Need help with PAIN CONTROL after my SURGERY advice please..

Discussion in 'Fibromyalgia Main Forum' started by Kimba4318, Oct 16, 2006.

  1. Kimba4318

    Kimba4318 New Member

    HI friends - I am having a 3 hour surgery done in a private plastic surgeons surgical facility. They will be doing a scar revision and removing a nerve that was cut during the last surgery.

    I wish this was being done in the hospital because I remeber the pain from the original surgery (no FM at the time) and this one will be dealing with nerves -ouch!

    I am already on time released morphine and percocet for pain. I am soooooo worried that, when they send me home, I will not be able to control the pain. If I was in the hospital, they could keep me there to control the pain thru IV but that will not be the case.

    Anyone had surgery with the FM? How did you control the pain afterwards when you are already on strong pain meds prior to surgery? Please tell me about your experience and what helped please....
    Hugs
    Kim
  2. shelby319

    shelby319 New Member

    Hi Kim,

    It's nice to have someone else here to talk to about surgery and the issues of controlling the pain after surgery, as I'm going through it right now. I just had my surgery on my cervical part of the neck, with the 4 disks being replaced 3 weeks ago today. I went into the hospital with the exact same questions as you are having now over your surgery and the fear of not controlling the pain when you would come home. I was well controlled while in the hospital and then when I came home, I kind of went into a bit of a flair up with the Fibro and not being able to control it as well as it was in the hospital.

    Then I called my Dr. the same day I came home, and he increased the pain meds from 20 mgs of OxyContin to 30 mgs of OxyContin and also put me on 10 mgs of OxyIR (instant release) for breakthrough pain, as they had only given me the Percocet to come home with and that wasn't enough, along with the 20 mgs of OxyContin. I don't know alot about pain meds, so I'm not sure myself what the OxyIR really is, I think its like Percocet but without the tylenol, right? Anyhoo....it has helped me quite a bit with the pain and being comfortable enough to beable to sleep well. But I do have pain left over and I'm afraid to take anything stronger or how long before the next dosage of OxyIR I can take. But I would say I'm at a safe level and feeling pretty good with the recovery though.

    I hope I helped you some...but please forgive me if my typing or anything is off here, as I'm still having trouble with using my arms and typing. It will take much longer to recover they claim for people who have Fibro and go into a flair up after the surgery. I see you already are taking the Morphine and Percocet, so maybe when you come home from the hospital, just increase the dosage of each of the meds you are already on, and hopefully you will feel better with that?/!!

    I had gotten an update from the Immune Support Group right before my surgery, that claims to have the Dr's in the hospital give you an injection right at the site of the surgery and that too will help control your pain. I did tell them to do that and they did give me some kind of injection of an opiate, but I'm not quite sure what it was. I'm sorry I can't remember what it was though.

    I do wish you all the best with your surgery and a complete recovery too!!! I'll keep you in my prayers that everything turns out fine and you have your pain issues addressed properly, and are pain free while recovering. When do you have the surgery date?

    Gentle hugs,
    Shelby
  3. Kimba4318

    Kimba4318 New Member

    Thank you Shelby. Ouch - I hope you are feeling better. How long were you in the hospital. I know the surgical center "kicks you out" soon after you wake up - so I will make sure I get the injection thing after surgery.

    I will make an appt. to talk to the Pain Doc prior to surgery. Normaly (for "normal ppl) I think they would just send you home with Percocet... so I was pretty scared. That would seem like just taking a vitamin to me (unfortunately).

    I so appreciate your help and advice. I hope you are recovering nicely. Thank you for taking the time and energy to write back (I am sure it is hard)
    Hugs
    Kim
  4. MsOnlyMe123

    MsOnlyMe123 New Member

    Kimba,
    I really feel for you. I don't have any answers because I havn't had surgery since my Fibro. came along 9 years ago. About three years ago, I did have gum surgery and I was scared out of my mind, of the pain I would experience after. It was bad and along with it I was being treated for TMJ and a root canel. The doctors refused to give me any kind of relief meds. because of what I already take for my Fibro., arthritis, cuppel tunnel, ect...

