August 18, 2016 – I had a microdiscectomy laminectomy on my L4-L5 lumbar disc to relive chronic pain and some muscle weakness. This is an overview and chronicle of my recovery.
May 1st, 2013 I had urgent lumbar laminectomy surgery to repair a herniated disc at my L5-S1.
August 18th, 2016 I had a more planned surgery on my L4-L5 after months of conservative treatment. Every case is different and I will chronicle my journey and my L4-L5 laminectomy surgery recovery here.
Time Log for my L4-L5 Laminectomy Surgery Recovery
- April 2016 – Lots of pain that was in many places and changed location a lot.
- Late April – Physical therapists thinks it is disc related
- Early May 2016 – After dealing with insurance bureaucracy, I get an MRI that shows an 8mm herniation at the L4–L5 level.
- May thru July 2016 – I tried a series of Epidural Steroid Injections. They take some time to kick in and they helped some. I was still in pain and I still could not do much of anything. I tried a total of three with some short term benefits each time, but they never got me back to being active.
- Early August – Preparations for the downtime. I ultimately over prepared this time, but it is smart to get business things in order and physical things reconfigured.
- August 18th – Day of operation. A surprisingly uneventful day. Everything went smooth and I had very little pain. Possibly the only catch is that it was worse than expected, so the “take it easy”part of recovery will be the full 6 weeks.
- First few days – very little pain and I feel good. Have even made it out to my kids hockey games. Short trips are nice to break the boredom.
- Week 1 – No pain and no activities. I managed a few field trips, but I’m bored. I can walk fine, but I’m not doing much.
- Week 2 – Still feeling good. Occasional tingles, but little pain that I can remember. I’m cleared to drive, so I have a little freedom, but driving isn’t super fun.
- Week 3 – First pain. I think most of the pain is fear about what I feel. The swelling is down a lot, but there is still tenderness. Rest and time quickly helped with the pain.
- Week 5 – Bad headaches. Related or just allergy season? After 3 days they improved.
- Week 6 – I just passed my six week marker and I feel good. I’ve had the brace on less recently, but I’m still being very careful until I talk to Dr. Bawa. I do have a funny lump around the incision. Some times it is very big, sometimes it goes away.
- Week 7 – I began some basic physical therapy and felt pretty good. Headaches started to come back.
- Week 8 – Headaches with nausea when standing are cause for alarm. A scheduled MRI turned into being admitted to the ER followed by surgery to repair the leak and bed rest.
- Week 9 – The rehabilitation from bed rest is underway and I feel better. The clock is reset on the incision recovery; no lifting and take it easy. My friend the back brace didn’t get much time to relax.
- Week 10 – I sprung a leak. High stress and we don’t know if it is spinal fluid or a seroma.
- Week 11 – Stitches on the incision and the leak stopped. I need to lay low for a while, more time in bed.
- Week 13 – Things look stable, so I’m trying to spend more time sitting up and walking. I get little headaches that make me worry, but I think I’m making progress.
- December 15th, 2016 – I started Physical Therapy at Pacific Water Therapy.
- January 30th, 2017 – Not sure what the relative time line is anymore. I think this was the “2 month” post-op visit. Bottom line is I’m feeling good and the doctor is happy.
- February 15th, 2017 – Good progress in actually doing some aerobic activities in the gym, but my scar started a bump that made me worried again.
- March 13th, 2017 – the bump is going down. I don’t know what caused it, there is still some fluid. Physical therapy has been pushing me which is stressing my knees. Back is holding up well.
- April 24th, 2017 – I had my final follow-up with Dr. Bawa. At this point, I’m pretty healed. I say that as I’m not younger and may have some periodic pain, but I’m good to go.
All blog Posts on Laminectomy Surgery Recovery
All of the posts for the laminectomy discetomy can be found here.
For general laminectomy back surgery thoughts about these items, please see the Lumbar Back Surgery page.
- Recovery Phases
- Background and Why
- Diagnosis and Process
- Laminectomy Surgery
- Laminectomy Surgery Recovery
This time recovery has been split into two phases; the initial recovery and the CSF Leak recovery.
The initial recovery was very smooth and with little pain. Right away I felt relief. I remained cautious with lifting and got plenty of rest. So, that part was easy.
I got the bad head aches though, so that wasn’t good. It turned out I had a cerebral spinal fluid leak that needed another surgery to patch. That basically reset the clock to zero on my recovery.
Background and Why
I wrote a longer blog post on the what and why, but it is good to restate some of it here.
This time around, I knew my L4-L5 had a bulge when I ruptured my L5-S1. So, I’ll call this a continuation.
Lead Up to the Herniation
I don’t know when it went. I can theorize about it thinking about times when I had a lot of pain. There are a lot of time over the 18 months prior that I couldn’t get my leg pain to resolve. It usually went away in a few days. The same with toe numbness in my left foot; on and off for a long period.
It definitely got worse over many months that included cross country flights and probably some bad desk form. It came to a tipping point after a long 105 mile ride in horrible weather.
