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Thread: Pre-/Post-Op Pain Management...

  1. #1
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    Pre-/Post-Op Pain Management...

    My back is killing me - - it is absolutely killing me and i finally asked my ortho. surgeon who will be doing my surgeries in January for some pain medication. His PA called me back yesterday morning and when i explained to him just how much pain i was in he called he called in something to my pharmacy and to only take it "as needed." So when i picked it up, it was a 30-day Rx with no refills for Vicodin. Now, my surgery is 7 weeks away (49 days!) so how are 30-pills going to get me through until January 24th, especially when taken "only as needed"??

    Before calling him, i was using left over Tylenol3 from my sinus surgery this past May. I work 3 days a week and don't take anything ever during the day whether i'm working or home with my 2 little kids...but around 5:30-6pm my back is absolutely screaming and burning in pain i am literally bend over and that is the time when i would take the medication. The Rx says 1 pill every 6 hours prn for pain. If i did take it as prescribed, that would only get me thru 1 week! WTH?!?! I don't know - - i realize they can't put refills on pain medications but they certainly can write for more than 30 considering my surgery is 49 days away. Even if he wanted me to call back for a refill, it makes me feel like i'm begging for some pain relief - - why couldn't they just give me enough to get me thru til my surgery? I'm so annoyed. So now i really have to ration them and in the meantime, i'm in a TON of pain...a TON...

    Now Post-op pain, my surgeon said i'd have a PCU and a morphine drip directly into my spinal canal for the first few days. I remember having the pain pumps with my other 2 surgeries and it was great...instant pain relief for the most part...i think maybe i minimized just how much pain i am in right now and how FAR AWAY January 24th feels...
    1993/1995: PSF w/ Harrington rods T3-L4
    Jan. 24, 2012: ALIF of L4-L5, L5-S1 w/ cage spacer and BMP
    Jan. 31, 2012: PLIF of L1-S1 w/ pelvic anchors
    Scheduled Nov.15, 2012: Fusion T2-S1 w/ pelvic anchors to fix T12 fracture
    http://i31.photobucket.com/albums/c3...ot/myback2.jpg - BEFORE
    http://i31.photobucket.com/albums/c3...CT2342x406.jpg - AFTER
    http://i31.photobucket.com/albums/c3...CT1410x229.jpg - AFTER
    www.jerseyot.blogspot.com

  2. #2
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    Hi Honey. My doctor does the same thing. I get 30 percocet with no refils. When I am running low I just call and pick up a new refil. So I bet that is just protocal. They cant put refils on narcotics. So no worries honey your doctor wont let you be in pain

  3. #3
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    Hi...

    I think most surgeons are reluctant to ramp up pain medications right before surgery. For some reason, an increased use of narcotics preoperatively often leads to a difficult recovery. With that said, you also shouldn't suffer needlessly. Perhaps you can talk to your primary care doctor.

    Before I had my first surgeries years ago, I would have to lie down every afternoon. If I laid down for half an hour, I would be able to make it through the rest of the night.

    Hope you get it figured out.

    Regards,
    Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  4. #4
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    jersey, i am so sorry you are in so much pain...
    a good pain management doctor seems to be the one person in the medical
    profession who understands pain and suffering....
    i have a good one now in NYC...
    not all pain doctors are equal,in my experience...
    so some seem not to be as understanding and in sync with what
    their patients are going thru....
    it is stressful to feel you have to ration out the pain meds....
    that should not be necessary....especially when you are
    just looking for the pain to stop causing you to grind your teeth
    and suffer so badly....

    any chance you could find a pain management doctor in the 7 weeks you
    have til your surgery...?

    hope you get some relief soon...

    jess
    Last edited by jrnyc; 12-08-2011 at 08:16 PM.

  5. #5
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    Thanks everyone for your replies and support. I do appreciate all of your input.

    Linda, i know NSAIDS are generally not to be taken before surgery b/c it can increase bleeding and hamper bone healing but i never heard of that being the case with narcotics. I learn something new every day! Playing devils advocate, i don't think taking 1-2 vicodin at night after dinner is any reason for my surgeon to feel as though i'm taking too much. If anything, i'm not taking enough! I had one ortho tell me he was amazed that i wasn't on any pain meds given my pain and scans and xrays. But everyone is different. My husband and parents know that if i'm asking for pain meds, then i really MUST need them and be in a LOT of pain. I had 2 kids au naturale (no epidural obviously!) and so i know what real pain is - - the difference between childbirth/labor pain and what i am experiencing is that atleast the pain stopped when the kid popped out!! I can't seem to get away from my pain...it wakes me up, and if i DO manage to sleep for a few hours, it's just that - a few hours. And then i have to get up and come downstairs and try to sleep on my heating pad in the recliner. It sucks. But it's life (and has been) for a long time.

