Beating the Pain Game

[Jonathan Blue 311]

Knowing your pain management plan post surgery will allow you to reduce complications and get out of the hospital soon. I have included some helpful tips from a hospital pharmacy insider... ME!

I often times get asked what is the biggest piece of advice I could give someone for surviving their hospital stay. For me the answer is a hands down no brainer. CONTROL YOUR PAIN MEDS! Nurses and hospital staff will be in and out to see you, but you need to realize that each nurse probably has four to six other patients all vying for attention. It is your responsibility to take your pain management into your own hands. You do not want to mess around when it comes to managing your pain! If you are in pain you will be unable to get up and walk. The longer you take to begin walking the greater your risk of complication and the longer your hospital stay. In this case DO NOT BE A TOUGH GUY! Wuss out and take the meds.

You will be constantly asked during you hospital stay what your pain level is. It will be on a scale of 1 to 10 with 1 being no pain at all and 10 being the worst pain you have ever felt in your life. Be sure to answer honestly. DO NOT TRY TO BE MACHO! 3 to 5 on this scale is considered pain, but tolerable. If you drop below a 3 many doctors will begin reducing pain medication. Above 5 and they may begin increasing. The doctors and nurses want you in the blissful middle zone of 4 to 5. It should feel as though you have a bad muscle pull in your stomach, but no sharp or stabbing pain on a continual basis.

Your pain post-surgery will most likely be controlled in one of a two ways. The first is with a gloriously blissful device known as a PCA pump. This is a machine in which a syringe of Morphine or Fentanyl (depending on what your doctor and a hospital pharmacist deem to be appropriate) is placed to be administered to you at the push of a button. The best part is that you have control of the button! The machine can be set to allow you to administer the dose yourself every so many minutes; usually half an hour. The other way your pain will be managed is with an injection of morphine or fentanyl? This is pretty straight forward and don’t worry if you are scared of needles. This pain candy is injected into your IV.

Once you get past the injections or PCA pumps, usually once they take out your IV, you will most likely be weaned onto an oral pain medication of some kind. Many surgeons prefer Percocet for this application, but you may also be given an oral morphine. There is really no major difference between these in terms of effectiveness though there are other consideration that your doctor and a hospital pharmacist will use in consideration of which to give you.

It will be your job in the hospital to stay on top of when you get your pain medications. Here is what you need to know from an insider. I work as a pharmacy technician in a hospital so I am familiar with the workarounds. Here is the rule of thumb. The PCA pump will be available to you at your discretion and will most likely be hooked up before you wake up from surgery or shortly after, but injectables last about two hours and the oral liquid lasts about four. That is a very short window and you need to be sure to talk with your nurses and find out how long each medication is good for.

I made it a point to let my nurse know half an hour before each medication was due. This will allow them plenty of time to get your medication to you before time runs out. If the medication is not stocked on the floor then it will be delivered from the pharmacy and will take time. You want to give your nurse plenty of time to make this happen. Your nurse will not always remember when your pain meds are due so it will be your job to remind them. Remember, they have five other six people all needed medicines and all needing extra special attention so it is possible that you could be forgotten if you do not speak up. I am positive some nurses found me annoying, but other said they really appreciated the fact I was trying to stay so consistent with things and remind them. They key here is to be very nice and just let them know you are trying to stay on top of things since you know how the pharmacy works. Nurse’s love blaming the pharmacy for delays and they will love you for not blaming them. Far too many people do.

Running out of pain medication is a lot like falling off a cliff. You go down fast and it takes a while to climb back on top of it. So do yourself a favor and make sure you understand how long your pain medication will last and what types you are on. Make it a point with one of your final doctors’ visits prior to surgery to discuss what their plan for pain management will be and specifically which drugs he likes to use and why. With this in particular and your weight loss journey in general, KNOWLEDGE IS POWER! The power to finally begin taking control of your life. That is what this amazing journey is all about. This will be a great way to practice in the hospital before you get home and the real work begins!

[mrsbailey921 117]

great post! unfortunately the self controlled morphine did pretty much nothing for me and i had self administered drips every 10 minutes. the only way i was able to get some semi relief from pain via the self administering was when i would hit it every single 10 minutes for at least 4 times in a row. but for the most part, i worked through my pain by walking within hours after surgery, talking, sleeping and focusing on talking to my husband.

i do wish i had a better experience with the self controlled meds...but my nurse Lenor was such a sweetie and we made jokes about it all that night.

however i do agree--pain management is CRUCIAL for a good recovery and this post is awesome.

[epiphani 28]

If your pain medication is not working after surgery, please ask your nurse to contact the surgeon to increase the dose or try something different. Nurses are used to working with what they have, and sometimes forget that a simple phone call can make a huge difference in a patient's experience.

[AgentShepard 88]

They moved me from IV drugs to oral oxycodone the day after surgery, and it wasn't enough. The nurses called my surgeon and he ordered me a change to Percocet. That did the trick and enabled me to keep up my walking! I moved to the oral oxycodone when I went home the next day and was fine. The moral to this story is, if it isn't working, ask for a change - it can make a world of difference.

[samuelsmom 670]

Great post! The only thing I would like to add is that if pain is due to gas, which is quite common after laparascopic procedures, the pain medication won't really help. Walking, however, will do wonders.

[itsmekarenlee 129]

But if you get a dr that refuses to give you the one pain med that works on you and you tell him before surgery that morphine and diludad (and others) don't work on you and still he refuses to give you that one pain med (Demerol) that DOES work and that you've just had 8 months earlier for a major surgery (and some of my other surgeries, that's how I figured it out), then you are just poop out of luck and you have to writhe in agony after surgery as the nurses feel helpless and on your side (they called him twice and he still refused and couldn't be bothered to come in and check on me) when you chew the dr out the next morning, he snickers, and then get an anxiety pill scripted to you an hour later. I was fine and refused it and the nurses, again, agreed. Jerk. (I have more choice words but will refrain). Needless to say, I will no longer pay him over $200/visit for him to ignore me anymore. DONE. Now, If I can just be DONE with these resentful, hurt, hateful feelings..................... ugh

Edited December 5, 2014 by itsmekarenlee