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Tolerance to meds Am I Screwed?

I am having L4-5 Fusion sugery in8 days and im afraid i will have to suffer in pain. After being on Oxycontin and Oxycodone for 5 years my tolerance for pain meds is high and i cant seem to get that across to my pain mngt doc .Its been 2 years since i have taken anything stronger than Norco 10-325. My doc putt me on Norco 10-325 2 every 8 hours and that dont help at all. I saw my pain mngt doc 5 days ago and i asked him to put me on something else because the Norco wasnt helping and he just increased the Norco to 2 every 6 hours he said he didnt want to put me on anything new this close to surgery. I am scared to death to have the surgery because i know i will be in more paain than im already in and ill be made to suffer. I dont know if the surgion will prescribe anything differant that will work for me after surgery and I dont know if he can or if i will get in trouble if he does and i have it filled because i signed a pain management contract with my pain mnft doc. Can someone please give me some advice i


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    Have you clarified who is responsible for your pain management post op once you are discharged to home? In the hospital, your pain will be managed by the anesthesiology and pain management department , and they will take into account, the medications that you have been given at home previously. In most situations, they use a pain pump for the first day or so that the patient may push a button to deliver a bolus of medication for pain when they find it necessary, and usually continue the meds you were taking at home, unless the surgeon changes them during your stay.
    Since your surgery is coming up quickly, I would contact both the PM doctor that you are seeing now, and ask them specifically, how your discharge pain should be managed and by whom, and for how long. Most surgeons will , with the permission of your PM doctor prescribe meds for the first couple of weeks post op, but if there is a need after that, expect you to return to your PM doctor for ongoing care...
  • Actually, if the surgeon does their job right, you should be in less pain after the surgery. You may feel uncomfortable the first few days and my guess is you will get stronger meds while in the hospital, but the whole goal of surgery is to reduce your need for medication.

    Getting the jitters before surgery is normal. But, if you insist on medications stronger than the doctor is willing to give, it may prove negative for you. My doctor cut my meds before surgery like yours did. I wasn't given ANYTHING prior to surgery for a month. Yes it sucked, but it got my tolerance down so the meds would work once surgery was over.

    I suggest you speak openly to your doctor about the pain, but in the end, trust them to do the procedure. You might be pleasantly surprised by the pain relief you get from the fusion.

    Good luck.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • dilaurodilauro ConnecticutPosts: 9,841
    said, assuming the surgeon does what he/she is supposed to do, you will have less pain then you did before. You will of course have the surgical pain and the initial recovery pain. But once that passes (2 - 8 weeks) hopefully you will not need any more pain medications.

    While I was recently in the hospital, and they know I am a chronic pain patient they had to do a lot of playing with various pain medications,oral, IV, dosages until they came up with the best mix. That was a lot more than I was taking before I has surgery. They will work with you while you are in the hospital, you just need to speak up.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • i think some people mistake lack of getting high with loss of tolerance to pain meds. when you take meds, your body adjusts to them. i have not had the so called high feeling for 10 years but my meds work. i have not taken more or have my dr adjust my dose to more. in fact i have taken less. it seems to be a common thread here, my pain meds no longer work. they do work but you are not aware of it because your body is adjusting and building up a tolerance to them.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • After I had my 5th spine operation, L4-L3 w/ hardware a couple of years ago, the very first thing I realized right when I woke up was that the pain was gone. It was amazing.
    I have a med contract with my pcp of 10 oxycodone per day and for a few weeks I was taking between 1-3 a day where before I was taking anywhere between 8- 12 a day.
    But being me, if i'm not in pain then that means I can do stuff, which I did (and still try & do - house & yardwork), which means my backs worse than before & i'm just waiting to finally blow out my thoracic area.
    Operations can be successful but the way you treat yourself afterwards can make all the difference.
    The crappy part is dealing with the stuff you may have to give up doing unless you've been (like me) used to crossing 'stuff' off your 'list' over the decades....;>)
    Good luck!
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