L5/S1 Microdiscectomy Success - Week 3

Discussion in 'Back Problems' started by microsuccess, Jul 12, 2012.

  1. microsuccess

    microsuccess
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    Hi, I am writing this as I have gone through 2 years of chronic sciatic pain in my left leg and 3 weeks ago underwent a microdiscetomy on the L5/S1 at Stoke hospital UK on the NHS.

    I'm going to keep this short: I feel down stairs on a night out and awoke in what only other sufferers will know as the agony of sciatic pain. I couldn't sleep properly, or move other than walk short distances. Sitting was out the window and the drugs regime was intense. Having waited 2yrs on the NHS waiting list without a I was finally called to my local hospital to undergo the L5/S1 procedure. I couldn't of done this without being self employed and my heart goes out to anyone in a similar position that has an unhelpful employer when it come to work.

    Surgery: General aneasthetic and I was kept in over night (if you can get this then stay over night, I personally felt this has led to my present relative success).

    Awoke: 99% painfree!!! No leg pain except a tiny dull attempt by the nerve to try firing. My pain threshold meant I barely noticed once every 3-4hrs. Nurses and dr came to see me in the morning to explain the surgery was a success and they envisaged a success if I was in very little pain 15hrs on from the surgery. This is because the anaesthetic would have just about worn off. Oh and all numbness gone!!! So all in all if they'd rubbed the nerve or aggravated it during surgery then the signs of a dural tear or negative impact on the S1 nerve would have been noticable. Please note the part of your back they enter from is very very tender and getting up/down is difficult. BUT the pain is just pain and not sciatic so you will see (if you have it) that it equates to an annoyance and no where near sciatic pain:). The bum tightness/pain had also gone. Oh and drugs. I had 1 x ibuprofen at breakfast. This is all I needed!!! I was told 6 weeks and the NHS would be in touch.

    Home: After NHS physios have you up and walking and doing stairs for 10mins they will sign off you can go home. They show you how to get in/out bed and move round - Brilliant. I had a friend pick me up and I laid in the back of the car. Again this worked well. I hadn't sat at this point 24hr since surgery. I live alone so had set things high up as I had seen online is better. Ok so not a good idea. I wish I had family round more often but im 41yr old and prefer'ed to look after myself. If you can get help in do it. Drinking, eating etc all require you up and moving. This is dooable but hard work and I did feel undid a bit of the good work the surgeons had done. You can walk little shuffles and is pulls on the incision site but is amazing. I could even stand up straight for the first time in 4yrs with Zero pain!

    Week 1 suggestions: Get help. Use ice. Put pillows by your side when you sleep so you dont twist while asleep. Sleep!!!! (Your body recovers better). Relax, the incision site hurts a lot, let it heal

    Week 2 Suggestions: Same as above but I started walking. 200m twice a day down the street. Tired me out and pulled on the incision site but I was told its needed to work off the scar tissue

    Week 3 Suggestions: Same as week 1. I've decided one step forward one step back for the 6 weeks for optimum recovery.

    If your living in pain and have had the steroid injections, physiotherapy etc with no success then you may be left with the microdiscectomy as your only option. Some people I know fully recovered after the injection calmed the disc down and let it go back in. Some people I met in the waiting room had gone with chiropracters that made it worse. So for me I focussed on getting surgery because I wanted a full fix and not a quick plaster with temporary relief. For all anyone may abuse the NHS this surgery is very common for spinal surgeons and they see very good results. I trusted them and believe they will help me get through this.

    Final note: Before surgery they will go through expectation management. For me I said if they can remove the pain and resign me to a less active life then I can live with this. I was very active for my age and an avid american football/rugby player. This i was told is possible to return to but not overly advisable. There are case studies on professional athletes showing 80% return to very demanding sports so I see it as, do what your told and you can go far.

    Don't read to much internet stuff. Its blighted my outlook
     
  2. SPINELF

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    Great post microsuccess, great detail:)

    It looks like you got one of the good & caring Surgeons. [​IMG]

    Your post goes to prove, once again, that if a Good Surgeon catches a back and leg pain sufferer early, whilst they are still at peak fitness, the clinical outcome of 'even' open back procedures, is far better and more complete for sufferers.

