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Extreme Post Surgery Pain

I am a 47 yr old recovering from yet another procedure. had 2 level fusion of L3-l5 in 2007  which  brought great relief, however 3 months ago started having lots of leg pain again. Had a micro foraminotomy on 4/28/09, but I am in still extreme post surgery pain. The DR says to just wait it out that I should be fine soon. But If i get out of bed and  try to do anything, light walking, sitting for short periods of time, I get extreme pain again. Had a post surgery epidural 3 days ago.
My question is, can the epidural cause more symptoms? Can it increase my pain level? How long after the shot should I start to see some relief from the cortisone? Can Heat be counterproductive to healing and pain relief? should I stick to only ice packs for a now? Could half pack of cigs a day increase pain? I am generally in good health other wise. my pulse and blood pressure are low. But I am trying to go back to a little life. My work is small amounts of walking, and sitting at my desk. I have a special back chair.
should I just stay home for a couple more weeks and try to increase my  healing time? could trying to work extend my overall healing and pain relief time?
would it be appropriate to have a post MRI? or another coritsone shot?
any suggestions for find pain relief would be helpful. Pain meds suck!
12 Responses
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547368 tn?1440541785
What awful news. I am so sorry. Life can throw a lot of garbage our way and it appears you are getting more than your share.

We'll be here whenever you need to chat. Don't be too hard on yourself, I quit for seven years and went back to those darn cigarettes.  I smoke less than you and some days not at all but it's still called smoking! Awful habit.

I think you may be waiting too long before you take your pain meds. You are waiting until the pain is out of hand. If you took them a little sooner your pain level wouldn't get as high and you may heal faster. You may want to bring this up with your prescribing physician. I learned the hard way not to be a hero. Pain has no real function other than to let you know that something is wrong. Once you know what's wrong why tolerate high pain levels. At least that's my opinion.

I wish you the very best. Keep in contact with us. If you would like to send me a PM please feel free to do so. We are always here for you, even if that means just to vent. Peace, Tuck
Helpful - 0
Avatar universal
well, I spent all day at the DR. got a new MRI, after review, he says that the vertebrae is rotated and out of place. He is reviewing my case with the other dr's in his group, but the prognosis is poor. According to him the soft tissue decompression was good but the bone is out of place and the only option I have is another fusion. That would mean three level fusion. I am 5'8" 160lbs and a horrible back. it was all I could do to drive 1hour and barely sit. Taking Hydrocodone by mid afternoon. Course I should have taken it at noon.
This *****, but I kind of expected this. Since I am not better from the conservative surgery and little to no results from the epidurals, although I am getting another tomorrow, with the outside hope it will help, the only option to relieve pressure on the nerve is to move the bones back into the original (god given) position. so, the saga continues. no real quality of life, lay around resting hoping for relief and then taking pain meds when I cant stand it any longer.
Of course if I have to have fusion AGAIN, then like before i will not smoke at all. I did fuse just fine last time, but after a few months, i started again. I guess this will be another opportunity to quit and this time stay quit. I smoked right up to the surgery last time and then stayed off cigs for a few months. stupid to go back huh?! I was a heavy smoker 20 yrs ago, but the last 4 yrs have been a light smoker, off, on, weeks or months smoking then not at all for a while.
So thats my update.
Questions, not to many right now. I guess I have to try and get better all by myself or damn the winds, and have to go back under the knife. egast for sure. that could be the savior from pain but it will bring plenty of it for a while.
Again, thanks for listening, I hope you have some pain free life for a while.
In the meantime, I am going to try and rest and avoid surgery number 5 on my back, all in the last 8 yrs. how horrible is that. I keep injuring myself, they fix it and then boom, something goes horribly wrong and they have to go back in. Terrible huh?
Helpful - 0
547368 tn?1440541785
I don't think the light smoking will completely prohibit your healing but I do think in many instances it prolongs the healing process. I'm an occasional smoker too, so it's not that I am so against smoking that I can't understand where you are coming from.

But is is true that the RBC's are not able to carry as much oxygen in a smoker as they are in a non-smoker. How good of shape you are in does not make a difference in the delivery of oxygen as it relates to smoking. Obviously the less you smoke the better.

And you are welcome. We are here for you. I am glad that you are feeling better. It does sound like you just need a bit more rest before you are up to par.
Peace, Tuck
Helpful - 0
Avatar universal
Do you think the light smoking can prohibit healing or just prolong it? I did stop for the first 1.5 weeks post op, but i was going crazy, even from the little cigs that i was smoking. it seems to be my one slight release that i seem to get from the pain. Probably in my mind that it give any relief, but at least my mind games stop.
I just figured that since I am in such good health otherwise, that the cigs would not make much difference. Could  it be that harmful? I may try the  noco gum if i have to since stopping seems so hard when I am in pain.
I figured when I got better I would concentrate on one thing at a time and  stop once and for all. I had planned to not smoke after this procedure, but it was nuts.
I did stop for 3 months after my fusion. and I did fuse fine according to the DR. He said before that this is just some other non related issue. seemed to think all along that in short period of  time I would be better after this procedure. otherwise I would have probably put it off and tried to manage.
all your help and feedback is so appreciated. this group is the  only place I seem to be able to be completely honest with my problems.
thanks so much for being there.
Helpful - 0
356518 tn?1322263642
I hope your doctors appointment gives you some answers. Everyone is different when it comes to healing and how long it takes for your body to heal.
I have had epidurals many times and my pain is primarily on my right side yet when I had then epidurals my left side would hurt bad. I never really got much benefit from them but kept getting them because I thought they would eventually start working.
I know alot of doctors that refuse to preform them as they say they do much more harm than they do good. I will see if I can find the information on this article I read in JAMA about the harmful effects.
Some do get tremendous relief from them though and for those people they are a god send.
Smoking does prohibit your healing. My Dad's doctor refused to operate on him until he had quit smoking. Of course if you had a headache it was from smoking too according to him. No matter what was wrong with you if you smoked that was the problem:)
Helpful - 0
Avatar universal
even just a half pack a day could have that much negative effects? I am slim and in good health other wise, just have a bad painful back.
day 5 from the epi and so far I feel better than I did on day 2. but doing nothing and trying to not take any meds.
almost getting by. but I am not going to work.
Going to see the DR today for a check. will post later with results.
Thank you for your support. Intellectually I think I just need week more to heal and find some relief. As you say. I just had assumed I would be doing better this time and  need some hope that I can return to some semblence of life sooner rather than later.
thank you so much, I hope you have a pain free day.
Helpful - 0
547368 tn?1440541785
Hi Bigdonkey,

I'm sorry to hear that you are not recovery as quickly as you had hoped. You have asked a lot of questions, which is fine. The more knowledge you gather the better you will be able to understand the healing process. I assume you mean that you had a microforaminotomy

"Can the epidural cause more symptoms....and increase pain? Yes to both. Sometimes it will hurt more before it is effective but I would think that within 3 days you should see some decrease in your pain level if the epidural was effective. Everyone is different but 24-72 hours is the standard to gage the success of the epidural.

And yes heat can be counterproductive. Although it can initially "feel good" it brings fluids, including blood to the site. That can cause even more pain as by swelling an area that is already edematous from the trauma of the surgical procedure. So I would continue the ice until you are instructed otherwise.

Cigarettes reduce the amount of oxygen that circulates through your blood stream thereby slowing the healing process. Some surgeons in my area will not perform surgery on an individual that smokes for that very reason.  

I don't think a post-op MRI is out of line but I am not a physician and this will depend on his/her opinion. As far as a second cortisone injections goes, usually if the first one isn't effective a second one is not recommended but again this will depend on your surgeon.

Two and a half weeks seems rather soon to expect a lot out of yourself. According to what I have read it usually takes 4-6 weeks for recovery. Everyone is different. Much will depend on your specific condition, the skill of your surgeon and how fast you heal. We can heal quicker from one surgery than another. Sometimes even less invasive may take our bodies longer to heal. I think I would take it a bit slower than you have been.

I doubt that after a short period of time and not a really high doses that you are experiencing withdrawals from the hydrocodone, especially since you have had it in the past for longer periods without these problems. But anything is possible, just not likely. You ask if  you are "having pain and craving relief"?  I'm not certain what you mean by this question. We all seek relief from our pain but that doesn't mean we are addicts.

Tramadol has a similar action as morphine. Many ppl have used this drug thinking they did not have to worry about addiction problems and have found themselves with addiction and withdrawal issues with tramadol. I suggest that you be just as cautious with this drug as you are a narcotic.

These are all issues to address with your physician and/or surgeon. We are here to support you and offer suggestions and personal opinions. We are happy to do so but you should always follow up and check with your health care provider.

Please let us know how you are doing. We will look forward to your continued posts and updates.
Take care and best of luck in your recovery.  
Tuck


