I've had X-rays and an MRI scan done and have been diagnosed with severe spinal stenosis. In Bangkok Hospital Pattaya they tried physio and a cortisone shot but they were no help at all. Surgery was recommended but I wasn't comfortable with the doctor I was seeing here, so I went to see Prof. Wicharn at BNH in Bangkok last week.

He seemed to be in no doubt, I need spinal decompression surgery and sooner rather than later. So I'm just about resigned to this prospect but I'm a bit concerned about the recovery.

This will be minimally invasive surgery which should keep the recovery time short but, from what I've read, it still seems to be quite restrictive and prolonged. BNH gave me an information sheet on the surgery but it stops at the point where you're up and about and have been released from hospital.

Reading up on the recovery process at home, it seems that, for around 3 weeks, you're not allowed to lift anything weighing more than 1 to 2 kg; no bending over or twisting of the body; and no driving. This is a bit difficult for me as I live alone, have a large garden that needs constant care, and cook all my own food. It seems that after the operation I won’t be able to do any of that for almost a month, so how does one cope?

I also read that you need physio, but this hasn’t been mentioned by BNH so far. I assume the dressing will also need to be changed daily and the wound cleaned, but it doesn't sound like it's in a convenient location to be able to do it yourself. If you have a live-in partner then fine, but my Thai ladyfriend lives 30 km away and has a business there so she can help me out occasionally, but it's not fair to ask her to do it every day.

I'm sure there are people here who've had this operation and would be grateful if you could share your experience of the recovery period at home once you were released from the hospital. Is it as restrictive as I've read and outlined above? And what happens after the first 3 weeks or so, how long does it take to be able to get back to bending and working in the garden and swimming and so on?

Thanks for any experience and insights.

You need to find someone to take care for a while, one reason i stay friendly with massage ladies, there are residential places you can go

10 minutes ago, scubascuba3 said:

You need to find someone to take care for a while, one reason i stay friendly with massage ladies, there are residential places you can go

I might be willing to pay for a nurse to do home visits to change the dressing, but I have koi carp and a large garden that need to be taken care of. I thought about a hotel stay for a week or ten days, but I'd then have to hire someone to take care of them for me and I may as well just stay at home and save on the hotel cost. Do I need to hire a gardener, a cook and a nurse? That's a bit much, it's why I'm wondering just how restricted you really are in the week or three after the op.

I think you have been reading things that pertain to more extensive types of back surgery...and/ or surgery on cervical rather than lumbar spine.

I have had this surgery. Recovery was quite easy.

No restriction on driving unless taking opiate pain killers, which you are unlikely to need after discharge.

No dressing changes or other wound care that I recall. It is a very tiny excision.

Main movement restriction is on bending over more than x degrees (?45? 90? I forget) and sharply twisting the spine. Buy a "grabber" (reacher) stick beforehand, Lazada and Shopee both have them, and use that to pick things up from the ground or from a high place.

Rare to need physical therapy unless you have muscle wasting etc already developed, and even then it's simple things you can do at home.

Once you are allowed to bend completrey at the waist again, may need to do daily stretches ar first due to muscle tightening.

There was advice not to lift heavy things but the limit was more than the 1-2 kg you have mentioned. I forget what it was exactly but it had minimal impact on my daily life.

Unless there are complications (rare) or you are otherwise debilitated from other causes, no need at all for a nurse or cook. Might be good to have lady friend stay with you first 1-2 nights at home just in case you are still a bit woozy from the anesthesia and post op pain meds. I wasn't, but you could be.

If your garden work is strenuous and involves heavy lifting or bending over, might need to hire someobe to help with that a few times a week.

You will be given a hand out on post op care.

Really not a big deal. Main thing I remember is using the "grabber" stick to avoid bending. Though this proscription is not as serious or prolonged as in fusion procedures.

You are in the best possible hands.

22 minutes ago, Guderian said:

I might be willing to pay for a nurse to do home visits to change the dressing, but I have koi carp and a large garden that need to be taken care of. I thought about a hotel stay for a week or ten days, but I'd then have to hire someone to take care of them for me and I may as well just stay at home and save on the hotel cost. Do I need to hire a gardener, a cook and a nurse? That's a bit much, it's why I'm wondering just how restricted you really are in the week or three after the op.

I have had 2 operations on my back Laminectomies. Yeah you are not gong to be doing a lot of moving around.

