My L5/S1 Microdiscectomy – Male/49

After reading many very interesting posts on this site (including PieNic’s – thx!!), want to share my experience. As one person noted, it seems like many of the posts are from people working through serious post-op issues, and the people who didn’t have any post-op issues (or have worked through their issues) are probably out enjoying life rather than posting on blogs. I am currently 5 days post-op with GOOD results so far. Hopefully that continues, and my posting(s) can help balance out expectations of people considering this procedure. I will try to post periodic updates.

First, some pre-op background starting at the beginning, since I understand time elapsed between herniation and procedure can affect outcome and recovery expectations. Overall, have had a very good fitness level in recent years, running, rock wall climbing, weight lifting, etc. FIVE MONTHS AGO, bent forward to get something. Back and right leg hurt instantly. That was the first lower back / lumbar area / sciatica event I ever experienced. Was prescribed Medrol pack and it seemed to go away completely. Then, THREE MONTHS AGO, it came back, slowly this time, but got worse. Given another Medrol pack, had x-ray taken, saw surgeon, and was prescribed PT. The Medrol helped, but not as much as the first time. The PT seemed to help – but did not eliminate the sciatica, but I didn’t keep it up as much as I should have towards the end, then stopped. What’s the harm in stopping? Big mistake. I had resumed running and rock wall climbing, and seemed to be functioning fairly well. Gradually, week by week, it started to return, especially after 1 hour car rides would make it flare for a few seconds. ONE MONTH AGO, I went out for dinner, had some drinks and moved some furniture. Didn’t feel quite right and went to bed early. Woke up and couldn’t make it to the bath room without excruciating sciatic pain which got worse the longer I stood. Essentially bed ridden. Was given another Medrol pack, MRI ordered, surgeon said herniated disc, and was given a spinal shot. That worked great for about 2 or 3 hours (the numbing portion of the injection), but then the pain returned. Several days later, very little improvement. Could sit / stand / walk for a few minutes just fine, but after a few minutes, excruciating sciatic pain. Essentially bed-ridden and not working. My options were to try another spinal shot (and rely on these forever?) or get the MicroD. I opted to pursue the latter. Since I live in NYC, my medically involved friend said I had to consider Hospital for Special Surgery (HSS) and NOT my regular hospital. They are supposed to be one of the best – if not the best – for spinal surgery. Picked a surgeon, had a consult, and scheduled surgery. Was told that I should not bend, lift, or twist for 6 weeks post-surgery. My post-op visit with the surgeon would be at 6 weeks. I have a management / office desk job, so hopefully resume work rather quickly. Will need to take PT seriously after, and re-think my entire exercise regimen.

Day 0: After surgery, I could not speak – from the tube they put in my throat before surgery. Not a big deal, this got better very quickly, and not even sore after a few days. My back was sore on the first day, around the incision, felt like I was laying on a wallet. On pain meds, so not a big deal. They kept me in the hospital overnight because of my sleep apnea, and maybe because of my history with a-fib.

Day 1: PT walked me the next day, and taught me how to go up and down steps. My affected leg was still tight, but functioning. No more sciatica!! Still had the same foot/heel numbness that I had before surgery. Think the leg was tighter than before surgery, but not really sure. After they wheeled me downstairs to be released, I walked around a bit to find our car service and rode home sitting upright for the 20 minute ride home. No more laying down in the back seat! Got home and walked and sat a bit more. Sitting on my “bad” leg hurt a bit – felt like sitting on sore bones or tight ropes. Squirmed on the chair to get comfortable. Went to bed for a quick nap and slept for 16 hours. Finally was able to sleep decently.

Day 2: Really no pain except when first getting out of bed in the morning or after a nap, but that quickly subsides after taking a few steps. Visiting nurse came by and showed me how to remove my bandage, check the wound, and replace the bandage. Able to walk around the apartment quite a bit. Sitting up to about 15 minutes at a time. A few rests / naps throughout the day. Not taking ANY pain meds since discharge, just laxative. Some discomfort when changing positions in bed, and when laying on my back. Wake up during the night when I need to change position.

Day 3: More improvement. Less sore walking around. More walking around the apartment, longer sit times, and less daytime naps / rests. Walked outside (with a walking buddy) for about a block or so. Everything good.

