What can we expect as far as recovery for my Mom's spinal surgery?

I had similar surgery 3 weeks ago. I have stairs so bought a small microwave and small fridge to be in sane floor - very nice! I advise a shower chair and a roll of press ‘n’ seal (like Saran Wrap) since you will need to avoid getting the dressing wet. At the last minute I needed to switch to our guest room bed because ours is too high to sit on, then log roll into a lying position (a maneuver that avoids bending). Smart change. You might check out the bed heights involved. Also a thermal carafe for ice water. You are not allowed to twist but getting things off a nightstand require twisting! I bought a shoebox sized plastic box and kept all my nighttime needs in it next to me on the bed. Meds, notebook to record meds, tissues, chapstick, eye drops, glasses holder, book to read. So helpful to just reach out and it’s there. Finally, same issue with turning on a bedside lamp. Buy a couple of remote switches to keep in the clear box or to tape to the side of the box. One press and your bedside lamp comes on to light the way to the next light switch. Buy some lumbar ice packs with waist strap. Liberal use of ice per Dr directions can get your mom off heavy meds days early. That mini fridge I mentioned has a little ice cube holder that keeps these nice and cold. Buy nightgowns, low cut panties, and housecoats. I could not handle a waistband over my stitches until the third week; lived in nightgowns! I bet she does great! One more thing: bolster size pillows fir the drive and to prop up knees in bed (takes stress off lower back). Amazon has velour covers for 20” decorator pillow inserts—the combo is fabulous!!

@juliedyan Hello and welcome to Connect. Hopefully some other back surgery members who are older will share their experiences too.

I am a spine surgery patient which for me was a cervical surgery with a fusion of C5/C6, and I have been a caregiver to my elderly disabled parents going through surgeries. The recovery from a lumbar spine surgery is more difficult than cervical because that area bears most of the body weight. Recovery might be 6 months or more for lumbar fusions as patients have talked about here, and of course age and health conditions other than spine issues also play a part in how well someone recovers. My 80 year old cousin had a lumbar laminectomy and he recovered from that fairly quickly and really only had pain for about 2 weeks and then stopped taking pain medication, and after a month, he felt good and was up and around and going out. Adding a fusion to that is more invasive and will likely have a longer recovery.

Especially after spine surgery, you have to do everything you can to minimize the risk of falling, so remove area rugs and anything that could be a tripping hazard. Some patients have trouble with the height of the toilet, and you may need a riser on the toilet. Have her use a walker for stability. When you mentioned a step stool for getting into a car, I would ask if this is necessary because that could be a source of instability or tripping and cause a fall. Your mom will not be able to bend or twist at all or lift anything. Having elastic laces in her shoes will make them slip ons because she will not be able to look at them or reach down to tie them and she needs shoes with good walking support. She may not be able to navigate stairs well. Will she be able to stay on a single floor and have bathroom and shower access?

As far as driving goes, the day after my surgery, I was OK as a passenger for a 5 hour drive home from Mayo. I had to get out of the car every 2 hours to walk so as not to risk blood clots. That will be a risk for your mom too. She may be able to have home health come in to monitor her and help her get up and walk. That would be something to ask the doctor. They can teach you how to help support her for fall prevention. Usually they use a gait belt placed around her body that they can hold to break a fall, but after spine surgery, I don't know if that it can be used. She needs clothes that are loose and easy to get in and out of. She may need assistance in the bathroom. Do you have a bench for the shower so she can sit down while bathing? Surgery and recovery is exhausting, and falling in the shower is a risk. Your body is using all it's energy toward healing. I slept a lot for months.

There are hand rails that attach to beds, and my mom actually has a floor to ceiling pole with hand grabs to get in and out of bed. The height of the bed may be important because sometimes older people don't have the leg strength to navigate. My mom had my brother lower her bed. Medicare may cover a rental of a hospital bed that goes up and down, and also folds like a recliner. That is a question for her primary care physician, I imagine. I don't know if incontinence is an issue, but it will take a long time to navigate to the bathroom and it may not be enough time. Talk to your mom about it, but wearing Depends may help if this is a difficulty. I found out how hard it was to navigate with a disability when I broke my ankle, and getting to the bathroom in time was a real challenge, when I was hobbling with a walker or crutches and in a lot of pain.

