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iSpine Discuss frustrated with meds-- 1 week post op in the Main forums forums; I am one week post op laminectomy/discectomy and then another explorative surgery to relieve extreme inflammation from the previous ...

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Old 02-11-2009, 02:27 AM
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Default frustrated with meds-- 1 week post op

I am one week post op laminectomy/discectomy and then another explorative surgery to relieve extreme inflammation from the previous procedures. Now my docs want me to start decreasing narcotics. I have been doing this all along but they want me to take tylenol-- which does absolutely nothing for my pain. I'm not trying to be a baby and I know the downfalls of narcotics as I am a social worker but going from Morphine to Oxycodone to Tylenol is somewhat extreme. There must be another option?? Sorry to moan but I still have pain (yes it has decreased and I have decreased meds). Does anyone else have these experiences or suggestions on how to manage the pain?? Thanks for all the help as I am still new to this site.

Sarah
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31 Year old social worker
work injury January 2008
Have undergone PT, epidural injections without success
2008 MRI/discogram/CT-scan confirm damages L4-L5 herniation L5-S1 annular tear and protrusion
Jan. 2009 Yale-- Dr. Yue--emergency discectomy/laminectomy L4-L5 exploratory surgery postop 1 week due to increased pain -- swelling complications pressing on nerve roots
Possible candidate for 2 level Pro-Disc

Sarah G.
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Old 02-11-2009, 02:39 AM
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Angry Cutting Meds After 1 Week Post Op?

Sarah,

I'm a bit surprised that your doctor is cutting you back on pain meds so quickly after surgery. I was on Oxycontin & Percoset for 3 weeks after my fusion surgery. I'm off of the Oxycontin now but still on the Percoset & using a pain patch.

Do you have a pain management doctor? If not, perhaps your surgeon could refer you to one? Or maybe you can get a prescription for a Lidocaine patch or Codeine?

I don't see how they can expect you to recover comfortably if you are still in such pain. I agree that Tylenol just doesn't cut it.

Karin
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Disc Bulge C4/C5, Disc Degeneration T11/T12, Bi-Lateral tears L5/S1, Diagnosed w/ Lumbar Disc Derangement w/ Radiculopaphy. Treatment: IDET, Percutaneous Discectomy, SI Joint Injection, Facet Block. All failed. Empire BC/BS Denied Coverage for ADR-lost all of my appeals. MVP also denied coverage.

Anterior/Posterior Fusion L5/S1 -1/20/09
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Old 02-11-2009, 03:09 AM
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Default medication

Thanks Kim I thought maybe I was just being a baby about the pain but Tylenol never has worked for me for anything. Thanks for making me not feel like I'm crazy
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31 Year old social worker
work injury January 2008
Have undergone PT, epidural injections without success
2008 MRI/discogram/CT-scan confirm damages L4-L5 herniation L5-S1 annular tear and protrusion
Jan. 2009 Yale-- Dr. Yue--emergency discectomy/laminectomy L4-L5 exploratory surgery postop 1 week due to increased pain -- swelling complications pressing on nerve roots
Possible candidate for 2 level Pro-Disc

Sarah G.
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Old 02-11-2009, 06:26 AM
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Sarah,

It is a real red flag when i hear doctors trying to get patients to go down to a medication like Tylenol one week post-op. My spine doctor (neuro) let me taper off pain medications slowly and when I started getting an increase in pain at six months post-op ADR surgery, he said I could start taking narcotics again. I haven't had a problem with medications with him which really makes me more relaxed knowing that I don't have to justify my pain levels to my doctor.

I read that only three percent of people who take medications for pain have a problem with addiction. We might become tolerant to medications as a natural physiological process but we take medications for pain and not for the "high". Actually, pain meds do not give me a high at all, they just help the pain.

I did go to an orthopaedic surgeon before my surgery that told me he wanted me to get off pain medication 30 days after fusion surgery and that really made bells go off in my head, knowing that is kind of a blanket statement about pain and pain medication.
That turned me off that doctor. Plus the fact that he dismissed ADRs.

I would tell your doctor: "Don't you think I will heal better with my pain under control?" and "Isn't it important to taper off these medications slowly?"
These are two legitimate questions that a doctor should be able to address.

If he balks, maybe get some info off the internet about pain control and healing. Everyone heals on their own schedule and pain is subjective. Your pain is your pain and if you need to control it, that is your right as a patient. Any doctor that does not try to help you control pain, is not a good doctor.

runner
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Old 02-11-2009, 02:09 PM
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Amen runner. Everything you said absolutely is true. I already don't like this doctor. I think you should ask for a referral to a few pain management doctors, so you have a couple of options to pick from. Switching to tylenol one week after surgery is absurd. You're not crazy Sarah. Your doctor is.

Cindylou
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bicycle accident 6/01: 2 compression fractures @ T12-L1; vertibroplasty; 4/06: right hip labral tear & arthroscopic repair; 4/07: lumbar prodiscs @ 3 levels, L3-6 by Dr. Bertagnoli; 7/02/08: ALIF L6-S1; 7/30/08: reopened to remove bone cement, leaked onto S1 nerve root; 8/08: pulmonary embolism, double pneumonia, collapsed left lung, pleurisy, pleural effusion; ALIF fusion complete; 3/10/09: SI Joint Fusion by Dr. Stark; Jury still out.
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Old 02-11-2009, 06:11 PM
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Ditto everyone,

Get yourself a pain management doctor. Their concern is your pain!

Just for the telling, I was on Dilaudid for 6 months. I had no problem slowly getting off of it.
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Old 02-11-2009, 06:31 PM
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My family doctor, not a pain management doc, advised me to quit being a martyr and take pain meds so I could get better.

