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dianajune 11-05-2011 02:59 PM

Still needs pain relief from recent surgery
 
I thought I'd start a new thread because this is a slightly different issue from what I had previously.

About three weeks ago (Oct. 17th) I had emergency surgery for what they thought was a perforated colon. It was not, thank God. They repaired an incarcerated hernia, removed adhesions, removed my appendix and fixed something else.

The incision was not nearly as long as the one from two years ago when I had the strangulated hernia and bowel obstruction.

This past Wednesday my staples and JP drain were removed, and I finally got to the point where the Vicodin was adequate for my pain. He gave me another prescription just in case, which I had filled. It's nearly gone. I've got two pills left.

So, I skipped my morning dose and took two during mid-afternoon today. Was I in agony.....my back was bothering me and my stomach to some degree, but ever since the operation alot of the pain has been in my back. I think it's because of my stomach still being swollen from the operation. It's getting smaller, but it's still having a negative impact on my back, I think.

Now that I've taken some Vicodin (2) I feel better. I have just two left. I want to skip a dose tomorrow morning so I can drive to church. But what do I do for pain management?

I was released from the hospital on October 25th. Here I am, 10 days later, and the surgery was 8 days prior to my release. Shouldn't I be reaching the point where I don't need Vicodin any longer?

Can anyone tell me if it's normal to need prescription pain meds for at least 3 weeks or so after surgery? Could it be that I'm getting addicted to this stuff and by trying to get off of it, the pain is getting worse?

I don't know what to do. I felt better once the Vicodin kicked in, but it's harder to control pain after it has started. I'm going to see my general practioner on Monday for a checkup that was scheduled long before I got sick. I could ask her for a pain prescription, but knowing her, I doubt she will write it for me. She'll most likely tell me to ask the surgeon for it. I won't get to see him for one last checkup until this coming Wednesday.

I would appreciate anyone's suggestions as to what to do. I don't want to get addicted to this stuff, but I find that I still need prescription pain meds. I've got Tylenol here, but that just won't cut it. It never has, even for a headache. The only reason I have it on hand is in case I come down with a fever.

Help!

:(

pupcake 11-05-2011 05:08 PM

Re: Still needs pain relief from recent surgery
 
"Can anyone tell me if it's normal to need prescription pain meds for at least 3 weeks or so after surgery? Could it be that I'm getting addicted to this stuff and by trying to get off of it, the pain is getting worse?"

You are probably not getting physically addicted but perhaps mentally.


A lot of "drug seeking behavior" in chronic pain pts is the fear of running out and being in unrelieved pain. It's not that they are addicts jonesing for more meds.

When I have had abdominal surgeries (3) I have never needed all the pain medications given at discharge, let alone refills. (but that is me- I do have a "normal" pain tolerance-I can't judge your pain)

After 3 weeks perhaps you should try other forms of pain relief. Tylenol, heat, etc. That's usually what I did during recovery. I did have the safety net of narcotics left which mad it easier as I didn't have to worry about things getting out of control.

I'm not sure your surgeon would want to give more meds esp since you say your pain is more in your back now.

I hope things get better

Pup

dianajune 11-05-2011 05:49 PM

Re: Still needs pain relief from recent surgery
 
[QUOTE=pupcake;4874358]"Can anyone tell me if it's normal to need prescription pain meds for at least 3 weeks or so after surgery? Could it be that I'm getting addicted to this stuff and by trying to get off of it, the pain is getting worse?"

You are probably not getting physically addicted but perhaps mentally.


A lot of "drug seeking behavior" in chronic pain pts is the fear of running out and being in unrelieved pain. It's not that they are addicts jonesing for more meds.

When I have had abdominal surgeries (3) I have never needed all the pain medications given at discharge, let alone refills. (but that is me- I do have a "normal" pain tolerance-I can't judge your pain)

After 3 weeks perhaps you should try other forms of pain relief. Tylenol, heat, etc. That's usually what I did during recovery. I did have the safety net of narcotics left which mad it easier as I didn't have to worry about things getting out of control.

