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HELP! Agony 1.5 days post-op POSTERIOR C-SPINE surgery

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Posted 8/23/2014 5:38 AM (GMT 0)
Hello all, I am having a very hard time. My surgery was at 1:15 on this past Thursday. I had a difficult time in recovery, they had a difficult time controlling my pain. I only remember crying so hard that I had a hard time getting my breath, They had me on a pain pump that would give me .20 mg dilaudid every 8 minutes.

I didn't sleep at all Thursday night, after getting out of recovery at 730pm. The pain button was discontinued late this afternoon. They started me on oxycodone, first 1 5 mg tablet, then 2, then 3 tablets, given every 4 hours with flexaril, and phenergan and zofran for nausea. This didn't even begin to control this ferocious pain.

I was in tears when my husband got here to the hospital tonight. My nurse called my surgeon, and he added 20mg OxyContin every 12 hours. This has been a scary feeling because I have caught myself having a hard time breathing right. When I was on the patient controlled pump, they had me hooked up to oxygen. I think I may need it now.

I am in awful pain, and I don't know what to do at this point. I have not eaten anything but liquids today, and I don't think I will be any different tomorrow (Saturday). Thus is the worst pain I have ever experienced after surgery. It is awful and I am having a hard time keeping it together.

To make matters worse, when I got to the hospital yesterday to check in, I reminded the nurse that I have a port. I was told that it would be fine at my pre-op appointment, but the nurse said they wouldn't use them. She said it would be up to the anesthesiologist, so the doctor came to speak with me. She told me that it "created a place for possible infection" and she wouldn't use it. I lost it.

I have zero veins from having huge doses of IV steroids over the years for my MS! I mean I was upset! She was determined NOT to use my port!!! That is what the port is for!! She finally asked me if she could stick me "just once" to see if she could get an IV. She was "sure" that she could!!

When she started looking, she finally saw that I really really don't have good veins, but she was hell bent on sticking me. And dang, she twisted it all around before she finally conceded that I HAVE no veins that will support an IV for surgery! So, they accessed my port, after considerable tears and stress.

I am in agony people!!! It is 1:20 am and at 1:50am, I will get 15mg of oxycodone. It is not touching this pain!! It is horrible, burning sharp pain at the surgical site. I am just trying to exist through this pain! and I am in despair. This is horrible. I don't know what tomorrow will bring...I cannot imagine going home like this...do you guys have any suggestions?

Abilene, what meds did you leave the hospital with? I am a chicken, but this pain is God-awful. I am trembling it hurts so bad. I hope and pray that this surgery will fix what it is supposed to fix. He told me that he made lots of room back there for all my "smushed" nerves! (Quote!). I have a strong faith, but it is being stretched right now.

Please please if you have suggestions of how to handle this situation, I will be checking. This is excruciating. I am wondering if there is some kind of reaction to the nucynta I was taking the last few weeks? Since August 11th, the day they called to tell me my original surgery scheduled for August 14 was cancelled, he prescribed 100mg nucynta every 6 hours, which was twice what he had been giving me.

I was planning on taking much less up to the September date, but when my surgery got pushed up to yesterday, August 21, I was taking what he prescribed. I do not know if this interacted in some way, or if this was actually WEAKER than the nucynta my body has gotten used to taking? I am hurting so terribly.

Thank you for listening to me. I sure do hope someone can shed some light, or have a suggestion as to how I can get on through all of this agony. No sleep again tonight.. I have not slept since Wednesday. HELP! :(
Posted 8/23/2014 12:55 PM (GMT 0)
When my wife had a similar reaction to surgery they prescribed her mepergan which is a combo of Demerol and Phenergan. This worked wonders on the pain but should not be used for more than about 4 days. She was finally able to sleep with this so perhaps you could ask about it. You definitely need more pain control than you are getting. Best of health, I feel so sorry for you . . . Q
Posted 8/23/2014 1:12 PM (GMT 0)
Hey Poplar...I'm so sorry you're suffering.  IMO the 100 mg Nucynta every 6 hours was probably stronger that your initial post surgery pain meds.  My experience with Oxycodone for PM is that it does not relieve pain.  It seems to "change" one's perception of pain. Yet I still hurt shocked   Q's suggestion is spot on and certainly worth a try. I'm sending prayers your way.
Posted 8/23/2014 1:24 PM (GMT 0)
.2 mg dilaudid is nothing for CPers who are regularly on opioids. I've been there too. You need 2, not .2 every 2 hours, or maybe oftener. It's awfully short acting.

