What Can I Expect When I Get Home?
Most people who have spine surgery experience good to excellent results. They get significant relief of pain and the return of functional movement and strength. You should be able to sit, walk, eat, void, and perform other activities of daily life by the time you leave the hospital.
After spine surgery, people often report feeling better soon after they awake from the surgery. Although you may see and feel immediate benefits, you will get the maximum benefits of surgery by participating in a comprehensive rehabilitation program. The sooner you become active, the sooner you will get back to your normal routine. At the same time, remember to protect your healing back. Increase your activity level at a slow but steady pace.
Prepare Your Home for Your Return
If your movement is limited during recovery, ask a family member or friend to help prepare your home for your return by removing hazards that could cause you to trip, slip, or fall. One place in particular to prepare for your return home from the hospital is your bathroom. The tips below will help make your bathroom safer and more comfortable while you heal. Keep in mind that some of the equipment listed will need to be ordered so it is ready for when you get home.
Bathroom Safety Tips
- Prevent slips and falls by using non-slip surfaces in your bathroom
- Consider putting in grab bars and railings for support
- Watch out for hazards, such as wet floors
- Talk with your occupational therapist if you need more instructions in using bath aids
- Install a hand-held shower hose
- Use a long-handled sponge to wash hard-to-reach areas
- Use a non-slip bath mat to help keep the floor dry
- Use grab bars in your shower or tub for support as you get in and out
- Sit on a bath bench or shower chair while you bathe
- If you had surgery that limits bending, use a commode chair or elevated toilet seat to raise the height of your toilet
Things You Can Do At Home to Help Yourself Get Better
When you are leaving the hospital, your doctor or PT may recommend some or all of the following to help you get better at home:
Ice and Heat: Cold treatments are usually recommended in the first few days after surgery. Ice makes blood vessels vasoconstrict (vase-oh-con-strict) (get smaller), decreasing the blood flow. This helps control inflammation, muscle spasm, and pain. Heat may also be recommended. Heat makes blood vessels vasodilate (vase-oh-dye-late) (get larger), increasing the blood flow. This helps flush away chemicals that cause pain. It also helps bring in healing nutrients and oxygen.
Relaxation: Pain after spine surgery can be physically and emotionally draining. Relaxation exercises can help you control pain and the stress that comes with it. You may be given instructions for breathing exercises to help air reach even deeper into your lungs. You may also be instructed to slow your breathing to a more relaxed pace. Slower breathing can help muscles relax, while bringing much needed oxygen to sore tissues.
Rest: Giving your body a chance to rest can help ease soreness after surgery, giving your spine time to heal. Follow your doctor’s instructions for using any prescribed supports or braces.
Positioning: Your PT may suggest ways to position your spine for the greater comfort. These positions may include the use of pillows or towels to support your spine and help take pressure of the surgical area.
Movement: Careful movements suggested by your PT can safely ease pain by providing nutrition and lubrication in the areas close to the surgical area. Movement of joints and muscles also signals the nervous system to block incoming pain. Using safe body movements can help you avoid extra strain on your spine in the weeks after your spine surgery.
Lying in Bed: Avoid lying in positions that twist or angle your spine. Do not curl up in the “fetal” position. Choose a firm mattress. Do not lay on a soft bed or sofa. Keep enough pillows nearby to support your head, shoulders, trunk, and legs.
Moving in Bed: When getting in or out of bed, use the “log roll” technique. To get out of bed, roll onto your side and sit up while keeping your spine steady and secure. Instead of twisting your upper body when you roll to one side, try to roll your whole body as a unit, like rolling a log. Then let your legs ease off the edge of the bed toward the floor as you push yourself up into a sitting position. This reduces strain from twisting your spine and gives the surgical area time to heal. To get into bed, do just the opposite: sit first with your legs hanging off the side of bed, then lie on your side and roll like a log onto your back.
Sitting: Keep your spine upright and supported when sitting. A safe, upright posture reduces strain on your spine. Choose a chair that supports your spine. Avoid soft couches or chairs. Place a cushion or pillow behind your back while driving or riding in a car. When standing up, keep your spine aligned by leaning forward at the hips.
Bending: Your doctor or PT may tell you not to bend for a few weeks after spine surgery. Always follow your doctor’s instructions. If and when you are given the okay to bend, do so safely. Keep your back straight and secure as you bend forward, making sure your spine is straight. Consider using a “grabber” to avoid bending over at the waist to put on socks or shoes, and to pick up items from the floor.
Lifting: Your doctor may tell you not to lift or carry anything for a period of time after surgery. Do not test your back by trying to lift or carry anything until your doctor says it is okay. If you must pick up or carry lighter items, squat down by bending your knees. Do not lean forward by bending your spine forward. Keep the item close to your body, even if it is light. Holding the weight out in front of you puts extra strain on your spine. Check with your doctor or PT if you have any questions about the safety of lifting or carrying.
Outpatient Therapy: Your doctor may prescribe outpatient rehabilitation once your condition has begun to stabilize. Your recovery from spine surgery can be improved by learning new ways to strengthen your spine and prevent future problems. Your PT will teach you ways to help reduce your pain now, and help you develop new habits to keep your spine healthy.
Post-operative Follow-up: Your doctor will instruct you on when you should go to his office for a post-operative follow-up appointment. This typically ranges between 1 week and 2 weeks after surgery. At the post-operative follow-up appointment, your doctor will like to find out if the symptoms that made you decide on having surgery has improved. He will examine you, and take a look at your incision(s). If you have staples or stitches they will be removed and steri-strip tapes (butterfly stitches) will be applied over your incision. These tend to fall off on their own after about 7 days or so, and they are used to decrease tension over the skin edges while your incision continues to heal.
Incision Care: If you stayed in the hospital for more than 48 hours, chances are your bandage would have been removed or changed in the hospital. If you still have your original operative dressing by the time you are sent home (typically for smaller spine surgeries), you should remove your dressing 72 hours after surgery – unless your Surgeon tells you otherwise. If you have steri-strips (butterfly stitches) over your incision, you do not have to take those off. They will tend to peel off on their own in about 7 days. If you have steri-strips, that indicates that your stitches are dissolvable and are buried beneath your skin.
You may shower ONLY after your bandage is removed. Avoid bathtubs, swimming pools, hot tubs, or any other stagnant water environment until after your first post-operative office visit with you Surgeon. You should not soak your incision in water for 14 days.
If you have external stitches or staples, these can be removed in 7-14 days by your Surgeon during your first post-operative follow-up visit, or by a visiting nurse.
Check the incision twice daily for signs/symptoms of infections: green/yellow discharge, foul odor, increase in pain at the incision site, increased redness, opening of the incision, flu-like symptoms, temperature above 101.5 degrees. If you have any questions or concerns, call your Surgeon at 863-688-3030.
Post-Operative Medications:
Use your prescribed pain medication as directed. For the first 3 months after a spine FUSION surgery, do not use any anti-inflammatory medications such as Advil (Ibuprofen), Indocin, Naprosyn, Aleve, Feldene, Relafen, Celebrex, Mobic, Zipsor, etc. as they may inhibit spinal fusion.
Smoking after Spine Surgery:
Refrain from smoking following spine surgery, since it will delay your wound healing process, and increase your chances of developing a wound infection. Smoking can also inhibit spinal fusion, and hence may lead to failure of you spine surgery.