Pain medicines and anesthesia also cause extreme constipation and can cause nausea. Changes through diet, medications, and added fiber to counteract constipation can help. I didn't take pain medication after my spine surgery because of the nausea and constipation, and I was having breathing issues with my asthma. I was able to tolerate my pain levels after cervical surgery fine without drugs, but after my broken ankle a couple years later, I had to take pain meds and just be a zombie on the couch. I found a half dose was better for me as far as nausea. The broken ankle was much more painful than my spine surgery and over a longer period of time.

You may want to have an honest conversation with your mom now about what her abilities are, but keep in mind, sometimes parents think they can do everything and don't admit what their disabilities are. I had to be a caregiver to my parents because they wouldn't admit they needed help, and they could not live on their own. I hope your mom is able to come through surgery and be able to walk well afterward. The recovery will be in months, not weeks, so also discuss with your sisters about how you will handle this if it is much longer than expected. That can turn your life upside down and it can be hard to find a way out until your mom can be on her own again. Care giving is exhausting for you too. It is good that you have sisters willing to help, and you don't really know how hard it is until you're feeling swamped. An evaluation with a physical therapist or with her primary care physician may help answer some concerns after about her after surgery care, and expected progress in recovery. Some spine surgery patients go into a rehab facility for a few weeks before being discharged home, and at the hospital, the staff will work to make sure your mom can safely navigate. I hope your mom will do well. My parents were both disabled enough to need wheelchairs, and my dad was at end stage heart disease and did not have the strength to get out of bed on his own. At that time, I needed spine surgery myself and I was using a Hoyer lift for my dad. As a caregiver, you also need to make sure that you don't physically injure yourself in being a caregiver to your mom if she needs a lot of physical assistance. The nurses and physical therapists and aids, can all instruct you on best ways to help without injuring yourself. Your mom also may get depressed during recovery.

I hope this gives you a sense of what questions to ask of her providers. She's lucky to have a team of loving daughters ready and willing to help. I did that too for my folks. I'm sure you will feel good about making the effort. Does this raise more questions in your mind?

@roma76 Those are some great suggestions. Would you be willing to share a bit more? How is your recovery going for you? What is your timeline like for rehab therapy, and when do you expect to follow up with your surgeon? It sounds like you have all of this figured out. How are your pain levels at 3 weeks post op? When do you expect to return to your normal activities?

Keep up the good work!
Jennifer

Thank you so much for taking the time to give us all of this information. I really do appreciate it. We have really been facing reality this weekend on what is to come!

Mom is now interested (after talking with some friends) in going to a rehabilitation hospital directly after surgery. Just until we know she is well enough to come home and we can handle it all. She lives in a maintenance free condo and does not have to use stairs. She has a recliner. Her bath tub/shower combo is absolutely terrible (especially considering the fact that they built these units for retirees)! It is very very high to step into and this is going to be a problem. I have never seen a bath tub that is this high! I don't know what the solution is going to be for that - she has a walk in shower in the basement portion but it sounds like the stairs will be impossible for her to go down!

At 78 I would say she looks young but this all stems from her getting hit by a man on a mountain bike when she was walking on a sidewalk. It also shattered her shoulder which she had to have replaced about 16 months ago and she still has pain from that.

I am getting worried. Also, I wonder what the process is for her going into a rehabilitation hospital. Who decides? If she wants to go, does she have to "fight" to get it? There is a really nice one where she lives and she is very interested in going now. Of course we would still be there for support. Do they decide at discharge or do you happen to know the process?

We also have a lot of things to buy this week. Nightgowns, slip on shoes, toilet necessities, etc.

I am also concerned about her mental health. We lost Dad unexpectedly 11 years ago (widow maker heart attack). He was only 68. She does deal with depression and since her accident it has gotten worse.

