Two Weeks After ACDF Revision Surgery

Posted:  January 3rd, 2012 by:  Scott comments:  19

Today, January 2, 2012, marks exactly two weeks since my revision ACDF surgery to repair a non-union at c5-c6. I have the very unique perspective of having gone through the exact same surgery  exactly one year ago. I re-read my post marking two weeks after the first surgery and I am struck by both the similarities and the differences. On the similarity side, the main thing I am experiencing is not pain but boredom. On the differences side, I am not experiencing any of the post-surgery depression I had last time around.

It seems that with this second surgery, I was much better prepared mentally. Of course, having gone through the surgery once was a big advantage mentally. I knew exactly what to expect. This time around the weather was much different this time around and that has made a big difference. Last year it started snowing the day of my surgery and continued for several days. For the first two weeks after surgery I was not able to get outside and walk around because of the ice on the sidewalks and the danger of falling. This year the weather has been unseasonably warm with temperatures in the 50′s and 60′s most days. I was able to get outside and start walking immediately after returning home from the hospital. I have been walking twice a day for about 20 minutes each time. It’s amazing how just that little bit of exercise makes a big difference.

There really isn’t much else to report two weeks out from surgery. I am feeling pretty good and getting better every day. The pain is not terrible but there is still some pain. The level of pain is directly related to my level of activity and how much pain medication I have taken on a particular day. There seems to be an upper threshold of activity and a lower threshold of pain medication.

For privacy reasons I wont’ discuss what medications I’m on or how much I’m taking but it is all well within normal ranges for what is prescribed by my doctor. The physical activity level threshold is about a mile of walking and carrying almost no weight of any kind. On the couple of occasions that I have carried my laptop, I have seen a rise in pain.

I have my post-surgery follow-up with the surgeon on Friday, January 6, 2012. It will be interesting to see the x-rays and get his take on my progress. I’m also curious as to whether he will recommend the same amount of time off of work and in the hard brace or if, since this was a single-level surgery, he will clear me to go back to work and switch to the soft brace sooner. I am in no hurry. I don’t want to go through a third surgery, and so prefer to take things slower and give myself plenty of time to heal. This is why, after all, I have good insurance.

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    • Anonymous

      Glad you are making good progress.  Keep up the walking.  My progress has flattened and is quite sporadic – surgery was 6 weeks today.  I had planned to return to work this morning, but will now not return for at least another 2 weeks.  I have inflammation on my right hand side; from the shoulder, up across the yera and over my head.  Not sure what’s causing it, but if it could be fixed i think I’d be okay.  Unfortunately no anti-inflammotaries allowed for many months.  I agree that the psychological side is just as bad as the physical  – you just worry about whether the metalwork is all where it should be and fusion is happening!
      Remember to keep up the walking and don’t rush back to work.

      David

    • http://www.facebook.com/profile.php?id=100000499574182 Phil Sykes

      I hope all is well, I had c3 thru c5 fused in 1982 and now in 2012 I have to have C5 thru C7 fused becuse of the first fusion had dropped on the others below from stress, I know what to expect in the surgery and recovery, But my mind is not ready so I know how you feel and I know it is for the best.

      • http://iconify.it Scott Lewis

        Hey Phil.

        Sorry to hear about your upcoming surgery. It is challenging to prepare mentally. I just kept telling myself all I had to do was show up and go to sleep. I also kept focusing on just making it to the point where they give you the first sedative. After that I didn’t really care about much of anything.

        I also spent as much time exercising as I could. I figured the better physical condition I was in, the smoother the recovery would be.

        As you say, it is for the best. I hope it goes perfectly and I hope your recovery is over before you know it.

        How long until your surgery?

        • http://www.facebook.com/profile.php?id=100000499574182 Phil Sykes

          Thanks for your support my surgery is scheduled for July 25 and Im counting the days

          Once Again
          Thank You

          • http://iconify.it Scott Lewis

            Phil, good luck with your surgery. It will be over before you know it and you’ll be on your way to recovery. When you feel up to it, feel free to share your experience.

          • http://twitter.com/fiercekitten Cassie Destino

             Phil, I am having the same surgery on July 25th too. This site has been really helpful to me (thank you!). Best of luck to both of us…all of us, in fact.

            • http://iconify.it Scott Lewis

               Cassie, good luck with your surgery too. I hope everything goes smoothly and you’re quickly on the road to recovery.

