L4-S1 fusion coming up

So I am getting L4-S1 fusion with 2 cages put in as well. I have a few back issues that are being addressed. 
L5-S1 spondylolisthesis and bilateral pars fracture, broad central right central and foraminal disc potrusion/extrusion, severe foramenal stenosis
L4-L5 broad central disc disc protrusion that indents the thecal sac

also scoliosis 
rightward curvature of mid t-spine with apex at T5-6
leftward curvature of lower spine apex at L4

congenital fusion of C4-C5

also possible small retro slip at L4-L5 

I have a few concerns for my fusion. I have t1 diabetes as well as endometriosis and interstitial cystitis and extreme anxiety. I'm not worried about the T1 diabetes management in the hospital but a bit worried about management of the IC while having a catheter placed. My doctor recommended getting the catheter removed sooner rather than going by the clinical pathway. Anyone have issues with catheter and peeing after. My friend had trouble and had continual in and outs and then 2 foleys placed. They think it was the meds though. Is this common? 

I know many people say they are comfortable with wearing just a gown but can you bring some comfy clothes? I'd rather be in my own clothes or pyjamas. I also have realllllly bad anxiety and was told not to worry about the BM part that they'll release me even if I haven't gone if i'm only on fluids anyway. I am totally prepared for the actual fusion tbh I'm just worried about the other stuff that could happen as well as having to deal with some other health issues along with the fusion. Any words of advice?


  • also having a decompression laminectomy if that makes a difference
  • MagistraMarlaMMagistraMarla San Antonio, TexasPosts: 78
    Hello Aliciam,
    I had L3/L4 and L4/L5 fusion in April,2015.  I've had urinary incontinence problems that have gradually gotten worse since about 2003.  I'm convinced that this is related to my lumbar problems, since it began at about the time that my legs started giving out, leading to falls.  Doctors have poo-pooed this, telling me that it is "normal" for a menopausal woman, etc. IC has even been suggested and then ruled out.  However, I've found that the less pain that I'm in, the more control that I have over my bladder.  I've recently become even more convinced that I'm right.  The L3/L4 fusion failed and I've switched surgeons.  My new one insists upon lots of pre-op tests so that he can fix everything at once.  I recently had an Epidural Steroid Injection at L5/S1, which proved my doc's theory that this segment needs to be addressed.
    Ever since the injection, I've been fairly pain-free and I've had almost complete control of my bladder - yay!

    About the catheter post surgery - mine was left in for over two days.  I'm not sure if it was forgotten or for the convenience of the nurses.  I've since read that 24 hrs. is standard.  Once it came out, I had no control at all.  I used up every Poise pad that I had packed and then the nurse acted like I was asking too much when I begged her to bring me one.  My bladder was so irritated that I still had no control after I got home.  I tried desperately to reach the gyno-urologist, but was never answered.  (All of my docs were at a large teaching hospital, which I thought would be great.  I've learned my lesson - I've switched most of my doctors).  I think that you should have a good talk with both your surgeon and your urologist before the surgery and make very sure that there are notes about your IC for the nurses.

    On to the BM question.  I'm severely allergic to all opioids.  When the nurse came to give me 2 stool softeners and 2 Senecot at once, I told her that I had already had 2 glasses of prune juice, so those were not necessary.  She rolled her eyes and told me that prune juice wouldn't work after having narcotics.  She rolled her eyes again and wouldn't believe me that I'm allergic to narcotics, insisting that I take the pills.  I did, and they worked explosively, four times.  The same nurse wouldn't answer when I buzzed, so I used my walker and took myself to the restroom.  She then chastised me for not waiting for her!  Hopefully, you won't have Nurse Ratchett and will have less problems than I had.
    I think that prune juice and Milk of Magnesia are both on that great post-op must-haves list.  I had both at home, but didn't need them at all, thanks to Nurse Ratchett.  My next surgery will be out-of-town, so if I need them when I'm released from the hospital to stay at the motel with my family until the surgeon oks my trip home, I'll ask my husband or daughter to go buy some.