    Best wishes and here's hoping for your quick complete recovery.

    SPINELF
     
  3. microsuccess

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    Week 4

    Hi, I thought as I'm still at home I will keep my status up to date in case anyone wants to know anything (fire away with pre-surgery Qu's - I'm more than happy to pass on any info I know).

    Week 4: I went back onto my active week this week after resting last week. The difference is amazing. Im only on day 2 of this week but already I've noted my bending is so much better. I can pickup things flat to the floor which I haven't previously tried. I obviously take care and bend at the knees but I can also lean forward without distress.

    Arms: Carrying objects is something I've noted you need to watch out for. a GLASS of water in week 1 when stood up was painful. Week 2 I was able to lift a medium sized book and week 3 my laptop. This week Im not going further than the laptop weight. My regime for my arms remains standing up right and raising my arms from the my sides out infront of myself and then up until direct above my head. I have been doing this since week two. I know it sounds like nothing but I was told reintroducing the lower back to common movements with no weight is a good excerise.

    Core: Rotating in and out of bed/laying down was an issue until week 3. The twist worried me as I raised my legs off the floor to lay down, and involves you momentarily sitting on the edge of the bed as you lower yourself. Don't panic about it. Your going to have to do it at some point. This week I've noticed nearly zero pull at the incision site when I go to perch and then lay down. I exercises yesterday with mini-dorsal flexes whereby you lay on your tummy flat out and raise one arms 2-4inch off the floor, then the other. Again tiny movements but you feel them and they get the lower back realising how to function. - Also i was told good for working off scar tissue.

    Legs: Walk walk walk walk. I was at 100m at the end of week 1. My choice, as Im viewing this as a long term recovery. Week 2 400m a day, Week 3 400m x 2 a day and this week I did 800m twice yesterday. I have been using a running track to walk round as it lets me stay on level ground a set myself a goal as I walk. I honestly know I could do upwards of 1-2miles but again Im a cautious man and never want to go through the trauma of the last 2yrs ever again.

    One final thing I missed out was ice. Use it. I went from day 2 after surgery with ice evrry 6hrs when laid down until week 2. Last week I had it strapped to my back with my lumbar belt and this seems to have helped. It weighs maybe 1kg, and i had it on both seated and stood for 1-2 hr x twice a day. It really seems to have kept things in balance.

    Well I will seek to keep this diary going and i wish every one the very best
     
  4. Baldfella

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    Very nervous

    I am writing this post after reading several and becoming bother scared and optimistic. I have suffered from back pain and sciatica for several years but have had chronic pain in my right leg and hip for the past 6 months, the pain can be anywhere down my right side and in different areas at the same time. To complicate things more at home I have four children the youngest being 16 month and a 6 week old baby. Compared to many on here my treatment of the NHS has been very good, I started with my gp who first prescribed regular painkillers and anti inflammitries after 8 weeks she referred me to physio I saw the physio for another 8 weeks being given several exercises to relieve the pain and to try and ease the disc back in. During this time I have progressed through the painkiller ranks as nothing was touching me at first to the point that I was taking anything I could get my hands on. I am now taking 2 targinact 40mg/20mg twice daily, pregablyn 300mg twice daily as well as 8 hydro codeine tablets a day and liquid oramorph 5 ml up to 6 times a day if needed and can you believe I still have pain. After the pain continued to get worse my physio referred me to the senior physio who then sent me for an MRI scan. This showed me to have two prolapsed discs, L4 L5. I was asked if I was willing to travel if it meant being seen quicker which of course I was and was referred to see a consultant at a private hospital ( which looks like a bit of a scam as it is a NHS consultant doing overtime at a private hospital but I guess getting paid considerably more for it) The consultant showed me my MRI where you can clearly see two discs protruding quite a bit and pressing into the nerve pushing it out. He advised me the best way forward was a double discectomy, where he will take away the part of the discs that are protruding. He said he would normally do it keyhole for one disc but as it is two it will need one longer incision. He told me I will need to stay in hospital overnight, he also explained several possible complications but also said these were rare. He also told me that while the pain in my leg would be gone immediately not to expect it to cure me of backache as well. I have been told to expect a 6-8 week recovery period although he didn't say what this would involve. I am fortunate that my Missus is on maternity leave so I have someone at home 24-7 although she has enough on her plate. I have been given a date for my operation which is in two weeks, unfortunately we have booked to go to the coast a week later which involves two hours travel. I don't need to drive and can just rest as much as I want when I'm there but will this be possible as I don't want to deny my family something they have all been looking forward to. I wasn't too nervous at first until I read some of the horror stories on here although I suppose people who are happy and recovered don't necessarily feel the need to post on here about it. So I have my date and will wait anxiously for the results, I'll be grateful for any replies and will update this as things happen ......
     
