Chumphon my first birding holiday after Spinal Fusion for Scoliosis

I owe you all an update of what I did during my 8^th month post ops. I am very slow to update my blog. I have being busy in my normal daily lives juggle with my job as a database administrator in a financial Institute and do frequent swimming as my physiotherapy. Working in the IT field in the financial Institute take care of production environment is very challenging. Many of times we need to sacrifice our sleep as maintenance slots is only available for us after the system have finish serving the customers.

Scoliosis started to enter into my body ever since I am about 10 years old. The long list physiology effects of scoliosis experiencing low self image, dislike people to take candid shots of me, feel left out, feel so different/ugly due to body deformed, back-ache, muscle soreness, I fully understand and know them well. Ever since the spinal fusion for scoliosis that I had gone through, I have a better posture, in additional to that the unexplainable muscle soreness and the weird back-ache have also lifted off from me. “Given/constructed back with a new spine”, it is like being granted with a new lease of life. As I am experiencing the benefits of medical help on my scoliosis I wish no others scoliocian continue to be ignorant, lack of awareness, shun away from the society suffer in silent. So in my free time with this new life and new spine I do give back to spread awareness of scoliosis, sharing my scoliosis journey, support another scoliosis patients and their families. Able to help another person who is having the same spine deformities like me gives me a very nice satisfy rewarding feel.

With this heavy pack daily schedule unknowingly I am heading towards my 13^th months post ops. Now I have to re-track my mind on my birding holiday trip that I did during my 8^th months post ops.

This spine surgery that I took on 17th Feb 2014, hearing my spine doctor said “You are now only allowed to carry/lifting less than 3 kg until your spine is fuse...”, it is like pronouncing to a hyper active small kid “you need to be grounded...No further question until further notice...”.  It has seems to be my annual ritual since a few year already that during mid Oct till end of Oct I will be at Chumphon, Thailand.

This year I did not secure my flight ticket to Surat Thani in order for me to land at Chumphon. To me this year Chumphon trip is  my wishful thinking.   I console myself “It is OK that this year I am unable  to witness flocks and flocks of many thousand of Black Baza migrating.   However my birding friend (Mr Lam) keep tab on my recovery progress. This year he has the intention to drive about 1,200 KM per way from where he is base to Chumphon. Mr Lam keep persuade and invited me to be in his car. I was hesitating at first. On my 6^th mth post ops based on my full spine X-ray my spine doctor told me that my spine is fussing in progress. My weight lifting or carry things of less than 3kg has lifted off. This is indeed a good news cause the less than 3kg weight restriction rule me out of whatsoever holiday.   

Mr Lam assured me that there will be many Malaysian birders friends who are also in this trip will look after this "new titanium lady”.  It will be a free and easy trip with no fixed itinerary. We will make many stop over just in case my back could not handle the long car journey.  The word "Free, Easy and we are not bound in fixed itinerary sound very ideal to me.   So I agree to spend my annual “a must to have a long stretch of days where we keep away from office" to be one of his car passenger.

As the days approaching, he has collected 2 more others passengers, so we have a full car load. I keep repeating the words Chumphon a few times. Many of you would wonder what foreign word is that ? Where is this place?

Where is Chumphon (pronounce as choom-pond) ?

Chumphon is located in the narrow land-bridge connecting the Peninsular Malaysia with Thailand. With the geographical coordinates of 10º 30´0 North, 99º 10´ East. This place is midway of Bangkok and Hatyai. Chumphon is in between Andaman Sea and Gulf of Thailand. Chumphon is the gateway to the Archipelago Koh Samui, Koh Tao, Koh Phangnan

What is the attaction there?
click to find out

http://chumphon.sawadee.com/attractions.html

Food
As this place is near the coast, you would not want to miss the seafood when you are there.

How to get to Chumphon?

1. By Flight

Chumphon's domestic airport is located at Muaeng(district) Pathio about 30km from Chumphon city. Nok Air the Thailand low cost airlines is serving this route and the flight duration is 1 hour from Don Mueang. Overnight nearby at Don Mueang (Bangkok) may be necessary if you doing connecting flight to match with your flight schedule.   http://www.nokair.com/nokconnext/aspx/flightschedule.aspx

Alternatives Airport you may consider are Phuket, Don Mueang, Suvarbhumi and Surat Thani. The distance of land transfer, your budget, your convenience, how much traveling time you have and what you want to see along the way will determine your choice.

For me the journey from KL, I will choose Surat Thani.

