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    Old 06-04-2007, 08:01 PM   #1
    onyxgates
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    approaching your doctors regarding pain management?

    Please tell me how you approached your doctors regarding pain management. I am currently on 50 Fentanyl and am facing a craniotomy for my aneurysm. I am able to wear my patch up to my surgury but will have it off for a couple of days. I spoke to my surgeon today and he mentioned that they will put me on diluded or morphine post surgery (never had before) and then Norco when they switch me to oral meds. Hello...Norco??? I hope he means on top of the pain patch because I will be for sure going through withdrawals.

    Would it be worth it to to go through this with my pain managment doctor and have a written plan that my doctor can provide to the nursing/doctor staff after I am out of surgery.

    With all that can go wrong with this surgery, I can't believe I am worried about this aspect. It's a testament to the state of the hospital staff and pain managment. Pathetic. I am having this down at Evanston in Chicago. They do have a pain managment group (which I have not seen) within the hospital. So hopefully they will better informed.

    Last edited by HBMod07; 06-05-2007 at 02:06 PM. Reason: Please do not direct posts to specfic members as per the Posting Rules at the top of the board. Thank you

     
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    Old 06-05-2007, 02:42 PM   #2
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    Re: approaching your doctors regarding pain management?

    Onyx-
    I would deffinately make sure that your PM doctor & your surgeon have some kind of SOLID agreement as to your pain management post op. It may not be fun getting this put together, and may require you to be the one doing all the work to make sure you will be covered, but it will be worth it in the long run.

    I would suggest maybe a conference call between you and them so that you are totally in the "loop" as to how your pain will be taken care of after surgery. I also don't think you are asking too much to have the plan in writing either. This way, you might be able to at least not have to worry about that aspect of surgery. I know it's already a lot to deal with knowing you are having surgery, so having one less thing to worry about can only serve to help you be a bit more "at ease". You need to be able to rest before the surgery and also keep your stress levels as minimal as possible.

    I wish you the very best with your surgery. I'll be sending thoughts for a successful surgery and a speedy and "pain free" recovery.

    Hugs...

     
    Old 06-05-2007, 05:40 PM   #3
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    Re: approaching your doctors regarding pain management?

    Good luck Bro!

     
    Old 06-06-2007, 11:10 AM   #4
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    Re: approaching your doctors regarding pain management?

    Onyx,

    I am sorry it took me so long to get back on the board! The anesthiesiologist is in charge of your pain control in the hospital. I spoke with mine beforehard (very important) and told them my fears and past experiences. On the day of surgery, he already knew the plan. I have no idea why they would want you to go off the patch during your recovery in the hospital. You should always stay on your cp pain meds, with other meds in addition for acute pain. My surgery day one, I didn't take my cp meds. But first thing the next morning, they gave me my long-acting med around the clock after that.

    I am nearly two weeks post-op, and I am still having to take additonal doses of meds for acute pain, on top of my chronic pain meds. A good anesthiesiologist will tell you that it is THEIR job to treat your pain and make sure you do not suffer from withdrawal. After that, it is your surgeon's job. I asked my surgeon beforehand how he would handle this. He stated that he would consult my pain doc if needed, and also the anesthiesiologist when I left the hospital.

    I had some hard times, but overall, I think most tried very hard to deal with my complex issues. Get these things sorted out BEFOREHAND!!! Make sure your pain doc will be available if the surgeon isn't cutting it!

    Amanda

     
    Old 06-06-2007, 01:01 PM   #5
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    Re: approaching your doctors regarding pain management?

    When I had surgery last year my surgeon, knowing I am a chronic pain patient, asked who I would like to be in charge of my post op pain. We decided that it would be easiest to have my primary doc take care fo my pain since she knows me the best. It worked out great. I hope you have good pain control after your surgery.

    I also understand (as much as someone not actually having the surgery can) your anxiety(from your other post). My sis-in-law had an avm removed from her brain stem in March. She came through with flying colors. Right after this my mother died. And in the midst of this I had finals....(I'm sorry to say that I flunked out). For two weeks I felt as if I couldn't breathe. I would just stand in the middle of my living room and not know what to do. At the same time I was physically doing nothing my mind was going 2,000 miles an hour and I thought it was going to explode.
    My doc gave me some alprazolam(xanax) .5mg and after two days of taking them I felt like I could gather myself enough to have a rational thought. This thought was....'I'm not going to go completely insane. Things are happening to me that are not under my control and freaking out is not really helping me.'

    Talk to your doc. Maybe an anti-anxiety med is what you need to get you to your surgery date in one piece. Marcia(Feelbad) has had an avm(hope I'm right) removed from her back and one from her brain. I hope she will chime in and try to help ease your fears. No one wants to go under the knife and a craniotomy is not at the top of my to do list.

    Good luck and please, please let us know how you are doing as your surgery approaches and after. Take care~Mush
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    Old 06-06-2007, 02:47 PM   #6
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    Re: approaching your doctors regarding pain management?

    Thanks for the reply. One last question. Who would you ask? Surgeon, pain mgmt or Primary Care? Thanks again!

     
    Old 06-07-2007, 07:01 AM   #7
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    Re: approaching your doctors regarding pain management?

    Mush is right. I don't take anything for anxiety or depression, but after all I have been through with nightmarish treatment and pain after surgery, I was having ALOT of anxiety. I finally called my primary doc (who knows me well, and knows about the bad experiences I've had), and he called in a script for Klonopin within the hour. I took it sparingly before the surgery, and listed it as one of my meds, due to thinking it would effect the anesthiesia.

    This actually worked great for me, because the surgeon ordered it as one of my meds in the hospital. When I had a really bad episode with pain after surgery, the nurse (wonderful lady) brought not only extra pain medicine, but a Klonopin as well. The combination worked great for the pain and calmed me down enough to let the pain meds work. (It was so bad I was crying and distraught). So even though I fought it, which is silly, I am so glad I called my doc and told him about the anxiety. (It got so bad that I couldn't sleep at night, just layed awake thinking of the surgery). Not only did it help me before, but it helped me after. As you know, anxiety and stress make pain worse, and harder to control. Call your doctor today!

    Also, speak with the anesthiesiologist and the surgeon about your anxiety. Ask that they order your anxiety med PRN, or as needed. Also, I found out that a great med in the hospital is Benadryl. They gave me this once for itching, and turns out my surgeon also had it written for bedtime if I couldn't sleep. I thought it would not help much, but given through the IV, it is very effective at helping you relax and get a few hours of good rest. My nurse gave me the inside tip. She said that most docs only write that you can have one dose for sleep, but if you need it for itching, you can have it more often. When I lay awake at night after surgery begging for sleep, I was "itchy" alot! Hope this helps!

    Amanda

     
    Old 06-07-2007, 07:08 AM   #8
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    Re: approaching your doctors regarding pain management?

    Also, I told the anesthisiologist and surgeon about ALL the meds I take, even the ones I take only as need. Besides my pain med, I also take Flexeril as needed. I may only take one once or twice a week for spasms, but when you are laid up in a hospital bed, you are going to have spasms! My doc ordered the flexeril as needed too, so problem solved. They ordered all my regular meds, even my vitamins. It makes a difference when you feel like they have your best interest at heart. So report all meds, even those used rarely.

     
    Old 06-07-2007, 07:30 PM   #9
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    Re: approaching your doctors regarding pain management?

    Wow!!! I had no idea. I have been getting such horrible headaches. I keep taking Florinel but I don't want to keep taking it. I just want to feel better. When I take the Florinel, it helps for four or six hours and then I get it back again. I am going to call my primary doc tomorrow. Thanks for your help!!!

     
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