Narcotic Pain Meds Pre-Surgery

[Guest guest]

Hi Everyone,

Please excuse the partial message I sent last week. I hit the wrong button. I’ve been typing with one hand and it's not easy. So, I’ll try again, from the beginning. Sorry, this is long.

Two weeks ago, ten years after revision surgery with Dr. Boachie, I had another operation. This one was a CMC Arthritis Arthroplasty. It's a reconstruction of the joint that joins the wrist and thumb. Some things happened to me that I think may be of interest to the Group.First, I have been on a small dose of Methadone for about a year and a half, for pain after revision surgery. The pain is from a deteriorated SI Joint, probable Arachnoiditis, scar tissue and goodness knows what else. I also take Cymbalta. Both drugs are given to me by my wonderful pain doc. I was concerned about how taking these drugs before my wrist surgery would affect my pain level immediately after surgery. I remember several members saying that their revision surgeons insisted they stop all pain meds prior to revision surgery on the theory that taking pain meds up to surgery would decrease the effectiveness of pain relief meds after surgery. My pain doc said that theory is old, that I should continue taking the Methadone and Cymbalta right up to surgery. He said those meds would be my base line and I would be given whatever I needed on top of that. I also discussed this with my hand surgeon and his response was exactly the same as my pain doc’s. Whew. (I had been told by other patients and the surgeon’s PA, that this wrist surgery would be the most painful surgery I would ever have. I just laughed at that.)

The first person I saw in the pre-op area was the CNRA, who looked at all my records and then admonished me for not decreasing my pain meds before surgery, by 20%. She was angry! I told her what my pain doc and surgeon had said and she clearly did not believe me. The day after surgery, someone from the hospital called me to see how I was doing and I told her all about the CNRA and she apologized. She knew the CNRA was wrong.

I went home from the hospital soon after surgery with a continuous drip of nerve block meds delivered through a catheter imbedded in my arm, which numbed my entire arm and hand. Fantastic gizmo. I could even press a button and deliver more as needed. It could have lasted three days if I never pressed the little button, which I pressed quite often. As a result, the meds were used up after about 32 hours. I was left with a prescription for Percoset, 1-2 every 4 hours, as needed. Ha. Didn’t do a thing for me. I found out later that everyone having this surgery gets the same nerve block and Percoset. So, in the end, no matter how many times I brought up the subject of being on Methadone and Cymbalta pre-op, my post op meds were not adjusted accordingly. My mistake was in not asking what is usually given and what would I be getting in comparison.

Once I realized that the Percoset wasn’t working, I just suffered that night knowing the pain would diminish in the next day or two. I just kept thinking that I made it through the awful immediate post op pain of revision surgery, so surely I could make it through another two painful days!

I have to wear a fiberglass cast, from my fingers almost to my elbow, for 5 weeks. As they put it on, they told me how difficult it would be to have the cast for that long. I cut them short; I told them I once lived in a full body cast for 9 months, so really, 5 weeks in an arm cast is no big deal.

I came home after the wrist surgery with bad pain in my back and even muscle pain in my midriff. It lasted for about 5 days. It was the worst back pain I’ve had in years. Even with Methadone and Cymbalta, I could not sit, stand, or even lie down without back pain, for more than a few minutes. Sleep was very difficult. I complained to the surgeon that I must have been tossed around the OR as though I were a piece of red meat, despite my having told everyone about my back. He then told me that everyone with a really bad back has back pain following a stint on an operating table, because it’s not comfortable under any circumstances, and mainly because you are placed there by someone else while your are anesthesized , so you have no way to put yourself in a comfortable position. I wish I had been told about that ahead of time so I’d have been prepared and, therefore, not spend days worrying whether the pain was related to revision surgery.

I hope these stories help someone.

Bonnie