Pain Management

[Lorz]

Hi to everyone. Hope you are all doing well. I am now 5 weeks post-op, and saw Dr. B. last week. I asked him if I should be thinking about starting to decrease my pain meds, and he said yes. When i asked how I should approach it, he suggested a pain management Dr. I have called several, and the minimum wait is 2-3 weeks. My question is, did most of you manage this on your own, or go to a pain management Dr.? I have tried decreasing dosage, and spacing time intervals, and my back immediately gets so tight, it is difficult to walk. I know some have mentioned a day or 2 of feeling bad, then progressively getting better. Should I just "power through"? I start out-pt P.T. next week, and am concerned that the increased activity level will just increase the pain level. Maybe not a good time to start weaning? Thanks for any thoughts!

[Debra JGL]

Hi Lori, Great to hear from you. I hope your visit with Boachie went well. It so nice to see the doctor on the other side I did reduce my pain meds on my own, and in the way you've tried. If the pain is coming back strong though, I don't think I would have 'powered through' until feeling better. Good idea seeing the pain specialist, and I would think staying on your normal course of pain meds for the next few weeks would be fine. I did push through the walking though, it would be painful at first but definately helped, no matter how slowly I went. Walking was the main thing that helped the pain and swelling for me (besides the meds), even if I was just doing laps around the inside of the house. Congrats again on your surgery, and being in recovery!

[loves to skate]

Lori,
There really shouldn't be any rush to get off of your meds. I was off by three months and many here were on longer than that. If you still have pain, wait another week and then try again, but there really is no rush to get off of the meds. Everyone is different.
Take it slow and easy. Sally

[LindaRacine]

Hi...

I managed my own withdrawal from narcotics. I first dropped one of the two oxycontin doses. Then, when I was over the nausea from that, I dropped the other dose. Then, I started taking percoset only as needed. Other than the nausea, it was really easy for me.

--Linda

[jeneemohler]

You can try it on your own when you are ready. If you have troubles, then you could contact a pain management doctor. It sounds like quite a few of the patients do ok on their own, especially if you aren't on them for an extended length of time.

Don't compare yourself to others, as far as how long you are on them. It is NOT a competition. It doesn't matter what anyone else does. Just be concerned with what works for YOU. Do you need to quit, or just cut back? Or maybe right now isn't the right time...don't rush it just for the sake of getting off pain meds. You just went through a major surgery, and need to be able to heal, and do it as comfortably as you can.

My method-
I took about 2 weeks... I was on a short and a long acting oxycontin. I quit the long acting one first. First the morning one, then the night one. Then I gradually increased the time between doses on the short acting, from 6 hours down to 8 hours, then 10, then 12, then only at night to help me sleep. You need your sleep! Healing is hard work... I still would get bad days that I had to take more, but I wasn't on the daily, round the clock regimen anymore. And I DID feel SO much better after I was off of them. I had a better appetite, and the nausea and just blah feelings went away. I felt so much better that I was extremely reluctant to take one on the bad days. I had to be pretty bad!
Some people do fine just quitting cold turkey and toughing it out for a while, but you can have some withdrawals-it varies with individuals. I went the gradual course, and it was a breeze. Even after I was off the pain meds, I still continued to take muscle relaxants, and still do off and on to this day. Yes, your back gets tight feeling. That will probably last quite awhile. I still have quite a bit of tightness after 6 months. And I think I remember others on the forum mentioning being tight for quite awhile, also.

Take care, and keep healing!

[Lorz]

Thanks everyone, for your replies/suggestions. Regarding the tightness, what did everyone find the most effective for that? I am on Zanaflex, which does not really help. I had a few doses of valium, so I tried that, and it seemed to work much better. I can take a lot less Percocet when the muscle tightness is under control.

[CaroleM]

At three weeks I went off all narcotics on my own. They were reaking havoc on my bowls and I couldn't take it anymore. I started to take two acetaminophen in the morning and night with Valium and the Valium is a life saver for the tightness and spasm. If necessary in the afternoon too about every 6 hours. I had surgery on 5/27 and now only take the Valium and acetaminophen at night to sleep comfortably or if I have had a rough day at PT or the gym. I find that the Valium is the most effective but you do have to be careful with that to because it is a benzodiazepine and can be addictive too just like the narcotics, that's why i try to only take it once a day. Walking alot is key with pain management too, I can't tell you enough to get up and walk as much as possible even if you are exhausted and feel like you can't. I used the walker for two weeks then slowly went on my own with my husband coming with me for safety but it helped tremendously, I always felt better afterwards no matter how much I didn't want to do it before. Now I try to do 3.1 miles daily, or I swim and do the PT where they have me doing a lot of stregthening excersises. It doesn't always feel comfortable but it's not really painful, so I push through it. Discomfort is to be expected and I think that sometimes we have to be careful in differentiating discomfort from pain. Good luck to you, what ever you decide to do!

[Lorz]

Carol,
I cannot believe you stopped all pain meds at 3 weeks! How much Valium were you taking, and how often? You make a very good point, about discomfort vs. pain. I think a lot of the times I take a Percocet, it is because of the extreme tightness and pulling i am feeling, vs. actual pain. I just called and asked my Dr. for a script for Valium. I hope it helps. Thanks for the tip.

[jrnyc]

hi Lori
do you think a longer fusion requires more pain medication...?
if someone is fused thoracic only, would that not require a little less pain meds...?
just something to consider...
you had a very long fusion...not everyone on forum had a fusion that long.....some have shorter fusions....

also...i agree with the writer who said not to compare yourself to others!
everyone is different, their response to surgery is different, their response to pain is different, as is the way their body reacts to medication....

hope you are feeling better soon...
you know, you can always make an appt with a pain management doctor, and can cancel it if the day comes and you do not need the appointment...

jess

[CaroleM]

Carol,
I cannot believe you stopped all pain meds at 3 weeks! How much Valium were you taking, and how often? You make a very good point, about discomfort vs. pain. I think a lot of the times I take a Percocet, it is because of the extreme tightness and pulling i am feeling, vs. actual pain. I just called and asked my Dr. for a script for Valium. I hope it helps. Thanks for the tip.

I take 2 mg every 4-6 hours as needed, but now at approx seven weeks I only take before bed with two Tylenol. I'm happy to say I sleep through the night. Something I could not do before the surgery. Hope it helps!

[Lorz]

Hi Jess,
Nice to hear from you. Yes, i definitely think a shorter fusion, esp. a thoracic only, would require less pain medication. I know, my fusion was about as long as they get! I just never took narcotics prior to the surgery, and hate how they make me feel. I do have an appt. with a pain management Dr. this week. Thanks for the well wishes!