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Old 05-16-2012, 05:04 PM   #1
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Hello this is my first post!

I'm scheduled to have a two level ACDF (possibly three) June 25th. I have been dealing with the excruciating pain from this mess since October. I'm pretty sure I hurt my neck the year before when I passed out cold from low potassium. If you take a diuretic for blood pressure or any other reason please make sure you get your labs done regularly!!! I was on one for three months and then started a supplement for slightly low potassium and within a couple of months on the supplement it dropped to below 2.8. Anyways, on the way down a wall was kind enough to slow my fall, but I woke up on the floor with my head scrunched up against it and the floor. What a fun memory that is! (ha ha) I have been on different meds including the fentanyln patch. I'm now on Opana ER (generic) with Percocet 10/325 for breakthru. The Opana lasts about 10 hours for me, so I have started taking the Percocet at scheduled times instead of as needed. It doesn't seem to last either. I almost need a breakthru med for my breakthru med. Does anyone else feel this way? I have rescheduled my pm appt from next Thursday to tomorrow. I don't think I can even make it to Monday with the Percocet I have left. This happened to me last month too. Does anyone have any suggestions about a different breakthru med that would work better or last longer? I'm not interested in changing my long acting med again. Would increasing the Opana make it last longer? My doc said I can't take it more often than 12 hours like I could some other meds. We are getting ready to move and my pain is going to go through the roof! I am so ready for surgery at this point!! I have been waiting for my son to get out of school for the summer and for the move to a bigger home to do the surgery. It feels like my life has been on hold! I hope this post is not terrible! I wanted to give some background and will try to be shorter in the future! Hugs to everyone dealing with pain on a daily basis.
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ACDF 2/3 level sched. June 25th!!(prob from passing out/fall from low potassium (2.8)~Facet Joint Arthritis~ Meniscectomy left knee x 2 ~Fibromyalgia~Shingles 04/2012 thanks to stress no doubt!

 
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Old 05-16-2012, 08:45 PM   #2
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Re: Hello this is my first post!

Hi, welcome, nice of that wall huh, sounds like not so much.

You never want to be in a situation where your relying on your breakthru meds as part of your scheduled maintenance pain care, it's not what they're for and not what they do. If your pain is that out of control, you need to talk to your dr. about increasing your Opana dosage. Rule of thumb when your doing the LA/BT combo is, control the pain with the LA meds, use the BT meds sparingly when needed for flares.

About the only thing that might be stronger that Percocet for BT pain is Dilaudid, it's a toss-up. Some folks also get better relief with straight Oxycodone instead of Percocet, I always have myself. With the straight Oxy, it would be 10 mg. pills. But as far as strength your pretty much at about the "premium" BT med. Your Dr. is most likely not going to increase your Percocet monthly amount, so you can't count on increasing it to control your pain.

The other issue you've got to deal with is that in a month you've got to deal with post op pain, if your maxed out on BT meds and LA meds now, that will be a nightmare, and I'm not trying to scare you here. You need to get with your Doc and get this worked out soon, so that your system can get adjusted and have plenty of time before surgery.

Right now you kind of seem to be in a "flip-flop" situation with the meds, you just need to "flop" back around and get to relying on your LA meds again and not your BT meds. You don't say how much Opana you take, but if there's room to increase your dose, that would make more sense then trying to control the situation with more or different BT meds.

Take care,

Kat

 
Old 05-16-2012, 09:05 PM   #3
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Re: Hello this is my first post!

