Pre Op

I read many articles and blogs about lumbar fusion and I was terrified. The internet is full of horror stories. There a few positive blogs that I liked — Mommy Runs It and Fritz’s Pain Support thread. I also watched a number of youtube vlogs like Billy’s. I also spoke with 5 acquaintances who’ve had 2-6(!) levels fused and all were happy with the results.

My surgeon assured me that a single level fusion for a healthy non-smoker of my age was relatively low risk. Given my age, the surgeon opted for a posterior approach as an anterior approach risks damaging nerves in men. The procedure was “L4-L5 PLIF with TLIF.” The surgery would take ~2 hours with a 2 night hospital stay. The first 2 weeks will be “the worst pain I’ve ever had” then steady improvements until 3 months.

I have a desk job but a complex commute into NYC that involves trains, buses, and automobiles. I’ll likely be able to work from home after 4-6 weeks, when I can sit long enough, and commute after 2.5-3 months. 3 months is a critical point when most limitations are removed. I’d be back to normal at 6 months and “could run a marathon” after 12-18 months. I scheduled 3 months of disability leave. I’m having surgery in early March and my goals are to be active during the summer, start exercising in the Fall, and ski next Winter.

I continued PT, which started 4 month prior, until the surgery. The doctors felt that stronger, more flexible muscles pre-op would improve recovery. I was fitted for a back brace, got a 5/325 Oxy prescription, and had pre-op blood work done a week before the surgery. The back brace was similar to a weight lifting belt made of plastic and foam with velcro straps. The brace was less supportive and restrictive than I expected, it is meant to to act more as a reminder to limit activity rather than actual support.

Back brace

While I have a long history of back pain, the month preceding surgery was uneventful — the pain was under control and PT helped maintain mobility. I spent several weekends before surgery taking care of household things that I wouldn’t be able to do and didn’t want to burden my wife with. Things I bought in anticipation of the pain and no bending/twisting/lifting limitations:

  • A long shoe horn: Slip on shoes (or loose lace ups) are a must and a 24″+ long shoe horn helps.
  • Bidet: I was concerned about being able to go to the bathroom. This ended up being a nice, but unnecessary purchase.
  • Big bottle of Tylenol: NSAIDs are off the table for 6 months and I wanted to limit my opioid intake.
  • A few pairs of sweat pants because jeans don’t fit well over incisions.
  • That’s it! My wife took on all the household chores — shopping, laundry, cleaning, childcare, and food prep.

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