What to expect after surgery and going home
Immediately after the operation you will be taken on your bed to the recovery ward where nurses will regularly monitor your blood pressure and pulse. Oxygen will be given to you through a facemask for a period of time to help you recover from the anaesthetic. You will have an intravenous drip until you are able to drink adequately. A drain (tube) may be placed near the surgical incision if there has been significant bleeding during the operation. This removes any excess blood or fluid collecting under the wound. The drain will be removed when the drainage has stopped, usually the next day, after surgery.
It is very normal to experience some level of discomfort or back and leg pain after the surgery. The nursing and medical staff will help you to control this with appropriate medication. The symptoms in your legs may fluctuate due to increased swelling around the nerves. As the nerves become less irritated and swollen, your leg pain should settle. This can take 6–8 weeks, or longer. It is important not to suddenly stop taking certain pain relief medication. It may be necessary to gradually ‘wean’ yourself off them – your GP can advise you if necessary.
The ward physiotherapist will visit you after the operation to teach you exercises and help you out of bed. They will show you the correct way to move safely. Once you are confident and independently mobile, you will be encouraged to practise climbing stairs with the physiotherapist. Once stable, you will be allowed home, sometimes the same day but usually on the day after surgery.
Please arrange for a friend or relative to collect you, as driving yourself or taking public transport is not advised in the initial stages of recovery. If you qualify for patient transport and are likely to require this service, please let one of the nurses know as soon as you can as this may need to be pre-arranged or your discharge home could be delayed.
Wound care
Skin wound closure will normally be with absorbable sutures (stitches). You will be advised by the ward nurse whether you need to make an appointment with your GP’s practice nurse to have a wound check or when you can take off the dressing yourself. You may shower 48 hours after surgery if you are careful but you must avoid getting the dressing too wet.
Most dressings used are ‘splash-proof’, but if water gets underneath, it will need to be changed. A simple, dry dressing from a pharmacy is sufficient to use. Bathing should be avoided for two weeks. Please contact your hospital or your GP if you think your wound might be infected. Symptoms could include: • redness around the wound; • wound leakage; or • you have a high temperature. Once the wound has been checked and if the scar is sensitive to touch, you can start to massage around the scar using an unperfumed cream or oil to encourage normal sensation and healing.
Driving
Normally you will be advised to avoid driving for 2–4 weeks, depending on the type of surgery you have had. If you have no altered sensation or weakness in your legs, you may resume driving if you feel safe to do so, but you must be confident to do an emergency stop. It is advisable not to travel for long distances initially (no longer than 20 minutes), without taking a break to ‘stretch your legs’. Gradually increase your sitting tolerance over 4–6 weeks.
Recreational activities
It is important to keep mobile after surgery. You will find you get stiff if sitting for longer than about 20 minutes, so get up and walk about regularly. Walking outside is fine but again, increase your walking distances gradually. The fibrous wall of the disc cannot be repaired during surgery and will heal at different times for everybody, so you will be advised to avoid lifting anything heavy, certainly for the first 2–3 weeks, but maybe for as long as three months, after your operation. Having surgery does not prevent you from developing further disc degeneration.
Please check with Mr Paremain and your physiotherapist when you are able to resume specific activities, such as swimming or running, as the advice could range from between two weeks to three months. A gradual return to sport is then advisable. You should avoid flying for six weeks (and long-haul flights for up to three months).
Work
Returning to work is dependent both on your recovery and your job. Most people are off work for an initial two weeks but if you are in a strenuous job you may need up to six weeks. It is always sensible to discuss with your employer if you can return on ‘light duties’ or reduced hours at first. There is usually nothing to stop you doing computer/office work at an earlier date, as long as you can keep moving about. The hospital will issue you with a fitness to work (off work) certificate or you may ask your GP.
Follow-up
You will be sent an appointment to attend clinic about six weeks after your operation. If you have any queries before your follow-up date do please contact the nurse specialist or other member of Mr Paremains team.