Cervical disc surgery - advice?

#21

Absolutely talked to the surgeon - he will be the one doing the procedure. There will be an additional observer assistant surgeon who is there also in a learning capacity, but the procedure itself will definitely be done by him, the lead surgeon.

Jogging - yes, bouncing up and down is in fact impossible when the symptoms are in full bloom. However, I had a corticosteroid shot in the area in the diagnosis process (long story that’s quite instructive, I will write a post about this once it’s all over). As a result I have had a temporary abatement of the symptoms and I’m simply taking advantage of the situation to exercise the way I couldn’t in the previous weeks. I cleared this with the surgeon. Some exercises are restricted: no weighted jump squats for now or months post surgery etc.

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#22

Brilliant of you to point out what needs to be discussed prior with the surgeon.

I was a pharma rep a million years ago. One day I was in surgery with a doc to observe him doing a laparoscopic procedure, and he offered to let me grab hold of his tools so I could take ‘look around’. ME!! I was mortified (as was everyone else in the room).

Needless to say, when I’ve had surgeries, I insist no reps be in the room! This was obviously not normal, but you can’t ignore what wildly inappropriate things some people will do in their misguided effort to flirt.

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#23

Wow, that is scary! The reason I thought of this is that recently in Seattle, a dentist was left paralyzed from the chest down after a spinal cord surgery to remove a benign tumor. He claims he was specifically assured that no residents would be involved in the surgery (only observing behind glass), but says this isn’t what happened. Of course, it all needs to play out in court to find out the full story.

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#24

I don’t think it has been said and maybe not super critical given the audience here but…

Recovery needs protein. Appetite is often very diminished from surgery, pain etc. Chowing down on meat after a c spine surgery is probably not what you want to do.

IMO, nearly everyone should be on protein shakes after most significant surgeries.

Nearly everyone carb loads the morning of surgery now. If that isn’t in your surgeon’s protocol, it maybe worth wondering what else isn’t. Many also do the night before.

Hibiclens showers for 2 days prior also basic protocol.

The data on pre op urine testing and nasal swabbing is less clear but hardware instilling surgeries are allowed to overkill on these things.

NSAIDs post op is one that orthopods were mostly late to the game on. They had data from the mid 90s about reduced cartilage healing. It was a common disagreement in the trauma world. It seems like most of them have gotten past this. The narcotic avoidance has driven that home for most.

On that topic (rant here) most orthopods still give too many narcotic pills after surgery. The addiction data correlates very well to number of pills given and back surgery is one of the gateways to addiction. Mostly pre-op pain started the process. Neck surgery is a different world with much less pain and better satisfaction which was noted above.

No resident anywhere observes behind glass except in the movies. Perhaps exaggeration - maybe outside the US? But hard to have glass near a field.

Reps often help in the room. If there is a problem, they are the technical assist. They never scrub in - not allowed. Lots of people make requests and generally these things are ignored if they aren’t reasonable. Residents assist in teaching hospitals. And that is non negotiable in most situations.

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#25

Eighteen days post surgery.

Just back from post-op checkup.
All good as far as the surgery.
Still have swelling around my neck.
Still difficult to swallow.

No more requirement to wear a soft collar.

Cleared to sleep on my side.
Cleared to use the Katalyst suit.
Cleared to do body weight squats, lower body exercises (below my shoulders), walking.
Cleared to do lower body mobility work.

Full body stretching a month or two out.

Got in 10 thousand steps this morning.

Started doing isometric squats against a wall while I brush my teeth.
I sometime vary this with horse stance or full squats (hamstrings to calves).
I can pull myself up if I get stuck but so far pretty good.

Main restriction, don’t introduce momentum to any movements that can torque my neck beyond where it can currently easily move.

Bending my head forward, no issues.
Turning my head is to side maybe 50% restricted from before the surgery.
Bending my head backwards, I can go further than I feel comfortable doing (the X-Ray tech had me bend back for one of the images.

No physical therapy for another month.

No issues with bending forward, backward, or side to side from the waist or even up to the thoracic spine e.g., no issue picking something up from the floor.

All in all, much less restrictive than I anticipated.

Still waking at night 3 to 4 times, but this has improved from waking hourly.
Post op congestion has cleared.

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#26

Fabulous, @Alpha, sounds like the recovery is going well. I have given a lot of thought to exercise post-op, want to start ASAP, long before PT sessions, start walking immediately, and yes, isometric exercises - I do tons of squats anyhow, and isometric will be perfect. Need the blood and nutrients circulating to assist with recovery.

@DavidCary, yes, that was mentioned by the surgeon, since he has an official teaching position at UCLA, but assured me that the resident is not going to actually do the procedure, just assist and observe, plus he emphasized that there’s a well trained team around, so many eyes, no danger the resident is going to muck it up.

Yes, I gave a lot of thought to nutrition. I routinely take in soy and pea protein powder with my breakfast “soup”, but decided that post-op I will switch to whey protein shakes for some time (lactoferrin etc.). My one concern is to keep up calcium intake (and other bone related minerals), because sometimes high protein low calcium can leach out of the bones, not ideal when looking for bone fusion. I have developed a protocol centered on bone health I am going to follow. That’s another reason I want to get back to exercise as soon as possible. However, I am rather ambivalent about using a bone stimulator - I am going to talk to the surgeon, I have only one level C5-C6, he can assess how the bone looks and what is necessary.

Re carb loading:

Role of preoperative carbohydrate loading: a systematic review

also:

Re: opiods, I’ll use them as needed, but every time I’ve had them prescribed (for dental surgery etc.), I pick up the prescription and don’t end up using them as I don’t need them (I have a bunch of bottles in my medical fridge, some going back like 15 years - good reminder to get rid of the old ones!). Odds are I am not going to go big on them - when I had massive radiculopathy pain prior to a proper diagnosis (a story in itself🙄), my wife reminded me I had a bunch, urged me to take some to at least get a bit of sleep… took a couple of times did diddly squat, so I gave up on them and gritted it out.

I still have another consult scheduled before the surgery, so I’m writing down my questions and concerns. Pro tip: yeah, I know we are all supermen with a memory like a steel trap, but seriously, write down your questions on your ipad or notebook, and don’t be embarrased to crack it open with your doc; amazing how things can slip your mind while there’s a firehose of info and sensory input coming at you during your limited time doctor visit. You may even want to have someone come with you to the appointment as a note taker, as two sets of ears are better than one.

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