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Thread: Stopping narcotics before surgery

  1. #16
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    May 2009
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    i found it to be true that some people do self medicate undiagnosed
    depression and undiagnosed anxiety....
    but i also found that some people use drugs for recreational purposes...and some use very hard
    core drugs for recreation...
    of all the years i worked in detox and rehab, i met some hard core addicts...
    it was eye opening...

    i think it may be very hard for someone who is an addict to deal wtih post surgery pain....
    i hope your son has a good team working to care for him, especially after surgery...
    there is another thing...motivation...
    it may be quite difficult to be motivated to quit and stay off "drugs" when in extreme
    pain and in need of real medication....

    jess

  2. #17
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    Mar 2008
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    New Bern, NC
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    1,445
    Jess,
    Morphine pumps will only deliver so much medicine in a given time period. You cannot overdose on them.
    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.

  3. #18
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    May 2009
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    3,745
    hi Sally
    yes, that is while in the hospital....
    what about meds after discharge...?
    very tough situation....

    jess

  4. #19
    Join Date
    Mar 2010
    Posts
    2,755
    He's going to have to have something after surgery. It would be just cruel to withhold medication from a person that needs it. He will have to be closely monitored, though. Also, his pain tolerance may be low because of past drug use. That is something to consider. Prolonged use of opiates sensitizes the nerve receptors to perceive the most minor things as great pain (they become overactive in sending pain signals so that the brain will want more of the drug). This may be the "why" in why they want him clean for eight weeks. This would give his nerve endings time to recover to a normal level of activity. It makes sense, but I feel for the guy. Again, I wish him all the best and HOPE he can get through this and stay clean afterward. Remember, none of us have walked in his shoes. We don't know his whole story. It's just a tough place to be right now is all. He needs lots of love and support.
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  5. #20
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    May 2009
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    no doctor would expect him to go without pain medication after major surgery...
    that is not at issue....
    but he does have concerns that people who are not addicts do not have to deal with....
    because of that, he wil require medical staff with special knowledge and experience....

    jess

  6. #21
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    Mar 2011
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    Tallahassee, Fl.
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    Quote Originally Posted by jrnyc View Post
    as a licensed social worker, i worked in the field of addiction and recovery....i spent many hours
    in detox and rehab facilities...
    i am wondering about the pain from the urinary problems triggering a relapse...?
    and wondering if all the pain, combined with the stress of worrying about the spinal surgery, might
    lead to some self medicating...??????

    also....will any surgeon give him a self administered morphine pump after surgery, with his history....????

    a surgeon familiar with operating on addicts, recovering addicts, etc, would be great to have...
    if not, a team of people to work with that surgeon....

    best of luck
    jess
    HI Jess...He doesn't really have that much pain from the urinary issues...that is more psych pain from not being able to function sexually...but yes...I understand your view and it is a possibility. I can't imagine that they won't give him a PCA after surgery. I would have to pitch a pretty big fit if that were the case!!! The surgeon is going to have the anesthesiologist call to discuss everything...including getting off the saboxone. I spoke with the surgeon today and his reasoning for taking him off everything for so long before surgery is to get the brain to recoup from the narcs with the hope being that after the initial healing from the surgery he won't need as many pain meds...if any. That would be a dream and oh how I pray that will be the case.

    Thanks for your thoughts.

    diana

  7. #22
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    Mar 2011
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    Tallahassee, Fl.
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    Quote Originally Posted by titaniumed View Post
    I can understand what he is going through. I just wanted you to know that living with a full fusion isnít all that bad. I hope that things turn out for the better, they usually do.

    No matter how bad things were with me in the past, I always had hope no matter what happened. Its something that kept me going all these years....

    I never ever lost faith.....

    Ed
    Wow ED!!! Amazing you are!!! Do you take pain meds now? I'm wondering how your pain level is now compared to before the surgery? This is the surgery he will be having.

