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Old 06-29-2005, 04:20 AM   #1
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Upcoming shoulder surgery-help

I've been dealing with a bad back for years. MRI and other imaging approaches basically say DDD, some spondy, facet issues and bone spurs. It's more problematic in the L5-S1, but otherwise, spread up and down throughout. I take Vicodan. 7.5/500 2x in a.m. and again in the afternoon. Been doing that for a long time. (I know about the long term effects of the tylenol but the doc. keeps me there)..

I broke my arm, have a labral tear and rotator cuff tears from a fall this winter. The vicodan doesn't touch it..and sleeping is unbelievable difficult. Been in pt for 3 months and now will have surgery. My question is what do I tell the shoulder doc and also, the hand surgeon who will also be operating at the same time (again fall related)? I had major surgery for cancer 2 years ago and the doc tried her hardest to find something that might work based on my tolerances. Morphine was used and didn't touch it. I also woke up from surgery way to soon before they could get the pain meds in and just never was able to get on top of it.

I don't want that to happen. Morphine and it's variety of forms doesn't seem to work with me. Is dilaudid morphine? It does seem to help. I'd really like something that lasts longer than 2 hrs. Any suggestions? My pcp tried Avinza but it just made me nauseus and didn't do anything for the pain.I'm dreading this surgery. I remember the pain right after the fall and for the weeks it took to get the fracture healed. Now..I will be back to ground zero again. Will go looking for a lazy boy to try to sleep in for a few months.. Help!

 
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Old 06-29-2005, 07:38 AM   #2
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Re: Upcoming shoulder surgery-help

Sorry to hear about the upcoming surgery. I was kind of in the same place as you with meds. In just one year I underwent 4 surgeries, 3 of those being on my spine. Needless to say, Meds didn't work the same.

When I did my consult with the surgeon, I just told him that I had a high tolerance to pain meds. I told him why and have not really had any problems with it. They don't even order Morphine for me anymore. Its always Dilaudid.

And no, Morphine is not Dilaudid. Dilaudid is stronger than Morphine about 2-3x stronger. The thing is with both these drugs are they will get you out of pain. They can give you enough to get you out of pain. You may be sick, but you will be out of pain. It makes more sense to just give you a stonger drug, so you can have less. Just before my last surgery, I was at the hospital in severe pain (I had broke my back). I told the DR there about my tolerance, however he was believer in Morphine. He started me with IV Morphine at 10mg and gave an additional 5mg in another hour. Most people start with 2-4mg at one time. It actually worked pretty good, but Dilaudid works better for me I think.

The other thing you can do is when you meet with the anestheologist is let him/her know. Mine called me at home. She said she heard I had a high tolerance. She asked me what worked. I told her Dilaudid. She said, "No problem." She told me I would be comfortable, and she was right.

So, I would just bring it up to them. After my first surgery, I decided that I was not going to be laying in a hospital in pain. Especially after I saw the bill. Now I just let them know before hand. There is nothing wrong with being honest with your DR. When you tell him that your other DR has had you on pain meds for x amount of time, he should be able to understand tolerance.

Good luck with the surgeries, hope all goes well and you pain free.

 
Old 06-29-2005, 12:12 PM   #3
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Re: Upcoming shoulder surgery-help

Thanks for your reply. You've certainly been there. I have explained to the shoulder doc that I am on vicodan and why. This was after he offered pain meds. I told him I what I was already on and then asked him what he suggested. He suggested darvocet. Yeah. So, since the guy whizzes in and out in a blur and I have to sort of nail him down, I do expect to have this conversation with all involved. I thougth I'd had that with the prior surgeon on the previous surgery. She was most concerned about making sure that I did get whatever was necessary to keep me comfortable. Problem is, it was not acted on by the other nursing staff. I'm hoping this is outpatient and I won't have to rely on what the other's "think" is enough. I heard that one enough while in the hospital..

I will let them know that morphine and it's various versions haven't really worked. Dilaudid does.. we'll see what happens. I do know that they will use a general and an epidural..so, when I wake, my arm will be numb for awhile. That's the plan anyway.! Take care..wishing you a painfree day!

 
Old 06-29-2005, 05:02 PM   #4
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Re: Upcoming shoulder surgery-help

Darvocet...you've got be kidding. I can see if you have never been on meds, but Darvocet (Proproxyphene) is not very strong. I would be demanding something else. Like in my previous post, I made up my mind that If I am laying in a hospital, post surgery, I'm going to be as pain free as possible. Everyone responds differently, and maybe Darvocet may work for some, although never seen it offerred in a hospital, it doesen't work for all. Same goes for Morphine and other opiates.

The last time I was hospitalized, my Dr had Dilaudid 2mg every 2 hrs and Morphine 4mg every two hours in between if needed. I only used the Dilaudid, but my Dr know my situation. For some people, that dose that frequently, would put them in a coma.

After I the one Dr as mentioned in my previous post gave me 15 mg of Morphine in an hours time, I was asked if I was human. But when you have had 4 surgeries and hospitalized an additional 5 pr so times for complications, it takes more to achieve an analgesic effect. Of course, know I am down to Lortab 10/500, because the pain has decreased some. My Dr understands this and has watched me lower my meds over time. Problem happens when you continue to take the same dose for other than prescribed or pain relief. As long as you have no history of drug abuse, you should not be denied the proper medication that YOU require.

