My Spinal Fusion Scoliosis Recovery Formula

Notes :- I had Posterior Spinal Fusion for Scoliosis on 17/2/2014. I underwent this treatment at  UMSC (University Malaya Specialist Center).  My surgery was lead by Prof Kwan Mun Keong. University Malaya Specialist Centre  (UMSC) is the private wing of Pusat Perubatan University Malaya (PPUM).

At current I am in my 7th months post operation. I am really glad that I undergone this spinal surgery.  Besides having a number of my health problem resolve it also improve my self-confidence and self-esteem.

I hope my sharing on scoliosis and me will serve as an encouragement to those who have spinal deformities like me. There is hope/help for you in today modern medical technology.

--------------------------------------------------------------------------------------------------------------------

14th Aug 2014 is my 6th month post operation clinical appointment.  I have “butterflies in my stomach”.  What would my full spine x-ray show?  Are the titanium screws intact? What would my spine surgeon says once he look at my 6th months post operations full spine x-ray?  Would he deliver bad news and suggest that I need to undergo another surgery because the fusion does not happen as per expectation?  Would there be any possibilities during fussing of spine process my spine curve increase before it fully settle down in fully fussed up stage?  Increase due to certain sleeping posture and some minor twisting position I did during my clothes wearing?

These are my thoughts while I was driving down to UMSC for my clinical appointment at 2.30pm.  After the full spine x-ray taken I took the lift to head to the waiting area of room 12 – Prof Dr Kwan’s clinic at UMSC.  There are so many people waiting together with me. Among them I notice a foreigner elderly man in big body build but he is in so much pain.  Is he having spinal problem that lead him to have problem even with simple mobility?  From his look he might be from the Saudi Arabic country.  Those relatives who gave him a helping hand to assist him to walk into room 12 speak in foreign language.  Wooow… my spine doctor must be world famous. He has patients come all the way from the far foreign land. 

Soon my name “Wong Chor Mun” was being called.  I walk into his room greeted my surgeon.  With a worry heart I ask him are all the titanium screw and rods that hold my spine intact and not loosen. He blow up my spine x-ray image and comments “….your spine is fussing up.. very good .. you are doing very well. There is no dark ring nor hollow ring around the screws.  I expect this kind of result in 9th months post ops due to your age but your recovery progress like the teenager….You are no longer on any weight lifting restriction …however you not allowed for any competitive sports and high risk activities… continue your swimming and the superman exercise to build and strengthen your core muscles.  You are allowed to do your own exercise. You are allowed to do light running…”

Yahoo…with those statement my heart is relieve but  But … huh.. my naive and simple brain cannot apprehend what is competitive sports.  He explained to me competitive sports are eg relay races, football, basketball, cross country… Woooh…oooh Hah!! no more weight lifting restriction!… I can plan to go for holiday… 

From a 64 cobb degree I have being corrected to 25 cobb degree 

Now I have a balance shoulder (My frontal plane has being corrected). My gravity line has improve (I have a better sagittal plane. 

Hmmmm since I am not allowed for any stress activities until 18th months post ops..then a light and easy… eating… sightseeing … birding holiday with do I guess?

Yes!!! I can wear back my trekking shoes very soon...

From my own experience, spinal fusion heals as intended is not a loop sided responsibility to stop at sourcing the best spine doctor in town to get the spinal implant properly installed only.  It also required the commitment of the patients post-operative cares that leads to the successful spine fusion result.  We need to aware that during recovery stage we need to modify our movement in order to avoid no body bending, twisting and not allowed to carry/lifting things with more than 3 kg.  If the patient body mass is lower, then the weight lifting restriction is even smaller than 3 kg. 

Every movement need to be very careful during recovery period to avoid destroying the surgeon’s handiwork.  I have a good laugh when I discovered that I am not the “weirdo” who do bed turns with my eyes wide open and cautious mind in the initial recovery period.

Click on this  link to find out what need to take precaution during recovery

                          watch this you tube clips to find out what need to take precaution

                                                        http://youtu.be/wRea1GrRkxA

Even though with the list of NO and don’t, I am being prescribe to perform some exercises (physiotherapy).  This is essential to work out the muscles and to promote new muscles growth to support the new spine.  

Walks

From day 1 we are encourage to walk.  During the hospital stay in between of bed rest we are to increase the amount and length of walks each day. Once I am allowed to go outdoor that is after the bandage removal, I do brisk walking for at least 10 – 15 minutes daily.

Core muscle stretching exercises

Before discharge from the hospital, the physiotherapist thought me 2 form of exercises that I need to do 1st thing in the morning and before I retire for bed.  His advice to me “Perform this while lying on the bed for 20 times… once in the morning and before you sleep.”

1.  Bridging exercise

2. Sit up and down on a chair or wall squat.

extracted from http://www.athleticadvisor.com/injuries/head_back/back_strengthening.htm

As my recovery progress to the 4th month 

I being advice to do swimming 4 times a week.  There are times I do the night session swim also my skin got tan.

Have the routine superman/thoracic extension exercise 1st thing in the morning and before retire to bed exercise.  The superman exercise/thoracic extension exercise and swimming as the physiotherapy is indeed very helpful in gaining back my back flexibility. 

                                                    
Click on this link to find out how to strengthen your spine..

extracted from http://www.athleticadvisor.com/injuries/head_back/back_strengthening.htm

Unlike the youtube video clips, we need to perform this lying on bed.  I discovered the mattress need to be hard in order to perform this.  Due to this exercise is quite strenuous for spinal fusion after ops patient, it need to be done in great care.  Being advice by my surgeon to start with only 2 repeatedly times for the 1st week and increase progressively until 20 times over the week as per his prescription.

