Five weeks down!

Today I am officially five weeks post-op!  Things are definitely starting to look up, and I am getting stronger and growing more independent every day!  I was a little nervous as to how I would feel today after spending hours on my feet celebrating Easter with family yesterday, but this morning I woke up feeling pretty darn good.  Mornings are generally the roughest in terms of pain, as I usually wake with some good stiffness, but today I felt suprisingly good!

I took some pictures of my incisions at four weeks post-op that I meant to post last week, but never did...so today is the day to post them!  The steri-strips have all come off, and things look pretty darn good.  The incisions are both still quite tender to the touch, but really feel strange when you do touch them...it feels like a thick rope under my skin, especially on my abdomen where there's more layers that were cut through.  I even grossed my dad out yesterday when I made him feel my belly incision! 

WARNING!  There's some incision pictures below!!

Here's the back incision:

The picture is a little blurry, but the incision is pretty thin!  I'm hoping that as time goes by, the redness starts to fade.  All of the surgical pen marks have finally washed off and there's no more purple writing all over my back!  I still have quite a bit of painful sensation to the right of my incision, but I've been trying to kind of massage the area when I'm just standing around...I found a tip online to massage the painful area so that the nerves "relearn" that they don't need to tell me when I'm touched that it's pain to try to get them back to their normal state.  Hopefully this works and this painful sensation goes away soon!

And here's a picture of the front:

I'm also quite impressed with how thin this incision turned out as well!  I think that the weirdest part of the incision is where my body jewely used to be (I had belly piercings on both the top and bottom, which you can clearly see from the picture and remaining scars!), and hope that these jewelry holes eventually close up too (the bottom one was pretty much stitched shut, but the top hole still looks pretty open).  Considering that the scar goes around the left side of my navel, I'm pretty impressed just how normal my belly button still looks!  Again, I too hope that the redness in this incision will decrease with time as well.  In fact, in looking at my scar today (just a week after this picture was taken), I already feel like my incision looks totally different and not so "fresh"...I'll try to post pictures of the change every couple of weeks.  This incision has come to be a running joke in the house, and is now referred to as my "front butt crack!!"  The abdomen around the incision is still a little puffy from surgery, and I'm not super thin to start with (although I'm down almost 25 pounds since this winter!), so when I push my belly inward toward the incision, it really does look a bit like a butt :)

During the course of last week, I really cut back on my pain meds and I finally feel clear minded!  I'm only taking one or two of the "good pain pills" daily, which has left me feeling the pain a little bit more (but it's definitely not out of control!) but I definitely feel more like myself.  I told my husband that I think that this past Friday was the first day where I actually was kind of bored here at home by myself.  Now that I don't feel like I need to nap every so often, I feel like I'll be able to actually concentrate on some of the things that I wanted to accomplish while I'm at home...like doing some good book reading and watching some movies! 

Unfortunately, I also started feeling additional pain last week, which may correlate with the reduction in pain meds.  Some of the pain that I had before surgery has returned, and I noticed it while out for my daily walks mid last week.  The pain is lower and less central than the levels where my back was fused...I was fused from my fourth lumbar vertebra to the sacrum, but I think that the pain that I am having (in reading other patients' notes and the location of the pain) is coming from my sacroiliac (SI) joint.  The picture below shows the relation and placement of these joints:

 
This is generally a common issue years after having a fusion at these levels due to the increased stress on the sacrum having a solid piece of bone sitting on top of it versus three individual bones with discs to minimize some of the stress.  But the pain I am having I know all too well and definitely had it prior to surgery as well.  I put a call into the doctor this morning to see what we need to do, and a member of his team called me back...unfortunately (although clearly the best route!), he said that we need to wait until this fusion is complete before we start poking and proding and testing for additional sources of pain.  This clearly makes sense, and if the pain is still there after my fusion has started to heal there are some diagnostic tests to see if the SI joint is also causing pain.  I asked if there could be arthritis in this joint as well, considering the extensive arthritis they found while working on my lumbar region, and he said for sure...we'll have to reach that road when we get there!  I'm definitely pretty disappointed to have this pain return, but we've definitely addressed a good portion of the pain and I can only hope that there are additional options if this pain remains once my lumbar bones have fused.  They have scheduled my four month post-op imaging studies (I'll have an x-ray and a CT scan) and follow-up with my surgeon, at which point we'll be able to tell if the fusion has been successful...this will happen during the last week of June.  I sure hope time flies by...although I feel really good, it's hard to not know whether this is actually working or not! 

Trying to stay positive!!

Home Equipment!!

