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Old 04-27-2008, 05:15 AM   #1
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hi all, my brother needs pain management help!

I have posted here before for myself, and you all have helped me so much with my medications and also helping me with dealing with my marriage and chronic pain.

I am writing for my brother. I just received a phone call from my sister that my brother broke his leg in 3 places last night, and he is having surgery at 8:30 to fix his leg and put in plates.

My dad was with him through some of the night, but called my sister because my dad could not take it anymore. My brother was crying and screaming in pain, and nothing touched the pain. My brother is a recovering addict and has been going to a clinic for probaly 3 years now, and is on methadone. My brother is 23 now, and when our mom did not wake up one day, he was 16, he took a bad turn abusing alcohol, and drugs. My brother is now doing very well, working, and living with my dad.

Until last night, he was working at our family business, and fell down a set of stairs. I am scared for my brother, he is in pain, a lot of it, and it is not undercontrol. His surgery is this morning, and then he will stay in the hospital for a couple of days. The hospital he is at is in a very small community and limited.

Whe she called this morning, and asked me questions, I knew I could come here and get some help. I respect and appreciate everybodies help. How can he get help, and what options does he have for pain control, while being on methadone? Does the methadone make other pain medications not work at all? He is in extreme pain, and what options are there for pain control? He has been tapering down off methadone, but could they increase his methadone for now, as this is going to be a long haul for his recovery? I live over an hour away, but should I suggest he see a pain management dr?

I thank you for your advice, and time, my brother does too. Also, has anyone ever had this surgery, broken leg in 3 places and they are putting in plates, and what is the recovery time, and he will have to have physcial therapy right?

Thank you,

Kassandra

 
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Old 04-27-2008, 07:51 AM   #2
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Re: hi all, my brother needs pain management help!

Hey Kass....Sorry to hear about the accident.

I think what this will come down to is the philosophy of the physician / surgeon. You need to definitely communicate what is going on to ensure (A) The Docs know about his past and how to address it properly, and (B) Because he is on Methadone, his sensitivity to pain is much higher and will need to be treated accordingly.

IMHO, I think the Docs have to treat his pain like any other patient...And, in fact, with stronger dosages due to his tolerance. It sounds as if it's going to be a long haul for him and you don't want him to suffer. Then, when he heals up after some time period (how ever long that is), you can deal with the dependence issues then....Titrate back on methadone and go from there.

Hope this makes sense, and I really hope all goes well for you and your family. Please let me know if you have more questions.

Ex

 
Old 04-27-2008, 08:07 AM   #3
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Re: hi all, my brother needs pain management help!

Thanks Ex,

I just talked to my sister and he just went into surgery. He is very grumpy, edgy, and in pain. They have him on Toradol, and morphine, and it is not enough. The doctor told my sister that he would work with them, and he mentioned Ultram. I have taken Ultram Er and it did nothing for me, so I don't think that is a suitable medication, especially given that the toradol and morphine is not working. I told my sister that she needs to suggest a pain management dr, and that it is possible to treat him, and manage his pain, but he is going to need higher dosages. They need to seek a dr who can help manage the pain for now. I am scared for my brother, as I have read that people who are on methadone for addiction, often not get their pain treated appropriately, due to drs who are afraid, or not knowledgeable.

Thank you, Ex for helping me. I will keep posting.

Kassandra

 
Old 04-27-2008, 03:13 PM   #4
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Re: hi all, my brother needs pain management help!

Thanks again Ex, I went and saw him, and he is out of surgery. I was glad I was there. Last night he said no one helped him, and he overheard that there was an order to give him fentanyl and valium, but he then was admitted and was never given the med. He said he was in so much pain that he was biting down on the blanket. They gave him morphine 10 mg i.v. and toradol and it was not enough. Finally he took his methadone and between the 3 meds it helped before the surgery, and his pain was a 6. He felt it was the methadone and the other 2 together that finally made it go down to a 6. So when he was out of surgery, the dr told him he was going to send him home with hydrocodone, and my brother was so upset and scared of going home. When I got there I suggested to the nurse that we talk to the dr about pain control and the possibility of a pain management dr. Also I talked about him sleeping, and he was getting very edgy after surgery, so I mentioned something for anxiety, and they gave him ativan, and ambien for sleep tonight. Also right before I left his dr came in and we talked about pain control and getting it under control before he left tomorrow or the next day. She was going to keep him on morphine and toradol, and now dilaudad to see if it would control his pain, and then if it did they could send him home with dilaudad orally to keep the pain under control, and also morphine orally. I was so glad I was there and pushed for him, he was very relieved that his pain was getting under control, and also his anxiety and sleep. My father and sister were there too, but they let me do the talking. I guess there is one good thing about me having chronic pain myself, I can help others sometimes.

Thank you for helping me this morning, I took what you said with me, and you helped me.

Kassandra

 
Old 04-27-2008, 04:50 PM   #5
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Re: hi all, my brother needs pain management help!

Kass....Glad I was able to help. Sounds like you were a HUGE asset to your brother.

Just an fyi....The Dr on call issues the "order" for meds, and the nurses execute it. Without an "order", the nurses can't do anything...Not even Tylenol. Thus, you did the right thing by getting to the Doc. Patients often suffer because there is no order, or it's inadequate. Unless the nurses call the Doc to change, nothing can be done. Everyone is so busy in the hospital, that invariably, things fall through the cracks. I hear of examples like this all to often.

Stay on the Doc....Be strong, but professional & caring.

Good luck!

Ex

 
Old 04-27-2008, 09:48 PM   #6
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Re: hi all, my brother needs pain management help!

Kass, god bless you for being there for your brother and speaking up on his behalf. You are a good sister. What a blessing that his doctor listened to you and is going to make sure his pain control is adequate.

 
Old 04-27-2008, 11:33 PM   #7
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Re: hi all, my brother needs pain management help!

Kass: Just read through your thread. I am so sorry your brother had to endure so much pain. I was very happy to read that you were able to advocate for him and get him some relief.

I hope you are doing well. It has been a long time since we've heard from you. I want you to know you are always in my thoughts and my prayers. You are such a sweet and caring person. Keep us updated on your brother and on you too. God Bless, cmpgirl

 
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