Tuesday, August 30, 2016

BJJ after 360 Fusion


Because of my size, I only needed the appliance
on one side. You may be different.
  
If you are new to the show and haven’t read my post, 360 Fusion aka Fried Egg Surgery, I will quickly
recap. In January, a disc in my lower back collapsed. (How did that happen? Hard work and dedication, that’s how!) Its collapse compressed my sciatic nerve causing me to lose function and feeling in my left foot, a condition known as “foot drop”. In order to avoid the paralysis from becoming permanent, I had emergency surgery. The disc was removed and my L5 vertebra was permanently attached to the S1 with titanium. (See pic)  

   While recovering, I scanned the internet to learn how my jiu-jitsu game would change after the fusion. I found absolutely nothing. In fact, there wasn’t much positive for anyone hoping to get back to any activity outside of walking. There were warnings-a-plenty and after care instructions that would bore an anvil but nothing that made the tedious effort of recovery feel anything less than a daily shlog.

   Here is what I wish had been there for me. Do not do any of the following without consulting your doctor. In fact, call your doctor now and ask if you can even keep reading.

Pre Op: 
   Leading up to surgery, walk or swim as much as pain allows. Eat plenty of protein and calcium rich foods and consider taking supplements K2 and D3 which aid in calcium absorption. You will need this to build new bone in the gap of the removed disc. Ladies, get a good probiotic, some cranberry juice and D-Mannose to thwart UTIs caused by the catheter and upcoming restroom issues.

Note: In the days leading up to surgery, if you notice sudden weakness in any appendage, call your doctor. You may have compressed a nerve as I did. If that compression isn't relieved within a few days, the loss of function is more likely to be permanent.

   Stock up on leafy greens for post-op. You will need both the calcium and fiber. Speaking of fiber, it is likely the doctor will have you cleanse your bowels. If that isn’t mentioned, request a prescription for GoLYTELY. It will save you a good bit of trouble after surgery. (Be advised that name is completely ironic. You will not, in fact, go “lightly.” I would venture, however, that a more accurate moniker i.e. Bowel Bomb, would be a hard sell marketing-wise.) 

   Ask if you will be given a walker at the hospital. If not, buy one and grab a shower seat while you are at it. Do not attempt to use crutches or a wheelchair. Handy tip: get a tool belt to hang on your walker for odds and ends like the remote, phone etc. Also, if there is an item that you use daily that is stored below waist level, put it on a counter. You will not be bending over for one month and kneeling won’t be possible for at least a week or two, maybe three. But, that’s ok. You’ll be ok.

   When you tell your surgeon that you do BJJ, they will likely look at you like you said you’re a unicorn rancher. You’ll probably then call it Judo or wrestling to help them understand which it won't. I can almost guarantee they will be negative and tell you that you will never do it again. That’s their job. They can’t say you will be fine because sure as shootin’ some stupid patient will hop back on the mat while still on pain meds and end up paralyzed. Remember, the goal of the surgeon is to get you back to a higher quality of life than you have at your worst, not your best.

(The following timeline may be different for you. Might be shorter, might be longer. Either way, be patient. Suck it up, buttercup. If at any point in your recovery you believe you have injured yourself, get ice on your back and call your doctor immediately.)

Day One:
   Today will be terrible. As soon as you are solidly conscious from surgery, you will be taught to get out of bed and made to walk. Yes, even with “foot drop.” A little strength will return to your appendage as soon as the sciatic nerve is freed from the pinch of the disc. But, expect full function to return slowly. (At the writing of this, 7 months post op, my foot and leg are still not 100% functional and may never be. However, nerve regeneration is painfully slow and a bit more may return. I don't notice it on a daily basis and it hasn't caused me issues on the mat. I can even jog some and skip un-inspiringly.) 

   You will also be given a little plastic toy that you blow into to keep your lungs clear. It looks fun. It ain’t. All of this will suck. A lot. (Crude, yes, but completely appropriate.) You’ll be ok. As terrible as today was, you are one day closer to being better that you are right now.

