addional pain management for the CP sufferer

I had two horrible situations after my 2nd and 3rd fusion surgeries. The first situation was just because I had a terrible Neurosurgeon and I knew upon waking that something just wasn't right but he came into my room and said, "I had shoulder surgery this year and only needed Tylenol"..I wanted to kick him!

The second situation was just a miscommunication with my Neuro (new one and one I have now and love!), and the hospital staff.

Right before the surgery I was loopy as all get out as my Neuro wanted me to be as pain free as possible and get a head start...LOL..So he had me double my OxyContin dosages...Let's just say I was pretty goofy with my Pastor, mom, and then separated husband.:)

Anyway, this surgery I knew would be rough as it was going in through the anterior and the posterior approach in my neck and he was removing all the hardware and putting in a lot more so it was close to an 8 hour surgery. I woke up with the most excruciating pain I've ever been in....At that time I had not gotten to be actual friends (we chat and see each other outside our appts.) with my PM yet so didn't have his cell. So it took a good 10 hours or so for them to get it sorted out that I was on pain meds prior and needed x amount to cover things now with this surgery.

The other funny part though is that I woke up with a nice black eye as it turns out when I was flipped over on my stomach (they have that metal cage screwed into your head), my breathing tube fell out and the anesthesiologist had stepped away for a second and my Neuro said he had to literally jump over and accidentally elbowed me in the eye as I was in big trouble! Of course it was scary for my family when he told them but no biggie to me being asleep...LOL

So, I think we can try as hard as we can as WhiteBeard did before his recent surgery and get our PM and surgeon to have a solid plan but I think there needs to be more written down on the chart BIG and BOLD by one's bedside to alert any new Dr. or Nurse that this patient is on x amount of meds because of previous pain management meds being "such and such"...So they know right away and don't keep trying to say, "You are getting what everybody gets and should be ok"....

I unfortunately think it happens way too often. I also think there should be mandatory training for hospital staff to learn more about chronic pain management and surgery and realize that you can't just have a "standard" as every patient will be different with different pain levels.

Sorry it happened to you and your father.

I was on 7.5 lortab from the pain DR . and had rotator cuff surgery cuff repair 2 years ago. My pain Dr. said to continue my lortab and the orthpedic could add if needed as long as I made them aware of it. He added more Lortab. I had a problem getting ease the night after surgery in the hosp because of lousy staff. The pain meds worked at home but I had a tough first 2 weeks. My surgery was extensive and he could not repair all the muscles. I did the rehab and recovered in about 3 months.
I had my spleen removed (they thought due to Lupus but was Lymphoma) a few years later. I had an understanding with my surgeon that he would not let me hurt. He had me covered on orders on the chart and the nurses were not afraid to give the meds. I was able to come home earlier than expected and he sent me home on Percoset. I only needed the one prescription.
I made a good recovery.
Now I am on a time released pain med and tramadol if needed between times.
I was in the hosp 10 days with a bacterial infection last year and had quite a bit of abd pain. My Dr. had the orders on the chart to take care of it.

If I had to have another surgery I would have an understanding before I went in, any problems I would take up with the Dr.
Nurses go strictly by whats on the chart and even then are sometimes afraid to give any closer together or make any deviation. Some will let you lay there in pain if it does not work while others are not afraid to call the Dr. and let him know its not
working and he will usually add something or make a change.
Most nurses are not used to chronic pain patients and the amount it may take to ease some of us. We scare them.

Oh SB, it brought back a memory for me when you mentioned your Neuro and his comment about Tylenol! After one of my surgeries, the attending told me (after I had requested additional pain medication) how he had NEVER needed anything stronger than prescription strength Motrin after ANY of his surgeries. He went on to tell me that his surgeries included 2 back surgeries, appendix removal, and 2 knee surgeries. I congratulated him on his super-human abilities and asked him to please increase my pain medication. I too considered kicking him! lol

The best bet is to try to make sure that everyone is on the same page about pain control before any procedure or surgery, but as some of us have discovered, it doesn't always make a difference. Also, many hospitals have patient advocates - they can be very helpful. A family member or close friend can also be a big help. With both my father (r.i.p) and my fiance, I have literally chased down nurses and/or doctors to voice my concerns about their pain control (or lack of!). It's just really unfortunate that we have to fight so hard for something so simple - to be comfortable.

Post Edited (Splashdancer) : 1/11/2013 6:07:25 PM (GMT-7)

My plan is simple. A list of my current meds, stapled to my PM (when I get one) and lawyer's business cards.

If it is a planned surgery, you can also find out ahead of time the name of the hospital administrator, and a way to contact him/her, along with key employee information, such as nursing supervisor, department heads, etc, and sometimes their contact info, usually publicly available from the hospital website.

Stack all of that paper together and hand it to the surgeon in the pre-op meeting before they start talking. Work from there, and have more than one copy of all of that info with your personal belongings in your room. Any questions from some nurse working the night shift, or a doctor falling down on the job, and a reminder that you know who to contact is usually good inspiration.

But, I'm a bit of a jerk when I'm in real pain, and my mom is a retired RN who knows how things work and would be by my side, so it probably not come to that. But the lawyer's business card is a very handy item to have. Don't say anything other than regarding your condition, don't threaten, just hand them the card. Ask any lawyer and they will give you a stack of them. This device usually at least makes people double check the orders and dosages.