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Post surgery rant... sorry... pls tell me if I am overreacting

DedalusDDedalus Posts: 92
edited 06/11/2012 - 8:47 AM in Back Surgery and Neck Surgery
PLS: Be patient with the rambling... I am not myself right now and that's why I am writing. I can't judge if all the details are worth writing, but I will leave then in since I am confused and don't want to leave anything useful out.

SO I had a TLIF on Sept. 2 and came home form the hospital the night of the 3rd. The surgeon was great. The hospital stay was very comfortable and productive. I came home in such good spirits. With the help of a walker, I walked quite a bit in the neighborhood. I could do that about 30 min after taking my pain meds and the walking really improved my attitude. I loved walking even before the surgery.

The problem is that my meds wear off after 2.5-3 hours... but I am only allows to take them every 6 hours. Full disclosure here, the scrip is for 7.5/325 percocet to be taken: 1 every 4 hours for pain; or 2 every 6 hours for pain. (other 2 scrips were 20mg Valium 6 hrs as needed and robaxin 750mg 6 hrs as needed) Well the one pain pill every 4hr scrip route did not help my pain. The 2 percs helped... get me down to a 5 out of 10, so I could at least walk a bit as long as I went back to bed as soon as I was done. I have no problem with any of this up to this point. Pretty much what I expected after surgery. Pain, but somewhat controlled pain.
But here is the problem, even with the 2 percs, after 3 hrs more or less I am back in a pain that has made me, 38 and idiotically proud sometimes, cry at least once each day. Pain worse then my bad days pre-op. The 2 percs (and other scrip) just will not last the 6 hours... omg I wish they would,but they won't. My judgment is poor right now, so my wife is handling all my meds and all the calls to the doc's nurses. All that 4 or 5 calls have accomplished is a change from robaxin to Zanaflex. No difference in pain, but it does make me very very slur my word dowsy, so it helps me sleep a little. My pain pill is same and they aren't trying anything else like NSAIDs or slow release meds. I' not eating much anymore and I haven't felt up to walking for days- the pain is wearing me down. I haven't been posting because I can't sit at the computer.
Am I right to think they should help me more or should I just suck up and try to sleep my way through it. I am a surgery noob... am I expecting too much in regards to post-op pain care?


  • Sorry to hear you're in such pain.

    Do you drink coffee or other caffeinated drinks? Caffeine speeds up your heart rate and makes medication leave your system faster so you might not be getting the most effect from your medications. That's why strong coffee helps clear alcohol from a person's head--same principle.

    Just a thought. :)

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled

  • It sounds to me like you need more meds to help relieve your pain. You are still very new in your recovery. I would contact your surgeon and talk to them about how much pain you are in.

    Please do let us know how you get on. :-)

    I hope that they will be able to provide you with much better control of pain to make you comfortable.
  • Hey there,

    Did you contact your surgeon? I know sometimes people hesitate but I would call on Monday. Tell them what's happening.

    It might be you are trying to do too much walking too quickly. I know after my microdiscectomies I was anxious to get back to life but I found that I was better off keeping my walks to about 15 mins every few hours. The frequent but shorter walks seemed to be better for me. I didn't overdo it and b/c I was walking every 2 hours I didn't feel as 'stiff' either.

    Also, be sure you are drinking water. Water is good for you.
  • Please be sure you are not doing too much too soon. Try to not be so hard on yourself and think that you "have" to be doing this much in your recovery. Every person is different in their recovery. I'm at 9 weeks post op after a double fusion at L3/4 & L4/5, with a cage and bone stimulator implanted. Be sure you "ice" the area to get swelling down, and lay down in between your walks. You may want to shorten the walks.
    They don't like giving a person NSAID'S because they can interfere with the fusion of your bone. At least that's what my spine surgeon and Orthopedic surgeon both said. You are still "very" early in your recovery process. When your body says "rest" do what your body needs. One way this comes out is through pain and emotional upsets. Sometimes I would be sitting on the sofa and tears rolling down my cheeks and my hubby and daughter would look over and know immediately that I needed my pain meds and ice. Sounds like you have a wonderful wife to care for you. I took Oxycodone and a muscle relaxer every 4 hours for the first 3 weeks. Now I take Lortab 10 mg every 6 hours and also Neurontin which helps with pain. Call, or have your wife call the Dr. on Monday if pain levels continue higher than you can handle Again try to rest, and ice more. Just some suggestions.
  • I talk to the surgeon's office twice last week. My wife talked to them 3 times. We tell them that ALL the meds stop helping the pain after 2.5-3 hours instead of the 6 hour schedule they have me on. Their only response has been to switch muscle relaxers (still on a "WTF aren't you even listening" 6 hour schedule though.). And I am not overdoing it now; I hurt too much to walk. With the pain not being addressed it is building and building like you all know it can. I am not walking more than to the bathroom and back at this point.

    I am so pissed at this point that I am going to go back to my pre-op meds with the exception of Zanaflex, the muscle relaxer that they gave me that knocks me out so I can't talk or wake up easily. It doesn't help with the pain at all, but maybe it will help me sleep through more of this wonderful part of my life. I don't want to be awake unless I have to be. The only question is if I ca get enough sleep taking my my old tramadol.

