The Pain Med Shuffle - Pain Management Message Board

Bictwin · 01-03-2006, 01:07 AM

Okay so im getting the brush off from the surgeon to the pain management doctor. Before I had surgery i was seeing the PM, she had me on dilaudid and it wasnt working too great, but i was tolerating it. I had surgery, T10-L1 spine fusion, and the surgeon put me on percocet. And i tolerated that just fine too. But my surgeon decided they were "too strong" for me since im only 20 years old and switched me to vicodin. I had an allergic reaction to it (i think) and broke out in purple/red rash and joint pain. They assumed it was the vicodin and took me off. I had only been on it 8 days and for once a pain med seemed to be working. SO they switched me to darvocet and now every time i take the minimum dosage (which doesnt even work the whole 6 hours) i have some breathing problems. Not huge, but its hard to catch my breath even while im just laying down. I hate when they shuffle the meds like this. They say they're trying to help but its just making everything harder. Any advice??

Ash

Shoreline · 01-03-2006, 08:01 AM

Hey Ash, You nee to let them know about the breathing problems with Darvacet too. Allergy effects or reactions can be cumulative in nature, Meaning with each exposure youtr reaction get worse. II think the breathing problems are something to be very concerned about an there is no point in waiting for your throat to close up from anaphalactic shock to make your surgeon more comfortable with what he prescribed.

Personally , after years of this BS, I don't seee docs on any sort of pedestal and I have no problem confronting a doc about my ealthcare..
Because you responded wee, to Oxy, there is no reason oteher than his discomfort for you not to take it. If he wants to reduce the stength, he can rduce the strenngth of the percoet. He knows you tolerate it, If his goal is to reduce strngth to reduce tolerence/dependency, Explain they do make a 2.5mg Percocet. Call around first be sure you can find them, they are a slightly unusual dose, but it cuts your med strength in half which he was trying to achieve with the hudrocone and more than achived witth Darvacet. That's a big jump in stetrength.

Unforutunately discontinuing meds after surgery is pretty much ievatable,and at the docs pace and descretion.When you balk they get an tude and mention addiction and deependence and pretty much draw the line. After all we are paying our docs to torture us for our own good. At least n their mind, when you have no input on post op meds. BUt some folks come home with nothing but apap after fusions and some folks are kept on stronger meds for a year after surgery. I would say the adverage is about 6-8 weeks. THat's stepping down from percocet, to hydro products to ultram and or darvacet. Few surgeons are educated or trained in PM and if they can keep you from climbing the walls post op in the hopital, they are doing a good job under the supervson of an anesthesiologist. It's normal to slowly DC or taper down the meds if you're more than 4 weeks out. Due to your allergies it has limited what products a surgeon has to work with, as far as finding an alternative to hydrocodone there really isn't a great subsitute. Perhaps using a much smaller dose like the percocet 2.5/325's will be something he is willing to do. Surgeons are rough though.
Been there and done it with every surgery.
Good luck, Dave

feelbad · 01-05-2006, 07:33 AM

Dave is soo right about surgeons,they feel like they are doing you some huge favor when they Rx anything at all for most patients,and most do have that additude problem when it comes to Rxing any narcotics to those who are even in severe pain.If you talked to him about the pain med issue and that the percs are indeed just about the only option for you,just tell him to Rx you about half the amount of what he would normally Rx and tell him you will just cut them in half.they do come scored down the middle and agood pill splitter will work wonders.I just think this would be much easier for you than trying to actually locate a pharm that actually has this more obscure med in stock.but always remember,you DO have the right to have any post op pain properly addressed,sometimes you just have to be a bit more direct with docs espescially surgeons.a minimum of six weeks of proper pain control is not that unusual and in most cases,depending on the type of surgery done,this would be very much expected.good luckand let us know how things are going.Marcia