    • Brenda T

      Thanks for this blog. I have not found as much information about this surgery as I had hoped, but your blog keeps coming up on google. I had a single level fusion at 5/6 one year and 8 months ago. I continued to have trouble and a myelogram back in December showed that my fusion failed and that the disc below is not long from blowing out. And, so, in two weeks and some change, I’ll be heading in for a revision and additional fusion. It was all I could do to mentally prepare for the first surgery and I can’t tell you how many times I’ve cried in front of my surgeon as it became more and more apparent that the need for a second surgery was imminent. I am trying not to be a baby, but I’m just flat out scared. I was supposed to be back to my normal life by now….not facing this. :( Anyhow, enough whining, just wanted to say thanks again for this blog. It is comforting to hear your story. I hope you are back to yourself now. God bless you.

      • http://iconify.it Scott Lewis

        Hi Brenda. I’m really sorry to hear that you have to have revision surgery. George, the other blogger on this site, and I both have had revision surgery so I can relate to the fear and the discouragement of that prospect. I cried in front of my surgeon when I found out I needed a second surgery as well.

        I was terrified the first time around though not quite as much the second time. But I felt completely discouraged the second time because it took all of my mental strength to get through the recovery. I felt like I had nothing left the second time around. I fell into a depression and it took me a long time to come out.

        That said, you can do this. Physically the second surgery wasn’t as hard. I don’t know what the difference was but I got through the physical aspects easier the second time.

        I don’t really have any wise words to share but I wish you well and all the strength you need. You can get through it and you will. Just take it one day at a time and lean on friends and family as much as you need to. Being afraid and discouraged doesn’t make you weak, it makes you human. Anyone who tells you otherwise simply lacks self-awareness and compassion.

        Good luck. Feel free to vent on this site all you need to. I don’t check the site very often but I’ll try to remember to do so more regularly.

        Take care.
        Scott

        • Brenda T

          Scott, thank you for taking the time to share words of support. Your blog, and especially your comments were so timely, that it had to be a gift from above. It was just what I needed to hear at just the right time. Though I hate that you felt like that, it is oh so comforting to know that I am not alone in the way that I feel about this surgery. In many ways, I’m mentally and emotionally exhausted and, though I have never in my life, been depressed, I’m wondering if I’m not dealing with a bit of that as well. BUT, I do know that I will get through this and that it will all be ok. And that one day in the not so distant future, I will have me back. Now to just get through this week and get myself on that OR table. At my pre-op Friday, I asked the nurse if they could have something ready to calm my nerves as soon as I step foot in the hospital. Thankfully, she said “yes” and wrote down an order for valium. I hope she realizes it needs to be the size of my head. ;)

          • http://iconify.it Scott Lewis

            Oh, they will definitely have something for you to calm you down. Most likely they will give you Versed, which is a sedative. Trust me, when that stuff kicks in you will be good to go and all of your anxiety will be gone. They call it “the mind eraser” for good reason. The entire process is traumatic because all animals, including humans, instinctively avoid danger or injury of any kind. Even though I was terrified the first time around, it turned out to not be bad at all. My anxiety was much greater than the reality. The surgical staff are accustomed to dealing with fear of the process and they will take very good care of you. The best news is that you will be completely out. From your perspective, you will feel like you just blinked and it will be over. It is literally that quick. When they wheeled me into the OR, I talked to the anesthesiologist for just a few seconds before I was out. The anesthesia hits you really fast, maybe 30 seconds, and you’re out. Next thing you know, you’re waking up in the recovery room.

          • http://iconify.it Scott Lewis

            Brenda, did you have your surgery? How did it go? Did they take good care of you when you arrived the day of surgery?

            • Brenda T

              Hi, again, Scott. No, no surgery yet. Is scheduled for Wednesday so I’m still in overdrive trying to get everything ready at my house. In fact, just took a break and saw your message. Looks like I”m going to be extremely busy tomorrow trying to tie up lose ends with work and house prep. Figured I’ll just stay up all night tomorrow so that when I get to the hospital I’ll probably fall asleep before they give me the first shot. :) Pretty nervous. I’ll try to check back and let you know how it went. Hoping I can say “piece of cake”. Thanks for checking on me.:)

              P.S. Were both of your surgeries done through the front and did they cut over the same incision? I think that is what is planned for me and I worry a little about the scar tissue and additional swelling as that is what really freaked me out the first time. Actually, it wasn’t too too bad, but I just wonder if it’ll be worse because of the scar tissue and the fact that they’ll be doing a bit more work, i.e. drilling out the bone that did grow (yuck! that sounds awful) plus doing a new fusion on the disc below.