    I took it upon myself to take the meds. I already have and doubled here and there to try to make myself as comfortable as possible.

    Anyway possible you can have your surgery done at a hospital?

    Eileen
  5. alearner

    alearner New Member

    Kim - I don't know what would be best for you. I can only share my experience.(I have FM & CFS as well as a host of other health issues.) In July of 2005 I had to have surgery to repair my right rotator cuff (shoulder area) and have a cyst removed. I had tried cortizone shots and physical therapy but those gave no improvement. I was really concerned because I am right handed (and knew I would be in a sling for several weeks after surgery) and I live alone.

    I asked for advice on this message board and the best advice I got was talk to the surgeon well in advance of the surgery and advocate for yourself.

    Prior to surgery -and as I am now- I take oxycontin 20mg 3x per day to manage the pain. I also have Percocette 7.5 which I take several times a week for breakthrough pain.

    When I told the surgeon this - he said that I live on more pain meds than he usually gives people after surgery. ( I really trust this MD since he is a doctor to several of our pro sports teams in the area.)

    Of course I had all the presurgery tests, EKG, liver function, blood etc. What he decided to do was (in addition to my daily meds) was to give me an automatic (I did not / could not control the release of the med) pain pump. It was called a "Stryker pump". The liquid med was in a pouch and the lead (tube) was inserted into my shoulder area. The pouch had a strap which I wore over my neck (sort of like you would wear a shoulder purse - with the strap on the other shoulder). I had the pump for 3 days and basically felt only mild discomfort.

    Because I was afraid of not being able to function on my own without use of my right hand and I was afraid of the pain, I had the doctor help me convince my insurance company (was buying COBRA from the employer I worked for when I got too sick with FM to work any longer) to let me go to a rehab wing of a local nursing home. There I received OT, PT to learn how to function and nursing care to help with the transition. I stayed for 8 days. Probably could have gone home after 4 days if I had been forced to.

    The pain pump and the extra training were exactly what I needed.

    So to make my long story short...Talk to surgeon way ahead of time and ask if something like a pain pump or maybe even a patch might help.

    Wishing you the best and keeping you in my prayers.

    kathy
  6. Kimba4318

    Kimba4318 New Member

    Eileen - oh how I wish I could go do it at the hospital! I would feel so much better if I was. Insurance is not requiring it (darn). Thank you for you kind words and support! Hugs..

    Kathy - That is very helpful to me too. I was wondering about the process on the pump. How do they keep it in place? Just wondering if you can provide more detail on that. Did you take other meds along with it? I am so braindead.. you may have already explained (sorry)

    Hugs & Love to you all.
    Kim
  7. shelby319

    shelby319 New Member

    I'm glad I could help you a little with your questions. I went to lay down for a bit, but decided to come back to see if anyone had answered you and had anymore info for you than I did...which wasn't alot!!

    As far as your pain Dr. and seeing him before the surgery, that is a great idea!! My Neurologist who did my surgery, didn't want to handle my pain issues for Fibro, so that is why I called my own Dr to handle it, and he did quite well I must admit. So by seeing the pain Dr. to make sure your well taken care of before and after the surgery is a good choice for you!

    Just make sure they give you everything you need to go home the same day. I was in the hospital for 3 days before releasing me to come home to fend for myself!! Which at first I thought I was left out to dry, until talking with my own Dr. and getting what I really needed to control my pain was a god send for me!!

    Sometimes I think the surgeon's only do the surgery and then leave it up to someone else to handle our pain control, as they don't seem to understand what we go through and how to really handle our "type" of pain than someone who would need less pain control. Like my Neurologist said..."we don't handle Fibromyalgia patient's pain issues"!!! I was quite dumbfounded by what he said when he said that, and almost fell off the chair when he told me that!! So thats when I turned to my own Dr. for helping control my pain meds!!

