Pain medication/management after lumbar fusion/decompression

Pain medication/management after lumbar fusion/decompression

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kathyy
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Joined: 10/29/2008 - 2:18pm
Pain medication/management after lumbar fusion/decompression

Good morning fellow warriors! I say "warriors" because we are all in the major battle of recovery, eh?

Wondered from the rest of you what your docs allow in terms of pain meds. I am exactly 2 weeks post op and my doc is pretty aggressive about getting me to reduce my use of Lortab down from 20 mgs every 4 hours after surgery to 10 mgs every 5 or 6 hours now. In addition, I can add in tylenol every 4 to 6 hours, small dosage. Doc says NO NSAIDS for at least 3 months and longer if there is a problem with fusion.

He also won't allow any type of ice pack, etc. I am using the magnetic field machine (obviously not the technical term) once a day for 30 mins.

Aside from meds, I've noticed that if I get up and walk at least once every hour the pain seems to be more manageable.My secondary incision where bone was harvested for graft is actually much more painful than the central, 5" incision for the fusion but I've read that is normal.

What are the experiences of others in terms of what their docs are allowing and are there any other "tips" for pain management? I'm sure there are other posts that address this but I'm not sure how to search for them so forgive the redundancy.

Blessings and hugs - Kathy in Atlanta

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Lo
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Joined: 08/28/2008 - 10:10am
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I've been on Percocet, two 5/325's every 4-6 hours. I was on 10 a day, now I'm on 8, but I moved myself down on that. They have never asked me to lower my dose of it, but I did have to space out my Valium. They said once I start PT the therapists won't want me to take it at all because it's counter productive... Otherwise she'd give it to me every day like usual. I had started Percocet 2 weeks before my May 1 MicroD... I've been on it since then... After my Fusion Sept 26, I was on Dilaudid, two 2mg pills every 4 hours, and Valium 3 times a day... For two weeks, then they switched me back to my Percocet. She told me I might need it even more now once I start physical therapy. She's awesome about it. They won't up my dose... Even if I get pain back, but they haven't tried to lower it, either. I call to request a refill, and 48 hours later, I can come pick the script up. In Massachusetts they can't call in Narcotics, they have to be physically picked up in paper form and you have to bring that to the pharmacy with your ID. So, I have to do that about every 8 to 9 days. Kind of sucks, but I need the meds. If I don't take them I can't stand up straight. I am fusing already at 2 months post op... She said that may actually be part of my pain. So, I dunno when they're gonna get me off the meds... They never said anything to me about it... If they try to take me off while I still have pain, I'll probably look for a pain management doc... But they don't seem like the type to deny me pain meds when I need them. I requested pain meds before my MicroD. My primary had me on Tylenol number 3... Even though she knew how bad my Sciatica was for a year that she put me off, and how bad my back was, and saw the MRI films,.. She was cruel. Then I saw an Orthopedic surgeon who prescribed me Tramadol, which did NOTHING.. So my first visit with my Neurosurgeon I requested something and told her Tylenol number 3 and Tramadol didn't work for me, so she just wrote up the script for the prescription... 1 to 2 every 4 to 6 hours, right off the bat. In the beginning I was taking 1 pill every 4 hours, but after surgery I had to up it to 2 every 4 hours... and sometimes 3 at a time. (Max single dose of Tylenol at a time is 1,000mg, and the max dose of Oxycodone is wayy higher than 15mg, so it's okay) but I only do that in the morning and at night, and if I do, then I only take it twice, three times a day max. I dunno, that's just my experience. I hope to be off them not long after I finish Physical therapy.... Providing all the pain is gone. I'm not one of those people that can live in pain anymore. I have a high tolerance, and I sucked it up for a while... But I'm not happy being 22 and in pain, unable to do anything with my son, unable to enjoy the outdoors or go see movies, or walk around the mall with my boyfriend... Nobody wants to be your friend or date you at 22 and being stuck at home every day from pain. I rambled, but it's early and I'm bored... Home alone. Lol. Sorry.

