This fall my mom had back surgery. She had back pain for a long time and finally made the decision to have her back procedure done. We did a lot of things correctly before, during, and after her surgery. However, there are things that I learned through this experience that I thought would be helpful for other people to consider if they’re facing back surgery.
The History of My Mom’s Back Pain
This is a picture of my mom’s spine after the back surgery procedure. Yep, those dark spots are really screws through her spine! She knew that it was going to be intense but she was ready for the relief the back surgery would bring. You have to be in pretty serious pain in order to know the details about the back surgery procedure.
My mom had suffered chronic back pain for years. Her back pain was because of arthritis and spinal disk degeneration or degenerative disk disease. The combination created a condition call spinal stenosis. For many years, she was treating her back pain with arthritis medications like Celebrex, rest, heating pads, cold packs, and physical therapy. As the pain and inflammation increased and the previous treatments became less effective, her doctor prescribed steroid injections in her spine to reduce the inflammation and relieve her pain. Ultimately, these therapies did not provide the level of relief and the pain really impacted her quality of life.
Over time she also experienced nerve pain, numbness, and tingling in her legs and feet. Her spinal vertebrae, a disk, and a buildup of arthritis was really pushing on her nerves and spinal column. She was losing her balance – it helps to feel your feet when you walk – and she was not walking easily. We were also worried about her ability to drive and use the gas and brake pedals. It was time to get serious about the back surgery.
I am Not a Doctor
Friends, I am not a doctor and this post is not meant to diagnose, to treat any condition, or to provide any type of medical advice. These are my personal observations from helping my mom through her back surgery experience. My goal here is to help you if you or someone you know is facing or considering back surgery. This will also help you be of service when someone you know is recovering from surgery.
Making the Decision and Pre-Op Conversations with the Doctor
My mom had a long relationship with the back surgeon and they had discussed the surgical options for a long time. When she went to the surgical consultation, the nurse practitioner showed my mom the latest MRI image of her back. The MRI was amazing and scary. They were able to show us an internal “slice” or an internal horizontal view of mom’s back. They were able to start at the top of her spine and show us the healthy vertebrae. The healthy vertebrae had a well defined opening for her spinal cord.
As they scanned the MRI image down to her LV and L5 vertebrae the opening for her spinal cord practically disappeared. It looked like there was no room for her spinal cord. I wish I had a picture of that. The arthritis buildup and the bulging disk was pushing on all sides of her spine and putting pressure on it. It was time to get that cleaned up. All of the other methods had stopped working and really they were just treating the symptoms of the pain. The surgery would help correct the root cause of the pain and be a long term solution.
The surgeon’s office gave us a lot of information about the procedure that they would do and what to expect. They took time to answer all of our questions. They shared that we should anticipate at least one night in the hospital but possibly two. We planned for the surgery to take place on a Thursday. We hoped to be transitioning out of the hospital by the following Saturday. That wasn’t exactly our experience… keep reading!
Planning for Support After Surgery
We did ask about post surgery support. My mom is eligible for Medicare. We were nervous about her ability to come home after the surgery. I am not a nurse and I wasn’t sure that I’d be up for helping her. I am SO GLAD we asked about this. Mom’s needs were pretty intense after her operation and I am not sure I could have done it myself. Home Health Care was an option and we also asked about rehabilitation centers. Mom investigated rehab centers before she had the operation and had a few listed in order of her preference. Medicare has a rule around how long a patient must be hospitalized for Medicare to help pay for the rehabilitation center. If the patient is up and walking after the surgery, then they might not need rehab. My mom was in rough shape after her operation and really needed help walking to the restroom, getting up and down, and taking care of herself like washing and brushing her teeth. Post operation rehabilitation was a lifesaver!