Is there any particular food to stimulate bone fusion?

My surgeon advice to all of his after ops patients is no “pantang” (abstain) on food.  A balance diet will do.  To play safe in order for me to avoid fusion failure and quick recovery on the incision scars, below is what I practice.

Protein that my muscles need in order to heal more quickly.

Food that are high in PROTEIN are 

http://www.healthaliciousness.com/articles/foods-highest-in-protein.php

The bones need Calcium and zinc in order to heal more quickly and fussed up properly.

Adequate calcium is the requirement for spinal fussed up properly.  Food rich with calcium are http://www.healthaliciousness.com/articles/foods-high-in-calcium.php

Personally I change my daily breakfast menu to a cup of milk, two pieces of bread & a slice of cheese.  To top up the remaining calcium I use calcium vitamin pill where I ritually pop in after lunch and dinner.

The skin required vitamin C to promote the wound to heal faster and nicely.

Vitamins C that are found in many fruits and vegetables are essential to wound healing because it helps the body to form new cells/tissue.

How to reduce the appearance of spinal fusion scar

Notes :- I had Posterior Spinal Fusion for Scoliosis on 17/2/2014. This series of posting on Scoliosis is my personal experience.  I hope my sharing on scoliosis and me will serve as an encouragement to those who have spinal deformities like me. There is hope/help for you in today modern medical technology.

For Spinal fusion surgery the procedure required the surgeons to cut through multiple layers of skin until the spinal disc vertebrate are expose. Only up to this stage then the surgeons is able to install the necessary spinal implants.   As the cut is right through all layer of skin, more care are requires for spinal fusion wounds compare to the accidental knife injuries in the kitchen during food preparation.

Immediately after the operations the wound are then seal up either with staples, stitches or tissue glue. A large long strip of Opsite post-op bandage strips are then use to paste on top of the incision. 

extracted from https://www.youtube.com/watch?v=ir3L_jIJeuo
she can be contacted at layla-james@live.com

Many people asked me did I sleep with my frontal body lying flat where my back is facing upward. (prone position) after the surgery?  NO.. NO immediately after the surgery I sleep on my back lying flat (supine position).  We can do bed turn as well. In fact bed turn every  1 hour is a must on day one to prevent blood clot and bed sores.

http://www.charlydmiller.com/def.html

On the first day post- ops the doctor will change the dressing and inspect the incision.  The doctor would then able to anticipate of any signs of infections or abnormalities. A new large long strip of Opsite post–ops bandage strip is then paste on top of the incisions. This bandage can sustain certain level of waterproof. 

It is the uttermost patient responsibilities to take care of the incision.  This will help to lower the risk of infection. No doubt this bandage is waterproof.   Patients are allowed to take bath however need to be aware that it could sustain certain level of waterproofing only.  While the long strip of Opsite post-op is still there, the patients are allowed to take shower /sponge bath  however suggest do it in great precaution. 

Surgical incision always leave a permanent scar however care need to take to reduce the scar appearance even though you have vow not to allow anyone to look at it.

Stage 1– when with the Opsite post –ops bandage

• NO soaking in the bathtub
• Make sure no excessive sweating cause this will promote infection
• During shower use a quick gentle water spray on the back
• Use towel to gently pad dry on the back.  No back scrub or rub the incisions.
• Ensure that at all ends of the bandage are properly seal.  If torn, water can sip in.  If this situation occur run to the nearby clinic with the extra op-site bandage plaster. Need to be aware that this is a special op-site bandage the normal clinic, pharmacy do not stock them.  You would not be surprise that some hospital also do not have such op-site bandage plaster as they do not handle spinal fusion.
• Ensure no abnormalities eg signs of bleeding or oozing out yellow fluid.  Quickly run back to the hospital where you are treated if it does happen.

Stage 2 - Immediately after bandage removal till 6 weeks post ops.

This bandage will only be removed on the 1st clinical appointment post ops.  This usually happen in between of 10 - 14 days post ops.

Soap can be use on the incision scar after the bandage removal. Do not hastily apply lotion/oil.scar cream on the incision scar. You need to allow natural healing to take place. Do not purposely pick the scabs. Let it drop off by itself.  The scar will undergo a lot of changes including colour and texture.

My incision scar on 2nd month post ops

For some their scars healing taken a bigger footprint and tend to enlarge and rise progressively from the original wound.  Unlike the usual scars keloid do not subsides. Keloid are not health hazardous  however the bulging lump will get irritation from friction rubbing from clothes, beside occurrence of severe itchiness, pain even though it is a long years past scars.  Discuss with the dermatologist how to treat this if you scars develop into keloid. 

https://www.sthetix.co.uk

Stage 3 - From 6 weeks - 6 months post ops or longer

Once the scabs had drop off, that usually happen on the 6th week after ops.  Lotion and scars removal cream can be administered. During this stage of healing process the incision scar need to keep moisture to promote a better healing process. Care should be taken into consideration of external application as you may develop allergies reaction. I use Bio Oil massage in a circular motion on the scar, at least twice  daily after shower. 

Diet

Beside external care, a proper balance diet during recovery period is also important.

Avoid Sunburn

While the incision heals, the new skin form is very sensitive and less resistance to UV rays. The new skin are more prone to sunburn.  Sunburn will lead to worse scarring.

Does Incision Scar Fade

Yes, in the initial stage after the bandage removal, the scar line is reddish and a slightly raised.  As the days past the reddish line turn to pinkish and no longer slightly raise.  The scar line will continue to fade in colour.

This is my scar appearance during 4th month post ops.