Day Two:
   Today will be worse than yesterday. You will practice getting in and out of bed a lot and walk down the hall. Other patients will stare at you in horror and you won’t care a bit. Take your pain meds around the clock. Hit that morphine button all you want. It’s ok. Your catheter will likely be removed and you will go to the restroom a good bit. It will get on your nerves but it's actually a healthy sign so get over it.

   Point of interest, you may feel little scabs all over your scalp. Do not let the pain meds mess with your head and make you tell the nurse that you have bed bugs - like I did! (I’m telling you, saying “bed bugs” in a hospital is like saying “bomb” on a plane. It doesn’t go over well.) The sores are from wires they attached to you to be sure your spinal cord communication wasn’t disrupted. (Freaky. I know. Don’t think about it.)

Day Three:
   You will go home. Getting in and out of the vehicle will be terrifying but you will do it and you will make it home to your bed and be ok. Keep using the breathing toy every few hours and wear those super sexy therapeutic hose. When you look at your back, don’t freak out and don’t forget there’s another incision just as bad on your lower abs that you won’t be able to see for a while. (I have pics at the bottom of the page. Consider yourself warned.)

Week One At Home:
   Your job is to eat well and sleep hard. The latter is CRUCIAL! Sleeping is when your body does the most healing. Ask your doctor if you can take magnesium at night to aid muscle relaxation. Do not sit up more than a few minutes at a time - 10 minutes max. Get in and out of bed as you were instructed and walk with the walker around your house as much as you can even if you just go to the front door and back to bed. Wear that medieval torture corset (back brace) as much as possible. Do not go to the restroom without your walker and don’t shower without the shower stool.

   Keep a notebook by your pain meds. Write down when you take them and make notes of all the wonderful things you saw while legally high off your rocker. If said rx has you constipated, drink prune juice. You can take a stool softener as well but the juice is better. But for the love of light colored carpet, do NOT take a laxative. You do not want bowels that go faster than your legs or anything that causes abdominal cramping. (Aren’t you already going though enough?) 

   Everything about the restroom is going to be precarious! You’ll be ok. Ladies, take your probiotic and D-Mannose and drink your cranberry juice. Oh, also of note, might be a slight digression, but if at any point you strain, cough or sneeze you will be completely sure your back has exploded. And, if that happens on the commode, well, you’ll get religion. But, you’ll be ok.

   If your doctor used skin glue on your incisions it may start peeling. Leave it alone. Make your loved ones leave it alone. (You will be surprised how many of your loved ones and friends suddenly become highly skilled doctors!)

You will see your surgeon this week. Riding in the car will be scary. Wear your back brace. You’ll be ok.

Week Two:
   You will turn a little corner this week and upgrade from feeling horrifyingly awful to just terrible. Ween off the pain rx as soon as you can. Switch to acetaminophen. Remember, NO ibuprofen for three months.
Continue to take your walker with you to the restroom and keep that seat in the shower. Eat well, sleep lots, walk often. You may now take off the therapeutic hose and display them proudly on your mantel. 

Weeks Three & Four:
   Continue walking. You can’t walk too much. If you have foot drop, do not walk until your foot drags behind you. It's not good for your foot or your self esteem. (Although, it's a pretty sweet gansta swagger!) Wear your back brace a little looser to make your abs work some. Do not be tempted to bend at the waist. Remember that scene in Alien where the little critter burst out the guy’s stomach? If you bend forward it will feel like that except out your back. 

Month Two:
   Get to a physical therapist that actually knows what Brazilian Jiu-jitsu is! Ask around at your gym or call local MMA/boxing/gymnastics gyms. Find who those athletes go to and start going. The therapist will work on your flexibility and strengthening your core and by core I mean everything from the base of your neck to your knees. The fusion(s), once set, will not break because they will have titaniumly awesome support. Notice that I said, once set. Do not disrupt that crucial process by doing anything other than walking. Don’t even do an elliptical just yet. It takes a full year for the fusion process to complete but months one through three are when you have to be most careful. 

