Introduction:  

Good morning, let me introduce myself.  My name is Phillip.  I am 47 years old, have been married happily for 26 years, have two wonderful children, a great son-in-law and the cutest granddaughter you ever did see.  Up until March 8, 2011; I also had Spondylolisthesis and Spinal Stenosis.  These two conditions had been impacting my quality of life for about 22 years.  The impact was first felt when I worked for a drywall company.  I carried bundles of drywall all day long.  At 5’11 and about 160 pounds I was in good shape.  I worked hard to keep up with guys much bigger and stronger than me.  And I did good too!  No brag, just fact.  However, one Saturday morning, I was done in when I took out the garbage and flung the five pound hefty bag into the dumpster.  My back locked up and I was curled up like a spider.  It cleared it after a few days – after all I was 25, and I went back to carrying drywall.  The next bout did not come for a few years.  I think it came after a hard 2.5 to 3 hours of basketball on a Monday night at the church.  I went to see the doctor and received my first diagnosis of Spondylolisthesis.  He told me I should take it easy, take some steroids and wait at least 10 – 15 years before I even consider surgery. 

 I did my best to take it easy and still maintain my athletic lifestyle.  I still ran 4 to 5 times a week (approximately 4 miles each time in about 32 minutes) and I lifted weights using machines that did not load my spine.  I pretty much maintained my weight and a good level of physical health.  By 2011 I was still 5’11 and up to 176 pounds on the day of surgery. 

 The flare ups have become more common over the years.  I had tried 3 spinal injections during the prior 5 months with no lasting relief.  The pain was persistent every day in my right hip/buttock area and of course, the lower back.  I had not played basketball in months and at the urging of my regular back doctor and my wife I had planned on never really playing again.  My regular back doctor at Austin Spin Clinic (who had done a very good job) said that he had done all that he could do and we were just putting on band-aids that were being less and less effective for shorter periods of times, steroids, injections, etc.  He suggested I talk to the surgeon.  I agreed. 

 I talked to a wonderful surgeon at Austin Spine Clinic.  He said the situation called for a L4 and L5 spinal fusion, posterior lumbar spinal decompression with cages and a Laminectomy.  This is what is referred to by most patients as spinal fusion or simply “back surgery”. 

 This blog is meant to record my journey and hopefully share some insight of what to expect.  Please let me add the following disclaimers.  I am not a doctor, and I don’t’ even play one on TV.  Everybody’s journey is different.  Everybody heals at a different rate.  This is just what I experienced. 

Pre-Op Planning:    My main concern and prayer going into my surgery is that I will be patient and not worry about anything during my recovery time.   See, I am a fairly busy person.  Over the years I have worked in an office; for a great insurance company; Farmers Insurance.  I have been blessed to work for them for 21 years now and they have been very good to me.  During that time not only have I have been blessed with a wonderful career but I have made some wonderful friends within the company.  There are people I can call on anytime night or day from Farmers and they will come running.  God has been good to me!  I have also been blessed to serve in ministry and am a bivocational pastor.  I pastor Onion Creek Baptist Church.  It is a wonderful congregation on the South East side of town.  I can also call on any of them anytime day or night.  Come look us up if you get a chance.  Well, back to lining things up. 

 If you are going to go through this surgery, let your employer know well in advance.  That way you can help train your replacement or do some big report in advance and have one less thing to worry about and encumber the healing process.  I had about 6 weeks to do this.  This amount of time allowed me to get the Leave of Absence paperwork started, and the cross training for my desk started.  The time also allowed me find some great pulpit supply for the church.  I was able to connect with some old friends and rest assured that the flock would be in good hands during my absence. 

 Take care of other things too.  Who will watch the dogs, the kids, the cat, the husband?  Who will mop the floor, mow the grass and do those things you will not be able to do for 1 week? 2 weeks?  6 months?  Make a list that of priorites to take care of prior to surgery.  Men, buy a mirror for the shower so that you won’t have to bend over to shave.  Buy some new underwear and pajamas to take to the hospital.  Buy some undershirts to go under that brace you will be wearing all day long.  At home, put everything you need at waist level because trust me, you will not feel like bending over!  Have that dog’s nails trimmed two weeks before surgery.  When they see you that first day back they will jump on your legs!  If there is something that you think you may need to have done, make a list.  Schedule it out prior to the surgery and then make it somebody else’s list!  Go into the surgery knowing that all you need to do is rest and recover!  That is your Pre-Op Plan.  Another item to include in your plan is prayer.  Pray for strength to follow the doctors orders and be sure to let others know the areas you are concerned about so that they can join with you in prayer.  The bible says in Philippians 4:6 – 7.

