Not ready to go back to work

Hi everyone ,


I have been to 3 checkups since I had my lami/discectomy 2.5 months ago. During these three checkups I have been seen by a P.A. . Which I thought was kind of strange . On the first visit I told the P.A how physical my job was and she was like ok we will see how you are feeling at week 6 post op . At week 6 check up I let her know that I was still not ready to go back to work that I was still sore in the back from the operation . So the P.A. gives me another 5 weeks to heal and tells me I still have the same restrictions but to walk more and when I come back for my checkup they were going to see if I was ready to start a 4 week PT .

Today I went back and i told her that my back still feels sore and I feel that I am not physically ready to go back to work . I get easily fatigue standing up . After 1hr my back gets tense and tires out . So i have to lay down for a while . She tells me that it my fault that I lay down too much . I should push through the pain and suck it up so that my back muscles get their strength back . Also that I should have been doing a little bit of stretching to loosen up the muscles . So I was like what the heck you told me during the last check up not to do much that I had pretty much the same restrictions from weeks 1-6 only difference was I can sit down for longer periods of time and walk more . So it my fault now . lol

The out come of this follow up was The Final check up . She told me that after 90 days I should be 100% healed . Since my back was feeling weak she was going to set me up for 2 weeks of PT and she was going to mail me my release to work form . I felt kind of blind sided today . I was originally told that was going to do 4 weeks of PT then see where I am at . I don't believe that I am going to be ready in 2 weeks to go back to work after doing PT. I am on short term disability my
work has given me till December to get well and back to work . So why is this PA in such a hurry to get me back to work ? I still have 3 more months to get better. Shouldn't I be given a chance for more time to recover ? If by December I am still not able to physically do my job i will have to resign . I wish she would give me the time to heal ? Or is she right by 90 days I should be able to do everything and not worry about it ?

Should I fight it if am not ready to go back to work in two weeks ? or suck it up and go back ? Is there anything I can do to get more time ? I guess they got their money now why would they give a hoot about me right ?

Hi Pie and I'm probably not going to be your favorite poster here but you asked!

At 90 days you should be seeing a huge improvement over week 1-6. True enough,the need to exercise those muscles are imperative to a full recovery, it truly only takes a very short time of inactivity for atrophy to occur.

PT can and will help tremendously and in many would have began as early as 4 weeks out. The therapist are trained, actually have almost as much Med school as a Dr and know what to do and not to.

As for work temp disability policy tend to be limited, meaning if your entitled to X amount of months that could likely be out of a certain time frame say 12 months, that's very common. Meaning if you use the entire amount and something else happens you wont be able to use it again until after the 12 month mark.

You could have and should have been sent back on restricted duty and they could've even limited the number of hours.

Im inclined to think like the PA that the soreness is muscle inactivity more than laminectomy related.

So get some exercises going with your therapist, maybe call and see if they would allow for a light duty return with some restrictions since your job has some physical aspects.

Good luck

Well I've been chewing on this foot since I signed on today, might as well go ahead and shove it down my throat! You all are really not going to like this poster now.

Im all about support, but support with honesty. Im not known for my inclination to just tell you what you want to hear. That's not going to help you in any way.

General consensus is if your 6 months out from surgery and your not much or any further along then 3 months out you either haven't given your best shot at healing or you've joined the ranks of failed surgical procedure's.

Now this is tricky too since your failed op could be caused by your failure to follow your Surgeon and therapist or rehab persons orders. Maybe pain was more then you wanted to deal with, maybe skipping days or exercises were the thing, maybe you just felt you would do it later when it didnt hurt so much. This is definitely not one of those times when slacking is advised.

There all many many ways to help your progress and many more to hinder it. Healthy eating, healthy living in general, not smoking, not lying in bed for that xtra hour, climbing stairs when your told not to even if its only 2 or 3. Hydrotherapy is a natural healing element, just being in the pool helps.

Your surgeon can fix you he cannot heal you, that's your part and how well you heal if your going to is up to you.

Unfortunately there's times surgical procedures just fail. No rhyme nor reason, its a gamble from the time you scoot onto the table. There's always hope, there's varying percentages of success rates, their are better surgeons but the one thing there is not is guarantee.

Doctors and especially Surgeons are notoriously vague. You need to be your greatest advocate for recovery, ask questions, get specifics,what do's and don't 's specifically. How long should I sit, stand, walk, and walking usually means flat even ground, not climbing hills or slopes or stepping onto curbs. Is it ok to walk my dog? Be specific if your dog weighs 80lbs and is going to be pulling on the leash, what kind a chair is better? Sleep flat or head at 45 degree? See my points? Get gritty but these are things that may effect the outcome of your healing or not. Having a successful surgery or failed.