  5. microsuccess

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    BaldFella

    I do feel for you. Im nearing week 5 and feeling very good regarding leg pain ( = 20-40% what it was). Those percentages go up and down during the night mainly and are closer 0-20% when awake and 0-10% when walking. The issues I can see are 3:

    1)Double discectomy removes more on the disc structure BUT does 95% time resolve the leg pain if we take NHS stats. I would say a friend had a single left L5/S1 discectomy in 2009 only to find a month later the surgeon had seen the disc pushing out on the right and left it. And hey presto she needs to go in for the right to be remedied - which it was but she had to recover twice over and it took a lot out of her.

    2) Larger incision effects more of the tissue/muscles prolonging recovery. So only from her experience I would say while your very likely to be elated on waking your in very little pain to now, its going to take time, more time. I believe at 8 weeks she is about where I am now.

    3) That holiday. The first 6 weeks are crucial for rest, recovery and mobility. sitting in the car for 2hrs or even laying down in it may be an issue. Not that you would notice, but its what we dont see in the body that hits so hard, as you will know with the nerve pain.

    I really do wish you the best. Any Qu's please fire away
     
  6. Keano16

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    What means keyhole? Its doesn't mean less invasive, micro or endoscopic or minimally-invasive... So, what is keyhole surgery? Ask your surgeon to tell you exactly which method does he plan to use. Keyhole is just too wide term!

    Double level problem can be solved trough two minimally-invasive approaches (two level endoscopic surgery for example, or two level micro-endoscopic surgery).
     
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  7. Clairnewbie

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    I agree take the surgery!!

    Hello, I am glad things are really working out for you! I had same op 3 days ago and also feel fantastic!! Like you I lay in the car coming home and I'm not pushing things but I do feel so much better already. Keep up the good work and a speedy full recovery I wish for you! xxx Clair. xxx
     
  8. microsuccess

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    clairenewbie

    Hi, It is amazing, the difference on waking and I am so happy for you. I would say don't get disheartened if you do start getting nerve pain after 3-5 days, it peaks and troughs for a good while before you'll get an idea of where you'll end up. The surgeon I had was luckily for me very good and explained the scarring over on a disk takes 3-5 months so only at that point do you have a clearer picture of success (or the other)

    Ice ice ice as well. I have a rehab ice compression belt which allowed me to stop taking meds nearly all together. Except ibuprofen because of its anti inflamatory use, which I was told to take up until the 6 week point.

    All the best
     
  9. Baldfella

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    I'm going for my pre op today so will ask as many questions as I can think of. What post op care did you have for your dressing etc? When the surgeon told me the recovery was 6-8 weeks what exactly does this entail, will I require more physio or is it a case of get on and see how you go ? How long do most people wait until driving? So many questions ??:(
     
  10. microsuccess

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    Baldfella reply

    I'm going for my pre op today so will ask as many questions as I can think of. What post op care did you have for your dressing etc? When the surgeon told me the recovery was 6-8 weeks what exactly does this entail, will I require more physio or is it a case of get on and see how you go ? How long do most people wait until driving? So many questions

    OK

    Pre-op appointment: taking blood, checking your ok, will do expectation of result of surgery and give you some info on what to take to the hospital the day of the appointment. This appointment is good for asking Qu's and the biggy for me was, how many times have you (surgeon) done this procedure, and what are your results like. My surgeons had a very good record and I trusted him.

    Before you go for surgery: If the letter of appointment hasn't arrived yet it will say Pack a small light bag with tracksuit bottoms,t-shirt and slippers. Towel and toothbrush. mobile phone. Get the house tidy so your not tripping over on day 1 recovery. Put some ice in the freezer (post op I've been iceing twice a day for 45mins). Put everyday things by your bed (tv remote, a book etc).

