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  • Pain after surgery

    I have never had back surgery. My back pain now is intense. I take 2 Dilaudid twice a day and I don't think that it does anything to help. Now, I'm worried about postoperative pain after the PCA is discontinued. I imagine that the pain after surgery is severe, and if Dilaudid doesn't help now....how am I possibly going to be able to control my pain postoperative?
    Susan
    Last edited by susancook; 01-04-2013, 03:10 PM.
    Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
    2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
    2018: Removal L4,5 screw
    2021: Removal T1 screw & rod

  • #2
    Susan,
    Yes, you can expect post op pain but this is something your doctor will be able to work to find the right thing to help control it. It is also one of those things you wont know how your body may react. It is something that you don't need to stress about. You need to look at the bigger picture and end result which is your spine being fixed and long term pain being gone. Start positive thinking now, because that is what is going to get you through the rough patches. There is power in positive thinking. Invest in a good heating pad because that too will help calm things down.
    Tamena
    Diagnosed at age 12 with a double major curve

    Braced till age 15

    SSBOB T12-L2 Anterior age 34. (October 22,2012) Dr. Robert Gaines Jr. ( Columbia, MO)

    Revision Surgery T2-Sacrum with Pelvic Fixation Prosterior age 35 (November 13,2013) Dr. Michael Kelly (St. Louis, MO)

    Revision Surgery L4/L5 due to BMP Complication age 36 (November 20,2014) Dr. Michael Kelly (St. Louis, Mo)

    Revision Surgery due to broken rod scheduled for October 19, 2016 with Dr. Michael Kelly (St. Louis, MO)

    Comment


    • #3
      I thought you said you had neck surgery where a nerve was accidentally injured??? Maybe I'm confusing you with someone else. Anyway, post-op pain is always managed no matter what surgery you have. If the medications don't cut it, then they find something else. I've never had back surgery, but had other surgeries. The pain meds don't always get rid of the pain entirely, but enough so that you can rest and recover and get around as your body allows. I would discuss this concern with your doctor.

      Yep, it was you. You said:
      "I had neck surgery and the surgeon cut the terminal part of a nerve and I can't more one arm in a certain direction. I would still have the neck surgery again because I needed a diagnosis. I get it, honestly I do. You can let go of this one. Let go.......
      Susan"

      So how did you fare with recovering from this surgery? It sounds pretty invasive to have cut the nerve. Although soft tissue surgeries (I'm making an assumption that it was) are probably easier to recover from than spine surgeries. Again, I would bring this up with your doctor. I had a surgery and was already on pain meds for my back and was worried about pain control. They just gave me stronger pain meds for a while.
      Last edited by rohrer01; 01-03-2013, 10:25 AM. Reason: added info.
      Be happy!
      We don't know what tomorrow brings,
      but we are alive today!

      Comment


      • #4
        Originally posted by tae_tap View Post
        Susan,
        Yes, you can expect post op pain but this is something your doctor will be able to work to find the right thing to help control it. It is also one of those things you wont know how your body may react. It is something that you don't need to stress about. You need to look at the bigger picture and end result which is your spine being fixed and long term pain being gone. Start positive thinking now, because that is what is going to get you through the rough patches. There is power in positive thinking. Invest in a good heating pad because that too will help calm things down.
        Tamena
        I own 3 heating pads, even one that stays warm for a couple of hours unplugged. You are right, I do need positive thinking. I stayed in the house for a couple of days and of course, my pain was quite minimal. So then, I started to think that maybe I don't need surgery after all. We went downtown San Francisco and walked around an art gallery and I was toast and in a lot of pain. I am micromanaging everything and really feel down about what to do. I feel like I'm in a rut.
        Thanks for caring. Susan
        Last edited by susancook; 01-03-2013, 12:55 PM.
        Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

        2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
        2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
        2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
        2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
        2018: Removal L4,5 screw
        2021: Removal T1 screw & rod

        Comment


        • #5
          Originally posted by rohrer01 View Post
          I thought you said you had neck surgery where a nerve was accidentally injured??? Maybe I'm confusing you with someone else. Anyway, post-op pain is always managed no matter what surgery you have. If the medications don't cut it, then they find something else. I've never had back surgery, but had other surgeries. The pain meds don't always get rid of the pain entirely, but enough so that you can rest and recover and get around as your body allows. I would discuss this concern with your doctor.

