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ALIF S1-L5 should I proceed?

Long story short, I fell 5 years ago and herniated S1-L5. I have used PT, Crossfit/Weightlifiting, injections, and meloxican to "survive" the past 5 years. I get an updated MRI every 18 months or so and my injury is progressivley getting worse. I was offered ALIF when I was first injured and put it off as long as I could (including 2 full term pregnancies). My disc is completely gone and I have stenosis. I think compared to some people that suffer with chronic pain I am doing okay. I am really strong, workout 3-4 times per week, can work with no issues, and manage taking care of my 3 small kiddos. On the other hand, at my last MRI the Doctor was surprised I was walking and functioning. Mornings are hard. I struggle doing basic things like getting dressed, shaving my legs, getting my 20 month old out of his crib, doing laundry, and have had to move away from early morning workouts. As the day progresses, my pain improves but it starts all over again every morning. As of right now I am going to go through with surgery on 2/7/2018. Most things I read are not the most pleasant stories as people are looking for support and empathy. I would love to hear positive stories and any tips people have from day 1 and all the way through recovery. My goal is to go back to my active lifestyle after several months recovering and to have more pain free time with my family. I also will have my husband home with me for one month, but he will return to 24 hour shifts as a firefighter after a month. I will be solo with the kids those days. I will take 4-8 weeks off of work from my fairly demanding corporate management job. Just looking for positive and upliftng stories (mainly so I don't back out of this in the next 2 weeks :)). 

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  • I've been active my whole life (62 now) ... including 40-plus years of cycling: racing, commuting, and adventure touring in South America, New Zealand, etc.    About 2 years ago I had a nasty bike crash that resulted in a week's stay in IC, and had to have my C1-3 fused.    I can turn my head only about 50% of my past normal, and have 7-24 low grade pain in area of surgery (base of neck).   I could minimize the pain by sitting in a leather recliner all day - then I'm fine, and life is good.   But I can't live my life that way .... so my activity (modified single bicycle and recumbent) aggravates the situation but I'm willing to make the trade-off.    It's good that you have a support group, and have been active - don't ever give up some kind of activity if your body will allow it!    I've found excercise on any level is great for mental outlook.   If you have any kind of religious faith/background, now is a great time to tap into that support base.  My sister (surgeon) and my neurorsurgeon we're dumbfounded that I didn't end in a wheelchair or dead all things considered (I was moved from crash site to my home thinking I'd be ok but within minutes, as I layed on my bed, I knew I was in big trouble and called 911).   I'm blessed to be even walking ... as much as possible, maintain a never stop fighting mentality.   Sometimes you just have to put your suffering or life's challenges in perspective, and appreciate what you have - not what you've' lost'.   I keep thinking of some of my friends that have ended up in a wheelchair after similar deals (or worse) - mental strength is just as important as physical strength.   I've done stuff similar to what you're doing (PT, gym, etc.) but, in my case, hasn't done much good for strengthening the neck - you can only do so much in overcoming the fusion hardware.   If you have good medical support (including a second opinion), and surgery is recommended, do it!   I think you've already found that most of the journeys on this forum do focus on the negative and / or suggestions on getting better and what to expect.    I look at my current situation as a new chapter in my life and, once I got over the realization that my cycling passion that had been such a huge part of my life for so many years would never be the same, I moved forward to make the best of the situation.    I've taken up walking/hiking again (I did a lot of backpacking in my college years) which has reminded me how much I love nature and the outdoors - something I probably wouldn't have experienced again if not for accident and being forced to look at alternatives.


