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Surgery Tips for Fibromyalgia Patients

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Posted 4/16/2015 3:40 AM (GMT 0)
I saw this posted on facebook in a fibro group I belong too and thought I'd share with ya'all. :)

Surgery Tips for Fibromyalgia Patients

Having surgery is a concern for anyone but it can be especially concerning for people who have fibromyalgia because of their problem with pain amplification, also known as central sensitization. There are, however, steps that can be taken before, during and after surgery that may reduce the "fibro-flare" that often occurs after surgery in fibromyalgia patients.

The following guidelines have been recommended by the Fibromyalgia Information Foundation (founded by Drs. Robert Bennett and Sharon Clark and their colleagues at Oregon Health & Science University). You may want to print copies of these guidlines to share with your surgeon and anesthesiologist.
Discuss the fact that you have fibromyalgia with your surgeon and anesthesiologist about 2 weeks before you are scheduled for surgery. The American Society of Anesthesiologists recommends that all herbal medications be discontinued 2 to 3 weeks before an elective procedure.

Pain after surgery is inevitable because nearly all surgeries result in trauma to the skin and muscles. This post-surgical pain is usually accentuated in fibromyalgia patients due to their enhanced pain processing (see "Understanding Pain and Pain Amplification" - also known as central sensitization).

Request that you wear a soft neck collar to reduce neck hyperextension (if an endotracheal tube is anticipated). This will help minimize inadvertent stretching of your neck muscles during positioning while you are unconscious.

Request that your arm with the intravenous line be kept near your body, not away from your body or over your head. This will help minimize inadvertent stretching of your arm and shoulder muscles during positioning while you are unconscious.

Sometimes "postoperative myalgia" is due to the use of a muscle relaxant drug called succinylcholine. If you have experienced this in previous surgery, I suggest you mention this to your anesthesiologist.

Request that you be given a pre-operative opioid pain medication - about 90 mins. prior to surgery. Opioids are morphine or morphine related drugs. The rationale for the pre-operative use of opioids is to minimize "central sensitization" - as this inevitably worsens the widespread body pain that you are already experiencing.

Two to three grams of magnesium sulfate given intravenously over a period of 45 - 60 minutes has also been recommended to minimize central sensitization.

Ask to have a long-acting local anesthetic infiltrated into your incision - even though you will be asleep during the procedure. The rationale for this is to minimize pain impulses reaching the spinal cord and brain, which in turn drive central sensitization.

Postoperatively you will need more, and usually longer duration, of post-operative pain medication. In most cases opioids should be regularly administered or self administered with a PCA pump (patient controlled analgesia).
Posted 4/16/2015 5:24 AM (GMT 0)
I busted my elbow a while back and the pain post surgery was truly bad ...but then they gave so much meds..it took a long while to get over both the meds and surgery.

I had 5 months of physical therapy..i think that also went slowly because of fibro, and i had to take a pain pilll to be able to tolerate the therapy, which is not unusual with fibro.

My outcome was good, they said i was so dedicated to getting full use back that i did better than most patients..

Still , before a storm , that arm swells.

My surgeon had done the same surgery on a gymnast and she went back to gymnastics , so i figured i could do anything too...lol..
Posted 4/16/2015 5:26 AM (GMT 0)
They tried to give Percocet while i was waiting for surgery...it made me weepy...could not take that med at all.😥
Posted 4/19/2015 12:15 AM (GMT 0)
Thank you for this information. Everyone should copy and keep it in their healing well plans. Great self advocacy. Sadly, already had my surgery. Not clear that my issues are w centralized pain or just really hard to do excrcises when shoulders neck and head hurt after doing knee strengthing. Up one day down the next.
Blessings
Posted 4/26/2015 6:33 PM (GMT 0)
Wow!! Thank you so much for this information!!

I am having major knee surgery oh June 23rd. I've been nervous about how this will effect my Fibro. The standard recovery is 2-3 months since this is my 14th knee surgery I always take longer. ( it is a 3rd revision to my knee replacement that I had)

I am going to copy and paste this info and show my Dr. This is my first surgery since being diagnosed with Fibro ...

Thanks again!!
Posted 4/26/2015 10:36 PM (GMT 0)
I've had many many surgeries over the years, and here are my tips.

I always recommend a cervical neck pillow (mine is called a McKenzie cervical roll). The time before last when I had surgery, my neck ended up hurting way worse than my incision. I suspect it was from lying on my back too long. I had surgery again last year and used a cervical roll, and it helped quite a bit.

I also had an abdominal nerve block (I had abdominal surgery) in the recovery room. They wouldn't give it to me until I requested it, but I did as soon as I was able. It helped tremendously. Not all hospitals offer it, but it is worth discussing if you are having abdominal surgery. I guess this is a similar premise to requesting a local anesthetic in the incision.

Also, stay on top of your pain meds. It's much easier to prevent the pain than to get it under control once it gets out of control. Again, you often have to ask for it, but I suggest requesting it as frequently as the doctor allows, at least at first.
Posted 4/26/2015 10:53 PM (GMT 0)
Interesting stuff. I've had a couple of surgeries post-Fibro and I don't know how many of those suggestions were followed.

what I did find though was that pre-op preperation on my part went a long way. Eating properly ahead of time and making sure that I had plenty of nutritious food on hand for after surgery. Also, making sure that I had plenty of pain meds for after surgery.

The funny thing was that the first surgery I had the recover was so much worse than the second. The first one the doc told me I'd be all good in about 3 days and didn't give me pain meds to go much longer than that. I ended up back at the office and in the ER needing refills. The second surgery the doc gave me plenty of pain meds and I was up and good in 3 days. Fibro is so unpredictable, but I do think it had a lot to do with preparation on my part, and on knowing what to expect the second time around.
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