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Having surgery, does my PM do my additional meds???

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Posted 12/30/2008 1:07 AM (GMT 0)
Hi everyone.

I am due to see my PM doc next week, but just thought i would check here first.

I am having surgery to remove my ovaries due to chronic complications with them over the yrs. It will NOT be laperscopic but will be a full inscision like a C-Section (actually going through my section scar).

Since i have taken percocet for 8yrs now (5mg 3x a day), there is no way that will work for my surgical pain.  I never thought to check w/ my PM when i was haing my csections, i just took what my OB gave me.....After reading everyone's posts, i assume i should discuss this w/ my PM. 

My concern is that how would he be able to judge what i need, when he is NOT the acting surgeon? I don't want to have to see both my GYN and my PM post surgery either just to jump through hoops for my meds.  Is it out of question to just tell him i want my OB/gyn to handle it? But that im just letting him know as a curtisy(sp)?

What do u all think? Do i discuss it w/ my PM or just forget about it??? I would not want to make him feel like i was trying to be sneeky or anything either....but again, i never did discuss it when i delivered my two children...was that my mistake?

Posted 12/30/2008 1:23 AM (GMT 0)

Shannon, I think it depends on what your contract says and what your PM doc wants you to do. My PM doc has the surgeon prescribe post-op meds and then if they do not cover the pain and the surgeon will not increase them, then we are to call him.  I have had a few surgeries under this policy and it has worked out pretty good.  I informed my pm doc that I was having it and then the surgeon took over.  Of course I was still on all my pain meds from the PM, the surgeon just gave me enough to cover the surgery pain.

I do recommend getting it all straight BEFORE your surgery as the last thing you need after surgery is to be in pain and having to get someone to treat your pain and each one passing the buck. I learned that the hard way my first surgery after starting pain management when the surgeon wouldn't give me enough and the pain was horrible. So now I refuse to have the surgery unless all that is taken care of.

I hope your surgery goes well and you have as little discomfort as possible.

Just a note, I had the same exact surgery that you are having and it was not too bad except for the pain I had in my back. I wasn't expecting it there and my doc said that it is common. So if your doc didn't say anything, don't be surprised if your back gets uncomfortable. I wish someone would have told me that was normal because I thought something was wrong.  Good luck and take care!!

Melissa

Posted 12/30/2008 3:07 AM (GMT 0)
I am under contract to tell my PM dr when I have been given any kind of narcotics. Unless they are in the hospital or ER as the form of an IV or some med for spasms, I usually refuse whatever they are going to give me. I know they aren't as strong as what I am taking, so whats the point? I always let my PM dr know when something else is going on, that way if I need something stronger, he will accomodate me. Not saying all PM drs are like that, but mine is good to help when I have other issues causing me pain. Either way, I think its important to always release what meds you are on to all your drs just so nothing reacts against the other medication or so they know that a regular pain killer -for example- won't work as well as it normally would because you already have a tolerance built up against it, so you will need something stronger to help curb the pain. Good luck with everything & hope your pain isn't too bad!
Posted 12/30/2008 3:14 AM (GMT 0)
Melissa,
Thank you for your response to Shannon's question. I have often wondered
about this subject but didn't quite get my question formed.
A surgery could be coming up for me and I want to get things all straightened
out beforehand.
I'll serve tea and crumpets and have my a host of doctors all get together
and discuss my pain management.
Pamela Neckpain
Posted 12/30/2008 3:32 AM (GMT 0)
Hi Shannon,

My old contract with my PM also said that I had to inform him of any pain meds being prescribed for an acute issue, such as surgery. We had two weeks to inform the doc & ideally the doc would like to know asap or even before the procedure so that he could make adjustments to any meds, if needed.

I also agree with the others that you should talk to your doctor sooner rather than later. Your PM may also want to talk to your surgeon to chose your post-op pain meds since you already have a tolerance to percocet. Also make sure that your surgeon know whats meds you take, so, like kttn said, you don't have any negative interactions.

Good luck with the surgery! Here's to a speedy recovery!

Skeye
Posted 12/30/2008 4:09 AM (GMT 0)
Shannon,
You've been given some great advice. I'd follow what skeye has just said (as have others). I don't even know if your PM would do a consult in the hospital; does he have priveleges at that hospital, and does he do any hospital work? If the answers to those questions are no, it would only be a telephone consult. But you do want your surgeon to know, an remind the anesthesiologist what you've been taking when he/she comes in to talk with you just before the surgery.

I hope all goes well! Take care of yourself!

PaLady
Posted 12/30/2008 6:02 AM (GMT 0)
When I have had surgery while under the care of PM, I simply let him know that I was having surgery. The surgeon took care of post op pain meds and for a few weeks after surgery, of course depending on how long I needed them. After that, I returned to my regular PM for my regular PM meds.
On a second note, when I had my hysterectomy, I had a pain pump for pain. I didn't need to hit it at all after the first day. I was up and moving around on my own quite well. In fact, I hadn't felt so good in a long time, even with a huge incision. It might not be as painful as you may think.
I remembered my mother's and thought that it was going to a horrible pain, and I wouldn't be able to stand or sit or any of that stuff, but I felt remarkably well.
I was a bit sore sitting up, but once I was up, I was fine.
Best of luck to you, and I hope you have minimal pain Shannon.
Sandi
Posted 12/30/2008 1:16 PM (GMT 0)
Thank y0ou so much everyone!!!!!!

I will discuss it all w/ my PM next week when i see him for my regular appt. I honestly can not even remembr what my PM contract says, as i signed it 8 yrs ago and have not seen it since. Docs office is pretty far from the hospital im having surgery at, so i doubt he will find the time to do a hospital consult, but maybe he and my surgeon can have a phone consult...I will also discuss all this w/ my gyn! I dont' worry to much about not getting adiquite pain relief, as my gyn is very good about that and i was fine after my csection just 19mo ago.

With my last laperotomy, i did have alot of pain, strangely, more than when i had my csections.....I have UC and my gyn always fills me soooooo full of gases to help him see around my big swollen bowels! LOL

Anyways, surgery is on Jan.21, and im sooooo ready! Thanks again for all your words of wisdom!
Posted 12/30/2008 7:59 PM (GMT 0)
Yes, I had surgery and discussed this with my pain dr. I too had a Contract. He was able to handle my meds and in my opinion pain dr know much more about pain than the surgeon. Surgeons wants you off meds ASAP. Good luck. Susie
Posted 12/31/2008 5:04 PM (GMT 0)
Shannon -

Good luck with your surgery! Take plenty of time to recover and remember you only have one chance to heal correctly. Adhesions are a horribly thing to get from over doing it after surgery. In fact, it is the reason I am a chronic pain person. I was bad, overdid it after my hysterectomy (falling down the stairs did not help either) and will now suffer for a long time because of it.

I am only saying this as a warning and because I don't want another woman to ever go through what I am going through.

Take care of yourself!
Sarrah
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