    Good luck to you and keep me posted on how you do, ok?/!!
    Hugs,
    Shelby
  8. Kimba4318

    Kimba4318 New Member

    Thanks Shelby for jumpin' back in - I appreciate it! I do feel that is the right thing to do and I scheduled an appt. with him. We will see what happens.

    It makes me feel good that yours was under control. My pain doc seems to be very caring so I hope I have success like you. YOu made me feel not so scared about it.

    Ohhh..... I am being so paranoid I guess.... My other thought.... If you are on pain meds daily and they put you to sleep (using your weight, height etc...) what if I do not stay asleep??? I am being crazy, but was wondering if the meds they use to put you under would be affected by all the meds I am already on. Stupid, I'm sure... just a thought. I woke up during a colonoscopy before and when I was supposed to be sedated during a mouth procedure. Kinda scary... I think I need a horse tranquilizer (LOL)!!!

    Thanks for caring!
    Big Hugs!
    Kim
  9. lv2sing

    lv2sing New Member

    You might ask about the Fentanyl patch, & I believe it might come in a generic now. They gave me this @ a hospital to take home w/ me for a week before I had back surgery. I could barely walk when I went to the ER, & I begged them to admit me, but they wouldn't. To make a long story short, my disc had already ruptured, & I ended up in an ambulance like 2 days later, & in emergency surgery. But...while I was on the patch, it worked pretty well, & I had already been on Vicodin & morphine sulphate. It can give you stomache cramps till your body adjusts, but it's something I would still recommend. They work for 3 days, so you only change the patch 2x a week. They even kept me on it after surgery along w/ other meds because the pain was so intense.
    I wish you luck, I'll be thinking about you, & pray it all goes well. I'm sure you'll be OK. Usually they are pretty good about making sure your pain is under control before releasing you. You are already on strong meds, so I don't know if they will want to mess w/ your meds, but it's always worth checking on. I agree w/ everyone else though, try & speak w/ your surgeon about it BEFORE the surgery. HUGS!!
  10. Kimba4318

    Kimba4318 New Member

    Hi Lv2sing- I was on the Fentanyl patch after a surgery I had a few years ago and I do think it worked pretty well (except when it was time to come off - yucky withdrawl). I forgot about that - thank you for the reminder!

    Sounds like you have been thru so much! I am so sorry to hear that!

    Thank you so much for responding and giving me your advice. I was wondering why they gave you the patch 1 week prior to surgery - was that for pre-op reasons or because it would hold you over, for pain reasons, until you had the surgery?
    Thanks again!
    Big Hugs:)
    Kim
  11. alearner

    alearner New Member

    The little tube that delivered the liquid pain medication was inserted through a little (very little) poke hole or incision on the front of my shoulder. It sent the med under the skin to the area that has surgery. The tube was taped securely to my skin so that it did not come out until the doctor took it out.

    Regarding my regular meds. I took my usual pain meds before and after surgery in addition to the pain pump. The only change to meds was the morning of surgery there were a couple of meds I take other than for pain issues that the hospital said not to take.

    So again - I took my pain meds on their regular schedule before and after surgery.

    Hope this clarifies things better.
  12. Kimba4318

    Kimba4318 New Member

    Hi alearner - Thank you for clarifying that, I had always wondered how that worked. Putting it right at the source seems to make alot of sense.

    Thank you for getting back to me, it is very helpful & I appreciate it.
    Big Hugs to you:)
    Kim
  13. sniffles

    sniffles New Member

    Hi Kim
    I understand your fear of this surgery. I am facing a total knee replacement surgery soon and am scared to death of how I will handle the pain afterward. Both my surgeon and my pain dr. have told me that it will take about twice as long to recover as it does someone without fibromyalgia.
    I am already on the fentanyl patch and still have lots of break thru pain all the time. My pain Dr. told me to have a spinal epidural when they do the surgery because that will block the nerve endings above the block and it will keep everything above there from going in to shock from the surgery. He said it helps to slow or stop the flares. I haven't went back to see the surgeon since then, but am going to see if this might be possible when I schedule the surgery.
    Pain is such a big part of our daily lives and I know there are lots of days I feel it totally controls my life. So please know that you are not alone with your fears. All your friends here will try to give any advice that they may have found to be helpful.
    After my orthro-scopic knee surgery last month, the Dr. kept me on Darvocet when I came home for a short while. I used that and my Fentanyl patches together. Still had pain, but was bearable.
    We will be Praying for you, Kim Joyce
  14. lv2sing

