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Surgery and on Pain mngt contract

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Posted 7/10/2013 9:56 PM (GMT 0)
I am having surgery soon and would like to know how to handle doing my pain meds there and when I go home when I am on a contract that is done only through home delivery?

Please help me what to do? thank you
Posted 7/10/2013 10:06 PM (GMT 0)
I've had numerous surgeries. My pain dr has the surgeon and the hospital handle pain control while I'm inpatient. That's an acute pain situation and pain levels can change hourly. He allows the treating dr to prescribe meds upon discharge, but he has me follow up the same week I'm home.

You need to talk to your pain management dr and find out how the office handles surgery situations. I've honestly never heard of a pain dr having an issue with pain control while inpatient in a hospital. Of course, it's better to ask ahead of time to make sure all parties agree on what should be done.
Posted 7/10/2013 10:11 PM (GMT 0)
Sophia,

I would definitely put in a call to your doctor to see how he/she wants to handle it.

I've dealt w/ this several times.... while I'm hospitalized, I can get whatever needed (be it IV meds, oral, etc). Upon discharge, though, I have to make any changes with my meds (like needing additional meds, etc) w/ my Pain Management doctor. Sometimes they will just do a phone consult and approve the meds I'm being discharged with.... or sometimes I have to go see them.

If you get your meds via home delivery, that will just add another complication into the mix... you might talk to your doctor about having him write something now so you can get it delivered beforehand, etc.

Regardless, I think the best thing to do is get in contact w/ your doctor..... --Tina
Posted 7/11/2013 12:34 AM (GMT 0)
My experiences are like Tina. They treat me while in the hospital but my pain doc has to prescribe my after surgery meds. They write a recommendation and he follows it (or even does more to be on the safe side). Deinitely give them a call!
Posted 7/11/2013 12:59 AM (GMT 0)
Thanks so much!! I made an appt with her so its face to face. Also what about asking for a patient controlled pain pump after surgery? Im not sure if that is better as I know the nurses can get busy with other patients and its hard sometimes to wait around on them for meds. Do you think that is crossing the line to ask for it and will it benefit me?
Posted 7/11/2013 1:32 AM (GMT 0)
I've had a number of PCA pumps. I've never asked for one, they've just been prescribed. One factor may be how long you will be inpatient. My dr has said in the past that if a stay is less than 2 days, he usually doesn't go down that route. Drs want you on oral pain meds at discharge and a PCA will slow the transition.

I'm glad you have an appointment with your dr. I hope you guys come up with a good plan. Surgery is stressful enough without having to worry about pain control.
Posted 7/11/2013 4:48 AM (GMT 0)
I too have been on many PCA's, but I've never asked for one. My Doctor's usually prescribe it for me, like Rocckyd's Doctors do. I do know that if I'm not going to be in very long they keep me on IV pushes with the nurse giving them every 3 to 4 hours depending on how my Doctor writes it.

If I'm in longer they will order the PCA but the encourage me to get off of it ASAP. I know at least with my Doctors they want me on oral medication ASAP. You can't go home on a PCA so it hinders your discharge.

I hope your surgery goes well and that you may be pleasantly surprised that your pain post-op won't be terrible and adequately controlled. Best wishes and let us know how you do.

Hugs,
Barbara
Posted 7/11/2013 5:03 AM (GMT 0)
Sophia A, definitely talk with your Pain Management Doctor, and if possible have her/him talk with your surgeon and co-ordinate your pain management while your in the hospital for the surgery. In the past I have had major problems with pain control after my surgeries, while in the hospital. My surgeon and the hospital staff just didn't know how to adequately treat my surgery pain because of the pain meds I was on for my Chronic Pain. I was constantly being under treated! They often don't realize that when a person is already on pain meds that often we have a higher tolerance to the pain medications and it takes more to control the pain than it would on somebody that is not on pain meds. Previous surgeries they had me stop taking my normal pain meds and then after the surgery they did not restart me back on my normal pain medications but instead put me on a PCA pump and was just treating me for the pain from the surgery. It did not touch my pain, and I had a very difficult time!!!! My last surgery, I discussed at length my concerns and the previous problems I had experienced, and my PM then talked with the surgeon and had him keep me on my normal pain meds the whole time I was in the hospital and then, was given additional pain meds to control the pain from my surgery. I had a much better result this last time!. So I highly encourage you to make sure your PM doctor is right there working with your surgeon and hospital staff to manage your pain while your in the hospital having your surgery. I would hate to have anyone go through some of the problems I had had in my previous surgeries!

I wish you well! and good Luck to you with your up coming surgery!

White Beard
Posted 7/11/2013 6:50 AM (GMT 0)
Sophia,

WB gave you some good advice. Often times, CP patients are under-treated after surgeries.

For me - whenever I have surgery - I either coordinate things w/ my PM doctor.... or, at the very least, have a consult w/ the surgeon and/or anesthesiologist.... I let them know that I've been on high levels of narcotics for 10+ years and that I'm worried about my after surgery pain control... and we make a plan.

If it's a minor surgery - for instance, I just had a chest port placement - I had IV dilaudid (or fentanyl, now I'm blanking)... and I did ok.

If it's anything more... I ask for a PCA....

Again, that's for me and what's worked in the past.

But you are wise to be thinking about this beforehand and have a plan in place.

Take care, Tina
Posted 7/11/2013 7:17 PM (GMT 0)
Thanks all for the advice. From what you all say it seems it may be better not to the self admin one cus I should hopefully if things go right only be there for 4-5 days.

As far as the prescriptions go doc said that she would allow the doc there to do it and when Im discharged I can take the script to any pharmacy and then when I need to restart my original one with her then just call and they would restart it. I really am lucky to have such a great doctor that doesnt make things complicated or hard.
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