One thing to consider when thinking about a post-op rehabilitation center is if you want the patient to be close to their home or close to the primary care person. In our case, my mom decided that she wanted to be close to her home. She was familiar with the center and a friend had recently been a patient there. She heard good reviews about the rehab facility. If it had been up to me, I would have investigated rehab facilities closer to me because I was the one that was going there on a daily basis. However, it worked out because the rehab facility my mom chose and was admitted to was close(ish) to my workplace. The location of the center is something you’ll want to factor in your decision making.
A discharge nurse, a social worker, and your medical team will work with you to determine if you might need rehabilitation care. You want to be prepared with options long before the day of the surgery.
What to Do to Get Ready for Back Surgery
We did a few things “right” when getting ready for my mom’s surgery. There are a few lessons learned too. We had a great care team at the back surgeon’s office, at the hospital, at the rehabilitation center, and with home health care but there are a few things we learned in the process.
Weeks Before the Back Surgery
Get your support team together. Lots of folks want to help and you should schedule them. Ask folks for specific days and send them calendar invites. Visitors can lift your spirits and can help you in other ways. For example, after surgery my mom wasn’t able to get out of the bed and had dropped her cell phone. A visitor stopped by and was able to get it for her before a nurse or aide was able to get to her. Visitors can be advocates if you or your loved one needs something – like pain medication, help going to the bathroom, or bringing food, clean clothes, or just turning the volume down on the TV. If you sign up volunteers before the surgery, they can ask off from work and make arrangements to help you.
Bills, Mail, Legal Items, Pets, Car Keys
- You don’t want to have bills to pay the days immediately following your surgery. You won’t be in your right mind and you may forget. Go ahead and get things taken care off before the operation.
- Arrange for a neighbor or volunteer to get your mail or your newspaper. It’s nice to have someone bring the get well cards to you.
- The hospital can guide you on the legal issues like medical power of attorney, a living will, organ donation, DNR orders, and payment documents. You probably haven’t been through a major surgery before but the hospital does this every day. That was one thing that was frustrating about the experience. This surgery was a BIG DEAL for us but it’s routine in the hospital. Hospital workers sometimes forget that we don’t do back surgeries everyday. Be sure that you have your legal affairs in order before surgery. Make sure someone you trust knows where your important documents are. It can be morbid to talk about death but it’s a risk with any surgery and it’s better to be prepared. Be brave and have this important talk.
- Be sure you line up pet care and someone to tend to your home. In some neighborhoods, you might want someone to house sit for you or to check by every day to make sure things are in order. It wouldn’t be any fun to come home to water damage or some other home repair.
- Stock your freezer with meals and stock your pantry with staples that are ready to eat. Have soda and water on hand and other things like crackers, jello, pudding, etc.
- Physical therapy or Occupational Therapy might help you learn to use a “grabber” before your surgery. If not, find a good one and have a few in your house so you don’t have to walk all over to get one.
Research and Find Some Home Help
Household Help: Cleaning and Laundry
My mom already had someone that cleaned her home on a regular basis. This is something to consider. You might want to get them to come more frequently after back surgery. You aren’t going to be able to bend, lift, or twist for months. So, you’ll need some help with washing clothes, putting clothes away, cleaning the house, and light housework. This is also something a volunteer can help you with too.
Find Help for After Rehab Outside of Nursing
My mom had a wound that required a little longer care by home health but she also asked around at the rehab facility and found someone there who would come help her shower for several weeks after she got home. This was a huge help. This person also would help pick up prescriptions and so small runs to the grocery store. It’s very important to line this up before the surgery. Of course, this could all be another job for a relative, friend, or helpful neighbor. However, it was a big relief for me to know that my mom could get someone to help her with these items. It meant that I could go back to work and then help her after work. This was surprisingly less expensive than we thought. We were blessed to be able to afford this level of care but these are other jobs that people are more than willing to do if you ask them and they can plan on it. If we had to do it again, I would have lined this up and interviewed folks before the surgery.
Physical Therapy and Occupational Therapy BEFORE Back Surgery
The back surgeon prescribed physical therapy (PT) and occupational therapy (OT) before the surgery. In these sessions, they worked on helping my mom strengthen her core, her arms and her legs. They taught her how to sit and get into bed and how to roll to get out without hurting her back. They taught her how to use a walker. These lessons were helpful to know before the operation.
