Training after cranial MVD surgery

[Alchemist]

I have a condition called hemifacial spasms. It is caused by an abnormal vein location pressing on a facial nerve causing it to fire intermittently. I am very seriously looking at having it treated by Micro Vascular Decompression surgery which is "an involved procedure requiring general anesthesia in order to remove of a portion of the skull, expose the brainstem and dissect the offending blood vessel away from the facial nerve".

Unsurprisingly there is a 2 week post surgery prohibition on lifting anything over 10 lb. Their primary concern is intracranial pressure resulting in leaking spinal fluid from the incision site. In theory I can resume 'normal exercise activities' after 4 weeks total but they were at a loss how to advise working back into heavy lifting. The first stab at advice was high reps (10-20) and low weight (not specified) and cardio.

Do you or anyone there (Dr. Sullivan?) have any experience to get back to my training and the appropriate progression post surgery?

50 yo male
HLM
Heavy sets
Squat 295 lb 3x4
DL 350 1x5
OHP 162 3x4

[Jonathon Sullivan]

Nobody here (or anywhere) in their right mind will advise you to do anything but follow the directions of your neurosurgeon. If it were me I wouldn't lift for at least a month after. I'd start with low weights and progress slowly for the next month after that. If no ill effects, I'd run a judicious LP and come back up to weight. Red flags are rhinorrhea and otorrhea (clear fluid draining outta da head or ears), headache, nausea, fever, collapse, death, etc. All unlikely.

But if somebody removed a PART OF MY SKULL and scraped shit OFF MY BRAINSTEM, and I woke up alive, I'd do whatever the fuck they told me for at least six weeks.

This post is for ejumacational and infotainment porpoises only and does not constitute medical advice for you or any other particular person, patient, disease, or condition. Sullydog is not your doctor. Actually, he's not anybody's doctor anymore, a circumstance from which he derives unremitting satisfaction and joy. He never even contemplated training or practice as a neurosurgeon, because he wanted to have a life and not be married to the hospital, and becaise those brain surgery guys are all a bit twitchy and bitchy. You shouldn't believe anything Sullydog says, and you should obey your own physician without question, regarding all of his pronouncements with the utmost credulity and reverence.

[Chad Mynhier]

I can't address your exact situation, but I have something that's pretty close.

Two years ago, I was diagnosed with an acoustic neuroma, a tumor on the acoustic nerve. Mine was large enough to be pressing on my brainstem. I had surgery to remove it. This involved cutting a hole in my skull behind my ear, and I was given the same instructions. I was cleared for normal activity after about a month, and I ran an LP with no problems. (Your mileage may vary, of course, and just because I had no problems doesn't mean you won't.)

(And since I'm telling the story, I'll add this amusing anecdote: after the surgery was over (mine took about 12 hours), I spent the rest of the night waking up about every hour for a bout of dry heaving. I have no doubt that my intracranial pressure for each of these episodes was as high or higher than it's ever been during a squat, and yet I'm still alive.)

[JFord]

But if somebody removed a PART OF MY SKULL and scraped shit OFF MY BRAINSTEM, and I woke up alive, I'd do whatever the fuck they told me for at least six weeks.

Expressed with apropos elegance.

I can't address your exact situation, but I have something that's pretty close.

Don't be so sure of this. Vascular decompressions "can" be more complex than acoustic neuroma resections and the post-op experience can be quite different.

[Alchemist]

Thanks Sully. The sincere but apropos humor is just what I needed. I was by no way intending to not do what they say. it was more a matter of how to apply it.

To that end, and yeah, I'm a pedantic bastard with a woody for quantitative over qualitative, given my numbers, what would starting "low" for a month entail? At this point you are not offering medical advise, just common sense programming advice (which due to having my damn eye twitching at me, I seem to be lacking right now ) Are we talking empty bar work for 5s for a month, or just start empty and LP non-standard (meaning the first month is going to be weights way below where one would normally start an LP)?

And for what it is worth, don't think that having them open up my skull isn't freaking my shit out just a little bit.

I'll report back if that red flag of death happen to occur

[Alchemist]

Bump. Is what I outlined a not unreasonable progression post surgery?

[Jonathon Sullivan]

Thanks Sully. The sincere but apropos humor is just what I needed. I was by no way intending to not do what they say. it was more a matter of how to apply it.

To that end, and yeah, I'm a pedantic bastard with a woody for quantitative over qualitative, given my numbers, what would starting "low" for a month entail?

Start with empty bar. Make tiny jumps. Give thanks to Providence for each day you wake alive and without brain juice running out your nose. Repeat.

At this point you are not offering medical advise, just common sense programming advice (which due to having my damn eye twitching at me, I seem to be lacking right now ) Are we talking empty bar work for 5s for a month, or just start empty and LP non-standard (meaning the first month is going to be weights way below where one would normally start an LP)?

The latter.

And for what it is worth, don't think that having them open up my skull isn't freaking my shit out just a little bit.

Correct emotional response. You'll be fine. Neurosurgeons are assholes, because they never get to go home, and because they are confronted daily with the brutal fact that all our "spirit" and all our "dignity" and all our "humanity" and all we are is really nothing but the sloppily encoded contents of a few pounds of squishy gray electric meat. Makes for a dismal existential bias and a bad attitude. But they are the products of a fairly extreme selection process. Smart fuckers. Competent. Generally.

I'll report back if that red flag of death happen to occur

Yes, that would make a great article for the site.

[Alchemist]

Thanks!!!!