    I found that the hospital gown was best for the first couple of days, so that I didn't get blood, etc.  on my nice PJs.
     I bought a drawer full of soft comfy PJ sets from Soma.  After my husband helped me to take a shower on day 3, I switched to them.  Soma also sells wonderfully soft T-shirts in all sorts of colors to go with the PJs.  I found that those were perfect to wear under my brace.  I could pull on a soft pair of yoga pants with those T-shirts for PT, too.
    I hope that this helps! 
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  • MagistraMarla said:

    Thank you! I am going to mention the IC at my pre-op so that written instructions are made. I don't have incontinence just sometimes I have frequency issues. I'm supposed to take meds for it but I like to take the least amount of pills possible. For the BM they don't require you to have one before leaving. I WISH I could have a shower day 3 but unfortunately that won't happen until I go home which I could be there up to 6 days. My friend actually just had the same surgery but 1 level not 2 and she was there 6 days and I visited also. I met the nurses and they were amazing and very very nice and she said the same. I'm not worried about any ratchets..she said there was just one who kept trying to do an in and out cath and couldn't do it but kept trying and that was her only bad experience. 

    I won't have a brace but maybe I'll get a black nightie for the hospital...I hate the gowns and having my behind hang out. 

  • Kimmy72 said:
    Hello, Aliciam!

    I had L4-S1 fusion surgery with decompression in January.  It was only supposed to be a single-level fusion, but my bilateral Pars defect went undetected until I was on the operating table.  In retrospect, I'm so glad I gave the surgeon permission to fix any other issues he might encounter prior to having the surgery.  My Pars defect never showed up on any imaging studies.  I did have a setback with my recovery because of internal scar tissue that went nuts and decided to imprison my nerve roots at the surgical site.  Please don't let this alarm you--everyone gets a little bit of it after any kind of surgery--I was just one of those unlucky few for whom it became a problem.  I've since had a procedure to take care of that, and am now blissfully experiencing the 80-90% pain relief that my surgeon promised I would receive as a result of having the fusion.  My six month check up was yesterday, and I'm 80% fused already! 

    I did bring my own comfy clothes to the hospital, but with all the IV/catheter tubing and pain, all I ended up wearing that was mine was my robe over the hospital gown.  I didn't want any kind of pajama bottom banding getting anywhere near that fresh incision.  I would, however,  recommend bringing a pair of slip-on shoes with good treads on them (I found a decent pair that were relatively inexpensive at Kmart).  Those hospital floors can be a tad slippery, and the absolute LAST thing you want to do is wipe out after surgery! 

    How are you set up at home in terms of recovery?  I had my doctor write me a prescription for the rental of a hospital bed, and it was one of the smarter things I did regarding recovery at home.  There's a good post in here--please do a search in the upper right hand corner for "Post-Op Must Haves".  A little prep sure does go a long way.

    It sounds like your doctor is making sure your other health concerns are going to be taken care of.  It must be hard to have so many other health issues on top of the spine problem!!  Oh, and they didn't make me "do the doo-doo"  before I was discharged, either, or I might STILL be there....hahaha...

    When is your surgery? 

    Hi kimmy! Glad yours went well minus the scar tissue. I haven't had any other scar tissue problems before with surgeries (non back surgeries) so let's hope that doesn't arise :) I also discussed the same thing with my surgeon that in the event he finds anything else to please address it. He kind of scoffed and said with all the different imaging he's sure the plan is what he will do but you never know right. I'll remind him day of surgery for that and stitches instead of staples which he said was fine just to remind him! Maybe i'll bring a robe too then just so I can have something comfy. I know i'll prob end up with pants on though something that can be tied and be left a bit baggy because I know me and I'm always cold and I like having my insulin pump on my waist band. 

    I am going to definitely look into a good pair of slippers. I'll probably go to walmart. I was thinking of getting a pair of toms so may just use those. My friend used birkenstocks. Unfortunately renting a bed isn't an option since my mom and I live in a condo and it's not big enough to have a bed somewhere else. There also crazy expensive to rent. I bought a maternity pillow for comfort and sleeping so that I stop sleeping on my stomach now than trying to stop after surgery. My mom also has the handles for the side of the toilet to help get up and we may get rails for the shower. I'll have a walker since I already have a walker and wheelchair ordered since I can't walk much anymore and I'm still waiting on surgery. I know walking is necessary in small baby steps but my doctor doesn't know how much nerve damage will be fixed and I know I won't be able to really go out shopping and such after surgery and walk around a grocery store so for those type of outtings the wheelchair will be my go to. 

    My surgery is supposed to be in September but it's already been pushed once because of vacations. Hoping I can still get an early september date! 

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