Patient-controlled pumps just don't work for us. We need to demand well before surgery that we don't want them. If you hit the button too soon it will lock you out. If you wait too long you will suffer horribly. The minimal dose just doesn't do anything either, and nurses and doctors often don't comprehend our tolerance!

Make a fuss and ask a friend or relative to complain also. Ask for a patient advocate. Ask for a pain doctor to consult.
Posted 8/23/2014 1:27 PM (GMT 0)
Good point Dixie, it takes me at least an hour before I feel the effects of Oxy. Whereas my wife said that the mepergan kicked in in 20 minutes . . . Q
Posted 8/23/2014 1:32 PM (GMT 0)
A dr came in 2 hours ago and said she thought I just needed to go home so I could relax. I can hardly breathe I am in sch agony. I was supposed to try 20 OxyContin at820. No show. This is a nightmare.
Posted 8/23/2014 3:39 PM (GMT 0)
Poplargrove,
I am so very sorry to hear that you are in such pain. Dilaudid in the hospital, then Hydrocodone at home is what I got. I was not on pain meds before surgery, so I'm sure that makes a huge difference in what works-and why don't they know that!

Going home would probably be more relaxing but you still need pain control. Others with more experience have made good suggestions. And you are not in a collar, right? I wonder if you have been able to get up and move any?

Praying for you to relax, breathe, and feel a peace that you CAN get past this and for the medical people around you to make better decisions for you.
Posted 8/23/2014 3:42 PM (GMT 0)
Poplar, be sure not to leave the hospital without a script of Oxycontin. This very same thing happened to WhiteBeard when he had his surgery. His pain was not controlled at all, the surgeon did not take into account the medications he had been on for pain for years. Like you, the pain was through the roof. Once he got home where he had access to his meds it helped a lot. He was also on Valium because of the severe muscle spasms for awhile. That is about the only time now a dr will rx Valium because it is so habit forming. But it is a wonderful muscle relaxer especially after surgery. If the Flexeril do not get the spasms under control call the surgeon even with it being a weekend because those spasms will cause you a lot of grief for quite a while after surgery.

I sure can believe you about the port. I had to have a port put in because of horrible veins. I have crohns disease & was doing Remicade infusions every 4 weeks. Any time I was put in the hospital the nurses never wanted to use my port & the reason they didn't is they did not want to take the time to access it or didn't know how to access one. I had one idiot nurse that said it was stopped up & it wasn't, she did not know how to access it. They had to call another nurse in from another city to put in a PICC line which I refused. When the new nurse got to the hospital he came in the room & said he was there to put in a PICC line, I looked at him & said no you aren't either. I did not authorize a PICC line & why would I when I have a perfectly functioning port. He said you have a port, I said I sure do & 2 weeks ago it worked just fine & this nurse has tried telling me it was stopped up but I know better. He said well even if it was clogged we can run a clot buster through it & open it up. He accessed my port & guess what there was nothing wrong with it, the nurse had no clue what she was doing.

