Excessive weight gain, causing severe depression after spinal fusion

@darla77 I do really think the gut issue is overlooked by spine surgeons because they tend to the surgery and consider management of surgical recovery symptoms to not be of their concern but it should be.
I had such awful blocked bowels that I needed an enema but the ER wouldn't administer one even though I had done everything else I was told to, I had to have my mother administer one which was humiliating because I couldn't reach my own behind to do it and the hospital was willing to let me suffer in pain and gut bloat for weeks.
The pain of having the blockage dislodge and finally evacuated was also excruciating surgically because I had a 4 level lumbar to sacrum fusion laminectomy with a cage and tons of inflammation. Was not happy with the saddists but finally recovered pain wise. But after my bowels were not working properly and I believe it was due to the long surgery itself making my gut inactive, there's a term I can't remember but your gut actually stops metabolizing food properly and that was just the beginning. I still try to eat very high fiber to keep it moving and as much walking/hiking activity my body will tolerate to combat it. I think some of us are more sensitive to the anesthesia and drugs used in this major surgical process and surgeons can be negligible to the health of the patient after clearing their handiwork of the actual surgery of liability.

Yes I also had excessive weight gain after my 4 level PLIF with what seemed like chronic inflammation and low grade fever for over a year. I had always been very active and before my back issue got bad I used to trail run 3-5 miles several times a week and had great muscle tone, never skinny but athletic build.
After surgery my body shape changed drastically, I had trouble breathing whole walking due to the feeling that my diaphragm was jutting forward and my abdomen grew 3 pants sizes. It is ridiculous! And not to mention very counterintuitive to the whole purpose of stabilizing my spine in the first place. My core became weaker as I wasn't given PT for 6 months while growing in girth the whole time due to lack of activity for fear of aggravating terrible nerve pain in my sacroiliac region. It has been the hardest physical obstacle I've dealt with in my entire life and I still feel about 7 months pregnant everyday with no hope of shedding this pain baby. I refuse to be broken so I keep trying to research for myself as most surgeons are not willing to help after the failed surgery around my area. I do believe it has to do with immobilized gut health and hormonal backlash of the trauma that is spinal fusion, don't give up on yourself even if the doctors are immoral saddists to your woes. We must keep self advocating and know this is not your fault and you deserve to feel and get better. Best to you and don't give up on you, you're worth it!

WOW!!
I have been on the osteoporosis forum for a while, getting opinions and advice to treat my osteoporosis. Now that my Tymlos treatment is just about complete, I'm looking at spine surgery and will meet with a neurosurgeon next month.
I have never heard of the depression, constipation and weight gain. Does it eventually go away? I have had a problem with constipation at times. Now I take a stool softener morning and night. I also take a digestive probiotic before bed with Greek Yogurt. I have to force myself to remember to drink more water but have found that filling a water bottle every morning and leaving it on the counter, reminds me to drink it.
I don't know much about depression, but I do make sure to get outside everyday, let the sun warm me and the fresh air energize me. I have not heard anyone mention exercise for the weight gain. I normally walk at least five miles a day at our park.
Not only does it strengthen your bones, but helps move your bowels and maintain a healthy weight.
I understand exercise is probably difficult immediately after surgery, but within a few months? I suppose these are issues to add to my list of questions for the neurosurgeon....Nothing is easy....

You are going to need to calm down, have patience, and become your own doctor in order to heal yourself. I can tell you that surgeries and healing from them cause major challenge. The surgeon who did your fusion doesn’t want to deal with the other stuff. He wants to deal with your surgery and send you to another doctor to deal with your other stuff. And that’s the way it should be because the surgeon is focusing on your fusion. He is not focusing on the IBS you may have acquired from the surgery. For that you should go to a gastroenterologist. For me it was like I fell off a cliff. Six months after fusion I had really bad IBS and I went to TWO gastroenterologist. They ran all kinds of tests and then they dismissed me. Fortunately for me, I found the FODMAP diet And that helped me resolve the IBS. I also developed SIBO and that required a targeted antibiotic called xifaxin. Been seven years since my surgery and the IBS and Cibo are very well managed. I don’t know how the surgery interface is with the IBS but it does for some of us and it’s impossible to expect the spine surgeon to deal with your gut issue successfully. So just realize that you have these new conditions and that you have to deal with them. It also may be coincidental that they show up For us after we have these major surgeries as a part of having a new normal.
I had to increase my exercise to keep my weight in check and allow my body to continue to heal, but it wasn’t enough. I ended up developing insulin and resistance, and that added a bunch of weight I wasn’t happy about. When my A1c was detected as borderline, I demanded some medication called metformin and miraculously after seven years of gaining weight, I am now losing weight and a lot happier with my waistline. I did such a great job of keeping my insulin resistance and check that the doctors didn’t see it. But now they can see it and now controlling with food isn’t enough. I need medication. The constipation was part of a post surgery reaction. Many people go through that and there are definitely ways to resolve that. I am almost 69 and after the many surgeries I’ve experienced starting with my cesarean at 31 I’ve gotten major bouts of constipation. I just accept it and have to wait a few months till I can get things back to normal. Make sure you are drinking a sufficient amount of fluids And make sure you are putting some fiber in your diet and make sure you are not eating constipating foods like cheeses too much. I definitely see how my body ages after my major surgeries, but I am extremely happy with all the surgeries I’ve had because I get my life back. Part of getting my life back is adapting to the new body, I have as in ages. It’s all in your attitude and how you adapt to these challenges. I suggest you have a bucket list for when you don’t feel well like books and movies, warm and cozy socks, and a way to make yourself happy in the meantime while you are on your search.. I suggest you find some good support groups or some good friends to help you through the bumps. I also suggest if you can’t talk to your doctor, you talk to your doctor assistance or nursing staff and ask them for referrals to other doctors and other management groups to help you through. Making yourself well again is like a job that you do for yourself and the reward is that you feel better after you’ve done all the work to determine what the answers need to be on your path to good health. If you have an expectation that someone ELSE is supposed to make you feel better. You are going to be disappointed over the long haul. It is up to you to advocate for yourself. I can tell you that for sure having been in the medical system for 15 years, always having to advocate for myself. It was quite a wake up call to realize that a single doctor can’t fix us and that we have to go from doctor to doctor and idea to idea and keep plugging away at our own wellness. I wish you luck in your journey!

