Discussions that mention morphine

Back Problems board


Hello fellow back injury sufferers! This is my first post. :wave:

I'm having surgery on Friday, and have a question about use of narcotic pain relievers on that day. I've heard that morphine, Percocet and Tylenol with codine all cause constipation. [img]http://www.healthboards.com/ubb/redface.gif[/img] Is it bearable to just take tylenol (without codine)?

I have a pretty high pain threshhold. (I just use Tylenol occasionally even though my herniation has invaded 90% of the cross-sectional area of the spinal canal.) Did any of you try doing without narcotics the day of surgery?

Thanks for taking the time to reply. I've benefitted a lot from information posted on this board.

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HNP at L4-5 late Sept
3 months PT
Reherniation late Feb
Nerve block mid March
Microdiscectomy April 4


[This message has been edited by HNPatL4L5 (edited 04-01-2003).]
Hi HNPatL4L5, :wave:

Welcome :wave:

Good luck on Friday, I will be thinking about you :)

I had major problems with constipation from Percocet, make sure to use a stool softener if you choose to take the meds.

One of our members (Go Big Red) was taking Tylenol after her surgery, I think she had the morphine for the first day, but hopefully she will be along soon to share her story with you.

Good Luck [img]http://www.healthboards.com/ubb/t_up.gif[/img]

Please let us know how you make out once you are feeling up to it.

Be Well,
Baxter [img]http://www.healthboards.com/ubb/love2.gif[/img]

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Two level laminectomy fusion L5-S1 & L2-3 done on 12/6/02.
Fifteen inch scar from the very top of butt crack (sorry), to the bra line.
BAK cages, rods & screws.(Titanium)
My pelvic bone was used for grafting.
Praying that the other two discs in between, won't have to be fused later, as I was told it was a possibility, due to the other two discs in between, not being in that great of shape.
Doc didn't want to fuse four levels, unless it is really necessary.
I would hate to repeat the surgery, as the recovery period, is so very painful.
I also have a free fragment in my T11-12 area, that I'm still refusing surgery for, at this point in time.
That surgery is way too dangerous for me to consider, until if affects my being able to walk.
Hi HNPat! Good luck with your upcoming surgery. I recently had a laminectomy/discectomy as well -- I believe you are having a microdiscectomy.
I was also hoping to go without pain meds, but changed my mind after the surgery. I've always considered myself to have a pretty high threshold for pain and also did not take any pain meds prior to surgery. They gave me morphine in the recovery room and let me tell you, it was the "wonder drug." I felt great during the first night of my surgery! I then took Percocet for about week, but probably would have been okay with just Tylenol or Advil after about 3 days. But, of course, every person is different. I would suggest kind of playing it by ear and seeing how you feel. Don't completely rule out the pain meds. Keep in mind, your body is about to go through a pretty decent trauma, so listen to your body during the recovery phase. The Percocet really helped me get through the first few days, but, it did make me constipated--I didn't go for almost a week, but didn't have such a bad experience like Baxter. The stool softeners are a GREAT idea and you could also take a mild laxative if that's turns out to be a problem for you.
Good luck on your surgery--you will be just fine!! A bunch of us recently went through the same surgery and have been posting on all of our experiences on "L5S1 hemilaminectomy with microdiscectomy." It's rather lengthy, but feel free to join us if you have any questions or need some encouragement/support!

Have a good one! [img]http://www.healthboards.com/ubb/t_up.gif[/img]

[This message has been edited by ddp11 (edited 04-01-2003).]
Hi Kristen (ddp),

Thank you for the encouragement and advice. :) It is useful to hear from someone who thought she could go without narcotics after surgery. I promise to listen to my body and take anything needed to stay sane. A friend of mine (who had a microdiscectomy on 3/5) recommended morphine the first day and Percocet the second.

I am nervous because the one time I took 2 tablets (each 5/325 mg) of Percocet, I felt absolutely no pain (despite a recent reherniation) so tried to stay sitting up during an extended airplane landing. I almost fainted (cold sweat, scrambled vision, vomiting) due to pain I couldn't feel! :( Did you find yourself doing too much being on Percocet for a week?

Thanks for the invitation to join the very friendly group on the other thread. Think of me as there but just listening. I'm shy in a crowd.

