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  • Pain Meds needed

    I came home from the hospital on Oxcodone 10 mgs - up to 6 pills a day. My surgeon prescribed Tramadol which did nothing for me. He does not want me on Oxcodone. What are some other drugs?

    Thanks

    Melissa

  • #2
    i am not sure whether oxycodone is the same as hydrocodone...which is like vicodin...
    i take a 30 mg oxycontin on "bad" days, and 2 hydrocodone together, up to 3 times a day, on "regular" pain days...
    my system is funny...i NEVER get constipated from those meds...
    i stopped all pain meds for a week once, and nothing much happened...i mean, i was a little grumpy, but that was it...no other symptoms...

    i also have nucynta...but i don't like it...it doesn't do anything for my pain...
    i have opani, but i can't take it, as the morphine in it makes me throw up...as soon as it hits my stomach!

    i do not know what a doctor should be giving you for pain...but i do believe you need a serious pain doctor or physiatrist or neurologist or anesthesiologist or other pain specialist to address your needs!

    jess

    Comment


    • #3
      I just don't understand why some surgeons are so skimpy w/the pain meds in the early phase of recovery. My discharge pain med, after my hardware removal surgery, which is not as rough as the fusion surgery, was 20 mg oxycodone every 3 hours - the same as I took during my 2 day hospitalization. The spine fellow wrote that order, not my surgeon, and I very much appreciated it. My surgeon would never have written for that generous of a dose. But, I needed that much, for the first week or so. It made a huge difference - I wasn't zonked, I was just reasonably comfortable.
      At my pre-op appt on Tues, the RN went over, among other things, pain meds. That office discharges you from the hosp with about a week's worth of oxycodone, then when you call them for a refill, they take you down to hydrocodone. I told the nurse that I've never found Vicodin any more effective than Tylenol. She paused and said she agreed, in some instances - that oxycodone is better for bone pain, and hydrocodone is more for soft tissue injury pain. I didn't know that.
      Pain management seems to be an area where there are wide differences of opinion among surgeons, and a common area of patient dissatisfaction.
      Fused T-3 to L-3, Aug 25
      Hardware removal surgery, Nov 2, 2010
      Fused T-10 to L-2, osteotomy, Feb 22, 2011

      Comment


      • #4
        I agree with mgs. The pain meds are an issue. I'm 4.5 months post op and am told that my pain should be subsiding, but my upper thoracic is still very painful. I was all but told that my most recent refill will be my last after a 15" incision and a 12 vertebrae fusion. I don't know, should the pain just magically go away?

        My primary care physician has gotten into a pissing match with my pain specialist as to who should write an rx and I feel kicked to the curb. I think you may want to consult with another provider; I know I am if my pain continues as it has.

        I think these providers are too worried about liability and perhaps should undergo the scalpel themselves for perspective.
        57 Degrees Thoracic, 23 Degrees Lumbar - "Corrected" 09/29/10

        Living life one turn at a time - Vivendo a vida uma curva de cada vez.

        "We don't see things as they are, we see things as we are." -Anais Nin

        http://i135.photobucket.com/albums/q...scoli_shot.jpg -Before

        http://i135.photobucket.com/albums/q..._post_shot.jpg - After

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        • #5
          Yesterday, my surgeon's nurse called me back and is giving me some more Oxcodone . She says that I have to go to a Pain Mangement Doctor for future pain meds. Why? Is this an insurance issue?



          Melissa

          Comment


          • #6
            Originally posted by mbeckoff View Post
            Yesterday, my surgeon's nurse called me back and is giving me some more Oxcodone . She says that I have to go to a Pain Mangement Doctor for future pain meds. Why? Is this an insurance issue?
            Melissa

            When I went to the drug store today, the drugs that had been prescribed were Hydrocodone. Where do they fit in in terms of getting rid of pain and additicion?

            Thanks
            Melissa

            Comment


            • #7
              Hydrocodone is not as strong as oxycodone. It's not a "nothing", though. A lot of doctors and oral surgeons use it for post-op pain. Also, it is common for surgeons to have patients go from oxycodone to hydrocodone after a while (in the case of my surgeon, at about 2 weeks post-op).

              There is a difference in how easy the meds are for you to get them. For hydrocodone, the dr's office can call the prescription in to the pharmacy. For oxycodone, there is no calling it in. .. you (the patient) have to give the pharmacy the paper prescription in order for them to fill that prescription..

              I hope that you can find a pain mgmt doc SOON.

              Why do so many surgeons want to back off from pain mgmt fairly soon after surgery? I can only postulate.
              Last edited by mgs; 02-19-2011, 02:24 PM.
              Fused T-3 to L-3, Aug 25
              Hardware removal surgery, Nov 2, 2010
              Fused T-10 to L-2, osteotomy, Feb 22, 2011

              Comment


              • #8
                i do not think it is an insurance issue..
                i think it is a doctor issue...

                there are a lot of doctors who do not understand pain...
                they are afraid of prescribing...they think they will either be responsible for creating a dependence or addiction problem....or will contribute to one that already exists...
                my pain management doctor in Manhattan is the only one who is not worried about that...at least not with me...
                he told me flat out that he does not believe i have the potential to abuse meds,
                though i know from working in the field that dependence is a different thing from abuse...

                i have met pain doctors...at least, that is what they call themselves...who are hesitant to prescribe large amounts of meds, even when they are clearly needed!

                i think it is horrible that patients in severe pain often go without appropriate medication!

                jess

                Comment


                • #9
                  Jess, you are so blessed. . .your doctor is a friggin' saint.