 Be anxious for nothing, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.  And the peace of God, which surpasses all comprehension, shall guard your hearts and your minds in Christ Jesus.               Philippians 4:6-7

That was the Pre-Op Plan for me, prioritize my “Things to do list” and Pray.  Not necessarily in that order. 

Things to Do Before I Have Surgery

1.  Pray for patience for me, strength for my family and healing for my body.
2. Mow the Yard
3. Set up a contract for someone else to fertilize.
4. Take the dog in for a toenail trimming.
5. Buy Easy Frozen Paninis for Lunch along with fruit.
6. Buy those Yogurts I Like for breakfast (since I won’t be running I want to follow a good, healthy diet and not gain weight).  But I want plenty of nutrients so my body can heal. 
7. Buy a Grabber and Reacher tool.  The Gopher for $9.99 at Walgreens is working great!
8. Buy a mirror to put in the shower for shaving purposes.
9. Line up replacements at work and church.
10. Be sure to give my list to someone else to complete or toss for me after the surgery because then, Rest and Recovering are my Goals.

 Tuesday March 8, 2011 Day One – Marta and I got to the hospital about 7:30 and the people were awesome.  The staff was very nice and they took us back to a room within 15 minutes of our arrival even though we had showed up about an hour early.  We needed to be prepared for a wreck in Austin traffic.  The operation was scheduled for 10:00 but the one my doctor was doing before mine was running long.  He came in to visit with me at 10:10 to let me know he just finished and was going to take a short break.  Did that bother me?  No way!  “That’s okay doc, take five.  I don’t need you cramping up at a crucial point.”  (At least that’s what I said on the inside!)  I let him know that I had been praying for him and I just knew everything was going to be great!  “You take all the time you need Doctor” I said out loud.  The operation finally commenced about 10:45; I think.  I received my IV about 10:30 am and a few minutes later I was given a shot into the IV that Marta who has had a few surgeries in her time refers to as “THE MARGARITA”.  Once I received “THE MARGARITA” I must say I did seem a little more relaxed and lot wittier.   From that point on Day One the details are a little fuzzy.  I don’t remember much more about Tuesday and that’s okay! 

Day Two – Wednesday I woke up and the first thing I noticed was I did not have any of the back pain that I had prior to the surgery!  No pain in the hip bone, etc.  There was some heaviness at the incision site but no back pain.  There were some other discomforts though.  I was nauseated and had a headache.  About 9:00 am the physical therapist came by to take me for my first walk.  Yes, you will be asked to walk the day after surgery.  The walk itself was not that painful for me.  However, the effects of the medication and the general impact of surgery on my body had left me feeling rough.  I still had the IV for maintaining my body’s nutrients and fluids, etc and I had one of the hand held buttons you push for the pain killers.  This allows you to have a shot of pain killer every ten minutes and let me tell you I was hitting that button it like I was surfing channels on cable TV!  Because I am allergic to certain pain medications, I was put on some medication called Dilaudid.  At least I think that was the name.  It should have been called “deluded” because that’s what I was if I thought hitting that button all the time was the answer.  I wasn’t hurting that much but I kept remembering everybody saying before the surgery to, “Stay ahead of the pain.”  Let me tell you I was ahead of the back pain.  The back pain was not even visible in the rear view mirror.  But due to me hitting that button so much, NAUSEA was in the backseat and HEADACHE was behind the wheel!  I believe my over use of the pain medication had made me sick to my stomach.  I was unable to keep anything down – like my migraine maintenance medicines and you guessed it – I got a migraine which only aggravated the cycle of NAUSEA.   NAUSEA soon moved into the front seat. 

