[Artificial Disc Replacement / Lumbar] Lumbar L4/L5 & L5/L6 (S1) Prodisc-L - Cathy......Dr. Bertagnoli May 26, 2009

[treefrog]

Last night I did a couple of things differently. I took my diclofenac closer to bedtime, I took amitriptyline instead of lorazapam for sleep, and I slept on my back with a pillow under my knees. Bob keeps turning the a/c down at night, and I get cold and feel the need to curl up on my side. So last night I turned the a/c up a little, and put on socks to keep me warmer, so I was fine sleeping on my back.

This morning the ache in my legs is so much less, it is really amazing. I think it is the sleeping position, because there was a short time in the morning where I turned over on my side and my legs started aching some, but I went back to my back and it seemed to get better.

I don't think I want to risk not taking something to help me sleep yet, the aches in my legs are still there to some degree. I think I need something extra to make sure I can sleep. I haven't been taking these drugs for very long, only since just before surgery, so it shouldn't be a problem.

[Justin]

I don't think I want to risk not taking something to help me sleep yet, the aches in my legs are still there to some degree. I think I need something extra to make sure I can sleep. I haven't been taking these drugs for very long, only since just before surgery, so it shouldn't be a problem.

It makes sense to use what you need to help sleep through the night. You are still very early post-op. Sleeping well and sleeping in a position that doesn't cause you to hurt the next day will not only help in the short-term, but will also greatly help in the long run.

After my 2-level ADR, I would change my position frequently while sleeping, but the best position for me was flat on my back with a pillow under my knees to help relieve stress on my lumbar spine.

How are you doing with distraction pain?

[New-disc]

Cathy,

Thanks for keeping us updated!!

[treefrog]

Bob measured me last night, and I am now 5'4". All my adult life I have been 5'3.5", but at my last physical just a couple months before surgery I was measured to be 5'3". So, a half inch taller than my normal height and a full inch taller than pre-op.


Justin, I guess I am doing all right with distraction pain. In fact the only "pain" I feel has been this aching in my legs. I don't know if that is distraction pain or??? The brace pokes into my butt when I am sitting down, and if I am sitting too long with the brace on I have to loosen it up a little as I start to feel like it is restricting my breathing (particularly when in a car).

How is distraction pain described? This is the pain that is caused by the change in disc height and spine alignment, is that right? I think I had some of that the first week after surgery, but I haven't really been feeling that lately.

[Justin]

Bob measured me last night, and I am now 5'4". All my adult life I have been 5'3.5", but at my last physical just a couple months before surgery I was measured to be 5'3". So, a half inch taller than my normal height and a full inch taller than pre-op.

That's great! I remember growing an inch after my 2-level Artificial Disc Replacement--I felt like a baby learning to walk for the first time during my first stroll through the hospital. It was surreal.

Justin, I guess I am doing all right with distraction pain. In fact the only "pain" I feel has been this aching in my legs. I don't know if that is distraction pain or??? The brace pokes into my butt when I am sitting down, and if I am sitting too long with the brace on I have to loosen it up a little as I start to feel like it is restricting my breathing (particularly when in a car).

The distraction pain for me was more of an "ache," but it was constant. I felt as if I could not get comfortable no matter what I did for a good amount of time. I agree about the brace--make sure to adjust it often, as it can get too tight.

How is distraction pain described? This is the pain that is caused by the change in disc height and spine alignment, is that right? I think I had some of that the first week after surgery, but I haven't really been feeling that lately.

Alastair sent me this excerpt on distraction pain some time ago and I believe it is a very good one:

In the context of ADR surgery the word distraction refers to the action of mechanically increasing the distance between adjacent vertebral endplates in order to accomplish the removal of disc material and insertion of an artificial disc. The result of distraction is a stretching of tissues (muscle, ligament, nerve, blood vessel) in the vicinity. This stretching, which is beyond what is normally experienced by the body, causes what has been referred to as 'distraction pain'.

The "pain" from distracting the disc space in an effort to ultimately restore the intervertebral disc height and permit the insertion of an Artificial Disc comes from the stretching of associated structures listed above. Nerves are very sensitive to any manipulation and the act of stretching them to a new length or altering their previous alignment can lead to significant pain / aching / burning sensations in one's legs and feet. This overall feeling of being uncomfortable is usually not relieved by massage, rest or stretching and takes time for the irritation of structures to subside before one feels relief. Distraction pain is very unique from person to person and depends on a lot of factors (duration of injury before surgery, the number of levels treated, weight, surgically-induced trauma, etc.) that are inherently unique to one's individual situation.

I hope this helps.

[Katie]

Justin, this is an excellent explanation. Until I came on the forums, I had never heard of distraction pain. This might be a good one for the 'sticky' that I mentioned earlier....the whole thing.

[Ben]

This is excellent information! I am going in for my surgery in two weeks!

Ben

[Justin]

Justin, this is an excellent explanation. Until I came on the forums, I had never heard of distraction pain. This might be a good one for the 'sticky' that I mentioned earlier....the whole thing.

Consider it done!

This is excellent information! I am going in for my surgery in two weeks!

Ben

I'm glad this helps Ben!

[treefrog]

Yes, that is a very good explanation Justin. I guess the aching I've had in my legs (going from my hips down to my feet) might be considered distraction pain. Maybe the sleeping position affects how well or not the ligaments, nerves, muscles, etc. are allowed to stretch and therefore a difference in the amount of pain depending on how I sleep.

It is definitely one of those feelings of not being able to get comfortable no matter what I do. The exception is that if I am up, being active and moving around more (like I am during the day) it is less intense, though it is still there a little.

[Justin]

Yes, that is a very good explanation Justin. I guess the aching I've had in my legs (going from my hips down to my feet) might be considered distraction pain. Maybe the sleeping position affects how well or not the ligaments, nerves, muscles, etc. are allowed to stretch and therefore a difference in the amount of pain depending on how I sleep.

It is definitely one of those feelings of not being able to get comfortable no matter what I do. The exception is that if I am up, being active and moving around more (like I am during the day) it is less intense, though it is still there a little.

Cathy, the bolded part above is what many consider to be distraction "pain." Most patients that I've spoken with after ADR surgery, have distraction pain in one form or another. Mine was pretty bothersome for a couple of months post-op (~3 months). Being up on your feet and moving around like you describe was a great way for me to temporarily forget about it--I was distracted from the distraction pain. (I'll be here all week folks.)

It sounds like you are doing very well Cathy. :thumpup: