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Just got out of oral surgery, pain reliever question

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Posted 4/28/2012 12:41 AM (GMT 0)
So I just got out of oral surgery earlier today, around 1pm. I have been on 2 10mg norco's for the past 2 months and just started taking 2 30mg ms contins a day and then the norcos for breakthrough pain for neck pain and a lot of other stuff. My GP prescribed these btw.

I told my oral surgeon that I was taking those and that I didn't like the ms contin so I had been taking 2 norcos at a time but ran out as my GP gave me an rx that ran out the day before my surgery, which sucked. So I read to tell your surgeon about all/any medications you're taking prior to so that they know you may have a tolerance to narcotic pain meds. He wrote me a prescription for 10 5/500 vicodin. I told him I doubt that will help the pain since it takes 20mg to even make a considerable dent in my pain. He said they should work bc the surgery should have helped my pain. It's now 8pm and I'm already hurting pretty darn bad. I'm afraid it's going to be worse tomorrow and hate the idea that I may have to suffer through the weekend when I've got finals this week. I'm sick of hurting and don't feel he is addressing my concerns. My GP is on vacation and the doc who's filling in for him that doesn't know me doesn't want to give me a refill on the norco, and I don't think he should have to. Isn't it the surgeons job to take care of me? Plus he told me to ween off of prednisone for this surgery, which sucked to do in only 5 days from 30mg a day, then gave me prednisone through iv before surgery. I asked him if I should start taking it again and he said he didn't know, ask my GP.

So what do I do? I feel like I'm just going to page him tomorrow if I'm still hurting and tell him they aren't working. Am I right in doing that? I knew this wouldn't cut it as my body somehow has a high tolerance for these types of medications, I told him that, and he decided to still give me less. I feel like he's more worried about the liability than my well being.

I had to edit a word in your post. We do have to watch our language since we do not know the ages of the people that reads these posts. Please take a look at the forum rules, thanks...Susie

Post Edited By Moderator (straydog) : 4/28/2012 10:54:11 AM (GMT-6)

Posted 4/28/2012 1:41 AM (GMT 0)
When you say you don't "like" the MSContin....can you elaborate more on this?

Adding 60mg of Morphine to your daily pain meds should help tremendously...along with the Vicodin....

The surgeon is only one to treat post op pain but since you were on medication before this....we had said for you to coordinate before the surgery on who was going to take your care over...

Oral surgeons usually only give like 15 days of medicine as the pain should shart lessening...

Your GP or PM Dr. is the one to take over the chronic pain issues...

So, unless you are having a life threatening reaction to the MSContin...I would be taking those as prescribed as they should really help with your pain...

As well as there is going to be pain after any surgery...including oral....so it's going to just hurt some that we have to be able to handle with ice, ibuprophen, resting, and eating soft foods....

Keep us posted..
Posted 4/28/2012 2:02 PM (GMT 0)
Matt,
The other problem is that you are taking far more norco/vicoden than you are supposed to, which is why you are out of them now, and it almost appears as though you hoped that the oral surgeon was going to give you more to supplement until your GP/Primary doctor returns. Your oral pain should diminish significantly now that the problem was fixed and on top of the other meds that you should be taking, in the prescribed doses, should have covered your pain quite well.

Acute pain subsides pretty quickly, and the dose the surgeon gave you should cover that pain adequately in the meantime. It will not however cover and should not be used for your chronic pain treatment. Meds given for acute medical  problems should never be used to treat your chronic conditions.

If you have swelling or additional pain , use ice , 10-15 minutes on the side of your mouth, followed by an hour or more off of the ice for today and tomorrow. Then you should be able to use something like motrin after that to help with pain and inflammation which works really well for mouth pain.  
Unless you are having significant allergic reactions to the MS contin, your GP is probably going to tell you to deal with the side effects which for the most part will diminish over the next two weeks or so. An allergic reaction is hives, severe itching, difficulty breathing, etc...drowsiness, sleepiness, nausea, etc usually subside over the course of a few days to a few weeks when trying a new medication , so give it time, and no, I would not call the surgeon for more pills since I think that it will wind up biting you in the rear if you do.

Post Edited (mrsm123) : 4/28/2012 8:07:13 AM (GMT-6)

Posted 4/29/2012 4:09 AM (GMT 0)
Matt!….after reading your post and the replies by Snowbunny and mrsm123…..I tend to strongly agree with them.
One thing I might suggest for future consideration, is if you are going to have a procedure that may require pain management post-op…then make sure you coordinate it with your PCD,…contract or not. I understand your fear of Acute pain following a procedure like this…especially if you are having tolerance issues. This has worried me as well…..as I know I will need dental work soon. I had a toothache here a while back, and my Chronic Pain med's gave no relief. (ER med) I did however take an extra BT med….along with Ibuprofen…and that helped. Luckily for me the toothache was gone the next morning.