Helpful - 0
Avatar universal
one thing I forgot to ask, I have been taking hydrocodone as needed for pain for the last month or so. on and off, more on in the last few weeks. Lots the last few days.
Today, despite doing nothing, I seem to be getting pain again and wierd system feeling.  Had to resort to taking a small amount to relieve pain and the sytem feeling.
Being on for a relatively short period of time, could I be suffering withdrawal symptoms already? I had to take this drug before for longer periods of time and as the pain stimulators decreased it seemed not to be an issue. Could I just be having pain and craving the relief?
I feel wierd not taking it, even though the pain is lower, still there though.
Should i try tramadol instead to come down from the hydrocodone? never really like the way I feel on that drug though.
Any thoughts or knowledge on this?
Helpful - 0
Avatar universal
Gee, I hope you feel better soon also.
I  am seeing the DR tomorrow to get a better idea of what to do to get some normal life again. soon though....
Thank you for your support. I am trying to limit the whining to my family and particularly my wife who is the single one I complain to. she is supportive but for how long can she do that?!
In the past I was better than this by this time. but you are probably right. since I did feel better last week, maybe I went to work a little to early. In this  economic climate i am worried about my job. even though they have also been super supportive and I have great benifits, my family can not survive if i do not work regularly. I am nervous about going on  disability if I can avoid it, however, can not work in severe pain all the time.
Hoping just time and rest can get me some relief. time will tell. I guess this sounds right to you? Rest, Ice, anti inflammatories and time I should get better?
thanks for listening also. I am really bored also sitting around. type A totally and I am laying in bed on my back watching TV and surfing the net.
terrible quality of life right now! egast.
How are you getting by? you in bed all the time also? What kind of pain meds do you take? I have Hydrocodone, but it ***** making my loopy all the time.
I wish you all the  luck also. You can vent to another sufferer if you  need to.
Seems like there is an army of pain sufferers out there.
Gary
Helpful - 0
760862 tn?1243097304
maybe some rest and relaxation are needed this time around,  each of us has our own healing time and each procedure, even if it is the 10th time for one creates a different time for healing.

myself as a prime example - was in a motorcycle accident in oct 08 and was told that most people only have to wear the TLSO brace for about 3-4 months.  well, i am going into almost 7 months past accident and still have to wear it for 4 more months.  i was also told that my bones would be totally healed within 3-4 months. well, look at where i am since accident and i am still not healed 100%.  my hardware has not had good calcification around it.

so bottom line is that since we are all individuals than our healing time is as individual as we are.  i understand and sympathize with your frustration, boy, it is enough to make a person go completely insane.

sometimes i honestly think that nothing helps me and ready to throw in the towel and quit doing anything the docs say cause it hasn't helped me up till this point.  it sounds like you maybe went back to work a little early also.  uphill battle started, but in order to heal fully and have little to no complications i guess we have to listen to the docs and just take time to baby ourselves and take care of ourselves also.  and if that means laying in bed for a couple of days and than take it easy for a week or so than it has to be done.  

dont give up, keep fighting the fight and try just what you are doing now - laying down and resting.  i wish you all the luck in the world and will keep you in my prayers and thoughts - if you have any questions or comments, want to vent or just want to visit - please let me know   i am usually here quite a bit.
til next time
montanagurl
Helpful - 0
Avatar universal
thank you for your support and feedback. I have had good preop success with the shots before. sometimes it really took most of the pain away in previous yrs. almost enough relief to avoid surgery, but with structural damage, I ended up having the fusion anyway. However, not much  experience with Post op shot. When I am inactive my pain level goes down alot. Should I take that to think that the shot is helping? Is that a good sign that I am on the uphill road? Its so hard to understand what to do. I feel sometimes like I am getting better, than I slowly increase my activity level and boom, I am back to square one. 2.5 weeks post op, with alot of pain when I increase my activity level. Is this normal? Do I just need months instead of weeks to recover?
I guess I am searching for some hope that I will get back to pain free life again. Twang or 2 not withstanding of course.
I may have to not work for a while though. I can't keep working like I did last week. it was aweful, by lunch time I had to start popping narcotics to keep from blowing my brains out. Trying today to not take any pain meds since I feel somewhat better, however lots of Advil.
Does this all sound normal and to be expected to you?
Thanks for your help and feedback, just laying in bed trying to keep from imflamming my back.
Helpful - 0
760862 tn?1243097304
hello and welcome.  i think the ice would work better right now, the heat might feel good but the ice helps more.  if you are taking any narcotic pain medicine while smoking, than your body does not absorb the amount of medicine it should.  the nicotine somehow stops the body from being able to take in the narcotics, therefore, making the medicine not work as well as it should.  i have no room to talk because i am a smoker also - but just an interesting tid bit that my doctor balls me out for.  sometimes, the epi's in the back cause you more grief than than are worth - my experience anyway.  sometimes feel good for a couple of days, than right back to square 1.  

it is good that you are working - i mean you have something to keep you occupied, a good chair is a good thing also.  have you tried or seen those little boards that go on the floor and you put your feet on them and they rock forward and back.  when i was at the office i used that litte board all the time.

sorry i dont have any more information but, i have been down the shot road before and i didn't like it nor did i think that it helped.  i have talked to others that sing praises for them so it does help some.  have you had any success with any of the epi's or was this your first injection?  

til next time
montanagurl
Helpful - 0
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