            • http://iconify.it Scott Lewis

              You’re welcome. I’m sure it will, in fact, be a piece of cake. I was really nervous before both of my surgeries but managed to sleep pretty well the night before, surprisingly. They had me bathe with a special body shampoo to remove bacteria. Then when I arrived at the hospital, I changed into the gown and a pair of pajama-like pants. They hooked up an IV pretty quickly and started doing things like taking blood pressure, administering fluids, etc. I was there for maybe half an hour before they started the sedative. It kicks in really fast, though, so don’t worry about that.

              My surgeon used electrical needles kind of like acupuncture needles to monitor spinal activity during the surgery. I don’t think most surgeons do but if they do, it’s not a big deal. You’ll be out cold when they put them into your head, hands, and feet. It doesn’t hurt at all. You’ll just have some tiny blood spots when you awake and maybe some slight bruising.

              One thing to remember is to breathe. When we’re stressed we can forget to breathe normally. It helps. Take slow, deep breaths. And I know it’s hard but just try to relax. You’ll get through it. The surgery itself isn’t bad at all. The only part you really deal with is the anxiety leading up to it. Once you wake up, they do a very good job of managing what pain there is. It varies from person-to-person but it’s really not bad. For 24 hours after surgery, nurses will be doting on you non-stop. My nurses were fantastic. I had the same handful of nurses for both surgeries. It actually felt kind of nice to get such nice attention.

              You will be fine. The anxiety is far worse than the actual surgery. Just keep reminding yourself of that … and breathe.

              Best of luck tomorrow.

            • http://iconify.it Scott Lewis

              Oh, somehow I didn’t realize this is your second surgery. My apologies. I’m telling you a bunch of stuff you already know. :-)

              They made a new incision about 1 inch below the first one. The surgeon did such a great job of placing the incisions in the natural creases of my neck that you can barely see them even if you know they are there.

              The swelling issue varies so much for each individual that I can’t really offer anything helpful. I was lucky in that I had very little dysphonia (difficulty talking) after both surgeries. Both times I was hoarse for a couple of hours at most. My voice was weak and would get very tired easily for several days, though. I didn’t really have much dysphagia (trouble swallowing) either.

              There is a possibility of increased issues with swelling and dysphonia, and dysphagia with second surgeries. As you rightly pointed out, it’s because of the existing scar tissue. There isn’t really any way to tell how your body will handle it, though. I think statistically it is usually minor, though.

              The bone drilling does sound awful but fortunately we don’t have to worry about that.

            • Brenda T

              Thanks, George. I didn’t mind the refresher at all. My first surgery was at a surgery center and then I came home same day; this one will be at hosptial and will be admitted for one, possibly two days. In fact, I just got the call. 5:30 a.m. in the morning with surgery at 7:30 a.m. Yikes, that’s less than 14 hours away!!! On the bright side, I’ll be my doc’s first patient for the day so he’ll be good and fresh. Pray that his kids and wife are extra sweet to him tonight, that he has a good dinner, spends the evening doing WHATEVER makes him happy and relaxed and that he follows that with a good night’s sleep! Inhale, 1…2…..3…exhale…repeat. Really, thank you so much for your words of support. It helps to talk to someone who has lived it. Praying that you continue to get better as well.

            • George Flanagin

              How did it go?

            • George Flanagin

              Scott told me about your situation just a few minutes ago.

              You asked: <>

              As a general rule, the surgeries from the front are much easier than the ones from the back. I have had one of each, and I concur with the consensus wisdom. It is fortunate that the neck is one place on the body where as you age, the scars (if any) become less visible with time. I had known Scott for a few years before either of us had ACDF, and his account of the diminished visibility of scarring is correct; for a man thirteen years younger than me, he doesn’t look all that bad. At my age, no one can tell.

            • Brenda T

              Hi, George. I can still see my scar from the first surgery, but it’s only because I know it is there. No one else would know unless i pointed it out. So, the older you get, the less visible it is???? Yay! Finally a bonus to getting older. ha ha. Of course, I’m not sure it works that way with women, but I’ll hold onto that hope. You guys can grow a beard if it gets all that bad. :) Seriously, thanks for your post and, as I told Scott, thank you for keeping up this blog. It was the best, “real” information I found. I hope you are doing well these days! –Brenda

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