    lv2sing New Member

    The ER doc put me on Fentenyl patch (sp?) (I can't think...I hate that!) till I could get an appt. w/ a neurosurgeon, which wasn't gonna be for another week. I asked her to admit me, & have one look at me the next day, she wouldn't do it. I don't know what she cared for. She wasn't paying the bill. But as far as I'm concerned, she was negligent. I wrote a letter to that hospital, but it did no good...surprise, surprise..I knew something serious was wrong when I couldn't walk. The stupid ER lady still wouldn't admit me. I basically cussed her out right there, & screamed "what is a matter w/ you? I can't walk!" She proceded to say that pain wasn't a medical emergency! Can you b-lieve that? . This Er was 2 hrs away from us, because our town doesn't have a neurosurgeon. We had actually been to a top 25 hospital prior to this one, 3hrs away, where my pain clinic was. I was hoping to be seen by the neurosurgeon that I had previously had my consult w/. After we got there, we found out the ER was jam-packed. We sat there for 7 hrs, & I hadn't been seen yet.They had 2 rooms full of people, & bringing people off ambulances & just sticking them in rooms w/ everyone else! There was people there from 10am that had not been looked at yet. At 6pm, we left because I needed pain control BAD,& went to the other hospital. After being there till midnight, the lady sent me home.

    So, 2 days later, I'm losing bladder control, my leg is swelling, I can't walk at all. I can only stay in 1 position in bed w/out screaming.We went to a teaching hospital an hour away,by ambulance, but they weren't in our insurance network. They did emergency surgery the next afternoon, & the neurosurgeon said my disc had been ruptured approx. 2 weeks already. I had a nerve block put in about that time, thank GOD. If not, he said I wouldn't have been able to w/stand the force of the rupture. And I was already in severe pain so bad I wanted to die. I never have had that bad of pain & I don't ever want it again.I basically cried & screamed till surgery time. What they gave me for pain wasn't working, I begged to be knocked out. It made having a 9lb baby a piece of cake! I had actually had a piece of the disc break off & go clear through a ligament, & was lying up against my spine, which is why I couldn't walk. I had to use a walker for 2 weeks after surgery, & 3 months of p.therapy. Since the hospital was "out of network", we got stuck w/ a $8000 bill to pay ourselves. How nice, huh? As if I hadn't been through enough. We give them $100 a month, & 4 yrs later, we still owe like $3700. I had another back surgery 1 yr after this one, in the same place. Another herniation, but both sides of the back this time, instead of 1. It collapsed w/in 2 months, a $28,000 surgery - so I am now on complete disability. I miss not working, but I can't stand to sit/or stand very long at a time. I move around lots while typing, or get up,walk around, & go back.
    I think thats "All" LOL! Best of luck w/ your surgery! ;) You asked, so you got the "book" version...LOL
  15. Kimba4318

    Kimba4318 New Member

    Just realized I had responses on this from a while aho, I like to get back to everybody & feel so bad I missed your response...

    sniffles.. thank you for your reply & I hope your surgery goes well too. The epidural actually does not sound like a bad idea,,, have you had that done before?? When is your surgery? I will pray for you too! Good Luck & Thanks :)

    lv2sing: My goodness!! I fell so bad for you... what a nightmare!! The ER's are pretty bad around here too, but MY GOODNESS, you were in that kind of shape and had to wait and wait and then not treated properly by and "IN NETWORK FACILITY" what a darn NIGHTMARE! Thank yo uso much for sharing your story & my heart goes out to you. Please take care of yourself... are you feeling any better?? Thanks for writing all of that.

    Big HUgs to your both
    Kim