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Post op pain control while on methadone...

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Old 08-03-2012, 09:16 AM   #1
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Post op pain control while on methadone...

Hi All. Long time no see.
Hope all are doing relatively well.
Personally my life has turned upside down but physically I was struggling along
until last week.
Brief pain history....I had pneumonia in 2003 but the pain in my chest never went away. Have been to many docs and taken many drugs and injections etc.
Moved away and spent my days going to the ER just trying to find a doctor. Finally meet a great Lady who would love to treat me but I have no insurance. She set me up with the free clinic and I've been doing well.

My question is....I'm due to have foot surgery(fusion because this is the 2nd time I've torn my posterior tibial tendon). What can I do for post op pain? My doc won't give me anything now for the extra pain. I take methadone. She says too many pain drugs interact with methadone.
If this is true what the heck am I supposed to do? Suffer?
I just got hired and am supposed to start training but how can I let them train me when I have to quit for 12+ weeks? I don't know what to do about the medication or the job. Argh.

Thanks for any help.~Mush
undiagnosed lung and back pain after pneumonia in '03, tmj, migraines,(two failed surgeries for) Kienbock's disease

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Old 08-03-2012, 09:44 AM   #2
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Re: Post op pain control while on methadone...

Sorry to hear about the upcoming surgery I would speak with your Podiatrist (I assume he is doing the surgery?) or whoever is doing it and talk to them about your concerns about post op pain and how they will handle it with you being on the Methadone.

When is the surgery?

I'm not aware of other pain meds not working with someone on Methadone as I know a few folks on it for chronic pain and have had major surgeries on their spine and did fine.

But the key is getting all this sorted out now and ask them what the plan is going to be.

What type of surgery are they going to be doing?

Tendons being transferred or repaired?
Are bones being cut or realigned?
Or the joints being fused together?

I guess it all depends on the severity of the issue.

I would also make absolutely sure that the Dr. who presribes your Methadone is ok with post op pain mgmt. and you getting opiates from another Dr.

A surgeon will usually be the one to handle the post op pain for that period of time. They will certainly take into account that you are on Methadone and adjust things accordingly.

Is your new job where you have to stand up all day? I was curious about this as you say you have to quit for 12 weeks....I was wondering that if it's a job where you are sitting that you can go back when cleared and keep your foot elevated when needed?

Obviously your surgeon will detail what you are allowed to do and not do.

I had just gotten a new job a month prior to my first cervical fusion surgery. I was lucky in that I could do a lot of work from home with the phone and my laptop. But they were very accommodating....Have you talked with your employer yet? What do they say?

I guess if it's a surgery that is a must do right now then you really have no choice and just deal with whatever happens...

Keep us posted on everything.

Old 08-04-2012, 11:18 AM   #3
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Re: Post op pain control while on methadone...

Definitely discuss it with your surgeon. You need to get the two doctors working together for your post op pain plan. At a minimum, your regular doctor needs to know that the surgeon will be prescribing additional meds. Or, the surgeon may turn over that responsibility to your regular doctor. Its something to plan in advance though. There is no reason I know of that you can't increase your methadone and/or add in a short acting narcotic post op. Probably the short acting med. It is very common to take methadone with a short acting med on a routine basis (I do). I don't know what she means that they interact...sounds like she was confusing it with Suboxone? With Suboxone for example, a short acting pain med may not work with it, depending on the dose of each, and the type of short acting med. Do you get the methadone from a pain specialist?
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Old 08-05-2012, 05:47 AM   #4
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Re: Post op pain control while on methadone...

Excuse me, Interaction with which opiate. Ive had several surgeries, mostly oral but the last was my pump implant while on meth. So I not only had the morphine the new pump was delivering, my 30 mg Oxy for BT, the meth in my system and while tapering off but after the pump my surgeon gave me 10 mg percs to take hoeme and used fent in the recovery room. Find a Podiatrist that has had more than 1 3 credit hour class in post op pain managemnet that wont flat out lie to your face because he isn't comfortable with your med use.

My wife had a surgery consult for a neck problem that will eventually be fused. This doc spent 45 minutes explaining the evils of opiates and how she wouldn't operate on her if she was taking pain meds stronger than the percs she uses for all her surgeries. She went on and on about all the potential side efects incuding cogantive, forgetfullnes etc etc. She's done pretty well at running a 120 million dollar line of credit at the mortgage broker for the past 7 years. Her cognative powers are likely greater than the doc she was speaking too at the time. But old school docs were given minimal training in post op opiate use and it included the evils of opiates and the certain addiction that follows.

Any doc that went to med school before 98 has the same minimal trainig unless they specialized in PM or anesthesia. Your option is to have your PM doc handle your post op pain or simply find a podiatrist whos head hasnt ben inserted where the sun dont shine since their minimal training when the went to med school. I suppose he thinks you can roast marshmellows with your bare hands since you have opiates on board? Really???
Good luck, Dave

Last edited by Shoreline; 08-05-2012 at 05:57 AM. Reason: grammer

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