6 weeks post-op review

Nick is now 6 weeks post-op, and today he saw his surgeon for his follow up appointment. He also saw his physio yesterday.

This is where Nick is at....

• Occasionally a little sciatic pain in his calf and thigh
• No lower back pain
• A little upper back ache when he sits for a long time (maybe stiffness?)
• Able to sit for about an hour at a time
• Bending forwards. Sometimes reaches about half way down his calf, sometimes he can only reach his knees. Update as writing this - Nick has just been able to reach three quarters down his calf!
• Sitting straight leg raise - to virtually horizontal
• Lying straight leg raise - about 50 degrees
• Very tight hamstrings, glutes and calf muscles
• Not taking any pain medication or muscle relaxants. Finishing off his course of anti-inflammatories
• Doing the 6 weeks post-op exercises which now includes some strengthening work, along with lots of stretching
• Not been able to go back to school yet as today was the first time he could sit for as long as an hour
• Managing to sit some of his mock exams at home
• Emotionally, prior to our visit to the surgeon he was a little worried about progress, however the surgeon has put his mind at rest

The surgeon was completely comfortable with Nick's progress. Specifically...

 

• he felt that Nick was likely to experience a little sciatic pain because the nerve is healing and was compressed for such a long time prior to his operation (about 15 months)
• Nick should not worry about experiencing occasional pain. If necessary he should take some painkillers, but unless the pain continues for as long as a week some pain is not a concern
• Nick will need to push through some pain in order to continue progressing
• Nick should try to keep as mobile as possible - to continue walking and doing his physio exercises
• Nick should try to return to school, probably on a gradual basis initially, to avoid getting left behind
• Nick needs to keep a long term view, and not just focus on each day at a time, as he will have good days and bad days - it’s the long term progress that is important

Overall, the surgeon was completely relaxed about Nick's progress, which I think was the main factor in re-assuring Nick. Nick was noticeably happier and more relaxed afterwards, which in itself was lovely to see.

And I have coined a new phrase - 'surgeons think in months, physios in weeks and patients in days'. I think this reflects the differing perspectives that each have and helps both Nick and me to remember to look beyond each day.

 

And I have added in his 6 weeks post-op exercises in a new tab.

Posted with Blogsy

5 weeks post-op summary

Nick is now 5 weeks post-op. Generally he feels he is doing quite well, fairly positive about it all. Not taking any painkillers or muscle relaxants, just continuing his course of anti-inflammatories. This is where he is at....

 

• Stands tall and straight
• Sitting - haven't really tested recently. Can do about 30 minutes - will be trying a 45 minute session at school tomorrow
• Bending forwards. Can reach past his knees, about 2 inches.
• Describes a hamstring tightness as the reason for being unable to bend further (rather than sciatica)
• Sciatica - occasionally has a little sciatic pain in his calf
• Buttock pain/ache seems to have gone
• Doing the 4 weeks post-op exercise routine
• Finds swimming a bit tricky, can trigger mild sciatica
• Schoolwork. Doing some at home but finds he gets very tired. Doing most of it lying down. Hoping to do a GCSE at school on Friday
• Currently trying to plan how he can return to school, whilst still doing physio stretches and not over-doing it and causing a flare-up.

Posted with Blogsy

4 weeks + 3 days

Over the last two days Nick has sort of oscillated between no pain (yesterday) and a little buttock pain (today). He's not taking any painkillers or muscle relaxants, just the anti-inflammatories which were a 10 day course. Yesterday he said that, with the exception of bending forwards, he had no pain at all which he was absolutely delighted about. It's the first time in the last 15 months that he has been pain-free.

He's being very cautious about not over-doing it. He's doing the 1 week post-op exercises and a little walking, but that is all. This slight buttock pain (more a sort of ache) is annoying - we just can't work out what triggers it. Although it doesn't worry him hugely, I can see that it niggles at him. Oh well, just have to be patient I guess.

He does seem to be sleeping again OK now which is a relief as I am sure being exhausted can't help with coping with it all.

Posted with Blogsy

4 weeks post-op summary

This is Nick at 4 weeks post-op.
In the last few days has had what seems to be a flare-up. Still monitoring it closely and because of the flare-up he is now really cautious of over-doing it. Just prior to this flare-up he was doing really well...

Pre his flare-up....

• Could sit about 20 minutes then again if he had a brief walk in between
• Could reach just below his knees
• Could stand up straight and walk correctly
• No problems with surgery wound
• Was off painkillers and no need for ice/heat
• Some residual pain in his calf and buttock
• Doing the three weeks post op exercise routine, including some cycling

Post his flare-up....

• Taking anti-inflammatories and muscle relaxants
• Back to the 'basic physio stretches' only
• Walking about 1 km gently
• Sleeping a lot - probably because of the muscle relaxants
• Can still reach below his knees
• Can stand properly, although could manage this only once he started taking the muscle relaxants/anti-inflammatories. Before the meds and in peak flare-up he could no longer stand or sit
• We've ditched taking his exams for the moment until we are over this flare-up.

Posted with Blogsy

4 weeks post op

So, Nick's now at 4 weeks post op. A few days ago I was anticipating a very different 'this is where he is at' type post than what you are getting! For the moment I am going to update during the day to see how this flare up is developing. Hopefully by the end of the day I will manage a proper 4 week summary.

 

10 am. We were up early to see Nick's GP. Not looking too bad, some pain but clearly very worried about it all. The doctor has helped us with a pain management plan for flare ups consisting of a 10 day course of anti-inflammatories (diclofenac), some muscle relaxants (diazepam) for the next few days and some painkillers (codydramol) to use when he needs. Also gave him some anti-bacterial cream and anti-fungal spray for his tummy button. We talked about longer term neuropathic medication but decided to manage this flare up first.

Nick currently curled up on the sofa with a hot water bottle on his back (says that feels really nice) waiting for meds to kick in. Says he is feeling a bit better than yesterday which is hopeful. We have decided to ditch doing his mock exams, although he will need to go into school tomorrow for a French GCSE listening paper which being a public exam has to be done at school. Hopefully meds will have started to take effect by then.

11 am. Nick fast asleep. Very pleased - probably the best thing for him at the moment.

1.15 pm. Nick's just had some lunch and is looking so much better. Before lunch he was a bit groggy but after a bite to eat he began to perk up. Joking, laughing and generally happier. Very little pain, and did some very basic and gentle exercises (from just post op days) without problem. Can stand straight again. However, he doesn't want to overdo it so is back on the futon resting.

School called to say that they have arranged for him to do his GCSE exams later so he doesn't have to go in tomorrow after all. The teacher in charge of exams has had a micro-discectomy himself so genuinely understands what Nick is going through. Very helpful! Fingers crossed that all will keep on improving.

6.30 pm. Nick is still feeling a whole lot better. Very little pain (not taken any more painkillers since this morning) and more cheerful. He's gone for a couple of short gentle walks and done more stretches as he is concerned that he doesn't get stiff lying down so much. Still likes to lie on the hot water bottle!

He's decided not to take any painkillers tonight, just the anti-inflammatories and muscle relaxants. The downside of taking a stack of meds in one go is that you can't tell which one is having the right effect, so the plan is to drop the painkillers first and see if he is still doing OK.

Fingers crossed - looking like this was just a flare up.

Posted with Blogsy