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Spinal fusion Surgery pain medicine
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Spinal fusion Surgery pain medicine

I had a Spinal fusion surgery at L5 S1 level just about a month ago. I am still having a lot of pain and it is time for a refill on my medicine. I just needed Valuim 5 mg. and Dilaudid 4mg which my Dr. has me on. I called my Dr.'s office today but he is on vacation. The covering Dr. said he won't write that kind of prescription because he only writes for Lortab. I already have a few Lortab from before the surgery and they don't cut through the pain. ...and he said he won't write for Valuim at all. I asked them can't they look at my chart so they can verify what I was taken the Didlaudid and the Valuim and they told me they already saw that thats what I have been on but the covering Dr. won't write them he will only write me the Lortab prescription. My Dr. won't be back to the middle of next week and I can't sleep and I am in a lot of pain. Does anyone have any suggestions?  
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317787_tn?1373214989
Hi, I am so very sorry for your pain , it is awful that the doc is on vacation and has left you hanging.  I guess, if the doc on call will only prescribe Lortab I would take them,  Do you have a GP that you could go to and explain what is going on?  Perhaps they would help until your doc gets back.  If all else fails I would take my record and prescriptions and go to an ER to try to get some relief.  Just my opinion.
I hope it all works out for you.  I think it is terrible what they have done to you.
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547368_tn?1332173665
Hi Floodmaster,

Welcome to the Pain Management Forum. I am so sorry to hear about the situation you are facing. I think we've all been there.

Unfortunately I don't know if you have a lot of options. When you say "Doctor" is this your Surgeon, your PCP or your PMP? You should have all three and one should back up the other. That would be my only suggestion. Contact one of your other physicians and explain what has happened.

ER will probably will not help you.... but I could be wrong considering you are a surgical patient. It depends on the state, the situation and the specific ER Physician. In some instances if they have access to your records they will supply a short term prescription.

I wish you the best and hope you are able to find a solution. Please let us know how you are doing and what you discover. I'll look forward to your updates.

Best Wishes,
~Tuck
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1754079_tn?1329324770
Thanks for responding. Yes, it is my Spine Surgeon that is on vacation. I also called my Neuro Surgeon and he is out on a 4 day weekend(whats the chances? I guess good in my case) I called my Primary Doctor to see if he can prescribe me just my Valuim until my Surgeon gets back but I was only able to leave a messege yesterday and he hasn't gotten back to me as of yet. I am just stuck with the Lortab and as long as I don't do anything I should be ok and if not I will just have to deal with it. I do have Oxycontin CR that lasts 12 hours but it don't cut through immediate pain that I get throughout the day. Yesterday was pretty rough because the Lortab don't help when I get the pain that feels like my tail bone is disconnecting from my spine. I know that isn't happening but thats the only way I can discribe the pain. Thank you both very much for responding. Tony  
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547368_tn?1332173665
Hi Tony,

If your PCP is in today try giving him another call. It can't hurt.

Lay low until your physician returns and use the usual and customary comfort measures. I wish you a tolerable week-end.

~Tuck
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1769830_tn?1313912172
Sorry to here you are having such issues getting your MEDS.I have had the same surgery and I also know that pain.I would go to the ER if it get to bad.Hang in there Tony
Brad
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1754079_tn?1329324770
My Primary Doctor called me back yesterday (Monday) and said he was sorry and he didn't get my messege until yesterday. I explained to him about my problem and he said he had no problem writting me a prescription for Valuim.  My Surgeon will be back in tomorrow(Wednesday), thank God and I have an appointment at 1:40pm. I would like to thank you all for your support. This website has helped me out in so many ways. If it wasn't for this site I wouldn't be able to talk to people who have been through this and it would be a lot harder to deal with and I wouldn't know if what I was going through was normal. Once again I can't thank you enough for helping me through this. I will let you know what my Surgeon says tomorrow after I see him. Thank you, Tony
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547368_tn?1332173665
Hey Floodmaster,

You are so welcome. We are glad that you found us and hope that you will be active in our community.