The big birding holiday trip I did is in October year 2012 . That is also to Chumphon. That time I travel on my own, parked my car at terminal bersepadu bersatu get into the bus to head to LCCT, took a flight to Surat Thani then continue the journey by van to Chumphon town. To land myself to the guesthouse I took motorcycle taxi from Chumphon town. I was traveling with 3 bags (1 suitcase, 1 laptop bag and 1 backpack fully loaded with my camera, lens and binoculars). I manage to travel all the way alone with just of my very limited thai vocabulary.

2. By Train

This land mode of traveling require longer time to reach your destination. There is a railway network connection stretch from Singapore to Thailand passing by Peninsular Malaysia.

http://www.seat61.com/Map-southeast-asia-train-routes.htm#.VQbPeo6UfVI

3. By Car

The Asian Highway also known as Great Asian Highway the main intention is using land transport infrastructure to interconnect Asian land.

The abbreviation of AH (Asian Highway) followed by the digit number is assigned to indicate the route.
AH2 (Asian Highway 2)

3,177KM is from Denpasar, Indonesia to Merak Indonesia, Singapore, Peninsular Malaysia, Thailand and then leads to khosravi (Iran).

To include meal break and toilet break you need 15-16hrs

Where to stay at Chumphon?

Your choice of accommodation are range from affordable guesthouse, hotel room to luxurious resort/posh hotel room. The location also for your preference at Chumphon city or along the quiet holiday clean beach of Thung Wae Lean beach (Mueang Pathio) about 15km from Chumphon city. Thung Wae Lean beach is peacefully quite and beautiful. The good thing is not crowded as  this place not a popular tourist spot.  

This is the second time I stayed in this guesthouse

                               This is a two bungalow lot, the one on our right is non-aircon.

                                      Per room is only 350 baht.  All the rooms are WIFI enabled. 

               The speed of the WIFI is so much faster than our Telekom Unifi

This is thung wae lean beach

The fisherman village at Sapli Pathio District Chumphon

At Tung Wae Lean beach

My birding trip from 18^th of Oct 2014 - 31^st of Oct 2014

I wish to thank Dr Lim for extending his hospitality to me by hosting me one night at his house. It is so happen that his house location will ease Mr Lam to pick me up. Even though I have being to Chumphon numerous times but this is my first time pack along as passenger all the way from KL, Malaysia. I remember very well as I was packing on top of the excitement I also have thoughts wondering how are we going to compromise each others living with harmony for two weeks. Before we start the journey I offer to pray for all asking for God's covering cause we need safe journey, the cars in good condition, all of us have good health throughout the trip, have an enjoyable trip and living harmoniously with each other.

On 18^th of Oct 2014, three cars fully loaded with the passengers and our luggage convoy all the way from Malaysia. All of us are full of excitement and we did 16hrs drive to reached Chumphon on the same day. For me to be there I wish to thank Mr Lam who made the tiring journey of “driving and driving and keep driving of wondering when are we reaching Chumphon” that day.

From my scratch book this is what I recorded.

We left Dr Lim's house at 6:30am, reached Rawang R&R @7:05am, push off from Rawang R&R @7.30am. 

I took a break from my normal high calcium breakfast menu today.

At 9:50am we are Bkt Gantang for toilet break. We left Bkt Gantang R&R @10am and @12noon we left Changlun after we had our lunch and settled the cars permit and insurance to enter Thailand. @1:25pm

we are at Immigration Malaysia to present our Malaysia passport. @2pm we are done with presenting our passport, cars permit and insurance coverage at Immigration of Thailand office at Sadoo Thailand. @3.05pm I saw 102 sign board of Pathalong. @4.05pm we have out toilet break at PT petrol station where Pathalong is about 28KM.

@4.25pm I saw the sign board leading to Thale Noi (the first world ramsar site in Thailand).  Oops and I did not record further cause I slept but at 7:15pm (Malaysian Time) we had our dinner.

Tssssh..Tssssh.. hot hot.. super hot.. but nice and yummy (aroi)

Some of my friends had noodle from this stall.

Then after about 20mins we push off again, the sky is getting dark, I sat at the back and I could not see any further signboard to record. Finally after about 4hrs of driving we finally arrived at Marakot Hotel @ Malaysian Time 22:00pm. Oooosh it was indeed a very long car journey.

18^th of October 2014 mark as my 8^th months anniversary post ops. Friends are worry that I have soreness/back ache due to the long 16 hrs of car journey. I told them unlike those years my back could not sustain such journey but that day I have no soreness at all.