    Why the hell should I keep taking the damn percocets if they either don't work (as one of the surgeon's nurse said) or aren't strong enough to work at the dosage the genious' prescribers are willing to give someone post-fusion? Even the surgeon's nurse told they will wean me off everything in the next week anyway. So, I might as well just stay in bed, face the pain like I've done for years and years now without the surgeon's office getting my hopes up that I will hurt less. They act like they are doing me a favor giving me 15mg of percocets every 6 hours when I have been taking more than that of Norco and Tramadol for years leading up to this surgery. I told them I was scared of this happening, and they told me they don't believe in toleances unless you are taking narcotics at abusive levels. I guess they are trying to say somethnig about me...
    Well they can have their damn percocets back and I'll deal with the pain on my own like I have for years.
    The surgery seems to have taken well as far as we can tell, so if I can just bite the bullet without the meds for just a few more weeks, I will heal whether I hurt or not. At least that is that they've told me when they told me I don't need anything else for pain.
    I just expected too much compassion I guess. Sometimes I am such an idiot and let myself think that the docs actually care after their operation room heroics are over...
  • Giving up the medication you have and the comfort it gives you because it isn't quite enough and you think it will somehow punish the doctor is called "cutting off your nose to spite your face." I know you are angry and not yourself right now, but don't go that direction. Keep what comfort you DO have, because your body heals more quickly during the periods you can keep your pain levels down.

    Have you actually spoken to the surgeon or just the nurse? I think it sounds like you've been filtered out and just spoken to the nurse, who has not taken your request seriously. Is there any way you can get through to the surgeon, and make sure he understands that you are not sleeping, and are spending at least half of your days above the 6/7 range?

    The only other thought I had was staggering the oxy and the muscle relaxer so you aren't taking them at the same time.

    Reading these types of posts so frequently, I made a note to discuss this issue before my surgery, so my surgeon understands my tolerance level and which meds work well for me before I go in! This kind of runaround is just unacceptable!
  • I got to say, that was WAY less medication than I was taking post TLIF and WAY more activity than I was doing, too.

    If you can take 2 perc every 6 hours, why not take 1 every 3? This might give you a more even level of meds(I assume this would be ok with your pharmacist or dr.) Still, I would not have been able to do it without something stronger and longer acting AND the percocet on top as a breakthrough med.

    In my opinion, it's harder to heal if you hurt. If you truly feel your surgeon has not listened to what your wife and you have said, maybe your primary dr. or the ER is an alternative to get you some relief? You sound like you are at your wit's end, with good reason.

    I do want to caution you to be careful with your preop meds and count the amount of tylenol you are taking per day. If you are not sure, ask the pharmacist to help, they are usually very helpful. Pharmacy can also advise you on what is the max per day of tylenol(8 percs per day is almost 3 grams and then if you add in ultram/norco/etc. you get really close to dangerous level.) I understand you gotta get some relief, but please be careful of the tylenol and ask the pharmacist. Another poster mentioned that NSAIDS inhibit fusion, so most of the time docs don't like it.

    I don't think I could have done postop TLIF without stronger meds, and I used the first 3 weeks for resting, not near as much activity as you. I hope that your primary dr or someone gets you relief soon. Please post an update on how you are doing.
  • I think it's totally unrealistic for them to expect you to wean off of all meds within a couple of weeks of a TLIF. I don't know how long you were taking pain meds before your fusion, but the fact that you are only lasting 2.5-3 hours sounds like a tolerance issue to me. I had the same issue. Unfortunately, surgeons don't like to step up post-surgical meds 10 days after surgery (at least that's my experience).

    While I was in the hospital, they switched me to Dilaudid because 10mg of Percocet didn't touch my pain, again because I was on narcotics for a long time prior to surgery. At ten days post-surgery, I would think that they could allow you to take 10mg every 4 hours. They would probably write the script as 1-2 tablets every 4-6 hours (5mg Oxy/ 325 APAP). If you assured them that you would do your best to limit it and space it out as much as possible, they might cut you some slack. Gentle walking is very important, so maybe you could tell them that you are having difficulty and that you need more of a safety net if the pain flares up.

    I'm not in a position to give you medical advice. I'm just sharing my thoughts based upon my own challenges when I was at ~2 weeks post-TLIF.