Day 4: Even more improvement, than previous day. Still a nap / rest or two during the day. More walking (both inside and outside), longer sitting, etc. After changing my bandage, noticed that the area around the incision felt warm, and thought I had a bit of swelling just above my incision. Visiting nurse checked, and said it appeared normal. Sat in a chair with my back against the back rest, but pillow in between. Sitting up to 1 hour at a time. Walked outside continuously for 1 mile.

Day 5: Foot/heel numbness reduced considerably, but still there just a bit. Still discomfort when getting out of bed in the morning. Still some discomfort on the back of my leg when sitting, but less than the first day. Overall, still improving each day. Will increase my outside walking distance, but will try doing so in multiple outings instead of a single outing, e.g., 1 mile first outing, then a half mile later in the day.

Glad I did it? So far, YES!!!

Hope his helps others considering this procedure. Will try to give additional updates on a periodic basis.

Welcome to the forum Jim. Glad to read that so far you are having a decent recovery at this point. Like most you may hit a bump or two along the way but just be careful & let your body heal.

I do hope that you will return to this post with updates. Many, many people read these posts looking for various information. By putting your story out here it will help many.

Take care.

Thanks Abilene, Susie, and Vickie for the positive encouragement and advice. Much appreciated! I will do another update shortly, probably weekly, then monthly, etc.

Thank you for posting this, I hope your progress continues and I wish you the best recovery!
It's good to know of success...also, like the others said don't push it...
Just keep taking it one day at a time and use ice packs, ice might help that swelling...
One weird question, if you don't mind,: are your bladder movements good again?
Thank you...

Thanks Chartreux! I was icing before the procedure, but have not done it yet after. i may try icing my leg, but also don't want the blood to slow down. don't want any clotting. don't think icing would do this, but not sure. bladder has been fine both before and after. I did NOT have a foley cathether during my surgery. Bowel movements are a different story. I got impacted (ouch, yuck) BEFORE the surgery, when i was on kinds of painkillers / narcotics. Stopped those immediately and dealt with the issue. had some pain killers / narcotics in the hospital, but not any since release. I have been very careful to not get constipated again. I did miralax the first 2 days after being released, to make sure everything was "coming out ok". been drinking plenty of fluids and eating plenty of fiber. All a-o-k.

Thanks Vickie! Will look for it in the cp 101 sticky thread.

Susie - I totally agree about the sitting, and thanks for the caution. Most of my job is done sitting - reading emails, sitting in meetings, listening to conference calls. When I "return to work", I will be working from home (telecommuting) for 3 weeks. That gives me more flexibility to walk around while on conference calls, and stand while going through emails. I will start work earlier than usual and later than usual, so I can take some walking breaks or lay down and do ankle pumps if needed. I will definitely be listening to my body and doing these. I'm not physically going back into the office until 6 weeks post-op. I was out from work for 25 days before the surgery, so eager to get back as long as I can take things easy. Seems like the general guidance for getting back to work after Microdiscectomy is between a week or two in the US, at least according to the multiple MicroD post-op guidelines from different hospitals I found on the web. So being out for close to 3 weeks seems reasonable.

Chartreux - Was thinking about your bladder question. Did you have a bladder issue following back surgery, or is there some correlation? Anything in particular I should look out for, or do anything specific to prevent an issue?

Vickie - I couldn't find the spinal surgery comments in the CP 101 sticky thread. If you know where it is, can you give me a unique word or two to find the spot in the thread?

Thanks all!!

Jim, unfortunately what you read on those hospital websites about the return to work in the US being 1-2 weeks is incorrect. I don't know of anyone returning that quick. When I worked I saw a lot of different surgeries including micros. The soonest any of our clients returned to work was 6 weeks & they ended up back off work longer because they were not ready physically. We see people come through here all the time that has had fusions done & their drs tell them you will be back to work in 6 weeks. That is nothing but what we call text book talk it does not have a thing to do with the every day recovery of the patient or their ability to work. They are taught this junk in medical school. It takes a minimum a year for a fusion to become solid so returning to work in 6 weeks is not going to happen very often.

The best thing you can do is listen to your body, keep in mind that even though your surgery was a micro there was still trauma involved to the spine. The more time that passes after your surgery the better. Probably at about the 6 month mark you will have a better idea just how successful your surgery actually is. The main thing is don't push yourself that will not help at all.

2 WEEK UPDATE:

Overall, recovery seems to be going well.

The bump / swelling by my incision has grown somewhat since last week, just as the surgeon had predicted. Not terribly large, but big enough to feel it when lying on my back. I can still sleep well on my back. Not sure how long it will keep growing, but will ask him if it doesn't stop growing soon.