    Jess, i was referred to a pain mgmt doc back in August but it was 5-6 weeks before i could get in to see ANYONE for an evaluation. When i told my surgeon about that, he was dumb-founded. So i never established myself as a patient with a pain mgmt doc and now with only 6+ weeks before surgery, but the time i'd get in to see one of them my surgery would be here.

    I go back to see Dr. Clements on 12/23 for a pre-op visit of sorts i guess. My questions are geared toward medications, pain mgmt while in and once d/c'd from the hospital, pre-op tests that he might want me to have done (ie: I had an evoked potentials test for both PSF's in '93 and '95 but Clements never mentioned any tests so i want to ask him about that). Also to let him know my weekly blood donations for my surgeries beging 12/22 and go up thru mid-Jan. I have to donate 4 pints total. It's all starting to hit me...the reality is starting to sink in and with the amount of pain i'm in today, i am so ready to get this over and done with.

    Thanks again ladies!!
    1993/1995: PSF w/ Harrington rods T3-L4
    Jan. 24, 2012: ALIF of L4-L5, L5-S1 w/ cage spacer and BMP
    Jan. 31, 2012: PLIF of L1-S1 w/ pelvic anchors
    Scheduled Nov.15, 2012: Fusion T2-S1 w/ pelvic anchors to fix T12 fracture
    http://i31.photobucket.com/albums/c3...ot/myback2.jpg - BEFORE
    http://i31.photobucket.com/albums/c3...CT2342x406.jpg - AFTER
    http://i31.photobucket.com/albums/c3...CT1410x229.jpg - AFTER
    www.jerseyot.blogspot.com

  6. #6
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    Did what I said make sense? I am horrible at explaining thing thru email

  7. #7
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    Hi Annabelle -

    Yes, it made total sense! I'm so sorry i didn't acknowledge your response as well!! It does make perfect sense and when i go to see him on 12/23 i plan on asking him to write for pain meds to get me up to my surgery date. My dad (a retired pharmacist) also said the same thing - that they can't write for refills on narcotics but he too was surprised that the dr. didn't write for more than 30 - they can write for up to 60 at a time. So either way, i'll get something to get me thru til 1/24/12.

    I also decided my last day of work will Jan.6 (not Jan.13 like i had planned) - and for 2 reasons: (1) the sooner i stop working and lifting the better, (2) i have a problem with Friday the 13th - i'm afraid i'll break my arm that day or something (LOL)...so Jan.6th is it...i told my boss i'd work thru the holidays because i know it will be hard to find a replacement for me around the holidays. So with that, i only have 4 weeks left of work. (yaaaay)....i'm hoping to be able to come back when i'm healed and recuperated, although i have no idea when that will be. Instead of resigning altogether, my boss encouraged me to just go out on short term disability until i'm ready to come back...so we'll see how that goes...
    1993/1995: PSF w/ Harrington rods T3-L4
    Jan. 24, 2012: ALIF of L4-L5, L5-S1 w/ cage spacer and BMP
    Jan. 31, 2012: PLIF of L1-S1 w/ pelvic anchors
    Scheduled Nov.15, 2012: Fusion T2-S1 w/ pelvic anchors to fix T12 fracture
    http://i31.photobucket.com/albums/c3...ot/myback2.jpg - BEFORE
    http://i31.photobucket.com/albums/c3...CT2342x406.jpg - AFTER
    http://i31.photobucket.com/albums/c3...CT1410x229.jpg - AFTER
    www.jerseyot.blogspot.com

  8. #8
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    Quote Originally Posted by jerseyot View Post
    Hi Annabelle -

    Yes, it made total sense! I'm so sorry i didn't acknowledge your response as well!! It does make perfect sense and when i go to see him on 12/23 i plan on asking him to write for pain meds to get me up to my surgery date. My dad (a retired pharmacist) also said the same thing - that they can't write for refills on narcotics but he too was surprised that the dr. didn't write for more than 30 - they can write for up to 60 at a time. So either way, i'll get something to get me thru til 1/24/12.

