The healing process can begin as soon as the foramen or spinal canal openings have been enlarged and the spinal nerves are no longer being pinched (Fig. 10). Healing is the body's natural process of restoring its damaged tissues to a normal, or nearly normal, condition. Healing occurs on its own, but is influenced by such factors as general good health, physical fitness, nutrition and rest. Recovery is the process during which you work at becoming well. You must commit yourself to staying in good health (which means exercising), maintaining a positive mental attitude and following your physician's instructions.

During the recovery period in the hospital and at home, try to rebuild your strength gradually. Rest when you feel fatigued but be persistent in your efforts.

It is important for you to recognize that we all heal at a different rate. The speed at which you will recover depends in part on your age, your general level of health, your overall physical fitness and your mental attitude. Generally, you will heal more slowly if you are overweight, out of shape or smoke, or if you are a diabetic or have other pre-existing medical problems.

It is normal to have some pain after any operation. After a decompressive lumbar laminectomy, there may be some leg "aching" which occurs as the nerve(s) attempts to heal. You also may feel some muscle spasms across your back and down your legs. And if there was inflammation in the nerve root, you may continue to feel some pain until this inflammation diminishes. You will be given appropriate medication to control your pain, relieve back spasms and reduce inflammation.

It is not unusual to feel tired and discouraged for several days following surgery. These feelings may be your body's natural reaction to the cutback of extra hormones it generated during surgery. Although some emotional letdown can be expected, you must not let it get in the way of your recovery. Don't look back at past problems. It is important for you to look at even the smallest positive steps you make as progress towards your recovery goal.

You should begin to work on a positive mental attitude even before the surgery is performed. Direct your energies toward the solution of your problem, rather than worrying about what caused your problem. Don't be discouraged by minor setbacks during the recovery process. Concentrate on the progress you make and will continue to make in the future.

Now is the time to commit yourself to a healthier lifestyle. You can begin by taking these important steps:

Watch your weight: If you are overweight, you must gradually return to your proper weight. Crash diets rarely work. Commit yourself to better eating habits and stay with them for the rest of your life.

Become more active: Your physician will tell you when you when you can resume normal physical activities after surgery. Make up your mind now that you will develop a regular aerobic exercise routine, such as walking, swimming or riding a bike. However, always check with your physician before starting any exercise program.

In general, hospital stays are becoming shorter, and even though you may feel somewhat uncomfortable at the time you are released, your physician usually will allow you to go home when:

1. your vital signs are stable;
2. you can walk on your own;
3. you can eat without having nausea;
4. you have resumed normal bladder activity; and
5. your wound is healing.

Once you are at home and you begin to resume your normal activities, follow the guidelines listed below (and contact your physician's office if you have any questions):

1. Exercise: try to do as much as you can. Daily walking is the best exercise. Set reasonable goals, but gradually increase the distance you walk each day. Check with your physician before starting any exercise program.
2. Sitting and standing: do not sit or stand for long periods of time. If you have muscle spasms in your back or pain in your leg(s), changing positions frequently should help.
3. Sleeping: rest when you feel fatigued, but do not spend all of your time in bed. Please note that waking up with a "stiff" back is not uncommon. For relief, try taking a short walk or a warm shower. If you do not have a firm mattress, invest in one - it is important for proper back support.
4. Caring for your incision: wash your incision gently and pat it dry. If you see any increased redness, swelling or drainage, notify your physician.

You should gradually reduce the amount of pain medication you take. Begin by increasing the amount of time between pills, and then reduce the number of pills taken each time. A certain amount of discomfort can be expected until the swelling goes down and the nerve sensitivity decreases. Substitute moist heat, gentle exercise and short rest periods for pain medication whenever possible.

The best way to minimize future problems with your spine is to maintain a healthy lifestyle. It is important that you:

1. eat a well-balanced diet in order to aid proper healing (avoid foods high in calories and fat content);
2. continue to eat a healthy diet in the future to reach and maintain your proper body weight;
3. get the proper amount of sleep;
4. participate in some form of regular aerobic exercise (such as walking, swimming, or riding a bike.)
5. Take extra care when lifting, bending or twisting; and
6. Take care of other health problems (such as heart disease or diabetes.)

This book is provided to help you make an informed decision about your health care. It is an essential part of a patient-centered approach to medicine, called collaboration, in which the health care team (physicians, nurses and technicians), the health care institutions (hospitals, insurance companies, etc.) and the patient's family all work towards achieving the best possible recovery for the patient.

Experience has shown that patients who are given the opportunity to make decisions about their own health care have less anxiety before their surgery and recover more quickly after their surgery. Recognize that you have a right and a responsibility to participate in the decisions involving your health care.

The human body is an intricate network of interrelated systems. Each system functions on its own but is also influenced by and dependent upon the others. When illness or injury occurs, it disrupts the function of one or more of these systems.

Surgery is a human effort made to correct one system's malfunction, but it will affect all others. Because of this complex interrelationship, surgical outcomes cannot be predicted.

When recovery is possible, it occurs as a combination of the surgeon's effort, the patient's faith, and a positive acceptance of the outcome.

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