[img]http://www.healthboards.com/ubb/heart.gif[/img] HNP (Herniated Nucleus Pulposus)


[This message has been edited by HNPatL4L5 (edited 04-01-2003).]
Hi there HNP!
So glad I could help and please feel free to ask any questions! I wish I would have found this board before my surgery!
Your friend's recommendation is a good one--I would definitely take them up on the offer of the morphine. I was in the recovery room and at first, I told them that I didn't want any. Let me tell you, that only lasted a few minutes and I called them back over and they gave me some--it really helps!!
To answer your question about doing too much while being on the Percocet, I don't think I pushed it too hard. You are right though--the pain is still there and the Percocet just "masks" the pain and makes you believe it's not there--sounds like you learned that the hard way! So, I think if you stay on the Percocet, just know your limits. Your body will take awhile to heal after this surgery--it's been almost 7 weeks for me and I'm still recovering! I feel almost back to normal, but even now, if I do "too much," my body lets me know about it.
Are you going to have anyone staying with you following the surgery? I had people taking care of me for the first few weeks and that was very helpful. They kind of limited me from over-doing it during my recovery.
Well, I hope this helped at least a bit. Isn't this board wonderful?
Glad you are checking out the other posts--there's a lot of different experiences over there and everyone is so helpful.
Good luck once again--I'll be thinking of you on the 4th!

[img]http://www.healthboards.com/ubb/heart.gif[/img] Kristen

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L4-L5 disc herniation
Leg/butt pain for one year
Laminectomy/Discectomy - 2/12/03

[This message has been edited by ddp11 (edited 04-01-2003).]
Hi Kristen,

Thanks for asking if I've lined up folks to be with me during recovery. You bet! I'm pain tolerant but not loneliness tolerant. For the first 5 days I picked my sister, who provides whatever makes me feel better before I ask for it; the next 5 days goes to my mother-in-law, who cooks really healthy food; and the last few days of the first two weeks (when I might be tempted to overdo it) go to my father-in-law, who won't let me lift a finger (oops, bent, twist or lift more than 4 lbs) until my surgeon says it's ok.

It is good to hear that morphine acts so quickly. (So you can wait to see if you really need it before asking for it.) Do you know if the same is true with Percocet and Tylenol-C? When I was surviving on 2400 mg of Ibuprofen, I had to be really careful not to miss a dose, because it takes time for an anti-inflamatory to act.

It is wonderful that despite local ups and downs, your recovery is advancing. Do you feel that at 6 wks post op you could have taken a coast to coast flight?

Warmly, HNP

PS: The most constant company when you don't have many vertical hours per day is a pet. Here is my grouchy lazy one, who feels like a rug this time of year.

[img]http://www.haverford.edu/math/lbutler/siam.jpg[/img]

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HNP at L4-5 late Sept
3 months PT
Reherniation late Feb
Nerve block mid March
Microdiscectomy April 4


[This message has been edited by HNPatL4L5 (edited 04-01-2003).]
post>>Did any of you try doing without narcotics the day of surgery?<<

I haven't had Orthopedic Surgery but I've had a
Hysterectomy that involved adhesion entrapment of organs and muscles and colon surgery so
I don't know how that compares for pain.
I woke up from the Hysterectomy attached to a morphine pump and even with the pump the pain was considerable.
At one point I do remember my Doctor telling me that
a major medication was needed to handle "that"
kind of pain, when she was refering to the surgery.
Yes, narcotics do make for constipation, but pain makes for constipation too and a bad case of uncontroled pain can shut you down just as fast as a narcotic.
I would suggest going with the pain control.
Well controled pain effects how you heal since you won't be gritting your teeth and tensing muscles so badly. All that coping business is just too tiring for the convelesing patient.
However, you can ask for a stool softener as soon as you can keep liquids and a bit of food down.
And, there's always the friendly little glycerine suppository to help things along on the other end and,
There's that wonderful Osmodic stuff called Miralax that the Doctor has to prescribe which is good for binding water to your stools so if you do get a case of the sleepy gut, at least the stool won't dry out and cause you a whole other kind of grief.
And, speaking of the sleepy gut, well, the anesthesia alone can put your gut out of commission following surgery so you need to be prudent anyway with or without pain help.
So, since you need to do bowel management anyway from having gone under anesthesia, might as well benefit from a bit of pain help while to take care with the bowel.
Oh, and a foot massage helps too. Deep in the arch.
Good Luck and hope your recovery is short and easy,
kat
Thanks for your advice and good wishes, kat. I will definitely ask for colase and take care not to let pain get out of control. If folks tell me that Percoset and Tylenol-C are not as fast-acting as morphine, I'll decrease dosage very gradually.

