What to Expect – Back Surgery and Recovery

This was originally written and posted on a 2d party website on 2007-06-28. Since June 2007, I have had five more surgeries – only one was for my “back” problem,” which in reality, as I had been telling my doctors, was somewhere in my right sciatic area. It turned out that I had a “genetic anomaly” of a split sciatic nerve AND a split piriformis muscle. These were intertwined and had become hardened and scarred from the 5 prior surgeries and the extreme stretching I was doing to try and relieve the ongoing pain originating from that area. Three additional nerves had become entangled in the flattened and hardened piriformis/sciatic mess causing all kinds of other issues. My account of finding the doctor that finally listened to me, diagnosed my condition and subsequently operated on the area causing most of my pain will be the subject of several posts that are forthcoming.

Someone recently wrote and asked me what they can expect after back surgery. What was recovery like? What should they do before surgery to prepare for the recovery period? I am sure many back pain sufferers would like to know.

BEFORE SURGERY:
1) Probably the most important thing to do: make sure you have strong abs – the stronger the better. You will need them for recovery. I did pilates to get mine into shape – it was the best thing I EVER did. No excuses. If you want to  – you can. I did.

2) Be honest with your anesthesiologist. You will be interviewed extensively at least twice onthe day of your surgery by the anesthesia team. There are literally 80+ drugs they can choose from to make your own personal cocktail. For example, if you get carsick, ever had unpleasant side effects from ANY medication, get headaches easily, etc. –  TELL THEM. It makes a difference in what they give you. After 3 of my 5 surgeries I actually woke up smiling!  What happened with the first two? I didn’t tell them everything!  Turns out that having what is called a “paradoxical reaction” to medications or alcohol (I get wired when I have a glass of wine instead of mellowed out) makes a HUGE difference in what they choose to give you for sedation.

3)Make sure thay your doc writes for BOTH a painkiller AND a muscle relaxant (a benzodiazipine – not a Parafon Forte, Skelaxin, Flexaril type). You will thank me later for this small piece of advice.  It  makes moving around after surgery possible (see below).

WAKING UP:
You will be wicked thirsty and very sore all over. The first thing you will notice is that you cannot move in the usual way – which is by using you leg muscles. This is where stomach muscle strength comes into play. I can’t explain it well in writing – but if you think hard about moving using discrete muscle groups in your abdominal area, you will be able to move around much easier. Try (I know it sounds impossible) not to tense or “guard” your back muscles. This could very well be one of the most intense and deep pains you will ever experience!

MOVE ASAP:
Get up and try to stand as soon as they will let you. You will need this skill when it comes time to the bathroom. Going pee is the most important thing you will want you to do after surgery – you do not want to get recath’d – trust me.
Walk as much as possible – this retrains your back muscles, helps your abdominals learn their new job of carrying the responsibility of supporting you – instead of your back muscles, as usual – and it helps the back muscles heal.

HEALING TIME:
In most cases, I was taking short grocery trips within 7 days of my surgeries. I was usually back to work or school (part-time) within 3 to 4 weeks. I was able to drive short distances within 3-4 weeks after my surgeries.

Would I do it again – yes-  if it was going to help me. If my first surgery had been done correctly (and the 2d), I would not have had to have the last 3 surgeries.

NOTE added 9/15/2011: I was STILL in lots of pain after I recovered from surgery number 5. My orthopaedic surgeon gave up on me – my spine was in fine shape – my segments had fused and my spinal nerves were not impinged in any way. I began my 3 year search for a doctor to figure out WHY I was hurting so much – and why I had new symptoms occurring. As mentioned in the italicized portion above, also added on 9/15/2011, I DID have another surgery – by a neurosurgeon – who actually listened to me and therefore, diagnosed my condition correctly! I am currently 6 weeks post surgery and I have been walking around, going about life, since the 3d day after surgery! This just proves that just because you have BACK pain – you may not always need BACK surgery. Sometimes, the pain actually tells you where the problem is.