how long before return to work after surgery?

[janetm2]

Violet,
Thank you for the guidance, this illness is so much to sort through!
Janet

[Karyn]

I got the earlier appointment today but they said they think they can get me back to work with a full force of PT etc

Who is "they"? The PM doc?

I have to remind them I need to be able to sit 1-2hours at a time and 7.5-8 hrs of my 8.5 hr day and be able to drive 20 to and from work to be full time 5 days a week.

Yes, I'm in the same boat, Janet. I feel very fortunate that Dr. Conway truly understands this, which is why he's having me come back in 8 weeks for another evaluation before releasing me back to work. When I saw him last week for the 12 week check up, he wasn't the least bit surprised or discouraged that sitting was still an issue for me. My disability company had fax'd him some medical update forms and he wrote:
"Patient still can't sit or drive because of severe pain".
"Patient can't work at all - can't sit"
Expected to be able to return to work on: "UNDETERMINED - follow up in 8 weeks"

They were clearly apalled by the push for going back to work and even the disability evaluation at this point.

Again, who is "they"? PM Doc? PT? I'm apalled, too! This is NOT something you push yourself through!

Janet, I have a friend who has gone through this disability maze and she said that if you are told to do something painful that you should tell them it's too painful. I strongly encourage you not to do the exercises they are recommending if they cause you additional pain because you could really set yourself back. You can just say you tried them but they were causing you too much additional pain. Personally, I was in too much pain to do PT for almost a year after surgery so I am a big believer in letting your body heal before pushing too hard.

I strongly agree. Dr. Conway doesn't want his patients to even consider PT for 12 weeks post-op. He's also very supportive if you don't feel up to it at that time. I'm outraged, apalled and furious by what you're going through, Janet! And I can not stress enough that this is not something you can push your way through. Your body needs to heal in it's own time and I personally believe it's imperative to achieve the best possible recovery. My heart and thoughts are with you, Janet!
Hugs,
Karyn

[janetm2]

Karyn,
I would not believe this if it was not happening to me. Sadly the story gets worse. The appointment was as you guessed the new pain management rehab group suggesting the full force PT. The worse is that they told me to put a one inch lift in my right shoe and when I went to my PT today she got really upset because she said that is not the way to realign your pelvis but should only be done if on leg is shorter than the other (even then you would not do a whole inch at the start!). Also for me if a leg was shorter that would have been found years ago by one of the many doctors I have seen for my foot pain. So tomorrow I go to my regular pain guy and tell him my woes, how I wish he knew more about PN.
Glad to hear you are getting support from your doctor and can take time needed to recover. I will need to see if and or when I may need to try to work may start with two hrs a day. The extra PT is for 7 weeks and if continue pain meds during the day it will have to after that. I am doing better on a chair that is similar to my work desk chair and may need to use that at my computer since I sat over there and upped the pain trying to use a different chair / cushion. Honestly work is looking easier thannsorting through this medical stuff. Hugs to you too.
Thanks,
Janet

[Karyn]

Oh, Janet ....
I'm sorry if you've already stated this, but were you a travelling patient of Dr. Marvel? I guess I can't wrap my head around him accepting ZERO responsibility for your recovery care. I can't fathom him not communicating or writing a letter to .... someone .... explaining the MAJOR surgery you recently had and the recovery process involved. And he sent you to a PM doc who knows next to nothing about PN?!?!? Please tell me I'm misunderstanding, Janet!

The worse is that they told me to put a one inch lift in my right shoe and when I went to my PT today she got really upset because she said that is not the way to realign your pelvis but should only be done if on leg is shorter than the other (even then you would not do a whole inch at the start!).

Well, at least the PT has a clue. Do they agree that "intense PT" isn't the way to go for someone with your condition?

Honestly work is looking easier thannsorting through this medical stuff.

I totally understand why you would feel this way. You shouldn't have to be going through all this additional stress during your recovery. It makes me sick to my stomach to think of you going back to work, still healing from TG surgery and then have to go to PT after work. It's too much.
With love,
Karyn

[janetm2]

Karyn,
thank you so much for follow me through this chaos , it reaaly helps to have someone who understands and is going through recovery talking with me. I actually didn't say but Dr. Marvel is local and I thought that was great but then again maybe not? I so try not to say anything bad and give everyone the benefit of the doubt but yes he is not saying in writing the extent of recovery needed for this type of surgery. On the up side the Rosen-Hoffberg PM group does know about PN and my PT did agree with the extra PT but not sure how truly aggressive it will be. She really did not do much yesterday because of the extra eval and I was still recovering from Monday, I do trust her and I will have a break with the beginning of july I guess vacations so less PT personnel were available to treat and some new PT people are being added in August to the Her Health (PT group). Today I saw my regular pain guy Dr. Clark Brill and he gave me guidance about the medicine and getting through PT and said the lift was too much but I could do an experiment with a 1/4 inch lift with only using it very gradually each day. In addition he said I should not go back full-time but the 2 hr then maybe 4 hr, etc over time would be good so I don't have a setback and would also be good towards a disability write-up if I do need to go to that in the future (if not able to sit enough to get through the full day). He will sent the Rosen group his notes from today and his info on my foot limitations on standing so that can be used by them. I feel a little better mentally and even seeing some physical improvement (able to sit without pain for (10-15 min on one chair in my house and at Dr. Bril's with a fleece cushion to just soften the seat) but will take it slow.
FYI the intense therapy is on the surrouding muscles and stuff not the actual pudendal nerve since they are straining the nerve so I am willing to give it a try. What was done did not flare the nerve but just really sore tummy and inside thigh muscle.

Hugs and Love,
Janet

[janetm2]

Update: Now that I hit the first of two days in a row of PT my therapist said this is more aggresseive than PN patients should be doing. She said to see how it went and encouraged me to go back to twice a week or 3 time so long as it is every other day. Given what others have said on this site I need to follow the people who obviously know, it is a shame we don't have more doctors to guide us.

[Karyn]

Hi Janet,
Yes, I was cringing when you were recommended "aggressive PT" and am so glad your therapist is aware of the consequences for someone with your condition.
What type/methods are they using with you, Janet?
Love,
Karyn

[janetm2]

Karyn,
Besides the nerve glides that Dr. Marvel suggested the rehab group said low back including improved ROM (range of motion seems to be big with them), body mechanics, postural exercises, stretch bilateral HS(ham string), HF, RF, massage, pain relieving modalities, instruct in home exercise program. I know I should be more up to date as others really know all the body info and other terms but I am still just keeping my head above water trying to prioritize, keep my job and try to relax and recover despite being sent to an osteopathy dr that with th helpers I am seeing are clueless to PN. The other PT info is hand written so here are some of the words I could make out myofacial release to Grn(?), adductors, hamstrings, HF, sacral mobilization, pelvic floor muscle something(?)/biofeedback, then something about HF, RF, HS manual in pelvic tilt(?). My therapist said she was doing most if not all of these before I gave her the prescription. The rehab asked about biofeedback so that wasn't added until the gave me the TENS machine and I just got a low back conductor garment in the mail for it which will really help me maybe use this by myself. Thanks for asking and hope things are going your way a bit these days.
Janet