 I ended up throwing up big time, the kind where you swear you just lost a toe nail.  Let me assure you, dry heaves after back surgery is no fun.  I could not keep any migraine medicine down long enough for the headache to stop.  On Day Two, Day Three, any day, be sure to know your level of pain.  Yes, stay ahead of the pain, but don’t be so anxious and worried about the pain that you put yourself in a bad spot.  Overmedication is never good.  The pump limits you and you won’t OD, but you may feel like you did!  Did I pray for relief that day?  Yes, I think so.  But even Day two is still a little foggy.  A nurse came in told me, “You look awful.”  Then she added, “Well, this is the worst day of recovery.”  I am sure my prayer was simply, “Help me Lord.”  During this day, my faithful wife Marta was putting cool towels on my head, interpreting my grunts for my nurses and doctors, and watching me take my first of two walks down the hall with my Physical Therapist.   Just as importantly though she was letting me know she was there for me and letting my friends know my needs so they could pray for me.  The bible says in Galatians 6:2 “Bear one another’s burdens, and thus fulfill the law of Christ.”    Be sure to have your support network ready when you go to the hospital, you’ll need it and appreciate it.  That was Day Two. 

Day Three – Thursday, as I recall.  I was still having headaches and nausea.  I had now been on some anti-nausea medicine called Zophran for a couple of days and it had not helped.  The doctor had added Phenegran to help with the NAUSEA.  This is the equivalent of calling in the big guns.  After having the dry heaves again at 2:00 am, I definitely agreed with the decision.  The only problem is that Phenegran puts me in the monkey zone.  What is the monkey zone you ask?  You know those old monkeys at the zoo that just sit there in the August sun and don’t move?  You know the ones who never blink they don’t even reach out for the peanuts that the kids chunk at them?  That was me!  I was in the monkey zone.  I would mumble every now and then that I had a headache, sip some sprite, take a pill and watch the clock hoping to stifle a gag reflex for at least 20 minutes.  

 This was the day that I had the nurse who was going to “cheer” me into wellness.  During the little neurological tests they give where they ask you to push your feet up, then your knees, then stick out your tongue and then smile, she wanted to see a “bigger smile!!”  What she perceived to be a bigger smile was actually me baring my fangs at her.  I was almost ashamed of myself and would have apologized if she had not so cheerfully pointed out to me that “that this was usually considered to be the worst day of recovery.”  Fortunately before I could bite her and make my headache worse, she was paged and had to leave. 

 Day Three was the beginning of a turn around as my doctor and I discussed utilizing Tylenol #3 with Codeine to fight the pain rather than the pain button.  I began taking the T3s about noon and did not hit the other button all day.  I refused.  I would have if I needed it but my pain was not that bad.  Except for my headache, my back hurt less than before I had my surgery.  My plan was to only use that button, which was still available if I needed it.  Two T3s seemed to work fine every 6 hours.  Still had to hide my eyes from the light and fight nausea, but hey, I was not reading any books and I was trying to get that other medicine out of my system.  Day 3 – at least it progressed with me getting on board with a plan to move forward. 

Day 4 – Friday.  I started off the day and prayed pretty hard.  I was feeling a little better but still had the headache.  I asked the Lord to make this a break through day.  When it was pill time at 6:00 am, I did not feel that bad and I asked if I could only have one T3.  The nurse reminded me to stay ahead of the pain.  I told her I felt pretty good and said that if it did not alleviate the pain sufficiently, I would ask for two next time and hit that pain button in the interim.  I was still on the Phenegran and Zophran and some Reglan (?) for upset stomach.  I ordered some yogurt for my stomach because I knew the impact of being on antibiotics for several days – diarrhea.   I wanted to try to head that off at the pass if at all possible.  During this day I was able to keep down a half of a piece of toast for breakfast, a half of a yogurt for lunch and another half of a yogurt for dinner! 

 The general practitioner in charge after the surgery visited me about 2:00 pm, the first direct visit since day 2 (not complaining, just saying, because she was great!) and saw the wet cloth I was covering my eyes with and said, “You have a migraine.  Those are classic symptoms.”  What I heard her say was, “I see the hiding of the eyes with a wet cloth, the baring of the teeth, and you appear to be in the monkey zone.  We are going to try to migraine medicine again.”  That’s why she’s a doctor. 

 The Imitrex was brought a little while later and I prayed to the Lord to help me keep it down.  He did!  About 75 minutes later my headache was gone!  Thank you Lord!  I was finally able to rest peacefully!  Inside rainbows burst through the clouds, sunlight danced upon the meadow and children sang the Hallelujah chorus!  He did give me a break through on that day!   It wouldn’t be the only break through though. 

