Yesterday morning I had a Lumbar Laminectomy and a Micro Discectomy. I've had a pretty rough time since the surgery but I'm here and I'm at home now. Since I was awake all night I wrote in detail what happened. I thought I'd forget if I didn't. I'm cutting it and pasting it from Word to here for anyone interested in reading about my horrific experience.
About a week before my surgery I wrote an email to Gigi at the Washington Brain and Spine institute with several questions and concerns that I had thought of over the past few weeks. One of my concerns was that the amount of medicine I was on prior to surgery would not be taken into consideration when selecting the dose for my post op medicines. Another concern that I had was that the doctor or nurse wouldn’t know how to convert Opana in to the medicine I was to receive. Gigi explained to me that I would be bringing a list my medicines to the pre-op appointment so that the doctors would know what doses would be required after surgery.
When I had my pre-op appointment I told them that I was taking 40mg’s of Opana twice daily and that I was taking 15mg’s of Roxycodone 4-5 daily. I explained to them as well that the Opana was twice as strong as Oxycontin as stated on Opana’s website on the conversion chart. I was also told that I could take pills the morning of the surgery but it’d be better if I could do without. Since the surgery was scheduled to start at 7am I did not take my pills the morning of the surgery.
Just a few minutes before the surgery started, while in the operating room I was asked by the physician’s assistant what is Opana. I explained to her that Opana is my long acting pain medicine and that it’s converted 2 to 1 from Oxycontin to Opana. The Physician’s Assistant told me that the hospital didn’t have Opana and that I’d be given something comparable and I told her that was fine. I also told her that the doses I’d been on prior to my surgery hadn’t been effective but I didn’t have them raised since I knew they’d be raised after my surgery and I didn’t want them raised twice. I remember thinking “oh great, I have a feeling that this will be an issue later.” That was the last thing I remember prior to surgery.
After my surgery, I remember waking up in a lot of pain and telling the nurse that I was really hurting. She said she was going to give me a shot of Delodid. When she came back with the shot I asked her what I would be taking while in the hospital. She told me that I’d be taking 40mg’s of Oxycontin twice daily and Oxycodone every four hours. She also said that if I needed something between the four hours that I could ask for a shot of Delodid. She also said that I’d only get the Oxycodone if I asked for that as well. I told her that couldn’t be right since my Opana was stronger than the Oxycontin. She said that’s what was ordered. I explained to the nurse that 40mg’s of Opana was equal to 80mg’s of Oxycontin. She said she would look in to it. I continued to tell her that I was in pain and she would occasionally give me a shot of Delodid. I saw my wife only for a few minutes but she was told that she couldn’t stay in recovery. I was also told that there were no rooms available and that I’d have to stay in recovery by myself until a room opened up. The nurse gave her a $5 gift shop voucher to make up for my wife having to sit in the waiting room for an extra 6 hours after I came out of the anesthesia. My wife and I both agreed that it was a nice thought but doesn’t come close to making up for this. I had to sit alone for the first 6 hours after I was out of the anesthesia. I even asked the nurse several times if she could let my stay with me as an exception due to the circumstances and I was told that she could not stay back there. I was pretty concerned because my pain was severe and wasn’t going away. I kept telling the nurse about my pain levels and my concerns about the Opana. Between the pain, the medicine mix-up, and the fact that my wife couldn’t be with me, I was getting scared and agitated. Around 2:45pm I heard my nurse talking to someone who appeared to be a head nurse. I heard them talking about the conversion of my medicine and I also heard the head nurse say that she at took medicine for chronic pain and when she didn’t take it, she became agitated. I really thought that at this point they had it figured out and that they were going to finally be able to get my pain under control. I didn’t hear anything else from anyone for about 45 minutes which is when I finally heard that a room was available. I was told that it was a nice single room that they were putting me in and that it was a really nice room.
When we got to the room I was introduced to my nurse. I told her about the confusion regarding my medication and that I was in a lot of pain. She said she’d look in to it. The Physician’s Assistant that asked me about Opana prior to my surgery came to my room with another woman. I told her that my medicine doses were still messed up and that I thought they were close to figuring it out downstairs. She said “I told you downstairs that we didn’t have Opana and that we’d have to substitute it. “ I told her that I didn’t have a problem with that but that the levels were wrong. She told me that they pharmacy decided on those levels and they knew what they were doing. She also said that my medication was lower because the disc fragment that was causing me so much pain had been removed and that I shouldn’t have as much pain. I told her that I expected that but I was thinking that it’d be at least a few weeks after surgery before they started cutting back my meds. I said that I actually expected them to be a little higher than I had been on since I now had an incision. She told me that some people don’t even stay at the hospital at all after these types of procedure and that my incision was only a small one. I continued to tell her that the conversion was off and that I hadn’t yet received anything to replace my Opana. She said she’d look in to it. By this point I was beginning to feel a significant amount of withdrawal symptoms. I was very restless (especially my legs) and I was alternating between shivering and sweating.