    Sugery day: At Surgery they'll get you into a gown and ask you to wait (i waited 3hrs like this), if they take along time you can get chilly. Be prepared the nurses may well keep asking you to sit as your in a generic waiting room. Tell someone ASAP that sitting and standing still (was for me) is a real issue so if there's somewhere to lay down you'd appreciate it/ Ok the nurse will come and get you for surgery. Chill in a few hours you'll be groggy but hopefully when laid in that hospital bed you'll be leg pain free (the buttock may still ache and the back pain still stays to about 10% of pre-op)/ That bag of stuff you brought will have the clothes you arrived at the hospital with and be by your bed when you wake post surgery

    Waking up: The wound will be 2 inches long so they put on a 3 x 3 inch plaster. The NHS didn't give me replacements because I didn't ask. If you don't get any then ask your GP for an appointment 7 days after you leave. The GP nurse will check the wounds healing and re-dress it for you. If done after 3pm then NHS usually will keep you over night so the mobile will let you tell your family times for pickup. Before you discharge the physios will take you for a walk. BE CAREFUL the incision sight is painful and you'll be stiff. Do as they say and you'll be fine, they show you best practise for moving and getting out of bed. OK so your told then you can go at xxxx pm so ring and get someone to pick you up, Lay down on the backseat so your back remains flat. Its hard getting in but I wanted to stay flat for first 3-5 days.

    Getting home: Go to bed. You still need to take ibuprofen and other drugs for 3-5 days as the nerve STILL thinks its trapped so generates memory pain DO NOT PANIC if in 1-2-3 weeks you feel like pre-surgery ITs the damn nerve memory. I know this as I was mistakingly called for an MRI at 2 Weeks and they told me the nerve wasn't impinged and had loads of room (NHS mistake they though i was 3 weeks away from the Op). Stay in bed those first few days. Remember outside when laid down you may well be in zero pain, I was untill standing then it creeps in. By week 3 I could stand upright and when stood still = No pain. My last hurdle is walking with no pain:)

    Hope this helpa and good luck
     
  11. microsuccess

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    Baldfella 2

    Sorry:

    Driving at 4 weeks possible not advisable. After 6 weeks I feel I could do it.

    Physio: Can start at week 2 with stretches. I was told leave until 4-6 and do walking in the weeks leading up to it so you yourself can assess how far you can walk before upsetting your body. if at week 4 your still struggling in your home bending then a physio will struggle to do much with you. Let your body guide you, if you find mobility easy at week 4 then ask the physio at your hospital to start early. Im week 5 now and feel in 2 more weeks I will be good to start, I can walk 2 x 2miles a day now although it hurts during but 10% of pre-surgery. I swam without pain from week 4.

    Wound: I wrapped cling film round me to shower from day 3 leaving hospital. I know that sounds dirty but I just loved not moving in bed and being painfree:)

    Sleeping: Sleep on your back for the 3-5 days. I put a pillow either side of me to stop rolling. You will know about it if you roll, it does hurt a tad, but your pain tolerance will now be very very high so you will hurt but its not a patch on before.

    Drugs. Whatever they gave you carry on. After 3 days i was down to ibuprofen 3 times a day just for its inflamitory use and tramadol 500mg once maybe twice a day. From week 2 you will be hopefully managing just on the ibu. After 15-20 days take the dressing off and and start showering normally.
     
  12. Baldfella

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    Final Countdown

    Thanks Guys, 5 days to go and whilst I'm obviously still nervous I do feel I have a better understanding of what to expect. This time next week it'll all be done hopefully andill let you know how I get on. Thanks again x
     
  13. mgavril

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    Baldfella

    Good Luck and wishing you a speedy recovery :)

    Keep us posted
     
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  14. Baldfella

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    Ouch

    Ive finally had my op and all the pain in my leg and hip has gone although the pain in my back from the wound and op is immense. I've got painkillers and I'd say my threshold is quite high but oh my does it hurt. Can anyone tell me how long it takes to start to ease and should I be using an ice pack? The physio gave me my exercises to do for the first three weeks but never mentioned ice and I didn't think to ask. I'll post more later. Thanks for the advice and goodwill xx
     
  15. microsuccess

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    Baldfella 2

    Ive finally had my op and all the pain in my leg and hip has gone although the pain in my back from the wound and op is immense. I've got painkillers and I'd say my threshold is quite high but oh my does it hurt. Can anyone tell me how long it takes to start to ease and should I be using an ice pack? The physio gave me my exercises to do for the first three weeks but never mentioned ice and I didn't think to ask. I'll post more later. Thanks for the advice and goodwill

    So happy for you. Yep the incision site will be sore for 7-14days. The actual site pain totally gone at 20days for me.