My sister had an ovary removed, and was in considerably more pain afterwards than my friend who had a microdiscectomy. [img]http://www.healthboards.com/ubb/idea.gif[/img] Maybe incision length is one guide to how painful post-op is. My sister's scar is 6 in; my friend's scar is 1.5 in. Do you remember how long an incision was made for your hysterectomy?

I never know how long to wait for a BM, called "poop" on another thread :D, before taking something more powerful than colase. After 6 days I give up and use Senokot, but I'm afraid constipation caused by narcotics might be much harder to resolve.

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HNP at L4-5 late Sept
3 months PT
Reherniation late Feb
Nerve block mid March
Microdiscectomy April 4
Hi HNP, :wave:

I don't think you should take the stool softeners on the day of surgery, the nurses will give them to you when you return from surgery.
(I would double check with your doctor though)

The only med I was allowed to take the day of surgery, was my Xanax for anxiety, and to calm me down (I had to get permission to do this)

I was given the stool softeners over my five days in the hospital, but they never told me about taking them at home, until it was too late, by then, I was in labor with a very painful impaction. (Morphine is terrible for constipation as well, I had that for a few days)

Nobody ever told me about the constipation issue, yes, I read it on the side effects, but figured that it would never happen to me. They should have stressed how bad the Percocet is for constipation.

I had no warning, it all happened over a day or two (you would think I hadn't gone in a month or something), then bang, labor it was.

It funny how I went from being "loose as a goose" in the hospital, to a 72 hour labor.
It was so bad, I really wished I was dead, I will never forget that experience, ever [img]http://www.healthboards.com/ubb/bang.gif[/img]

You are doing the right thing by joining us, I bet you feel better already, first hand experience by real people, to me, is what helped me get through this period of my life :angel:

Take Care,
Baxter [img]http://www.healthboards.com/ubb/heart.gif[/img]


------------------
Two level laminectomy fusion L5-S1 & L2-3 done on 12/6/02.
Fifteen inch scar from the very top of butt crack (sorry), to the bra line.
BAK cages, rods & screws.(Titanium)
My pelvic bone was used for grafting.
Praying that the other two discs in between, won't have to be fused later, as I was told it was a possibility, due to the other two discs in between, not being in that great of shape.
Doc didn't want to fuse four levels, unless it is really necessary.
I would hate to repeat the surgery, as the recovery period, is so very painful.
I also have a free fragment in my T11-12 area, that I'm still refusing surgery for, at this point in time.
That surgery is way too dangerous for me to consider, until if affects my being able to walk.
Hello Kristen (ddp), Baxter and L. (NucleoGirl).

Kristen, since I've had so much down time the last six months and love studying [img]http://www.healthboards.com/ubb/grad.gif[/img] , I've read a lot about different surgical procedures for repairing herniated discs. Perhaps why you have a larger scar is that you had a discectomy rather than a microdiscectomy. The procedures are very similar. In particular they both require a laminectomy. The difference is that during a microdiscectomy the surgeon uses an operating microscope, so he doesn't have to make as large an incision to get a good view! Back muscles can be moved aside instead of cut, so the recovery time is shortened. (Thanks for warning me about not letting the pain get bad, because it will be aweful before the meds kick in. I guess Percocet and Tylenol-C are not as fast-acting as morphine. I'll start up Percocet after I'm released from the hospital, being careful to take stool softeners.)

L. (NucleoGirl), it is wonderful that your disc herniation was contained and small enough to be corrected using nucleoplasty. Was it "bandaid" surgery like micro endoscopic discectomy? How did you decide to have nucleoplasty rather than MED? (And do you have any pictures of your kitties? How old are they? When mine was little, she slept across my neck. I loved that when I lived in Minneapolis, but as she got heavier... I'm sad I can't let her sleep on my stomach any more. Wish she was like yours and warmed my feet! Instead she sleeps right next to my head and purrs loudly.)