Once you get home take all of your meds on schedule even when you think you don't need them. Keep us posted.
Posted 8/23/2014 4:19 PM (GMT 0)
Hi Poplargrove I am so sorry your having to go through all this! I know exactly how you feel and can relate completely!  For some reason Surgeons just can't relate or understand how to controll pain for patients that are used to taking pain meds!  If you have only been on pain meds even a few weeks or months your body has become accustomed to them, and then when you have additional pain from the surgery, it takes more medication to even touch the new pain!  Going home is a double edged sword, yes you would probably more comfortabel  but only to a point! Allot of times, going home to early can be mentally challenging!  There is a certain amount of comfort, just knowing that when your in the hospital that if you feel anything unusual or severe pain or anything, that there is trained medical staff right there that can help and treat you! Now whether they do or not is a different story! But there is something mentally comforting about knowing that!  Not like being at home when if you really feel bad there is no professional there to calm your fears, even if they are irrational!  I guess all I am saying is, allot of people want to go home right away after surgery, and then once they are home, well they might find it might have been a mistake! I have seen that when working in a hospital setting, and we end up getting the patient back! Just make sure your doctor is not pushing you out the door, if you really don't think your ready! Getting additional pain treatment once your home can be really difficult, and time consuming, an hour can seem likte an eternity! Where as in a hospital you have nurses that are there to be your advocate, and can speed things up getting you relief!

Just something to think about! Before making your decision!

White Beard

Posted 8/23/2014 5:29 PM (GMT 0)
So so sorry to hear that you are hurting so much. Posterior surgeries are a lot tougher than anterior surgeries, I say that from my personal experience.

It seems EVERY surgery or hospitalization I have had over the last few years they REFUSE to take into consideration the pain meds I was on prior to admission. For example I was using 50mcg fent, 30mg liquid oxy (I have malabsortion from gastric bypass) every 4 hours and 4mg zanaflex 3 times a day, I had a horrible car accident at 4pm with broken collarbone, neck injury, burned arms, abdominal bleed, increased back pain as well as seatbelt bruises; I was given some IV fent 2-3 times after arriving at the hospital but my regular medications were abruptly stopped and dropped to 25 fent, 5mg oxy tab every 4 hrs and 2mg zanaflex every 8 hours. Thats what the treating trauma drs thought should be sufficient. I was strapped flat on a board until 1AM, screaming in pain and starting withdraws, and they kept telling me once I got to a room I would get something for pain. Got into the room and nothing was ordered. Finally the order was entered and the nurse called the dr a not so nice name, and said this is not going to help compared to what I was normally taking. She called him from my bedside and he started yelling at her. By 9AM I was talking to my PM drs and they called to confirm my dosages and their recommendations, the dr still wouldnt increase, stating what he was giving is enough to cover the type of pain I had.

My PM dr said bluntly, to get OUT of the hospital and they would give me instructions to get things stabilized correctly. Hospitals are one of the worst, most frustrating places for CP patients in my opinion!

I hope that either you have gotten things going better in the hospital by now or are settled in at home relaxing. Please keep us posted. Hugs!
Posted 8/23/2014 5:57 PM (GMT 0)
I am so sorry you are having to go through this! Sounds 100% awful!

Surgeries are bad enough without stubborn drs who don't get CP.

I don't know your relationship with your pain management dr, but can he see you when you are discharged? If your pm can see how awful your feel, he may be able to switch up some meds.
Any time I'm discharged(which you guys know is a lot!), my pm has me stop by his office since it's in the same hospital.

I really hope some sort of pain control plan can be worked out today. It sounds like you are chasing the pain when the drs/nurses should have provided adequate pain control.
Posted 8/23/2014 6:17 PM (GMT 0)
I was hospitalized two months ago for drug drug interaction that mimicked a slight stroke. I was having extreme difficulty in differentiating reality from these vivid hallucinations. That is not the purpose of the post, but while I was in there the first thing they asked was what meds I was on, and when they heard the high level of pain meds they said that they couldn't provide me with them there but instead sent my wife home to pick up a supply. I was surprised as in the past ( 40 years has gone by since my last visit to a hospital) hospitals wouldn't let me take anything that didn't come from their pharmacy. My pain meds are #240 Oxycodone IR and #150 Fentora 600 mcg. You can imagine the WDs I would have had without these meds. To all posters on this thread, were you not allowed to get your pain meds from home so that you could keep your serum level on its proper keel? That seems so simple an answer to everyone's problems, I suppose that it is too simple, huh?j
BTW, the problem turned out to be that I had run out of Abilify and forgot about asking my wife to call it in for me. I am taking 2.5 mg p/d
along with Cymbalta and the lack of the drug caused the troubles . . . Q