    Painkillers: For upto 14 days keep taking what they say but ensure ibuprofen is one of them 400mg x twice a day. This is purely for the inflamation relief.

    Ice: Yes ice. I still do twice a day. Mainly now for after walking because the nerve was trapped so long i got mild permanent damage potentially. The ice will all help with inflamation.

    I stayed in bed 5 days as I wanted the best chance for success in letting the nerve calm down, they do rag it around a lot so it gets sore. HOWEVER people advocate exercise nearly immediately to wear down the scar tissue so its personal choice.

    Mega happy for, and goes to show while surgery is the last ditch attempt in my experience I've found the nhs have a very very high success:)
     
  16. Baldfella

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    Relief at last

    Day four and finally have some tangible relief which although I'm sure it would improve by day has I think been vastly improved by me starting to take some ibuprofen yesterday which the hospital didn't Reccomend. I'm going to start using an ice pack today and might feel more benefit from that. I'm spending most of my time lying down which is frustrating but necessary I know, I only stood grating vegetables the other day and felt the worse for it. I'm really grateful for the advice I've been given and as you can see it has made a differance.
    Only day four and I think I can see a light at the end of what is very long tunnel x
     
  17. microsuccess

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    Week 8

    So I totally don't know where the times gone. Between stretches, walking and visits to the physio my lifes been passing me by. HOWEVER at present its all been worth it:

    While at 3 weeks I considered the surgery a success I still have had niggles and the odd day that felt like 80% of the pre-surgery pain had returned. I've stuck to the exercises religiously along with ice after every session, I've stepped up the walking weekly and currently sit at 1 mile pain free (flat road) but have exceeded 5.5 miles three times in the last week. Yes it hurt but I'm resigned to staying positive, I know the nerve isn't caught and that its just healing and will continue to go with this thought.

    So at 8 weeks I know a lot of people go back to work but as I'm self employed I have decided to have the luxury of 4 more weeks devoted to recovery. For anyone in the weeks 0-8 please stick with it mentally. Its definately worth it compared t pre-surgery if you've had the sciatica very bad or had it over a long period.

    I've decided to put down where I am at but everyone will be different:
    Laid still: 100% painfree
    Stood still: 100% painfree
    Walking flat 1 mile: 0-10% pain
    Walk uphill: 10-30% pain
    Swimming: Over 50 lengths is 0-10% pain
    Sitting: 40mins - few mins walking or stretching - then 30min blocks
    Lifting: 15-20kg when bending knees (5% pain)
    Sleeping: 8hrs
    Drugs: 1 ibuprofen on the evening
    Ice: morning and tea time

    One big thing I learnt from week 4. Get a bandage and from just above the ankle on your left leg (sciatica leg for me) wrap it tight so it covers 20cm up the leg. The physio explained the nerve endings around there are most sensitive. If they are compressed post surgery this should reduce the memory pain. Trust me it made a significant change to when I sat or stretched.

    Happy healing
     
  18. microsuccess

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    Week 10

    What a slog - But worth it in my eyes.

    Walking in the last week has shown dividends. I couldn't of done what I have in any of the previous weeks and have noted it feels every 14 days I notice a real difference in my recovery. Anyway I walked out a 5mile. rest day. 8mile. rest day. 12mile in the last week and noted that an incline regardless of gradient increases the pain. So the 8mile and 12mile walks I've done have been on the flat and I've had relatively no pain while walking. The incision area is sore but more like a weak bruise. I iced afterwards and after 40mins felt quite good. I'm down to taking drugs only if needed this week but after each slog 1 ibuprofen was enough.

