Surgery in monitoring

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What does one do if surgery is needed during monitoring? The anesthesia etc. 

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1. Communicate THOROUGHLY with your case manager.

2. Communicate THOROUGHLY with anesthesia. Anesthesia sees this regularly with people in recovery and there are techniques such as regional nerve blocks they can use to minimize and often prevent any opiates, but some controlled drugs will still be needed like potentially Ketamine, Versed (a benzo) and Propofol, which has a 28 day detection window through a Propofol urine drug test of which Recovery Trek is regularly doing for nurses now.

3. What will be required? A list from the CRNA or Anesthesiologist on the EXACT drug names, amounts, and time given. This takes away any responsibility off you, especially if you get a Propofol test 26 days after surgery.

4. Communicate THOROUGHLY PRE operatively with your surgeon on what POST OP pain management will be. What will be prescribed, how long, what drug, what amount, etc? Your case manager needs to KNOW what the plans are post operative and Not be blindsided.

5. In step 4 above, you also need this THOROUGH communication with your case manager. Your case manager shouldn't be "surprised or shocked" that you are on Percocet for 7 days after surgery. He or she should be well aware on that plan BEFORE you have surgery.

6. Write a letter in Microsoft Word and save it in a PDF format and upload it in Affinity-Spectrum or Recovery Trek saying you have done all 6 steps above and attach the letter from the anesthesiologist AND your post op prescription for pain and make it clear HOW LONG you are prescribed pain meds for. This uploaded letter is for the physician/MD officer at the drug testing lab located across the country who knows nothing about you or your surgery, but they soon will if you do this letter and make it very clear.

7. COMMUNICATION.

P.S. Do NOT be the person that needs their post op pain meds extended. Please, just don't do it. If you have a controlled drugs like T3s prescribed for 7 days postoperative, I'm warning you, if you go and ask the surgeon for the additional 7 more days of it, Fire Alarms go off with your case manager and you are BEGGING for problems. 

Hope this helps.

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I don't have a SUD. I will try to hold off on surgery until I'm done with monitoring.  I have only a few more months.  I want a tummy tuck and the plastic surgeon had a cancelation.  I've heard the recovery is brutal

I don't like opiates but would want to take them as long as needed for pain. Also I don't tell doctors I'm in recovery because I'm not. I don't take any prescription medication. 

Out of curiosity, do you have to refrain from working until your tests are negative ? 

Thank you 

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Healer555 said:

I don't have a SUD. I will try to hold off on surgery until I'm done with monitoring.  I have only a few more months.  I want a tummy tuck and the plastic surgeon had a cancelation.  I've heard the recovery is brutal

I don't like opiates but would want to take them as long as needed for pain. Also I don't tell doctors I'm in recovery because I'm not. I don't take any prescription medication. 

Out of curiosity, do you have to refrain from working until your tests are negative ? 

Thank you 

No and Yes. Depends on your case manager. BUT....they will want you to be OFF all controlled meds for pain when you return to work, and of course, for abdominoplasty, the usual is 7 to 10 days of opiates PRN for pain following surgery. But, you will not be cleared for work anyway post surgery within a 10 day period just based simply on recovery physically from the surgery. But some cases manager's would want a negative test (not common) before returning to work. Obviously, Propofol can and often Does test positive for 25 to up to 28 days, but you will not have to wait for that to show negative IF..you don't work in surgery, anesthesia, have no real access to it.

Smart choice by waiting to finish. Would be crazy to even consider it in my opinion prior to being as close as you are. Obviously, a non elective surgery is different and you have to do what you have to do, but for abdominoplasty, I wouldn't rock the boat and gives the corrupt people a chance. I wouod wait.

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SheelaDavis said:

No and Yes. Depends on your case manager. BUT....they will want you to be OFF all controlled meds for pain when you return to work, and of course, for abdominoplasty, the usual is 7 to 10 days of opiates PRN for pain following surgery. But, you will not be cleared for work anyway post surgery within a 10 day period just based simply on recovery physically from the surgery. But some cases manager's would want a negative test (not common) before returning to work. Obviously, Propofol can and often Does test positive for 25 to up to 28 days, but you will not have to wait for that to show negative IF..you don't work in surgery, anesthesia, have no real access to it.

Smart choice by waiting to finish. Would be crazy to even consider it in my opinion prior to being as close as you are. Obviously, a non elective surgery is different and you have to do what you have to do, but for abdominoplasty, I wouldn't rock the boat and gives the corrupt people a chance. I wouod wait.

Thank you. My case manager has.no authority.  She's just the messenger. 

I'll wait. I understand that the monitoring program I'd helpful for some people but it'd been the worst thing in my life and want it to end on time.  They won't check to see if I'm prescribed controlled substances when I'm done? That's the other fear for me that they'll check and I'll be stuck in this again. 

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Healer555 said:

Thank you. My case manager has.no authority.  She's just the messenger. 

I'll wait. I understand that the monitoring program I'd helpful for some people but it'd been the worst thing in my life and want it to end on time.  They won't check to see if I'm prescribed controlled substances when I'm done? That's the other fear for me that they'll check and I'll be stuck in this again. 

They can't check at all when you are done, if they did, you can consider yourself very rich and lawyers will BEG you and compete for your services.

1. When you are done, you can take what you want to take with a Doctors order. You aren't in monitoring for life. You can get drunk if you want or whatever. You can tske Methadone with a Doctors order and nothing they can do. 

2. Part of monitoring is consent for Narc Prescription checks in your statewide pharmacy database. Whether you remember signing it or not, its part of the paperwork up front. That consent you gave automatically expires when monitoring is over, so they legally can NOT check and if they did, you have a lawsuit where they write you a check because they not only no longer have consent, it could be considered harassment and your lawyer would basically be receiving a nearly blank check. There is Zero chance they would check. Trust me, they know better. Even the BON isn't that stupid. 