  • smartens162smartens162 Manitoba, CanadaPosts: 361

    I am interested in hearing the responses, I am in very much the same position as @jeoder .  Ruptured L5-S1 almost 4 years ago now.  I had a discectomy surgery hoping that would solve things, was also recommended fusion from the beginning.  Revisiting it now as the re-herniation has to be dealt with somehow.  I have not been working these past 3.5 years, due to needing to quit my job at time of injury (retail, heavy lifting) and never feeling sure enough to start another job as frequent flare-ups put me on bed rest for days at a time.  Also looking into artificial disc replacement surgery in Germany.  But it comes with a hefty price tag as it is not approved surgery here in Canada and insurance will not cover it.  Were money no issue, I'd have done it early on.  I know several people who've gone that route and are out living life like nothing every happened.  I agree with @ROBTEMPLIN, don't give up exercise if you can at all manage it.  You may have to find something different to do, but keeping active gives your body and mind something POSITIVE to do.  I have enjoyed walking for exercising, but it is becoming increasingly painful to do it, so I do it less often now.  I discovered aquacise classes at our local pool and it has been a lifesaver for me, drs and therapists highly recommend it as it is zero-impact (I do it in the deep end with a flotation belt).  I am struggling to adjust my perspective on life.  I still want what I had.  I am quite certain that a fusion will not bring me back there.  But I need to find a way to live out the rest of my life without laying flat in my bed watching the world go by.  I wish you all the best, too!

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  • jeoderjjeoder Posts: 7
    edited 01/24/2018 - 3:43 PM

    I am honestly hoping I am more active after surgery (once healed and recovered). If not, I will be frustrated. When people I know with similar injuries to mine could hardly walk or function, I have been able to continue to lift heavy (back squat 250+, deadlift 280-300lbs, clean and jerk 155lbs) and stay active with a scaled version of Crossfit. I agree on having a positive mental outlook in being key to success (in so many things and not just surgery). I have had 2 csections with my back injury. I honestly recovered from my csections with no issue because my back still felt so good from all the pregnancy hormones. I was back to lifting heavy weight (70% of my maxes) only 2 weeks post op this past csection and performed in a Crossfit comp at 8 weeks post delivery. I also Crossfitted and lifted heavy right up until I delivered all my kids. It made everything a breeze. I am hoping it also aids in the recovery from this surgery. I have talked to several folks that have positive stories but you just don't find them often in these forums. I would love to hear some. I would also love to hear from women that have had csections and alif and if it compares at all. My Doc plans to use my csection incision for alif. He thought the incision and surgery pain would be one of the more difficult parts of recovery but from what I am reading I am not convinced. Thank you for your stories and outlook. I really appreciate and agree with both of you on many fronts!

  • Jeoder it’s great to hear you are active. I’m not as active as you by no means, but I am fairly active for 38.  I am at 4 weeks post op. I had an anterior/posterior fusion on my L5-S1. Obviously the first week was painful. And the hardest part is keeping your spirits up when you feel good enough to do everything you used to do, but know you can’t bend lift or twist. I learned the hard way today how important it is to not BLT! I went grocery shopping and that was enough to irritate my low back. I sat down and surfed Netflix for a few hours and felt better. This surgery does have an extensive recovery time. And I am hoping I made the right choice by doing this. My doctor stressed and stressed to me that if I have a strong core my recovery will go a lot smoother. So keep that in mind if you go through with the surgery.  Anyway, my recover is going very well I would say. I go for my 4 week post op this Friday, and hoping for good news and being able to do a bit more than I have been able to do so far. Keep your chin up and try to stay positive, seems to help a lot. 

  • Thank you!! Do you have kids by chance? I have a 6,3,1 year old. All boys. Any tips on caring for them (if grocery shopping results in pain I am very nervous for kid raising). LOL. Do you work at all? My job is mostly a desk job. I walk around a lot for meetings, etc. Do you think work would be feasible at 4 weeks? When did you start driving?

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  • I do have kids but they are older. My youngest is 10. So I think you’re going to find it difficult for a while not being able to carry the 3 and 1 year old. You might have to sit down and have them climb on your lap if they need snuggles. I currently don’t work. I was waiting to start working again after my back surgery. So I have been doing college classes while I’m laid up. I did ask my doctor if I would be able to work in a group home setting with disabled clients at 6 weeks. He said that would maybe be possible after one year. So I’m panicking about that now. I think he did say a desk job is just fine after 6 weeks as long as there is no bending lifting or twisting. But every doctor and every procedure is different. Driving, I started driving after two weeks. I did notice it was really hard to back up without twisting. Good luck on your surgery!!  I’m sure it will turn out better than expected. I thought mine would have been a lot worse than what it was. 

  • Thank you!! I do have a back up camera and sensors on my car, so that should help. My kids are my biggest worry. My Doctor thought I could be fully released with no restrictions around 12 weeks if things go as planned. Less than a week to go. 

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