Thank you Katlin09 for the reply! I think that you made some really good points. I think my doc has also told me some of this, but maybe not in a way that made sense to me. I am on 7.5mg of Opana. Not sure why I left that out, but definitely room to increase. I know that my pain doc is also concerned about post op pain. My neuro says that he will take care of me, but I am petrified of waking up in a world of hurt!!! Hmmm, I guess I will see what happens tomorrow. I just dread packing and unpacking with the neck/arm/shoulder pain. Oh I also take Cymbalta for my nerve symptoms. I would go completely insane without that one! Thanks again for the response. I guess if the Opana didn't wear off I could use the breakthru med sparingly. The Fentanyln patch wore off after a day and a half. I spent more time trying to catch up with the pain on it. I guess I should thank that wall, but it could have given me a little more room to spread out while I was laying there! lol Laugh or cry right!!!
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ACDF 2/3 level sched. June 25th!!(prob from passing out/fall from low potassium (2.8)~Facet Joint Arthritis~ Meniscectomy left knee x 2 ~Fibromyalgia~Shingles 04/2012 thanks to stress no doubt!

 
Old 05-16-2012, 09:39 PM   #4
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Re: Hello this is my first post!

That darn sheetrock just doesn't have the elasticity it should! You are on a pretty low dose of Opana, got tons of room to grow. I would definitely focus on getting your LA meds working at better managing your pain and decreasing the BT meds as much as possible.

Nerve pain also causes the extra fun of not always responding the best to narcotics. Hopefully your surgery will be a success and you can get some relief and get on with your life! As for the surgery, generally what they do is put you on a Narcotic "Holiday" where they significantly decrease or stop your narcotics 3 weeks to a month before surgery, but your already in that window and your Dr.'s chose not to do that. Your not on a large dose, so that will work in your favor. Try to get your BT meds down as much as you possibly can between now and your surgery....it will mean dealing with some extra pain, but in the end you'll be glad you did it. I'm not sure if it's an option with your surgery, but with some nerve block anesthesia's they will inject morphine directly into your spinal cord which offers extended pain relief post op, it saved me more than once on various operations. You might ask your Neuro what his Operation Anesthesia and Post Op pain control plans are in detail and see if you have options, its perfectly within your right and reasonable to discuss this with him prior to surgery.

Be careful with that move...hopefully you have plenty of musclemen to do all the muscle work!

Kat

 
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Old 05-17-2012, 01:14 AM   #5
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Re: Hello this is my first post!

I should have checked the cushion on the sheet rock in the new house! Hopefully I won't find out the hard way. I will see if my doc will help me control my pain during the move. I have tried to taper down on my Cymbalta more than once to see how bad my symptoms are without it. I can't go two days! lol It drives me absolutely nuts having those strange feelings. I do want a true idea of the before and after and will try to taper off right before surgery though. Nerves are pesky little things when they are not happy! I just had a small case of Shingles and that was fun too. Lidoderm patches were a blessing for that. I didn't think I could get that until I was older, but that just shows how bad stress really is for our bodies.
I had read about stopping meds before surgery. Maybe since my dose is still low it isn't necessary?? I will definitely try to cut out the breakthru meds like you suggested. Once we get moved and i dont need to take my son to school it will be easier to do.
The anisticiest (?) will call before the surgery and can make me nice and comfy immediately after surgery. I will let him know my concerns and maybe send him/her flowers??? ha ha couldn't hurt! My neuro is such a nice laid back guy and I feel very comfortable with him. He is very different than what I pictured as a "brain surgeon" and he knows about struggle with the pain. Im having my surgery at a specialty hospital and the nurses will be very experienced with ACDF post op. That makes me feel better too! Oh gee I'm getting myself worked up thinking about this! Sigh, I am so ready though and I wouldnt put it off any longer even if I could. My neuro would hunt me down if I did.
I used to think that when a person had pain they took pain medicine and it went away. It always worked after my surgeries before. I had no idea that it could be this hard. It has been hard on my family too. I am so thankful to be over the worst of it.
Thanks again for the response! Your info has helped me tremendously. I hope you are well and feeling good. Thanks for letting me ramble away also. :-)
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ACDF 2/3 level sched. June 25th!!(prob from passing out/fall from low potassium (2.8)~Facet Joint Arthritis~ Meniscectomy left knee x 2 ~Fibromyalgia~Shingles 04/2012 thanks to stress no doubt!

 
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acdf surgery, breakthrough pain, opana er



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