   Although the titanium in your back is basically indestructible (btw, you won’t make metal detectors go off), the discs above and below the fusion will be working extra hard to make up for the mobility and will be fragile because of it. Those discs should be cared for and valued like they hold the secret to life because they are key to you getting back to it! You want to be sure they have tough muscle supporting them. 

   The physical therapy will be crummy. Be patient. If you have “foot drop,” be extra patient. You may have to go for shorter walks multiple times a day. Again, don’t walk until that foot is dragging behind you.  

NOTE: Somewhere between months two and four you are going to have a mental set-back. You will find yourself more mobile. You will be turning over in bed without waking and moving a little quicker. But, you will also be keenly aware of the metal in your back. And, when you cough or sneeze, you will still brace for explosion. You will wonder if this is how you will be forever. You won’t. Promise.

Months Three Through Six:
   Time to pick up the pace! The growing bone needs to solidify and your movement helps that process. Walk more. Walk farther. Walk faster. But, just walk. No running. The elliptical will likely be fine but ask your PT first. Don't ride a bike because of the fall risk. Also, stretch as much as possible, at least once a day.

   You should be good to drive now. Wear the brace every single time you get into the car until your PT says otherwise. Whenever possible, park so that you don't have to back out. Looking over your shoulder will be very hard. 

   Drive to your BJJ gym. Smell the funk and watch class. (Don’t you dare get on that mat or walk across it while others are rolling.) Work hard in PT. Make them push you and do the exercises at home that they prescribe. You will be able to take ibuprofen soon which will really help.

   Keep an eye on your scars. Note the swelling and tenderness. How you are healing on the outside is a good indication of how the inside of you is doing. Remember, you had major surgery. There were a lot of doctors in the room for a reason. It wasn’t a club meeting!

Months Six-Ten:
   With PT approval, get back on the mat…sort of. You will not be sparring. You will find a purple or higher belt THAT YOU KNOW to flow with. (Do not be tempted to roll with a lower belt no matter how easy they promise to go. Also, steer clear of folks you don’t know for now. Just trust me.) If you aren’t skilled enough to flow, tell your partner to help you. You should be in no situation that requires you to tap! If you are too tired or sore to keep flowing, see if anyone will just let you practice technique and transitions. 

   You will likely be shocked at how your game has changed. You will not have the mobility you once had. A backward roll won’t be possible just yet. When you pull your knees to your chest and fall back, you will look like a Lego block toppling over. If the fusion is low on your back, your hips will make up for the lack of mobility and be very sore. Be patient. Go slow. Don’t do anything fast. The only goal you have right now is increasing your flexibility. Do not try to get better at BJJ. Just figure out your new game and I will tell you, it may not be on your back. That’s ok. The beauty of Brazilian Jiu-jitsu is that you can adapt it to your needs.

NO TAKE-DOWNS FOR ONE YEAR!

Months Ten - Twelve:
   Spar easy after a good long warm up. Do not ever start class without warming up. Start practicing shoulder rolls from the ground as well as granby rolls. Use a wall to help you do some backward. Tell your high belt partners (still purple and above) to put you in submissions and allow you to work your way out of them. Get your defense and escapes solid with your new “game”. Don’t worry about your attacks. If you see one and can get it, great. But don’t work for it. It’s the defense that will keep your back safe. 
Tell your partner no wizzers, bow and arrows, stacks, or anything that twists or puts pressure directly on your spine. Remind your partner to sweep slowly and go gently into truck. 

   The majority of your pain will be from stiffness. Good ole’ BJJ will help with that. If a hand, fist or foot gets trapped under your back on the site of the apparatus and you lie back on it, it will smart and maybe remain sore afterward. You’ll be ok. If you are sore after class, ease up for the next couple and, sore or not, get some heat on your back after every single one. You may notice your vertebrae above and below feel bruised. Tell your PT. Likely, it's just muscle soreness. Epsom salt baths are great for that and don't forget to take magnesium at night. Again, make sure your doctor is ok with that.

One year.
   Attack! Get back on that mat! You will be better than before in many ways. You will have a greater appreciation for the mat and the patience of Job which is as valuable an attribute as any other. Be thankful for your new body. Encourage others who are injured and just work to be bester than you were yesterday. Yes, I said bester because today is your best day for the simple fact that you have it.



