Back Pain Relief Institute's Caring top spine surgeons work together to bring you a smooth and seamless outpatient surgery experience.
Prior to you appointment with us:
- Please stop all Aspirin and NSAIDS products 14 days prior to your expected diagnostic date and remain off until after your surgery. All other regularly taken medications should be taken with a small amount of water as usual.
- Stop Coumadin 5 days and Plavix 7 days prior to your expected diagnostic date and remain off until after your surgery, after you have consulted with the doctor who put you on the Coumadin or Plavix.
- Stop all supplements (especially fish oil) and herbs 7 days prior to your procedure date.
- Start Colace (Available over the counter) 100mg 1 tablet twice daily on the day before your surgery and remain on it as long as needed after your surgery. Colace, is a mild stool softener which can lessen the constipating effects of Narcotics used for pain control. If you are unsure about taking or stopping a medication contact our office at the above number for clarification.
- Please stay hydrated before and after your surgery. Drinking one (1) quart of water for every 30 pounds of body weight per day is adequate.
Day of your surgery:
- DO NOT EAT OR DRINK ANYTHING, NOTHING BY MOUTH AFTER MIDNIGHT THE DAY PRIOR TO YOUR PROCEDURE, except your normal medication which can be taken with a small amount of water. Otherwise, no food, water, candy, gum, cough drops, or fluids of any kind. (It is acceptable and encouraged to brush your teeth prior to arriving at the center.)
- Please do not wear jewelry the day of your procedure, this includes body piercing. We suggest leaving any valuables at home or secure them with the person who brings you. Wear loose, comfortable clothing. You may want to bring a light jacket as well.
- FOR YOUR SAFETY, WE REQUIRE YOU TO ARRANGE SOMEONE TO DRIVE YOU HOME AFTER ALL PROCEDURES. AFTER THE SURGERY SOMEONE IS REQUIRED TO STAY WITH YOU FOR THE FIRST 4 HOURS.
If this is an issue, let the office know as soon as possible to discuss your options. Some facilities will cancel your procedure unless you bring someone with you on the day of your procedure.
After the Surgery
The best plan of action is to arrange for some food back in the hotel room. Good choices are soup and and something light, like a salad or sandwich. I don’t recommend a full meal. Remember to get a little something on your stomach before taking your pain pills. There is usually enough local anesthetic to keep the pain tolerable till you get back to the hotel or home and eat.
The pain will increase as time progresses so we recommend getting back fairly quickly and getting settled and comfortable. Some people might want to go to a restaurant to eat before going back “home”. This is sometimes possible if the patient is feeling pretty well and steady after the surgery, but not my best recommendation.
Your first couple of days after surgery can be made so easy by using the pain pills properly. In general, I think it is best to take smaller amounts of narcotics more often for the first couple of days to stay ahead of the pain. Don’t wait till pain increases before taking the pain pills. Start taking the pain pills right away after surgery to prevent the pain from getting going. This will make all the difference in the world.
The reason I suggest taking smaller amounts of narcotics more frequently is because they can make you nauseated, especially with a sensitive or empty stomach! So get something in your stomach and take one half or one pain pill and see how it goes. Usually the prescription will say one or two pills every 4 to 6 hours, well this can also mean one pill every 2 or 3 hours. If you are very sensitive to narcotics, then you could break the pill in half.
For the first couple of days, take the pain pills “by the clock”, in other words, take some pain medicine every so many hours; don’t wait for the pain to increase. The reason for this to maintain a “blood level” of circulating narcotic, rather than let the level drop too low when you would be more vulnerable to the pain.
Right after surgery, you might take a pill every 2 or 3 hours. Don’t even let the pain start to increase, take the pills “by the clock” with a little something to eat. If things are going well pain-wise or you are feeling too sedated, then try stretching the interval out to a pill every 4 or 5 hours.
A common question is whether to waken someone to take their pain pills. I don’t have a definitive answer for this. My recommendation is to take your pills “by the clock” and don’t worry if you fall asleep. There is no need to wake up to stay on the schedule. When you do wake up, just have a pill and something to drink at bedside, and reset the clock. After a couple of days pass, then you can increase the time interval until you can take the pills on the basis of “when you are beginning to hurt”.
Don’t forget the ice, it can be really helpful.
When you leave the hospital, there will be a waterproof plastic covering over your dressing. This is waterproof, so you can take a shower if you like.
If there is some drainage from the wound, this is not that unusual. Sometimes there will be some superficial bleeding or oozing that occurs on the first night that will stop shortly. On rare occasion, the bed sheets may become tinged. In this situation, a folded towel can be placed against the wound to apply some pressure.
Feel free to call Dr. Mork if you like. Dr. Mork will check your dressing in the morning and give instructions on what do from there on.
4.Activity Immediately After Surgery (Days 1-4):
Stay comfortable for the first few days after your surgery. Avoid the temptation to “test the work out”. Changing positions from sitting, standing/walking and lying down can be helpful. Use pillows when helpful. If you want to walk, go about half the distance that you think you can, and quit. You will make slow steady progress this way and not stress the situation.
5.Activity After Surgery (Day 5+): Use the clock.
The main problem I see after surgery is one where people attempt an activity, feel comfortable, then do it too long, and then start to ache later on. If you want to start walking, start by going five minutes out and five minutes back on day two. Even if the day is beautiful, just quit and see how you feel after a couple of hours.
If you have some aching, you could shorten your time to three minutes out and back. If you had no problem with the five minutes, then move up to eight minutes out and back. Using this technique with the clock, you will always know within a couple of minutes what is enough of an activity and what is too much. This “activity by the clock” technique should be used for all activities from sitting in a car, playing golf, or mowing the grass.
Go “by the clock” and not by how you feel. The reason for this is that there will be a lag time after an activity finishes and that you might feel the pain from overdoing it. The only way to avoid this is to not overdo it in the first place. This “by the clock” technique will allow you faster and smoother progress by not trying to “work through the pain”. The “no pain, no gain” concept is not appropriate after spine surgery.
6.The Biggest Problem After Endoscopic Spine Surgery
The biggest problem I have with patients after surgery is that they forget that they had a pain problem and do something without thinking and the pain will come back. In 10-14 days, most of your surgical pain will be gone and often so is the pain that was the cause for your surgery. At this time it is easy for you to forget that you ever had a problem and it’s easy to just bend over the dishwasher, or pick up a child or suitcase without thinking. Without pain, your mind will return to a time when you could do anything without any pain and you will act accordingly. You must avoid extra stresses or strains for that first six weeks at least, till the early scarring process starts to stabilize the surgical area.