Recovery: Doctor's Orders

Wow! Your emails and phone calls of encouragement this morning and all throughout the day were amazing - YOU are all amazing! I cannot thank you enough for all of your support!
Everyone keeps asking, "How did it go?" Well... it went...
The best thing that I could have done was asked my mom to attend. She was quite the advocate! (And so was my wonderful husband!)

Here are the facts:
- Structurally, the swelling around the incision is down and according to x-rays there has not been any harmful movement, so the pain is not coming directly from the Spinal Fusion Surgery itself.
- We won't know if the surgery "worked" until the 1-year mark... so we have some work to do in the mean time to get me better and some patience to work on (LOL!).
- The theory is that the pain is coming from severe muscle tension. While my PT and The Surgeon still have not come to an agreement on the fact of whether or not my muscles were strained during the first few months and set me back in recovery (she says "Yes!" he says "No!"), they did agree that my muscles currently are in over-drive and are the cause of my atypical pain...

Next Steps: Time, reduced stress - and the biggest step of all: Pain Management Strategies (they are going to find and set me up with a Pain Management Specialist who works specifically with people who have pain caused by muscle tension). For now, I need to keep my work schedule at the 3 days/week, I need to stay positive and I need to keep focused on my healing.

One interesting thing that was noted is that stress amplifies the muscle tension (duh, right?!?!) but who'd-a-thought that it could play this big of a part in my healing... Physical Stress and Emotional Stress are both working against me right now - so Gage and I are committing to focus our prayers on these two areas (please join us in agreement)!

Everyone knows that the first year of marriage is stressful. Everyone knows that being a Special Education Teacher is no piece of cake. Everyone knows that trying to sell a house in a dying market is beyond a burden to anyone, let alone a couple who is working with a reduced income. What I learned today is that the body, literally, at times has "a mind of it's own." With their (my Medical Team's) theory, they think that because my body has dealt with muscle tension and back pain for SO many (about 10) years, my body does not know how to reduce the tension once something triggers it. This is all connected to nerves and neurons and bruised muscle tissue... a lot of things that are out of my control, but some that are also controllable. I'm fascinated and terrified at the same time by this information! The hope is that the Pain Management Specialist can re-train my body to respond to pain and the things that cause pain so that my healing may come. I am believing for this - please believe with me!

Again, I thank you ALL for your love, encouragement and support! Thank you for praying for me!

Doctor's Orders

Hi Prayer Warriors!

God sure is moving since we started this Prayer Chain! After talking to my head nurse last week The Surgeon called an "emergency appointment" for me for tomorrow at 7:30 am. He doesn't know why I am still experiencing such severe pain and symptoms and doesn't want to wait until my November appointment to see me. My wonderful husband and my mother are coming with me to be my advocates. I am hoping that we leave there with MANY solutions to whatever "challenges" are causing me to have such extreme back pain and to experience such a slow and "abnormal" recovery.

If you are able, please send prayers that all goes well tomorrow. I know that, because of you, I was able to get this faster appointment!

The Power of Prayer

It’s been a little while since I’ve sent an update on my recovery. While I will give you a glimpse of what recovery life has looked like for me, the purpose of this email is to promote healing!
A wise woman reminded me yesterday of the power of prayer. Another wise woman, over a year ago, lent me a book called “God’s Prescription for Divine Health.” I have decided to combine the wisdom of both of these fabulous ladies and call forth a prayer chain.
The people that I have chosen to send this email to are either believers or people who believe in the power of prayer and/or healing thoughts – and you are all people who want the best for me and for me to recover as soon as possible.
I believe that I will be healed. I also believe that you could possibly help me in that healing process. Gage and I decided that at 4:00 pm everyday we are going to stop and say a prayer for my healing. I am asking each of you to do this, too!

I recognize that not everyone on this email list may know how to pray… I want to assure you that there is no right or wrong way to pray! One example could be for you to simply stop what you are doing at 4:00 pm and meditate on my healing. Another example would be to say, “God, I thank you for the healing that you are doing in my friend, Stephanie. Please complete the healing work you have started in her.”