Statistics prove that Chronic Pain Ppl and others with major medical disorders, etc do better when they are part of some kind of a Support Group. In my opinion MedHelp is the best. You can come here any time of the night or day. You don't have to wait for a group meeting on Wednesday, Friday or whatever day it might be scheduled and you're basically anonymous.

I am delighted that your PCP was able to help you and that your surgeon's appt is early afternoon tomorrow. Please keep in touch and let us know how you are doing.

My Best,
~Tuck
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1754079_tn?1329324770
Well I saw my Surgeon on Wednesday and he said that the incision looked great. Thats not what is hurting me!!! He did an Xray and said that his work looked good (Good for him) But the pain is still constant and even unbareable at times. He said it is going to take time and I will be is pain for a while thats the way it is. He really isn't helping my pain at all. He had me on Dilaudid 4 mg., Oxycontin CR 20mg.,  Valuim 5 mg.,and Zanaflex 6 mg. I was able to deal with it then but when I saw him he said he didn't want me on anything stronger then the Lortab 10-500 max 6 per day  and the Zanaflex 6mg. every 6 hours .but I explained that it isn't helping. He said that is all he will write me a prescription for. I asked him if there was something in between the Dilaudid and the Lortab and he said not really. My Fiance works at a pharmacy and he is full of s--t!!! I understand he wants to cut me down but I can't stand the pain with what I am taking. I don't even want to get out of bed let alone to to PT. I called a pain management place and made an appointment for next Wednesday. I hope they will be able to help me more cause I can't go on like this. I don't know if my pain is normal or if there is something wrong?? I feels like everytime I move my tailbone is disconnecting from my spine. It is a very shape pain and radiates around my stomach, up my back to my shoulder blades and shoots down both legs. I had the pain that goes down my legs before the surgery and a little around my sides and stomach but the rest is new and much, much more intense. I will keep you up to date and once again thank you. Tony
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Avatar_f_tn
I can't believe with you being in so much pain he is doing this to you. That goes to show how some doctors just don't get it. He is probabley afraid of you becoming dependent on the stronger meds, but good grief you are just out of surgery. My last surgery two years ago when they took the instrumentation out I was allowed to stay on the Valium for three months and the higher level of Morphine also. I also worked with a pain management doctor,  but it was the surgeon who gave me the valium. How old is your surgeon and how long has he been doing this?
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1754079_tn?1329324770
I would say he is in his last 40's early 50's and he has completed his medical education in 1989, General surgery in 1990, Orthopaedic surgery in 1994, and Fellowship in Spine Surgery in 1995. I undrstand that he don't want me to become dependent on stronger meds but the one problem I have is that the Lortab has 500 mg. of Aceteminophen each X 6 for a total of 3000 mg. of Aceteminophen per day and my liver is sore sometimes.(That can't be good?) The other problem is that even taking the max of allowed Lortab doesn't even come close to taking the edge off. I'm not expecting to be painfree at all but I have a very poor quality of life as it is right now due to the pain. He said he won't write me the valuim because once people get used to being on it they can't get off of it. The only thing I can think of is that he had problems with Patients in the past and I undstand that. There is always that risk when your patients require pain medication when they have spine surgery. I just can't understand that you can just leave your Patient in pain that they can't deal with. What exactly does the pain management doctor do? I know they are all different but I was wondering what yours did for you?  
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547368_tn?1332173665
Thanks for the update. I am so sorry to hear about your surgeons reaction to your pain. My heart goes out to you. Unfortunately some physicians are not educated in pain or pain management... or something in their past limits their ability to prescribe opiates. I think your assumptions are correct.

I know it will be tough but your best bet is to see the PMP. They are the true experts in pain management and hopefully he/she will help control your pain. My experience has been that they evaluate your pain and its cause and treat you accordingly.

In my opinion it doesn't have anything to do with age.... I think it is education and compassion that makes the difference. I've had older physicians that have been great.... and younger ones that seem indifferent to pain.

Again I know it'll be tough to wait to the appointment but hopefully the PMP will be your best answer. Surgeons "fix" things and that's about where it ends. As a general rule they will not continue to prescribe past a few weeks before they cut you back to less potent opiates.

