8 weeks post-op - tough times

This last week seems to have felt like really hard work, for both Nick and myself.

Nick has found it very tough trying to get back to school, constantly trying but not managing. And every time he does make it to a lesson he ends up with more work to do whilst having to recover from making the lesson in the first place. He admitted to me that he had considered stopping school completely, which is extraordinary for him because he has always been completely determined to complete his schooling.

He was in school for a full day yesterday, which we now realise was a bit too soon. He was absolutely shattered afterwards and consequently needed a lie-in the next morning.

He is also still worried that something is not right, or at least that he is not progressing as much as he should be. His physio was re-iterating to him yesterday that it will take time because his nerve was compressed for so long. Also, Nick was using how far forwards he could bend as an indicator of progress. The physio discouraged this, pointing out that other aspects may be improving (eg how long he can sit) so he shouldn't focus on just one indicator.

He's had the start of a couple of flare-ups, but each time we have managed to divert it by rest or Diazepam. Each time it has been sitting that has caused the problem.

People are now starting to ask when he'll be starting to play tennis again - well meant questions but for someone who struggles to sit yet alone run it doesn't really help being asked when he can play tennis!

His year group at school are going through various activities designed to help them plan university/career paths which is creating another cause of anxiety for him. Hardly surprisingly he can't contemplate careers when all he has ever wanted to do was to play tennis and that's something he can't do at the moment.

Overall, this is where he is at...

• Can sit for about an hour at a time before his upper back starts to ache and he feels stiff
• Generally standing and walking properly unless pain has kicked in, when he then tends to lean forwards
• Only once taken any pain meds this week, and that was after sitting for too long
• Still needing to lie down a lot
• Finds gentle stationary cycling helps to mobilise his back
• Muscles - generally he says his muscles feel looser... hamstrings slightly, glutes fine, calves slightly. New last night at the physio was that his QL is tight
• Tried a sports massage last night, focusing on his QLs, glutes and hamstrings. Also being taught to breathe better to help relax. Comment re sports massage - yes, seems to have helped
• Emotionally, fragile. Ups and downs. Sometimes very worried about it all, sometimes pretty calm
• Schooling - tricky but slowly managing to sit through some lessons. Took an iPad into school yesterday so that he could type lying down. Double lessons still a bit of a nightmare for him
• Some of his physio exercises trigger pain on occasions so he tends to mix and match what he does, avoiding those that are painful. No new exercises added this week to his 7 week routine

Each evening we plan out the next day. I then email school and his teachers to let them know when Nick is hoping to be in and I keep my fingers crossed that he'll wake up the next morning feeling ready for it. It does make it hard for me to get much done as I never know in advance when I will be needed to take/collect him to/from school but we have found that planning more than one day in advance just doesn't work.

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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.

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4 weeks + 1 day - over the flare-up!

Phew, Nick seems to have got over the flare-up. He can stand and sit properly again, has virtually no pain (just a little sensation in his calf), needed no painkillers today and is generally back to his normal pre flare-up self. He has been incredibly cautious today re exercise, basically just a couple of short walks and the basic physio stretches but he says that he wants to start re-introducing the 1 week post-op exercises tomorrow.

 

He tried a little gentle swimming in a hydro pool yesterday but found that it triggered a little pain in his calf so will wait until next week before going again. Mind you, his idea of 'gentle' was 100 lengths - admittedly it's a very small pool - which was a bit more than I was envisaging!

 

I'll give him one last diazepam tonight to help him sleep but I am hopeful that he is back on the road to recovery.

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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.

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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.

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