Thats my take, it came with 15 years of working Ortho/Neuro and experience of both successful and failed procedures.

Sorry if anyone is offended, its not my intention to do so. I wish that we could get to the point there's never a failed procedure but with so many variables that's not likely.

Wishing you all the best in your recovery!

Pie, I think you are doing great, and I can definitely relate to much of what you said. I think, perhaps, Vickie's post was meant to apply to some others of us as well. She's subtle, that one! ;)

Our surgeries can fix the mechanical issues that are causing our problems, but yes, it is up to us to push and be pro-active. I understand because the spinal reconstruction they did on my spine was to correct several problems, and I faithfully followed up with PT, straight into Rehab and outpatient,...then my hip replacement with complications,...straight into Rehab and outpatient. And I had to push with my insurance to request 3 x week because I'm working around so many issues.

I "think" what Vickie is getting at, for me too, is sometimes that pendulum can swing too far in both directions...and that can mean not being persistent enough in working out and rehab to make sufficient progress,...to pushing too hard and doing things prematurely.

I am personally impressed that you can walk 6 miles a day, I think that's fantastic! I get the most pleasure at PT on the treadmill because it's level and I can hang on... I know lots of us here understand how hard you must work from those "can barely make it to the bathroom on all fours" situations, to being able to "walk miles on your own" situations!

I, for one, am going to take Vickie's advice. My PT's feel I'm not even close to a resolution, even though I've made extensive progress,...because I had complications with my hip, which affect my back, and let's face it, everything we do originates from our pelvis and low back complex. My PT's remind me that the physicians also look at still pictures of our hardware and make assessments based on those mechanics.

But sometimes, it's the bio-mechanics, it's our gait, our ambulation, our proprioception, things that get tracked a little sideways for a bit and are skewed. It's not necessarily a failed surgery, but a complication. It's not a spiral downward, it's merely a detour. We need to learn how to work around things, rather than avoid them.

And as for Vickie's advice, (and I do not mean to hijack this thread, but she has excellent points),...while my neurosurgeon told me to give it two years due to the extensive nerve damage, and we're both pleased with the major progress I've made,...I am not going to accept him saying "just keep doing what you're doing" and "you'll get plenty of exercise with your new house!" I am going to ask for and relay specifics, with regards to duration and movement. This far out, I may be so happy to not be crawling to the bathroom that I'm avoiding those details, as Vickie mentioned.

Perhaps speaking with your doctors and PT's about specifics, something finite and tangible, accepting those numbers as "for now" anyways, these are what our restrictions and limitations are...and not accepting being told "do what you can tolerate." That may be too fuzzy of an area to base on.

There was a man in PT this morning, his FIRST visit there: He had a total shoulder replacement....one and a half years ago! And this was his first visit ever to a PT. He "said" at least, that he was never told he needed to go to one, so he didn't....and now he's wondering why he's having so much pain.

Just sayin'..... Sometimes the news CAN get conveyed to the patients wrong. And sometimes, the patient may not "hear" what that news is.


Merrida

Thanks Vickie and Merrida

I am going to do the physical therapy and see were I stand after two weeks . I have never been to PT . Is there a chance that at the end of the 2 weeks the PT will determined if I am going to need more time to rehab ? and tell the surgeon to keep me off for a little bit longer ?

Yes. The two weeks is just a starting point. If your therapist determines you need more time, then he/she will send the recommendation to the necessary Drs.

Basically, a referral to PT is just like any other referral. You get sent to the "specialist" and the specialist takes over from there, conferring with your team when necessary.

In most cases the physical therapist's office bills insurance directly and it's a separate process.

Once your therapist has worked with you and feels you're ready to take over rehabbing on your own, you'll be discharged from his/her care.

Wow, if you can walk 6 miles (at one time, or broken into pieces?), you may be doing much better than you think.

Also aside from Physical Therapy, there are Occupational Therapist, that teach people how to move, lift, bend, and do things that would be more related to getting back into the work place. At the facility where my wife is a nurse, they have an entire OT department, that helps people be able to continue to live on their own at home, and to get back working, depending on their needs. If you feel that could be useful in your transition, might be worth asking your doctor or checking into it.

As far as some other remarks I read on your thread, pain in general, and CP in particular, is very personal and subjective. No one knows exactly how much you are or aren't hurting at a particular moment. I would be very annoyed with my doctor (oncologist), if he randomly said that I shouldn't be hurting, when I am hurting. Thankfully, he's not like that.