Get clothes and other items you will need after back surgery
You will want to consider getting:
- jersey knit tops and bottoms
- loose fitting dresses that would fit over the head – like “house dresses” or long nightgowns
- a robe
- warm socks with the gripper bottoms
- a soft warm blanket
- straws that flex
- Styrofoam cups
- hand sanitizer
- lip balm
A Video About our Back Surgery Experiences
Days Before the Surgery
Follow Dr’s Orders: The surgeon’s office directed what to do the days before the surgery. My mom had to continue some medications and she had to stop taking some medications. Your doctor should go other this with you. Write this down. It’s really important that someone knows what prescriptions you need to get and which ones you do not.
Mom also had special instructions to clean the area that was going to be operated on. She had a special cleanser to use. Follow those instructions to reduce the risk of infection.
Get your phone list together: My mom and I created a list of phone numbers and contact that she wanted me to connect with during the surgery and afterward. Having everyone in a text string was an easy way for everyone to stay in touch. Get the prayer circle going!
Make a Checklist: Sit down with the person having the surgery and make a checklist for everything you can think of that you’ll need on the day of the surgery. Just try to brainstorm. See if there are things that you need. Try to get everything ready.
Pack Your Bags: Go ahead and pack clothes and toiletries. Get things ready to go to the hospital. The hospital we used provided my mom with all of her supplements and prescription medications. You won’t need to bring any of that.
The Day of the Surgery
The doctor will tell you what you can do and what you cannot do the day of the surgery. Thankfully, my mom’s surgery wasn’t scheduled for too early in the morning. I was glad that we had everything ready to go. The stress and anxiety of the morning is enough to worry about without having to put a bag together.
I was able to join her for most of the pre-surgical process and then she was wheeled off to the operating room. This was particularly heart wrenching. I quickly went to the waiting area and notified everyone by text.
There was a screen that updated the surgery status. Once the surgery was over the doctor came out and met with me. He said that everything went well and that she would be in recovery for a while and then transported to a hospital room. Soon I was called back and went with her to the room. She didn’t have to transfer beds. They just wheeled her bed into the room.
What was the Back Surgery Procedure
My mom had a Lateral Lumbar Interbody Fusion or XLIF. Lateral lumbar interbody fusion XLIF is a minimally-invasive procedure used to treat leg or back pain generally caused by degenerative disc disease. The procedure is performed through the patient’s side to avoid the major muscles of the back. Here’s a video of the procedure (It’s not gross, I promise). The surgeon also cleaned up the arthritis around those vertebrae too which required a third incision.
Immediately After Surgery and the First Days After the Surgery
Honestly, the timeline immediately after the surgery is a blur at this point. The nurses on the floor were busy with the intake process and getting my mom settled into her room. The anesthesia was still keeping her pretty comfortable and she wasn’t in much pain right after the surgery. It was a challenge getting her comfortable. They put on support hose and over that there was a machine on her lower legs that used air pressure to massage and maintain pressure. She complained about the hose but you have to keep those on.
Mom was prescribed high powered narcotic pain medication. We assumed that she’d be given that medication on a schedule but we quickly learned that she would only get it by request. The nurses would make sure she wouldn’t get too much. I appreciate the controls around this. This medication made my mom really loopy in a way I wasn’t anticipating. At some point she really wasn’t making sense and would become agitated. You just have to be patient and gentle. My job was to keep her comfortable and safe.
My mom was prescribed those pain medications and a muscle relaxer. The muscle relaxer interacted with her body in a dramatic way and her blood pressure dropped to a very low level. This was unanticipated. It was good that someone was there to get help and to monitor her status.
Physical Therapy in the Hospital
The in-house physical therapy folks gave the day after the surgery. The goal was to get mom up and moving. They helped her take a few steps and get to the restroom. It was hard to see mom in so much pain but it was important to get her up and moving. They had a walker that she could use.
