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.

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3 weeks + 6 days - shitty day

We've had a pretty shitty day today....

1 am. Nick wakes me up. He's in a lot of pain (buttocks), very upset and can't sleep. Desperately worried about this new pain. Took 1 x 30 mg Dihydrocodeine which after a while kicked in and he managed to get to sleep. Before going to bed he couldn't stand up straight which had upset me - he looked like his pre-op days which was depressing.

10 am. Nick wakes up and not looking or feeling too bad. Walks into the kitchen standing properly and walking tall - huge relief. Perhaps last night was just a temporary glitch. Cancel the planned trip to hydro pool for swimming because his tummy button is looking very infected.

11 am. Starts his first mock GCSE. We've planned out the day with basically cycles of sit - walk - sit - walk - exercise - rest. Each sit is doing his exam paper with an expected finish time of 3 ish.

Buttock pain gets steadily worse and he gets stiffer and stiffer. By the third cycle when he gets back from the walk he collapses on the floor by the door. Virtually in tears, unable to lift himself up to sitting and certainly can't stand. Abandon exam paper, another Dihyrocodeine.

Crawls to living room and rests on futon. Can't find a pain-free position at all.

5 pm. Visit to physio. His lower back had shifted a bit and muscles gone into spasm. Strangely can bend forward but can't stand straight. Lots of massage on lower back and calf. Advised that this may just be a flare up, and to rest with a warm pad on back. Revert back to the 1 week post-op stretches only. If no improvement in next 24-48 hours to contact surgeon again.

So, at time of writing (7. 30 pm) feeling pretty miserable and uncertain what is going on.

10.15 pm update. Took a couple of paracetamol and now looking a bit happier. Just praying that he manages to sleep tonight.

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Brief history

15 months ago, aged 14, Nick started to have leg and back pain. As a keen tennis player, it was diagnosed as a muscular problem due to not stretching enough. So for the following few months he religiously performed a series of physio stretches several times a day (glutes, hamstrings, quads, piriformis etc).

The pain didn’t improve, and 3 months later his GP referred him to first an osteo and then a neurosurgeon. It took the neurosurgeon about 60 seconds to diagnose a herniated disc, and it was confirmed in an MRI the next day.

By this stage Nick was losing sensation in his foot, had reduced reflexes in his leg, had severe sciatica and couldn’t sit or stand for more than about 15 minutes without pain. He had difficulty bending forward, and could only reach his knees. These problems made life at school a nightmare for him.

10 months ago he had nerve decompression surgery to relieve the pressure on his sciatic nerve. Initially the situation improved, but very quickly (a matter of weeks) his original problems came back. He regularly saw his physio and tried to keep fit by swimming and cycling. However, his nerve was severely tethered and no amount of work seemed to release it.

3 months ago he tried a steroid injection in his spine to reduce the inflammation. He had relief for about a day, but beyond that it had limited effect.

1 month ago it was decided that the only option left for him was a micro-discectomy. By this stage he could not stand, sit, walk or even lie without pain.

This is where he is at today. He takes painkillers three times a day just to carry out his day to day activities. Remember he is only 15 years old! I hope this blog will help anyone else in a similar situation.