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Post Op Pain Management

sleeprgirlssleeprgirl Posts: 695
edited 06/11/2012 - 8:40 AM in Back Surgery and Neck Surgery
I'm 7 weeks postop one level PLIF. About 10 days ago, my surgeon switched me from Percocet 10-12.5mg a day to Lortab 22.5mg daily. My pain(which I have had since the surgery) has progressively gotten worse with no relief on the Lortab. It is difficult to sleep with so much pain. Is there anyone else out there who has had a similar experience? I am thinking about contacting a pain management Dr. Is this the next step?? I don't see my surgeon until February 18th for Xrays, etc.



  • Unless you already have a relationship with a PM doc, if I were you I would call the surgeon and tell him your level of pain has shot up since the switch in medications...that you're not able to sleep due to the pain, etc. If he does not want to manage your medications, and this does vary widely from one surgeon to another, then you can find someone else. Both my surgeons wanted to manage all aspects of my case, but I know some surgeons cut their patients loose as soon as the healing is underway.

    Was your pain controlled prior to the switch in medications? Where is your pain? Is it something you had prior to surgery or was it new after the procedure??

  • My surgeon wanted nothing to do with prescribing me pain meds post op. I was told to see a pain management doctor and boy am I glad I did. It's a much more personal experience (at least mine it) and I don't feel like such a bother when I call him with an issue regarding my medication.

    If the pain is affecting your sleep, definitely call your surgeon at the very least, and I'd also ask for a referral to a PM doctor. Good luck! I have so been in your shoes, it'll get better : )
  • Gwennie, I called my surgeons "medical assistant". She did call me back, and I explained what was going on, and that I needed to go back on the percocet for a while, she asked me if I was asking for "stronger pain meds", and I said, I'm looking for managable pain. So, she is forwarding the information on to the "nurses". I have never spoken to the "nurses" or the surgeon, and I have had to call his office 3 times since surgery. We will see...

    My pain before surgery was bilateral...typical L4-5 pain. Now my pain is on the left in my back, working around my hip toward my groin, down my leg, and my toes are numb. Yes, the percocet helped to keep my pain managable..plus, the lortab causes me extreme nausea, and I've lost 20 lbs since surgery.

    In the mean time, I did get in touch with a friend of mine who works with a pain mgt. doctor at my hospital. He is working tomorrow, so I have his number. I heard he was the best at pain mgt. Again, we will see... If my surgeon can't help me with this problem, I will call the pain doctor tomorrow.

    Oh, by the way, I'm not sitting on my duff eating bon-bons...I'm single, and trying to take care of myself, and doing physical therapy 3 days/week. I think I'm doing my part in this recovery effort to reach the ultimate goals.

    Thank you both for the quick response.


  • Just spoke with a real registered nurse, and he did write a Rx for me to pick up tomorrow. I'm surprised, but am so grateful.

    One day at a time; and humbled again.

  • Well, it is good to have a PM lined up. I would just wait for some confirmation from the surgeon that he doesn't want to deal with your pain. As Nose points out, each surgeon has his own personality and way of dealing with things. But since you have some unresolved issues, I don't think you want to do anything to turn the surgeon against you at this point. Because of the unresolved issues, I think you might want the surgeon to be involved in the decision to handle your meds or to suggest you transfer to a PM doc.

    If you don't get any response, then I would just call the PM doc and start working with him, as you suggested....This would be the way I would handle it. :O

    Are you on lyrica or gabapentin for nerve pain? Is the pain running down the front of your thigh from the groin?
  • I'm not on any other meds. I was on Soma, but was having some weird side effects from it, and feel better off it. I have tried flexeril and skelaxin, too...horrible nausea. Everything makes me nauseated.

    You are very right, I don't want to put a wedge between me and my surgeon. If, however, he had not agreed to give me help with the pain, I would have looked else where.

    How much does Lyrica generally help? I really hate poly-pharmacy; and hopefully the percocet will help.
    Also, I used ice today during my PT, and I am going to try it as well.

    I do see my surgeon in 4 weeks, if I am still having pain, burning, and numbness in a week, I might try to work on the radicular issues.

    Thanks so much,


  • As a PLIF 2 level paitient, I am glad you got stronger meds to help you out. It is hard to focus on walking and such when you hurt. So I am glad you got something to help you out. Good Luck, but remember, you are very early in your recovery and dont BLT and do what the Dr says. Good Luck and if I can help, let me know. Love, Robin
  • I'm so glad someone got back to you and gave you something stronger.

    I cannot take any of the muscle relaxants either. I found that sometimes ice works just as well as any of the pain medications.

    Some people get relief from Lyrica or neurontin. I do not happen to be among them, but I know people who have had their leg pain substantially reduced. Just be aware, that many people gain weight on these meds and swelling can be another side effect.

    Be sure your PT is not aggravating your nerves. Sometimes they have you doing too much too soon. I started PT and after three visits, I decided I wasn't ready yet, so I stopped and then started over about a month later. As you know, there is such a fine line between doing just enough to make a little progress and in overdoing it and cause a flare.

    What I found though is that once the nerves are aggravated, it is really hard to get them to calm down and to get any inflammation to go down. It is hard to differentiate between what is healing nerve pain and pain that is being caused by the exercises, stretching, etc.

  • I am scheduled for 3 level ACDF on Jan 21st. My NS has already told me he will only prescribe pain meds for 30 days post-op! After that I guess it's OTC drugs.
  • Glad to hear you finally got some stronger meds to help with the pain. I know from experience that PLIFs are a very painful recovery.

    Something in your post triggered a thought: you live alone and have (2?) dogs. Could you maybe doing too much too soon? I know how hard it is to comply with all of the restrictions: its just second nature to bend, lift and twist and all of a sudden we aren't supposed to!

    Also, Gwennie mentioned PT. It may be too soon for you and its causing some of the pain. 7 weeks post op is still very early for a PLIF, I know its frustrating, but it will get better.
  • I'm trying not to do so much, and actually am so far behind on just keeping my house in fair order. I feel that the pressure is on for me to get back to work...maybe, it's just my paranoia-lol..but, I do think that is what is expected of me.

    My new resolution is to just concern myself with my health. I liked a post that I read a few weeks ago. It said "if it hurts, don't do it". So true.

    Everyone have a blessed day,

  • good for you! take care of your health! It is so hard for some of us to actually put Our well=being first-----for me,sometimes it is because of too much time to think:hmmmmmmm,I really should be doing this or that" take one day at a time,and remember spineys rule!

  • things that don't get done today, can wait until tomorrow, or the next day.
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