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Oh! My (previously) aching back!
May 18, 2011 9:11 AM   Subscribe

In seven days I will be having back surgery: laminectomy, fusion, and fixation. Yesterday, I attended the "Back on Track" class that the hospital provides for those about to have surgery. They stressed the BLTPP rules: NO Bending, Leaning, Twisting, Pushing, or Pulling. What are YOUR best tips and tricks (and best kept secrets) for adhering to these rules for my next few months? PLEASE add any suggestions on how to make my life (and my wife's life!) easier during the recovery time. Any and all ideas are welcome! [Yep, I know YANMD, but I hope you have good ideas.]
posted by Drasher to Health & Fitness (11 answers total) 1 user marked this as a favorite
 
When I had Very Bad Whiplash with a side of No Insurance, I found that a very tight shirt (as in, Under Armor) helped to keep my body awareness such that I didn't move in ways that would hurt.

You might consider keeping a magnet on a stick and a mirror on a stick on your person, as well. The kind that mechanics use.
posted by notsnot at 9:30 AM on May 18, 2011


House slippers and sandals, depending on the weather. Socks are impossible.

Consider taking up kilt wearing, you can pull a kilt (skirt) over your head, which means you don't have to bend to put it on like pants. Otherwise, super lose sweats so you can drop them on the floor, step into them, and then use one of those grabber things to pull them up.

Oh yeah, one of those grabber things. They're not great, but they are helpful.

I'm not sure if you have time or want to modify your house, but installing rails in a few places is really helpful. A shower rail is great. Also one near the toilet (if the wall is close in front of your toilet, then a rail in front is probably the most useful--you can balance with both hands while you lift with your legs to get up). An alternative is a raised seat that goes on top of the toilet and has grab bars, the height does help with getting up but I find that they're really narrow (if you're skinny, this may not be a problem). Extra sturdy things to grab on to anywhere you normally bend, such as in the kitchen (getting things out of the bottom cabinets or fridge/freezer, getting stuff in and out of the stove) so that you can squat to reach things, especially once you're feeling better. Something really sturdy and immobile which you can lean on to get in and out of bed! (Also, if your bed is on casters jimmy it somehow so that it won't roll, you'll want to be able to sit straight up, leaning on the wall, without the bed sliding away.) You might also want to evaluate the height of your comfiest chairs, a little higher is easier to get out of.

Sorry this is really discombobulated, I've never had back surgery but I did recently fall on my back in a bad way.
posted by anaelith at 9:36 AM on May 18, 2011


I had a fusion at L4-L5. First, I can say that the first few weeks, you will not want to bend or lift heavy objects. Nor will you be able. As for not doing all the bending, pushing, pulling, twisting for months, I think that is unrealistic and a mistake. The road to recover is through rehab as soon as you are able. I flew on a 13 hour flight 5 weeks after my fusion and was stiff and uncomfortable but otherwise fine. I probably would have felt the same way if I had not had the surgery. Do not sit around for months. Make your goal to start doing things as soon as possible. If you must adhere to those rules, your best bet is simply inactivity. Sit in a chair and watch re-runs of old shows all day. I found that getting out and walking and building my core muscles was the way to go, but I am not a doctor so not doing anything the first few months may make sense in your case.
posted by JohnnyGunn at 9:54 AM on May 18, 2011


I had the laminectomy 9 days ago, L2-L5. Ouch. It is not possible to entirely avoid all of these things, but they can be kept to a minimum. The grabber is important, though not intuitive. I seem to need to force myself to remember to use it. Actually, I have 2. One is the cheapie long pistol looking thing for tiny things. The other is the long set of tongs from the BBQ set,used for more substantial items or turning on or off the cieling fan. Let the dog come to you.

Since you have prep time, do a bit of re-organizing countertop and cabinet spaces to make frequently needed items easier to access. Keep the walker handy and be sure to use both arms to raise and lower yourself.

If you're going to be sitting a while in one spot, (you will) try to assemble what you'll want beforehand to avoid the annoyance of one at a time stuff for both of you. Get the remote, book, glasses, water, and snacks in ziplock bags together before settling. Avoid putting the box of wine right next to your chair, though.

I've found it to be mostly mental. Remind yourself in advance that things are not the same as they were just a short while ago, and save yourself some pain. Great question, I wish I'd have thought to ask it. Get well soon.
posted by scottymac at 10:50 AM on May 18, 2011


Buy groceries in small containers. No gallons of milk, they're too heavy.
posted by Carol Anne at 11:42 AM on May 18, 2011


Having had three back surgeries and a spinal cord injury, I have lots of advice!

Will you be having occupational therapy either in the hospital or once you are out? There are many tools that are specifically made for dressing and picking up objects, and they are often sold together as a package. An OT can show you how to use them effectively. If you won't be having an occupational therapy, then I would definitely ask your doctor prior to your surgery about these aids. If you have an unusual housing setup (excessive stairs, a low bed, etc) ask if you can get assistance in being shown how to navigate things safely.

When I was first recovering, I used my grabber and dressing stick quite a bit to minimize my bending. Also, since it was the summer, I invested in some good shoes that were easy to slip on.

A shower chair can be a great stability aid, but getting up and out of it might be difficult at first. I found it was great as I didn't feel like I was going to slip and fall on my face (thereby negating my surgery in the first place.)

Prior to going into the hospital, try to get your room/living areas as organized as possible. Put commonly used items in a place/height that doesn't require you to bend or lift. Organize your coffee table/beside table before you leave for the hospital.

If you live alone, try to freeze up a few meals, and stick them in the freezer in individual servings It's a lot easier to grab a small container out of the freezer and heat up than try to bend down to peer into a fridge to find stuff. Put dishes/glasses on the countertop so that you do not have to reach up to grab them.