For those of you who have asked me for specifics on where I am in my recovery so you may pray specifically, here they are:
- The challenges that I face daily are severe back pain and lack of physical endurance; this also, at times, leads to feelings of sadness or stress because I can’t live the life of a “normal” 30-year-old.
- At first, my surgeon told me that the initial recovery process would take only 8 weeks; however, recently, my medical team told me that because of the obstacles I faced over the past 3 months (I had the wrong sized walker, I went back to work 3 weeks too early, I used harmful postural techniques, I “over did it” at work day after day, my initial OT failed to teach me the correct way to go up and down stairs…) the initial phase of my recovery could now take 5 months to 1 year – and the secondary stage of my recovery could take 1-to-2 years.
- Right now, I am only released to work 3 days each week. This adds a financial and professional burden to my life.
Instead of focusing on the pain, I have decided to focus on my healing. In the book, “God’s Prescription for Divine Health” the author said, “Your eyes are the gateway to your body. If your eye (or attention) is on darkness, or the sickness that is in your body, there will be no light to expel it. If, however, the eyes of your heart are trained strictly on the Word, your whole body will eventually be filled with light, and healing will be the result,” (p. 15-16).
Every day, I am looking to God for healing. I am asking you too, friends and family, if you would be willing dedicate 30 seconds/day to my recovery.
From the bottom of my heart, I thank you.

Recovery: The First Eight Weeks

I have been encouraged to send an update on my recovery, as it has been about 8 weeks since the Big Surgery and, with juggling recovery, marriage and work, the greatest challenge that Gage and I have had has been keeping in touch with those we love - and keeping you all informed on my progress and our lives. Here goes:

The good:
- Gage and I are still happy and totally in love! We both have "love coaches" in our lives who encourage us to put our marriage - specifically, our spouses - first (after God, of course). We are dedicated to growing as a married couple - I love you, honey!!!!
- Gage has a great class of kids this year so he actually enjoys going to work every day (as opposed to the class from you-know-where with whom he worked last year - poor guy!)
- I am working my way back into the working scene (more details below).
- I am up to 1.5 miles a day (with my walker, my husband and my pup).
- Since living with a healthy vegetarian, Gage has lost over 10 lbs (whew whoo, hot stuff!!!!)
- Lady is cute as ever and knows to be "gentle" with me (and "ruff" with Gage :)
- My students all think that it is their job to take care of me when I am at school (awe!). They are even better at calling me Mrs. Dodson than I am - WOW!!!!!
- My Building Team at work has been incredibly supportive - they carry my things, they re-arranged my classroom so it is functional to my physical needs and they prep the students when I am having a bad day so the kiddos are sympathetic (ha!).
- I made it through turning 30!!!!
- Gage has found a new love in Pickling (jalapenos, garlic, you name it, it's in a jar!!!)
- A friend at work bought me a basket for my walker so that I can be a little more "self-sufficient" and carry small things like a bottle of water or my book and walk at the same time (and yes, I can chew gum, too!).
- My boss has finally stopped giving me trouble about my recovery and has really shown sincere sympathy and flexibility with her demands.
- My school principal donated a super-comfy chair to my room that, when I need to rest, I curl up in and "feel better".
- We had about 2 weeks of great recovery progress (about 2 weeks ago) - my pain level reduced and I was able to decrease my pain meds (last week; however, for some reason, it went back up and I "slipped back a bit" - but at least we know that my body IS CAPABLE of such relief...).
- We have had some friends & family members really pulling through and be our "rocks" of emotional support during moments of craziness, saddness or frustration - We LOVE You!!!!

