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Is there an alternative to using opioids for post surgery pain management?


I am having 360 fusion surgery (L4/S1) in the next month or so and have a major concern about the opiates that will be used post surgery to control pain. This is the second fusion surgery in 10 months and is necessary because the cage at L4/L5 has migrated forward to such a degree that there is not enough between the bones to allow a fusion. The NS is also going to fuse L5/S1 while he is in there because of ongoing problems at that level.

When I had the last fusion we discovered that I am extremely sensitive to opioids. So sensitive, in fact, that they caused a headache so bad that they thought I might be having an issue with my brain. It didn't help when they treated the headache with endone and then morphine on top of the oxycontin that I was already taking. It took a couple of days for the doctors to figure out what was going on. Once they did we had to find a balance between the level of back pain I could tolerate and the level of headache that the meds caused. As a result, my short stay in hospital ended up lasting almost two weeks and my recovery was severely impacted because I was too ill to get up out of bed for most of that time.

Since then I have had to limit my pain meds and only take something when the pain is so bad that I can no longer deal with it. My life has turned into one long mental battle to block the pain. As you can imagine - this makes me a little irritable at times 'cause there isn't enough mental energy left to deal with much else!

My question is - has anyone come across any different means of post-operative pain management? I am dreading the pain meds even more than I am dreading the surgery!


  • I also get a headache from opiates. I have to be sure not to concentrate on anything like reading or the computer. Also taking cymbalta has greatly reduced the headaches.
    ACDF C4-5 June 23rd, 2011

    Another surgery in the near future. I am 26 years old.

    Current Meds- Norco 7.5/325, Cymbalta 60mg, Gabapentin, Adderall 20mg
  • BkinsBBkins Posts: 364
    edited 09/06/2012 - 9:43 AM
    Have you taken this up with the pain management people and your surgeon? Does it help to take a very small amount? I would try taking half of the smallest tablets and see what kind of relief/problems you get. If a 5mg tablet is to strong anf gives you problems then get a pill cut and take half or even a quarter. Just offering a idea so don't take it as medical advice.

    I am sorry I vered away from your direct question as I have never read, or seen posted and other ways to deal with your situation. Maybe one of the physoctic drugs would help give you some relief.

    I have a friend who has had a few back surgies and got really moody and mean on pain meds. He ended up smoking a joint and that seemed to help enough to get him through the day. This was a good deal before medical joints came about. Might be another avenue to check out although it won't help you while your in the hospital. I would give it a try just to see how/if it helps. There is a reason it has become a medical product.

    Good luck with your surgery and comfort level afterwards.
  • Hi Donnabe and Bkins. Thanks for your replies.

    Have been down the psychotic drug path and also can't take them. I will try cutting the tablets in half and see if that helps but I am really not looking forward to the post op regimen following the next surgery. NS and pain management people are talking about using fentanyl - from what I have read this also seems a little bit scary.

    Re the MaryJ - not an option I want to explore.
  • CherylC said:

    Re the MaryJ - not an option I want to explore.
    Yep, can totally ubderstand your view. Its just that it must work for some types of pain in order for it to become legal for such. It wouldn't fit into my life to well either. Maybe 25 years ago when I didn't need the gov. to say it was OK.

    The pill cutting should help, at least it did with me.

  • Even though it didn't work well for me, Ultram (Tramadol) may be used. It is a synthetic pain reliver and for some people don't experience the same side effects as opioid's.

    Best advice on this string though was to speak with your doctor! Be 100% up front and tell them what medications made you sick. Early on in my recovery, I was prescribed Darvacet for pain. I got killer headaches while taking it. But, when I was switched to both hydrocodone and oxycodone, the headaches went away. If I have to take a bunch of oxy when I'm having a bad day, then I get a headache, but nothing like the Darvacet caused.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
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