I think you may have overlooked one crucial area, though. I am not sure I would want to do a car or bus from BNH to Pattaya after I got discharged, nor coming back to see Dr.

Yes you are going to need someone to look after you. My suggestion would be to ask your lady friend if she knows anyone who can look after you for a month.

You will be limited to walking short distances, and steps are a big no-no.

As for the physio, that is not a big issue, as BNH is part of a large chain and can refer you to Bangkok Hospital in Pattaya. Going for check-ups with Dr. Wichan will be a pain because it is a long trip and uncomfortable.

I was lucky and had a ladyfriend that I was living with who helped me before I went in and while I was in the hospital, as well as when I went home. BNH provides bedding and other items to help you in the hospital and get you meals. Check the meals section, as the last time I was there, it was a separate order. GF bought my meals and brought them into the hospital. I was only in for 4 days, 1 before and 3 after.

If you are having the same surgery, you will be walking the next day, slowly and limited, but walking.

I used BNH and they are very good all the best

49 minutes ago, kingstonkid said:

I have had 2 operations on my back Laminectomies. Yeah you are not gong to be doing a lot of moving around.

I think you may have overlooked one crucial area, though. I am not sure I would want to do a car or bus from BNH to Pattaya after I got discharged, nor coming back to see Dr.

Yes you are going to need someone to look after you. My suggestion would be to ask your lady friend if she knows anyone who can look after you for a month.

You will be limited to walking short distances, and steps are a big no-no.

As for the physio, that is not a big issue, as BNH is part of a large chain and can refer you to Bangkok Hospital in Pattaya. Going for check-ups with Dr. Wichan will be a pain because it is a long trip and uncomfortable.

I was lucky and had a ladyfriend that I was living with who helped me before I went in and while I was in the hospital, as well as when I went home. BNH provides bedding and other items to help you in the hospital and get you meals. Check the meals section, as the last time I was there, it was a separate order. GF bought my meals and brought them into the hospital. I was only in for 4 days, 1 before and 3 after.

If you are having the same surgery, you will be walking the next day, slowly and limited, but walking.

I used BNH and they are very good all the best

What he is having done is quite different from a laminectomy.

He will be up walking before he leaves the hospital and there will be no restriction on walking afterwards, in fact much encouraged.

1 hour ago, Sheryl said:

What he is having done is quite different from a laminectomy.

He will be up walking before he leaves the hospital and there will be no restriction on walking afterwards, in fact much encouraged.

Thanks for the positive information, Sheryl. The handout from BNH on the operation itself calls it 'Spinal fenestration', though Prof Wicharn said spinal decompression. he said the operation would only take around 40 minutes, but it has to be done under general anesthesia. If the recovery is as easy as you say then it's no problem, my ladyfriend can come and stay for a few days and the security guard I use to watch my house, feed the fish and water the garden when I'm away will be happy to help out with that side of things. I already have the litter pickers to get leaves and debris out of the fish pond. I can manage a week of restrictions, but if I can get back to light work after that, especially cooking which is one of my hobbies (it's sole with lemon garlic herb butter and fried potatoes this evening, lol), then I'll be fine. I'll give the nurse who was dealing with me a call and check a few of these things with her.

I had similar surgery some years ago in the USA. A few days before the surgery a 2 piece cast was made that attached with velcro straps. Entered the hospital at 6:00 a.m., had the surgery and recovery rest. I walked out of the hospital in my 2 piece cast at 4:00 p.m. the same day. Did not even have to sleep in the cast but did sleep with the back half still in place. The usual no bending, no twisting applied but I was working 10 days post surgery. My work required driving and flying, quite a challenge at airport security. I think I had the cast about 4 weeks and continued with minimum lifting, bending or twisting another few weeks.

As far as BNH and Dr Wicharn, you would be in very good hands. I have seen him at a later time but at the time I decided to delay the procedure discussed at that time. I have been an in-patient twice at BNH under the care of Dr Nopparat, Chief of Cardio and more departments, I would not trade him for any doctor I have seen here or in the USA during my first 85 years.

i

need a nurse for a month live-in. Hospital usually have a list which can recommend. Cannot handle yourself, alone, cannot go toilet for example.