The challenges:
- I am still in a great deal of pain daily. I consult with my head nurse, Bernie, every few days and she is constantly giving me tips on how to manage the pain. Some work, some don't. However, Bernie is very encouraging, and tells me, "Everybody's body is different. We cannot predict when you will turn your corner, but you must believe that you will get there and keep working towards your goals." I have only been able to make it up to 3 and a half days of work/week this whole month - and last week I had to leave work early unexpectedly on 2 days due to unbearable pain. I guess my "corner" is further away than I had hoped... but she tells me to hang in there. I'm/we're hanging...
- Gage has turned into Super-Husband. The first month back to work, he was waking up at 5:00 am every day so he could get to work 2 hours early, set up his classroom then attend 7 hours of workshops. On his way home, he would run any errands we needed, then once home, he would cook dinner, do the dishes, bathe and walk me (yes,me, not Lady), then get everything ready for he and I to be prepared for the next day. Wow! Superman in action! For the past two weeks, he has been caught-up at work enough to sleep in (you know, until 6:30 am). Now, every morning, Gage follows me to work and is my bell-boy (I discovered that I had been actually hurting my body by trying to carry my walker myself up and down the MANY stairs at my job, so Gage volunteered to walk me into work each day, carry my walker, computer bag and any other teacher-stuff I have.) What a saint!
The Blessing and Turn-Around - Thankfully, things have calmed down a bit. My mom has been so kind as to cook us about 2 meals a week, which has greatly helped us both on the weekend and through the week. Gage and I (well, mostly Gage, but I help when I can) now spend Sundays cooking the rest of the meals for the week and preparing lunches for the whole week so all we have to do is re-heat food after work. We have also (sorry environmentalists - we are doing the best we can) resorted to paper products so the dishes are not piling in the sink and Gage can have at least SOME time to relax after a 14-hour day. Now we just need to get better at using our microwave!
- I am still unable to help Gage with any housework - and will likely not be able to do so for another 4 months to a year - or 2 - yikes! (He only ruined 2 pairs of my jeans and shrunk a few of his t-shirts, so I can't complain too much :)
- The doctor thought I would be done with my walker by the end of August; however, upon returning to work, I began experiencing extreme numbness across my back, down my buttocks and both legs. Until the numbness disappears, I have to continue to use the walker. On the plus side, my arms are getting totally buff from putting so much pressure on them when I use the walker!
- Our social life is almost non-existant. I don't have the energy to go to work and do anything afterwards. And, with all that Gage does to pick up on my slack, he needs as much R&R on the weekend as he can get! Saturdays are usually my "coma" (recovery) days - or the days I spend working on all of the work-related paperwork that I couldn't get to during the work week & Sundays are spent grocery shopping, doing laundry and food prep. I am usually in too much pain to do the things that "normal" people our age (heck, I cannot even do the things my grandparents) do for fun, so when I am up for it, we have friends over who will sit with us on the couch and let me wear sweats and leave when I turn into a pumpkin... We are hoping that this changes soon, because we really miss everyone!!!!
- I am running out of sick days, so if things don't pick-up soon, I will need to fill out a Family Medical Leave Application and try to qualify for Non-paid Leave of Absenses (and, hopefully, I can keep my job at Bristol if I do need to take more time off).
- We are not always up to going to our Church - and we really miss this! It's difficult for me to sit in their chairs without triggering pain. Gage still goes by himself or with our friends when he can; however, if I am in a great deal of pain, my loving husband insists on staying home to take care of me.
- The house is still on the market. While it is under a LOT of clients' lists as a "favorite" property, we still have not gotten any offers...

That covers it for now! I know it can be overwhelming, but we are actually managing :)
Please keep us in your prayers (as I know you have been). Even though it has already been 2 months, we still have a LONG way to go and we can use all your love!
Love,
Steph (and Gage)

For you doctors out there...

What is Spinal Fusion Surgery?

Spinal fusion is a surgical technique used to join two or more vertebrae. Supplementary bone tissue, either from the patient (autograft) or a donor (allograft), is used in conjunction with the body's natural bone growth (osteoblastic) processes to fuse the vertebrae. This procedure is used primarily to eliminate the pain caused by abnormal motion of the vertebrae by immobilizing the vertebrae themselves.

When I finally found my way to the Orthopedic Surgeon's Office, I had experienced low back pain for over 10 years; that is over 1/3 of my life...

When is Spinal Fusion Surgery Necessary?

Certain types of spinal deformity, such as scoliosis, are commonly treated with spinal fusion. Scoliosis is an “S” shaped curvature of the spine that sometimes occurs in children and adolescents. Fusion is indicated for very large curves or for smaller curves that are getting worse.

I was diagnosed with scoliosis when in 1994. I saw a specialist for 3 years; however, was never treated beyond consult. The specialist said that while my curve was "moderate" it was not severe enough for treatment...

Another condition that is treated by fusion surgery is actual or potential instability. Instability refers to abnormal or excessive motion between two or more vertebrae. It is commonly believed that instability can either be a source of back or neck pain or cause potential irritation or damage to adjacent nerves.

During my Junior Year at college (2001), I first began experiencing severe back pain that greatly impacted my mobility and lifestyle. I was prescribed 12 sessions of physical therapy. After the 12th visit, the PT explained that I "knew how" to execute the exercises and as long as I "kept it up" the pain would be minimized...

In 2003, I was the victim of a drunk-driving accident. While my car was totaled, my back was "only sprained." The driver did not have insurance; I was young. I was treated by a chiropractor for a few weeks then released... The pain; however, never ceased.