          Yep, it was you. You said:
          "I had neck surgery and the surgeon cut the terminal part of a nerve and I can't more one arm in a certain direction. I would still have the neck surgery again because I needed a diagnosis. I get it, honestly I do. You can let go of this one. Let go.......
          Susan"

          So how did you fare with recovering from this surgery? It sounds pretty invasive to have cut the nerve. Although soft tissue surgeries (I'm making an assumption that it was) are probably easier to recover from than spine surgeries. Again, I would bring this up with your doctor. I had a surgery and was already on pain meds for my back and was worried about pain control. They just gave me stronger pain meds for a while.
          That was a soft tissue surgery. I had some enlarged lymph nodes and they removed them for biopsy. They were all negative and the pain was minimal.

          I will talk to my surgeon ( unsure who that will be) and pain management MD about the postoperative pain concern. I just feel so ambivalent, yet in a lot of pain when I try to go outside the house and do anything to be active. My husband planned a trip to Mexico in a few weeks and I wonder how I am going to survive. I wish that I could figure out my ambivalence. I think that some of my problem is having confidence in a surgeon. I am working on that.

          Thanks for all of your support. Susan
          Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

          2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
          2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
          2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
          2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
          2018: Removal L4,5 screw
          2021: Removal T1 screw & rod

          Comment


          • #6
            Have you had a steroid shot recently? If so, did it not work well this time?

            I have a friend who needed fusion for degeneration and refused. It came to a point where surgery was no longer an option for her. I'm not trying to scare you, it's just that she was bone on bone, too. Her spine fused itself and then there was nothing that they could do for her. She says she still would NOT have the surgery even though she's in a wheelchair now. It scared her too much. I guess my point is, you have to know what you want and what you are willing to risk. There are risks both ways. Right now you know what you're dealing with and surgery is an unknown. You have to consider how bad your pain really is. If it is really that bad, then could surgery make it worse or could it only get better or stay the same? Just some things to think about.
            Be happy!
            We don't know what tomorrow brings,
            but we are alive today!

            Comment


            • #7
              I didn't experience any pain after surgery for several days because I was given two epidurals which were set before closing. I am unsure if this method of pain control is used in the States, but might be worth asking about. It gave me a chance to at least get over the effects of 8 hours of anaesthetic and I was already up and about before they removed them on Day 3 or 4 (I forget now.) I then went on to oral meds and didn't feel any pain for another day or two, so it was a nice reprieve and I think I was probably over the worst before I experienced any pain. I am totally grateful for that.
              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

              Comment


              • #8
                Originally posted by rohrer01 View Post
                Have you had a steroid shot recently? If so, did it not work well this time?

                I have a friend who needed fusion for degeneration and refused. It came to a point where surgery was no longer an option for her. I'm not trying to scare you, it's just that she was bone on bone, too. Her spine fused itself and then there was nothing that they could do for her. She says she still would NOT have the surgery even though she's in a wheelchair now. It scared her too much. I guess my point is, you have to know what you want and what you are willing to risk. There are risks both ways. Right now you know what you're dealing with and surgery is an unknown. You have to consider how bad your pain really is. If it is really that bad, then could surgery make it worse or could it only get better or stay the same? Just some things to think about.
                Sobering thought. I wish that I knew why I am hesitant to have surgery. I have a second opinion next week...I expect a lot out of 30 minutes!

                I did have a steroid inj about 4 weeks ago. The pain relief only lasted 4days this time where previously it was 2 months. Maybe I needed steroid inj on 2 levels?
                Susan
                Last edited by susancook; 01-03-2013, 06:50 PM.
                Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

                2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
                2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
                2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
                2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
                2018: Removal L4,5 screw
                2021: Removal T1 screw & rod

                Comment


                • #9
                  Susan,
                  I had never had any surgery prior to this major surgery and was really worried (terrified) about the post-op pain. It was not nearly as bad as I had imagined. It was well controlled at the hospital and at home. My main pain was from constipation, which took time to get under control. I hope that you find confidence in Dr. Hu. If not, maybe you need a third opinion. Unfortunately, it seems to me, that because of your age and your current level of pain, you don't have the luxury of waiting too long.
                  Karen

                  Surgery-Jan. 5, 2011-Dr. Lenke
                  Fusion T-4-sacrum-2 cages/5 osteotomies
                  70 degree thoracolumbar corrected to 25
                  Rib Hump-GONE!
                  Age-60 at the time of surgery
                  Now 66
                  Avid Golfer & Tap Dancer
                  Retired Kdgn. Teacher

                  See photobucket link for:
                  Video of my 1st Day of Golf Post-Op-3/02/12-Bradenton, FL
                  Before and After Picture of back 1/7/11
                  tap dancing picture at 10 mos. post op 11/11/11-I'm the one on the right.
                  http://s1119.photobucket.com/albums/k630/pottoff2/