Around 4pm, my nurse came in and told me that she had 60mg’s of MS Contin for me to take in place of Oxycontin since the conversion hadn’t been done correctly. I thanked her and took my medicine. A few minutes after the nurse left the room I remembered the conversion cart that I had looked at on Opana’s website. I didn’t think that 60mg’s of MS contin was equal to my 40mg dose of Opana. I looked it up on my Blackberry while my wife called her brother to have him look it up and we both discovered that 60mg’s of MS Contin was equal to half of my 40mg dose of Opana as well. The conversion chart states that for 10mg’s of Opana you need 20mg’s of Oxycontin and you’d need 30mg’s of Morphine. It was around 4:30pm that I verified that my doses were still only half what I’d been on prior to coming to the hospital for my surgery. I couldn’t understand why they would have switched me from being on half my dose in Oxycontin to half my dose in MS Contin. Even if the dose would have been doubled, I would have only been at the dose I had been on for the past several months. I was told I’d be getting 15mgs of Oxycodone which would have been a max of 6 and I was already taking 4-5 of those per day. It was around 4:30 that I began trying to get my nurse so that I could explain to her that this dose of MS contin was half just like the dose of Oxycontin that I was originally prescribed. I pushed the button on my remote and waited but nobody showed up. After waiting about 15 minutes I tried to push the buttons on the bed but still nobody showed up. After about an hour my wife went looking for the nurse. My wife got the nurse and when she came back she found that the nurse “call button” didn’t work in my room. She replaced the controller. My son was at home sick and my wife had to leave soon but she didn’t want to leave without getting my pain medicine resolved. My wife explained to the nurse that I was in severe pain and needed to speak to someone again about the doses. The nurse said that she’d call the Physician’s Assistant again. She said he wasn’t the same PA that I’d seen before. The nurse told my wife that she called him and he was in a procedure and that he’d come talk to me as soon as he was finished. My wife came back to the room and continued to wait so that we could resolve the issue before the she went home to our sick son. We waited several hours while I tossed and turned restlessly in withdrawal. I was also shivering quite a bit. Around 8pm my wife had to leave and could not wait any longer. I called the nurse back around 8:30pm and told her that I wasn’t doing very well and that I was in a lot of pain and I asked for an ETA on the Physician’s Assistant. She told me that she’d try to call him again. Around 9pm a doctor showed up and said that he heard that I was in pain. I told him that I was in severe pain and that I was also in withdrawal. He said that I was explained earlier that the hospital didn’t have Opana and that’s why they were substituting them with other types of medication. I told him that I didn’t have a problem with that but that I’d been telling the staff for the past 12 hours that he dose was half my normal dose and that I’d been in agony the whole time. I should have had a morning dose of Opana (or something comparable) and that it was already time for my night dose and all I’d had all day was half of one dose and shots of dilauded. I explained the whole story to him. After hearing the whole story he said that the issue had been sent to the pharmacy and they were the ones that confirmed the doses and that it was right. I told the doctor that I had the conversion chart right here on my Blackberry and that he could look at that or even look it up on his own. I told him that I felt very uncomfortable being a patient and telling the doctors that they’re all wrong but that in this case, they really were all wrong. He said he’d have to look it up himself and began using his Treo type of cell phone device. I told him that all he’d have to do is Google “Opana Conversion Chart” and any of them would show him what I had been trying to explain for the past 12 hours. About a minute later he stopped typing on his phone and said “you were right. You have been getting half your dose all day. He said “I’ll get your dose of MS contin switched to 120mg STAT.” He said that when the nurse came in to give me my PM dose of the MS contin that he’d have her give me an extra shot of dilaudid. I thanked him and he left.
About 20 minutes later (approximately 9:30pm) my nurse came in and said here’s your 60mg dose of MS contin. I said “you have to be kidding me”. She said that she wasn’t kidding and that the doctor wrote to change me to 120mgs of MS contin and to give me 60mgs as my evening dose. I asked her how that made sense and she wasn’t sure so she left the room to find out. She came back a few minutes later and said that since I didn’t get my AM dose until 4pm that I couldn’t take more than 60mgs for my PM dose. She said that I wouldn’t actually be able to switch to the correct dose until 4am the following morning.