PS: Poplar. I had the same problem with my port and veins. They just won't listen to you when you explain why you have this thing sticking out of your chest even tho it should be obvious.
Posted 8/23/2014 7:28 PM (GMT 0)
My husband came over to the hospital and asked the nurse to help me. They are giving me20 mg OxyContin every 12 hours and 15 mg oxycodone every 4 hours and 50mg nucynta every 6 hoursl

. I was taking 100mg nucynta every six hours at home, but I actually was only taking about half that amount. I just find it hard to believe they expect you to suffer. My daughter is a nurse practitioner in another state and she is suggesting to ask for oral dilaudid.

Their argument is that I can't take IV stuff at home. That sounds crazy! I am talking about excruciating pain right now!! My incision is on fire,a and it is hurting so bad it is nauseating me. I am getting redy to call them back in and try to ask for dilaudid oral.

I am so sorry I did this surgery. Pain makes me short sighted I guess. They haven't even taken my drain out yet. It keeps filling up, they have cleaned in a couple d times but it keeps getting blood/clear stuff in it. The idiot doctor who came in here this morning said , oh, that should have come out yesterday... It is still in and it's 330 in the afternoon

. Wish me luck. I'm gonna call the nurse. Thank you all so much. Thank y for sharing ideas. I areciate it.

Post Edited (poplargrove) : 8/23/2014 2:07:11 PM (GMT-6)

Posted 8/23/2014 8:40 PM (GMT 0)
Gosh poplar, what a nightmare to go through. I was very lucky when I had my back surgery. The first thing my surgeon asked me was what meds I was on before having the surgery. He then went on to notify the nurses and to inform them that if I am not getting adequate pain relief then to up the dosage. The pca pump did nothing for me so they started giving me shots instead. Dilaudid was the only thing that touched my pain, along with the steroid pack for a week and a good muscle relaxer. The surgery was the worst thing I have ever gone through due to how much pain I was in.

I can't imagine them saying go home when your pain isn't controlled. Where I live, they will not send a person home if their pain cannot be managed by oral meds. I am so sorry that you are having such a hard time and you should not have to be in so much pain. When I end up in er due to a major flare, they always make sure that I get my regular meds on time that I normally take at home if I'm there at the time I would take them. They don't want to see me in withdrawal as it's not pretty. Okay I'm rambling on but I really hope that they will help you more and get this pain under control. The body cannot heal properly when it's so stressed out. Good luck to you and keep us posted on the progress.

Lynn
Posted 8/23/2014 8:43 PM (GMT 0)
I wish you luck!!!

If you are still draining that drain should stay in. With my wife's drain, she had to wear it home and I was instructed to keep emptying it till it was done draining and then take her to her Dr. to have it removed.
Posted 8/23/2014 9:09 PM (GMT 0)
I agree with quincy about the drain. Don't waste any energy being concerned about that.

What position are you in? Keeping my neck very tall and straight worked the best for me. Bending head forward just slightly created extra pain. It needs to remain straight, at least mine did. Same thing in bed on your back, keep the neck straight, looking forward. How I wish such a small thing would help you. I'm just trying to think of anything I can. I didn't come to this site for quite some time after surgery because I was not comfortable reading or typing.

Prayers continue for you.
Posted 8/23/2014 9:26 PM (GMT 0)
Hi Abilene, thank you for the tips on position for my neck. I am laying just like you said. Necessity, I couldn't lay any other way. I am kinda looking down my nose at my ipad.

And my typing is not great. The nurse finally called the surgeon again, (he wouldn't answer his phone earlier) and he increased the OxyContin to 40mg every 12 hours and. Nucynta to 100. I am praying that I can finally get some relief so I. Cam sleep some.

I am so tired but this searing hot pain will not let me relax. Oh, and she just took out that drain.... I hope that's ok. The cna just took my temp and it is slightly up at 100.2 so he told me to do the re spirometer thingy more often.

