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Decrease in Pain Meds before Surgery...is this normal?

Well, I'm kind of mad...no. Irritated.

I saw my Surgeon last week, Thursday to be exact, and he refilled my Rx for Lorcet every 4-6 hours. I have a 2 level microdiskectomy scheduled for 4/25.

I take 4 tablets a day.

He's on vacation this week, and when I called for a refill, the PA switched my dose to 1-2 tablets a day, telling the med secretary that I should be using them "sparingly."

In my opinion, I am using them "sparingly."

The best part??? I explained that the surgeon and I had this conversation about pain meds, and that there was no indication that I would need to mak a change. He refilled the rx.

The medical secretary said: " Well, do your best. If you need to use more than that that just call us." I told her that I thought that was not appropriate, as I refuse to use the medication any other way than what is prescribed on the bottle.She assured me that she would put a "note" in my chart.

I thought about it overnight, and I think that they are worried about the amount of meds I am on prior to surgery, but if I back down to 2 a day I am not going to be able to walk without excruicating pain.

I'm sure that they have stronger pain meds for me after surgery since I have probably built a tolerance.

I also resent the implication that I am not using the medication "sparingly." That bums me out. I've been good.

OK....I'm done. Any thoughts would be appreciated.

"My Blood Type is Be Positive"




  • HopeInBraceletsHHopeInBracelets Posts: 73
    edited 04/04/2013 - 5:50 AM
    I am scheduled for a fusion at L5-S1 on the 11th. I am currently on Opana ER 10mg every 12 hrs and Oxycodone 5 mg taking 2 every 4-6 hours (as needed). I was worried about my tolerance to pain meds for recovering after surgery......even if they have to double up on doses of say morphine for after surgery, that will be a lot for any body to take. So I was told to decrease pain meds, if I could, 48 hrs prior to surgery. That the body has a quick "reset" button for pain med levels. So this is what I am going to do next week and I will see how it goes. :)

    DDD 2 level ALIF L3-L5 in 2007. 4/11/13 posterior fusion w/decompression on L5-S1.
  • I agree that the body seems to have a "reset" button so to speak. I'm given 3 10/325 Percocets per day. I take one every 6 hours, but when it would be time for my 4th dose (which I don't have) its also bedtime so i take a dose of Nyquil instead, lay on my heating pad while the Nyquil works and fall asleep. The next morning it has been 12 hours since last dose and it still works great and I've been on these for about a year and a half. So i think this has also kept my tolerance down. But that's just my theory, but it works for me.

    But anyway, sorry for rambling. I wouldn't think there would be much problems with after-surgery pain control as the lorcet is pretty weak compared to some of the other things out there. I would call your doctor when he gets back from vacation to clarify though because it sounds like the PA is making the change himself and not based on what you and your doctor have arranged. Good luck to you.
  • EMS GuyEEMS Guy Posts: 920
    edited 04/04/2013 - 9:59 AM
    Most doctors will bring your medications down as much as you can physically tolerate before surgery. This is typically done to bring your therapeutic level down so that the medication has a better chance of working right after surgery and while you're recovering. It's frustrating, but it does help you after surgery.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • I had an issue with pain control after my L5/S1 TLIF because I was up to 10/325 percoset up to 4 times a day (I think I was doing 3 most of the time, with breakthrough pain still an issue). If I could have done it, I would have tried to wean down before surgery.....morphine wasn't touching the pain, and the surgeon's PA kept trying to keep me at the 10/325 percosets I was on pre-op :-P

    One thing to bring up if you have to call is that many insurance companies won't refill a script if it looks like you're using them incorrectly (aka not as the label says). I had this happen to be because of my surgeon telling me to double up on my pain meds (going against what his PA told me).
    1/16/2013 Minimally invasive TLIF with rods, screws, and cage on L5/S1 joint to treat grade 2 spondylolysthesis, pars defect, degenerative disc disease. Dealt with chronic pain & nerve issues since at least 2007.
  • When I had a double fusion my doc didn't say anything about this. I understand the therapeutic aspect but really???

    In my experience most docs after major back/neck surgery are going to put you on a long acting med routinely and breakthrough, probably stronger than what you are taking. The PA may have called it in wrong....4/25 is far away what are they worried about now? You're having a micro so you probably will get a rx for percocet post-op as that's routine in most hospitals. With a micro surgery you may not need the long acting stuff they save that for major surgery.

    Just me but I would call and ask them to call in (thats one they can call in) just the difference explaining that you need them before surgery to unfortunately to function. That's a bunch of bull quite frankly. There is always a doc covering for one that's out so another thing you might try is asking to speak to the doc covering for yours and bypass that lazy PA. Calmly explain your doc has you on a specific regimen and you need to keep it that way in so many words.

    take care of you ok?
  • I just called the Medical Secretary, who I found out made the change on her own when she called the refill in. She was quick to call the pharmacy and re-instate the old directions when I asked her (very kindly) why, if the doc and I agreed on something during an office visit, why it would get changed?

    All is good now with the world. She apologized, and said that she understood and did not want me to worrry. Ya, for the last two days I have been a wreck!

    Anyway, we have to advocate for ourselves. State the facts, and stay in WISE MIND!

    Thanks for all the support!!!

    "My Blood Type is Be Positive"


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