    Best wishes,
  • Hi Dedalus,
    It's really horrible reading through your posts and frustrating to see that there seems to be no 'set level' or 'specific meds' for people before and after surgery.
    I found that before my percudyn implant surgery I was having to take around 180mgs MST morphine(12 hour slow release dosage) which I was told to continue right up until the day of the surgery and then following surgery I had a little oromorph(liquid morphine) when required and my MST was upped to 200mgs 12 hourly.
    I left the hospital the day after my surgery and was simply told to wean off my meds as soon as I felt I could.
    This dosage has been described to me as quite a high dose and I'm about 6ft 3 inches and 236lbs in weight.
    I started on the morphine in June 2009 and managed to wean off it in April 2010 after my surgery in March 2010.
    Here in the UK I am lucky enough to have a good relationship with my doctor who is totally seperate from my surgeon. I also noticed that my surgeon has no input or possibly no idea about my pain meds so I would never have called my surgeon for meds advice.
    The point I wanted to make was the fact that doctors presumably look at charts and medical documents to decide what meds they think we need but do they allow for the fact that the body becomes accustomed to meds so you need to keep upping the dose to get the pain relief you need.Do they allow for your size and weight? To down an elephant you need a larger dose.
    I think not.
    I'm on oxycontin at the moment while waiting for my fusion surgery.My doctor started me on 10mgs(12 hourly) and after about 4 days of adjusting things I'm now on 40mgs 12 hourly which doesn't feel like it's doing the job but my feeling is-if you kill the pain completely you don't know what further damage you may be doing having a false sense of security.

    Anyway,no I don't think you're over reacting because everyone is different so it would be nice if our doctors treated uas as individuals when prescribing our meds and following up with their patients regularly and adjusting when required.

    I'm on a cocktail of meds at the moment and wonder whether they're competing against each other.

    For the record:-
    Breakfast=1x50mgs NSAID,1x omeprazole 20mgs(to protect stomach from NSAIDS)1x 50mgs cyclizine(to stop nausea),1 x lyrica 50mgs,1 x 40mgs oxycontin.

    Midday=NSAID,cyclizine and lyrica.

    Evening=NSAID,oxycontin,cyclizine and lyrica.
  • I'm glad to hear from you now that the surgery is over, but very sorry that you're in so much pain. I remember well how painful a TLIF can be post-op, as I also had some days that were worse than pre-op.

    You're still so early out from surgery, so I'm not surprised that you're in pain, but I agree with the others that it sounds like you might have done too much so soon after getting home. I'm even surprised that you didn't spend another couple of days in the hospital.

    Anyway, I hope you start feeling better soon. Time is the only thing that truly helps, but you might consider taking the percs as scheduled to get what relief you can. Please keep us posted on how you're doing.

    Take care,
  • After you get through the first 2-3 weeks, the pain ever-so-slightly improves.

    I took Oxycodone 5mg q6hr, Oxycontin 10mg q12hr, Soma 350mg q8hr...this was my regimen for the first 2 weeks. The amount of oxycontin was small, but it really helped.

    I agree with ernurse...be careful with your total dose of tylenol. You can get oxycodone without tylenol.

    I would want to talk with my surgeon as well. There are so many wonderful options for pain control. It is your Drs. resonsibility to provide you with adequate pain control. Hopefully it will be an easy fix.

    Hang in there, it does get better.

  • Ty for the responses. I am not taking anything with APAP a this point because I have given up on the percs. Why take them if I am not getting enough relief to justify the inevitable dependency. I am taking my Tramadol, zanaflex along with my normal BP and depression meds.

    We will call the office again tomorrow. If no luck and I still feel like this, I'll go to the ER which I really don't want to do because it cost me $375.

    If I take my tramadol, I can keep myself at around a 6. If I take the percs I am anywhere from 5 to 8 depending on where I am in the damn 6 hour cycle. The roller coaster isn't working for me anymore!

    Something needs to happen though because I am not walking anymore like I am supposed to, I haven't eaten more than a couple pieces of bread for days and haven't showered for over a week (showering hurts like hell). Thank God for Netflix, because all I do is lay in my bed all day and all night... and that is NOT like me.

    PS- I have lost right around 10 pounds since the surgery, so I guess that's something good.
  • Well, I have lived with a pain level of 6 for extended periods of time, so I know it can be done, but the not walking thing is definitely not good! I just can't believe the surgeon's office won't help you at all! That's horrible.

    What if your wife called and just said "He is in so much pain I can't get him to get up and walk. Really, the pain meds you gave him ARE NOT WORKING." (not in a yelling voice, just for emphasis)?
  • This is just awful. Do you have a pain management doctor? Sounds like there was no communication between your doctors who prescribed your meds before surgery and your surgeon. I know in my case I was on neurontin and skelaxin before surgery and I coordinated with the neurologist and surgeon to taper off before surgery and stop completely on the day of surgery. These are no where near what you were taking and I'm floored that they expect you to do such a reduction.

    I would think the best thing would be to go back to the doctor who was prescribing before. Also has anyone done any assessment on you to determine where your pain is coming from? I've see doctors prescribe nerve meds when the pain was really bone based. That's won't help no matter how high the dose.

    Good Luck tomorrow getting through to your doctors.
  • I was never put on a long acting med after my PLIF but I was given percocet 10mg tabs..and I could take 2 every 4 hours if I needed them..I have never taken more than 1 1\2..during my first 3 weeks after surgery..I took them every 4 hours on the dot because I never slept more than 3 hours at a time anyways.

    Im sorry you are having to deal with this...Many of us had pain mgt MD before surgery and can go right back to them if needed. My surgeon is still giving me pain meds 6 months out..he is fine with it..I have never asked for meds any earlier than my scheduled appt with him..

    Im sorry you are dealing with this..Post op pain from this surgery is terrible...I don't wish that on anyone.

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