If you've had ACDF surgery, would you help me with some advice?

Wow, I genuinely didn't know that NSAIDS are contraindicated for bone fusions.

Seems doctors push them on people (after the whole down time you're on Coumadin I mean). I cannot take them, but was surprised after reading this, at just how many doctors (before glancing at my chart) told me to take NSAIDS.

Wow. Simply.....wow.

Hot diggity.

With that kind of information out there, why are the docs pushing NSAIDS on us post-op after fusions? They're more in a rush to get us off the opioid meds, and onto an NSAID,.... And in the face of this kind of potential damage, they weigh the risks and think we're safer?

This is really frightening.



M.

Wow. My wife just told me they mentioned this to me during my discharge, but I was so narc'd out that I didn't remember. They sure don't do a lot of reminding. . .I am a huge fan of aspirin for headaches but I guess it'll be Tylenol for awhile.

I won't be touching NSAIDs or my beloved cigars for at least another 9 months I guess.

Hello Im Grammy. My dad had 3 level ACDF 2 weeks ago. The op went well but the next day it was evident he had aspiration pneumonia and he ended up in Intensive care for 5 days . He was put on feeding via naso gastric tube and is now in the ward. A speech therapist is assessing him and he is being fed a couple of spoons of water which he is swallowing with difficulty. My wife who is a physiotherapist suggested that he swallows somehting thicker than water but the speech therapist insisited on water as if the stuff goes to the lungs he gets another infection. On tuesday he will be assessed again by the speech therapist. I am afraid that he might be left on the feeding tube forever. He is getting depressed now as he feels without strenght but I think this is due to the diarrohea being caused by the feed they are giving him and also staying in bed and on a couch all days does make you feel tired.

I'm late finding your post, spiritofscouse; I'm so sorry. I've been out of pocket for a few weeks. I'm wondering how things have progressed with your dad? I understand the swallowing issue and, I have to tell you, I was a bit afraid that I'd never be able to drink water again. Anything thin just strangled me. I'm now 11 weeks post surgery (if my math is right) and I'm now swallowing normally again and, after researching to find what exercises I could do on my own to get my vocal cord to move, because I did NOT want anyone cutting on my neck again (or however they'd get in there) my voice is pretty much normal again. (Humming, and also incorporating Mmm and Nnn sounds when you hum can actually, over a short period of time, help the vocal cord to move properly again. You just hum until you feel it in your face and then keep that up whenever you think of it and it helps greatly.) I find I can even sing again, although I'm retired from that sort of thing.

I am, however, a bit bummed. You see, while trying to favor my left arm, which was so painful because of the stenosis that it was actually debilitating, I lifted a 24-pack flat of bottled water with my right arm and felt (and heard) something rip. (I'm told that my brain just processed the event as a noise but still... it sounded like Velcro being pulled apart.) I found out last week that I have a fully torn supraspinatus, so, essentially, a torn rotator cuff and that I have to have surgery to repair it. I had to let it go because everything came to a screeching halt for the ACDF surgery, but now it has to be dealt with. It has grown worse, because I let it go and because it is my right shoulder and wouldn't you just know that I have to be right-handed?

Look at me go: if they make rambling an Olympic event, I'm bringing home the gold.

All that to say that I'm very sorry to hear that your dad is having such a rough time of it but, 11 weeks on this side of it, I'm optimistic that he'll make a good recovery. My neck is still a bit inflamed because I keep lifting more weight than I'm supposed to (grandbaby!) and it does affect those muscles across the back, so I hope he does what I say and not what I do and listens to the discharge advice, particularly pertaining to lifting anything heavier than he has been told he can lift. I'd also advise staying away from NSAIDs while in bone fusion. One other thing and this is a bit odd but, regarding swallowing... it actually helps, believe it or not, to hold the water in your mouth then bend your head slightly down while swallowing. I don't know the science behind that, but it does help. Let us know how he does.

So his infection hasn't shown any sign of clearing up then. Other than the condition that made ACDF necessary, what sort of health was your dad in prior to surgery? How old is he?

Choking while swallowing is difficult enough when someone in good health has had ACDF but complications from infection make it hard for the patient to compensate. (For instance, I'd mentioned bending the head forward to help swallow without choking but if your dad is fighting this infection, swallowing technique wouldn't matter.)

Depression plays a big part in making recovery difficult. You mentioned prayer. If your family subscribes to prayer as part of a belief system, are you having clergy or some other spiritual counselor come in to spend some time encouraging your dad and building up his faith? Even the most optimistic, vital person can hit the wall after a surgery like this one because there are so many aftershocks associated with it. Someone with your dad's added challenge might benefit from spiritual guidance that helps place his faith and focus beyond the ordeal he's currently facing.

I think of prayer not as a last resort but as an ever-present help in time of trouble.

That's the same with my vocal cords, the left moved okay but the right was paralyzed. The ENT told me that if it was the same when I come back (3 months out from that visit) that he'd have to either inject something next to the cord to stimulate it to move or even consider surgery. Vocal cords apparently help with the swallowing process as well as speech so I expect he was more concerned with my ability to swallow than whether or not I'd get my voice back.