So, I asked for some physical therapy and the therapist once again said I have disc like symptoms. That got me in to see the doctor and begin the process for the MRI.
Diagnosis and Process
My physical therapist first said I had disc like symptoms. One of those is feeling like I had a tight hamstring. This was bad in the weeks going into the Gran Fondo ride, so I know it was there for a while.
Ultimately, the MRI showed there was a problem.
Getting the MRI approved was a challenge. I’ve had a surgery already with scar tissue, so I needed contrast. My insurance denied that since they didn’t know why. The problem with that is they didn’t think they should tell us it was denied. So, after getting a run around, I got it scheduled.
I honestly didn’t think I had a herniation. I really didn’t want one. My last experience was bad with a long, long recovery.
Epidural Steroid Injections
ESI as they are known are in injection of Cortizone into your back. The goal is to reduce the swelling. Swelling after all (along with the disc bulge) is causing the pressure on the nerve. The question is how much is from swelling. Reducing the swelling can relax the back muscles and set you up for a therapy based recovery.
The first injection helped a bit for a few days. Since there was some help, we scheduled two more.
I got some temporary help from each one. But not enough and the pain came back fast. I was also developing some foot drop in my left foot.
I’ve been there before. Or so I thought.
For back issues, there is a commonly accepted practice of physical therapy first, injections second and then surgery as a last resort. I followed that procession even though the MRI showed a big disc protrusion.
Last time it was miserable. But I came back ok over time. Last time, I had a lot of nerve damage and could barely walk. Aside from the miserable pain and fact I couldn’t do much, I went into this one from a better position.
There is an old saying that minor surgery is that which is performed on someone else. Dr. Bawa listed the normal risks; infection, bleeding, a leak in the spinal fluid and re-injuring during recovery while the disc is still weak.
I talked about the risks last time, so this time I wasn’t too worried. The risks didn’t change, but I knew them.
Cerebral Spinal Fluid (CSF) Leak is a painful risk in the 1-5% category. At 5 weeks, I had some headaches which registered as some of the worst I’ve ever had. They went away and came back at 7 weeks. Instead of getting better, things got worse.
An MRI confirmed fluid around the level of the surgery and I underwent a surgical process to repair it. My repairs included sutures and a blood based patch. 3 days of bed rest and I was able to sit up without a headache.
These fixes have a good history of working which is good because it is an additional surgery with bed rest. Best rest is mentally miserable and you need to physically rehabilitate your whole body.
This was truly a minimally invasive procedure. The first non-intrusive part was getting there. I took Uber. No need to wake my wife up at 4am to sit in a room for 5 hours. Who would watch the kids? The interesting thing about the ride was that it was the third time that driver had picked me up.
I knew the cast and the routine, so my stress level was low. I was mostly bored.
The coolest thing was the new gowns you wear. They can hook up your own heating system to them. It is pumped air, so you inflate like a marshmallow, but it is comfortable.
I chatted with the anesthesiologist and learned about an upcoming trip he was about to go on. As they were setting my up in the OR, the last thing I remember is telling him “Have a nice trip.” He responded, “You too.”
Initial Surgery Report
Dr. Bawa let my wife know that all went well, but it was bigger than expected. It was also going out the nerve root. He had to drill out a little more bone than expected. He also had to tug on the nerve a lot more to get all the disc fragments out.
He was concerned on two levels. First, he is worried I might get some new pain from having to move the nerve around. Second, as it was bigger, he wants me to take it really easy.
Laminectomy Surgery Recovery
Fitting with “they are all different”, this one is not like the last one.
At two weeks, I’m bored. No Pain and I feel a lot better. I feel like a kid that got an ice cream and I can only look at it.
So far (2 weeks) I going through a completely different pain profile than last time. Last time, I had a lot of pain.
One key in the early days was to “stay ahead of the pain.” That means take the pain meds on time. There is a lot to not like about pain meds, but even less to like about the pain. This time, I started out on schedule. Toward the time I should be taking the pain medication, I wasn’t feeling any pain. For the first two days I took it on time.
I took some before bed the second night.
The next day in the late afternoon I realized I forgot to take the medication. I had no pain, so I stopped taking it. I did take another half pill before bed, but I probably didn’t need it.
So far, there has been very little pain.
Very little numbness this time around. I do have some odd tingles.
Sleeping was super hard last time. Maybe without the nerve damage, I was just in better shape. Getting in and out of bed was easy and mostly pain free.
The hardest part of sleeping the first few nights was from the pain meds and the associated crazy dreams.
Since I’m not really recovering from the surgery, progress will start when I can try to live life again. I need to let it all heal first.
It has now been many months since the whole ordeal with the CSF leak and subsequent second healing phase. Physical therapy in the pool was good.
Toward the end of the initial 6 weeks post-op, I started on some basic core work in the pool. After about 6 weeks of that, I was doing more dynamic core work; jumping in shallow end and other movements. The irony is that my old knee issues have flared up, so I’m trying to ramp up my activities without hurting my knees more.