I have just gotten the new des of OxyContin and the additional 50mg of nucynta. What a nightmare this is. Thank you all for the answers and suggestions.

I hope this surgery will end up being the best choice....kind of a moot point right now. I cannot believe how they will just let you lay here and suffer, when it is easy to help. Unreal, whew
Posted 8/23/2014 9:33 PM (GMT 0)
Your signature tells quite a painful story, Abilene. You are something special to have such a great attitude after all that.

Poplar, I'm sure that it's ok that they remove your drain , they usually don't need more than two days anyway. I am so happy that they finally listened to you and your husband about the pain meds, I so hope that you get a nights rest after all they have needlessly put you through . . . Q
Posted 8/23/2014 9:37 PM (GMT 0)
Thank you Quincy. This forum is such a good ting. Whew
Posted 8/23/2014 10:00 PM (GMT 0)
Thanks for the prayers, Abilne and help Quincy, Dixie, Alcie, Straydog, White beard, Angeleys, Rcck and Lynnster. I am starting to get some relief fom the OxyContin at 5pm.

Oh my goodness I am thankful for my nurse sticking up for me. I am still in disbelief that trying to get relief AFTER surgery is such an ordeal. I am glad I may get a chance to sleep tonight. I hope he will rx me correctly if I get t go home tomorrow (Sunday)
Posted 8/23/2014 10:09 PM (GMT 0)
Wow Poplar.I hate that they've let your pain get so bad.

God Bless and Comfort you and hopefully change the thinking of your Surgeon.I know that's a long shot.

I wish I could send you some of my 2 mg dilaudids through the computer.

I hope your pain lessens,

Rick
Posted 8/23/2014 10:42 PM (GMT 0)
My 78 year mother TLIF surgery on Wednesday. They have given her so much meds that she as barely woke today. No meds today. Said she had enough to put a horse down. Morphine, dilaudid, percocet and norco. It has had me in tears scared. She def has not had much pain. She has been talking out of head when awake and dreaming. This has been one rough day. Crazy how they can give on toooooo much and one not near enough.
Hope you get relief soon and sleeping beauty here wakes up!
Posted 8/23/2014 10:51 PM (GMT 0)
I had a revision reverse shoulder replacement, 2 intraoperative fractures, and neither the ortho or pain service ordered post op pain control. I guess each thought the other would. I begged the night nurse to call the pain service as the surgical block wore off but she did not. She said Tylenol was enough. So i get it - how CP patients are treated.
Several hours later they had to do rescue meds, then gave me too much so that i was not conscious.
Take care, heal well.
Posted 8/23/2014 11:53 PM (GMT 0)
Oh my you have my many many prayers and i hope you ask for the patient advocate...So very glad the nurse finally got to your doctor. Don't leave at all unless the prescriptions are correct and ask about them...

Sure hope your pain is in control soon, your breaking my heart...so very sorry...
Prayers and I wish I could help you out....
Posted 8/24/2014 4:12 AM (GMT 0)
Poplargrove I really do empathize with you! My last two spinal surgeries I had a dickens of a time with pain control! And the posterior cervical one was definitely the worst! I too wondered if I had made a mistake having the surgery! It took quite a while before coming around and thinking I had done the right thing having the surgery! This is a tough one! It will take a good while to heal, so your definitely going to have to be patient with yourself!! Right now pain control is a major concern keep on your doctor if your not getting adequate relief! Easier to get it managed while your in the hospital than to wait till you get home! I can't stress that enough! I know from experience!! Heck after my posterior cervical fusion I went to a rehab/nursing home facility (was suppose to have been there a couple of weeks) they (the hospital) discharged me there without any orders for pain control! I thought the hospital was bad, nothing compared to that! Yes it is amazing how they react to and then treat patients with pain! Animals are treated by vets better than what allot of patients are when it comes to pain!!!

Just remember your end goal! It will take time but you will feel better in the end! As trite as it may sound, hang in there poplargrove!!! I will continue to keep you in my prayers!

White Beard
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