Hi AV Momma, Sorry to hear about the popped stich. I know in my moms case , She had the original RM done a year ago and just has her 3rd reconstriction to cover the sunken and scared area which turned out quite nice. The only thing remaining is the Tatto. y mom was also surprised by the amount ofpain and pain from dying nerves that had been severed. The biggest problemis the way docs make surhery sound, They do hundredsds a year, it's no big deal, these thinks happen, but it's not their body. The last surgery aside from cosmetic they removed some necrotic fatty tissue that had lost it's blood supply. Surgery 2 months ago with an infection and still neeeding pain meds insn't that unusual, but if your doc makes it sound like it's as simople as out patient surgery, pain is minimal etc etc etc, everything a doc could say to minimize the minimize the experience and yet a year later she's till having a giant X covered and dead tissue being remobved isn't minimal surgery. There are other meds for pain they can use, they jst have to be more creative and although a plastic surgeon may be creative when it comes to reconstructuion, they aren't too empethietic or creatice when it comes to pain conntrol. It sounds like your have allegies to the keto synthetic and allergies to the naturl opioids like morphine, but you do have 2 other disticnt and different classes of opiates that may help and a bunch of meds to use tomanage nerve pain and meds to improve the effectiveness of pain medds. You didn't mention the class of synthetcis that include the fentanyls and demerol or the class that includes methadone or Levo-Dromoran, which are both much more potent than morphine other than demerol.
Meds like alevill and lamyctyl can also be good adjuncive meds and you might want to consult with an infectious disease doc. Once you start having complications you have to stop worrying about how your surgeon will feel or if he may be insulted if you want second opinion and different docs brought onto the case. A special consult with anesthesiology to discuss anelgesic options and the ID doc to discuss healing the infection. The plastic surgeon did his thing and got paid , more often than not things do go smooth but when things don't some docs simply don't know how to deal with the follow up problems.
Plastic surgeons don't normally deal with long prolonged recoveries unless working on major recoctruction or burns. When they are dealing with major issues like this , anesthesiology is managing pain control, not the surgeon who''s knowledge of pain medication and post op pain control was limited to one semester during medical school where anyone that went to med school before 96 and the oXycontin revolution was tought opiates are bad, depeddnecy and addiction isn't any different and dealing with a failed or complicated suregery is better than having to deal with an addiction the docs seems to be overly concerned about.
Your 2 months post op with a major infection, controlling the infection and controlling the pain are the two things your doc should be doing but neither fall undeer the specialty of plastic or cosmtic surgery.
I've had 3 failed back surgeries and fusions that didn't take where the hardware eventually starts breaking because it's not designed to hold things together indefintely witout bone growth from the fusion starting to take over the load bearing. No fusion and the hardware does it all untill it starts snapping.
Your definitely still in the acute phase , not the Chronic pain phase so managing this kind of pain is actually simpler than trying to manage pain they can't find an answer too or are dumfounded why you still have pain, Obviously all you need to do is show the incision scar and the open wound, the visusal is worth more than anything you can describe or rate the pain as.
There are still meds to try and adjunct meds to try. Using antidepressants for nerve pain or anti siezure meds for nerve pain are very common and don't imply the pain is in your head, so try to be open to the idea that something like elevill may bring some relief even if it's just a little in addition to the pain meds.
As far as time line goes, It's not unuaual to start to taper down 8 or more weeks post op but in the case of infection, treating your pain now isn't going to turn you into an addict . Some docs will go 4 weeks with meds, some 8 and some 16 weeks post op, It just depends on the docs comfort level prescribing opiates.Your alergies complicate things but don't make it impossible if you dealing with a doc that manages pain allt he time. Some of the best chronic pain docs are also the docs that manage post op pain , The anesthesia dept should be able to do more than try something as uncomon and as harsh on the tummy as DHC.
If your not getting relief and the surgeon doesn't know what to do, there isn't alot of point in keepin a surgeon around that doesn't know what to do when things don't go perfectly smooth. IT does sound like the wound infetion is also beyond the docs capabilities and that's what infectious disease docs are specifically trained for. Hopefuly as the infection heal the amount of pain your ecperiencing will also deminsih, but you stil have o get through the rehab and wall walking and wilprobably need pain eds longer than this docs averge RM that they describe as everyday surgery for them. It may be everyday for them but not for each patient.
Unfortunately we stil have lots of opiate phobic docs still practicing and they will continue to practice the methods and ideals they learned when the POV of the benefits of opiates wwere very diferent than it is now. You do have options and finding a doc to manage what the surgeon can;'t in't an insult, if anything perhaps the doc should take some continuing edcation on pain management if they happened to sleep through or squeek by the one semester of training they actualy get.
There are options but if the surgeon isn't familiar with what's available it's not going to be offered, that's why it may be best to say thank you but I do't feel were making the progres managing the infection or pain that we should and get the consults with other specialties that can help.
You havne't done anything wrong so you shouldn't feel bad about telling the doc DHC isn't even coming close to managing the pain. Aside from meds there are also procedures that may bring relief, like innercostal nerve blocks that wrap around to the front that will dampen some of the pain, other meds and adjunct meds eve though you have alergies, so try to hang in there. Don't worry about what this doc thinks if they bring up dependence or addiction, right ow thepain is acute, the problem is obviously clear, so you have nothing to feel bad about. Although itmay bve tough to get a surgeon to admit they don't have a 100% sucess rate, it doesn't mean they are somhow managing to carry odds of succes that are vitually impossible for any doc to claim 100% success in all patients.
I am sorry your still having problems and very sorry docs can be mso misleading regarding the ease of surgery and recovery, it's very easy on them so whats the problem. :dizzy:
Hang in there and keep doing the trial anderro thing untill you find what works and you back on the road to healing. Asking for pain medecine when you have giant open wound , doesn't make you a drug seeker and any doc suffestion you are neesds to experience the same wound and procedure themself.
Hang in there, Dave