I have fibro and positive lupus tests so far also have PLMD and RLS. Naturally I take alot of meds. Ok here is what scares me. I have had cervicle ca recurr several times. So far I have been able to hold off on the hyst. I also have gallbladder disease so they want to take it too. I want them done at the same time but here is my fear. Pain management. Because I daily take flexeril, hydrocodone, ultram and temazepam I am afraid that they will not manage my pain well enough. Since I have been on all this for over a yr I am afraid the usual stuff will not work at leaste not in the usual doses. I know that alot of Dr's and nurses for that matter tend to look at pts as drug seekers and often tend to undertreat or holdback on the drugs. Call me a whimp but I already have pretty steady daily pain and dont know how they will treat my pain. I dont know what to do. I guess I shouldnt worry to much yet as i have not found surgeon willing to do both at the same time. Just felt like talking about it I guess. Thanks for listening or should I say reading.
Jun 18, '03
Pain management is an integrel part of nursing/patient care. We have anesthesiologists where I work who specialize in pain management. I would suggest when you schedule your surgery you need to have a discussion with your surgeon and anesthesiologist regarding your options. An epidural may be used to help post op pain. Local infiltration of the surgical site while you are under anesthesia can help minimize incisional pain in the first 24 hours post-op. In this day and age there is absolutely NO reason for any patient to expereince undo pain associated with a surgical procdeure.
Jun 18, '03
I'm sorry to hear that. Hope it goes well. Hopefully you can communicate your fears to the surgeon and he/she can write appropriate pain control post-op. Good luck.
Jun 18, '03
Worrying in advance will only make things worse. Talk to surgeon and INSIST he/she assures you that pain management will be a big consideration. Also, have a patient advocate on hand (friend or family) just in case you don't get one of the caring nurses who frequent this board. Good luck.
Jun 18, '03
First of all angel, let me express my deepest sympathy and compassion for you--I think I have it tough sometimes. You sound like a strong woman, and seeing as you have developed a medication regime that works for you, try to get the physician to re-order your home meds at the hospital--bring your empty prescription bottles to the hospital with you and show them to your nurse and physician. If that doesn't work, i'm sure he/she will order you a sufficient painkiller for post-op pain like everyone here said, but if they begin to wean you off of them after a period of time, remind them of your hx of illness such as SLE (verrrry painful autoimmune disorder, I have treated it many times, and every Dr orders at least a dilaudid SC pump in moderate doses, and even in earlier stages). Please communicate these things with all of the health care professionals taking care of you, as well as your fear of inadequate pain control, and your fear of stigmatism due to potential narcotic use in the hospital. Stay strong, i'll say a prayer for you!
Jun 18, '03
See if you can consult preop with anesthesia for acute AND chronic pain management. An epidural would be great IMHO.
I had 1 darvocet after my GB, my daughter took 1 mepergan. My hx on the other hand WAS in 1978 but it was quite painful. I understand they can do laparoscopic hx nowdays.
I think epidurals (continuous) 24h are the way to go.
It goes without saying you need to have your doctor continue necessary meds.
Jun 18, '03
Agree with above. Epidural sounds like the way to go. You should ask to speak to someone in anesthesia early on, and explain your concerns. Good luck!
Jun 18, '03
I understand your concerns regarding pain management. I too, have many health problems and suffer from chronic pain. I won't get into all of the dx's but I definately would make sure that they know all of the meds you are on first off. A friend of mine had major surgery and for some reason she didn't tell them that she was on larger doses of narcotics. Anyways to make a long story short at the end of surgery when they reversed her anesthesia and she was sent to recovery room, she started with withdrawels. No fun at all.......So, it's important to not only let your surgeon/doctor know what you are taking but also the anesthesia dept. Only during one of my surgeries did I have a problem with adequate pain control. I had my husband bring my meds from home. This was after trying to solve this with the doctors, who couldn't or wouldn't believe that I was in so much pain. All of my other surgeries, I brought my meds with me to the hospital but I didn't need them. But, it made me feel better knowing that I would not be left to suffer with pain. I know that many can't understand this, but after one has been through so many problems just trying to get adequate pain control and/or been through many days of suffering because doctors back then didn't understand chronic pain or the impact of it. Many doctors thought that patients like myself were after pills or they would think that we were addicts etc......Talk about being humiliated, then be hurting big time. I still get so mad when I hear one of my coworkers say something like, "ms. so and so is always worrying about her pain med".....or "she's a pill popper, not happy unless she has a pill".......or that famous statement, "she doesn't look like she is in pain"........oh boy, don't get me going, lol....
Anyways, good luck with your surgeries and be upfront and honest regarding your meds. Discuss your post-op plans for pain control. Keep in touch,
Jun 18, '03
Does the facility do preoperative pain screening? They should be doing this. You have every right to request a "Pain Control" consult -- may even be a Pharmacist who specializes in pain management. You need to verbalize your request regarding pain management & present your surgeon with an accurate list of your pain med regieme that you follow at home. Make a copy for your chart.
Now ... can they do a lap hysterectomy? Lap choley?
Perhaps you will have to have them done separately ... you just need to find the right surgeon for you. With all the advances we have in pain management, please do not let the fear of pain stop you from having the surgeries if you need them. Yes, you have "special" pain needs -- and you should expect an individualized pain medication regimen for you at the facility -- this is not one size/fits all. Take it one step at a time ...
Jun 19, '03
Thank you all for the responses. If I ever get brave enough for these surgeries I will definately ask for a pain management consult. It doesnt help that I had a bad clinical experience in my OR rotation. Thanks for all the advise when the time comes I may ask for some more.
Jun 19, '03
I understand what you are saying about pain and surgery. On Monday I had perio-surgery and it was the first surgery I had since my tonsils were removed when i was a kid. I know your surgeries are going to be deeper than what I had. I caution you on your own confidentiality re: your meds.
I casually mentioned to some people that I had this surgery and that the doctor gave me vicodin (5/500) for pain, and I commented on how it made me sleep right away, which it did when I took it at night.
I admit to not knowing enough about this, and have no other reason to take vicodin except when someone cuts open my gums and scrapes the roots of my teeth, but someone expressed to me that I could "loose my licence" for taking them at work for any reason. Hydrocodone is a narcotic. During the prescription consult, the pharmacist warned me not to take them if I was going to be at work.
I don't want to touch off an arguement by presenting this here, and I emphasize with you on the management of pain. How are pain management meds, like any narcotics, addressed if you are taking them and working in PT care? It's scary to think of loosing your job because someone reported observing you make an error and also mention you are on known narcs.
Myself, i learned that pain can effect the mood you are in. Tuesday and Wednesday, after my surgery, I worked my job as a CNA and felt miserable. It's not that I didn't want to be there; and would have felt miserable whether at home or work, and felt pity for myself, and staying home would have worsened self-pity, so I worked anyway and tried not to open my mouth and sobbed to others about the discomfort from time to time. It felt like Rocky Marciano had socked me as hard as he could w/o gloves on :-) And the amoxicillin 4x a day is doing a number on my GI tract, I can tell. It's hard to take these meds for me because I don't like taking meds to begin with. The chlorhexidine gluconate mouth rinse (bid) has made my teeth green :-(
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