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This wil be different for each individual and each procedure Before surgery ask your surgeon and care team any questions that you have Your recovery from surgery wil depend on the procedure you have had. There is a huge range of operations that can be done on the spine ranging from a minimally invasive microdiscectomy through to a large spinal deformity correction. The former may involve discharge from hospital after only a few hours whereas the latter may involve a short stay in a high dependency unit, days of close monitoring There are however a few general tenets that apply and most surgeons or members of the surgical team should provide you with adequate information before your operation – never be afraid to ask no matter how sil y you think the question may be! You can expect to be mobilised early after surgery. There is no reason for keeping a patient on bed rest unless there has been a leak of spinal fluid during the operation or another very rare problem. Your surgeon should tell you about any reasons for staying in bed longer than a day. Even after major surgery you can expect to be helped to move as soon as comfortable, and if possible on the first post-operative However the wound is closed, regardless of where or how long it is, it must be kept clean and dry until it has healed. Excessive bending or twisting may put undue stress on the wound and should be avoided until it has healed. The skin should heal within 10 days but the tissues inside can often take longer. It is a very personal thing and generally you wil know your limitations! The evidence for immediate post-operative physiotherapy is not strong and probably should be arranged on an individual basis rather than for all patients. Good practice would be for the surgeon to discuss with the inpatient ward physiotherapist whether you would benefit from any advice on discharge and then to re-assess at the first follow up in the clinic. At this stage most patients are fully mobile and progressing well with exercises, but some may need formal physiotherapy input. Post operative pain relief is provided by administrating local anaesthetic during surgery and as little oral medication as may be required afterwards. In more complex cases, a morphine pump may be used on patient demand or even an epidural for the first 48 hours. Once home, as a rule, painkil ers can be tailed off as you wish at your own pace. Sometimes, if a nerve is inflamed it may be necessary to take an anti- inflammatory or an anti-nerve pain drug eg Gabapentin for a longer period and your surgeon wil explain Call the BackCare Helpline on 0845 130 2704 for more information and support These can go to sleep after spinal surgery due to the anaesthetic, lying on your front, the painkil ers and lack of mobility. It may be necessary to build up from fluids through to soft diet and then solids in the unlikely event that a problem occurs. After major surgery you may be kept nil by mouth for a while. You can drive only when you feel safe. Could you stop your car in an emergency and have control? Pain, tiredness, weakness or fatigue may all impair driving skil s after surgery. This of course depends on occupation and surgery. Most patients wil return to a sedentary occupation four to six weeks after decompressive surgery or discectomy, although it may be up to three months for heavier jobs. It is worth talking to your employer about phasing your return and about any specific areas of work you would need to avoid for a period, following advice from your health professionals. Relevant Information BackCare factsheets: DWP and Access to Work, Beds, Exercises for a Better Back, BackCare for Drivers BackCare booklets: Should I have spinal surgery?, Basic BackCare, Back to Posture. Information sheets made available by BackCare are provided for information only and should not be considered as medical recommendations or advice. Medical information is often controversial and continually changing. BackCare is not responsible for errors or omissions in the information. Some of the information may come from outside of the UK. This means, for example, that some of the drug names may be different, and the sources of help quoted are not available in the UK. Please consult your GP or Specialist to discuss any specific concerns or if you are considering changing treatment in any way eg adding dietary supplements or different exercise routines. BackCare March 2010 Registered as the National Back Pain Association charity no 256751 Helpline 0845 130 2704 512-Eurocrat-220910

Source: http://www.backcare.org.uk/CMS/files/512-Eurocrat-220910.pdf

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DE INTERMINISTERIËLE COMMISSARIS INFLUENZA Betreft: Influenza A/H1N1v – wijziging aanpak in België Geachte collega, Sedert eind april wordt de nieuwe variant van influenza A/H1N1v nauw opgevolgd in België, net als in de andere Europese landen. Ondertussen heeft de Wereldgezondheidsorganisatie op 11 juni 2009 fase 6 van de grieppandemie afgekondigd. Dit betekent dat het virus rui

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