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    Old 10-18-2006, 08:30 AM   #1
    Join Date: Aug 2006
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    lala1022 HB User
    TLIF spinal fusion MEDS....

    Hello all, I am 5weeks post op from TLIF surgery L5-S1. I still have alot of incision pain and pain to the right and left of where my scar is. I also get a shooting pain down my right leg sometimes(maybe scar tissue hiting a nerve)
    I take 3X300mg neurotin, 3 5mg valium for spasms, and 5mg percocets which i take anywhere from 40mg up to 55mga day depending on the pain level.
    As we know some days are good others not so good.!! Also I am getting a bone growth stimulator Friday!!!

    I need the medication and am I know I need the pain meds, is this normal amount or am I taking to much or to little? I go some exytra hours to keep my dosage down, but I am hurting. PLease respond with your info......

    thanks guys and gals

    Last edited by lala1022; 10-18-2006 at 08:31 AM.

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    Old 10-18-2006, 01:27 PM   #2
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    Re: TLIF spinal fusion MEDS....

    I would say your dose is pretty low considering your pain levels they make percocet in a 5 mg. a 15mg and a 30 mg.. I take 80 mgs of Oxycontin a day plus 20-30 mgs a day of percocet for BT pain which I don't need every day, I had surgery a few years ago and have a herniated disc that is VERY painful.

    A lot of people take a much higer dose than what we are on, on the oxycodone so I wouldn't say your dose is very high at all.

    I was wondering why your Dr doesn't have you on Longer acting meds, your having to take up to 12 percocets a day when you could be taking (2) oxycontins a day for the same effect....

    Old 10-18-2006, 08:03 PM   #3
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    Re: TLIF spinal fusion MEDS....

    Percosets come in 5, 7.5, and 10 mg of Oxycodone. Roxicodone (or generic Oxy) comes in 5, 15, and 30 mg. Going the Roxi route would be best if you're staying on SA drugs because they don't have Tylenol in them. That is the part you need to be careful about.

    Oxycontin would be the best bet, if you can get your doctor to go for it. They're suppose to last for 12 hours, but most people (and docs) are finding they don't last that long. Most people, I think are on TID dosing.

    Old 10-19-2006, 06:42 AM   #4
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    Re: TLIF spinal fusion MEDS....

    Hi LALA, 6 weeks post op isn't alot of time, I know there is always that fear of a doc cutting you off and the stress that goes with making that call for a refill, But now isn't the time to be thinking about increasing your dose.

    If you have more pain now than you had when you first came home you should follow up with your doc, you may have an infection if you're having more pain now than 4 weeks ago. People do have back surgery and move on with their life and don't need to be dependent on opiates for the rest of their life. If this was first time surgery, the odds are greatly in your favor that the surgery will be a success. I wouldn't start planing a lifetime of pain management when the goal of surgery was to relieve your pain and allow you to move on with life.The foks you meet here are the 10-20 % that surgery didn't helpp, lets hoep you are one of the 80% that willnever need to see a PM doc or look for answer for CP on the net.

    You're going to have pain, stifness and spasm for weeks if not months after a fusion, but this is acute pain, not chronic pain. Increasing your dose is a bad idea unless you plan on remaining on meds for a long time or you think just because there is a styonger med available , why experience any pain. At this point, pain is your guide not to push to hard so you don't tear apart the work that has been done. The idea of post op pain control is to make the pain tolerable, not obliterate it so you can carry on with your normal activity and end up under the knife again because you didn't give yourswelf time to heal.

    There is no reason to think this pain won't continue to diminish at this point, it's perfectly normal for post fusion pain. Just because they make stronger meds, doesn't mean you need to be doped out of you mind at this point. You should really be at the point where your starting to walk and rebuild some of the strength you lose doiong the first few weeks when you realy don't move. Strength and endurance go very quickly when flat on youir back. You managed to get through the worst of post op pain with these meds, are you saying they aren't working or is it normal to still have pain. It is normal and you will likely have more pain once you really start PT. But uyou need that pain to guide you as far as how hard to push.