19 hours ago, Guderian said:

Thanks for the positive information, Sheryl. The handout from BNH on the operation itself calls it 'Spinal fenestration', though Prof Wicharn said spinal decompression. he said the operation would only take around 40 minutes, but it has to be done under general anesthesia. If the recovery is as easy as you say then it's no problem, my ladyfriend can come and stay for a few days and the security guard I use to watch my house, feed the fish and water the garden when I'm away will be happy to help out with that side of things. I already have the litter pickers to get leaves and debris out of the fish pond. I can manage a week of restrictions, but if I can get back to light work after that, especially cooking which is one of my hobbies (it's sole with lemon garlic herb butter and fried potatoes this evening, lol), then I'll be fine. I'll give the nurse who was dealing with me a call and check a few of these things with her.

Barring complications (rare), there should be no problem getting back to cooking and normal household stuff within a few days at most. It was immediate in my case, I even stopped off and did grocery shoppipng on way home from hospital. Just no bending far over or sharp twisting and no heavy lifting for a while. Sounds like you could ask the security guard to help carry in heavy groceries & the like.

Fenestration means removal of part of herniated disk. He will also remove any bone spurs and might thin out thickened ligaments. This is all done through tiny excision using specialized tools. Surgeon skill & experience is everything. You have the very best. .

In the West this is sometimes done as an outpatient day surgery.

One tip: keep opiate pain med use to minimum required as it definitely prolongs recovery period otherwise (not to mention, constipates). It is unavoidable immediately post op but I was able to tell them to take it down in less than 24 hours. Paracetemol usually suffices at home, if not then just keep the other to minimum e.g. once at bedtime if you can. Wooziness from pain meds does more to limit activities than the effects of the surgery per se.

By the way you can email directly to BNH Spine center at <[email protected]>. If appropriate put "Question for Prof. Wicharn" in the subject line. Sign with full name and hospital number. They are usually pretty prompt in replying.

With all due respect the MRI shows a clear but not severe stenosis. I have experience with 7000+ spinal procedures and that has taught me that the "size" of the operation poorly correlates with the speed of post-operative recovery. I have seen the young woman with the mini-surgery taking more time than the construction worker with a multi-level procedure. It is however important not to underestimate spinal surgery. All in all it requires about 2-6 weeks of gradual increase of activities, avoiding too much bending and lifting. A good alternation between resting and light activities works best. But in general the speed and level of recovery is highly individual and depends on other factors than just the extent of surgery.

This is the info document the nurse gave me after the consultation with Prof. Wicharn.

By all accounts, it seems to be a common and not terribly traumatic procedure, so why do they want me to stay for 3 nights? If you can walk not long after the operation that length of stay seems a bit excessive, especially as many people on the internet say they were sent home the same day.

Also, above where the nurse has written 'Admit 3 night', does anyone know what that 'OR 1 ???' means?

Thanks.

Length of stay is mostly hospital policy "we have always done it like this". When I started my career in neurosurgery all spinal patients (mostly disc) stayed 14 days in hospital. One week strictly in bed and one week just mobilization. At careers end all spinal patients, including fusions, were out of bed the same evening and went home the next day. Talking about re-thinking....

6 hours ago, Guderian said:

This is the info document the nurse gave me after the consultation with Prof. Wicharn.

By all accounts, it seems to be a common and not terribly traumatic procedure, so why do they want me to stay for 3 nights? If you can walk not long after the operation that length of stay seems a bit excessive, especially as many people on the internet say they were sent home the same day.

Also, above where the nurse has written 'Admit 3 night', does anyone know what that 'OR 1 ???' means?

Thanks.

It is saying use of the OR for 1 hour. It looks like these notes relate to how the price quote was derived.

The 3 nights was for purposes of price estimation. You will not be required to stay longer than necessary. Once the surgery is over, you've been able to stand & walk OK, and not having much pain/needing much in the wsy of narcotics, you can discuss discharge with the surgeon. Could be less than 3 nights and if so, final price will be less.

Get help arranged now, before surgery. Maybe plan for a month, and if you bounce back quicker, all is good. But if you take a little longer to start doing things on. your own, you have someone ready/already there. All the ones saying you'll be ok, walking before leaving the hospital, etc., it's not them getting the surgery, it's you. Prepare now, then try not to worry, but take care of this now.

THE ONLY MINOR SURGERY IS SURGERY SOMEONE ELSE IS GETTING.

Thanks for the information, Sheryl. I've sent a request to the spinal unit asking if they can give me a copy of their post-discharge advice for patients.