from the hips when fused to sacrum or pelvis...
but no one told me they couldnt bend from the knees...as a matter of fact, several patients told me that was what they often relied on...

i am also freaked out needing fusion to pelvis! but i do know that to stop the fusion any higher would not give me enuf stability...and when i asked the surgeon to stop at sacrum, he said "i'll try after i open you up...we'll see"...then i realized it would be best to let him do what he felt was needed...so i told could accept fusion to pelvis on his recommendation...

but i have not booked the surgery...yet...
i am playing with spring 2011 (i live where it snows and gets icy...would worry doing it another time of year)

best of luck with your decision...it's a tough one...and a forever one!
jess

[mbeckoff]

Stephanie, I am fused from T2 to sacrum amd it is not as bad as you are making it out to be, First of all - why are you having the surgery? If you are having the surgery because you are in pain , then you will be grateful that the pain is gone. I did not not really have pain and had the surgery as a way to prevent pain and other things from happening in the future. I am 4 months out now.

I was in the hospital from Tuesday May 4th until Sunday May 11th. Then they sent me to rehab until Thursday May 20th. When I came home, I was able to shower and wash my hair by myself and dress my self. Yes I could bend my neck to look up and down. Yes I had problems lifting my arms over my head. I had brought clothing that buttoned up the front because my surgeon had told me that he did not want me to lift my arms over my head any more than I had to. When I was in the hospital part, I did not want to read. I just sleep. By the time I got to rehab, I read or was on my computer. I was most comfortable sitting in a chair. I ate at a table.

I came home wearing a brace . Will you have a brace? You will be told that you will not be able to Bend , Lift to Twist. I had a 5 pound limit. Now at 4 months, my surgeon lifted it to 10 pounds.

You will need to buy quite a few grabbers and leave them around your house. This way they will be where ever you are.

What is it that you think that you will be doing that you cannot do?

The two month or so, your body is busy recovering from major major surgery. You are not doing much else than sleeping showering eating or walking. By month 3, you are then back in the human race
You really need to talk with your doctor about your concerns.

My doctor and I spent as much time as I needed going over all of my questions.

Please ask what other questions you have and we will try to answer them

Melissa

[jrnyc]

hey Steph
i sent you a private message...

jess

[JenniferG]

Hi Stephanie. Like Anne, I had no problems with my neck or arms. I had no trouble eating at a table sitting on a hard and straight dining chair from when I came home. But not for long, sitting was my least comfortable position for a while.

Reading in bed was a problem in the early weeks, I used to read sitting at my computer, the book propped against the monitor with a clothes peg holding the page back, again, not for long.

You should have neck movement, but you may be a little stiff for a few weeks.

I'm fused T4 - pelvis and I can do everything I want to do. But it takes time for your flexibility to return. The surgery was the best thing I ever did for myself, no contest.

[jrnyc]

so happy to hear that, Jen G...
and for you to feel so good at a year and a half after the surgery...that is fantastic!

may you continue to enjoy your pain free and active life!

jess

[JenniferG]

Thanks Jess. I'm hoping for the same outcome for you!

[KathK]

Stephanie,
I was told by Dr. Lenke's nurse that I could lean forward just far enough to spit into the sink while brushing my teeth . I would guess that would be more like a 5-10% angle, not a 45% angle. I have tried to not lean forward at all during these early weeks. Maybe I am being too restrictive with myself, but I don't want to risk any problems with my fusion.

I eat at the table (at one of our dining room chairs that has supportive wooden arms). Sometimes while one hand is lifting the fork to my mouth, I will hold the plate under my fork with the other hand to prevent any drips onto my lap .

The hardest thing for me has been not being able to bend down and give my 9 year old a kiss. Luckily, she's agile and will climb up on a chair to give me a kiss and a gentle hug .

Remember that all things are possible.....sometimes with a little help...