So many worries! I live 3 states away, one sister is a teacher and the other one is a marketing manager and has a very demanding job. A lot of it will fall on me (I am a homemaker) but it will be difficult living so far away (It is a 12-13 hour drive). Of course my husband is very understanding and I will do what I need to do. I have a granddaughter that I babysit quite a bit also.

We also found out that tomorrow (Monday) is her phone call with her surgeons office to get more info. I wonder how the rehabilitation hospital conversation will go!

One step at a time. I am writing down all of your ideas. Thank you again for your time.

Hello - this post was regarding our mother and what recovery will look like. Her surgery is a week from Wednesday (August 23).

Thank you so much for all of these ideas. I am making a list and this helps a lot! I especially love the plastic box that would stay next to her in bed. So many things to think about and I am taking notes!

@juliedyan I am sorry your mom is going through all of this. Her shoulder might be an issue if she has to use her arms to help support her body weight, and using a walker or cane will involve that. She may not have the strength for that and already has shoulder pain. I'm guessing she does not walk well from the spine condition and need for surgery. She may need something like a scooter to sit on and propel herself with her legs or a wheelchair. I suggest discussing his with her primary care doctor and surgeon. Rolators are not the best because they can roll away from you if you're off balance causing a fall. They have hand brakes. I did use one while sitting and propel myself backward carefully on it with my ankle fracture. They can also be a bit top heavy, and if you hit a bump in pavement, they can tip over.

My folks were on traditional Medicare with a supplement insurance plan. If that describes your mom, I suggest call Medicare or log into her Medicare account online and see what the rules are regarding a rehab stay after a hospitalization. It depends on how many days the hospital keeps her as a patient for qualification on her release and how many rehab days had been used within a certain time period. Medicare pays for a set number of days of a rehab stay. Also call the rehab center she is interested in. Availability of care changes and there could be a wait list. They deal with Medicare and will understand the parameters on getting approval. Rehab is really expensive and it might be out of reach if your have to pay out of pocket. Then that will suddenly leave you to try to manage and be a live in caregiver if everything falls apart. Discuss this with all the doctors too. The hospital has social workers who arrange discharge to a rehab center. They also evaluate her ability to function in daily living, for example, I broke my ankle and there were occupational therapy people at the hospital working with me to get me to be able to go up and down stairs. Before I was discharged, I needed to show them I could navigate with one leg because I had stairs at home. I was in the hospital an extra day because I had to figure out how to use my weight on my arms to do this while hopping on one leg and dangling my painful leg .

If your mom's surgery is being paid by a different insurance or if this is a legal case, you'll need to get advice from the insurance or legal counsel. Be proactive and make the call. I think this will be difficult to do from a distance. You may need to do a 3 way conference call because your mom has to give her permission so they can talk to you about her medical issues because of HIPPA laws. Have your mom sign permission for that with every doctor and insurance she has. Your mom may not remember what the surgeon says to her and probably needs you on that call. She is probably stressed and it is scary to have to go through spine surgery. I was anxious for a long time and had to work my way through it. Right now, she might think she is handling things, but if she doesn't remember instructions it will cause more tress. The stress she is under will affect if she understands and remembers things.

For the bath tub height, there are longer shower benches that can span from inside a tub and outside to the bathroom floor. Your mom could then sit down and then have to scoot over and pick her legs up over the side and scoot over the tub. That depends on her capabilities and that may be too much right after spine surgery. It's possible that her condo would not be the best place for her after this surgery. She may need a wheelchair at some point and being able to roll into a shower is much easier. My mom uses a wheelchair and has a shower chair inside of a large shower that has grab rails around. She transfers from the wheelchair to the shower chair by standing up and pivoting. There will probably be evaluations by physical therapists or home health along the way. Anything with insurance or Medicare payments must come from careful documentation. If you look at handicap accessible hotel rooms, the shower is just behind a curtain with no barrier on the floor and has a shower bench, grab rails, and a hand held sprayer. I stayed in rooms like that during my ankle surgery which was at Mayo.