 As I was lying in bed about 3:30 pm resting, it seemed like my problems were all behind me.  Then all of the sudden my problems WERE all behind me!  My stomach rumbled and I had the quick, explosive effect of having had antibiotics and a whole lot of medicine for 5 days.  That’s right – the runs, the “quick steps”, Montezuma’s revenge, a.k.a. Diarrhea.  Only problem is a man don’t run so fast after back surgery.  The feet refuse to take quick steps which can cause a problem.  See the prior post about my failure to bring enough clean pajamas. 

 The physical therapist came by and wanted to know if I had been getting up to walk.  “Yes, I have!”  She decided in my current state to come later.  The nurse reported my condition to the doctor who did not want to give me anything for the diarrhea in fear of it locking up my bowel and causing some even worse problems.  This to shall pass I was told.  I am sure they loved telling that one to a preacher. 

 Six o’clock rolls around and though my stomach has slowed down, I am still having issues.  It is always about that time when you have no pajamas and are relegated to your last pair of clean underwear (no pressure) that someone comes to visit.  My such visitor was Deacon Mike.  Deacon Mike was real cool and understood that if he was gonna stay, he was gonna gave to abide by Deacon/patient confidentiality and not tell anybody about my constant shuffling off to the bathroom in my skivvies.  I like a Deacon that can keep a secret.  I also like a deacon that knows when to ask others to pray for an “unspoken prayer request”.   I am glad Deacon Mike got some others praying because that night my stomach problems ended.  The bible says “The effectual fervent prayer of a righteous man availeth much.” Thanks Lord and thanks Mike. 

Day 5 – Saturday , I woke up at 5 and laid in bed watching TV until 6.  The hospital bed was not too hard to get comfortable in.  I had been trying to lay on my side most of the night so that I was not putting as much pressure on the incision.  I wanted to avoid pain and painkillers IF possible.  I wanted to stay ahead of pain but did not want to risk overmedication and let NAUSEA climb back into the car and upset this much more peaceful ride I was enduring.  At 6:00 my nurse helped me to put on my brace.  Once she was assured that my head was clear and I was not dizzy, she allowed me to go for a walk down the hall all by myself.  I had on a gray tank top under the brace and some pajama bottoms – the only pair I brought – which would prove to be a significant detail.  The walk was great.  I went all the way down the hall and met the lady who answers the call button.  This lady had a very nice demeanor and never answered my calls with a tone of “Yeah, what do you need now?” kind of attitude.  I thanked her for her service and her much needed help in the last couple of days.  

 I got back to my room and sat in the chair until 6:30.  Then I called in my breakfast order; scrambled eggs, toast, 2 pieces of bacon and a yogurt.  I finished the eggs, 1 piece of toast, the yogurt and some of the bacon.  (Nobody makes bacon like my wife makes bacon!)  Then because one can only sit up for 30 minute increments, I took off the brace and went back to bed.  I tried to spend an hour in bed and 30 minutes in the chair.  I went for another walk on my own too. 

 At 11:00 am one of the various physical therapists who ministered to me during the week (and it is an important ministry) came by to see me.  I greeted her cheerfully and let her know that I had gone on two walks already but would love to go again.  She said that she did not recognize me.  I don’t think it was because I had shaved for the first time in 3 days either.  (By the way, have someone shave you if you don’t feel good.  Spend some $ on a cheap electric razor so it doesn’t feel like you are pulling them out with pliers when finally shave after several days and you use that disposable razor you brought to the hospital with you.)   I told her my headache was finally gone.  The therapist said, “Good because you were grumpy.”  My wife said, “Yes you were.”  I tried to remember is she was the one I bared my teeth at.  “Did you ever ask me to smile?”  She looked at me funny, and I just apologized.  She laughed and accepted my apology and thanked me for waking with her when I must have felt so bad.  All day long I apologized to everybody I saw just in case I had been grumpy to them too. 

 About 1:00 pm the PA, Physician’s Assistant from the surgeon’s office came by and saw the progress I had made, and that I was eating well and said I would be able to go home the next day as long as I did not have any set backs that evening.  I had only taken on pain pill at 6:00 am and not needed another one yet! 

