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 move. Go 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! 

Giving up is not an option

We all have been to points in our lives at which we began to question:

Which route should I take?

Will I make the right choice?

Or, is it even worth it?

Many give up right at this point. They listen to all the nay-sayers, the non-believers, and those who simply do not know what we humans are actually capable of. Trapped in a system that is sick in its own way, I can't blame anyone who is unable to break free. I have been there myself probably more than I would like to admit. Yet, I have learned fromy past experiences that truly anything is possible. I just have to keep reminding myself of that lower that lives within.

When I started crossfit almost 2 years ago, I had no idea of what it would actually do to me and how important it would become in my life. At the same time, and as much as (or because of the fact that) I live crossfit so much, I need to look inside myself to anchor my feelings and to not get carried away in the storm I am I finding myself in right now.

Crossfit has changed me.

Yes, I have become physically strong. In fact, stronger than I ever thought I could be, but while the weight on my bar increased, I began to shed the burdens I was carrying inside. I had always tried to fit in. I wanted to be accepted, appreciated, acknowledged and recognized. In crossfit, this seemed to be happening. Even without looking good on the outside. I mean, have you ever seen the faces we make when we lift heavy weights? And for me, I turn tomato red with any physical activity already. A sweaty mess. So, I rid myself of the burden of becoming yet another "perfect woman," and felt I was returning to who I was supposed to be. A strong woman - inside and out.

But it's not just the sport hat did this to me. It's the community. Never have I felt more welcomed, accepted, and supported than in the crossfit community.

In fact, without it - I guarantee - I would have already given up and surrendered. I would be miserable. And worst of all, I would not have acted in my beat interest. My "fear of failure" would have won over my "thirst for success." Yes, I would be so miserable.

Although I must admit that i am getting increasingly frustrated about being injured and especially about being unable to do what I love (insert CrossFit), I am starting to appreciate the side of me that is usually pushed to the side: vulnerability.

It is difficult to step outside and see my neighbors who are all about 20-40 years older than me do yard work, walk their dogs or even go for a jog. It is even more difficult to get in the car and pass runners, cyclists and those, on the contrary, who sit at the bus stop smoking a cigarette throwing away heir health... Most difficult, however, is to go to the gym to do simple stretching exercises and easy, modifed movements while everyone around me is rigging the PR bell - loud and proud - as they should be.

Being supportive of them is important to me. I can be happy with them,bbut I admit that their successes can taste bitter sweet. This is where I am being tested, and this is where I grow stronger. I feed from this. I may not use the fuel just now, but I will when I return.

As much as I hate being injured, as much as I hate not being in control of my body, I am convinced that setbacks like these are put in our ways to challenge us to new levels, to overcome the impossible, and to advance in a way that we simply did not expect.

Most importantly: GIVING UP IS NOT AN OPTION!

Here are two stories (one in German and one in English) that basically talk about willpower, not giving up, and the possibilty of the impossible:

The German article is about Sami Khedira, a German soccer player (Nationalmannschaft) who suffered a typical soccer injury: Kreuzbandriss (= rupture of cruciate ligament). His quick recovery is said to be a combination of both, excellent medical help and his hard work. Two important factors in anyone's recovery. I'm clearly shooting for my part, and so far I am consulting any source I can to get the best medical help available to me.

http://www.dfb.de/news/de/training-und-wissen/das-kreuz-mit-dem-kreuzband/61049.html

In this one, we learn about Miranda Oldroyd, a female crossfit athlete who had a car accident that almost cost her her life. Her story is inspirational and reminds me of my situation. I am not going to give up. I'd rather become the beast of airsquats and pistols but I will not make my injury define me.

http://espn.go.com/espnw/athletes-life/article/11250303/espnw-how-crossfit-saved-miranda-oldroyd-life

Getting old stinks: Mental vs. Physical Strength

Please excuse me, if you find this post to be a bit messy. There are just a lot of confusing feelings and thoughts that I am trying to navigate, plus all the physical pain, and ups and downs...

Indeed, I have been feeling a bit better - disc-wise a - since Germany won the World Cup 10 days ago. My pain has decreased but the strength and range of motion in my left arm - which now is also visibly smaller than my right - is still at about 40%. Biceps, internal and external rotator, shoulder ROM and grip especially.

But I can move and I am off narcotics. whoop whoop! Even took the dogs for walks a few times again. But then I developed a knot or cyst in my left palm. It's inflamed, too, I think, as it's pretty painful and causes tingly sensations. Tomorrow, I will need to have that checked out... Ugh... Getting old stinks. Ha, that reminds me: my doc today told me to pretend I'm still 29. LOL

But as I said, at least I can move, so here is what I was able to do at the gym this week. Taking off tomorrow to get that knot in my palm taken care of. It's quadrupled in size within 3 days... Gross, I know.

Monday

Worked up to heavy backsquat

Got to 210 - so 25# below my max

WOD 4T

10-1 Deadlift 125#

1-10 straight leg raises to bar

In 5:50

34 strict push-ups in 3'

Tuesday

Roll

Worked up to heavy frontsquat

got to 190 - so 20# below my max

Plank and push-ups in between lifts

Ironscap

WOD

3rds .5m airdyne 3rds 1.5m airdyne

22" tire step ups 10 each leg

10# each side weighted lunges 10 each

15#l/25#r dumb bell curls 10 each arm

Wednesday

1k row warm up 4:25

3 rds

Reverse L-sit tabata

15/15 GhD

Plank holds

WOD 5RFT

250m row

10 20# ball front squat

In 9:58

500m row cool down 2:20

Iron scap

Mobi

I also saw another doctor today - spine person who does not do surgery. Well,he suggested to give an epidural injection a try. I hope insurance will approve that quickly and I can get that done next week so that I can see if it helps before going under the knife.