Pick up rugs smaller rugs in your house if you think you might trip over them, or if they are in a frequent traffic area.

If you have chairs you can adjust up and down, consider adjusting up temporarily so you can easily sit.

Don't lay down too long in one position or sit too long. Even after back surgery, most surgeons want you up and walking (even if it's in the house) for a bit of time each day.

As long as your doctor says to - Do get around and walk/move as much as you can stand after your initial recovery. It's not realistic to think you'll never bend, twist, lean, etc. Be mindful of your body, and be conscious of how you are moving as you recover. You can still get exercise without taxing your back too much and in the long run, the movement will help you quite a bit.

My doctors have always said - nothing heavier than a half-gallon of milk. I recommend you (if you can) lift one up before you go in, and remember how heavy that is. Let people do things for you, especially for the first few weeks.

If your doctor gives you any bracing materials when you are discharged, use them!

Good luck, and feel better!
posted by carmenghia at 11:49 AM on May 18, 2011


L4-L5, L5-S1 fusion surgery, almost six years ago. For the first couple of weeks, you won't need to be reminded to not twist/bend/push/pull. After the initial incision has healed, you should be able to begin twisting & reaching, although it will take a little longer to be able to lift or move any weight. It will depend on how well you're healing. At some point, you will want to start working your core, but not until the incision has healed and the inflammation has gone down. (AFAICT, they tell you *NO* BLTPP because there are people who expect recovery from back surgery to be nearly instantaneous, and it's easier to relax the rules on an individual basis than it is to tighten them. They'd rather have somebody take an extra week to rehab by being conservative than have them take an extra six months because they were aggressive and ripped something. I was back on the gym floor 3 months after surgery, albeit with limited trunk work.)

Get a walker -- we borrowed one from the local medical loan facility. Even if you don't need it for walking, it makes getting up and down easier.

You will be living on one floor of your residence for the next two weeks at least. Make sure you have everything you will want either on that level or out where someone can get it for you easily. Clear a path to the toilet.

Depending on where the surgery is, your doc may recommend that you limit the amount of time you sit up or stand. Have your "nest" set up somewhere before you get home from the hospital. If possible, have it in a living area of the house, not off in the bedroom. (It'd get even more boring stuck back there.).

Have some shorts or pull-on sweats to wear. And sandals or deck shoes -- nothing that needs to be fastened. Or just go barefoot inside (which is what I did).
posted by jlkr at 1:21 PM on May 18, 2011


Put a cup in the bathroom for use while brushing your teeth (bathroom sinks--much too low!). Is your toothpaste in a drawer or cabinet? Put it out on the counter.

Straws to drink with. Just for the first day or two, really, but it's not like a packet of straws is expensive.

Any kind of bodily maintenance that you regularly do... do it the day or two before. Clip your toenails. If you trim or remove any body hair normally, do that. Get a haircut.

Making your nest super clean is not necessary, but will make you feel a little better. Clean pillow cases, clean sheets. Vacuum under the cushions on your chair/couch. Vacuum a little around the living room. The drug/pain haze always makes me notice how grungy odd corners get, which is just kinda gross.

Ditto things like change in a fresh razor blade, if you were going to get a fresh toothbrush any time soon then get one now... Little things which will cheer you up.

Put your phone charger by your nest. Loop the cord around something so it doesn't slither away.
posted by anaelith at 4:28 PM on May 18, 2011


I should have had the forethought to mention:
- Yes, I will be having some physical/occupational therapy during the hospital stay and afterward.
- Yes, the doctors and nurses I have spoken with have said that the patients are encouraged (that's a nice way of saying 'nearly demanded') to walk often, but short distances. Yesterday, at the class, they said a distance of 80 feet on the first day of surgery, 120 feet the next day. I am looking forward to the walking; especially pain-free later.
- So far the instructions have been to lift no more than 5 pounds, and no reaching above head level.
- A back brace is already prescribed. The surgeon told me it is less of a brace and more of a reminder of not to bend.
- Already have a walker from my mom's surgery. The lumbar degeneration is hereditary. She had a cane too.
- Yes, they also told me that sitting is limited to 1/2 hour every 2 hours for the first few weeks.

[Oh, and I remembered that I messed up on the BLTPP, it is Bending, Lifting, Twisting, etc.]

I am due for an exam 6 weeks (?) after surgery to re-evaluate and possibly ease restrictions.

I did not mean to say that inactivity will be the rule for months; I know they want me up and around quickly. I do expect that the time to full recovery will be in the months range.

Thanks, keep those ideas coming.
posted by Drasher at 6:44 PM on May 18, 2011


Just a follow up...

Surgery went very well, actually better than expected. The actual surgery lasted 2.5 hours.
Six screws, 2 connecting bars, cadaver bone implants and bone 'paste' later and I am walking without pain. Immediate recovery was the most painful thing that has ever happened to me; getting up and standing for that first time. Ten days in a nursing facility were well spent, learning how to do normal things without causing damage to the newly fixed bone.

The current task is to let the bone heal (which takes a long time) and get off the narcotics.

If you are researching anything similar and have any questions at all, please do not hesitate to email me. Email address is in my profile.
posted by Drasher at 8:50 AM on August 12, 2011 [2 favorites]


Wow, you got time in a rehab facility -- I was home from the hospital in five days! But then, I didn't have to worry about possible rejection issues from the bone grafts, as mine were taken from my hipbone. (Get off the meds as soon as you can. I mostly kicked the meds after about a week, mod one at bedtime, and never refilled the 'script; and my surgeon was quite pleased with that.)

glad to hear it all went well.
posted by jlkr at 3:31 PM on August 19, 2011


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