[Artificial Disc Replacement / Lumbar] L5/S1 M6, Oct 19, 2011, Dr Clavel in Barcelona

[laid up doc]

thanks Genn... have been doing partial flip turns this past week - free to back only so no twist - and that's been going fine. had my 12 wk xrays on Thurs but there was some issue w/ the computer system and they couldn't burn me a CD... so i gotta go back. i looked at them and while i didn't know exactly what i was looking for, i didn't see anything weird. not sure how much the M6 is supposed to move on the flex/ext films...

best of luck to you Genn! looking forward to your post-op thread!

[laid up doc]

12 wk xrays... waiting to hear from Clavel... I don't see any issues other than a bit of spasm on the lateral (loss of lordosis). Glad to see the M6 bending in flexion, but just a little!
Foot is slowly but surely improving. Trying to increase walking very slowly.


Saw my pain doc Wed...
Had the left trochanter bursa injected again, but the right is better now and didn't need more 'roids. Left is about 50% better than it was, so hopefully this will knock it down!
Had some trigger points done in my TFL (tensor fascia lata), QL (quadratus lumborum), and a spot where the glutes attach to the top of the sacrum.
Will go back in 2 wks if more TP's need to be done.


Reallllly hoping to start work w/ minimal pain, though i know the 8-9 hours of walking/sitting/standing will totally wear my butt out for a bit!


Best news though -- still no spine pain AT ALL.

[Justin]

Best news though -- still no spine pain AT ALL.

A BIG congratulations to you, Laid Up Doc! This is fantastic news. I wish you the very best.

[laid up doc]

thanks Justin!

another new milestone last night!!!

went to a concert in a theater last night - about 2 hours with a stretch break - and while i wouldn't say i felt "normal" (felt fidgety), i wasn't in PAIN and have no residual issues today!

oh, and i had gone to dinner before, and sat there for about 1.5 hours.

first time i have done anything like that since Nov 2009...

continuing to advance my workouts, still w/ some hip and foot issues but they are SLOWLY getting better. massage therapist has noticed that my muscles are less tight every time i go!!

[laid up doc]

T minus 6 days til my first day back to work... starting a new job so expecting things to be kind of rough for a while.

My PT told me to expect a solid month of soreness/stiffness... I will be almost exactly 4 months status post my ADR surgery when I start back working.

Don't have an option of easing back into things due to the nature of my work. I work 8-9 hour shifts and they aren't really split-able especially being the newbie!!!

Anyone have good relief w/ those stick-on heat patches like Thermacare? I will be on my feet most of the time, with frequent stops to put in orders and chart at a computer. Most of them are at seated height, but I will be inquiring if I can do much of my work from a standing height computer.

[dentalrebel]

Good Luck Doc! I too may be making a little progress. When Dr. Centeno and crew did my sympathetic block with Clonidine, I had total pain relief for a while. It has returned some but I seem to be gaining some traction along with the Lyftogt procedure and Mackenzie therapy. My PT is working my butt off and my massage therapist said yesterday that my muscles are the best she has seen for me since we started.

I hope your job goes well and I'll keep you in my prayers. Already said a small one for you this morning! God Bless.

[laid up doc]

thank you!!! so glad to moving forward, but i do anticipate rough patches ahead. still - they are nothing like pre-surgery.

glad you've been able to get some relief. have you decided on the discogram?

[dentalrebel]

I have not had the discogram yet. Since I was getting better I thought I'd see what happens.

I should know within the next month or so what I'll do next.

[Justin]

LUD, congrats at starting back to work soon. The key will be changing your position frequently from standing to sitting. The Thermacare wraps can be helpful. Also, I would schedule weekly massages the first week you are back--this will be a HUGE help. Between patients on rounds, you can lightly stretch (just standing and leaning forward slightly to help take some pressure off of your lower back / SI joints). A short course of naproxen taken on a regular schedule before you start back on service will really help knock out some of the inflammation that is headed your way (of course, consult with a trained, licensed physician before starting any new medications ). Something that has helped me on long rounds is leaning my low back on a table / counter that is waist-high to put some pressure on my SI joints / low back (this really seems to help knock out some of the knots when I get "knotted up"). One last thing, a bath to soak in nightly during your first few weeks will really help.

Good luck!

[laid up doc]

thanks Justin! I thiiiink you know my specialty - it doesn't just allow frequent position changes, it MANDATES them!! luckily i do get to stick to a certain geographic area for the most part, so lots of moving around but never too far. no rounds which is part of why i chose this specialty!!! only tough thing is if i get behind on charts i might have to sit - but will be having a talk w/ my director to find a spot where i could stand and chart. there's also remote access so if necessary i can go home and chart on my laptop on the heating pad!!

i also plan to give away hip and shoulder reductions for the first couple of months - i'm not single coverage very much, and those are big RVU charts that i'll just have to give away til i feel i'm 100%. they're fun too, i love running sedations and doing reductions!!!

i will be stocking up on my favorite lavender epsom salts, and have a massage scheduled already. i was lucky to find a great massage therapist who has learned my bad spots and i always feel better after seeing her! (side note: she's a sickle cell patient! with a full time physical job! bonus points for her... i think you're in your clinical years so you know what i mean!) I have a membership with Massage Envy - set $59/mo for 1 hour massage per month, then each extra is $39. i usually throw in at least 1 90 min session a month.

my PT is also a Pilates instructor - which has been AWESOME for core, leg, shoulder, and back work w/o any stress on the spine. i'll continue it through her as long as insurance will pay for PT, then will definitely continue that as part of my fitness routine. if you haven't tried it... DO!!! will also be talking w/ an old swim coach (i'm living in my hometown now) about joining her Masters team - IF it fits my schedule ok. i'm super competitive about some things, which would push me but i know i can't hurt myself swimming. (can't say the same about the gym anymore... have to be REALLY careful still)

as far as NSAIDs... i have a really unfortunate history of NSAID gastritis (pardon the doc talk here folks) in fact, i have been taking BID PPI's since the 4 weeks of naproxen after my ADR (been off since mid-Nov!!!).... am going to a GI later this month and am pretty certain I'll need an EGD since I haven't had one in over 10 yrs. had terrible female athlete knee issues as a teen/young adult - finally relieved by a lateral release when i was 22, but i had taken enough NSAIDs to last a lifetime by then.

i have a topical compound of diclofenac/baclofen/gabapentin/cyclobenzaprine/tetracaine that i use on my bum foot and my sore back/hip areas. it costs a small fortune but luckily my insurance does cover it.

like i said above - my PT has mentally prepared me, which is half the battle in my case. if i know what to expect and know it will get better... i know that i can handle ANYTHING. i did my residency in one of the toughest hospitals in the country, and i survived that knowing what i was getting into and that it would get better so i'll try that approach again, almost 3 yrs after i've finished residency (time flies!!).