SDR TIPS for Pre-Op and Post-Op

These tips were developed with adult St. Louis patients in mind, but many may be helpful for children and patients at other hospitals too! I’ve organized the tips in chronological order.
  1. When they take the X-ray to mark L1 (which St. Louis does a day or two before surgery), ask for tegaderm over the permanent marker “X” on your spine. That way you can take a shower the night/morning before surgery and not have to worry about washing it off.
  2. If you’re prone to nausea after waking up from anesthesia, let them know! My anesthesiologist asked my surgeon’s permission to add propofol and extra fluids to my medications during surgery. I also was given a motion sickness patch to place behind my ear. I woke up with no post-op nausea for the first time ever. (These tips aren’t guaranteed; some people have used these tricks and still woke up with nausea. But my anesthesiologist said that it reduces your chances!)
  3. If you do have nausea later on and an anti-nausea medication isn’t working, make sure your pain is adequately controlled. My pain and nausea seemed to go together sometimes, and when my pain went down, so did my nausea.
  4. Ask for a wedge pillow when you’re in the hospital. It’ll support your back while you sleep on your side and it will make rolling over easier.
  5. Stay on top of your pain meds, especially when you transition to oral meds, because those take longer to kick in. It’s better to take the medication when you’re in a little bit of pain than to wait until it’s harder to control.
  6. If you get a headache during your hospital stay or shortly after, there’s a good chance it’s a spinal headache. These are quite common after SDR due to a small amount of cerebrospinal fluid loss from the surgery. Stay lying down with your head flat as much as possible, because these headaches tend to worsen when you sit or stand. Caffeinated beverages, like soda or coffee, can also help! Your headache should improve relatively quickly as your body naturally replenishes your spinal fluid, but if time, caffeine, and rest don’t help enough, you can get a steroid prescription that should resolve it.
  7. The neurosurgery floor of St. Louis Children’s Hospital has an accessible shower. If you’re feeling like you desperately need a shower, ask your nurses if they’ll let you use it. They offered to cover my incision to keep it dry and help me shower. But they can also wash your hair from bed if that’s easier. My wonderful nurse even did my hair for me! 🙂
  8. St. Louis Bread Company (AKA Panera Bread) is right near the hospital. They have great soups and breads that whoever is with you can get for you if you don’t have much of an appetite and don’t feel like eating hospital food. When I wasn’t hungry, a little bit of crusty bread and soup were easy on my stomach.
  9. St. Louis Children’s Hospital has a beautiful rooftop garden on the 8th floor; it’s a wonderful place to visit and relax for a bit after day 3 if your SDR is at Children’s.
  10. Ask the nurses if you can take a pillow home with you to put behind your back while you’re sitting, or borrow one from home or your hotel (with your hotel’s permission, of course). You’ll be a lot more comfortable that way.
  11. If you can afford it, plan to stay a few extra days in St. Louis after hospital discharge in order to recover further and catch up on sleep. You can even book some extra PT sessions with St. Louis Children’s, and these sessions may be covered by your insurance. (International patients will stay for 3 weeks of additional PT, so this tip isn’t applicable to them.)
  12. Take pain medication before even starting your journey home and top up as needed.
  13. Consider getting compression socks that fit you properly if your flight is long and you’re an older adult. These will help prevent deep vein thrombosis. If you can safely move around at all during the flight, this will help as well.
  14. Lie down on the airport floor (or benches, etc.) to relax your back if you have a long wait at the airport. Lie on a coat or blanket for comfort and to protect from germs.
  15. Book assistance for the airports and connections.
  16. If you’re short in stature, plan to put a bag under your feet during your flight to elevate your knees a bit. It will be much easier on your back.
  17. If you end up with nerve pain issues (usually around day 10 post-SDR, starting with achiness that progresses over the next few days to a painful static electricity/sunburned feeling), and if these aren’t being resolved with magnesium supplements, consider contacting your surgeon’s office for a gabapentin or Lyrica prescription. Gabapentin has many potential side effects and can negatively impact your mood, so it should be taken with caution and for as little time as possible (per your surgeon’s instructions), but it can be very helpful in resolving the short-term nerve pain that sometimes occurs after SDR. (See the Magnesium and Gabapentin page on this site for further information.)
  18. Occasionally, people will end up with a urinary tract infection around day 10 (the catheter used for the first few days after surgery can increase this risk). The usual symptom (burning when urinating) can be missed due to that early post-op numbness. Watch for other symptoms, like frequent urination and possibly fever.