Please keep in touch and let us know how you are doing.

My Best to You,
~Tuck
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Avatar_f_tn
I agree with Tuckamoore. You need to see a Pain Management Doctor. Fortunately for me I was already seeing one when I had my last surgery. The surgeon and the PMD worked together to decide what meds I needed and how long I needed to stay on them. I also think it made a difference how long I had been a patient to this PMD. He knew me well and knew I am not the kind of person to take new drugs, especially valium, so if I asked to keep taking it they knew I needed it. They knew I was the kind of person that perferred to stay at the lower end of the doses and if I did ask for an increase that meant there was a reason and that was pain, due to surgery. And they knew when the surgical pain got better I would wean myself off the meds, as I have done before, no problems. Really knowing your doctors before having surgery can be a huge payoff.

You need to get into a doctor that will listen to you and will be compassionate and understand what you are going through. You need to be able to function so you can do PT without being in so much pain. 6 Lortabs a day could not cut it for anyone after a spinal fusion.  

I remember with my first fusion they put my on 40mg Oxycontin right after surgery. I had only taken Vicodin before. This med took care of all my pain. After one month that was it. No more Oxycontin . I went back to the surgeon and told him I was still in a lot of pain and he said I was young and should be able to handle it. Instead he gave me mega doses of Vicoden and Neurontin. I was allowed to take up to 8 Vicoden a day. I did that everyday. At that time that had to help so that is all I knew. I had to get a refill every Friday. It was so tiring always needing a refill and being so afraid I would not get it before the weekend came. I think he only wrote me a script for a week at a time back then, Something like 30-45 pills a week, can't remember. I didn't know anything about PM at that time. Wish I had. All I know is I got up and moving and that is how I got better. Yes it hurt more so that is when I would take the pain meds. But if you sit and don't move because you are afraid of the pain, then the pain will become more overwelming and take over you and you will not heal. You have to get up and go on with life. I promise it does get better. It's all a mindset.
Push on and push forward. You can do this, you have to. The more you do the better you will feel and the better and faster you will heal in no time. It goes by so fast.

I am not bsing you. I have gone through two fusions and two other spinal surgeries. You have to get up and out to heal. F the pain. Get it out of your mind. You are a strong young man and you will beat this, it is in you to do this. I know you can. Keep this mantra and you will do just fine. Now say it like you mean it.
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1754079_tn?1329324770
Thank you both for your responses and imput. Today is finally here to see my PMP. It has been a long trying and tough week. Hopefully things will improve I keep being positive cause I know things will eventually improve just not as fast as I would like. I walk around my apartment as much as I can throughout the day and go to my PT no matter how bad I feel. I am in alot of pain but I try to keep moving. That shape disconnect feeling from my spine and tailbone that I have been talking about has really been intense. I don't know if things are getting worse or my Lortabs just are not cutting it. I am not the kind of person to take meds if I don't need them either. I go as long as I can until I can't stand it anymore which don't take too long lately. I will hang it there as I always do. Thanks again and I will let you know what the PMP says. Tony
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1795730_tn?1316495556
i am scheduled for a L4L5S1 fusion on oct 5 i have had five previous surgeries on l4 l5 and now they want to do fusion i am scared and apprehensive about the surgery however i am in lots of pain and if it works doc says lots of relief how long was your surgery and how many days in hospital just worrying thanks hope you are feeling relief
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Avatar_f_tn
It would really help if you asked your question in a new thread. You will get a lot more responses that way. Usually with a fusion the hospital stay is three to four days. The surgery can take anywhere from 3 to 5 hours for a typical fusion, it depends on how difficult the case is and how much scarring you have from previous surgeries and if there are any complications. What kind of fusion are you having? Are they doing it posterior, from the back, and using instrumentation-rods and screws? Or are they doing an interbody fusion anteriorly? Sometimes they will do a 360 and use cages in the front of the spine and then put rods and screws in the back to make sure it is secure and stable. I ended up with this three years apart. I started with the cages and three years later had to have the instrumentation put in from the back. I have spondylolisthesis. That is where one of the vertebrae slides forward over another one due to pars defect, this is where the vertebrae are supposed to connect but instead of bone it is more like cartiledge so the vertebrae is weak and breaks at the area where the vertebraes connect so they cannot be held together. It is a congenital defect I was born with and had problems with starting as a pre-teen with my first growth spurt but did not know until I was 21. I had pain starting at around 10 the first time my back went out. And then it would happen about every two to three years until finally I had pain at 21 all the time to where I could not straighten up. I had to walk bent over.
I have gone through 4 spinal surgeries so I understand your apprehension. My last one was two years ago to remove all the hardware because two of the screws had become loose. That does not normally happen, so don't worry about that. Before that it really helped me a lot. It stabalized my spine and gave me my life back. I won't lie, it does hurt, a lot. But you do get through it. As long as you are prepared going on and have a good mindset you will be okay. Make sure you have pain management set up and have proper medications for after the surgery. As you can see from the above poster, he has had problems with proper pain control. I have been through that and because of that have said I will never have surgery again. But I did and the last one was just fine. I made sure my pain management doctor and surgeon were well aware of my fears of my pain not being controlled during my hospital stay and we had a plan for action just in case and it was executed just as planned and never even had to call the doctor while in the hospital. My pain management doctor even gave me his cell number just in case because I was so scared. I think I had made three extra appointments just to talk about this. I actually left the hospital two days early because my pain was controlled so well. I did not even need to stay on the PCA for more than 20 hours.

