Spinal Fusion: Month 3 Update

I had my 12 week post-op check-up today, and things are going really well. Hardware is still solidly in place, and I’ll see the surgeon again in another 3 months or so. He always seems ecstatic when he sees me, and I’m never certain if he’s that happy for me and my progress, or because his handiwork was that damn good.

He asked “what are you doing right now that you’re not supposed to?” I looked away for a second and then said “well, NOTHING, since your PA said I could do whatever I wanted as long as it didn’t hurt too much.” He seemed to like that answer.

But, I’m being slightly flippant. We got into a detailed conversation about how I’d know when I was doing too much. I mentioned that yesterday I did a hard 90 minute workout on the trainer. No sprints, but lots of time at / near / slightly above my current sustainable power (FTP), and towards the end of the last interval my left leg got that very familiar numbness that creeps down my leg, then turns into a burning pain, and my big toe gets tingly.  I LOVED the feeling of exertion, breathing hard, and pushing my capabilities. However, the surgeon looked me in the eye and said “That. When that happens, you’re doing too much and need to dial it back. There is still swelling at the surgical site and sometimes you need to take it easier.” I promised to take it easier on upcoming rides, but it will be hard to find the right limit.

I told him he didn’t want to know how LONG I could ride the trainer (I secretly wished he would ask so I could tell him I did a trainer century not long ago!). I’ve discovered my current limit isn’t so much about time on the bike, but is more a combination of time and exertion level. I’ve been taking it easy as far as avoiding uncomfortable chairs or postures that aggravate my back. Tomorrow I go back to work, so I expect an increase in pain as I leave my optimized enclave of my home.

The surgeon looked me in the eye and said “That. When that happens, you’re doing too much and need to dial it back. There is still swelling at the surgical site and sometimes you need to take it easier.”

The great news is I have no restrictions on what I can do, as long as I work into it slowly. This is coming from the doctor that originally said I’d have to wait 4-6 months before I could ride outdoors! The doctors also said I couldn’t “do anything stupid” for 1 year (that phrase came out of their mouth after I told them I rode the Lutsen 99er on a fat bike, and explained what the ride was like and how long it took).  BUT PEOPLE!!  THIS MEANS I CAN TRAIN FOR ULTRAS!! Technically I AM banned from running (I asked again, always gotta ask) but that situation hasn’t changed much in the last 5 years. I’m excited because this news means I can continue to push and grow towards some of my 2018 goals. I have no predefined limits and need to go find them through trial and error. Game on!

Spinal fusion isn’t without its downsides. Bolting two vertebrae together causes the rest of the spine to have to pick up the load, and once you’ve had one level fused you’re at risk for having more levels fused in the future. I like knowing what factors are within my control in situations like this, and I asked my doctor just that — I wanted to know what I could do to lower the load on my spine going forward. The surgeon looked straight at me and said “Lose weight. Make your stomach smaller. Work on your core strength.” I nodded in agreement. Sometimes when a health care professional tells me to lose weight out of context, I bristle, but in this situation it made sense. I mean, it’s physics — weight hanging off of my core, where I tend to store fat, will stress the supporting structural elements.  I told him I’m down 10 pounds already since surgery and continuing to drop, and he said that’s perfect —  “You were inactive for months before surgery, that’s to be expected. You’re doing great.”

Long story short, I’m cleared to continue ramping up biking, indoors and out, in both intensity and duration. There are no capacity limits on my cycling as long as I work there gradually (for me, that’s a struggle, but I’m tempering my drive for now). I have a few signs to watch out for that will tell me when I’m overdoing it, and I toe that line and occasionally stumble across it. Steady weight loss will also be on the docket for months to come. I wanted to return to a lower weight, and now I have extra emphasis with legitimate reasons why it’s important. Onward and upward!

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