Spinal fusion is sometimes considered in the treatment of a painful spinal condition without clear instability. A major obstacle to the successful treatment of spine pain by fusion is the difficulty in accurately identifying the source of a patient’s pain. The theory is that pain can originate from painful spinal motion, and fusing the vertebrae together to eliminate the motion will get rid of the pain. Unfortunately, current techniques to precisely identify which of the many structures in the spine could be the source of a patient’s back or neck pain are not perfect. Because it can be so hard to locate the source of pain, treatment of back or neck pain alone by spinal fusion is somewhat controversial. Fusion under these conditions is usually viewed as a last resort and should be considered only after other conservative (nonsurgical) measures have failed.

In 2007 the intense pain that had been in mild remission resurfaced. I saw a chiropractor who asked me, "Do you want to have surgery or do you want to try alternative methods?" Of course, I said, "I do not want to have surgery!" What the doctor failed to tell me was that upon reviewing my x-rays, he saw that I had bulging discs on multiple levels of my spine. He withheld this information so that he could "fix me" himself. I saw this chiropractor for 3 years; at times, I was required to attend three appointments a week; other times, I saw him once every three weeks for "maintenance." Despite the appointments and the adjustments, he never "fixed me..."

In June of 2009, my (then future) mother-in-law suggested that I get an MRI. The results revealed that I have Degenerative Disc Disease. For a year, I saw a Pain Management Specialist. We started with cortisone injections. They didn't work. Then, I went to a radiologist and received 3 rounds of Epidural Steroid Injections. No difference in pain. I was prescribed medication after medication which only masked the pain. The Pain Management Specialist then prescribed another round of physical therapy. I went dutifully every week for months. After no significant changes were made, she recommended that I consult with an Orthopedic Surgeon.

In October of 2009, I saw my surgeon for the first time. He sent me to my third physical therapist. After working diligently with her for months, the doctor finally agreed to a pre-operation procedure called a discogram which would determine if I was a candidate for Spinal Fusion Surgery. Lucky for me, I was...

Recovery following Spinal Fusion Surgery

Recovery following fusion surgery is generally longer than for other types of spinal surgery. Patients generally stay in the hospital for three or four days, but a longer stay after more extensive surgery is not uncommon. A short stay in a rehabilitation unit after release from the hospital is often recommended for patients who had extensive surgery, or for elderly or debilitated patients.

I was scheduled to be in the hospital for 6 days. The surgery went beautifully (as described by my doctor); what was supposed to take 8 hours only took 4 due to lack of complications. The surgeon ordered 6 days of in-patient recovery. (Even thinking about the pain I felt while lying in that hospital bed, I get tears in my eyes...)

By the morning of the day after my surgery, the hospital staff had me sitting up and walking. By day 3, I was doing laps around the hospital floor. By day 4, I was walking stairs. By day 5, I was so desperate to go home, I begged the fellowship doctor to release me. I wanted to go home with my husband.

It also takes longer to return to a normal active lifestyle after spinal fusion than many other types of surgery. This is because you must wait until your surgeon sees evidence of bone healing. The fusion process varies in each patient as the body heals and incorporates the bone graft to solidly fuse the vertebrae together. The healing process after fusion surgery is very similar to that after a bone

In general, the earliest evidence of bone healing is not apparent on X-ray until at least six weeks following surgery. During this time, the patient’s activity is generally restricted. Substantial bone healing does not usually take place until three or four months after surgery. At that time activities may be increased, although continued evidence of bone healing and remodeling may continue for up to a year after surgery.

The length of time required you must be off of work will depend upon both the type of surgery and the kind of job you have. It can vary anywhere from approximately 4-6 weeks for a single level fusion in a young, healthy patient with a sedentary job to as much as 4-6 months for more extensive surgery in an older patient with a more physically demanding occupation.

My doctor released me to return to work at the beginning of the '10-11 school year for half-days for two weeks. I was in my 5th week of recovery. My doctor thought I could return to work full-time at week 7.5. My body told me otherwise...

Following spinal fusion surgery, a postoperative rehabilitation program may be recommended by your surgeon. The rehabilitation program may include back strengthening exercises and possibly a cardiovascular (aerobic) conditioning program, and a comprehensive program custom designed for the patient’s work environment in order to safely get the patient back to work. The decision to proceed with a postoperative rehabilitation program depends upon many factors. These include factors related to the surgery (such as the type and extent of the surgery) as well as factors related to the patient (age, health and anticipated activity level.)

