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Monday, August 25, 2014

Recovery from Foraminotomy: Week 1

One week ago, I had cervical foraminotomy to hopefully cure my left arm and shoulder radiculopathy.

Right now, I feel like retrospectively reflecting on surgery and the first week post-op, so here we go! 

The procedure
Unilateral cervical foraminotomy at c5/c6 was performerd. 4 bone chips and the protruded disk material were removed. I was put in a halo, so besides the 2inch long incision I have staples in the sides of my head that will be removed 10 days post-op. The surgery took about 2 hours. 
The day of surgery:
I quit eating by 8pm the night before and had my last glass of water around 11pm. We left the house at 5.30am and arrived shortly after 6am at the hospital. I only waited a few minutes in the pre-surgery waiting room and was taken to vitals and checks promptly around 6.30. 
My weight was around 150# and I had a hard time giving my urine sample. Information you surely needed.
I changed into a rope and the nurse tried to place an IV in my right hand/arm. She blew two veins and I started to get a bit anxious. This was probably the most painful of it all. She tried twice on my right hand and wrist and completely messed up. Then, she tried my left hand and left me with a pretty big bruise...
My anaesthesiologist came in, locally numbed my hand/wrist and finally got the IV to work! Phew! 
The neuromonitoring guy came I hook me up to his thing and he my doc came to answer final questions and make sure everything was ready to go. 
I was ready to be taken down to the operation room and I think all I talked about were my big dogs and my cat. Then I was in some white room with bright lights. I think there were other patients on their beds around me but I may have been imagining all this! I think I was out shortly after. 
Crazy! 
I woke up in a different room with two nurses circling around me. I tried to move but couldn't and I tried to open my eyes or keep them open but couldn't! Crazy again! 
One nurse then fed me pudding and I know I really liked the pudding! Had it for every meal after that! Tried chocolate, too, but vanilla was way better!
Anyway, my throat hurt from the breathing tube. Since I was on my tummy during the procedure they had to put in a tube. My head hurt a bit - staples. Other than that I was just really tired. 
I was brought back into my room and my husband and his mom showed up quickly after. I needed to use the bathroom and got up around 11am. I felt fine, just a bit shaky. 
I saw a PT and OT to learn how to move and do things but I was up and walking "rounds" by the afternoon. Climbed the cute set up stairs as well. I didn't see any problems come up. 
Yet, we decided to stay a night to make sure. The hospital food wasn't all that bad either. And I liked the pudding! 
At night, my alarm went off several times because my pulse fell below 45 and 40 so, again to be safe they put me on the oxygen. 
I was able to be discharged around 11am the next day. 
Complication and problems post surgery
Low blood pressure and pulse. While it's relatively normal for me to have a sub 40 pulse at rest, in the hospital they found it necessary to put me on the oxygen tank and monitor me at night. 
Dizziness and blackouts. Most likely a side effect of meds and my low blood pressure. I passed out in the shower on day 4 post-op. Already the second shower was a bit shaky but I managed to sit down in time. Learned the hard way that a chair in the shower is very helpful; when I passed out and found myself lying on the shower floor crying, I did get scared a bit. I don't think I reinsured though. 
Constipation. All the meds caused some irregularities, that is, no movement. Miralax helped the most. I improved within 48hours of taking it. 
Nausea. Also, a side effect from meds. I quit taking my meds every 6 hours/day on day 6 post-op because I started feeling sick. Only when I actually feel increased pain or muscle spasms, am I taking oxycodone or a muscle relaxer. I have used Ibuprofen and Bromelain for pain/inflammation now and it's working so-so. 
Headaches. Positioning, the hard brace and meds also caused some bad headaches on day 5 and 6. The doctor suggested to try the soft brace and I am wearing it for sleeping or when I am lying down. This, in combination with going down on meds, headaches have improved 100%!
Arm pain. I am a bit concerned that my pain is returning. I haven't had that kind of nerve pain anymore prior to surgery so I am not sure what to think. Did I overdo it? For the most part, I have muscle spasms in my wrist, elbow and upper arm.
Improvement post-op (so far):
As I said, I currently have occasional pain in my shoulder and upper arm but my surgeon said it should go away. He called it residual pain that was caused by inflammation and regeneration of the nerves. After all, I had surgery and it wasn't just a magic trick! Yet, no numbness or tingling have reoccurred. 
I feel like my range of motion has already improved, but I cannot really tell since I am not doing any crazy overhead moves. 
With the incision healing up and me trying to keep up good nutritional and recovery habits, I am sure I will be back to normal before I know it. Then, I will have to focus on rebuilding strength and muscle.
I am now wearing a soft brace about half the time and the incision looks good. The hair they had to shave is starting to grow back and I feel stronger every day.
First week post-op tips:
Eat. Have people cook for you or prepare a lot and freeze it. You will just not feel up to much of anything but you will need to eat.
Take miralax. Kick start bowl movement right away.
Set up your bed. Get a wedge for your bed and plenty of pillows (soft-hard) to adjust your lying position for any occasion.
Chair in shower. Get a shower chair and if at all possible have somebody at you side when you shower.
No overhead. Try not to reach overhead and get clothes ready that are easy to change.
Move slowly but moveGo for short walks, and get up often. Make slow and controlled movements. This helps circulation, healing and your mind. 
Call your doctor. With any questions or problems. I have asked every little thing and was happy to get response within 24hrs very time. 
Avoid heat. Interaction with meds or simply the impact of changes in temperature can impact you more than you would think shortly after surgery, even if you feel great! 
Know your meds! What they do to help you, but also what thy can do I harm you. If you understand your meds you can much better adjust and work around it all. Also, don't become addicted! 
Call friends! Let people know what you are going through and let them help you, even if it's just a phone call! It's helpful to know people are thinking about you. 
Stay positive!  Listen to your body and be careful!

Outlook
I'm looking forward to  start doing slow airsquats and increase my daily walks. Hopefully in a week from today I can drive and start PT! 

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