Baxter, I think I might be as sensitive to Percocet as you are. I know what you mean when you say you wanted to die. I've been on the toilet screaming with tears rolling down my face (after I had to stop taking Ibuprofen and got constipated from Percocet). I cannot imagine going through that right after surgery. You've been through a lot. There is a lot of diversity among the people who post on this board (which is great); I see you treat everyone kindly and sympathetically (even if her situation is quite different than yours). I love to hear how well folks are doing post-op. Gives me courage. A friend of mine who had a microdiscectomy on 3/5 talks with me every few days on the phone. When she started to feel better, I scheduled my surgery! I am using the same surgeon as she did. That's him below.

[img]http://www.haverford.edu/math/lbutler/wisneski.jpg[/img]

[img]http://www.healthboards.com/ubb/heart.gif[/img] HNP

------------------
HNP at L4-5 late Sept
3 months PT
Reherniation late Feb
Nerve block mid March
Microdiscectomy April 4


[This message has been edited by HNPatL4L5 (edited 04-01-2003).]
Post>>>I never know how long to wait for a BM, called "poop" on another thread , before taking something more powerful than colase. After 6 days I give up and use Senokot, but I'm afraid constipation caused by narcotics might be much harder to resolve.<<

Pat, 6 days is much much too long for a BM :eek:
I had total bowel shut down that required emergency surgery on less.
Trust me on this one, constipation caused by narcotics is nuthin compared to a bowel that is stressed and going on strike.
My bowel shut down 20 days after my hysterectomy.
I still had INTERNAL hysterectomy stitches.
I was not even doing narcotics.
I don't do well on narcotics so I don't take them
unless I'm agonized.
I was eating and following Doctors fibre and water orders and planning to get better so I would be ready for my warm weather sport recreations.
Then the Gynecologist finds this itsy bitsy urinary tract infection. She gives me a sulpha antibiotic and that was the last poop I had until I wound up in the hospital STILL not pooping even after the emergency surgery and STILL taking 3 more agonizing days before the bowel would come back to life.
Actually, at one point, the bowel was not budging so bad after the surgery the colon surgeon decided that I needed a GALLON!!!!!!!of Golytely after trying
a goodly amount of other laxatives.
I was so bloated I looked like I was going to have twins.
Because I was in so much pain, I couldn't imagine drinking a GALLON of a major surgery prep concoction
so I whined and cried until they gave me a shot of Demerol and phenergan and a xanax and a hyoscyamine and lo and behold the infernal impaction let loose like the Hoover Dam.
Yea!
Also, try not to take things like Senekot.
It's ultra rough on the colon.
If things are that bad there's prescription meds that don't wreck the gut as badly as senna will.
Herbs are not always the safe route contrary to popular belief.
Some cause the bowel to contract and you don't want that happening.
Even Aloe has it's down side although after I was recovering from the emergency surgery I did drink Aloe juice for a short while just to heal my poor little gut.
It's not something you want a lot of over a period of time.

Regarding the incision, the incision length probably has less to do with these problems than most people think.
I had 2 laproscopic surgeries in addition to the emergency Colon surgery.
That means itsly bitsy nuthin scars.
An inch at most and that's stretching it.
My hysterectomy was done with entry through the belly button, I tiny site at each pelvic bone and a tiny site at the pubuic hair line and all the internaal equipment taken out through the vaginal area like having a baby.
So incisions were not my problem.
Internal scar tissue, called adhesions, were my problem.
And looking back, most probably lousey pain control,
because I don't do well on narcotics so I try not to take them because I hate vomiting, even on anti emetics, for the whole ordeal probably didn't help at all.
If they give you a morphine pump you totally regulate your own doses.
You will never overdose because the doctor sets a timing thing to the maximum dosing you can give yourself.
So if you try to use the pump before the specified timing you are locked out of the pump and it simply does not give you the dose.
So you can use it or not use it at your discretion and according to the depths of your pain.So on the question on how long one should wait before becoming concerned about a BM that is not happeneing?
My personal opinion based on my personal experience is that I start worrying and taking action if I have not had a BM with in a 24 hour period or if a BM shows the unpleasant signs of heading in a disasterous direction with respect to difficulty and texture.
But definately a BM at least once in a 24 hour period is really what one should hope to have.
Even better if you can get two a day going with out the runs. A whole lot also depends on texture.
Runny stools or too hard stools are also cause for concern because that means things are not really all right in the bowel.
So, forewarned is forearmed and now you know, hopefully if there are any problems you will have no trouble at all in heading it off at the pass.
And that knowing takes the scaryness out of everything because you know what to do.
kat
kat (great name, I wish it were mine), I had no idea that hysterectomies could be performed with entry through the belly button and exit through the vagina. I imagine the procedure was described to you as minimally invasive and that it was a horrible shock when internal adhesions led to such serious complications. What a nightmare. You must be strong.