So all I can say is talk to your doctor until you are blue in the face and if and until you are satisfied before you have surgery. The last thing you want to do is go into surgery being anxious or scared. It's expected to be a little anxious, but not to the extreme.
Hopefully this has helped and given you a little information. You still have plenty of time to get with your doctor(s) ahead of time to get any questions answered.

Good luck and God bless.
Audrea
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1795730_tn?1316495556
thank you for your reassurance i had heart surgery five years ago and woke up in the middle of the procedure and could feel everything they were doing as a result i had an acute mi on the table and it really traumatized me i was diagnosed with ptsd from that so you see why i am so scared to go into another surgery, again thank you for your support and god bless you hope you are well!
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1754079_tn?1329324770
Audrea gave you a lot of great advice and she knows what she is talking about. As she said I have been having problems because of pain control because I never knew I needed a pain management doctor (PMP). My surgeon fixes the problem but don't help your symptoms. I now have a PMP and things are going to be much better. Make sure you have one before your surgery because it takes a little bit to get the ball rolling with a PMP at least it did me. Mine is a Workers comp. case and everything takes longer because of the need to get everything approved.

As far as my surgery goes... my surgery took 3 1/2 hours and I was only supposed to be in the hospital my surgeon said 2 days, but they had to keep me a 3rd day because I ended up running 102.7 temp. other then that they would have let me go in 2 days. Also like Audrea said every surgery and doctor are different so surgery times and stays may be different. The surgery does hurt but you will be in good hands at the hospital and they will be able to manage your pain very well. I wouldn't be in too much of a hurry to go home if I was to do the surgery again because when you come home in can't be controlled so easily. You will be ok if you decide to have it done. I don't know what your first 5 surgeries were but I'm sure you know what the pain feels like, it's just more intense. They will control it better with a fusion though. I hope all the best for you and if you want to know anything more about what I went through I would be happy to talk to you about itOnce again I hope everything works out for you and god bless. My thoughts will be with you!!! Your friend, Tony
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1795730_tn?1316495556
well i go for preop testing tommorow then meet with my pain management doc tues then my nuerosungoen on wed i took nurseaudreas advice and have three pages of questions for both docs and they agreed to meet with me together to ease my worries so we will see how this goes god help me im really nervous and scared and so are my two kids my daughter keeps askin if im coming home in a wheelchair?
ill post once i see all these guys it 315 in the am and once again i cant sleep thank you all for your feedback and support you guys and gals are all i have besides my kids and my mom so really thanks
mikeinohio271
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547368_tn?1332173665
I am glad we were of help... that's what why we're here. :o)  It's always nice to hear a thank you. We don't get a lot of those.... so thank you!!

