Activity
This is a major surgery and you need to give your body time to heal. Below is a list of instructions that you should follow until your first follow-up visit after surgery.
 Wear your lumbar support brace when out of bed, and when sitting, standing, or walking. You need not wear the brace while in bed.
You no longer need to wear the TED stocking (heavy white stockings) once you are home.
You may sleep with your brace off either on your back, stomach or side. You may also use pillows for support, when lying on your side. Place pillows behind your back and between your legs. When on your back place pillows underneath your legs.
You may climb stairs.
You can sit for any length of time based on your comfort level. For your comfort, we suggest that you change your position at least every hour. If you become uncomfortable change your position and activity.
You should begin a walking program two to three days after surgery.
You may shower 5 days after surgery without the brace. If you must shower sooner, you must keep the incision covered and dry while showering. No baths for 4 weeks. No hot tubs for 6 weeks.
Walking Program: This is just a guideline
Day 1:
Walk the length of the hallway at home 3-4 times, or walk to the end of the driveway and back once in the morning and again in the afternoon or evening.
Day 2:
Walk ½ block or the equivalent of a ½ block indoors once in the morning and again in the afternoon or evening
Day 3:
Walk 1 block in the morning and again in the afternoon or evening.
Day 4:
Walk 2 blocks in the morning and again in the afternoon or evening.
Day 5:
Walk 3 blocks in the morning and again in the afternoon or evening.
Continue increasing the distance you walk, as you are able. Let your comfort be your guide to how much you can do.
No driving for 2 weeks, however, you may be a passenger
No lifting greater than 10 lbs (about 1 gallon of milk) for the first 5-6 weeks after surgery.
No bending at the waist, however, you may squat with your knees.
No sports activity until your first follow-up visit other than the walking program.
No sexual activity for 2 weeks.
Return to Work
Your return to work will depend on your recovery and the type of work you do. You must discuss this with your doctor before you return to work.
Pain Management
You may have an occasional increase in back, leg pain and or numbness after surgery during the healing phase. This is normal and is caused by inflammation (or swelling) of muscle tissue in your low back. To reduce pain there are several approaches to decrease the pain you may be experiencing.
Ice the low back area for 15-20 minutes every hour for 4 consecutive hours. Do note put the ice directly on  your skin. Use a ready made ice pack or put ice in a plastic bag then wrap the ice pack or bag in a towel before you use it. If you have been given a cooling device please use while in bed.
Avoid sitting for more than 30-60 minutes at a time for the next 48 hours.
Reduce your activity (i.e. walking) for the next 48 hours.
Take the pain medicine as directed by your doctor. You can also take one extra strength acetaminophen (Tylenol) every 4 hours between the prescription medicines, only as directed. Do not take more than 4000mg Tylenol in a 24 hour period. NOTE” Some narcotic pain medicines also have Tylenol in them.
Do not take anti-inflammatory drugs (i.e. ibuprofen, Motrin, Advil, Aleve, Bextra, Celebrex, aspirin) for 3 months following surgery.
Eventually you should no longer need to use pain medicine. After anterior surgery a feeling of abdominal discomfort may occur. Abdominal discomfort does not pose any serious health problems and usually goes away within 24 –48 hours after surgery. Several things that may help to decrease abdominal discomfort are.
Walking around the house.
Lie on your back with your feet up on several pillows (above the level of your chest.
Gently rub your abdomen
If abdominal discomfort persists greater than 24-48 hours, contact a member of the staff at the Spine Center.
Caring for your incision at home is important to prevent infection. Please follow these steps.
Your incisions have been closed with absorbable suture material underneath the skin and small pieces of surgical tape (steri-strips) on the surface of the skin. In most cases these areas are covered with a dressing. You may remove the dressing 3-5 days after surgery.
The steri-strips will gradually peel away with time as they get wet and this is normal. You may peel off the steri-strips anytime after 10 days.
Take your temperature twice a day, once in the morning and once in the evening for the first 7 days.
Call your doctor if you have any of the following
If you have a temperature above 101 degrees F (38.8 degrees C) for two readings four hours apart.
Clear drainage from your incision.
An increase in pain, redness, and or swelling by your incision.
Difficulty urinating or controlling your bowel movements.
Future Follow-up Visits
1st Post-op visit:
Call 630-967-2225 to make your first post-operative appointment at the Spine Center. This usually occurs 2 weeks after your surgical date. All other follow-up visits will be as needed.
Activity
This is a major operation and you need to give your body time to heal. However, you do not need to stay completely inactive after this operation. Below is a list of activities you should follow. If you have a brace you should follow step 1 and if you have a soft collar you should follow step 2. All the steps after one and two are the same whether you wear a brace or a soft collar.