@gowalking I think you are doing the right things in managing your GI system. Keep doing those things. Anesthesia and pain drugs do slow down the gut and contribute to constipation. If you eat sparsely before going in for spine surgery, it will be easier because there will be less bulk in you.

I had nausea from the anesthesia, and the doctors do have a patch they can put behind your ear to prevent that. I did not take any pain drugs after leaving the hospital after a cervical spine fusion, so with only one day of drugs, I had constipation that I was able to get under control in a week. They advise you to take stool softeners and use fiber.

Another reason for constipation may be a physical issue if your pelvis changes alignment. I know that my left illium ("hip" bone) will come forward sometimes due to muscle tightness pulling on it. This causes constipation sometimes (because the descending colon is right inside that left hip bone), and getting it straightened out with stretches or working with a physical therapist is helpful. If you have issues that change your pelvis alignment, that would be something to ask about for PT after surgery.

I didn't go through depression. I had a positive attitude and that helps a lot during recovery. There will be changes in your ability to move and that is a tradeoff for the problem you are facing, and it is something you have to accept when you make this decision. You need to get onboard and want to do this. Remember it is your choice, no one is forcing you to do this. You need to accept there will be pain, and that pain is lessened by not being upset that there is pain. Being upset will escalate pain a lot. That is normal healing. I found I could manage fine without pain drugs. After surgery, it is healing and and that's a good thing.

What you say to yourself now is very important, if you believe it will be depressing and difficult, it will be. If you believe you are doing this as a gift to yourself, and that you will have a good outcome, that is possible. You affect your ability to heal better by believing that you can do this. It wasn't as bad as I thought it would be. Breaking my ankle was far more painful and for a much longer period of time. If you get outside and walk during your recovery, you will get more oxygen in your bones for helping healing and it will lift your spirits. Remember, even baby steps are progress!

Thank you for your encouragement. I have a very high pain threshold. I am very leary of narcotics and have only ever taken them sparingly. I am hoping I will not need them. The most I ever take now is Tylenol and that is only when I know I have overdone it that day. I don't have a lot of "pain". I have a lot of discomfort....sitting in the car too long, wearing a bra with a back closure, putting shirts on and off over my head, getting down on the floor, sleeping in a bed, standing at the kitchen sink or stove too long, etc...
We eat healthy, (carrot cake...lol). Seriously, we don't eat meat every day, we eat a lot of fresh salads, vegetables, fish, eggs, chicken. I don't care too much for milk so I do take vitamin D every day and a weekly Vitamin D prescription supplement. I eat cheeses and yogurt. We eat a lot of high fiber lentils and root vegetables. I do need to focus on drinking more water though.

I am going into this with a positive attitude. I have a wonderful husband who takes amazing care of me, our oldest son is close by and helps us a lot.
We have a niece who owns two care homes and has said she will help...shes the most compassionate person I know, another niece is an ER nurse and said she will help, another niece said she will cook for us, there are neighbors and friends who we know we can count on. In that respect, we are very blessed and I have promised to be a good patient. They have guaranteed me they do know how to be "NURSE RATCHET" when necessary...YIKES!!

I know the outcome will be positive and I am working on preparing for it..if the surgeon says surgery is in order. We have not told many people that I plan to do this...why do some people feel it's necessary to tell you horror stories about their experience or "I know someone who had that and this happened". Inconsiderate, if you ask me. It's scary enough without negative input.
I see a new PCP on Thursday and I have a list for her. Then I meet a neurosurgeon the first week in February and we have a list for him. I will keep you posted.

Are you on gabapentin or muscle relaxers? I gained 20 pounds inn6 months on that combination. After decreasing gradually and One year later I’m back to. Better weight and no boating.