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Thread: Pain Management?

  1. #1
    Join Date
    Jan 2009
    Location
    Virginia Beach, VA
    Posts
    455

    Exclamation Pain Management?

    Posting in regards to my wifes surgery. Via a lateral entry with a l2/l3, l3/l4 fusion with cages, with correection of rotation and level, compared with similar procedures what have others been give for pain relief in the hospital as well as upon discharge. I know that we should expect pain with her surgery, but I do not think they are doing enough. The head of Ortho, who performed the surgery, had to leave for a conference late last night. That has left me with 2 residents who I am less than confident in . I am about ready to put them in a bed next to Susan.

    Any info on others pain meds would be great.

    We do have a hospital bed, walker and shower seat at home already (more for next Wednesday surgey).

    Hopefully Susan wil be Home tomorrow or Sunday, at which time she will be on the computer before she is in bed.

    Thanks
    Susan

    Diagnosed at 10, Boston brace from 11-13 yrs old.
    50* Lumbar w/ 5 centimeter shift to the left and slight rib hump...
    Surgery Date: April 15 and April 22, 2009
    X-LIF approach for disc repair L5,L4,L3,L2
    Posterior Approach for fusions L5-T5
    Dr. Fox @ Naval Medical Center Portsmouth
    Nice and straight now!!!!!

  2. #2
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    7,102
    Hi...

    It's an unfortunate part of life, that unless you're in a non-university related hospital facility, residents and/or fellows will be in charge of your post op care.

    It's hard to watch a loved one in pain. Been there, done that. I hope that Susan gets some relief soon.

    My personal preference for IV narcotics is fentanyl or dilaudid. For oral pain medication, I prefer vicodin. Do you know what Susan is getting?

    Regards,
    Linda

  3. #3
    Join Date
    Oct 2008
    Location
    Sunshine Coast, Queensland, Australia
    Posts
    3,263
    I felt the same way about my pain control. But for me, it was the bed. It forced my back into an arch and my bottom was placed in a hole created by lots of bottoms over the years, sitting in that spot whilst the bed was in the up position. I couldn't sleep in that position, nor could I get away from that hole. 19 days I put up with that, in pain uncontrolled by the oral meds they gave me. They tried quite a few, to give them their dues, but most of the time I was in pain that brought me to tears. Frequently, I would be calling for pain relief, long before it was due, and ending up having injected morphine, which worked (heavenly relief) in 10 minutes.

    I thought I'd never get home because I had to go 12 hours without morphine before they'd let me home. The day I came home I was terrified that the pain would get out of control and I'd need an injection. My fears were unnecessary. The minute I lay down on my very ordinary, but flat, supportive bed, I knew I was going to be ok. It was the hospital bed and the horrible position it forced my back into, that was the problem. My pain halved from that first day at home. I've been reducing my hospital "horse dose" of medication ever since. I'm expecting to be off all meds by Week 9. I'm 7 weeks next Tuesday.

    I guess there was also an element of relief, to be home at long last, and in control of my own medication...because the nurses were often up to 2 hours late, by which time the pain would be out of control and the oral meds didn't help one iota. Of course, this doesn't happen at home!

    I wish Susan luck and hope she does get home tomorrow, because I think it will make a big difference to her pain control.
    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

  4. #4
    Join Date
    Oct 2007
    Location
    Indiana
    Posts
    1,978
    Quote Originally Posted by LindaRacine View Post
    Hi...
    It's an unfortunate part of life, that unless you're in a non-university related hospital facility, residents and/or fellows will be in charge of your post op care.
    Regards,
    Linda
    Just wanted to say that it's not always that way. There were three "fellows" (seems funny to say that since one was female...) who looked in on me quite often and they were so caring and good with me. My surgeon also stopped by, although I don't think it was every day. I also did not have a problem with nurses being late in giving meds. Maybe my hospital is not the norm-- but I don't want people thinking you get the shaft at all university-related hospitals...

    Susan's husband-- hopefully the pain will be better controlled soon. Then the other surgery-- and then the recovery. You're both in my thoughts and prayers.
    67 and plugging along...
    2007 52 w/ severe lumbar stenosis & L2L3 lateral listhesis (side shift)
    5/4/07 posterior spinal fusion T2-L4 w/ laminectomies and osteotomies @L2L3, L3L4
    Dr. Kim Hammerberg, Rush Univ. Medical Center in Chicago

    Corrected to 15
    CMT (type 2) DX in 2014, progressing
    NEW 10/2018 x-rays show spondylolisthesis at L4/L5 - Dr. DeWald is monitoring

    Click to view my pics: pics of scoli x-rays digital x-rays, and pics of me

  5. #5
    Join Date
    Jan 2006
    Location
    near Philadelphia
    Posts
    1,260
    In the hospital, shots of Dilaudid were like magic for me. Once I was home, Oxycontin (both quick-release and long-acting) worked very well.
    Chris
    A/P fusion on June 19, 2007 at age 52; T10-L5
    Pre-op thoracolumbar curve: 70 degrees
    Post-op curve: 12 degrees
    Dr. Boachie-adjei, HSS, New York

  6. #6
    Join Date
    Nov 2007
    Location
    Houston, TX
    Posts
    1,757
    My surgeon knew that I have an extreme tolerance to pain meds, so we'd lined out a fairly aggressive pain management plan for me when I did my pre-op visit with the anesthesiology department at Methodist Hospital.

    Immediately after surgery, I was on PCA Dilaudid in tandem with staggered doses (6 hours apart, but they overlapped at 3 hours) of 2 Norco and 2 Percodan. It worked well until my IV blew on Day 2 ... and I got *way* behind the pain. The oral meds were just not cutting it, so they started giving me intramuscular shots of Dilaudid until the IV could be replaced.

    I came home on the same staggered doses of Norco/Percodan at 6 days, and continued that for about a month (or at least until after the walk). I dropped the Percodan after that.

    If you don't think they're doing enough, request to speak to someone from anesthesiology or if they have one (most hospitals do) from the pain management team. There's no reason to be in the hospital in excessive pain. I hate to hear that.

    One word of advice I can give you is have them dose her up *right* before you leave the hospital, or have pain meds ready at home (hard to do when they don't write your scripts until discharge ... but maybe you can convince one of the kiddie docs to do it before ;-).

    The worst mistake I made was NOT doing that, being in pain on the car ride home (a whopping 10 minutes), and then having to wait while we ran around and filled my prescriptions.
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op 53, Post-op < 20
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


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