                  Comment


                  • #10
                    There are many things to think/worry about with this surgery, but post-op pain shouldn't be one of them. You probably will have it well controlled, and if you don't, the doctors will fix it. I actually don't remember any pain until I was home, two weeks after surgery. And that's when I voluntarily started decreasing meds. Oh, except the stomach issues. Karen is right about that being painful. But there are lots of combos to help with that, too.
                    age 48
                    80* thoracolumbar; 40* thoracic
                    Reduced to ~16* thoracolumbar; ~0* thoracic
                    Surgery 3/14/12 with Dr. Lenke in St. Louis, T4 to S1 with pelvic fixation
                    Broken rods 12/1/19; scheduled for revision fusion L1-L3-4 with Dr. Lenke 2/4/2020
                    Not "confused" anymore, but don't know how to change my username.

                    Comment


                    • #11
                      pain post-op

                      These are all excellent comments.

                      I just want to add that pain is different for everyone. It's subjective; everyone feels and experiences it differently. Some people may need a lot of medication after surgery, others not so much. Not to mention that everyone reacts to different opiates/narcotic pain killers in different ways.

                      Also, some people like to be prepared for every eventuality surrounding the surgery; it just depends on what type of personality you have. It sounds like you are of the type that indeed likes to be prepared, so perhaps you should consider hiring a private anesthesiologist at the hospital to be in charge of your pain management. Actually, I think you said you had a pain management doctor already. You should consider discussing the fact that you are already on opiates and therefore may be slightly opiate tolerant, and that you are concerned about adequate pain control after the surgery.

                      I hired the anesthesiologist from my last surgery to also be in charge of all my pain control after the surgery and while I was in hospital. I had already been on opiates for ten years at that point so I, too, was concerned about pain. Having a true expert made all the difference; I had a spinal cathetar with my pain meds and I can honestly say I didn't feel a thing during my entire hospital stay. When I told him this later, he said, "That is our goal; to have you feel no pain." So it is possible to have zero pain after a spinal surgery; at least it was for me. I hope it will be for you, too.
                      Best of luck to you,

                      Comment


                      • #12
                        Hi,

                        While I think that the goal of experiencing zero pain after major spinal surgery is admirable, I also think it is extremely unrealistic to expect that. It is inevitable that you will experience some pain, unfortunately. You are not a stranger to pain, however, so you can make it through some pain.

                        It is much more reasonable to expect your pain to be well-controlled and promptly treated. For instance, one of my best nurses after my second surgery told me her goal was to keep my pain below a 4 during her shift. Too bad I didn't have more like her after my first surgery, where my pain was very poorly controlled and none of the nurses seemed to care much.

                        Some docs will not allow an epidural (including Dr H) because it carries an increased risk of infection right into your back where the hardware and grafting was done. I was disappointed to learn this, but definitely understood the reasoning!

                        One of the best things you can do is have a helpful companion or private nurse who will not hesitate to make sure you get all the pain control and comfort measures you need when you need them.
                        Gayle, age 50
                        Oct 2010 fusion T8-sacrum w/ pelvic fixation
                        Feb 2012 lumbar revision for broken rods @ L2-3-4
                        Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


                        mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
                        2010 VBS Dr Luhmann Shriners St Louis
                        2017 curves stable/skeletely mature

                        also mom of Torrey, 12 y/o son, 16* T, stable

                        Comment


                        • #13
                          Originally posted by susancook View Post
                          Maybe I needed steroid inj on 2 levels?
                          Susan
                          Susan, I asked the pain management Doc about that and was told that since the injection goes right into the spinal fluid, it will reach the other level. So, no, they will not give you two steroid injections at two levels. I am so sorry that the last injection did not work for you. My SI injections did not work for me either.
                          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.

                          Comment


                          • #14
                            spinal fluid...?
                            i was told my SI joint injections went directly into the SI joints...
                            was given injection on left and on right sides.

                            jess

                            Comment


                            • #15
                              Originally posted by loves to skate View Post
                              Susan, I asked the pain management Doc about that and was told that since the injection goes right into the spinal fluid, it will reach the other level. So, no, they will not give you two steroid injections at two levels. I am so sorry that the last injection did not work for you. My SI injections did not work for me either.
                              Sally
                              I've been given steroid injections at as many as 3 levels at once. I think those were facet joint injections, as they thought that might be where my pain was coming from. So they do give injections at more than 1 level, but maybe it depends on where they think the pain is coming from?

                              Lisa

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