I'd encourage your dad to try those exercises, except for the fact that he's so recently post-op and I'm sure fairly weak due to the shock a body goes through following ACDF. But when I was at his stage of post-op, I could only whisper and was still strangling on thin liquids. Other than the tightness across the back of my neck and shoulders, I'm pretty much normal at 11 weeks out. I'd like to encourage you and your dad to not believe that what he's experiencing now is what he'll be left with. I can tell you that it does get better, it really does. I understand his being depressed but please share with him that things do improve. When he feels stronger, I do recommend the humming. It worked wonders for me. Also, if he sits upright when he swallows, I'd definitely recommend bending the head forward (slightly down) when swallowing. It's what helped me to stop choking, although I'm not sure why.

So glad the infection cleared up!

Hi, Jan Wan,

I'm so sorry to hear that you have not only a double dose of surgery coming up but both affecting essentially the same area of your body. Is your cervical repair being done to correct a failed fusion? Were you in an accident? The ACDF was my first surgery for this particular condition (stenosis) so I can't imagine having to layer it just two weeks out from another cervical surgery! I've made the assumption that these were both the same area of your body and, I suppose, in an overall sense, they are, but what disks will the ACDF focus on and what area is the cervical repair addressing?

I play the piano but probably not at the caliber you do, since my playing has always been for purposes of songwriting and concert accompaniment, but not as a stand-alone performance, so I can understand your concern. Following the ACDF, my playing is at about the same standard; my only issue now being the torn rotator cuff, which is becoming a bit worse as I thoughtlessly move my right arm away from my body. (Today, an immobilizer is being delivered to my home which will essentially bind the arm to my body so I will become a "lefty" for a while.)

Not being sure what your cervical repair is for, I would say that, from the standpoint of the ACDF, itself, you should be able to return to playing the piano just fine. However, you WILL have to get past the tight muscles across the back of your neck and shoulders and this takes time. Really do pay attention to your discharge instructions, Jan, and don't lift more than you are allowed, or you'll have to contend with the muscle tightness for quite a while. (I'm guilty in that respect and paying the penalty.) Your doctor will more than likely prescribe a muscle relaxer and, if you don't care for the sensation of feeling sedated during the day, you might want to ask him to provide Robaxin instead of something like Soma. It provides relief for tight muscles without making you feel like you've been abducted.

Four levels is quite a lot, so your experience will likely be a bit different from mine but good general advice would be:

1.) Pay attention and adapt to discharge instructions.
2.) Do practical things like what I've mentioned on this thread regarding head position while swallowing, humming for vocal cord movement.
3.) Use cold packs to help reduce inflammation around the neck and shoulders but also
4.) Use a heating pad or stand in a nice, hot, pulsating shower when you just want to feel better.
5.) Realize that time is your friend. It may seem like an eternity but it isn't.
6.) Do not pick at your steri-strips. Let them come off themselves over time.
7.) Do use sun-block on your scar when you go out, as soon as your doctor says you can begin putting something on it. Vitamin E capsules, cocoa butter, Mederma, etc., are all good to fade the scar, if used consistently.
8.) Don't rush your recovery, or you'll end up feeling worse and "hit the skids" (depression). Your body needs sufficient time to recover. Any surgery is a bit traumatic but the spine is particularly delicate.
9.) Invest in a good pillow to help you sleep at night. I found such a simple one, the Core 219 Petite Core Pillow-White-Firm (my neck is small, so petite for me). It took about a week to live with it so that I learned how to hit the sweet spot but I was so impressed with it, I wrote a review for it. You'll want to take the time to read other reviews and find just the right kind for you, but it's worth it in the long-run.

All these things (along with a few accidental discoveries I made on my own) were learned not only by surfing the web but here, where I've gotten some really good practical advice, as well as some good "hang in there" encouragement. These types of forums are a great place to ask questions, compare experiences and just commiserate together. I've been made to feel that there are no "dumb" questions so I'll just pass that on to you. I'm still an ACDF rookie but the vets are happy to jump in, so ask away!

Hi, Jan,

From what I've read concerning laminectomies, I'm hoping your case will be the "minimally invasive" scenario and that your recovery will be the standard "few days" (with no muscle having to be cut). If the ACDF isn't difficult to schedule, you might want to consider recovering fully from the laminectomies before you proceed, just so you won't have to deal with two separate issues.

It's interesting about post-ACDF collars: doctors seem divided on the issue. My doctor didn't put me in a collar at all. His position is that the neck muscles would strengthen faster if left to do so on their own, without support and I'm beginning to think that he was right about that. I'm only 11 weeks (and counting) out from the surgery and if I didn't have this torn rotory cuff issue, I believe I'd be feeling pretty good. There is the occasional stiffness across the shoulders but it's not always present and improving, slowly but surely. I did buy a soft collar in the early stages of my recovery and I bet I wore it for the total of one hour before I ripped it off and tossed it somewhere. Maybe if I'd bought a child's collar, it wouldn't have been so bad, but the one I bought made me feel like I was a giraffe in training.

