post op pain management

[crenglesberg]

my son is 8 days post op from spinal fusion surgery. he is 16 years old. we are still having a bit of difficulty managing his pain.



I'm wondering what combination of drugs worked best for others who have had this surgery.



Thanks. charlie.

[Carmell]

Charlie,

I believe that pain management (and controlling constipation) are the biggest issues patients deal with after a huge surgery like this. 8 days post-op is still very soon after surgery. Each patient is very different. What works for one may not work for another.

My suggestion is to try a combination of pain medications, alternating the doses so there is no "down time" for breakthrough pain to occur. For example, use Lortab (or some tylenol w/codeine combination) at 9am, then 3 hours later take Valium (or some other non-tylenol/motrin-type pain medication). Then, 3 hours later take the first medication. We found that alternating pain meds helps much more than having just one high-dose narcotic. Again, this is not medical advice, and may not be the right answer, but something to suggest to the surgeon/doctor's office.

Make sure he's drinking plenty of fluids. Keeping hydrated helps heal his incision(s) as well as helps get his bowels "moving" again (if this is a problem).

Good luck.

[trulyaries]

The first few weeks are going to be rough pain-wise. Alternating medications might help, but I don't believe anyone should try to self-medicate after a surgery without the doctor's supervision. And NO ONE should take Motrin or any other anti-inflammatory drug after surgery, because it interferes with the fusion process. I just now got permission to take Motrin at my 3-month checkup. For the first three months I was on Talwin, then gradually I started weaning off and alternated with Tylenol (which has never helped me much); but that was all with my doctor's recommendation/supervision.

[laurieg6]

At 8 days post-op, my son was still taking 5 mg oxycodone (down from 7.5 mg) & 650 mg tylenol every four hours. I was still waking him up in the middle of the night to give that to him. He was also on the stool softener twice daily. By the 10th or so day post-op, we started extending the time between doses of oxycodone & soon started alternating it with the tylenol. He had no more need for oxycodone by the 13th day post-op. We only had to use the ativan (muscle relaxer) once, maybe because he's so young & perhaps because we kept him so regular with the doses of the other meds. He also has always seemed to have a high tolerance for pain. Now, just over a month after his fusion surgery, he's taking no meds & claims he has an occasional ache but nothing regularly.

I hope your son's pain decreases very soon. I think that the 2-3 week mark has been a turning point for many of the kids I've read about & that they feel much better by then. I would definitely call your surgeon's office ASAP & tell him/her or the nurses about your son's pain & get more medication if you need it. I know for my son, having the muscle relaxers/minor tranquilizers, like ativan, really helped when he was really miserable in the hospital & our first night home.

Good luck with this. I'm sure it will get much better really soon.