I'm not sure your surgeon would want to give more meds esp since you say your pain is more in your back now.

I hope things get better

Pup[/QUOTE]

I noticed that the pain seems worse after bowel movements. Maybe it's because I have to strain at times? I don't know. One thing I should have mentioned was that prior to surgery, they put in an epidural catheter for post-surgical pain relief. It's not far from the area where most of the pain is located. Could that have something to do with it???

Also, standing for any length of time can be unbearable, even once the vicodin's kicked in. I was in line at a local store for a long time and was in agony.

I'm going to try to lie down for awhile. If worse comes to worse, I'll make an after-hours call to my surgeon's answering service to try and get help.

Thanks!

backhurtz 11-05-2011 09:47 PM

Re: Still needs pain relief from recent surgery
 
Diana,
If I were you, I would not call the surgeon's office after hours. First, they can not call in a prescription for pain medications, other than prescription strength motrin and the like. Secondly, doing that would set off red flags.
If you really need the pain meds, you are going to have to wait until you see him I think. You don't say how many he gave you on Wednesday, but running out this soon might be a problem. I don't know how he prescribed for you to take them, or how many the maximum daily dose is, but depending on several factors, asking for more before your appointment might set off red flags in his eyes.
As for getting addicted, it is possible, but not probable at this point. The back pain may be coming from your having a bowel movement because it may be harder for you to do so with the vicoden. Constipation is a common side effect of taking pain meds, so having to push isn't the answer. Try using a stool softener instead, and adding vegetables , fruits and salads to your diet. Those will help you pass stool far more effectively with less straining.
Back

pupcake 11-06-2011 08:09 AM

Re: Still needs pain relief from recent surgery
 
[QUOTE=dianajune;4874385]I noticed that the pain seems worse after bowel movements. Maybe it's because I have to strain at times? I don't know. One thing I should have mentioned was that prior to surgery, they put in an epidural catheter for post-surgical pain relief. It's not far from the area where most of the pain is located. Could that have something to do with it???

Also, standing for any length of time can be unbearable, even once the vicodin's kicked in. I was in line at a local store for a long time and was in agony.

I'm going to try to lie down for awhile. If worse comes to worse, I'll make an after-hours call to my surgeon's answering service to try and get help.

Thanks![/QUOTE]

If you are taking the pain medication for back pain you should see your GP not the surgeon. (You had surgery on your abdomen, right?) The surgeon will treat surgical pain. You need to figure out why your back is hurting.

Also take some stool softeners if BM's hurt.

Pup

Shoreline 11-06-2011 11:36 AM

Re: Still needs pain relief from recent surgery
 
Hi DJ, I'm sure straining would certainly cause increased discomfort after a BM. However using more opiates will just cause more constipation and more straining. Like others have said if you have back pain you should talk to your doc, not your surgeon. Although the back pain may just be from being sedentary. I can imagine how bad my back would hurt after a week in a hopsital bed and 10 days of being sedentary at home, wether sitting or laying in a bed, you are going to get stiff. The more you can get up and move around the better your back will feel and it will likely will help with your BM's. When i excercise regularly I rarely have any bowel issues and when the weather changes and i stay inside or spend too much time sitting my back hurts more and my bowels dont move at their regular pace.

If you had some type of injury from the Epidural it would more than likely be a spinal fluid leak which would have presented weeks ago and causes a tremendous head ache, not back pain. This doesn't mean you couldn't have a bruise from the epi causing pain but it's not the common complaint when your epidural space is punctured, the more common problem is spinal fluid leak if your dura gets nicked. You basically get a blinding headache that cause you to toss your cookies everytime you stand up when your loosing spinal fluid.