1} If you have a brace for the first six weeks after surgery, you must wear your neck brace at all times (even during sleeping). You may remove the brace when you shower. You may shower 2 days after surgery, but keep your incision covered with plastic and replace your collar immediately after showering. When you return for your first follow-up visit you may be given a soft cervical collar to be worn in place of the brace.
2} If you have a soft collar for the first 2 weeks after surgery, you must wear your soft cervical collar at all times, except when you shower. You may shower 2 days after surgery., but keep the incision covered with plastic. After 2 weeks, use the collar for comfort as needed.
You do not need to wear the TED stocking (heavy white elastic stockings) once you are at home. No sports activity except for walking and in some cases the use of an exercise bike (NOTE: there are no limits on stair climbing or sitting. Use your comfort level as an indicator of the length of time you are able to sit or climb stairs. Generally a person is comfortable sitting about 1 hour before a change in position or activity is needed.) Sleep either on your back or side. If you have been instructed to wear a brace, sleep with the supportive cushion under the back of your neck.
Limitations
No driving for the first 2 weeks after surgery.
No lifting more than 10 lb (about 1 gallon of milk) for the first six weeks.
No sexual activity for the first week after surgery, after that if comfortable.
Return to Work
Your return to work will depend on your recovery and the type of work you do. You must discuss this with your doctor before you return to work.
Incision Care
Caring for your incision at home is important to prevent infection. Please follow the steps below on incision care
Your incision has been closed with suture material under the skin and covered with steri-strips (small pieces of surgical tape) on the skin. The steri-strips will gradually peel off as they get wet and when you take a shower and this is normal and expected.
Take your temperature twice a day for one week.
Call your doctor if you have any of the following
A temperature of 100.5°F or greater for 2 consecutive readings, 4 hours apart.
An increase in pain, redness or swelling around your incision
Clear drainage from your incision
A sudden increase in drainage from your incision
Pain Management
It is usual after surgery, during the healing period, to have occasional pain, numbness, tingling and/or weakness in your neck or arms. If you have pain once you have returned home there are several things you can do to decrease the pain. First try ice, using the technique below:
Ice Technique
Ice the area for 15-20 minutes every hour for 4 consecutive hours. Do not put the ice directly on your skin.
Use a ready-made ice pack or put ice in a plastic bag and then wrap pack or bag in a towel before you use it.
You may also need to use pain medicine. If you do need pain medicine, take the medicine you were prescribed as directed. Do not increase the pain medicine dosage without first contacting your doctor or nurse.
Eventually you should no longer need to use pain medicine. However, if your pain continues, you should call the clinic. Narcotic pain medicine can cause constipation. A walking program that gradually increases the distance you walk will help prevent constipation. Eat plenty of foods with roughage (bran, oats, fruit, applesauce) and drink a lot of fluid (juice, prune juice, water) to prevent constipation.
Avoid taking non-steroidal anti-inflammatory drugs (NSAIDS) for 3 months following surgery. Examples include ibuprofen (generic name), Motrin or Advil (brand name), Celebrex, Bexta, aspirin. Also avoid smoking and limit exposure to cigarette smoke and products containing nicotine. If you have a bone stimulator, follow the instructions given to you.
1st Post-op visit:
Call 630-967-2225 to make your first post-operative appointment at the Spine Center. This usually occurs 2 weeks after your surgical date. All other follow-up visits will be as needed.
Activity
You do not need to wear your TED stockings (heavy white elastic stockings) at home.
You can climb stairs just try not to over-do.
Your may shower 3 days after your surgery day, but keep your incision covered with plastic. Avoid tub baths for the first 4 weeks after surgery and hot tubs for 6 weeks.
Sleep either on your back, stomach or side. You may use pillows for support placed behind your back or between your legs.
It is important to begin a walking program as soon as you leave the hospital.
You may sit for any length of time based on your comfort level. For your comfort, you should change your position every hour. If you become uncomfortable, change your position or activity.
Day 1
(at home)
Walk 1 block in the morning and 1 block in the afternoon/evening.
After Day 1
Increase your distance 1 block per day as long as it is comfortable. You should be walking 1-2 miles per day when you return for your next visit. NOTE: If you need to lift or pick up an object (less than 10 lbs) from the floor, squat with your knees bent; do not bend at your waist.
Limitations
No driving for 3 days, however you may be a passenger.
No lifting more than 10 lbs (about 1 gallon of milk) for the first 2 weeks.
No sports activities (except the walking program) until after your first follow-up visit.
No sexual activity for 1 week, after that if comfortable while lying flat on your back.
