Evaluating Surgical Options
This information is being provided to you in order to prepare you to make decisions about your own health care. If you should ultimately decide that surgery is the best treatment option for you, this section will help you understand what happens during a lumbar laminectomy and will help you prepare for your role in the healing and recovery process. Read it thoroughly and answer the questions before making your final decision about your treatment options.
The Health Care Team’s Role
The duty of your health care team is to:
- evaluate your condition
- establish a diagnosis
- present the various treatment options
- offer a specific treatment recommendation
- provide you with the information you need to make a decision
- and then support you in the decision you make
The Patient’s Responsibilities
You are the only one who can decide to have surgery. It is important that you take ownership of this decision, recognizing the limitations your particular physical condition places on the potential success of each of the treatment options.
If you choose to have surgery, your physical condition and your mental attitude will determine your body’s ability to heal. You must approach your surgery with confidence, a positive attitude, and a thorough understanding of the anticipated outcome. You should have realistic goals – and work steadily to achieve those goals.
The decision to have or not to have surgery includes weighing the risks and benefits involved. You will make the final decision, so ask questions about anything you do not understand.
Since medical care is tailored to each person’s needs and differences, not all information presented here will apply to the patient’s treatment or its outcome. Seek the advice of your physician and other members of the health care team for specific information about the patient’s medical condition.
It is normal to have pain after the operation, especially in the incision area. This does not mean that the procedure was unsuccessful or that your recovery will be slow. Pain in the extremities is also not unusual, caused by inflammation of the previously compressed nerve. It will slowly lessen as the nerve heals. Medication will be given to control pain. Moist heat and frequent repositioning may also help.
Numbness or tingling sensations are often the last symptoms to leave. Numbness which lingers in parts of the arm or fingers if you have had cervical surgery, and the feet and toes for the lumbar surgery patients, usually this is no cause for worry and should gradually go away.
You may move about in bed and rest in any comfortable position when you have recovered from anesthesia. Walking may begin within several hours. The easiest way for you to get out of bed is to raise the head of the bed as far as it will go, and then swing your legs to the floor. Avoid pulling up from a flat position with the trapeze.
The doctor may order a cervical collar or a lumbar brace to be worn whenever you are up and about. Your nurse will explain its proper use and help with any activity.
Gradually increase the amount of walking you do each day. Since it may at first be painful, try making short trips. Begin with a trip to the bathroom, then to the door, and later out into the corridor.
Sitting and standing also require a gradual pace. If discomfort occurs, change positions frequently.
Usually you may take a shower the day after surgery. This will make you feel better and should be done with the dressing left in place to protect the incision. Your nurse will change the dressing afterwards.
Intravenous (I.V.) fluids will be ordered during the early recovery period and continued until you can tolerate regular liquids without nausea or vomiting. Your diet will then be adjusted back to normal as your appetite returns. Constipation will be treated with laxatives, walking and a diet of whole grain cereals, fruits, and fruit juices.
It is normal to feel discouraged and tired for several days after surgery. These feelings may be your body’s natural reaction to the cutback of extra hormones it put out to handle the stress of surgery. Although emotional let-down is not uncommon, it must not be allowed to get in the way of the positive attitude essential to your recovery and return to normal activity.
Discharge from the Hospital
The hospital stay for anterior cervical fusion patients usually lasts 1 or 2 days. For lumbar fusion patients the length of stay is typically 3-4 days. This will be determined by your progress and by the amount of comfort and help available to you at home.
Daily walking is the best exercise. Try to increase your distance a little each day, setting a pace that avoids fatigue or severe pain. You may climb stairs when you feel able.
Sexual relations may be resumed during the recovery period, but positions that strain the neck or back should be avoided.
“Listen” to your body. Discomfort is normal while you gradually return to normal activity, but pain is a signal to stop what you are doing and proceed more slowly.
Your doctor will help determine when you can return to work and with what limitations. If a work release is required, it will be given to you during the first post-operative visit.
Your doctor will usually release you to drive after your first post-op visit. Do not drive after taking pain medication!
You should gradually use less pain medication while recovering at home. This can be accomplished by increasing the amount of time between taking pills, then by reducing the number taken each time. A certain amount of discomfort and pain in the neck, arm(s), back or legs can be expected until the inflammation and nerve sensitivity have subsided. Cold Therapy, exercise, massage, and short rest periods will also help relieve pain.
If the skin sutures or staples were removed before your discharge from the hospital, it is not necessary to keep the incision covered. Unless instructed otherwise, you may take a daily shower or tub bath, which will help you feel better. Let the water run over the incision, but do not scrub or rub over it. Pat it dry. After bathing, massage lotion over the tightened neck muscles.
If you notice increased redness, swelling, foul smelling, or any drainage around the incision after leaving the hospital, notify your doctor.
A well balanced diet is necessary for proper healing. Include foods from each basic food group: dairy products, meats, vegetables, and fruits. Since you will be less active during recuperation, avoid rich, heavy foods and those high in calories but low in nutrients. An iron fortified multi-vitamin is a good supplement to include in your diet at this time of recovery.
Healing and Recovery
Healing is the body’s natural process of restoring its damaged tissues to a normal or nearly normal state. Although healing may be improved by general good health, proper nutrition, rest, and physical fitness, it will occur without your having to work at it.
Recovery is the process during which you work to become well. It requires a gradual but persistent effort to increase physical strengths and minimize weaknesses. You must concentrate on what is improving, rather than on what symptoms remain. This focus on progress that has been made, combined with the constant effort to improve, make up the positive attitude that will speed your return to normal daily activity.