    I also decided my last day of work will Jan.6 (not Jan.13 like i had planned) - and for 2 reasons: (1) the sooner i stop working and lifting the better, (2) i have a problem with Friday the 13th - i'm afraid i'll break my arm that day or something (LOL)...so Jan.6th is it...i told my boss i'd work thru the holidays because i know it will be hard to find a replacement for me around the holidays. So with that, i only have 4 weeks left of work. (yaaaay)....i'm hoping to be able to come back when i'm healed and recuperated, although i have no idea when that will be. Instead of resigning altogether, my boss encouraged me to just go out on short term disability until i'm ready to come back...so we'll see how that goes...
    I think that that is best taking off from Jan 6. You need time to get your house in order and buy some items that you will need when you get home. You will want to get a haircut and just relax and have some fun before your surgery
    Melissa

    Fused from C2 - sacrum 7/2011

    December 8, 2014 - Another Broken Rod Surgery

  9. #9
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    hydrocodone can be refilled....a few others can as well...
    oxycontin cannot be refilled...
    however, a doctor can write for more than a month by indicating that you take
    2 oxycontin a day, when you actually take one a day, so then it lasts for 2 months...

    jess

  10. #10
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    jerseyot,
    I am so sorry about your pain. Doctors today have to be very careful about prescribing narcotics because of the abuse of narcotics of just a few. I am sure your Doctor will make sure you are not without the needed pain meds. I just want to mention about the blood donations. Do not fret about donating blood. Most women are not able to give more than two pints because we don't build blood up as fast as men, plus our red cell counts are generally lower than men to begin with. From working in a hosopital Blood Bank many years, I have seen many women who have donated their own blood needing blood transfusions prior to their surgeries because their blood counts are too low for the Doctor to start the surgery. I wasn't able to give any blood because I came down with a nasty virus three weeks before my surgery. Give it a try if you want, but make sure you eat plenty of iron rich foods. MY thoughts will be with you.
    Sally
    Diagnosed with severe lumbar scoliosis at age 65.
    Posterior Fusion L2-S1 on 12/4/2007. age 67
    Anterior Fusion L3-L4,L4-L5,L5-S1 on 12/19/2007
    Additional bone removed to decompress right side of L3-L4 & L4-L5 on 4/19/2010
    New England Baptist Hospital, Boston, MA
    Dr. Frank F. Rands735.photobucket.com/albums/ww360/butterflyfive/

    "In God We Trust" Happy moments, praise God. Difficult moments, seek God. Quiet moments, worship God. Painful moments, trust God. Every moment, thank God.

  11. #11
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    i have always found your writing to make sense, Anna...

    jerseyot...in my experience, surgeons are not always the best doctors for pain medication...
    i know they like patients to cut back on their pain meds before surgery...
    that is what Dr Lonner told me when i was planning surgery 5 years ago....
    (which i changed my mind about at that time for medical and personal reasons)...
    but you should not be suffering, and 30 pills for 49 days doesn't sound like
    enough...i would not count on the surgeon to cover you for all the
    days left until your surgery....i hope i am wrong....
    this is exactly why a good pain doc is a blessing to those of us
    who suffer from pain related to spinal problems...

    i will keep both you and Anna in my thoughts and prayers for a successful
    operation and uneventful recovery...hopefully leading to a pain
    free life you both so deserve....

    jess
    Last edited by jrnyc; 12-08-2011 at 08:18 PM.

  12. #12
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    Quote Originally Posted by jrnyc View Post
    i have always found your writing to make sense, Anna...

    in my experience, surgeons are not always the best doctors for pain medication...
    i know they like patients to cut back on their pain meds before surgery...
    that is what Dr Lonner told me when i was planning surgery 5 years ago....
    (which i changed my mind about at that time for medical and personal reasons)...
    but you should not be suffering, and 30 pills for 49 days doesn't sound like
    enough...i would not count on the surgeon to cover you for all the
    days left until your surgery....i hope i am wrong....
    this is exactly why a good pain doc is a blessing to those of us
    who suffer from pain related to spinal problems...

    i will keep you in my thoughts and prayers for a successful
    operation and uneventful recovery...hopefully leading to a pain
    free life you so deserve....

    jess
    I agree with Jess .Most surgeons do not like to prescribe narcotics . My NC surgeon,after a month after surgery sent me to a pain management doctor to get
    any pain relief. However, my current surgeon, is willing to work with me to get me the needed pain relief. Good luck and I will keep you in my prayers.
    Melissa

    Fused from C2 - sacrum 7/2011

    December 8, 2014 - Another Broken Rod Surgery

  13. #13
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    Quote Originally Posted by jerseyot View Post
    I also decided my last day of work will Jan.6 (not Jan.13 like i had planned) - and for 2 reasons: (1) the sooner i stop working and lifting the better.
    You should definitely not be lifting anything heavy. No surprise to me that you're having significant pain. Glad you can get out of there sooner than planned!