    Acute pain is treated very differently than chronic pain where you see high doses needed due to tolerance and years of exposure to oxycodone. 6 weeks isn't long enough to become tolerant or determine if the surgery faile dor was a sucess. If you have started walking, use common sense, don't start at 2 miles, be reasonable, shoot for the mailbox, then one block down the street, then 2 and always keep in mind you need enough strength to get back home. It's perfectly normal to have increased pain after you excercise this soon after surgery, that's why the doc is still prescribing. To ask for something stronger at this point may end up with the complete opposite results and you could end up with nothing.

    LA meds are not recomended for post op pain because the goal of surgery is to get you off meds at some point. They don't normally stop Oxy cold turkey after surgery. More than likely they will step down to 10 or 7.5 hydro products like Vicodin ES/lortab or Norco. For decades prior to the invention of oxyContin and 30 mg Roxicodone, the standard post ortho surgery pain med was 5 mg percs and it worked for those that haven't been exposed to high dose meds or high dose long acting meds for months or years.

    Although longer acting or stronger meds may sound good as far as sleeping through the night or more pain relief, The more you take, the more difficult to discontinue and taper off. Even if a doc was willing to use LA meds at this point, it's a bad idea and against the manufacturer recomendations. Scar management massage, the feel good PT can all help with muscular pain from the incision. As far as residual post op pain, time and PT will take care of that as long as you do your part.

    50 -60 mgs a day isn't outragous at this point but you never know what your docs schedule is as far as continuing to presribe pain meds, asking for an increase or stronger meds at the point he thinks you should be needing less is a really bad idea. At 6 weeks post op there isn't a single test to verify if the fusion is a success or not and the pain you describe is perfectly normal. An Xray would show if hardware has slipped, but it sounds more like you're just concerned about your present amount of meds and it's the standard dose for most pot op surgery. If you weren't on percs for years prior to surgery, you shouldn't even have a tolerance issue to worry about.

    I would think you came home taking 2 percs every 3-4 hours, you have cut back from that so it sounds like your right on track. It's just time to get moving and the pain will be your guide as far as how far to walk and when to slow it down. You could take enough meds that you could go and walk 3 miles, but you would pay for it dearly. That's when too much pain medication is more likely to cause harm than do any help.

    Come on guys, this person is 6 weeks post op, not a CP patient suffering without help. Longer acting meds and stronger meds aren't the answer for everyone. Particularly when they haven't said their present meds aren't working.

    If your asking is this normal to still have pain 6 weeks post op. Absolutely, I've had 3 fusions , the last was L1-S1 and surgeons can cut meds off any time they like. One did it at 4 weeks, one did it at 3 months, and the last one did it at 6 months.

    Good luck and it's way to soon to think your surgery has failed.

    Old 10-19-2006, 07:54 AM   #5
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    lala1022 HB User
    Re: TLIF spinal fusion MEDS....

    Shoreline may I first say TY for that great post, you truly are a great person for taking the time to write to me in my time of need. Here is my story in a quick rundown:facet shots , radiodenervation shots, cortisone, trigger pointshots ,PT, I have a torn and bulging l5-s1 disc(injured at work with an inmate), bone scan, positive Discogram, and a Failed IDET with nucleoplasty on 8/05. I have been on Percocets 5mg for a year then 7.5mg 4x a day pre surgery.
    I am almost 6 wks post op and tomorrow I get a bone growth stimulator. I now get a shooting pain down my right leg which seems every 3 days. I know I need more meds, but I try to tough it out bc I do not want to pop pills every 5 minutes. I also take 5mg valium 3x a day and 300mg neurotin 3x a day, I take on average 12-15 pills a day. All I can do is short walks which look like I am constipated bc I am hurting with baby steps.
    I have a 5wk old son who I havent even picked up post op, and it sucks. I just hope that this surgery helped.
    Thanks again for your reply Dave, TY

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