I can see how all of this may be very overwhelming for her and she really needs to know that the disability problems can be overcome. Loosing independence is very hard. My dad was depressed about the Hoyer lift, and I had to tell him it was for me because with my spine condition, I was too weak to be able to assist him on my own. Your mom will need reassurance. She should be involved in all the choices and decision making. At some point, the distance of her living arrangement may not work if she needs family assistance. She may need to move closer to family and that would be easier for everyone. All of this affects the entire family when you are absent in order to help your mom.

Another note about hiring caregivers is that there is a difference in what the job expectation is. Caregivers don't assist with physical problems like a CNA at a nursing home does. It costs a lot more to hire a worker who has to physically assist or help lift a patient. It is very easy to get hurt doing that, and there are specific ways to do things to minimize risk. You have to make sure you don't exceed your physical capabilities if your mom can't stand from a seated position or get in and out of bed by herself. There is a lot to think about as she goes through this. You don't have to solve it all at once, but as you go, you'll figure out what to do. As you move into a caregiver role with your mom, it can also be very rewarding, and your bond can become closer. I had that with my dad, and we had more time to talk and he told me how grateful he was for my help.

To expand a bit (and I am finding context is everything): I am 76 and formerly very active with walking up hills, 3-4 times per week Pilates classes, foam rolling/stretching every night. I had 3 bouts of radiculopathy of one or both legs over the past 2 years; each worse and more persistent. MRI showed scoliosis, degeneration of L4 and L5, hypertrophied ligament um flavin at that level, and essentially no normal disc. Spinal cord and nerve roots are citing that level showed no space at all. Severe arthritis of facet joints. All explained why I could only walk while flexing my lumbar spine (the shopping cart gait). For the first six months of this year I went from walking pretty well and doing a half hour daily of rehab exercises (after a steroid injection) to my shopping cart gait to a point in June where I had no “safety” position to get some pain relief. The right leg pain was extensive and breath taking in severity. I went back to my physiatrist to check on a possible second shot. He suggested exploring options with a surgeon which I promptly did. My husband and I spent 90 minutes with the Spine Center’s surgical team and, later, almost 5 hours pre-op with nurses, pAs and surgical fellow who would be doing the fusion with bone graft. Surgery was July 18. July 19 I was out of bed and walking with only a lower backache. No leg pain!! July 20 I had CT, Xrays, and passed the stair climbing test. Went home at noon and went slowly and carefully up 2 flights of stairs to our guest room. I had my 3 week follow-up Aug 11. Pain score zero, only Tylenol at night since day 10 (I used oxycodone freely at night before that to assure sleep). My docs do not prescribe rehab except for walking ( they want 30 minutes a day by week 3). Why have I been so fortunate in having such a fast recovery? 1) I was a highly selected patient for the procedure having only radiculopathy and little or no back pain. 2) 6 years of Pilates and an active lifestyle before that have given me very good hip flexibility and body awareness so that I could /can lift my feet to my waist to dress and bend from the hip (to get out of bed or chair). 3). I was on a large dose of Gabapentin (tapering off now) and pain meds work for me (I guess they don’t for everyone). 4) I had a total shoulder replacement on Nov 2021. My surgeon and his PA both said “if you made it through that, this surgery has a far less painful recovery and you will find it easier.” So my expectations were maybe in a good place. Here are some things I sort of expected but was not fully prepared for: 1) the fatigue level. I complained Friday at my follow up and they explained this is major surgery and it is normal. Don’t fight it but expect it will end. 2) the prolonged anorexia and flu-like feeling. I didn’t enjoy any meal until the 3 week mark. 3) How thirsty I would be; 4) the anxiety especially the first week due, in part, to the following 5) nerve impulses down both legs for several days, 6) how stiff and sore the front of my body was for over a week. This was due to going from weeks of bent over posture to being flattened prone for more than 5 hours of surgery and surgical prep (placing electrodes all over me and positioning CT scanner). I felt like I had been running hurdles! Heat helped. The surgical team executed a ballet of finely tuned maneuvers. I attribute my low pain to their skill and attention to detail. Sometime between 3 months and six months I will be cleared for any reasonable activity I wish. I enjoyed the 30-minute core strengthening regimen I followed after my injection and will slowly return to parts of that, then all of it as my graft fills in. Of interest, my surgeons do not recommend physical therapy for me. I guess they concur with my plan. This forum was very helpful to me and I hope some of my hacks for post-op life will be helpful to others. My final recommendation is to do everything to avoid falling. Knowing and respecting limitations are key. I am pretty mobile again but still take hold of handrails and pay attention to where I place my feet. I will never again take for granted the blessing and freedom of pain-free walking.

