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  • After fusion, how long before ending narcotics?

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    Old 05-21-2009, 06:06 AM   #1
    brendaks1
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    After fusion, how long before ending narcotics?

    I am having an L4-L5 PLIF fusion in 1-1/2 weeks. I just got a bunch of paperwork from my surgeon, and it says his policy is to have patients off all narcotics at 6 weeks post op. This seems really early to me and has me nervous!

    I had a failed decompression surgery of the same level last August and have been on a low dose of narcotics (Oxycontin & Percoset) ever since as those seem to be the only pain meds that even remotely help with my pain. I also take Neurontin.

    Is it realistic that I could be off narcotics 6 weeks post op since I have been taking them so long?

     
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    Old 05-21-2009, 06:46 AM   #2
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    Re: After fusion, how long before ending narcotics?

    Hi Brenda - I think that 6-weeks post surgery is probably the time you should look at lowering the amount of narcotics you are taking if the pain is strictly the result of the surgery. Has the surgeon given you any hope that after this upcoming fusion you may be out of pain? In my experience (I've had 12 spinal surgeries, many fusions included) I'm usually ready to reduce back to my original pain medication requirements. I'm a chronic pain patient and I take methadone and oxycodone for breakthrough pain. I know that sounds like an awful lot of medicine just to reach a 5 on the pain scale, but it is what it is, right? One hopeful thought.....each time I've required a fusion due to a broken vertabrae or collapsed fusions, the corrective surgery has fixed the problem and I'm relatively pain free at the site that was causing the pain. So...I would think positive and believe l might be ready for the change at 6 weeks. When you are no longer under the care of your surgeon, will you be under the care of a pain specialist or do you already have a p specialist? All the best to you!! I'm having a lapband surgery 1 week from today and I'm more nervous about two or three tiny incision on my belly than I am about a l5-s1 fusion that I will undergo on June 19th! BrittleBones

     
    Old 05-21-2009, 07:10 AM   #3
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    Re: After fusion, how long before ending narcotics?

    Wow Brittle Bones, Good for you! I am waiting for my forth fusion- you have a great attitude!, I agree whole heartedly with your six weeks. I think if I remember right it is in time with your post op visit with the specialist. If you can manage to go off of the hard stuff sooner then do it. It is much better for your tummy but don't be hard on yourself whatever happens. The first couple of weeks is the time to 'baby' your nerves and let your self heal. I am not a dr but I believe that is how chronic pain developes- you try to tough it out and your nerves remember the pain even though the area is healed. I am not sure if the jury has come in on that but that is what I think, good luck! btw I have chronic pain, I fell and ripped my fusions 6 months after surgery, something like spraining an ankle.

     
    Old 05-26-2009, 04:47 PM   #4
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    Re: After fusion, how long before ending narcotics?

    [QUOTE=brendaks1;3990591]I am having an L4-L5 PLIF fusion in 1-1/2 weeks. I just got a bunch of paperwork from my surgeon, and it says his policy is to have patients off all narcotics at 6 weeks post op. This seems really early to me and has me nervous!

    I had a failed decompression surgery of the same level last August and have been on a low dose of narcotics (Oxycontin & Percoset) ever since as those seem to be the only pain meds that even remotely help with my pain. I also take Neurontin.

    Is it realistic that I could be off narcotics 6 weeks post op since I have been taking them so long?[/QUOTE]

    If this is his "policy" and not a goal I would find another doctor. I have had 4 fusions, my time on painkillers afterward has ranged from 8 weeks to 20. Controlling your pain is a very important part of healing. It allows you to get up and move much more. The consideration to stop narcotics should not be a time line but your comfort level. I had one doctor that kept me absolutely miserable for 3 months before I found a pain management doctor.

     
    Old 05-26-2009, 05:46 PM   #5
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    Re: After fusion, how long before ending narcotics?

    Everyone's different. You may find that you really CAN be off them at 6 weeks. There have been some people here who have been off everything even sooner than that. It may also be your doctor's way of encouraging you to start thinking about being off them. I'd want to know if he makes exceptions if you're still in a lot of pain, or if it's a hard and fast policy. Like rainiermed1 said, if he doesn't want to prescribe them after that point, you can start with a pain management doctor if you still need them.

    Hang in there! Your day will be here before you know it, and then, hopefully, you'll have a great decrease in your pain. Then it's rest and walk and work at recovering.

    If you have other questions we can help with, post away!
    Emily

    Last edited by BlueAtlas; 05-26-2009 at 05:48 PM.

     
    Old 05-26-2009, 08:58 PM   #6
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    Re: After fusion, how long before ending narcotics?

    Thanks so much for your responses. I guess I have been in pain for so long that it has become a way of life for me. This surgery holds the promise of giving me back a fairly normal life which I am very excited for, yet I realize that it means a complete shift in how I have been living my life.

    It's really hard to get in the mindset that I (hopefully) won't be in severe pain anymore, so the thought of taking away my pain meds really freaks me out! Has anyone else felt this way before having surgery?

     
    Old 05-26-2009, 10:31 PM   #7
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    Re: After fusion, how long before ending narcotics?

    Hi, just imo, keep busy- take your meds when you need them. I've heard that if you don't need them you will soon forget to take them so from that I am guessing if you have a real need you do not have to worry, Good luck and take care.

     
    Old 05-26-2009, 10:45 PM   #8
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    Re: After fusion, how long before ending narcotics?

    If you are not able to get off the narcotics in time then it will be advantageous to get in contact with your pain management physician at that time. Some surgeons don't want to prescribe beyond that point but if you have any type of chronic or residual pain you may be able to handle that through pain management.
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    Old 05-27-2009, 05:43 AM   #9
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    Re: After fusion, how long before ending narcotics?

    Hi-

    I am 7 weeks post op L5-S1 fusion. My surgeon has the same policy of being off them at 6 weeks. I am still in a lot of pain and was able to squeeze a little more time out of him, but I am about to run out and I am terrified. I have still been on oxycodone (percocet), so I have asked if I can continue with something less potent like vicodin or even tylenol 3. I just asked yesterday and haven't heard back. Part of the problem is that we are not allowed to take any ibuprofen or anti inflammatories, so that leaves extra strength tylenol which just really doesn't cut it, for me anyway.

    Good luck with your surgery and hopefully you wont need them after 6 weeks!

     
    Old 05-27-2009, 06:54 PM   #10
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    Re: After fusion, how long before ending narcotics?

    Megs....

    I forgot that the inability to take anti-inflammatories would be an issue as well. Have you ever tried Tramadol? It's one that worked for me post-fusion. But I'll admit during my entire 6 month post surgical period there were times I needed the vicodin.
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    Rt thumb fusion '13. R&L thumb arthroplasty '12 ; RT TKR & Bilat CTS' 11. Fusions: L5-S1('87), L4-S1('93), C5-C7('06), L3-S1('10), C4-C5('13). C5-C7 foraminotomy '08

     
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