Return to Work
Your return to work will depend on your recovery and the type of work you do. You must discuss this with your doctor before you return to work.
Incision Care
Caring for your incision at home is important to prevent infection. Please follow the steps below on incision care:
You should change your dressing daily, and any time it becomes wet.
Your incision has been closed with suture material under the skin and covered with steri-strips (small pieces of surgical tape) on the skin. The steri-strips will gradually peel off as they get wet when you take a shower. This is normal and expected. You may peel them off after 10 days.
Take your temperature twice a day for 1 week.
Call your doctor if you have any of the following
A temperature of 101°F (38.3°C) or greater on 2 readings taken 4 hours apart.
An increase in pain, redness or swelling around your incision.
Clear drainage from your incision.
Increase in drainage from the incision.
Pain Management
It is not unusual after surgery, during the healing process to experience occasional pain, numbness, tingling or weakness in your back or legs. If you experience pain once you have returned home, there are several things you can do to try to decrease the pain. First use ice and try decreasing your activity for 1-2 days.
Ice Method
If you have been provided a cooling device, use it while in bed or sitting. Ice the area for 20 minutes every hour for 4 consecutive hours (especially in the evening). Do not put the ice directly on your skin. Use a ready-made ice pack or put ice in a plastic bag and then wrap pack or bag in a towel before you use it. You may also need to use pain medicine. If you do need pain medicine, take the medicine you were prescribed as directed.
Do not increase the pain medicine dosage without first contacting your doctor or nurse. If you were not given a prescription, you can take Tylenol, or an anti-inflammatory pain medicine such as Ibuprofen, as long as you do not have a history of gastric (stomach) or peptic ulcer disease, kidney/liver disease, or bleeding problems. Eventually you should no longer need to use pain medicine. However, if your pain persists or you have no control over your bowel or bladder you should call the clinic as soon as possible.
1st Post-op visit:
Call (630) 967-2225 to make your first post-operative appointment at the Spine Center.
This usually occurs 2 weeks after your surgical date. All other follow-up visits will be as needed.
Pain Management
This first day or two after surgery, your pain will be managed with IV(intravenous) pain medicine, in the form of an injection, or a Patient Controlled Analgesia Pump (PCA). The PCA pump allows you to control your own pain medicine. When you push a button, pain medicine is pumped through your IV line. Once you start to eat and drink, your pain medicine will be changed to pills.
Activity in the Hospital
The nursing staff will show you how to turn from side to side in bed, move to a comfortable sitting position, then stand and walk. You will probably be walking by the first day after surgery. You will need to wear a brace or corset when you are sitting, standing or walking. You do not need to wear it when you are lying down. You will wear a brace or corset for the first 6 weeks after surgery. Patients having a fusion done due to a thoracic scoliosis or kyphosis may not need to wear a brace. This will be decided at the time of surgery.
Leaving the Hospital
Before you leave the hospital the nurse will review the instructions you will need at home. Before you leave the hospital you should have:
Brace or corset
Pain medicine or a prescription for pain medicine
Dressings, if needed
Activity for the first 6 weeks after surgery
Wear your brace when sitting, standing or walking.
You may remove the brace when lying down.
You may sleep with your brace off.
You may sleep either on your side, stomach or back. You may also use pillows for support behind your back and between your legs when you are lying on your side. When lying on your back, you may use pillows underneath your legs.
You may shower 4 days after surgery. You should avoid tub baths for 4 weeks after surgery. Do not use a hot tub for 6 weeks. If you must shower sooner please keep the incision dry and covered with plastic medical tape. Change the dressing if it becomes wet.
You no longer need to wear the compression stockings once you are up walking and back to your normal activities.
You can sit for as long as you are comfortable, however, it is a good idea to change positions every 30-60 minutes.
You can climb stairs.
You should begin a walking program as soon as you leave the hospital.
Walking Program: This is just a guideline
Day 1:
Walk the length of the hallway at home 3-4 times in the morning and again in the afternoon or evening.
Day 2-6:
Increase the distance walked by a small amount each day.
Walk 1 block in the morning and 1 block in the afternoon/evening.
Day 7:
Walk to the end of the driveway and back in the morning and again in the afternoon or evening.
Day 8:
Walk a half block in the morning and again in the afternoon or evening.
Day 9:
Walk 1 block in the morning and 1 ½ blocks in the afternoon or evening.
Day 10:
Walk 1 ½ blocks in the morning and 1 ½ blocks in the afternoon or evening.
After Day 10:
Continue to increase the distance you walk as tolerated.
Limitations
Do not drive for 2 weeks after surgery or while taking narcotic pain medicine. You may be a passenger. Patients who have extensive fusions such as for scoliosis may not drive. The Doctor will let you know when it is safe to start driving again.