I agree with everyone, you need another doctor for pain management. There's nothing wrong with you.

I do have to share the advice my 102 yr. old mother gave me - "You know if you prayed more you wouldn't have to take all those dangerous drugs." I chocked back my immediate response and said I did pray, but I'd try harder.

If you've never had non-stop pain, it's hard to understand. I have apologized to my husband over and over for my doubts concerning his pain before his ankle replacement. I actually thought it was an excuse for not wanting to do some of the things I wanted to do.

It is difficult to understand a doctor who still believes this way. Sandy
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**Dec. 2007 numbness and weakness in left arm/thumb, x-rays, MRI, discs at C4-7 pushing on spinal cord, fusion or ADR out of country
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Old 02-11-2009, 08:13 PM
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Ditto everyone elses comments. I think your doctor is crazy not you. There is no way after 1 week you should be off all pain meds. That is nuts! Find a good pain management doctor fast!
Best wishes,
Roblin
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Old 02-11-2009, 10:06 PM
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Default pain meds--

Thanks for making me feel better everyone!!! I thought I was crazy!! Thank God that my pain has tapered down a little and I have some oxycodone left to take when I really need it. I think that I will take everyone's wonderful advice and seek out a pain management doc. I know a great one here. I am actually surprised that they have me going off pain meds so soon too-- but the other thing that I neglected to tell everyone was that the doc himself did not tell me to cut out the meds-- the nurse did. Perhaps I should request a talk with the doc about this.

Sarah
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31 Year old social worker
work injury January 2008
Have undergone PT, epidural injections without success
2008 MRI/discogram/CT-scan confirm damages L4-L5 herniation L5-S1 annular tear and protrusion
Jan. 2009 Yale-- Dr. Yue--emergency discectomy/laminectomy L4-L5 exploratory surgery postop 1 week due to increased pain -- swelling complications pressing on nerve roots
Possible candidate for 2 level Pro-Disc

Sarah G.
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Old 02-11-2009, 10:56 PM
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Sarah,

This is ridiculous. There is no way you should be off pain meds at this point if you are still having moderate to severe pain.
Come on. A nurse told you that? (Is she a real nurse, i.e. a registered nurse or some medical assistant, who doesn't know about pain?) Yes, you need to talk to your doctor as soon as possible and see if he told her to say that.
I would check with him before using your left over oxycontin. If he concurs with what the nurse says, you have two options. And I didn't tell you this (because I am an RN) but 1) don't tell him about the oxycontin so you have something to take inbetween getting into an appt with a pain management doctor or 2) If you have uncontrollable pain, go to an ER and get some help. I am sure they will be understanding of a post-op patient and even go to the same hospital where you had the surgery.

runner
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Old 02-11-2009, 11:01 PM
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Oh yeah,

If he wants your pain under control and wants you using something more than tylenol, tell him what you have available, what works for you and how much pain you are having. 0 is no pain and 10 is the worse pain imaginable. What is your pain on a 0 to 10 pain scale and don't sugar-coat it. Tell him what it is at worse.

runner
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Old 02-12-2009, 12:13 AM
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Default meds

Thanks for the tips Runner! I appreciate your feedback with mt situation. I will give my doc a call tomorrow.
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31 Year old social worker
work injury January 2008
Have undergone PT, epidural injections without success
2008 MRI/discogram/CT-scan confirm damages L4-L5 herniation L5-S1 annular tear and protrusion
Jan. 2009 Yale-- Dr. Yue--emergency discectomy/laminectomy L4-L5 exploratory surgery postop 1 week due to increased pain -- swelling complications pressing on nerve roots
Possible candidate for 2 level Pro-Disc

Sarah G.
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Old 02-12-2009, 06:59 AM
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Sarah,

Anytime. I just get upset when a patient's pain is not taken seriously or they are under treated. I have been there and suffering through pain does not help healing. Good luck. Sarah, I just read your signature. Is Dr. Yue at Yale the pretty well known surgeon? If so, please check with him directly.

runner

Last edited by runner; 02-12-2009 at 07:05 AM.
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Old 02-12-2009, 08:57 PM
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Runner-
Yes, Dr. Yue is the Dr. from Yale who has worked with Dr. B from Germany. He has done much research in ADA. I put a call in to the office but haven't heard back yet. Thanks again.

Sarah
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31 Year old social worker
work injury January 2008
Have undergone PT, epidural injections without success
2008 MRI/discogram/CT-scan confirm damages L4-L5 herniation L5-S1 annular tear and protrusion
Jan. 2009 Yale-- Dr. Yue--emergency discectomy/laminectomy L4-L5 exploratory surgery postop 1 week due to increased pain -- swelling complications pressing on nerve roots
Possible candidate for 2 level Pro-Disc

Sarah G.
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Old 02-13-2009, 02:39 PM
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I have been in the field of addiction medicine for over 30 years. You may become physically dependent upon the short acting pain medications as tolerance builds rapidly with the use of these medications. Physical dependency is easy to take care of with a competent physician doing a gradual step-down from the narcotic pain medication. Opiates act on the mu-opioid receptor site and block pains messages to the brain. Allowing your body to not be wracked in pain speeds the healing process. You are not going to experience euphoria from the medications if you are using them for the intended purposes. You owe it to yourself to talk to the physician directly. If his responses are the same as the nurses it is important to find someone who is going to adequately address your pain issues.

Hang in there and let us know how things are progressing for you.

Terry Newton
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1980 ruptured L4-L5
1988 ruptured SI-L5
1990 ruptured C5-C6
1994 ruptured C6-C7
1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic
Bicycle Accident 2004
MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram.
Stenum Hospital Surgery November 4, 2006
Prestige Disc C5-C6, C6-C7
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