Post-Op FAQs

When do I need to be seen in the clinic? 

 

·         Your first office visit should occur at 10-14 days after surgery. If you have been on the rehabilitation unit and have therefore been in the hospital longer, you should be seen in the clinic 14 days from the date of your discharge.

·         Please schedule a follow-up appointment accordingly. Call for your appointment today!

 

How do I manage my constipation after surgery?

 

·         This is a routine problem after surgery and with narcotic medication use

·         Prevention is the key

·         Start the following over the counter regimen as soon as you get home. Use each category together:

 

o    Colace or Pericolace, 100mg table, twice a day ALONG WITH Milk of Magnesia, 30CC once a day

o    Citrucel or Metamucil fiber supplements, twice a day

o    Use a stimulant such as Senekot-S, Dulcolax suppository or Fleet enema or equivalent if you have not had a bowel movement after several days

o    Continue this regimen for two weeks or as needed. If you experience diarrhea, you may back off the remedies.

 

What activities are permitted or restricted when I first get home?

 

·         You will require frequent periods of rest. Fatigue is normal for the first 3 months 

·         Walk as much as tolerated. There are no limitations, but you should listen to your body and rest when you are tired. 

·         Your exercise is limited to walking or using a treadmill and/or stationary bike. 

·         Limit sitting to 30 minutes at a time, no more than 4 times a day. Sitting for long periods will tend to make your back sore. 

·         Limit lifting to 20 pounds maximum 

·         Use your lumbar corset/brace 

·         When you feel you are ready, you may begin to wean yourself from use of the lumbar corset, walker or cane 

·         Do not lift, stoop, bend or twist more than 20% of your normal range 

·         Drive when you feel ready but never under the influence of medications! 

·         Use a position of comfort and control when you feel you are ready to begin sexual activity 

·         Use common sense with all of your activities 

 

What should I know about my medications before and after surgery?

 

·         Narcotics and controlled substances, muscle relaxers and/or sedatives are potent pain medications.

o    They are used to control acute surgical pain and other pain syndromes

o    They have a high potential for psychological dependence (addiction) and/or physical dependence (tolerance/dependence)

·         Do not drive, operate heavy machinery or dangerous equipment or perform executive or critical decisions. The mediations you may be using can cause sedation or cognitive/motor impairment. Resume these activities if you can function without any physical impairment and if you have stopped taking the medications or they do not impose any unsafe side effects or risks.

·         Stopping pain medication abruptly may lead to withdrawal symptoms. You may experience:

o    Insomnia, irritability, agitation, headache, tremors, sweating, racing heart, runny nose or eyes, diarrhea, hot flashes, poor appetite and increased pain

o    These symptoms usually last 3-7 days depending on the medication and dosage

o    We recommend that you gradually reduce your dosage with these medications

·         Remember that various pain medicines can only be picked up in person at the pharmacy. Prescriptions for these medicines cannot be called-in or faxed over to pharmacies. We expect you to adhere to the clinic prescription-medication-refill policies and agreements.

o    If these medications are required longer than necessary for chronic pain well after surgery:

§  You will be referred to either you primary care physician or to a pain specialist to continue pain management

§  We do not manage chronic/long-term pain

o    Do not take medications/substances that have not been authorized by a physician

§  This includes over the counter remedies, herbal supplements, etc.

§  Constipation will exacerbate your spine pain. Please follow the bowel protocol outlined above.

§  Over the counter stool softener and/fiber are recommended while you are taking pain medication

·         Spine Fusion Patients Only: Avoid Non-Steroidal Anti-Inflammatory Drugs (NSAIDS), steroids and cytoxic drugs (rheumatoid/anti-cancer agents) for the first 3-6 months since these may inhibit bone growth. The literature is controversial, but we prefer to be conservative.

 

Other Concerns

·         Use care when using stairs, walking on uneven surfaces, snow, ice or anything that could promote a fall, especially within the first 6 months of surgery.

·         A fall or other trauma has the potential of disrupting the surgical work performed on your spine

·         You may discontinue the TED hose/stockings one week after surgery only if you are waling frequently throughout the day.