Abdominal surgery is invasive and does cause discomfort, but the discomfort at this point should be a guide to not over do it and when it's time to slow down. Try and stay as active as comfort allows and find something that distracts you from how you feel. If you have nothing to do but think about how you feel, it's easy to become overwhelmed by even the slightest discomfort.
Good luck and I hope your feeling beter soon. Dave

dianajune 11-06-2011 01:16 PM

Re: Still needs pain relief from recent surgery
 
"Back" and "Pupcake":

I am currently taking stool softeners, in addition to citrucel tablets for extra fiber. They put me on stool softeners when I was still in the hospital. "back" - unfortunately, I ended up calling my surgeon because the back pain was excruiating last night. One reason could be due to my weight as I am heavy. Another could be due to my stomach being swollen from the operation. I know it's smaller than when I was discharged, but it could be pulling on my back, which has been acting up for years.

I spoke with a pharmacist a short time ago and she told me that the pain I'm in now could be due to my attempt to get weaned off the vicodin. She suggested a couple of alternatives - gabapentin and tramadol, only thing is re. the tramadol - it could be additive too.

I'm wondering if the epidural they gave me prior to surgery for post-operative pain could be another reason for this? Of all the operations I've had, only this particular hospital has given me epidurals.

Believe me, the last thing I want is to become an addict. I have a low tolerance for pain and may have to seek alternatives to the vicodin. I don't want to get addicted, or remain so if I already am.

dianajune 11-06-2011 01:24 PM

Re: Still needs pain relief from recent surgery
 
[QUOTE=Shoreline;4874769]Hi DJ, I'm sure straining would certainly cause increased discomfort after a BM. However using more opiates will just cause more constipation and more straining. Like others have said if you have back pain you should talk to your doc, not your surgeon. Although the back pain may just be from being sedentary. I can imagine how bad my back would hurt after a week in a hopsital bed and 10 days of being sedentary at home, wether sitting or laying in a bed, you are going to get stiff. The more you can get up and move around the better your back will feel and it will likely will help with your BM's. When i excercise regularly I rarely have any bowel issues and when the weather changes and i stay inside or spend too much time sitting my back hurts more and my bowels dont move at their regular pace.

If you had some type of injury from the Epidural it would more than likely be a spinal fluid leak which would have presented weeks ago and causes a tremendous head ache, not back pain. This doesn't mean you couldn't have a bruise from the epi causing pain but it's not the common complaint when your epidural space is punctured, the more common problem is spinal fluid leak if your dura gets nicked. You basically get a blinding headache that cause you to toss your cookies everytime you stand up when your loosing spinal fluid.

Abdominal surgery is invasive and does cause discomfort, but the discomfort at this point should be a guide to not over do it and when it's time to slow down. Try and stay as active as comfort allows and find something that distracts you from how you feel. If you have nothing to do but think about how you feel, it's easy to become overwhelmed by even the slightest discomfort.
Good luck and I hope your feeling beter soon. Dave[/QUOTE]

Being laid up in a hospital bed didn't help my back as the place where the bottom and top parts met hurt my tailbone. I had to keep switching positions and added extra pillows. I was glad to get home to my own bed, which is much more comfortable.

The surgeon told me that I might have overdone it the other day when I was in the store. I stood in line forever and my back was killing me. Figures - I only had a couple of items and the lady ahead of me had a cart full! :)

I will try to stay as active as possible, and as I indicated in my other post, will try to find an alternatives to vicodin. I must get off that stuff asap. Maybe a heating pad will help too, and like you said, I need to think about something other than this pain. Music is a good distraction, and so are other things like movies and shows I enjoy on tv.

Thanks to all for writing!

pupcake 11-06-2011 01:49 PM

Re: Still needs pain relief from recent surgery
 
I was 300# with my c-section so I do know how you feel.

One thing I would suggest is an abdominal support garment, (girdle)it will help your body hold your tummy together instead of your back muscles. They have them at a good price at Wal-mart up to size 4x. It would make getting around much easier.

What does your surgeon think the back pain is from?

