A Wound/Pain Question, Please

[sharpeimom]

i cut and pasted my post in the "asking for meds" thread last night. following a suggestion, i am reposting it here. i am not asking for medical advice! i'm just a retired disabled psych nurse who is very tired. so tired that my brain is scrambled and i'm not thinking clearly. i'm wondering if a pain management md or team appt. might be in order? again, i'm not soliciting medical advice. just thought i'd check in with you experts. my husband needs to be more comfortable in two weeks, when he begins teaching again. he's been diabetic since elementary school and has never had any problems. thank you,

[color=#a0522d]kathy

last friday, my husband had surgery on his rt foot and ankle. he has been in agonizing unrelenting pain for weeks and weeks. when i finally

strong armed him into seeing our internist, he was immediately sent to a surgeon -- right then.

she dx what i had thought it was -- a venous stasis ulcer. it was debrided weekly for four weeks, but suddenly there were two more plus a lump. the debridements were done without any sedation or local.

he was sent home with percocet. the next a new rx for double the amount when he had more than half left.

it only got bigger and bigger. more pain, more meds, more pain, different narcotics... i'm concerned about all the tylenol he's ingesting.

so now we wait... and wait... for the biopsy results on the lump and for the craters to heal and

for the unyielding dreadful pain to subside. we presently have seven bottles of various narcotics

in a small lockbox in a kitchen cupboard, but none work. one crater is so close to his ankle bone that i'm terrified.

the instructions on the labels were ambiguous at best. "take 1 or 2 pills q 4h prn for pain" what we have been doing is for me to assess his pain. he takes 1 pill (tablet) and we reassess in 2-3 hours. he almost always gets some relief but not enough to be quite comfortable. he's up about once every hour all night long. if he takes 2, he gets dippy, dizzy, and nauseated.

this isn't a inactive retired rn /c a masters typing this. it's a very tired and worried wife who hasn't slept much in the past week instead.

my husband was brought up as a christian scientist and usually getting him to take any type of pill is a battle. he takes his pain meds, but feels as though he's "weak" when he does. for someone who didn't give many pain meds in psych, plus having been inactive for seven years, i am in over my head.

he needs better pain relief as do many patients. many patients are sent home with inadequate pain relief and/or poorly worded orders on the label.

i apologize for my ranting and rambling. i have not been this tired since one trip to the former soviet union or grad school.

[XB9S, BSN, MSN, EdD, RN, APN]

You poor thing, and your husband. Ongoing chronic pain is demoralising, exhausting and down right depressing, especially is it's poorly controlled.

Regular analgesia is vital. Although I really can't give any more advise than that due to the terms of service I've included a few links that may be of use.

I would say that if the pain is poorly controlled then referral to a pain specialist would be beneficial. And as far as giving medication advise, I think it is unacceptable to prescribe any medication without patient education to make sure that what needs to be taken is understood.

The British Pain Society - Home page

http://www.ampainsoc.org/people/

American Chronic Pain Association

http://www.medscape.com/viewarticle/502439

Venous Leg Ulcer Pain | Ostomy Wound Management