So much time is spent on thinking about the different things you need to do before going in for surgery and then the things you need to do when you are home.
However, there are many items that so many people forget about and they could cause you a lot of worry and discomfort
During your hospital stayCase worker
A Valuable asset to you and your family when you go home
- Arrangements for visiting home nurses
- Transportation needs
- Help arrange for any medical equipment you may need at home
- Help you with disputes regarding medical charges during your hospital stay
- and mote
Discuss your medication plan with your doctor BEFORE you leave. You need to know what medications are required and for how long. Many surgeons put a 3 to 4 week limit on prescribing pain medications. For some that will be enough to get them through.
Some people dont think about this and when those weeks are up and you are still in pain, you might be out of luck
After that period is over, you would need to go back to the doctor who was prescribing the narcotics before your hospital stay. Make sure you contact that doctor BEFORE your surgery, giving them the dates and a heads up as to when they will be taking over your medications.
I had a pre-consultation meeting with the nurses before my surgery on Monday. If you have never had one of these, I would suggest that you strongly request one.
We went over everything from
Medications I can and cannot take the morning of surgery
Do we have a Living Will
Want not to have 1 week prior to surgery
Want anti-bacterial lotions I should use 2 days prior to surgery
What my adhesive allergies are ( to avoid sever rashes )
My problems with anesthesia ( nausea, vomiting for days)
Hiatal Hernia problem with anesthesia - hicupping for 48 hours
Pain management program In Hospital and at Home
It is so reassuring when you have had these types of discussions upfront before you go into the hospital. Once you are in the hospital, or upon leaving, some of those items are too late.
One of the more important items we talked about was Pain management. Their standard approach (from the Operating Nurses) is that while in the hospital, they will manage my pain level through a Patient-controlled analgesia (PCA). Then at least 24 hours before release, migrated over to pill format. Their goal is to keep up with my standard daily dosage and increase that to coordinate with the surgery.
Then on release from the hospital, they would provide me with both an Extended Release pain medication (ie Oxycontin) and an Immediate Relief medication ( Oxycodone ). Their plan is for 5 days. That appears to be the norm for many states. I told her about how my physiatrist looks to work my pain management.
Physiatrist takes me right up to surgery, providing me with the appropriate pain medication
Hospital Nurse/Staff takes over while in the hospital
Surgeon takes control of my pain medications until he releases me, normally about 30 days
Physiatrist then resumes managing my pain control
Now, 5 days from the Nursing staff and 30 days from the doctor are two different values that mean a lot to the patient. The nurse told me that the 5 days is standard throughout almost any hospital in the United States. But that is only a guideline and they realize that the final decision is really between the surgeon and the pain management doctor.
Fortunately, I have been through this before, so I am aware of the different guidelines and limits. So, I generally plan for the worst and hope for the best. But if this was your first time with spinal surgery and you didnt know to ask, you wouldn't even think it.
More detailed information needs to be discussed with patients PRIOR to surgery. I am fortunate in 1) That I have had so many surgeries and 2) My wife has been working at that hospital for almost 40 years and knows the various protocols.
But not even one is as lucky as me. We have a new member here, < Songlin > who just had ACDF surgery. She has a terrible time in the hospital and was set home with only a 5 day supply of narcotics. Unreasonable.
You never want to wait until its after the fact. But you have to know even to start with.
So, we hope by providing these type of discussions, we help educate our members