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  14. #14
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    Melissa & Jess - i'm not sure who will follow my post-op pain, whether it will be my surgeon (i doubt it) or a pain management dr. - - do either of you see one regularly for pain management? I imagine my surgeon will write for pain meds when i'm home but for how long i have no idea. So i will definitely have to ask him about that on my 12/23 pre-op appointment. Jess, at my 12/23 pre-op appt i am going to ask for more pain meds to get me thru until the surgery date. 30 pills taken "every 6 hours as needed" would only get me thru 1 week...and i intend on bringing that up - - i definitely need more than that if i am to take 2 pills per day. Sometimes i feel like they just have no flippin' idea what we are going thru or what kind of pain we're living with and living thru. I hope he can see my viewpoint (i think he will) and agree to give me enough to get me to my surgery date.

    Sally - I will be giving 1 pint of blood for 4 weeks starting 12/22 and i just started on iron pills 2x/day today. I had to give 2 pints for my other two PSF's years ago but with giving 4 pints in 4 weeks i have a feeling i'll be a little drained and lacking some energy. I am so glad to be going out of work 4 weeks from now. I have a lot of loose ends to tidy up before 1/24 so it'll be nice to have some time to do them.

    Linda - No heavy lifting is right!! I have a ton of support when it comes to patient transfers and i'm not afraid to ask - everyone i work with is really good about that (thank goodness!)

    Well, today was the day my boss and i told the rehab dept (my PT/OT co-workers) that i was leaving Jan.6 and why. It was a little emotional and i could feel myself welling up but i got it all out and everyone was so incredibly supportive. I had several even offer to donate blood for me! Can you believe that?!?! It was really good to get it off my chest - i felt like i was keeping a secret. BUT, about two hours later - after treating my last patient, i think i had a panic attack. My heart was pounding, my face got all flushed, i had a hard time catching my breath, i felt "weird" but in a way i couldn't really describe and my blood pressure was 155/94 (normal for me is about 110/70) - and my heart rate got up to 135bpm just SITTING there - - the nursing supervisor was called in to the gym b/c one of my co-workers was a bit alarmed by my HR and BP...it passed after about 10 minutes and then i felt a little better but it's been happening about 2-3x/week ever since i scheduled these surgeries. So i know it's all stressed related...has that ever happened to you or people you know? I don't feel like "OMG, i'm gonna die" or anything...just feel like my heart is gonna pound clear out of my chest and sometimes it's hard to take a nice deep breath. I called my family doc tonight and will tell him what's going just to fill him on and keep him informed.
    1993/1995: PSF w/ Harrington rods T3-L4
    Jan. 24, 2012: ALIF of L4-L5, L5-S1 w/ cage spacer and BMP
    Jan. 31, 2012: PLIF of L1-S1 w/ pelvic anchors
    Scheduled Nov.15, 2012: Fusion T2-S1 w/ pelvic anchors to fix T12 fracture
    http://i31.photobucket.com/albums/c3...ot/myback2.jpg - BEFORE
    http://i31.photobucket.com/albums/c3...CT2342x406.jpg - AFTER
    http://i31.photobucket.com/albums/c3...CT1410x229.jpg - AFTER
    www.jerseyot.blogspot.com

  15. #15
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    Melissa & Jess - i'm not sure who will follow my post-op pain, whether it will be my surgeon (i doubt it) or a pain management dr. - - do either of you see one regularly for pain management? I imagine my surgeon will write for pain meds when i'm home but for how long i have no idea. So i will definitely have to ask him about that on my 12/23 pre-op appointment. Jess, at my 12/23 pre-op appt i am going to ask for more pain meds to get me thru until the surgery date. 30 pills taken "every 6 hours as needed" would only get me thru 1 week...and i intend on bringing that up - - i definitely need more than that if i am to take 2 pills per day. Sometimes i feel like they just have no flippin' idea what we are going thru or what kind of pain we're living with and living thru. I hope he can see my viewpoint (i think he will) and agree to give me enough to get me to my surgery date.

    During my first surgery, May 2010, my surgeon passed me on to pain management at 6 weeks and it was a nightmare. Every time I went, it was like pulling teeth
    to get any meds. Since July of this year, with mu current surgeon it has been a pleasure to get what I need. At my appts or in between appts, via email, we talk
    about what I need and go from there

    I hope that you get into a good situation where your needs will be met
    Melissa

    Fused from C2 - sacrum 7/2011

    December 8, 2014 - Another Broken Rod Surgery

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