19^th of October 2014 it was raining/pouring that morning, all of us from Mr Lam's car we decided to stroll along Chumphon market as a normal tourist rather than head to Khao Dinsor.

Some of the scenes at Chumphon wet market and it's surrounding.

Zzzzzzzzz.. Is life so slow there?

This is Toyota Hilux lock in the cage.  Hmmm why does this Hilux need to be in prison?

I am impress of the Chinese culture there.  They use traditional Chinese character.

Where is the site for raptor watching?

Khao Dinsor 10.63°N 99.28°E

It was in the year of 2008, a thai birder Chukiat Nualsri notice large numbers of raptors fly close along the ridge of this mountain previously a graphite mine. Subsequently the next year with the financial support from the local government and community this site has develop into bird watching site. Due to this strategic location in the Asian flyway birds migration route in early september till early november we can see a wide range of raptors species fly pass here.

Ever since from year 2010 many raptors researchers and bird watches from various places all over the world make it a point to be there to witness and to study the raptors migrations pattern. We have noted that there are 25 species that fly pass annually. Each year the species continue to increase as someone would record a rare species.

I also want to thank Sam Liong as some days he will help me to carry my back-pack of photography gears. There are days I carry it myself on my back. As my coronal plane and sagittal plane has being corrected, this year of walking up and down I don't feel the soreness, pelvic pain and breathless. I am like a new person.

Black-Baza is the icon for Khao Dinsor

This is the scene at platform 1

It is totally a different feel compare the previous time I was standing here.

This is the night scene  Those small spots of lighting are the fisherman doing squid catching.

The following is only a small portion of birds photo that I harvest from this trip.  I could not insert all in this blog.

Click here to watch a fraction of a very Large flocks of Black Baza on flight
https://www.youtube.com/watch?v=KVxCjvf2D5Q&feature=youtu.be

Nong Yai area development Royal Project

During the Raptor festive day Mr Lam brought us to this place. This place exist and initiated by King Bhumiboi Adulyadej due to the tragedy of typhoon gay that hit hard on Chumphon in the year of 1989. The large reservoir act to mitigate flooding and also to conserve water to be use during dry season.  There are times researcher come to this place to study the wetland ecology.

This is a very small tiny snake. I use my DSLR mount with long lens to capture this.  

With great patience I was photographing dragon fly

The journey back to Malaysia we depart from Albaratos on 31^st of Oct 2014 at 4.30am Malaysian time. 3:20pm we are Malaysian's Custom. This time we stop overnight at Taiping rather than rush down back to KL.

I had a  great holiday, good company. My birding friends who was with me during this trip. Thank you for your company.  I have a wonderful raptors birding holiday, the local  food is delicious and most of all the warmness of Thai people  will makes me want to go there again.

Would I no longer able to do what I like to do "After Spinal Fusion" ?

Typically agree to have spinal surgery to resolve your spinal problem as suggested by your spine specialist is a difficult choice. Many still hesitate and consider is there any invasive methods. There are many who are out there would feed you with negative thoughts..fail back surgery...would have more pain than before operation..activities that you use to do after surgery till forever you will never able to do anymore. …due to fusion mobility will reduce.. etc.. etc..

When I was about 8 – 10 yrs old I noticed from my lung x-ray that my spine is not straight. AIS (Adolescent Idiopathic Scoliosis) start to enter to my body then. The very mild curve then progress to moderate curve when I turn to adulthood.

As long as I could recall I have no severe pain. Never did break my bones or get it fracture. My scoliosis is destroying me slowly. Over the years unknowingly from moderate curve it slowly progress to severe curve. How on earth my shoulder is getting lower and lower over the years? Does the normal aging cause my left shoulder getting lower towards my waist line?

I am grateful that I exist in this era where spine surgery benefits is greater then the risk. The most important factor is my health is still in good condition to undertake this spine surgery.

On my 8^th months ops I still able to hold up my DSLR camera mounted with long lens without tripod to take nature photograph.

Bees are fast moving , small object and most of all it does not allow you to go near. 

Prosumer camera, compact camera, phones camera, IPAD would not able to capture bees with details.  I am still able to do what I enjoy doing before. FYI my 400mm long lens that I use to take this photo are without image stabilizer.  This has prove that I still have steady hands.

Yes indeed I have landed in the operating theater having my back cut to installed the spinal implant yet I still could not produce a great straight spine x-ray. With today spinal surgery technology my severe scoliosis curve has corrected to mild  Most of all I no need to go through those daily discomfort soreness where I use to have before ops.

Be patient I still have many GB of CF cards that I harvested back from my 2 weeks overseas birding trip last year Oct 2014 that I need to go through.