   Seven months post-op, I don’t feel much in my back. Every now and then, I forget about it altogether. I’m still stiff and it is weird that a portion of my back doesn't bend. There are moves I’m not up for yet. Before, leg triangles from the bottom were my go-to. I haven’t pulled a single one off post-op but I’ve done them from side control which people don’t see coming as much so it's a better option anyway. 

   Even with stiffness and slightly limited mobility, my BJJ is better than ever, in part, because, for the first time, I can train five + days a week and spar every round. If I get sore during training, as I did today, I take a round off then get back to it without issue. Before surgery, I could only train twice a week and couldn't spar more than two rounds without taking a break. Otherwise, I would be in too much pain for days after to be productive. 

   Don't get me wrong, I’m still sore - which I don’t consider to be the same as pain. My hips are sometimes so sore I struggle to stand up from the mat. But, I’ll happily take it. Honestly, my biggest struggle now is fear. I fear hurting my back again, fear my partner will hurt it. I fear the people around me rolling will hurt it. I think that's good though for now. I once heard George Foreman say his greatest ally in the ring was his own fear. It made him keep his hands up. The one time he wasn't afraid was against Ali...who knocked him out.

   Last week, I earned my blue belt. Without the fusion,
that wouldn't have been possible. If you've earned your blue belt, you know that once you do, everyone else picks up their game. All the high belts that used to let you work and get submissions will no longer do that. So, I’m getting thrashed. Soundly. But, if at any point I feel in danger, I tap. And, I’m still not up for rolling with people I don't know unless a higher belt can assure me that the new person is safe for me. There's nothing wrong with that. I'm plenty tough and I have no need to convince anybody else of that fact. The scars on my back and abs are proof that I have absolutely nothing to prove. 

   Above all, I’m finding that the surgery wasn't just a blessing to my body but spirit as well. I’m thankful every single day for my health. I cried for days after getting my belt just out of gratitude to the Lord for letting me get back on the mat.  

   That said, I realize that some of you reading this may find that your fusion(s) doesn't/don’t allow you to get back to BJJ. Pout, scream, cry and mourn for a while. You are allowed, it's justified. Then, move on. If BJJ was your entire life, you have a problem bigger than not being able to do BJJ.

   Go look at yourself in the mirror. Check out your back. Look at your x-rays. You’re blessed to be up and walking. At it’s core, BJJ is about adapting, flowing like water, constantly moving forward, and, in that moving, wearing down or maneuvering around whatever is in your way. None of those qualities are peculiar to the mat. Adapt. Flow. Refuse to give up. Once upon a time, BJJ was new. How do you know that whatever new thing that comes next won’t be as life-changing? 


God bless. Keep flowing. See you on the mat.


   (I would be completely remiss not to say thank you to my husband and friends as well as gym family who supported and still support me through this. The folks at Ground Dwellers Brazilian Jiujitsu, Spring, Texas, took care of me from the moment I stepped back on the mat and continue to care for me. Without a gym like I have, it would have been easy to stay in my recliner, to give up and resign myself to sitting on the sidelines. If your gym doesn't support you in your recovery, if they don't ask how you are doing, aren't extremely careful with you and encourage you, you are at the wrong gym.)  

If you have had this surgery, please post any recovery hacks I overlooked.

As warned, here's the pics...


Week One - The incision on my abs is too low to show.  
Week Two - Skin glue is peeling.
Week Three - still swollen even on flanks. Skin glue off left side.
One Month

Seven Months - TaDa! Behold, the cyborg!


2 comments:

  1. Wow. So much info given in your honestly funny voice.

    Question: why the abdominal incision for back surgery?

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    Replies
    1. They go in through the front to remove the disc then flip you over. Thus the 360 part of the fusion. It's a crazy surgery. But, I'm thankful every single day for it. Read the "fried egg surgery" post if you have a chance. I tell all the stuff I did/said/saw while high on meds. It will and won't surprise you! :)

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