    God bless you!!
    diana

  8. #23
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    Mar 2011
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    Tallahassee, Fl.
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    Quote Originally Posted by jrnyc View Post
    "a disastrous addict" who would just like to be "numb to life" is a whole other level entirely!...
    it is not like scoli patients who worry about becoming dependent on the pain meds, use them only for pain, and
    are in a hurry to wean off...
    real addicts like the stuff...they like anything that can numb feelings...and will use "recreationally"
    not just for pain the way surgery patients do, the patients who are always worried about how much they are taking
    are not the same as the patient who is an addict before any surgery takes place....

    i can see why any surgeon having this young man for a patient would have a lot to worry about...
    a lot of dangers not there for non addicted scoli patients....

    jess
    You are exactly right Jess, and for this reason, I do appreciate how careful the surgeon has been. He has been methodical and covering all the bases. MY son has been doing very well the past 6 months...going to NA meetings...has a sponser and working the steps. It's not gone though...the addiction, and will be a lifelong battle for him I'm afraid. But...if the surgery does indeed decrease his pain and give him some quality of life then hopefully we can get some attention to his other issues and get him on to a track of having a quality life full of all he deserves...like a family and love. I think anyone would want to be numb if they were in his shoes, but it only makes life worse and he is seeing that day by day.

    ;o) diana

  9. #24
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    Mar 2011
    Location
    Tallahassee, Fl.
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    Quote Originally Posted by rohrer01 View Post
    Dianadee58,
    I'm wondering about your son and concerned for him. What I'm wondering is if his addiction problem happened as a result of untreated pain. I worked in a drug and alcohol rehab center many years ago. I would take care of the detoxing patients. It's been my experience, even with my own kids, that addiction to anything stems from trying to self-medicate something, whether it be emotional or physical pain. He may have very well been self-medicating his physical pain and became an addict that way. Addiction tendencies are partly hereditary as well. Some people inadvertantly become addicted to narcotics after a big surgery like this. I feel that he is most "at risk" post-op for becoming dependent on pain killers, and this has ruined many lives of the unwary. However, if he feels better, he may not "need" the pain killers anymore and would just need supportive care from either an addiction specialist or a pain psychologist or both to stay clean. I can't see them withholding a pain pump after surgery just because he's an addict. He's still a human being and is going to have pain initially. Those pumps are programmed NOT to let you have more than a safe level of narcotic as determined by the doctor. For me, it would be the months and years after surgery that I would most worry about. If he's truly in pain, I can not understand them wanting him to be off of all narcotics before surgery, especially if he is following his prescription protocol. Many of us have been on narcotics for years, but are not addicts. I wish you both the best and just wanted to let you know my thoughts.

    Sincerely,
    Rohrer01
    So...you've never had surgery? Impressive. I really wish we had never gone through with the 1st surgery and just let it take it's course as you have. His curves were in the 50's @ 16 yrs.

    I'm sure his addiction was a result of uncontrolled pain. After the first spinal fusion he left the hospital coming off of the dilaudid PCA just a few hours before d/c home, and was sent home on percocet. The poor boy had AWFUL pain and I couldn't get the stupid surgeon to give him more medication. He suffered sooooo much...and it never really got that much better, even after getting the rods removed after 18 mths. But...we also have a lot of addiction issues in our family...so it's a dual issue. he has been doing a lot better the past 6 months going to NA and working the steps with his sponsor. Any meds he does have I keep in a safe and hand out to him and that's how it would be after surgery. But...hopefully he will have less pain after the surgical healing is over. Oh how I pray so. He has a really good pain/addiction specialist he sees now, and he will help us after I'm sure. THe surgeon has been conversing with him and they are working out a plan together. God is good and I am trusting Him to bring my son through this. He just has to help him. He has suffered more in his young life than anyone should.