We really have to be careful and take our CP med's as scripted…and if an adjustment is needed, then it should be coordinated with your PM/PCD…under his/her direction. I myself and not going to preach against taking an extra BT med, as I believe some of our members have. However what concerns me and others,... is using BT med's as part of one's baseline on a regular basis. I also am aware of PM's/PCD's under medicating and leaving one not much of a choice, and I assume these Dr's know this. My Dr has!…but has refused to go higher on my ER med's.

Please be careful….and coordinate your care in advance if you can. I wish you well, and hope your post-op pain subsides soon! It also sounds like you and your PCD need to sit down and get your CP med problem straightened out as well.

SE
Posted 5/16/2012 2:18 AM (GMT 0)
I know this post is a few weeks old but...

It sounds like you're in a really sticky situation. You've built up a tolerance to the Norco that your dr doesn't *really* know about because you've been doubling your dose, so now what should help with the after-surgery pain (the lose dose vicodin) really isn't doing as much as it would have, if you had stuck to 2 norco's a day.

And now you're out of Norcos and don't have a script for them.

I don't think your surgeon is going to be of any help, your long term pain doesn't have anything to do with him, and getting caught up in that could get him in trouble. It could also get YOU in trouble. If your two docs confer with eachother and your GP thinks you're abusing your meds/seeking them elsewhere, he could stop seeing you altogether.

If I were you, I would take the MS Contin as prescribed, and the vicodin as prescribed, and just tough it out until your GP gets back. Then explain that the 2 norcs a day was not doing it for your "breakthrough pain" AND that you don't like the MS Contin (and say why) and see what happens.

The worst thing you can do is not follow directions when it comes to long term pain meds. Even if you have to tough it out for a few weeks with a med not working well (I think we've all done it) and wait to see the doc... Its always best to be honest. If a medication isnt working, or isnt handling your pain, say so, and get it changed or adjusted. Unless you talk about your pain level and the effectiveness of your medication...there's nothing your dr can do.

If you get yourself in a situation where you're always running out or looking for more meds than seem appropriate to your pain...then you could end up being seen as someone who exibits "addictive" behaviors and no dr (especially with the crackdowns) will want to script you anything and then you really will be stuck in pain with no relief and no place to turn.

I've seen it happen to a LOT of people, friends and family, with chronic pain. I wouldn't want it to happen to you. Good luck and I hope everything is/has worked out!
Posted 5/18/2012 3:50 PM (GMT 0)
Matt, I'm sorry for the pain you went through, but use this horrible experince to learn the most important lessons for a CP patient.

Never, Never, Never arrange for surgery or any other painful procedure that is not emergent without first having a solid plan in place to address the pain afterward. Two years ago I had terrible dental problems and opted to just go for full dentures. The Dentists were literally scared off by the Oxycontin & Oxycodone that I take on a regular basis and refused to give me an additional Rx for any opioid. They simply are not trained to treat patients in our situation and assume that since we are already medicated, we don't need an additional dose. However, we function on our dosage to whatever our level of normal is - the same way a person not being treated for pain does. This is called tolerance. We get very little benefit from our meds when a new pain is introduced and just like any other person, we require additional pain medication. Often times, we run into the same problems with Medical Surgeons as well. My Mom was had been taking 20mg of Oxycontin prior to open heart surgery. In the ICU afterwards, they would only give her 5/325 percocet for her pain. Since this was considersbly less than she was used to, she suffered severe pain & even some symptoms of mild withdrawal and it took me 3 days to force them to get her a Pain Mgmt consult to correct this. So, whenever possible work out a plan ahead of time with your treating Doc to handle the pain BEFORE any painful treatment.

MD vacations can cause real problems for us. I plan my visits for refills 2 months ahead of time because I use a mail order program and can get a 60 day supply. This allows me to know for sure that I can get to the Doc when I need to. I also have good relationships with my GP and Rheumy, so in an emergency I can get refills from either of them. However, I never go to a new med or an increase in dose from any Doc other than the Pain Mgmt Guy.

Certainly having more than 1 Doc write scripts for a controlled substance can be problematic. I have had occasions where my insurance company (in conjuction with the state Bureau of Narcotic Control) has contacted both Docs by letter. It's obvious to them that I'm not a junkie collecting meds all over the place by the small quantities I've gotten from either the GP or Rheumy to cover in an emergency, so this has not been a problem for me.

The biggest problem you're facing right now id that you're at the very beginning of your journey into Chronic Pain and it's treatment. You will find many good ideas and lots of help and support here.

I see that you've got a more recent post about which meds are better, so I'm going to hop over there to talk about specific meds for you. I hope you're feeling better.
Posted 5/18/2012 10:53 PM (GMT 0)
I totally agree with Keah. I too learned my lesson. I was on the patch and 3 Norco for BT pain. I had surgery, some biopsies and one was in my neck and was huge so it turned into a bigger operation than they planned. I was discharged with 7.5 hydro take one half every 8 hours. So basically I was given one and a half extra pills a day to handle post op pain and I was miserable to say the least. After that I will NEVER have scheduled surgery without an appropriate plan for pain management after surgery.
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