Squirrelypox
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Joined: 06/26/2008 - 8:18pm
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megb (not verified)
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I took Valium and

I took Valium and hydrocodone for about 2 to 2.5 weeks post-surgery. Really, they made me feel so bad I just decided to do whatever I could not to take them. I have done fine with ice and heat (and the occasional glass of wine) since. Ibuprofen would be wonderful some days but my surgeon says "no".

EllenH (not verified)
Title: Member
Hi Kathy: I am sure you have

Hi Kathy:

I am sure you have heard that every case is different as to how much pain you are in and what is prescribed for how long. I had a TLIF about 14 months ago and I fused in 6 weeks. I do remember the doctor wanting me off the "hard" drugs very quickly. I do take Tramadol now, it is non narcotic. One thing you want to avoid is getting constipated which can occur from some of the medications.

Ellen

Cali-Sue (not verified)
Title: Member
Hi Kathyy, I was discharged

Hi Kathyy, I was discharged from the hospital with 2-Norco10 every 4 hours. After a few days I decreased to 1 every 3 hours as suggested by a fellow nurse friend (I think I was sounding pretty loopy on the phone.) Then it was a gradual decline to 1 every 5 -6 hours. When I needed a refill, I requested Norco 7.5mg as my NS suggested. It really has been a very gradual natural decrease in how much I needed. Now I occassionally take half of a 7.5 with some plain tylenol, not even everyday. My NS says I can take motrin now after 3 months, but he prefers I avoid it. I have taken it only 3 times in the past 2 weeks when at work since I can't be on narcotics at work. Of course ice and heat are my friends Wink Take care, it will get easier, Hug Cali-Sue

TerriJV (not verified)
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hi

last yrs surgery i was sent home with 10mg hydro's 1-2 every 4-6hrs. those did not work. so a week later they upped it to 7.5 percocets. 1--2 every 4-6hrs. by nov i was down to 5mg hydro's. then by 4 months he did not want to give anything at all. but i asked so i did not withdraw from them. he told me to save them for a rainy day and boy did i.
this yr totally different story. got sent home with 5mg percs 1-2 every 4-6hrs. i ended up with 3 scripts of those. that lasted me till my 4wk ckup. at that point he wanted me to go down to hydro's (those he said he could refill, duh i know that). i said i was not ready he said ok gave me my script and said call when i needed more.
i called and they said no. all they would give me was 40 pills of 5 mg hydro's and 50mg tramadol. they said it be best that my primary take over my pain managment.

your going to see this alot depending on the state.
surgeons are getting away from rx'ing meds after a period of time your surgery is over. "since yes they think they fixed the problem" not always the case. it all runs into DEA rules etc.
Ex: like where Lo is you have to pick up your script. here they can call in a 5 day supply. then the rest has to be written.

same with my recent aortic bi fem. they will dose my meds till the staples are out after that they hand it over to my primary.

so if your not comfortable yet you can go to your primary or even a pain managment dr for a long acting med.
i mean i can understand 4wks dropping you down like mine wanted but 2wks thats early in my eyes. you need to be comfortable with pain managment to heal. and get your walking in.
i also got a letter stating my dr was more comfortable with my primary rx'ing my pain managment and it helped wonders.
plus docs don't like you on anything with tylenol or a motrin base for to long. (all personal experience of course from what my drs have told me).

im curious about the ice. you should be able to use ice after that. what is their reasoning for that??? i would be TOTALLY LOST without my ice packs. i am on one now.

good luck hun i feel your frustration!!!!
xoxoxoxo

Lo
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Joined: 08/28/2008 - 10:10am
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My Neurosurgeon thankfully gives me the option of having the Oxycodone... I switch it up every so often... Percocet... Then Oxycodone for a week or two... But my primary care doctor does tests of my liver function and stuff every couple months... If they see signs of it not functioning as well as it could, then I'll switch to Oxycodone and stay there.

I think the main reason my doctor hasn't taken my meds away yet is because I haven't done therapy, number one... And number two, I still have another herniated disc in my T spine that causes major pain in my mid-back. I still have C-spine issues, too. Sooo.. I don't know when they'll cut me off, but I pray to God I have my pain managed by something else before then.