Having surgery tomorrow to remove instrumentation from my neck at four levels - the rods, plates, & screws. Surgeon only uses the pain pump for pain control. I asked for the same amount of medication but in pill or injection form instead so that I won't have to wake up every 10-15 minutes to press the stupid button. I've had tons of surgeries before and know that sleep is the best way to get through the pain and that I don't get sleep if I have to press the stupid button all the time. Surgeon said NO! He only does the pump. He suggested I call my PM (but he knows that he doesn't have privileges at the hospital that the surgeon owns and can't take over the pain mgt. But I call the PM anyway and all he does it tell me what I already know -that he can't do that because he doesn't have privileges at that hospital. Duh! Knew that already. I'm afraid now and want to cancell the surgery. Please advise!!!!!!!!!!!!!!!
Okay, take a breath, calm down a little and tell us what your wanting help with here. Are you concerned about post op pain while your recovering the hospital or post op pain when you get home?
In the hospital you should be on an IV for pain meds, that's usually the standard of care, is that what your talking about when you refer to having to "push the stupid button"? For whatever reason, whether it's lack of nursing time, or concern over lack of pain control, they don't give you pills post op. Pills also tend to upset your stomach causing nausea and vomiting, which they definitely don't want you doing post-op. What you can do is ask for something to help you sleep at night, that's not an unreasonable request, and usually the Dr. writes a standing order for a sleep med. You'll see your doc in the morning before surgery you could mention it then.
Bottom line, if you don't feel ready to have this surgery, if your truly scared that your pain will not be controlled, then don't do it until you have more time to make different arrangements, perhaps a second opinion with a different surgeon? Going into a surgery with extreme fear and stress can cause blood pressure issues which you know are not good. You have to do what's best for you, not whats best for the surgeon.
I'm afraid of the post op pain. Been there before. First 24 hours are excrutiating. My incision will be at least 6 inches long and they have to cut through muscle. Whether it is oral or IV or IM is not my issue - it is the fact that this surgeon puts his patients on a pain pump (IV) with it programmed for "on demand". In other words, you have to press the button in order to get pain medication. That means you don't get sleep because you have to either be pushing the button every 15" or be in absolute pain!. Either way, you can't sleep.
Yeah, he put you on a PCA, and actually that's pretty standard among surgeons. They figure it's better for you to have to the pain meds when you need it as opposed to having it in your system constantly. I know, not the smartest idea in the world. I've had 30 plus surgeries over the last 23 years...this is definitely newer thinking. Back in the day they used to just give you nice continuous drugs through that IV. For the 25 or 26 surgeries I've had in the last 13 years most of been post op pain controlled with a PCA if it's inpatient surgery.
You only have a few options here:
1. Get a different surgeon and hope that he'll be a little more "old school" in his post op pain control methods.
2. Ask your Dr. if he'll add a bolus pain med to be given on top of the PCA every so many hours.
3. Ask for sedation at night so you can sleep through the pain.
If it were a normal hospital you could try going over his head because the pain wasn't being controlled adequately and you weren't able to sleep. Hospitals really don't like post-op patients to be up all night not sleeping. But since he owns the hospital, doesn't sound like that would be an option.
I'm sorry I couldn't be of more help, I do know exactly how you feel and it sucks big time, your Dr. should be more concerned for your welfare than this, he shouldn't be putting you through this kind of stress right before surgery. I don't know, if it were me, I think I'd be looking for a new surgeon, provided this isn't a one of a kind surgery that only he can do.
Thanks Kat for both the suggestions and the prayers. I'm pretty much locked into him so its suck-it-up time, I guess, for me. I will beg him for a bolus schedule & thanks all for letting me vent -it helps -although I'm still scared spitless - he's going over a previous scar so I know how much it will hurt from experience.