At least this doctor knows the surgeon I decided to go with and also reassured me that both discectomy and fusion are good procedures that should bring me relief. And they said the surgeon was excellent.

On a side note: I'm tired of filling out the same papers at all these doctors. Wished there was a platform that stored it from which they can just pull it.

Anyway, his strength test also - non-surprisingly - showed a strong deficit in my left arm. And for the first time today I experienced strange headaches as well as more numbness in my left arm and hand. Oh and after rowing, also in my left foot. But let me ignore that for a change. Every time I pay attention to a tiny feeling of pain it has turned into something major.

Who knows maybe it is all mental? In my head. And then it manifests itself physically. Very possible. I mean I have had the most stressful years of my life and battled through them more or less scar-less on the surface. Yet, I just felt like everything was finally settling down, and getting better. I finished graduate school, got an adjunct job that allowed me more time to do lots of lifting and working out, as well as taking care of things at home. Although I have been stressing to find a full-time job in my field. And I really want to. I want a career. I have such strong work ethics, I'm a good team player, and leader... I've even begun to question that having done the PhD was the right thing... I'm basically overqualified but underexperienced. It's a mess.

But, maybe, the reason why I haven't been able to land a full-time position is because I have to take care of myself right now, because all this was going to happen and any "real" job, as other people describe it, would have been in the way and I would have lost it by now.

But, it's no fun to be a financial, physical, and mental burden to everyone close to me and especially to myself. And let's add another stressor, from today on, I only have 6 weeks left to make this right. Make my body heal. But maybe I need to heal my psyche. Which I wanted to do by traveling home. But I can't anymore. I miss Germany so much. I miss my family and my friends. I miss the culture. I just miss it all so much. And there is no one who can understand these feelings.

And to make things harder, I'm not a very patient person. This is definitely testing me mentally. A lot.

It is very difficult for me to stay positive right now and I feel depression and negative thoughts creeping up on me.

My diet is calorie-wise the way it was when I hit it hard at the gym, so I am also getting fat. Which brings up a whole other issue that I thought I had overcome. I think I even called myself recovered the other day. But I am not sure anymore. I've given serious thoughts to returning to ED. I know it would be wrong. If I was pregnant I could turn my attention to that but that whole trying to get pregnant thing is not working either.

It all boils down to "feeling like a failure" again. I feel bad for my husband and I wished again I was "just normal" - whatever that even means.

But nope, always something new that is pulling me down.

I keep telling myself and I do want to end this positively:

I will not give up and I will come out if this stronger.

I need to set goals.

1. Get the knot checked out/ taken care of.

2. Get the epidural injection and wait and see if it helps.

3. Get approval for discectomy surgery.

4. Keep doing what I can at the gym but not overdo it.

5. Stay positive and acknowledge feelings.

Pain, surgery, and athletics

For the last 5 months I have been living with pain and only for the last 3 months have I been stepping back at the gym- at least with overhead movements. Ironically, pain increased drastically with me doing this. Also, unfortunately those are the movements I need to work on most. I've been blessed with some strong legs and a decent booty, but my chest and arms are the weakest parts of my body. Consequently, I am strong at lifts that are are hip-explosive and utilize leg strength. Think cleans, deadlifts (I have a strong grip), thrusters, squats. 

While the pain in my shoulder and arm at first didn't quite stop me from hitting WODs, I soon started noticing loss of strength on my left side. At first, I explained it with being right-handed, and simply considered my left side less strong. Kind of BS, if I consider how I did extra heavy left-hand curls and focused on using my left more in training. It did not help.

Muscle weakness also caused me to not hit any more maxes and I began to stagnate and even regress. Then with my EMG and MRI results, and conversations with my doctors and PTs, I ended the cycle of denial and stopped through the pain.

Light-weight back squats, front squats, pistols, step ups, one armed curls, one armed pullups and push-ups, leg raises, one armed planks, lunges... Yep, basically lower body movements are ok, but nothing over head. Even TGUs on the left shall be avoided. The last PR in my records book was a 210# FS PR about a month ago. Since, I had to take more loads off the bar.

Focus on form. Focus on core. Focus on legs. But I it is very frustrating to feel like I am losing all my strength and fall bac behind everyone else at the gym.


So, I was seeking out data and stories about athletes returning to sports with and without back surgery.

Here are some if my finds


http://www.back-surgery.com/athletes-spine-surgery/

http://www.medicaldaily.com/pros-and-complications-microdiscectomy-and-why-tiger-woods-missing-masters-back-surgery-273900 (this one mentions Tiger Woods, who had back surgery)


http://www.michaelgleibermd.com/blog/74-professional-athletes-undergoing-cervical-spine-surgery.html (this one has short videos explaining different procedures and mentions Peyton Manning who had cervical spine procedures)


http://www.readingneckandspine.com/return-to-play-after-anterior-cervical-discectomy.html (nice read, written by a fellowship-trained orthopedic spinal surgeon named Setphen Banco (MD), citing studies and using Manning as an example as well)

http://www.orthogate.org/patient-education/cervical-spine/cervical-discectomy.html (summary)



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Today I did the following at the gym, just to keep working a bit - all very slow and controlled - watching my pain level.



1k light row set to resistance 3 for warm-up followed by some easy stretching

40/40 GHD

10rds 5-10sec Ring holds alternating high and low 

5-5-5-5 ring rows 

Working up to heavy FS

5-4-4-3-3-3-2-2-1-1-1

35-65-85-105-115-125-135-145-155-165-175 (which is 35# below my 1RM)

4 rounds Untimed

250m row

20 alternating pistols 

20 alternating curls with 25#right/15#left DB

20 alternating step ups with 10#DB on each shoulder