3. If they were stupid enough to break the law, it still wouldn't matter if you were on 3 different opiates. There's nothing they can do. You aren't in monitoring anymore. Your time is done. The BON can't simply start searching Pharmacy State Wide Databases and start making nurses go for evals who arent in.monitoring or havent given consent. That's illegal.

Relax my friend. You got this and are close. When its over, it's over. I have the exact same feelings you describe about the BON and monitoring. It devastated me and ruined my life for 5 years from harassment to the lies to the BS. Best wishes

At the end of the day, the BON sees us as numbers and a paycheck. We are numbers they can collect money from for 3, 4 or 5 years. That kind of sucks, but the advantage is, when we are done, they still see us that way. A number who is expired and no longer pays them or a number they can no longer collect from. Thats good because they forget about us quickly and move on to the next victim.

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SheelaDavis said:

They can't check at all when you are done, if they did, you can consider yourself very rich and lawyers will BEG you and compete for your services.

1. When you are done, you can take what you want to take with a Doctors order. You aren't in monitoring for life. You can get drunk if you want or whatever. You can tske Methadone with a Doctors order and nothing they can do. 

2. Part of monitoring is consent for Narc Prescription checks in your statewide pharmacy database. Whether you remember signing it or not, its part of the paperwork up front. That consent you gave automatically expires when monitoring is over, so they legally can NOT check and if they did, you have a lawsuit where they write you a check because they not only no longer have consent, it could be considered harassment and your lawyer would basically be receiving a nearly blank check. There is Zero chance they would check. Trust me, they know better. Even the BON isn't that stupid. 

3. If they were stupid enough to break the law, it still wouldn't matter if you were on 3 different opiates. There's nothing they can do. You aren't in monitoring anymore. Your time is done. The BON can't simply start searching Pharmacy State Wide Databases and start making nurses go for evals who arent in.monitoring or havent given consent. That's illegal.

Relax my friend. You got this and are close. When its over, it's over. I have the exact same feelings you describe about the BON and monitoring. It devastated me and ruined my life for 5 years from harassment to the lies to the BS. Best wishes

At the end of the day, the BON sees us as numbers and a paycheck. We are numbers they can collect money from for 3, 4 or 5 years. That kind of sucks, but the advantage is, when we are done, they still see us that way. A number who is expired and no longer pays them or a number they can no longer collect from. Thats good because they forget about us quickly and move on to the next victim.

Thank you.  I just want to live like a normal person.  A benzodoazepine to fly on a plane,  opiates after a painful surgery if needed and maybe a drink on vacation.  Of course lemon poppy seed muffins.  Love them. Not much longer thank God. 

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Healer555 said:

Thank you.  I just want to live like a normal person.  A benzodoazepine to fly on a plane,  opiates after a painful surgery if needed and maybe a drink on vacation.  Of course lemon poppy seed muffins.  Love them. Not much longer thank God. 

How much longer? Have you ever missed a check in? Why not apply for early dismissal? I got out 90 days early. Your case manager won't decide alone. They tske it to a group forum where the entire monitoring staff vote on it. They can only say NO and you aren't penalized for asking. If they say yes....then there you go. Most nurses simply don't give the thought about asking out early. They assume its automatically 5 years without question and rock solid set in stone. Most of the time, it is, but not always.

What helps. Very you missed check ins. No positive tests obviously. No late reports. Therr is always a chance and its like an inmate asking for parole. Might as well. They can only say No and there's no harm done to you. If you are within 3 months, I would give it a shot.

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SheelaDavis said:

How much longer? Have you ever missed a check in? Why not apply for early dismissal? I got out 90 days early. Your case manager won't decide alone. They tske it to a group forum where the entire monitoring staff vote on it. They can only say NO and you aren't penalized for asking. If they say yes....then there you go. Most nurses simply don't give the thought about asking out early. They assume its automatically 5 years without question and rock solid set in stone. Most of the time, it is, but not always.

What helps. Very you missed check ins. No positive tests obviously. No late reports. Therr is always a chance and its like an inmate asking for parole. Might as well. They can only say No and there's no harm done to you. If you are within 3 months, I would give it a shot.

They don't offer early dismissals in my state. I haven't missed a check in. I've been completely compliant.  I'm almost within 3 months.  It's not an option per my pseudo therapist they make me see. 

Mine was 3 years. I can't imagine 5 years. 

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I understand. 3 months isn't long. 90 days will go by fast. My consent order stated 5 years and my BON said 5 years. I even asked my case manager and he said no sooner than 5 years. I sent the Chief of the Recovery Program the letter and requested a panel vote. I couldn't believe it. They accepted it and approved it, but the BON didn't. My monitoring was done and over with. Done 3 months early, but the BON still had me remain on probation for those final 3 months until it reached 5 years. I didn't have to do any reports or meetings or check ins or employer reports or basically anything in those final 3 months for the BON to clear my license. It was weird. I was voted or proven to be "safe to the public" by the clinical experts, but the BON with its bureaucracy still wouldn't clear my license until the 5 years were up. I had so much PTSD from the program that I still never touched alcohol in those final 90 days, even though I was done with monitoring. I didn't trust them. It felt nice not to check in though.

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Specializes in Home Health/Hospice, Public Health, Case Mgmt.

@Healer555 Congratulations on being almost done! 🎉🎉🎉

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LMRN2003 said:

@Healer555 Congratulations on being almost done! 🎉🎉🎉

Thank you. Can't wait..

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