    Thank you for your concern. ;o)

    diana

  10. #25
    Join Date
    Mar 2011
    Location
    Tallahassee, Fl.
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    33
    Quote Originally Posted by jrnyc View Post
    i found it to be true that some people do self medicate undiagnosed
    depression and undiagnosed anxiety....
    but i also found that some people use drugs for recreational purposes...and some use very hard
    core drugs for recreation...
    of all the years i worked in detox and rehab, i met some hard core addicts...
    it was eye opening...

    i think it may be very hard for someone who is an addict to deal wtih post surgery pain....
    i hope your son has a good team working to care for him, especially after surgery...
    there is another thing...motivation...
    it may be quite difficult to be motivated to quit and stay off "drugs" when in extreme
    pain and in need of real medication....

    jess
    Our hope is that his pain will be lessened by the surgery. I really believe if he doesn't have so much pain to deal with his life will be much better and he won't be seeking out the drugs so. He has a wonderful sponsor at NA and he will stay strong with that program. It stinks that we don't live in the same city as the surgery...we're 10 hours away...because they have a wonderful team approach. He has a good pain/addiction specialist and is going to see a psychiatrist next week. You're right though..we are going to have to have a good team approach.

    diana

  11. #26
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    Mar 2011
    Location
    Tallahassee, Fl.
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    33
    Quote Originally Posted by jrnyc View Post
    hi Sally
    yes, that is while in the hospital....
    what about meds after discharge...?
    very tough situation....

    jess
    It is a tough situation, but fortunately he has a mother that is a very big support and I lock the meds up in the safe. I know he can't live that way forever, but as stated before...our hope is he will have LESS pain after surgery and not need the meds. Please God.

    diana

  12. #27
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    Mar 2011
    Location
    Tallahassee, Fl.
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    Quote Originally Posted by rohrer01 View Post
    He's going to have to have something after surgery. It would be just cruel to withhold medication from a person that needs it. He will have to be closely monitored, though. Also, his pain tolerance may be low because of past drug use. That is something to consider. Prolonged use of opiates sensitizes the nerve receptors to perceive the most minor things as great pain (they become overactive in sending pain signals so that the brain will want more of the drug). This may be the "why" in why they want him clean for eight weeks. This would give his nerve endings time to recover to a normal level of activity. It makes sense, but I feel for the guy. Again, I wish him all the best and HOPE he can get through this and stay clean afterward. Remember, none of us have walked in his shoes. We don't know his whole story. It's just a tough place to be right now is all. He needs lots of love and support.
    Thank you so much. He does need a lot of love and support. I think your explanation here hits the nail on the head...exactly what the surgeon is explaining to us.
    diana

  13. #28
    Join Date
    May 2010
    Location
    Indianapolis area
    Posts
    966
    Just read in here about the need to stop smoking, too. That sounds terribly dillfficult on top of everything else, but I gather smoking significantly decreases chances for a good fusion.

    Rohrer, how do we post-ops avoid pain meds becoming addictions? Any basic tips would be appreciated, as I am starting to wean. Thanks!
    age 44
    80* thoracolumbar; 40* thoracic
    Reduced to ~16* thoracolumbar; ~0* thoracic
    Surgery 3/14/12 with Dr. Lenke, T4 to S1 with pelvic fixation
    Not "confused" anymore, but don't know how to change my username.

  14. #29
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,531
    I donít take anything at all.....

    Itís a long story.....and a phone call would be the easiest way to cover a lot of material quickly....PM me

    Iím going skiing tomorrow and Sunday so have to call this one short. I will be in my RV with my laptop and online at night.

    Have you seen this? Iím in the red jacket. California Sierraís 01/01/11
    http://www.youtube.com/watch?v=4tEyp...&feature=email

    Ed
    49 yr old male, now 58, the new 53...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  15. #30
    Join Date
    Oct 2008
    Location
    Sunshine Coast, Queensland, Australia
    Posts
    3,261
    Diana, your son has one major positive in his life - you. I wish you both the very best possible outcome.
    Surgery March 3, 2009 at almost 58, now 63.
    Dr. Askin, Brisbane, Australia
    T4-Pelvis, Posterior only
    Osteotomies and Laminectomies
    Was 68 degrees, now 22 and pain free

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