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Having completed your surgery, all of us at CCSI now want to
see you steadily return to health. To help you understand the
recovery process you are beginning, we've outlined below the main
steps in this process.
Length of stay
The length of stay in the hospital can vary greatly between procedure
types as well as amongst individual patients. In general, a cervical
surgery requires a two day hospital stay. A lumbar decompression
surgery has a similar length of stay. Fusion surgery can require
a four to five day stay in the hospital. Minimally invasive lumbar
fusions may require only a one to two day stay. Complex scoliosis
or other revision and reconstruction surgeries may require more
time in the hospital. The individual patient's general condition
and age may greatly influence the length of stay and each patients
situation is unique. This description is therefore a generalization
only. Your needs may be different.
During your stay:
DAY 1
The first day after surgery is mostly a day of rest. Pain medications
will be adjusted and blood tests will be performed as needed.
The therapists will allow you to stand up and walk as tolerated
with their help. A (PCA) Personal Analgesia Pump is often used
to allow you to control your own pain medication.
DAY 2
Small drainage tubes are often placed in the incisions. These
are removed on the second day. The PCA pump is also slowly decreased
and replaced with oral pain medications. Dressings are changed.
Physical therapy is continued with more walking, sitting and education.
DAY 3 to 5
The priority is more rehabilitation as required. The patient should
be working towards a regular diet and voiding normally at about
this point in time. The decision as to when you are ready to go
home is made during this time. It is based on all of the issues
already described as well as clearance by the Physical Therapists.
If more rehabilitation is required, we will usually transfer you
to the rehabilitative unit at this point. This unit is part of
the same hospital but is run by physiatrists such as Dr. Aznin. Your surgical team will visit you there but are
no longer your primary (decision making) doctors for the duration
of your rehabilitative stay.
DISCHARGE
The day of discharge brings a flurry of activity. Prescriptions
are provided and discharge instructions reviewed. These are all
provided in a written format as well. You will need to arrange
for transportation home. You are allowed to ride in a regular
car but make sure it is one that is easy to get in and out of.
You of course, will not be allowed to drive your own vehicle home.
At this time, is a good idea to already call the appointment desk
at CCSI to set up your first office visit which should occur in
about 10 days.
What to expect after you go home:
THE FIRST WEEKS AT HOME
During these first few weeks, you will find yourself to be very
tired. As such, you will be spending half of your time resting
in bed and the other half, up and around. You will certainly be
able to go to the bathroom and manage your surroundings without
additional help. You will most likely be using pain medications
on a routine basis. It is a good idea to have someone available
to help you for the first two weeks or so at home.
Activities at this point should include a progressive walking
program. Use of a stationary bicycle or treadmills are also allowed,
although it may be too early to begin this program as of yet.
Do what you feel you can do, but be conservative and safe. In
any event, no lifting of greater than 10 pounds is allowed. Also,
no stooping, twisting, lifting, housework, or yardwork are allowed
at this time. A return to sexual activity may occur when you feel
ready.
During this period of time, the wound must be kept clean and
dry. It is recommended to keep a dry 4x4 inch gauze over the incision
at all times. This dressing should be changed on a daily basis.
Cover the wound with a cut piece of Saran wrap, secured with tape,
for showering purposes. This will keep the incision dry during
this process. Change this to a dry gauze once again after the
shower. Place no lotions, powders, or ointments on the incision
unless instructed to do so.
Keep track of your prescription medications. Write down a schedule
as to when they may need to be taken. Please remember, narcotic
pain medications usually require the actual written prescription.
Do not wait until you are entirely out of medication to call the
office for a refill. A 3 to 4 day warning to our office of your
refill needs will make the whole process run more smoothly.
As the weeks progress, you can gradually increase your amount
of activity however, your restrictions do not change at this point.
Returning to work is based on your type of surgery, type of work,
level of energy, and general comfort. In general, a laminectomy
surgery allows you to return to a sedentary type of job within
two weeks. A more involved fusion surgery combined with more physical
types of work may require up to two or three months of recovery
prior to returning to work. Discuss the specifics of your situation
with your doctor for a better prediction of your particular needs.
ONE MONTH AFTER SURGERY
Your next visit in the office will occur at about six weeks after
surgery. We will now begin to increase your level of activity.
This may include progression towards a basic exercise program.
Again, the magnitude of your particular surgery will influence
this time frame. For instance, laminectomy surgeries allow for
rapid return to abdominal and back strengthening exercises. Fusion
surgery requires a longer period of time. In any event, with exercise,
excessive motion of the lumbar spine and pelvis is to be avoided.
Physical therapy may or may not be initiated at this point.
THREE MONTHS AFTER SURGERY
An office visit at three months after surgery is the norm. At
this time, a more vigorous physical therapy exercise regimen will
be initiated. X-rays will usually be obtained as needed. This
is done to check the healing of the fusion, if performed. If you're
surgery was a straightforward laminectomy, a full release to all
activities may well be provided at this time. Fusion surgery however,
will require the same restrictions for another three months.
SIX MONTHS AFTER FUSION SURGERY
The office visit at this time will again focus on your rehabilitative
agenda. X-rays will also be obtained to further assess the fusion
process. It is expected, that most fusions will be approaching
maturity at this point. As such, most all restrictions will be
lifted at this time. Understand however, the fusion is not as
strong as it will ever be until closer to one year after surgery.
It is therefore one year before it is expected that your recovery
is totally complete.
ONE YEAR AND BEYOND
A routine check in the office after a major spine surgery is recommended
on a yearly basis. At this time, your exercise program will be
reviewed and recommendations made to maximize your strength, agility
and endurance. X-rays will also be obtained as needed to monitor
the fusion and adjacent areas of the spine. Tips on lifestyle
improvements to further help your spine throughout the years will
be a major focus as well. The medical staff at CCSI have a strong
commitment and dedication to the long-term health of your back.
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