I do hope I am given a morphine drip. I definitely want to be in control of the dosage. I'm so sorry that your sensitivity to narcotics made them useless to you when things started to unravel after your hysterectomy. So many people get much needed relief from narcotic pain relievers (constipation and temporary addiction minor complaints given the enormous relief narcotics provide).

And thanks for the warning about Senokot,
[img]http://www.healthboards.com/ubb/heart.gif[/img] HNPatL4L5
(stands for Herniated Nucleus Pulposus at the disc between the L4 and L5 vertebrae)


[This message has been edited by HNPatL4L5 (edited 04-02-2003).]
Hi Everyone:
HNPatL4L5:
Good luck with your surgery tomorrow! FYI I had at least 5 doses of morphine in the recovery room. Not that I asked for them, the nurses just kept giving them to me. Kept me doped up because I had to wait 6 hours for a room to be ready for me. Oh well, that's another story. After I got to the room I had 3 pain pills all night and left the hospital at 9 a.m. the next morning. I highly recommend you ask for an ice bag. No one offered me one and I asked for one at 6:30 a.m. and it really helped. I used it on the ride home, (laying down on my side in the back seat). The next couple of days I used extra strengh tylenol and tylenol p.m. And the ice bag the first day. Worked for me. Didn't need any other meds until two weeks later when my leg pain returned. Called the doctor's nurse in a panic and she called in medro dose pack. (High dose of steroid anti-inflammatory you only take for 6 days). She felt it was the nerve acting up trying to heal itself and she must have been right. I'm pain free now. Had my surgery 5 weeks ago tomorrow. I've been walking and exercising for the past three weeks. I walked at least 3 times a day for 15 minutes from the day I came home after surgery. (I have a Maltese). Also, I'm a big water drinker. I probably drink a gallon a day. They say that helps keep things moving. I never had a problem so I'm not sure about that. I did take some darvacets and percocets and lortabs prior to surgry but I never experienced any bowel problems. I didn't use them much though. I always preferred my Tylenol.
You're in my prayers, after surgery you'll be feeling so much better. I woke up in the recovery room with my leg pain gone after 7 months of constant pain. It is so amazing that a couple of hours in the O.R. can give you back your life. Don't forget, drink lots of water.

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Hi, Pat

My this is a busy thread! I'd say welcome to the boards but you're already at home!

I didn't take the time to read all your responses, but did read all your pages to this thread.

Baxter mentioned me in her first reply to you. I had a PLIF (posterior fusion of L5/S1) March 5 and was off the morphine and valium March 6 at noon. Then took only tylenol every six - eight hours. Probably really didn't need that.

I don't know much about the procedure you're having done, but I was in so much pain prior to surgery that when I was in recovery, I had absolutely 0 pain. Honest. And, in the hospital, hiked to a ten the first time I tried to walk, but then only a 4.

My pain since the 3rd day out of surgery has really only been about a 2 but mostly 0. I think that is a-typical but I also have a high pain threshold. (I think actually most of us chronic painers do as we have adjusted to living with pain for so long.)

I do know that my surgeon and his office want to use me as their PLIF poster child! And, because I am and have been on no pain meds at all since I was released from the hospital on March 10, I am starting pt next week, which my understanding is that that is about 6 weeks early! But, I don't have any meds in my system to mask the pain, so pain is my guide. I am bending quite nicely and am very happy that this surgery and recovery is going so well.

I pray yours is relatively pain free as well - I know it is possible. I had alot of people praying for me also and that is a HUGE factor in recovery.

Good luck!



------------------
gbr

JDD
2 Discograms
4 Level failed IDET
4 Confirmed torn lumbar discs, 2 full thickness
Issues now with c-spine & thoracic
Fusion of L5/S1 scheduled 3/5/03
Fusion successful - feeling better all the time