Everything was going great.  I was tired though and at 7:00 pm I had a temperature of 100.4.  This was higher than it had been all week!  I was worried because the nurse said if it got above 101 they may not let me go home.  About 8:00 pm I took another T3 and some Robaxin, a muscle relaxer and about 11:00 I called my nurse who gave me an Ambien so I could go to sleep.  That was day 5. 

Day 6 – Sunday.   On Sunday I woke up at 5:00 am and felt great!  I got up wnet to the restroom and no diarrhea!  Thank you Lord!  I put on my brace all by myself and went for a trip up and down the hallway.  After making the rounds I got back to my room and rested a bit.  My nurse let me know that I was doing well, my temperature was only 99.3 and that the doctor would likely release me about noon.  I took another walk before we received the paperwork to leave and we pulled out of the hospital parking lot about 11:30.  We headed off to Walgreen’s to drop off 2 prescriptions – Tylenol #3 and Robaxin. 

I had practiced driving with the brace prior to the surgery and wearing the brace prior to the surgery and let me say that riding in the car after surgery is a little more painful.  It is more painful because the brace pushes in on your and seems to put pressure on your incision.  Perhaps the pressure comes from the inside, perhaps the pressure is just in the mind.  I don’t know but I do know it is uncomfortable.  Get used to it.  My brace does not pinch or bind, but I while I am thankful for the job it is doing, I will be glad when I will not have to wear it again. Oh well, 6 months is nothing compared to having a good, strong back for the rest of one’s life.  Anytime I have to do something that is uncomfortable or inconvenient I always think of Philippians 4:13 “I can do all things through Christ who strengthens me.”  Anything God wants us to do, He will helps us to do.

 We arrived home after dropping off the prescriptions and making a quick stop at Sonic – yes, my appetite was back!  Our three little dachshunds were so glad to see me that they were dancing and jumping up and down.  I can see that if somebody had a big dog waiting to greet them they would have to really be careful.  It was awesome to be home.  I went for one more walk that day and tried to rest.  Some friends from the church brought over an enchilada casserole and dropped of some wonderful cards of encouragement.  They let us know that our church family had set up a rotation of people to bring by meals each day for awhile so that I could focus on FOLLOWING DOCTOR’ ORDERS!  It seems everyone was concerned that it would be a fulltime job for my wife to make sure I did not over do it.  It was like they were afraid I would not push too hard and do to much. 

 Let me assure you, I do not want to do anything to compromise a great outcome.  For that reason, I make the following pledge.  On my honor, I will abide by my doctor’s orders; I will take my scheduled medications; I will follow the Lumbar precautions and live by the Girl Scout Law.  I will also chart my walking and observe the 2 hour rule.  If I walk or do something and I am hurting after 2 hours, then I have done too much and need to cut back.  Following are the LUMBAR Precautions following Spinal Fusion. 

LUMBAR Precautions following Spinal Fusion

1.  Log Roll to get in/out of bed at all times.  Move your body as a unit; keep your hips, shoulders and knees in line. 
2. Alter positions in bed – from supine (lying on your back) to your right side and left side.  Use a pillow between your knees and one behind your back if needed.
3. Limit bending or twisting!
4. If you must pick up an object off the floor and a friend is not available and you do not have a Grabber and Reacher tool, then squat and keep your back straight and bend and your knees and hips – NOT your back.
5. Limit the length of time in sitting to less than 30 minutes at one time.  It is okay to get up to stand or walk, and then sit for another 15 – 30 minutes.
6. Wear shoes with good support.  NO flip flops!
7. Take short but frequent walks.  The goal is to walk 3 – 4 times per day.  This does not include the short times of standing between the 30 minutes of sitting.  Gradually increase walking distance and time.  Chart it so that you do not OVERDO it.
8. NEVER lift anything over 10 pounds.  A full gallon of milk may be too much.   

 Overall the journey through the surgery went much differently than I expected.  I did not expect to have as little back pain.  The only pain I had in the back was from the incision.  I had none of the prior back pain – yay!  But I also did not anticipate the setback with the migraine and the throwing up.  It was difficult but I survived.  I had family and friends taking care of me and praying for me.  The Lord received and answered those prayers.  Yes, through it all, the Lord was good and gracious.  He had my back.  He always has our back. 

Gracious is the LORD, and righteous; Yes, our God is compassionate.  Psalm 116:5

 More posts to follow.