So a quick report summarising my experiences post surgery. Let me first emphasize the obvious - this pertains to me and my situation and may not necessarily translate to anyone else.
The surgery itself went very smooth, and as I suspected I was absurdly overprepared for all contingencies, but that’s better than the alternative.
My recovery - so far - has been seemingly pretty rapid. I experienced virtually no pain and so I can add the bottle of oxycodone and other bottles of muscle relaxants, naproxen, acetaminophen and the like to my collection of unused meds in my med fridge.
Movement limitations were emphasized by the surgeon, nurses, pt folks etc., and I tried to adhere to them the best I could. Unfortunately, because I’ve experienced so few side effects, I regularly forget the BTL rule (no bending, twisting, lifting), and have to catch myself, often after the fact. That’s one lesson from this: be more mindful, absorb that you are in a different situation and don’t just rely on muscle memory and automatic actions.
Right now I’m just about returning to my meds. First telmisartan which I had to stop before surgery, but which I believe can assist in the necessary bone fusion (I should post this also in the telmisartan thread) - there’s a study I found that’s quite intriguing (p values are not the greatest, but there’s a signal):
A retrospective cohort analysis of the effects of renin-angiotensin system inhibitors on spinal fusion in ACDF patients
Quote:
“In the analysis of fusion rates, patients treated with ARBs exhibited a higher fusion rate, while those treated with ACEIs displayed a lower fusion rate compared to untreated nonhypertensive patients (p = .04 and .02, respectively). The difference in fusion rates between ARBs and ACEIs was also significant, with the former displaying higher rates (p < .001).”
Another win for telmisartan!
It’s been two weeks since the surgery and I’m resuming my pitavastatin (which I stopped one week before surgery). The reason I’ve waited for a couple of weeks since the surgery before resuming any LLT is because a slightly higher LDL might be beneficial in fighting off any infections which are one of the major risks of this surgery. Now that this period of danger has mostly passed, it’s time to resume pitavastatin. I will hold off on bempedoic acid and ezetimibe, because there’s a very slight possibility that those agents might be suboptimal for bone/tendon health, so I’m giving it another three/four weeks before resuming them.
Empagliflozin I’ll be resuming in another week and a half, but I’m starting to use the urine strips to see if there are any bacteria lurking in my urinary track before resuming empagliflozin (all this partially due to catherer abrasions).
Rapamycin I’ll hold off until the 3 month mark after some imaging tests when the fusion is supposed to take place to be confirmed. Rapa literature on bone health is quite mixed, so I’m not going to repress mTOR at the moment.
I’m going a little crazy not being able to exercise, but I’m doing a lot of walking (60-90 minutes a day at a brisk tempo), daily calf raises and isometric squat holds.
One thing I made a mistake with: I wanted an EMS suit, but I should have gotten it before the surgery. Reason being, that at least Visionbody is made to size and the timeframe is 4-6 weeks, so now I have a lot of waiting to do instead of already being able to use it immediately. This weekend I aim to resume hiking in the hills for 2-3 hours.
I had one post op meeting with the surgeon who did some standard tests of strength and balance, and ordered PT to start 6 weeks post surgery. The scar seems to be healing OK, there’s still some puffiness that has to come down, but there’s no annoying itching which I was afraid might happen (and then scratching during sleep, yikes!).
I’m now back to my regular diet, with some tweaks to benefit bone growth. Unfortunately my sleep has not recovered yet and it’s pretty trash quality. Nonetheless I feel absolutely fine.
Prepositioning stuff around the house has worked well… except as I mentioned I keep forgetting that I’m limited in my range of motion. I go outside pretty much as usual, except I can not carry stuff of more than 5-10lbs when shopping. Very easy to forget again - I’ll grab the 20lbs water pitcher from the filter out of habit and then catch myself. Cats are annoyed I can’t play with them as usual and wonder why I’m being an aloof d|ck instead of getting down on ground level or lifting them up onto my shoulders. Friends from all over come in batches for dinner on various days and I have to show off my scar and relate the whole story again - shock and amazement that such things can happen and nobody heard of ACDF - a fresh hell to worry over. When visits last until 11pm my energy starts to flag, plus I can’t drink alcohol, so disappointment there for all those who bring nice bottles of wine.
I’ll update this when there is more info. For now, not much drama and things are going smoothly as far as I can tell.