    Ok so the downside. The nights after these walks were painful. I slept but felt sore and woke often. BUT thats only on the nights after the walks.

    To give you an idea of what I do every morning for building more core/hamstring/legs back up (and this has taken 6 weeks - I didn't/couldn't of done this pre-surgery):

    Strength
    Calf raises: 500 on each leg (leaning against a wall)
    Squats: 350 on each leg (leaning against a wall)
    Back flexions: 250 (lay on stomach and gently bring head and torso off the floor)
    Stomach crunches: 250 (like mini situps)

    Using a theraband (like a massive rubberband. found in physios)
    Hamstring lift: 300 each leg (Lay on stomach. tie the band round both feet. Keep one straight and pull the other up until at 90 degrees ).

    The bloody painful stretching the S1 nerve
    Lay on your back. Bring your right leg up until the thigh is 90degree to your stomach. Bring left leg up and cross it so the outside of the ankle leans on the right legs thigh. Then very very slowly lift the right leg knee toward the stomach. Just imagine if you sat on a chair and like some men bring one leg up and rest the ankle over their other leg. Now imagine that when laid on the floor and you have the picture.

    THIS MAY HURT A LOT!!! Please be warned I was only told to start doing this at week 6 and still it destroys me and I want to scream. But the day after I can situp more comfortably. Its something to do with how long I was immobile and the muscle wastage in my left buttock. Anyway it hurts.

    My take away points up to week 10.

    1) Rest when you can but set yourself a regime. I now have an hour in the morning and night dedicated to my stretches and strengthening and I see the benefit.

    2) Strap the left leg with a tight bandage from the ankle to below knee if the dulle nerve pain is still going on post-surgery. It should quieten the nerve down and give you some relief.

    3) DONT be disheartened. I've been bouncing around like a yoyo with bad day-good day-bad day-good day. That why I now only assess myself every 14 days as for example last friday I wanted to just give up, yet sat here now I think yeah, im doing well, I'm improving, and yes my calf muscles are huge:) a crap joke but a little victory.

    4) Im so gonna find a half marathon for 4 weeks time and walk the hole thing and not care one bit.
     
  19. microsuccess

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    Week 11

    The physio this week has tweeked my programme and added in 3 long walks, prolonged sitting and asked I lay off the ice and laying on my stomach.

    The walks were 7miles, 11miles and 14miles. For the 7miler the lower leg pain came on quite strong when I hit any incline and on saturday I thought maybe that long distances werent overly helpful. I didn't ice and had the worst nights sleep since before surgery! I was grumpy sunday but refrained from ice and laying on my stomach when not sitting and barely slept.

    Mondays walk was just as aggravating but at 9miles I found I was walking nearly 90% painfree (2/10 pain). I didn't ice and instead opted for a bath as my legs were tight and aching (which I kinda liked). Terrible night sleep again with sciatica flaring up quite a lot throughout the night.

    Yesterday I did the same route and at 9 miles yet again the pain dropped off and at mile 12 I was 0-1/10 on the pain scale. I didn't ice again after and went for a bath. Last night I hurt slightly but as soon as I stood up the pain was gone - weird.

    So anyway today I just strolled out 4 miles 100% painfree (except at a steep hill) and what was the most motivating was I honestly believe I could of jogged or at worst waddled quickly. I didn't only because the way things are going I want to be 100% happy I'm painfree before I try anything stupid.

    I don't really have any tips this week. The laying on me back instead of stomach has meant when I go to stand I now dont get the stiffness I was. As for the ice I'm in two minds. I see the benefit so will maybe next week go with my off days for ice but then bath after it. Drugs I used 1 tramadol on saturday night because the pain was so harsh it kinda shocked me and reminded what I had been going through the last 2yrs. Ibuprofen was once every other day and amitriptyline every night.

    Definate improvement. Its my last week before back to work so Im hoping this weeks trend of improvement continues. Scratch my last comment on walking a half marathon, I've done that distance now. Marathon is a bit far but who knows in a few months:)
     
    #19 microsuccess, Sep 6, 2012
    Last edited: Sep 6, 2012
  20. microsuccess

    microsuccess
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    Week 12/13

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    #20 microsuccess, Sep 16, 2012
    Last edited: Sep 17, 2012

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