                  Ditto everything Jess said, and I'll add that many docs are worried they'll be flagged by the DEA as heavy prescribers, then have to deal with a DEA audit.

                  Obviously, I have no idea how long I'll need opiates after my surgery on Tues. . .but, I'm sure it will be the same old story, me "hat in hand", a couple weeks post-op, begging for pills to get some relief.
                  Fused T-3 to L-3, Aug 25
                  Hardware removal surgery, Nov 2, 2010
                  Fused T-10 to L-2, osteotomy, Feb 22, 2011

                  Comment


                  • #10
                    i know you may be put in that situation, mgs...and that is just so wrong!

                    i do not like having to make the 6 hour round trip in bad winter weather, but i am thankful to have a pain doc who really understands pain! i know from reading forum to be grateful for him!

                    the only thing i could recommend would be to try to find a pain doc before surgery...
                    i know that is a lot to ask, as patients have enough to do to get ready, and a lot to worry about...
                    i don't understand why surgeons can't just work in conjunction with pain doctors, if the surgeons are so skittish about doing the prescribing themselves...
                    it would make sense...and show compassion to their patients!!

                    i wish you the best, mgs...i hope your surgery goes smoothly, and recovery goes uneventfully!

                    Melissa...is there a way you can just start making appts with all the pain docs in your general area who take your insurance...? better to see too many than too few...even if traveling is involved...

                    jess
                    Last edited by jrnyc; 02-19-2011, 04:25 PM.

                    Comment


                    • #11
                      Jess--
                      You are just making too much sense--and that never works! Getting pain meds to handle it was always tough. I could not get more hydrocodone after 6 months from the surgeon. No way was I ready for that. I had to go to my general doctor. She was very skimpy with it. She was out of the country then and the "sub" doctor was much much, much more helpful. Maybe because he was actually retired. I still have a whole bottle after I was done at about a year plus. Janet
                      Janet

                      61 years old--57 for surgery

                      Diagnosed in 1965 at age of 13--no brace
                      Thoracic Curve: 96 degrees to 35 degrees
                      Lumbar Curve: 63 degrees to 5 degrees
                      Surgery with Dr. Lenke in St. Louis--March 30, 2009
                      T-2 to Pelvis, and hopefully all posterior procedure.

                      All was posterior along with 2 cages and 6 osteotomies.

                      Comment


                      • #12
                        Was wondering if they prescribe the same pain meds post-op to teens that they do to adults and if so, how long do teens 'generally' stay on pain meds? I'm so focused right now on the countdown to my son's surgery, halo traction and second surgery that I haven't even begun to think about recovery but am very curious about it.
                        Son 14 y/o diagnosed January 20th. 2011 with 110* Curve
                        Halo Traction & 1st. surgery on March 22nd. 2011
                        Spinal Fusion on April 19th. 2011

                        Dr. Krajbich @ Shriners Childrens Hospital, Portland Oregon



                        http://tinyurl.com/Elias-Before
                        http://tinyurl.com/Elias-After

                        Comment


                        • #13
                          hey Janet
                          you are right...
                          and there seems to be a lot in the medical field that doesn't make sense...
                          so the medication issue is just one of them...
                          i think doctors are not well trained in the field of pain treatment...if they were, perhaps they would not be so freaked out at writing prescriptions that are justified...
                          maybe it is the government watch dogs, too...

                          the patient is always the one to suffer from their screwed up policies!

                          jess

                          Comment


                          • #14
                            Originally posted by jrnyc View Post
                            i know you may be put in that situation, mgs...and that is just so wrong!

                            i do not like having to make the 6 hour round trip in bad winter weather, but i am thankful to have a pain doc who really understands pain! i know from reading forum to be grateful for him!

                            the only thing i could recommend would be to try to find a pain doc before surgery...
                            i know that is a lot to ask, as patients have enough to do to get ready, and a lot to worry about...
                            i don't understand why surgeons can't just work in conjunction with pain doctors, if the surgeons are so skittish about doing the prescribing themselves...
                            it would make sense...and show compassion to their patients!!

                            i wish you the best, mgs...i hope your surgery goes smoothly, and recovery goes uneventfully!

                            Melissa...is there a way you can just start making appts with all the pain docs in your general area who take your insurance...? better to see too many than too few...even if traveling is involved...

                            jess
                            Jess, I actually have an appt with a pain doctor on Friday. I had totally forgotten about it until they sent paperwork in the mail.I do not even know when I had made the appt. I hope that this Doctor understands me and can help me
                            I took Hydrocodone last night for the first trime and keep waking up every hour. It seemed to have helped my pain somewhat , not as good as Oxcodone but OK

                            Melissa

                            Comment


                            • #15
                              During my pre-op visit with Dr. Lenke, I asked him about his attitude toward pain meds because I have had the same experience, having to beg for refills. The docs were more worried about creating a drug addict than whether I was in pain. I also developed allergies to several pain meds so it's going to be a challenge for me. I appreciated Dr. Lenke's response: If you're in pain you won't move. And I want you to move, so you will have pain meds as long as you need them. And we will involve pain management docs to find what works for you. Let's hope he follows through with this refreshing attitude.
                              FeliciaFeliciaFelicia
                              10/24/00 posterior fusion T4-L4 at age 57
                              8/5/05 posterior surgery for spinal stenosis at L4-L5; laminectomy and fusion
                              5/14/07 posterior revision with fusion to sacrum
                              2/11/08 anterior discectomy L5-S1, and reinforcement of fusion with plate attached to L5-S1
                              3/9/2011 and 3/11/2011 revision surgery with Dr. Lenke, St. Louis - complete revision and fusion with instrumentation from T1 to sacrum, one lumbar osteotomy.

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