The Moment you wake up from surgery

[CStadler]

I don't think you should have ever felt that type of pain. I remember feeling like I was laying on something when I first woke up but no pain.
It doesn't sound like they were managing your pain very well and you should have said something, if of course you could talk. I remember with my first surgery one of the night nurses decided to let me sleep instead of waking me for my meds. I woke up in so much pain that I could hardly breath or talk. They had to restart an IV and it took 4 hours before they could get ahead of the pain again. Do not let it get that bad. I was told to never let the pain get past 4 or 5 because it is so hard on you.
Talk to your surgeon and remind him what that pain was like when you woke up and then they should re-evaluate the amount of pain meds they will give you.
I hope it goes better this time. Carol

[geo]

I woke up without pain, pretty aware of what was going on around me, enough to ask for my family, but totally exhausted to the point of not even wanting to answer yes or no questions. My nurse let me know that I had a painkiller applied directly to the incision area, so I shouldn't feel any pain there until possibly the next day (and I didn't). The most pain I felt in the first few days was when they had to pull me further up the bed because I had gotten too close to the bottom and couldn't incline myself. That hurt! But otherwise, the morphine pump was excellent, and the real pain didn't come until switching to oral meds, and then later when I went off Oxycontin too fast (to a much weaker painkiller).

I remember being amazed at the effectiveness of the pain medication, because that had also been one of my big fears.

[Chihuahua Mama]

Thanks so much!

I was just telling one of my family just how much I was reassured after reading all your responses, nitty gritty and all. That's what I love about this forum, you all tell it like it is.

I'm just not going to worry about this anymore. It's time to move on to the next thing I intend to worry about.

BTW, I'm not quite ready to put my name on the surgical calendar yet, but unofficiallly, it's in June.

Thanks again

[Theresa]

I don't remember the waking up on any of the surgeries!!! When I realized I was awake on the first surgery I felt like I was laying with bricks under my back. It was actually the gauze pads along the incision! My family tells me I kept saying that I hurt but luckily it wasn't until a week and a half before I realized I was awake. The second surgery I woke up when I was already in my room, just a couple of hours after surgery. I had an awful headache. The last surgery I woke up about on day four. I don't know what they give me but it is great!!!!

For the record, if I had a choice I would do both of my kids birth's again before I was to do another spinal fusion. I had both of my kids natural, no meds at all, (Epidural????? What's that?????). My daughter was born forehead first, very longgggggg back labor, she was 7.6 and 19 1/2". My son seven years later was 10.3 and 22". I was up that same day walking back and forth to the nursery.

[txmarinemom]

I'm going to take advantage of all you experienced fusion veterans that have so kindly answered questions over the last few days about what to expect after surgery and would like to ask one more:

What is your first recollection of the exact moment you woke up and just how bad was it? I know the answer to my question is PAIN ...

Chi Mama, I had NO pain when I woke up: I even called a few people from here from my room just a few hours after they released me from PACU (I was there maybe 30-60 minutes).

I woke up in my room, STARVING, with a caffeine headache asking for my cell phone. The people I called from here can vouch I was FINE.

I've also given natural child birth (GOOD GOD, not by choice - labor was too quick) and that was FAR more painful than the 24-48 period after fusion.

Regards,
Pam

[Karen Ocker]

My experience

I had NO pain after the anterior approach- 1st stage revision because they put in epidural pain killers. The next week I had the posterior correction part and it was no longer possible to reach the epidural space because I was fused to the sacrum. I remember a lot of pain in the step-down unit. The nurse said I was not allowed any more medication for another half hour. I demanded they contact the anesthesia resident on call and she gave me dilaudid IV--mercifully. After that I was able to have adequte pain relief at all times.
It helped having private duty nurses who could go out and bug the staff when the time came.
It is NOT necessary to have so much pain. Demand to see the pain people on staff if necessary.

[txmarinemom]

Arranging pain management ...

... It is NOT necessary to have so much pain. Demand to see the pain people on staff if necessary.

Chi Mama (and anyone scheduled for surgery), the best thing you can do to control your pain post-op is make a visit with anesthesiology part of your pre-op hospital workup.

Set up your pain management plan (and backup plans) *before* surgery to ensure you're as comfortable as possible afterwards.

Karen is absolutely right: There are aggressive options available, and no need for excessive suffering. Make sure your pain management plan is documented for the nurses and other hospital staff so there's no delay in getting the meds you need. One thing you really want to avoid is letting the pain get out of hand ... it's tough reigning it back in.

Remember YOU - as the patient - are in charge of your care, as well. As Karen said, you're well within your rights to make demands (it's a bit more desperate when you're already in pain, I know).

Get all this lined out prior to your surgery, and hopefully you can avoid finding yourself in that situation.

Best regards,
Pam

[Chihuahua Mama]

the best thing you can do to control your pain post-op is make a visit with anesthesiology part of your pre-op hospital workup.

This is great advice. And, Karen, I'm going to remember that little tip - I can't imagine some nurse, after the surgery you just had, would have the audacity to tell you to "wait". Good for you for taking matters into your own hands.

I just wish I had some decent pain medication now - I'm having an awful day, in a lot of pain. Surgery can't happen soon enough.

[Chihuahua Mama]

Make sure your pain management plan is documented for the nurses and other hospital staff so there's no delay in getting the meds you need.

Pam, so then when you meet with the anesthesiology (sp) dept., you can make requests? I'm not sure how the mechanics of having a pain management plan works...do you have them outline what is standard procedure then ask questions/make requests?

[txmarinemom]

Pam, so then when you meet with the anesthesiology (sp) dept., you can make requests? I'm not sure how the mechanics of having a pain management plan works...do you have them outline what is standard procedure then ask questions/make requests?

Chi Mama,

One of the things that terrified me going in is I have a HUGE tolerance to pain meds. I mean huge to the point the doses I require would knock someone 3x my size OUT. For days, perhaps.

In addition to this quirk, I had MRSA in 2001, and *always* demand Vancomycin during/post-op.

I discussed both these issues several times with my surgeon, and he was the one who set up my appointment to meet with the Anesthesiology department at Methodist when I went for my pre-op.

I discussed what worked for me and what didn't for prior non-scoli surgeries, and during the 4 years I tried to alleviate the scoli pain with a pain management (anesthesiologist) specialist. If you don't have that background to reference, ask him for HIS standard protocol first. While a hospital pain mgmt team will ultimately devise a plan/send up the drugs, your doctor needs to be on board and write out the orders for your chart.

Remember, things also have a way of getting minimized/shuffled around/etc. I made it a point to remind my surgeon of what we'd decided at every visit.

If yours hasn't suggested it, just explain your concerns to him and tell him you'd like to meet with the hospital anesthesiologists and devise a pain management plan. Ask him (multiple times to make sure ... you're paying enough to be a pain in the a** at times) if he's reviewed it - and make it the last thing you ask him ("is it in my chart??") before they knock you out.

Yeah ... it's probably overkill, but there really IS no overkill with this.

Regards,
Pam

[Chihuahua Mama]

High tolerance to meds/low tolerance to pain

I too have a high tolerance to meds, but probably not as high as you...which is why I wondered what everyone experienced. I will be asking and looking for an appt. with the anesthesiology (sp) people as well, and will certainly talk to the doctor about it. Thanks so much for the heads up.

You're so right about how things manage to get shuffled around - conversations happen but no one notes it - next thing you know you end up with Nurse Ratchett telling you to wait until dosing time...I think not! I'm awfully good at being a pain in the a$$ - this time a necessary skill.