Do not Bend forward at the waist.
Do not life more than 10 pounds (about 1 gallon of milk) for the first six weeks after surgery.
No sports activities except the walking program.
No sexual activity for 3 weeks.
Return to Work
Your return to work will depend on your recovery and the type of work you do. You must discuss this with your doctor before you return to work.
Pain Management at Home
You may have an occasional increase in low back, leg pain and/or numbness after surgery during the healing phase. This is normal and is caused by inflammation or swelling of tissue in your low back. There are several ways to decrease the pain you are having:
Ice the area for 20 minutes every hour for 4 consecutive hours (especially in the evening). Do not put the ice directly on you skin. Use a ready-made ice pack or put ice in a plastic bag then wrap the ice pack or bag in a towel before you use it.
Do not sit more than 15-30 minutes at a time for the next 48 hours.
Take the pain medicine as directed by your doctor. You can also take one extrastrength acetaminophen (Tylenol) every 4 hours between doses of the prescription medicine. Only as needed. If you do wish to take one extra-strength Tylenol, between the prescribed pain medicine doses, you must keep track of how much you take in a 24 hour period. Due to effects on the liver, you should not exceed 4000 mg of acetaminophen in 24 hours.
Do not take anti-inflammatory drugs for 3 months (aspirin, ibuprofen, Motrin, Advil, Aleve, Bextra, Celebrex) after surgery. These medicines delay bone healing. Four to six weeks after surgery, you should no longer need to use pain medicine. Narcotic pain medicine may cause constipation. Eat plenty of foods with roughage (bran, oats, fruit, raw vegetables, applesauce) and drink 6-8 (8 ounce) glasses of fluid (juices, water) a day to prevent constipation.
Incision Care
Caring for your incision at home is important to prevent infection. Try to keep the incision as clean and dry as possible. Your Incision has been closed with absorbable sutures under the skin and small pieces of tape (steri-strips) on top of the skin.
The steri-strips will get wet when you shower. Allow them to peel off on their own. You should change the dressing over your incision once a day, and any time it becomes wet. The dressing may be made of a piece of dry gauze taped in place. It is Important to take your temperature twice a day for ten days after surgery.
Call your doctor if you have any of the following
A temperature of 101°F (38.3°C) or greater on 2 readings taken 4 hours apart.
An increase in pain, redness or swelling around your incision.
Clear drainage from your incision.
Pain behind the knee
Redness, warmth, and tenderness in the back of the calf of your leg(s)
Difficulty urinating or controlling your bowel movements.
If you need a prescription filled
Because your health condition may change over time, your doctor or another provider who has access to your confidential medical records reviews refill requests. By following these simple guidelines, you will avoid any delays in getting your prescription refilled:
1}Contact your pharmacy at least 5 days before your prescription requires refilling. To protect your health, pharmacies will accept refill orders only from your doctor. So, when you call DMG with your request an additional step is added. Your prescription will be filled faster if you call your pharmacy directly; they will then contact DMG.
2} Use the same pharmacy. That way, your pharmacist will have your complete prescription records and you avoid the danger of mixing medications. To make it convenient for you, DMG will work with the pharmacy of your choice. Please choose one pharmacy, and use only that pharmacy. It is an easy way to help protect your health.
3} Call your pharmacy early in the day. This gives your doctor time to review your records. To ensure you get the right medications, we do not rush refills without making sure the order and your record are reviewed. Often, physicians are in surgery or finishing with patients late in the day, and we do not want to interrupt those patients' visits; therefore, refill requests received after 3:00 p.m. Monday through Thursday or after 10:00 a.m. on Friday will be reviewed and filled the next DMG business day.
If you run out of medication before you request a refill
Always call your pharmacy at least 5 days before you run out of medication. This will give the pharmacy plenty of time to contact your doctor, for the doctor to review your record, and for the pharmacist to prepare your medication.
All you have to do is watch your medication levels and there should be no reason for you to run out of medication. It is dangerous to "rush" an order. For your protection, refills are not done at night, over the weekend, on holidays or as an emergency if you have forgotten to call your pharmacy.
If you run out of your prescription early
Your doctor ordered your prescription according to a precise dosage for a prescribed amount of days. If you run out early, it may mean you are experiencing some difficulty with your dosage or medication. Call DMG immediately and explain your difficulty.
If your prescription is lost, misplaced or stolen
To protect your health, lost or stolen prescriptions are replaced only with a physician visit. To avoid possible duplication of prescriptions when an order is lost or stolen, you will want to talk with your doctor. Call DMG to schedule an appointment.
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