Good luck to you. Hope all goes well with your DR's

 
Old 06-29-2005, 06:36 PM   #5
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Re: Upcoming shoulder surgery-help

I hear yah.. when I had major surgery for cancer 2 yrs. ago.. I thought and felt that my surgeon genuinely wanted to make sure I had the right pain management..after the pain pump quit working and they said they couldn't find another.. yeah.. and the attempts in recovery to give me enough morphine..and yelling at me when I kept complaining..they just gave up. Said I had enough. I have never been in so much pain. The doc tried to get me moved off the overflow floor but couldn't find me a room. It was a private room and they just refused to come in. It was horrible..that's where I found that morphine and percocets didn't do a thing. I had covered all the bases, was open and honest about my back history and my concerns.. but when you have to rely on the nursing staff..who in my case just didn't want to be bothered..it is difficult. Getting the message to everyone who has to be part of the care is difficult..

I'm hoping that this time will be different.

 
Old 06-29-2005, 09:39 PM   #6
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Re: Upcoming shoulder surgery-help

One more thing. It reminded me as I read your last post. One of my hospital stays a while back, they had Dilaudid ordered for me. Then a new Dr came in and changed my orders to oral Percocet, which did not work at all. The nurse said there was nothing she could do. I was ticked and asked her to call the Dr or call another one. She refused. I advised her I would be leaving the hospital. She told me that I couldn't. When I told her I would rip the IV out, she called the Dr. A few minutes later she told me the Dr changed the orders back. I don't recommend doing this unless it is drastic. At the time, my Dr had already had OxyContin and Percocet at home that I filled before surgery. I told the nurse, if they were going to keep me on that dose, I should just stay at home and take my own.

Anyway point is, don't give up if you are in pain whichever way you achieve that. Obviously the best bet is to talk with your Dr before hand and have a clear understanding about your pain management.

Best of luck.

 
Old 06-30-2005, 03:35 AM   #7
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Re: Upcoming shoulder surgery-help

Yes.. sometimes situations call for desparate measures! The second day after surgery the last time..everything seemed to be going wrong. The pump had stopped working..the nurses had messed things up good..my mother was in town to "take care " of things which meant that she'd visit for 1/2 hr. a day..thinking she'd join me for a cocktail at 5! Hilarious! I started getting the inkling of what was to come when the doc wanted me MOVED out..but that didn't happen. The next day..in pain and having the GAS pains kick in, I just had a major meltdown. Problem was, I was stuck in the bed..the call button had fallen down on the other side..couldn't get up and no one would come in. 8 hours later..really having some problems, started hollering and got a guy who showed up, asked what I was "in for".. told me he had better things to do and people "less stable" than I. HA.. I told him I didn't think so. He took my blood pressure (after asking what it was earlier in the day).. I told him I wouldn't Know since no one came in and TOOK it.. it was 190/120. Yeah. That got his attention. Anyway.. the next time...I will make sure I have my cell phone within arms reach. I will call 911. I just crack up thinking how funny that is that you'd need to call 911 while IN the DANG hospital. I will also make sure that I have my own stash of pain meds handy..(within reach of my good arm!) Pre-planning based on experience is the only way to go into a hospital these days. I will pre-program my cell phone with my doc's phone #...assuming this one gets with the program. I guess you just have to laugh about the whole mess of health care these days. It's darn dangerous to go into the hospital. Fun times ahead.

 
Old 04-06-2010, 02:14 PM   #8
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Re: Upcoming shoulder surgery-help

Quote:
Originally Posted by Josie115 View Post
I've been dealing with a bad back for years. MRI and other imaging approaches basically say DDD, some spondy, facet issues and bone spurs. It's more problematic in the L5-S1, but otherwise, spread up and down throughout. I take Vicodan. 7.5/500 2x in a.m. and again in the afternoon. Been doing that for a long time. (I know about the long term effects of the tylenol but the doc. keeps me there)..

I broke my arm, have a labral tear and rotator cuff tears from a fall this winter. The vicodan doesn't touch it..and sleeping is unbelievable difficult. Been in pt for 3 months and now will have surgery. My question is what do I tell the shoulder doc and also, the hand surgeon who will also be operating at the same time (again fall related)? I had major surgery for cancer 2 years ago and the doc tried her hardest to find something that might work based on my tolerances. Morphine was used and didn't touch it. I also woke up from surgery way to soon before they could get the pain meds in and just never was able to get on top of it.

I don't want that to happen. Morphine and it's variety of forms doesn't seem to work with me. Is dilaudid morphine? It does seem to help. I'd really like something that lasts longer than 2 hrs. Any suggestions? My pcp tried Avinza but it just made me nauseus and didn't do anything for the pain.I'm dreading this surgery. I remember the pain right after the fall and for the weeks it took to get the fracture healed. Now..I will be back to ground zero again. Will go looking for a lazy boy to try to sleep in for a few months.. Help!

 
Old 04-06-2010, 02:15 PM   #9
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Re: Upcoming shoulder surgery-help

I have the same prolblem did u try fentnyl patches? I too have to sleep in the recliner.

 
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