During the few days in the hospital, my mom became dehydrated. We’re not sure if the blood pressure and muscle relaxer issue contributed but she needed some fluid at some point. It was kind of scary when this happened. Once she got some fluids her condition improved. After that scare, I was really bossy and MADE her sip and drink. We’d fill up a cup and I’d time her to make sure she was drinking. You can try Gatorade or juice. The medication will make their taste buds “off”. So, I just gave her whatever she wanted. She wasn’t on diet restrictions so there wasn’t anything that was off limits (just not too much caffeine and no booze).
Post Operation Rehabilitation and Transportation
The doctor and the care team (physical therapist and occupational therapist) will work together to determine if a rehabilitation center is appropriate for post operation care. The other alternative is home health care. It was determined that my mom would be best served with a stay at a rehabilitation center. The hospital had someone that helped us get a room and luckily mom got a room at her first choice center.
On the morning of the transition from the hospital, I went to the rehab facility to complete the required paperwork and see the facility. It was a really nice place. I then traveled back to the hospital and helped to get my mom ready to leave. I have a Toyota RAV4 and mom wouldn’t have been able to get in my car. The hospital gave me the contact for a private transportation service. They came with a van where my mom could just roll in. They strapped her and the chair in. I met them at the rehab facility.
After the Operation: The Rehabilitation Center
I can’t stress enough how much of a godsend the rehab center was for us. At the facility, mom had a hospital style bed and the bathroom didn’t have any barriers. The staff was excellent and provided her great care. Her only complaint was the food. She wasn’t on a restricted diet and the food was too rich – good Southern style cooking!
At the rehabilitation center they administered her medications. She had in-house physical therapy and occupational therapy. Her incisions and stitches were taken care of by nurses. There was an on-site doctor that supervised her care. There was an OT and PT gym facility on site. Having mom stay at the rehabilitation center was the best thing. It allowed me to go to work and not have to worry about her all day.
Mom transitioned off the high-powered pain medication and now she’s only taking Tylenol on an as-needed basis. She cannot take Celebrex after the surgery.
When it was time to get ready to transition back home, the OT and PT people went with my mom to her house and did a site visit. They made sure that she could navigate the few steps at the threshold for herself. They checked out her bathroom and ordered a higher toilet seat. They made sure that her transition back home was safe. Mom was at the rehab facility for about 20 days.
After the Operation: Transitioning to Home
Right after mom came home she had a home health nurse that came a few times a week to monitor her incision site and change her bandage. She also had OT and PT. Now that it’s about three months after the surgery, mom has ended OT and PT related to the surgery. (The image above is an xray of my mom’s back after the surgery.)
Even though mom had a shower that has a door that was easy to get into, she wanted someone to help her with bathing and getting dressed. While she could have probably done this herself, she felt more comfortable with some help. We were able to find someone at the rehab center who wanted a few extra part-time hours. If I had to do it over again, like I previously mentioned, I would have tried to set this up before the operation.
Three months after the surgery, mom still cannot bend, lift or twist so grocery store shopping and laundry are limited. You’ll need to have some help with those items. Also trash and recycling removal are things to consider. Who can roll out the trash cart and bring it back from the road. If you don’t have municipal waste collection, then what do you need to do for that?
Initially, she was not able to drive for about two months. So, you’ll need to think about transportation to doctors appointments and lifestyle appointments (hair, nails, etc.). Either you’ll need prescription delivery or you’ll need help to pick up prescriptions. Depending on the type of pain medication, you’ll need to present the patient’s ID and your ID for controlled prescriptions.
The Future is Bright
Overall, the pain relief and increased mobility have made mom’s surgery worth it. It is a long road of recovery and you really need to think it through. Hopefully, what I’ve shared will be helpful to you. I am sure that I’ve forgotten something and and and I am SURE that you all have ideas to add. Please comment! We’d love to hear your experience too and it’s helpful to other readers.