I'm glad you are meeting with the "team".  I think it will help ease you fear... and don't forget your list of questions!

We'll be waiting to hear how it goes.

Good Luck our Friend,
~Tuck

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Avatar_f_tn
When is your appt with the team? Make sure when you go see them you ask what they will do for pain control. And then ask what they will do if the "normal" measures for pain control doesn't work. For instance they may put you on a PCA pump at a rate of 2mg of Morphine every 6 to 10 minutes if you push the button that often. You could ask that they do a continous basal infusion that way when you fall asleep and you can't push the button when you wake and the pain is out of control pushing the button to get 2mg of Morphine won't do much for you. That is how I had it set up and it worked like a charm. Like I told you in the private message, knowledge is power and will only help to ease your fears. The more your fears are eased the better you will do, and the better you do the faster you get up and move around and heal. You MUST get up and move around as fast as you can. It may hurt like all get out, but it will make the pain more bearable in the short run. For example, if you were scared of the pain and did not want to get up out of bed because of the pain every little move you make will hurt like the dickins. If you did get up and move the pain tends to ease up a bit more and more the more often you get up and move. I know this all too well from personal experience.

I hope this helps and let us know how the meeting goes.
Good luck and God Bless.
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4083264_tn?1349639821
I am having a lumbar fusion on Oct. 29 and I am terrified. I have a narrowed spine and degenerative discs. Does anyone know the pain level after surgery and how long recovery takes? I am a disabled single mother and I don't have the nessasary means for exercise other than walking. Any and all ideas are welcomed.
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Avatar_m_tn
I have had spinal fusion of L4 L5 S1  , spinal stenosis , bones graphed in as well as rods and screws in my back . Not to bad for pain most days but have a hell of a time trying to get to sleep . Also in enough pain a lot of the time that I don't want to move . Right hip expecialy and some shooting pains down leg. Left leg numb in most areas .i am on no pain meds , but really wondering if I should be ., thanks for help , Scott
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Avatar_m_tn
People are taking this pain meds and power struggle way to far. That's why there is so many angry people and violence in this country. Think about it if you keep hurting people not hurting and more comfortable they will be less angry and ready to flip out at the drop of a dime.i have 2 herniated discs in my lower back since 18 years old and sever pain I am 43 now and as I sit here now after a car wreck on 10/23/13 where me and my wife broke l4 and l5 and my wife had 4 layer fusion and 7 days after being sent home I found infection that was coming from her wound so we rushed back to hospital to find out she had massive infection and they instantly took her to surgery to open her back up to find it was the worst case of infection they seen and admitted her and said she will be her 6 to 8 weeks. Now she is laying here complaining about how bad it hurts and they want to come in and give her 2 Percocet 5 mg so now I am pissed doctors have this power struggle thing where they can decide how much pain you stay in and that is not fair. I don't care what the rest of the world does and neither should they if someone gets addicted that is there problem. But in reality everyone wants to control the next person it is sick. I been taking the same meds since 18 years old 30 mg oxycodone 2 to 3 times a day because they have been wanting to do surgery on me since 18 now 43 and I will not yet. Now everyone knows why look at my poor wife who can't get meds to stop her pain. Everyone knows what their bodies can handle and what stops the pain and as I look back at my life since 18 when I had pain cause of no meds life sucked. My back is now broke and they don't want to give her meds after being cut twice I know I am screwed. And my little girl is gonna suffer cause mommy and daddy can't do things cause they hurt so bad it is unbearable and I see that quite often where I can't even get off the bed or have to crawl to the bathroom it's not fun it makes life suck and just want to end it cause it hurts so bad now I know my wife is gonna go thru this I am worried and scared for her. I can see if it affected there lives in a negative way but I can say when I am not hurting I am so much happier and work so much better am easier to work with just better quality of life all the way around hurting makes me physically and mentally drained can't bend twist lean over a car hood nothing just pain pain pain. I pray that this country starts to see people that are pain free and hunger free will make this country a better place for everyone period.

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