[Spinal Fusion / Lumbar] New member 4 1/2 weeks post op PLIF L5-S1

[krismmic]

Hello. I am a new member, 4 1/2 weeks post op PLIF at L5-S1. I am an otherwise healthy, thin, active woman in my mid 40s. Back and bilateral leg pain/numbness/weakness prior to surgery for several years treated with multiple epidural injections, nerve blocks and PT prior to surgery. No narcotic pain meds prior to surgery ever and worked full time until the day before surgery. I think I am recovering well from the surgery. I have pretty much discontinued the vicodin I went home from the hospital with and now taking prn Ultram only. I am walking every day. However, I am having a few problems and wanted to see if others experienced similar symptoms and what you did about it. The first is a problem with insomnia which began about a week an 1/2 ago. I've experienced insomnia in the past intermittently as an adult, but typically resolved without intervention in a few days. Currently, I am getting no more than 3-4 hours of sleep a night. No daytime napping. I am exhausted and I feel like this is slowing my recovery. tried Ambien without success at the surgeon's recommendation. Is this a common post-op problem? Should I be concerned or just let it run it's course? Suggestions? I should also mention that I quit smoking when I had surgery. Obviously so important and I have been cigarette free since surgery!! Is it possible that the insomnia is related to nicotine withdrawal? My other concern are some leg and hip cramps. These cramps vary in severity and seem to involve mostly my hamstrings. Again, should I be concerned? I did mention it to my surgeon on my first post op visit and he said it was a normal post op symptom and should resolve. Finally, also wondering about when I will be comfortable with longer periods of sitting. I still find this very uncomfortable and am anxious to get back to work but know this can't happen until I can sit for longer periods of time. I've been told not to expect to return to work until the end of January. Is this realistic?

[KBear]

to the forum. The leg pain is pretty normal side effect from surgery. My legs hurt horribly for a while after surgery. I had never had leg pain prior to surgery, so it was a weird side effect. My understanding is that when they do surgery, many of the muscles being moved and cut connect to the leg muscles, thus possibly causing leg pain. It should resolve in a few weeks or months.

As far as sleep goes, there are so many different reasons I can think of. I never could take Vicodin close to bedtime because it made me hyper and I couldn't sleep; but you said you don't take Vicodin, so rules that out. The other thing that caused me insomnia was pain, I would be hurting and either not be able to go to sleep or wake up after a short time in pain. When this happened, I just started getting up and going downstairs to watch tv, read or play on the computer. I would take a pain medication and wait for the sleepiness to kick in. I took muscle relaxers for sleep and they helped a lot. I think because they helped relax me for sleep and also helped some with the pain. Also have you ever taken melatonin? It's a natural supplement and really can help too.

Depending on what you do for work, I think 12 weeks is very reasonable to return to work, especially since you were working before surgery and seem to have been able to stay very active. We all heal at different rates, but it seems like people who are able to keep up their lifestyle before surgery and don't wait too long for surgery heal quicker than those of us who went years in pain. I wouldn't expect to be 100% in 12 weeks though, that can take a year or more, once again depending on the person. It was at the 9 month mark that I was noticeably improved and the 18 month mark when I was able to quit taking all medication and be pain free.

Best of Luck and we are here to help if you need anything,
Kathy

[ajj1001]

Hiya and welcome. I have had a fusion of the same disc. Sitting does take a while to improve and even when it feels ok you should try not to sit for longer than 30 minutes. The surgeon "caught" the nerve during my op and it took a long while to settle down. The sleeplessness could be a reaction to the op or anxiety at the recovery process?

Whilst it might feel like forever till January it will fly by. Stick to the no bending, lifting and twisting and you'll give yourself the best chance of a full recovery.

[Cindylou]

A big welcome from me as well, and congrats on being on the other side of your surgery. Also congrats on quitting smoking. You are definitely giving yourself a much better chance of a successful fusion by doing that one act alone. So kudos to you. In regards to the insomnia question, I would definitely think nicotine withdrawal could affect sleep patterns. Also, increased anxiety could contribute to insomnia and I do know that raised anxiety levels are a side effect of nicotine withdrawal. You could have a combination of things such as these contributing to this scratchy problem. Lord knows, you need your sleep to heal properly. What was the reason behind the ambien not working? I've had years of insomnia, especially as I have aged and entered the menopausal years, and it bites the big one. But ambien or melatonin has always worked for me. If the ambien isn't working for you, I would definitely try melatonin or a muscle relaxant, maybe even an anti-anxiety medication. When I use the ambien for 2 weeks straight during a bad patch, it really helps to re-regulate my sleep patterns then I can stop taking it, and I am back sleeping like I should be. Hope one of these can help you and best of luck with your continued recovery, Cindylou

[krismmic]

Thank you for the input. I'm not sure why ambien isn't working. I took it for 3 nights and still had difficulty falling asleep and continued to wake throughout the night, so I didn't see any point in continuing. I am very frustrated by the lack of sleep but am just trying to take a deep breath and know that this too shall pass eventually. Even if quitting smoking is contributing to the problem, I don't regret it at all and insomnia is a small price to pay for finally being able to kick that terrible habit. I have tried to quit before to no avail. Perhaps knowing how important quitting was to a successful fusion was the final kick I needed! Relative to sitting, when did you find sitting to be comfortable? How long were you sitting at one time at almost 5 weeks post op? One more question. I still have a considerable amount of swelling on either side of the incision line. The incision is healing nicely, but the swelling continues. Is this normal as well? My family and especially my husband have been so supportive, but it's nice to hear from people who have been through similar things Krista

[ajj1001]

At five weeks post I spent most of my time semi reclined and tried a short sit a couple of times a day for 5 to 10 minutes (mainly to try to eat more upright) but it was pretty uncomfortable. It very gradually improved but I still try not to sit for long and keeping moving as sitting still seems to be a bad idea.

I didn't have any swelling around the wound but I presume someone has looked at it for your post op or will be doing soon so just check that its ok.

[Cindylou]

I can't recall precisely when sitting eased up, but eventually it does. Sorry, drawing a blank on that one. Now though, I am discovering that the additional sitting I am doing due to low back issues, is now slowly beginning to reaggravate my right hip (one I had surgery on 7 months ago). Grrrr. The cyclical he!! of it all. Oh, sorry....don't listen to my complaining.... I'm having a rant. It'll pass. Good luck w your healing, Cindy Lou

[Justin]

Hi Krista, welcome to the Spine Patient Society.

We're glad you found us.