Around 12:20am I was due for another dose of Oxycodone. Around 12am I told the nurse that had been around all day that I was in such agony and that I’d like my dose of Oxycodone. I decided to tell her at 12am so that she could have it ready by 12:20am when it was technically due. She said she was getting off soon so she’d pass it on to the next nurse. I told her that the Oxycodone actually seemed to work better than the delaudid. Around 12:50am I still hadn’t seen anyone so I called the nurse again. The new night nurse came down and said she hadn’t heard anything from the previous nurse about me needing anything. She then gave me a shot of Delaudid that she said she had been carrying in her pocket. I told her that the Oxycodone works better which is why I requested that an hour ago instead of the delauded. She said that it was too late and that now that she’s given me the shot that I’d have to wait a few more hours.
I noticed that my lip was swollen around 5pm when I first went to the restroom on my own. I asked the nurse and she said that can happen from the tubes that go in your mouth during surgery. She said to just leave it alone and it will go away. I asked the doctor that came around at 9pm to address my medication concerns and he said the same things about the tubes from surgery causing it and that I should leave it alone. I went to the bathroom around 3am and noticed in the mirror that it looks more swollen and like there are numerous blisters inside my lip where it is swollen. When I returned to my bed I noticed that my sheets were all twisted up from my restlessness that the withdrawal caused so I paged the nurse or tech to come to my room to help straighten my bed. The tech came and straightened my bed and while she was there I asked her about the blisters. She told me that she’d send my nurse down right away. It is now 3:50am and I still have not received a visit from my nurse.
At 4am I called for the nurse to come down to give me my 120mg’s of MS Contin. When she came I asked her about my lip and she said that it may be from tape or something and that I could ask the doctor. She gave me the 120mgs of MS contin which would just get me to the level I was at prior to having surgery. I asked if she could also give me a shot of dilaudid to help with the pain while I was waiting for the MS contin to kick in and even once it had kicked in since it was only the same dose I had been taking prior to surgery. She said that even though I was told I could have the Dilaudid in between Oxycodone doses that she didn’t feel comfortable giving me the shot of dilaudid at the same time as the MS contin. At 4:07am I called the nurse back to explain to her that the 120mgs of MS contin was just to get me to where I was at prior to coming to the hospital but when I called I was told she was in with another patient and would come back as soon as she could. I also thought that the MS Contin was a 12 hr pain medicine so I’m not sure I understand. Would I not be allowed to take Dilaudid at all during the 12 hours?
I’m pretty sure that I’m supposed to be on an equivilant dose to what I was on prior to coming in to the hospital plus dilaudid as needed in between my Oxycodone doses. Right now it’s 4am which would be exactly half way in between my doses. The nurse came back in at 4:17 with the dilaudid and said “I’ve brought you your dilaudid but it’s not time for anything else.” I told her that I didn’t need anything else. She said “well earlier you said the dilaudid didn’t even help. I said “earlier it didn’t help. This 120mgs you just gave me is equal to what I’ve been taking twice a day for the past 6 months. I didn’t have that earlier so the dilaudid didn’t help. Now that I have taken my proper dose of my base medicine, the dilaudid should help. “ She cut me off saying uh huh. See you later as she walked out.
I have been sick before. I have been in pain before. I have been through plenty of uncomfortable and bad experiences. I can say without a doubt that this was the most painful and horrific experience that I have ever been through. I never expected that I could tell so many people that I was in such a severe 10 out of 10 pain for so long and have nothing done. All that had to be done was for someone to look it up to see if what I was saying had any merit and that never happened. I was regularly blown off and left in excruciating pain for well over 12 hours. I first told the PA about the meds around 7am on Thursday the 24th. I continued to explain the situation to the post-op nurse from about 9:00am on Thursday July 24th until 5am on Friday the 25th when my 120mg MS Contin dose kicked in. I can say without a doubt that this has been the worst experience of my life. I will say that as of right now, I’ve been in severe, untreated pain for 20 hours. I’ve also never been treated so poorly or had someone be as unsympathetic as this night nurse has been. She has seemed rude and put out about everything she’s had to do.
Here's an update for anyone who has made it this far. I came home today around 2pm. I got setup in bed with my laptop and a walkie talkie. My wife has the other. I have my Opana and I'm taking the 15 mg Roxycodone's every 4 hours instead of 4-5 times a day.