On Christmas Eve of 2010, I will reach my 6-month mark of recovery. I am only working 3 and 1/2 days each week (barely). I am still on pain medication. I still am required to do physical therapy (walking 3 miles) every day. I am still restricted of a "normal" life because the pain is so severe...

At my 4-month check-up, my surgeon told me that I was "an outlier" and that "he did his part" when he successfully completed my surgery. The rest is up to me, even though the pain is real and present daily.

For the past month, I have begun the process of Biofeedback Therapy with a wonderful specialist named Mr. Mark. He was one of the many people who encouraged me to write this blog. This is my story...

Information from:
WWW.SPINE.ORG
And
http://en.wikipedia.org/wiki/Spinal_fusion

Home from the Hospital

July 2, 2010

Hi friends and loved ones!

I just wanted to thank each and every one of you for all of your prayers regarding my back surgery! As you know, my surgery was on June 24th - and the entire week before I spent meeting with my "team" of surgeons for pre-op appointments. As taxing as it was then, now that the surgery is over, I realized that all of that prep-work was SO worth it.

God was really with me! My surgery was supposed to last 5-7 hours (without complications) and it went so smoothly that it only lasted 4 HOURS! (Praise God!) Then, I was not supposed to be released from the hospital until Wednesday (of this week), but I "met" all of my PT (physical therapy) and OT (occupational therapy) goals early, so they released me on Tuesday. Believe it or not, even after having major back surgery, my doctor had me sitting up in a chair, standing and walking (a few feet) all THE DAY AFTER SURGERY!!!!!! He just kept making me do more and more as the days went on (I typically saw an OT/PT at least 3 x a day) - and the more he asked of me, the more my body was miraculously able to do! The funniest thing (because you HAVE TO find the humor in this somewhere) is that I, a young 29-year-old, now need a walker - ha (hopefully for just a few months...)!

It is SO good to be home, too! Nurse Gage, I mean my fantastic husband, has truly humbled me with his patience, kindness and love. (Sandy, Chuck, Ed & Karen - you raised a FINE young man!!!)

I thank each of you for your visits, phone calls, cards, flowers and get-well gifts. I strongly believe that it was your love and "positivity" that is helping me have such a strong and blessed recovery. I thank God with all of my heart for bringing each of you into my life!

I will continue to keep you posted as I can (but please don't be offended if I don't email right away - sitting at the computer is not so easy for me right now...). But, please feel free to call the house or Gage (or my cell) if you want.

Much Love and Thanks,
Steph

Life Before Surgery - The Honeymoon

The Honeymoon

Gage and I were blessed to go on an European Vacation and Cruise for our Honeymoon. Prior to the trip, I was terrified of the flight; not of the plane going down, rather, I knew that sitting for long periods of time was a major trigger for excruciating pain for my back. I consulted with both my surgeon and Pain Management Specialist. They offered the same advice: get up from my seat as often as possible, let the flight attendant know of my back condition and request that I be allowed to stand as often as possible, refill my prescriptions and take double-doses as necessary and walk as often as possible when landed.

On the flight down, God was really with us! Our plan was only 3/4 booked so Gage and I were able to convince a fellow passenger to switch seats with us. For the entire 10-hour flight, I stretched across 3 chairs (and my husband's lap). I took a Tylenol PM and slept like a baby. When we arrived to Rome I was refreshed and ready to tackle the city - time change and all!

The doctors recommended that I bring a good pair of tennis shoes for walking. Gage and I averaged 5-10 miles EACH day while in Rome. There were so many majestic sights that we couldn't allow ourselves to miss even one!

Our vacation started with 2 days in Rome, then we boarded the cruise and headed to Genoa, Italy, Toulan, France, Barcelona, Spain, Palma de Mallorca, Spain & Sardinia, Italy.

The flight back; however, was just the beginning of a long road of pain that I had in store for me. Unlike the trip down, the plane was over-booked. Because I was in so much pain, at a lay-over in Detroit, Gage and I opted to fly out the following morning in hopes that with a break from the long plane ride, my body would better handle the next trip. Eventually, we made it home and 7 days later, I was at the hospital for the first of many pre-operation appointments.

I don't know what I would have done had I not had the wedding and the honeymoon (and my new husband, of course) to take my mind away from the fears of surgery...