Spinal AVM/F - surgery and bowel issues

Hello again Stephanie,

I thought this would be a good place to reply to your topic and update you on my progress since being released from the hospital.
As I mentioned briefly, I too have had a set-back in my ability to walk since surgery. I notice my balance is a tiny bit better because I have a slightly better sense of feeling in the soles of my feet. A positive sign. On the other hand, my ability to control my leg movements are sluggish compared to my pre-surgery state and requires a lot more of a concerted effort to complete a stride which leaves me looking for any external form of support for fear of stumbling. Prior to surgery I could, slowly, negotiate stairs by firmly grasping the handrail. Now I need both the handrail and a cane.

I actually collapsed going up my hardwood staircase three days after returning home. Half-way up, gravity and my leg muscles came to a stalemate, with gravity slowly winning. I knew if I went straight down on my knees I would risk sliding down the 6 stairs I had just climbed. I also suspected if I rotated to sit on the closest step I could risk injuring the incision site on my back by scraping against the next stair up from where I would be sitting. I elected instead to abandon my cane (it was of no use at this point) and grabbed the handrail with both hands and “crumple” into a ”side-saddle” position on the closest stair. Now, what to do?

I had no power to lift my legs up, but could feel I had the ability to push upwards by digging in my heels. So my plan was to pull my feet up to the step below where I was sitting by grabbing my sweat pants below my knees and pulling my feet up into position and then, with the palms of my hands on both sides of my body on the stair above me, simultaneously pushing my legs straight through my heels and pushing my arms straight through my palms and thus lifting my butt to the next stair above. And repeat until I got to the top landing. Great theory! I quickly discovered my arms were about one inch too short!! I was able to quickly modify the procedure by reaching up and back with my right hand, grasping the handrail and while pushing with my legs and left arm while hoisting with my right arm, manage to get to the next stair above me.
Once on the landing, and after a few failed attempts, was able to roll over to a position where I was on my hands and knees and could then crawl to my bedroom and ultimately to the footboard of my bed. Fortunately my bed frame is made of a very solid hardwood and I was able to push up to a standing position and then maneuver myself to the side of the mattress and flop down into a prone position on top of the mattress. That was 30 minutes of hard work. I was sweating profusely and breathing hard, but I made it. So much for the “No Lifting, No Bending, and No Twisting” instructions I received when discharged from the hospital :sweat_smile:. I have had no re-occurrence while negotiating stairs since that episode.

But enough about my legs and back to the topic at hand – Surgery and Bowels.

I am experiencing some issues with my bowels as well post surgery. I have had a mishap and as a result take full advantage of trying to relieve myself on a regular basis whether I “feel” the urge or not. Apparently I have lost some control/sensation of my sphincter muscles. I was told this issue is not an unexpected result after this type of surgery due to increased swelling and spinal cord compression (in my case from T-11 all the way down to the Conus). The doctors carefully refrain from using the terms “normal” or “temporary” as they have little meaning since everyone is different. But the expected result is improvement as the swelling subsides. They are also attributing my collapse on the staircase to the increased swelling as well.

Now, my bladder issue is a different story. Certainly some of the intermittent incontinence can be attributed to the after effects of spinal surgery but in my case, there may be another underlying issue. Due to the AVM having not been diagnosed for so many years and the “good” doctors chalking up my ever increasing bladder issues to “just old-guy enlarged prostate” problems, further testing is warranted. In fact, I am going for a pelvic ultrasound (including kidneys) in about two hours from now. I am forced to self-catheter 4 times a day and track the residual amounts as mine are way above normal. We’ll await results!!

On another note, I am keenly interested in what your physio/occupational therapist prescribes for your rehabilitation regimen and please update with your progress once you commence your program. From all accounts I am several weeks away from knowing anything concrete about a rehab program for me. However, yesterday, I was given the go ahead to use a stationary bike (absolutely no resistance of course) in order to start training my body to produce a rhythmic leg motion.

As always, stay the course and setbacks are only there to have something to overcome!! As Sir Edmund Hillary once said, “It is not the mountain we conquer, but ourselves”.

Brent