I wish you the best as you continue to recovery. Hope you can make that transition back with the least amount of pain.

David

PieNic, first off, is there a possibility of getting your hands on a copy of your job description from HR? I cannot remember what type of work you do, sort of remember it being pretty physical.

I would make a copy of the job description & give it to your physical therapist. I would tell the therapist how suddenly your PT time for whatever reason was cut in half by the PA and let him/her know what you have been doing such as your walking. If the physical therapist does not think you are ready to return to work all they have to do is contact your for additional time, this is done all the time. But you need to let her know in advance that if she thinks you will need more PT not to wait till the last day of PT to contact your dr..That way you can avoid the check getting stopped if the dr agrees. May be better she/he contact the dr & side step the PA.

When you do return to work, the first couple of days will be killers thats normal. But if you get there and that old pain returns that has been gone you need to get a hold of the dr ASAP & let him know. Does your dr have a nurse too?


I do not blame you one bit for feeling like you have been blinded sided by the PA. It is this very reason that I am not all that fond of PA's. Some of them act like they have a chip on their shoulder, or they want everyone to believe they have just as much pull & rank as the dr. If you have any contact with this PA again and you get talked down to again, I would ask her/him just what their problem is. If you ever get the opportunity I would let the dr know about this.......Susie

In the event this ends up being 2 weeks of PT only and the release is mailed to you you will have no choice but go back to work.

Yes, sometimes OT can be incorporated right into PT, depending on the facilty and what type of program they are aiming for. When I spent the 3 months in non-oncology specific rehab, it was combined for people that were mostly out on W/C cases, and needed to be able to get back to work to save their jobs.

I am still impressed with your 6 miles. Now that I am back in oncology rehab, in my 26th month, after taking a break for 2 1/2 months, part of my normal routine is to walk laps in an indoor track that is air-conditioned and heated. Each lap is only 1/10 of a mile. Normal for me is 3 laps, or 3/10ths of a mile, on rare occasions I have done 4 laps, 4/10ths of a mile. By then, my hips are all but dead and the pain down my legs into my feet are severe even after that small amount. We have made no forward progress in that department in over 2 years, but they are happy in that they feel they are keeping me from slipping backwards even further as my cancer progresses.

To walk even a mile to me, would be a major milestone. When I was in oncology rehab way back in 2000, for different cancer battle, I was much younger, and not dealing with CP, my normal routine was 2 miles per visit, and I went 5 days a week. And when I left rehab, I would forgo the elevator and walk down 20 flights of stairs. What a difference between the two events in my life.

David

Double kudos to Susie's post. In fact, paying very, very close attention to her wording, is the key.

By being pro-active, by taking the initiative, by presenting yourself as being positive and willing and wanting to return to work,....notice her phraseology: ...asking if "they can whip you into shape in two weeks...."

That comes across very different than presenting along the lines of, "I don't think I can do it in two weeks," or "will two weeks be enough time," or if you start off the conversation by deflecting to the mistakes you perceive the PA to have made....

Very good. In fact, I am going to utilize this strategy more than I already to because I can see (it helps when it comes from someone else,...new sets of eyes and all that),...when I begin my work with new health practitioners up here.

Very nice, and very well thought out.



Merrida

That is awesome but don't kill yourself doing all of this before hitting PT or returning to work, lol. Oh, you might want to throw some stretching in there before walking now & see how that does since the PA suggested stretches.

It is fine to push Pie but please, please don't overkill here ok, lol. Sometimes we can be our own worst enemy. Lets be realistic about it when you say push more, if your body starts pushing back and it will, then you will know you screwed up by doing too much. Not preaching to ya, just want to see you keep staying on the right side up of things.....Susie

I remember that happening, its called slow & steady...

PieNic
Sounds like you are improving !

When I was still able to work, I had a sciatic pain episode & my doctor worked with me by allowing me to start back a couple of hours a day. As soon as my endurance was built up & I could handle that, I increased the length of my work day. Previous to injury, work week was usually 50+ hr.

Maybe suggest to your PT something similar so you ease back into your full time work schedule ?

Like David I am impressed by your ability to walk such distances.
My 'before body' enjoyed an entire day at the mall.. Now an hr is sometimes more than I can tolerate.

I stressed for years, thinking 'when can I start doing that again?
and work again?
Was sad - extremely sad! - when a consulting doctor said some things that made me understand that my life now is different..
Took awhile longer to accept... someone recently called it grieving for what 'was' - apt description I think.

Glad you are getting better!!