I would ask your surgeon his thoughts regarding post-surgery collars and let him know what you'd prefer and just see if he'll agree. Asking is always free, so I ask all sorts of things. Speaking of asking, I absolutely know what you mean about being in a fog when this first came up, so do bring those questions and your husband with you (since he'll be involved in your recovery) when you have your next appointment.

Don't be afraid to start a new thread here, too, when you're back after surgery and might have a question about something specific. The mods won't always stop by this thread because most of my questions were answered early on and by starting a new one with its own subject line, you'll draw more attention to your questions than you would posting on an older thread that might get passed over. I'm still a rookie but there are some heavy-hitters here when it comes to ACDF.

Let us know how your laminectomies go, Jan. I'd be very interested to hear. I have all the hope in the world that you'll be back at your piano as if you'd never left.

Hi, Abilene, and thanks for asking! I have to say, the left side of my body is doing well. That's good, because the right side is mad at me and has managed to get my neck pretty ticked off, as well.

My neck has pretty much healed and the fusion seems to be going well but, regarding the cadaver implant... not too long after my ACDF surgery, a pastor from another state was here on business and, since he knows me from having booked me for several music festivals in the past, dropped by to check on me. He'd heard that my voice was gone and I guess he wanted to encourage me. He sure had an odd way of doing it, though. He said, "Well.... you'd better hope that cadaver guy was a Christian. Otherwise, when the dead in Christ rise, parts of you may be in trouble."

I didn't have a torn labrum in my right shoulder, but a torn supraspinatus, instead. Fully torn. It happened back in mid-October and I literally heard a sound like Velcro being ripped. I didn't realize it was fully torn, though, and had to focus on the more immediate problem of the stenosis. The shoulder continued to worsen but the left side was so severe, that I failed to realize how serious the right was. I had the ACDF in January and 12 weeks later, my neurosurgeon finally told my orthopedic surgeon that, in spite of having metal plates and screws in my neck, I could have an MRI. The MRI showed that not only was the supraspinatus torn, but, over almost 6 months, had spread apart into a large gap, I immediately had rotator cuff surgery. I'm nine weeks out from that surgery, now. Recovery is difficult, partly because, instead of being minimally invasive, the surgeon discovered that there had been no blood flow to the area the entire time. He used an anchor to hold the muscle down but when he tried to use stitches, it was like trying to stitch paper. They would immediately come out. He had to make a three-inch long incision down my bicep and repair some damage there to get stitches to hold.

Isn't this a long and sad story? And me, without a Kleenex!

I had to wear an immobilizer for 7 weeks. So.... because I had not moved my arm for all that time, I've only been in PT not quite 2 weeks and am still "passive assisted". (But what they don't know is that I do venture to do a few things with the right arm. I'm so right-handed, it's not funny.) I bought a blow-dryer holder which has been a good thing, but I still look like an extra in Twister. So.... all that to say this.... my neck is healing but it's being affected by the rotator cuff and stiffening up.

On the bright side, my vocal cords are no longer paralyzed and I can talk again, almost normally. This was a big relief to my 4 year old grand-daughter. She's had a pretty traumatic life, lately, what with her Grammy being so weird and the arrival of her premature sister, etc. Plus, she thinks she's pregnant. A few weeks ago, before her sister was born, she looked over at her mother's tummy thoughtfully and said, "Mom..... did you sing Oh Happy Day and get pregnant?" Her mom laughed but she continued to look worried and said "You did! I remember, now, I heard you singing Oh Happy Day and then you were pregnant!" By now, her mom was about rolling on the floor and almost had the baby right then and there when she saw my grand-daughter's face screw up, ready to cry, and heard her wail, "Oh no, Mom! I was singing it today.... and now I'm pregnant....!" HA!

So... I'm doing okay. There are a lot of people out there worse off than I am. For instance, my sister. A couple of nights ago, she fell and broke her left foot and her right leg! (I still can't figure out how she managed that.) I sent her a care package today with the standard romance books, crosswords, word finders, a teddy bear with a "cast" on its left foot and right leg, a bag of Werther's Originals and some Carol Burnett DVDs. She's going to be out of commission for a long while; she may as well enjoy some of it.

Hi, good to see you again, as well! I have to tell you.... it's much worse, for me, at least. It feels as if there are bits of broken glass in my shoulder cap and one false move feels like whatever it was that broke the glass has come back to finish me off. Honestly, I think if I'd had surgery as soon as I tore it, it would have been a different story, but six months with no blood flow didn't give the surgeon a lot to work with. But there's nothing wrong with my typing fingers, ha! Just on my way to take a muscle relaxer, since this thing has kicked in the neck tightness, and off to bed. I'll stop in more often; I really enjoy this place.

IAmGrammy,

I referred to your quote about NSAID's in another thread hoping others will read it too.

Is your shoulder healing any better now?