12 yr old pain medication

[YogurtYum]

My 12 yr old just had an appendectomy and so far there has been no pain medications which affect her pain in any way.  She's had Norco, Morphine, Tramadel, Toradal, & Loritab, all of which did nothing pre or post-operative... Any suggestions as to what to try next? Also, she seems to have no response to either Ativan or Ambien.  Neither make her sleepy & the pain keeps her up all night!! Thanks for any help!

[YogurtYum]

Thanks so much for your suggestions.  We have an appointment with her pediatrician in the morning, so these are good suggestions to take with me.  Funny that one of you mentioned that you have family members who become more acutely aware of their pain, because this is what would happen with my daughter.  She has been telling me that the medicine actually makes it hurt more, although I couldn't believe this!  We have been off all pain medicine for 2 days now because she refuses to take it, stating, again, that it makes her feel worse.  She had laparoscopic surgery and it's her incisions that are hurting her so badly, now.  The pathology from her appendix was that it had fibrous obliteration... Not sure what that means either, except that her surgeon told me it was a disease of the appendix.  We are about 5 days post-op now, so I'm hoping the healing will become more aggressive and her pain will diminish... Thanks for the support... After 12 days in the hospital with NO pain management, we are all a little frustrated!!

[Jaybay]

Some people have a paradoxical reaction to opiates in that it wires them up and they become acutely more aware of their pain and can't sleep.  My mom and my brother react that way to any narcotic, no matter how strong or how mild.  The more they hurt, the more they'd take, and the worse they got.  Your poor little girl just might be one of the unlucky ones who reacts this way.  IF I remember correctly, this is something that happens more often in children and elderly patients.

How many days post-op are you talking about?  Did the appendix rupture, and was the surgery done laparoscopically or was it an open procedure?  The hospital should have given you a list of things to watch out for like fever of 101 or higher, significantly increased pain, or a hard and obviously bloated abdomen.  If any of those things happen, you need to call the surgeon immediately.

If none of the above symptoms is present, I think in your shoes I might discontinue the pain meds and sedatives since they aren't helping anyway, and try her on tylenol for a few hours.  Avoid ibuprofen or naproxen (aleve) until she's healed from the surgery.  Call her pediatrician and explain what is happening.  You may get better advice about pain control from a doctor who specializes in children.  If you can get the pediatrician to speak to her surgeon about it and agree to a pain treatment plan, so much the better.  

I feel so sorry for both you and your daughter!  Pain management is a difficult enough proposition for adults, but in my humble and non-professional opinion, children in pain are all too often undertreated.  The assumption being that if they aren't hysterically screaming, they're fine; or on the other hand they're just emotionally upset but not in "real" pain.  Those attitudes make me crazy!  Please post back and let us know how she's doing.  I'll be up for a while if you just need someone to talk to.  :-)

[JadedSweetheart]

Some people are somewhat immune to morphine, I know.  I'm sorry you're going through this with your child.  That is the worst!  I agree wtih Sara on calling the surgeon.  The lortab and norco are essentially the same medication.  Maybe oxycodone (percoset) would be good to talk to the doctor about?  As for the sleep, maybe melatonin?  Of course the doctor should be consulted about any medication for someone, especially so young, but it may be worth asking about.
I hope it is all straightened out for your daughter soon!  

[Sarajmt]

Yikes!  I am so sorry that your baby is going through this.  It's awful for you and her both.  I really don't have any advice as to a specific drug but would definitely call her surgeon.  Perhaps upping the dosages would help.  But always consult a doctor prior to doing this.

You might try asking your pharmacist.  She is a fount of information and may know of something new that will help.

Good luck to both you and your daughter.

Sara