Sharing my story hopping that I could help others

Some people asked me why I clutter Scoliosis inside “My Birding Field Trip”?

My answer

Birdwatching is my passion, Scoliosis is in my gene. There are part of me. 

By sharing Scoliosis my real life story, I hope that I could touch, change and help another scoliotic. 

If you are sourcing info related on “scoliosis” and unintentionally we meet virtually. Well let me tell you. If you have scoliosis or your close one have it. You are not alone. Your child is not alone. 

What is Scoliosis? How should it be handle

Photo contribute by spine unit of PPUM

You will able to see this series of scoliosis awareness posters when you walk around PPUM (Pusat Perubatatan University Malaya) and UMSC (University Malaya Specialist center).  If you really looks at these posters attentively you will able to feel that these series of poster has a voice.

Scoliosis is a Greek word that means “crooked”.

Why people have Scoliosis (the lateral curve of the spine.  The abnormal C curve or S curve)?

• Unknown --- Therefore it is called Idiopathic scoliosis.  Idiopathic scoliosis is a genetic condition.  Scoliosis normally runs in the families.  Parents have it, grandparents, aunties or uncles have it and it pass down.  For me, two of my close relative have this and they are from my paternal side.  Sometimes it might skip a few generations.  Tracing down who has scoliosis in your ancestor line might get your mind bongos sometimes.
• Sickness ---Could be resulted from some genetic disorder/sickness that effect the muscles, bones and nerves.  Examples are Muscular Dystrophy- muscles are too week to support the spine.  Neurofibromatosis – genetic disorder that cause tumors to grown in nerves.  Brittle Bones disease - the genetic bones defects that cause fragile bones. The sufferer’s bone can fracture easily.  Because of weak bones, the spine vertebrate could not form normally. 

How long scoliosis already existed in human history?

It exist since ancient times. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654856/

Have you ever read The Hunchback of Notre-Dame a classic novel by Victor Hugo published in 1831?  Inside this classic novel there is this one character a man name Quasimodo.  Quasimodo is hunchback, stunted in body build, very deformed man.  He is being shun and despise by the public. People view him as monster.  He is deformed since birth.  In modern medical term he has early onset scoliosis.

What is the level of research/cure we have achieve so far?

Until to date scoliosis is yet to cease from human like leprosy.  Researchers are still working hard to studies the correlation of genes, nerves and muscles.  Till to date there is no medicine/vitamins that we can take to reverse or prevent it. However researchers are progressively develop more and more advance treatment to keep the curves from getting worse and help to straighten the spine to the safest level.

Should you leave your scoliosis untreated and not monitor by spine doctor? Ignore the spine doctor advice?

Photo contribute by spine unit of PPUM

NO! I have watched my close relatives untreated and un-monitored scoliosis curve progressively deteriorate over the years. You may be like them have successfully conquered your mind to accept body deformed/disfigured as part of your misfortune/fated to be. However you still unable to escape from some forms of health issue cause by progressively larger scoliotic curve. Over the years as the curve progress it will diminishing the functionality of the internal organs as the curve is crushing down on them. Eventually the person experiencing pain/discomfort/soreness that will affect daily life.  Pain/discomfort can easily get relieve from pain killers, however the spine curve could cause respiratory, heart, bladder, stomach, neurological and some other kind of unexplanatory problems.  If untreated the person will daily suffer in pain and then eventually lead to early death.

http://www.viralnova.com/creepy-medical-field/

Corset or bracing can cure scoliosis on adult

Many still unable to accept the reality of medical help.  Deep down from my heart “I am glad that I lives in this modern medical technology whereby my spinal deformities has help.”  In the 5^th century BC Hippocrates comes out with the idea of a very torturous methods for treating scoliosis. 


Strapping the patient to a ladder with their head downward and pulling them up vertically and then dropping them down with great force. This is to create a sudden force gravity pull hopefully able to put the dislocated vertebrae back to alignment.  

Those days I always imagine that if I lives in the ancient times people including my parents will think that I am demonic due to my disfigured body. People may stone/burn me to death.

Renaissance Ambroise Pare the French barber-surgeon (1510 – Dec 20 1590), has a period of time serving as a surgeon in the war.  He has come out with the ideas of artificial limbs to help the war time wounded soldiers.  Along in his career he is also the first person who invented bracing for scoliosis. He conclude that irony corset that he developed will/may help in children but once they have turn to mature skeletal he recommend to use the traction method of Hippocrates.