Part of the reason I wanted to start this blog was to help out people who are thinking about undergoing fusion surgery, and thus I wanted to write a post about the equipment and things I've been using at home to help with the recovery process after my own lumbar fusion surgery.  Now that I've figured out how to incorporate pictures into my posts, you better get ready...this one will be full of them!!  More than anything I've learned since coming home from the hospital, the most important is that you need to understand that you WILL require help when coming home, including both from people as well as pieces of equipment that will help make your everyday activities easier...this has been a very humbling experience!

First things first, after undergoing back surgery, you are going to need assistance getting around.  In the hospital, you will be taught how to move without bending or twisting, get up and down from a sitting position, and learn how to log roll in and out of bed (keeping your back straight, moving up on your elbow while lowering your legs to the floor).  Despite these tricks, it is handy to have equipment to help make these tasks easier. 

I used the walker regularly when I first arrived home.  I used it to get some walking done around the house throughout the day and night (thank goodness we have laminate floors so I was able to move and pace around pretty smoothly, after Leo added the tennis balls!), to assist getting into a standing position while getting out of bed, as well as raising and lowering myself while sitting or using the bathroom.  I would highly recommend this piece of equipment if you are considering a fusion surgery...luckily, we were able to borrow this walker from Leo's dad.  Currently, it is folded up and ready to be returned...progress!!

Also pictured is a cane, which is also a piece of equipment that I would not have done well without!  After graduating from the walker, I relied heavily on the cane to help me move around.  I still take it out with me when I walk around the block when I'm on my own (although I am not currently relying on it to keep me up...I just get nervous about mis-stepping on uneven sidewalk when I'm by myself), and also tend to bring it with me whenever I know that I will be in a crowded area...for example, I have taken it to dinner with me or to the mall, where I know that people will be all around...this way, I'm using it more as a notice to others to be careful not to bump into me or to make room for me as I walk through. When I arrived home from the hospital, I also took the cane into the shower with me to help steady me...we also invested in a shower grab bar, which I'll talk more about later (of course, there's a picture for that as well!!).  Although I was tempted to purchase a hot pink one and totally bedazzle it, I got this one at the Mayo Clinic Store where I decided to go with a blue one in case Leo ever needed to use it as well!

The last thing in this picture is a grabber, which I also picked up at the Mayo Clinic Store.  This has definitely come in handy!  Remember after back surgery, NO bending!  And considering I dropped things regularly before surgery, I knew this would come into good use!  I still use it to pick things up that I've dropped and open up the curtains in the morning (the grabber fits perfectly around the curtain rod!).  This particular grabber also has a small magnet at its end, and the saleswoman in the store said she actually has one at home and uses the magnet to pick up metal things that have fallen behind something large, such as under the refrigerator...I'm guessing this grabber will come in handy even after I have recovered completely from surgery!

Something that I hadn't even thought about prior to surgery was having a hard chair to sit in on hand.  Unfortunately, our dining set is counter-height (so I couldn't get up into those chairs!), and the only other seats we have are our super-low, super-soft couches.  Luckily, my mom had a set of these hard, portable chairs and she brought over a couple for me to use.  Granted, the chair was a little too hard to sit on comfortably (hence the pillow!), but this is something I have used numerous times and have it sitting in the living room so I could sit with guests in the living room (I'm sitting on it right now!).  This is also where I sit to do my prescribed sitting exercises to get my legs stronger while my daily movement is decreased.  I've also been quite reliant on a great set of tray tables (thanks to my Aunt Patty! perfect Christmas gift!), which I use to do everything from writing, eating, using the computer, and even folding laundry.  They are lightweight and easy to scoot around the living room and are at a perfect height for me to feel comfortable at. 

Also in this image on the tray table is my own little "sippy cup."  My mom got this for me after I woke up in the middle of the night and  managed to spill my water (which was in a covered, but not spill-proof, to-go cup) all over the hardwood floor in the bedroom!  Luckily, Leo was patient with me and helped clean up the mess (which was made even bigger by the fact that I managed to kick the cup with my foot and the walker while trying to get up and out of the way!), and Mom found this great spill-proof cup at Walgreens after she heard about the incident the next day.  Needless to say, Leo was happy and we haven't had another "incident" like that again!

The biggest area where we've "installed" equipment to help with my daily tasks is actually in the bathroom...and all of these pieces really have helped me to feel comfortable with getting ready and showering now that I'm home on my own.

YAY!  One of the more expensive purchases, but definitely one of the most used(!): the toilet seat riser!  This particular riser Leo picked up at Walgreens, and it adds six inches to the height of the toilet.  This was particularly helpful when I first came home and during the first weeks at home, as it was still difficult for me to raise and lower myself.  It's still on our main floor toilet, and I'm hoping to take it off within the next week or so.  It did and still does make the process of getting up and down a little more comfortable.  It has definitely become a nice conversation piece as well!!