@juliedyan I wanted to share a few links so you can see a pole like my mom's pole next to her bed. It is like this. https://stander.com/product/1100-security-pole-curve-grab-bar/

I also found this link about choosing transfer poles.
https://elderwise.com/home-modifications/the-best-transfer-poles-for-the-elderly-and-disabled/
This link shows other handrails for a bed. https://stander.com/product-category/bedroom/

This article had some tips for helping seniors stay happy.
https://elderwise.com/health-lifestyle/tips-for-helping-an-elderly-loved-one-stay-mobile-and-happy/
I bought the transfer pole for my mom used and you may be able to find things at a medical supply place or resale shop. If you contact the county where she lives, they probably have a center for aging that can give you resources on where to find things. Sometimes, they have equipment that can be lent out to seniors.

I also saw this link as an idea on what to do about a tub as a conversion by cutting down a tub wall instead of removing the tub. I don't know if that is a good idea or not. Certainly remodeling could remove a tub and create an accessible shower but at a much greater expense. https://reliablemobility.com/pages/bathrooms

The hospital social workers and rehab people will also be able to recommend things to help with accessibility. I hope your mom does well. It is good to know about these things that can help, and you can decide if you need them when you find out how well she recovers. It would be nice if she did not need assistive devices, but degrees of disability can come as a surprise, and you don't know what you are getting into until you get there. Not being able to walk well also affects strength and physical fitness.

I hope all this helps. Do you have other concerns? Do you have questions ready to ask the surgeon and her primary care doctor?

Jennifer

I’m the 76 year old with the plastic box on the bed idea. Definitely ask about rehab stay in your phone call tomorrow. The hospital (at least in Washington state) will not release her until she has a safe plan for where she goes and how she gets care. If you wait until post-op it may prolong her hospital stay. High bathtub sill: can she sit in it and swivel, with help, to place her feet firmly in the shower area? I still use a shower chair at nearly 4 weeks. Depression: be prepared for periodic oceans if tears. This hit me hard one week after shoulder replacement. Thought I’d lost my mind until my daughter in law (a doctor) advised it was due to all the immune chemicals working on healing and is both temporary and normal. These same chemicals give you the flu-like feelings of fatigue, achiness and headache. Riding in the car: I have had a very easy recovery but the half hour drive home was exhausting. If it was as long as your mother requires, I would have opted for close rehab facility. You need lots of care in the first days out of hospital. My kids rotated being with me all day for over a week so my husband could take on night duty. For several days I had someone at the ready for my bathroom trips until I built up steadiness and confidence. I used a walker to the bathroom in the hospital then abandoned it as something of a nuisance but it’s great for steady walking and to give the hips/legs an assist getting on and off the toilet. Again, a rehab bathroom will have room for a walker. Nighttime help is wonderful for 1) recording meds - very important, 2) helping position in bed as hip hung up your hips to shift is very painful 3) packing pillows in to hold a fresh ice pack to the back. 4) safety. A fall can undo some very delicate work! Did your mom have a cold or ice machine for her shoulder? That surgery was so painful I finally bought one. With a flat pad attached it works great for the back and you can set it to go on and off every 20 minutes, or whatever time you want. We had mine all set to go for the back surgery but didn’t need it. I hope your mom finds as I did that the back surgery is a cake walk compared with shoulder!