Walked 2 miles per day (1 mile per walk x 2 walks per day) over the past week, and tolerated that really well. Yesterday, I added a third walk of just 0.5 miles, for a daily total of 2.5 miles. I also sat a little more than previous days, and no nap yesterday. My affected leg was a little more sore yesterday evening, but with ankle pumps (lying down) and sleep last night, feeling good. Will stick with the 2.5 mile per day and see how that goes. Still using taking a "walking buddy" with me on walks. Doing ankle pumps multiple times throughout the day (doing these lying down) and they seem to help.

I am now also pushing the (very heavy) lobby doors open by myself now. I was sometimes absentmindedly pushing them open when leaving with someone, so figured I figures it would be safer for me to consciously do this myself - plant my feet firmly near the door and push with just my arm. Started that this morning, and doing well. No twinges at all.

I'm able to take my shoes and socks off by myself, by lifting my legs up one at a time. Not able to put on my socks, nor tie my shoes since no bending. I ordered a "sock aid" and waiting for it to be delivered. I am using tie shoes, but could use another pair to avoid tying. For now, my "walking buddy" helps with putting on the socks and tying the shoes. It will be nice when I will be able to finally go take a walk outside by myself.

Susie - Good advice!! I definitely learned my lesson during the latter part of week 1 when I tried progressing too quickly. I will stay at 2.5 miles per day for at least a week. Don't have any plans to increase my sitting time this week.

1 MONTH UPDATE

Everything seems to be going well. My last update was back at week 2, and have progressed quite a bit since then. I'll try to point out what has approved, and also note anything that that is not 100% back to "normal".

Improvements:
A day or two after my 2 week update, started getting my energy back, appetite came back, and started feeling much better. about that time, I started doing dishes - or was that a couple days before my 2 week point? My temperature was higher than normal, but never a concern. That returned to normal somewhere between week 2 and week 3. The rash around my incision (from the bandage tape) went away around week 3. The area itches much less as well. Can lay on my back without feeling like I'm lying on a golf ball - that improved around week 3 to week 4. Swelling around incision peaked between weeks 2 and 3 before going away between week 3 and week 4. Increased mileage to a full 3 miles per day starting week 3 without issue. Started working from home (putting in a full day of work) starting week 3. Numbness in right foot/heel is gone - stopped around week 3 or shortly after. My calves no longer ache if I sit too long - that stopped between week 3 and week 4. Surgical glue started falling off the incision at week 4, and from what i can see, the scar looks good. I can put on my right sock now without help, starting around week 4.

Things not 100% back to normal:

Still no bending/lifting/twisting until 6 week postop visit. I could probably bend/lift/twist, but following doctor's orders.

I did feel some twinge / pain to the left and right of my incision, on and off for a few days around week 4, but gone now. Couldn't tell where the pain was coming from exactly, or if it was muscular or something else. Seemed a bit sharp. Don't feel that I did any wrong movements or overdid anything, so not sure what that was. Hope it doesn't come back.

My right calf is tight, and sometimes get a minor cramp at night. Doing the ankle pumps seem to help, but don't think this will get much better until I'm allowed to start PT. Can't tell if the tightness is nerve, muscle, or both. Butt and hamstrings seem relatively fine, main issue is the right calf. When I walk, my gait isn't completely back to normal because of the tight calf, and can probably walk about 80% of my previous fast pace walking.

Went out last night for dinner, but didn't drink. Playing it safe and not drinking until after my 6 week postop visit. Want the healing to have no impediments.

Even though I listed 3 things, the only definitive thing that isn't 100% back to normal is my right calf. Looking forward to 6wk post op visit and PT.

Post Edited (jimkiefer) : 9/27/2015 3:38:10 PM (GMT-6)

Jim, thats a great 6 week report. Just remember mircro-surgery or not, its still spine surgery so add your things back in gradually. Listen to your body if you do too much of something. Just back off a bit.

I would get in to see my PCP about the toe nail problem. You need to make sure this is not a circulation problem.

Take care.

Thanks PieNic. Really enjoyed reading your story as well. Appreciate the guidance.

Hi Jim, so glad to read another promising post about your surgery. It is always nice to see someone have surgery & be happy with their surgery & progress.

Just always keep in mind you have had back surgery & therefore you need to protect your back in the future. As you add weights do so with some caution. Your role is as important as the surgeon & therapist.

Take care.