Another area of the bathroom that we've altered was the shower:

This adjustable shower grab-bar (also from Walgreens) has definitely come in handy!!  I used this grab-bar along with my cane when I initially got home from the hospital while showering to help keep myself standing upright.  This particular grab-bar is adjustable and suctions to the shower wall...it even has a area on each suction cup (which turns from green to red) to let you know if the suction is not strong enough and if it needs to be re-applied.  The hospital staff also recommended a shower chair, but I felt pretty confident on my legs, so we decided to go with the cane and grab-bar.  I was quite reliant on this piece when I first started showering at home, but use it even now to balance myself when I close my eyes while rinsing my hair or washing my face.  I had watched a youTube video where a woman who had had a fusion surgery more than a month previously had fallen in the shower (she ended up fine, but what a scare!), so I tend to lean on this piece or on the shower wall while closing my eyes to ensure that my balance is as steady as it needs to be!

This non-slip shower mat has also been a life saver!  This is one of those super easy, suction-cup to the shower floor kind, but has definitely helped me from slipping when my balance wasn't as steady as it was before surgery.  In addition to this style mat, I also purchased a small non-slip mat for placing just outside of the shower...initially when I started showering when I was home alone, I would step out onto a hand towel, which worked fine but I was always nervous that the towel would shift on the floor and I would end up falling.  I feel much more confident exiting the shower on a non-slip surface.  I would recommend both non-slip mats for the bathroom!

One other thing that I've used in the bathroom is a long-handled scrubber for washing up in the shower.  After surgery, you are not able to bend (nor should you be doing this!!), and thus washing your lower half is quite difficult!  Luckily, I had family that was more than willing to help me initially, but after getting the long-handled scrubber, I was able to feel more independent and could wash my legs and feet on my own!

I can't get this picture to turn, but you get the idea!!  Once my mind was clear enough to sit down at the computer, I typed up a medication chart, which was integral to keeping track of when I needed to take which medication and if I had taken it or not.  The pain killers definitely do a number on your ability to think straight, so I was pretty reliant on this chart to keep track of if I had taken the meds that I had needed to.  I have tapered off the strongest pain killers within the last week and a half so I have just been keeping track of what I've taken and at what time on index cards (which are really easy to throw in your purse if you are planning on running some errands!), and make sure not to take too many pain killers within a short period and have been trying to take Tylenol every four to six hours to keep the pain in check.  This is something that you can't really prepare for in advance of surgery, as I had no clue what I would be on when coming home, but found to be really necessary in some form or another...trust me, your mind won't be all there when you are on such strong pain-killers, so you will need to keep track of your medications in some form! 

Other things that you will need when returning from the hospital will be saran wrap, gauze, and tape to cover your incisions while showering and recovering them when finished (if told to do so).  I was also sent home with an abdominal band to wear for about a month post-surgery to help with the abdominal pain caused from cutting through the abdomincal muscles.  I also found this elastic band helped minimize irritation caused from my clothing rubbing against my incisions (especially on my back where I have a painful pressure point).  I still wear this band and am trying to decrease the time I have been wearing it recently.  Having it on also helps remind me to walk tall, keep my back straight, and to just be aware of my movements.  Luckily, my mom was able to find a second band at a local medical supply store so that we could swap bands out every couple of days and wash them.  I was also sent home from the hospital with all of the ice packs that I used, and it has been nice to have these in rotation and could always have a frozen one on hand when the pain was particularly bad for either of the two incisions.

I tried to get as many things prepared that I could think of prior to surgery, including putting things that were in low drawers or high shelves within reach.  I bought myself quite a few pairs of black athletic pants, which I have been wearing religiously since surgery (I've worn jeans a total of three times since surgery!)...the athletic pants are easy to take on and off and do not really irritate the incisions as much as wearing jeans with a belt does.  Plus, especially early on, napping is common and the pants were comfortable to move around in as well as crawl into bed with!  Daily clothes turned into pajamas, and vice versa!

For some reason, I really thought that I would have time in the hospital to be bored...I purchased myself a Nook (which I'm really glad I did as I've used it quite a bit since then), brought my phone and both chargers with in a small bag to keep near my hospital bed and was worried I would run out of things to do...seriously, I hardly remember my time in the hospital thanks to the pain killers!  I was not in a stable frame of mind most of the time I was there, and think that Leo got the most use out of my phone and Nook playing games while he was hanging out with me!  So, if you're preparing yourself for a fusion surgery, don't plan on sitting in the hospital watching television or reading books...it probably won't be anything like that!  To be honest, I haven't read and have only watched one movie since I've been home...I've watched quite a bit of TV, but my mind had felt pretty tired while on strong pain killers and I didn't think I could really comprehend a book.  I have plenty of books on hand, and would like to try to spend more time resting my back and lying down and think I could handle reading now since I've dropped the major pain killers.