Pup

dianajune 11-06-2011 07:41 PM

Re: Still needs pain relief from recent surgery
 
[QUOTE=pupcake;4874837]I was 300# with my c-section so I do know how you feel.

One thing I would suggest is an abdominal support garment, (girdle)it will help your body hold your tummy together instead of your back muscles. They have them at a good price at Wal-mart up to size 4x. It would make getting around much easier.

What does your surgeon think the back pain is from?

Pup[/QUOTE]

I'm over that. But at my heaviest (and this is just a guess because at the time - over 20 years ago- scales didn't go that high) I was probably over 450. I'm nowhere near that now, but when I was told of my 30-pound weight gain just during my hospital stay I nearly flipped my lid!

I might be going to Wally World tomorrow and will look for that garment. Maybe it will help with my back. We talked about my pain and he thinks it could be due to the excess weight from the surgery. It makes sense anyway....whatever is weighing down my gut would have an impact on my back, which has been acting up for years anyway.

Please pray for me. Tomorrow I'll see my general practitioner and will be weighed in again. I hope that I dropped at least another 5-10 pounds since the last time I got weighed. My diet is improving and I am trying. The swelling in my stomach has gone down, but some of it's still there.

I'm doing a little better this evening as I took my remaining vicodin. Tomorrow will be interesting!

pupcake 11-07-2011 04:45 AM

Re: Still needs pain relief from recent surgery
 
I always said my back hurt from carrying around my front :-) (o)(o)

Good luck

Pup

dianajune 11-07-2011 07:53 PM

Re: Still needs pain relief from recent surgery
 
[QUOTE=pupcake;4875180]I always said my back hurt from carrying around my front :-) (o)(o)

Good luck

Pup[/QUOTE]

I think I'm going to have to go off-topic on my own post. Today I saw my primary care provider, who prescribed more pain medication - much to my surprise. She also gave clear instructions as to how to taper it off, which was good.

This was a routine visit that was scheduled months before this emergency surgery, and I had bloodwork done last week, as usual. This is also routine for them to do.

My thyroid is running low again, so my levothyroxine was increased. My vitamin d is low. But what really gets me is that she said my kidney levels were slightly abnormal, most likely because of the surgery. She said she looked at my hospital records and found that my kidney levels kept fluctuating slightly during my hospitalization.

My surgeon never told me this and I am at a loss as to why. Maybe this is a normal reaction after major surgery? I lost track of how many operations I've had and this is the first time it's happened to me.

I know nothing about kidney function tests. I think this may have come from the comprehensive metabolic panel she ran (CMP).

Should I be worried? I'm already freaking out. She said I shouldn't be alarmed by this and it is most likely due to my kidneys working harder because of the excess fluid I accumulated after the operation.

I gained nearly 30 pounds during the 8-day stay at the hospital. From the time I was discharged until last week when I had the blood drawn, I lost 15 pounds. I lost another 12 pounds as of today. I have two more to go and I'll be back to my pre-operative weight, which will be good.

So let me ask this:

Should I be in panic mode?

What should I do?

I'm climbing the walls and could really use the new anxiety medicine (klonopin) that she prescribed, but I am concerned about a possible interaction with the vicodin. The pharmacist said it should be ok, but I never took them both before.

Thoughts, anyone? I am very scared and unable to function.

jonnstar 11-07-2011 10:22 PM

Re: Still needs pain relief from recent surgery
 
When you're done with the Rx pain pills, you could try the trick of taking 2 Advil and 2 Tylenol at the same time - they work on pain in defferent ways, so the effect is adetive, and this aproach can be suprisingly effective.

Taking Klonopin and Vicodin wouldn likely be dabgerous, b ut it could make you quite drowsy, so dont do anything like driving or cooking with pot of boiling water etc until you find out how if affects your coordination and reactions.

Taking a supplement of zinc (50mg) and vitamin c (500mg) can help speed up the healing process, might help you feel better more quickly.


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