“Paré's seventeenth book includes a treatise on scoliosis in which he recognizes the female preponderance. He was the first to describe congenital scoliosis, but in cases of later onset he included among probable causes trauma, poor posture, and in girls the use of bodices and the requirement to curtsey.⁵

For adults with scoliosis he recommended the Hippocratic treatment involving forcible horizontal traction,⁵ but for children he was the first to prescribe iron corsets:

'... they should wear fine iron corsets with holes in so that they are not too heavy, and they will be so well fitted and padded that they will not cause any injury. They would be changed often if the invalid does not achieve the three dimensions. And for those girls who grow, it would have to be changed every three months, more or less as necessary: for otherwise, instead of doing good, it would do harm'.”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1079595/

Alternatives method to cure scoliosis?

                                  Thoracolumbosacral Orthosis (TLSO) (hard brace)

http://centralbraceandlimb.com/scoliosis-treatment

SpineCor (the soft brace)

http://scoliosisbracing.asia/treatment/spinecor-soft-bracing.html

Bracing this non-invasive treatment is meant for children where their curve is < 45 degree.  Once their curve touch 45 degree it is wise to start planning for surgery. Some children during their prime growing stage their curve can increase rapidly.  Please do not knock on the spine doctor clinic at the brim of time whereby their curve has progress until they are terribly disfigure. The thought of hopefully their curve will reach stability and the curve will not increase when their have reach adulthood is a wishful thinking.  I have watched under my own eyes how mine and two of my close relatives’ scoliosis curve increase slowly over the years. From moderate ...to severe ... and now to very severe..

It is still wise to address the curve before other kind of health issue arise and if surgery is recommended then take it before more vertebrate need to fuse. The more vertebrate need to fuse more flexibility are lost. Some scoliosis patient are not like mine, yes indeed my scolio start to erupt out from my spoilt genes when I am about 8 – 10 yrs old.  When I am about 11+ with a pair if observant eyes you can noticed that I have scoliosis but my curve progress slowly.  I was not send for bracing due to my parent lack of knowledge/awareness on scoliosis during my growing up days. I also miss to arrest my scoliosis curve during the “golden time” whereby my spine bones is less rigid because my curve has not touched 45 cobb degree in my teen. 

In my 1^st clinical appointment with my spine doctor (Prof Kwan) on 30^th Dec 2013, I was so relieve got to know that spinal fusion for scoliosis is still possible for adult with the condition of good health condition. My fatal risk is still less than 1% but unlike the teens I have additional 10% risk due to spinal implant failure. This 10% might or might not appear.  To me it is a good gamble. I surprise my spine doctor because I quickly told him repeated my statement few times “Yes. I agree for surgery, No need to discuss with parent.. I am old enough to decide what I want for my life and body”.  

It is ok to lose a very negligible flexibility cause I need a few more titanium  screws for my more rigid vertebrae  and I need to be lock till L2 even though I may have the same 60+ cobb “C” curve like those young teens. 

When I ponder back, I began to understand things happen in my life for a reason. My long suffering of untreated scoliosis is for me to know and experience from painless to soreness/discomfort, the meaning of low self-esteem due to body disfigured, sadness, worry and etc.  All these allow me to be the living testimony to relate my life experience with another scolio patient who is deliberating for surgery even though spine doctor has recommend it. 

I am truly very grateful

My low self image on my deformities has being lifted. Yes indeed I'm being installed with spinal implant in Feb 2014. I need to carry my spinal implant ID now. 

Initially in my recovery period I find that even a ceramic cup and my pillow is exceptional heavy.. I could only sit for 10 mins when my Spine Doctor (Prof Kwan) expect me to achieve 1 hr. The 30 mins home ride on my hospital discharge day was a great torture to me..

Each day my recovery progress. Additional quality life keep adding into me. On my 8th month post ops (18th Oct 2014) I did a 16 hrs car journey for my vacation with no complain.

On the 20th of Oct 2014 I could not have a better words to describe how grateful I am cause I am able to trek up (20 mins) on a nicely paved staircase mountain trail .  I no longer pants like a dog like last year and a few years ago.

It was a total different feel standing taller than before on the same spot of last year holding up my gears to photograph migratory birds.

This is how bad was my posture before the ops

This is the new me on my 8th month post ops

I so grateful to the Almighty God ...

"The LOVE of GOD is greater far

Than tongue or pen can ever tell

It goes beyond the highest star

and reaches to the lowest hell
With a grateful heart
I just want to says Thank you God
For what YOU have done
YOU took my sickness and heal my pain"

   

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.