There are a couple of unexpected results that I've discovered since surgery that I just wanted to note.  I know I've commented about it before, but a major side-effect of pain-killers is constipation!  Luckily, I've gotten this under control with the help of Colace and Miralax, but know that while on major pain killers, you are likely going to have some bowel issues!  The nurses in the hospital were helpful with recommending what to have on hand at home (one nurse highly recommended Miralax, which I've found very helpful!) and the Colace was started while I was in the hospital, so I was on track even before leaving the hospital!  Also in regard to the use of strong pain-killers, there is a likelyhood of minor withdrawal symptoms when trying to cut back on the drugs...the first couple of days I was dropping down my strong meds, I woke up with nausea and really bad headaches.  I am feeling much better now and am almost at the point of removing these drugs from my daily regimen (trying to cut back slowly!), but reaffirmed the withdrawal symptoms when speaking with a friend who had also undergone major surgery and had similar symptoms when dropping the drugs.  The last thing that was completely unexpected to me (but was reaffirmed after doing a little research online) deals with "lady symptoms"...I had never considered it, but obviously when undergoing serious abdominal surgery, it is possible to have some resulting cycle disruptions!  My face is broken out like I am a teenager again and my cycle is nearly two weeks late (TMI?!? Sorry!)!!!  I was a little nervous at first about the potential for pregnancy (but really, intimacy is one of the last things on your mind when your back hurts!), but after confirming that that was NOT the cause, I have found that moving all of your goods around inside your abdomen and the trauma of major surgery can really mess with all of your systems!  After googling the topic, I have found that many women experience this after major abdominal surgery, which I found very comforting!  So, if you're a woman considering fusion surgery with an anterior incision, know that this is something that could happen!

The one thing that my surgeon told me in the hospital that has really stuck with me was when he came to see me the next morning after surgery...he told me that the one thing that I couldn't do that day was to tell the physical therapist that would come to see me and work with me that day "no."  They were going to get me out of bed and try to get me moving and although this would be slow going, I couldn't turn down the opportunity as this was integral to my recovery.  This has really stuck with me, and has reminded me that even though things hurt and that I have not experienced pain and discomfort like this before, I need to move and get physical.  This being said, these next couple of weeks my goal is to focus on more "purposeful walking" (getting out and intentionally walking, not just walking around the house trying to pick things up), spending more time lying on my back and relaxing and letting things fuse properly, and really concentrating on limiting my bending, lifting, and twisting even when I'm starting to feel as though I can so those things without pain...I still need these bones to fuse together correctly and want to try my hardest at recovery...I really do NOT want to do this again!!

Okay, this turned out to be another novel!  But hopefully, for those of you who are considering undergoing fusion surgery, the equipment list was helpful and gives you some ideas as to what would be helpful to have at home when coming home from the hospital.  If any questions arise or if anyone can comment on other equipment that was helpful for them, please comment!!

Four weeks!!!

It's been awhile since I've last posted, but this last week has been filled with some fun days, great guests, and some encouraging adventures!!  I'll post more about what this past week has brought soon, but not until at least tomorrow afternoon, as my cousin Jenni has been staying with us for the past couple of days but unfortunately has to get back to Middleton, Wisconsin, to work on Wednesday so tomorrow will be her last day with us.

I just wanted to make a quick post, as it was four weeks ago today that I had surgery!!  How fast did this past month fly by?!  Today Jenni and I went and walked around Quarry Hill Nature Center here in Rochester after a quick picnic, and we ended up walking around the park for a total of about two miles!  Sure, it was a slow pace and I was pretty reliant on my cane, but what a milestone!  I'm feeling a little sore tonight and am trying to spend some time laying down to relax my back, but it was great to get out and do some walking around that was not around the neighborhood. 

And today, the last of my steri-strips covering my incisions came off!  My abdominal incision has been steri-strip free for about a week now, but finally the back ones were ready to come off (maybe with a little help with some picking...I just couldn't help it!)...both incisions look good (or so I think...I have nothing to compare them too!).  My back incision is extremely sensitive though, and although I've been trying to stop wearing my abdominal brace for a few hours a day, my clothing seems to irritate the incision and the skin on one side of the incision terribly!  I had mentioned the especially-tender area to one of my doctors at the appointment two weeks after surgery, and they said the sensitivity is likely the result of a pressure point resulting from lying on my back in a certain position for so long during surgery.  Hopefully these nerves figure out that they don't need to hurt all the time sometime soon! 

Alright, time to get serious here..."Hall Pass" is in the DVD player and I need to concentrate on that!  Another post will come soon...I've already promised one on post-surgery home equipment and now one sharing my adventures of the last week!