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cervical fusion
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cervical fusion

what medication should i be taking after multiple cervical fusion?
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Avatar_f_tn
The one your doctor prescribes you.
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1301089_tn?1290670171
Hi Babygirl.  I'd like to welcome you to the Pain Management forum.  Although we're not doctors and we aren't monitored by doctors, we do offer advice and support using our own experience.  We have some great people here.

How long ago was your fusion?  If it's been a while, you should not still be having pain.  Unless you now have neural pain.  We need a bit more information in order to help you answer your question.

Thanks
Sara
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1459695_tn?1285969193
my fusion was a lil over 2 weeks ago,i had 3 disks in my neck done.i woke up in the OR screaming in pain,it felt like they were still operating on me!it then took many shots of dilada and  a PCA machine which was constantly giving me dilada and i was using it every 10 min for pain.im a lil skeptical on my aftercare directions,they didnt have me wear a collar and sent me home with steroids for the swelling in my throat,dilada 4 mg every 4 hrs,and valium for breakthru pain.i had to take way more dilada then was prescribed and didnt really like the way it made me feel.they then put me on percocet 10,i am taking 2 every 4-5 hrs and it still isnt really helping.i have extreme pain in the back of my neck,it feels like my spine is bein crushed down and ripped outta my neck.i know there is gonna be some pain still,but this is really bad and unbareable.i am in worse pain now then before the surgery,although my arms/hands are not numb anymore.i also started wearing a soft collar,to stop myself from moving my neck more than i should,my doctor didnt take my insurance and only did it cuz it was an emergency and now i feel like they just want to be done with me now that it is over.they didnt even set me up with pain management for after the surgery,i had to find one myself and it takes at least a month to get in.dont they have to take care of my pain management until i get into the clinic?any answers anyone can give me would b much appreciated,thank you
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Avatar_f_tn
You need to discuss this with your doctor immediately.  First, you should not be taking more meds than are prescribed to you without discussing it with your doctor.  Second, not being doctors we can't tell you if your pain is normal.

No, they usually aren't responsible for finding you a pain management doctor after your surgery.  It would be nice if they did, but often they do not- they expect people to have PM doctors already, and they expect requirements for pain management to be low within several weeks after surgery.

But they are giving you percocet, which is pain management, so I don't know what the issue is.  They started you out with dilaudid which is much stronger than I've heard a lot of people getting (one person I know left the hospital with darvocet- how useless is that?).  2 percocet 10 every 4 hours is pretty high level of medication so unless you're very opiate tolerant,  your pain is very intense and you should let them know.
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547368_tn?1332173665
Hello Babygirl,

Welcome to MedHelp's Pain Management Forum. I am glad that you found us and that you elaborated on your initial post. However I am very sorry to hear about your high pain levels.

I have a bit of knowledge about cervical surgery and just recently my uncle had a cervical fusion. What I do know is that your post-surgical pain should not be as severe as you are experiencing. The prednisone should be reducing the expected swelling and the percocet is a strong enough opiate that is should be providing some pain relief.  In my opinion the fact that neither of these appear to be reducing your pain significantly bears some investigation.

Are you having extreme muscle spasms? If so a muscle relaxer may be beneficial. If it isn't muscle spasms then your surgeon might want to look for other causes. Admittedly two weeks is still fairly soon post-op so it may just take another week or two for the pain to be more manageable.

I don't think it is usual for a surgeon to set you up with a PMP so soon after surgery. I would hope the object of the surgery was to reduce or eliminate your pain. The surgeon was most likely hoping you will not require a PMP after recovery. As stated above percocet is a form of pain management......however if it is not controlling your pain you will obviously need to discuss this with your surgeon. He should keep you comfortable during this post-op period.

I was very surprised when my uncle's surgeon did not prescribe a cervical collar for him upon discharge from the hospital. His surgeon is considered one of the best in the state. He believes that with normal care you would actually heal better and regain muscle tone more quickly without the collar.

I am very sorry that you do not have a good relationship with your surgeon. I believe that is such an important factor. You might want to consider another opinion within your insurance pool. Based on that alone you have a good reason to seek out another surgeon.

I hope you will let us know how you are doing. Additional questions or comments are always welcome. I will look forward to hearing from you again.

Take Care,
~Tuck
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Avatar_m_tn
they gave me a collar (Put it on upside down, nursing student at starbucks fixed it for me)
Percocet, and methocarbamol for muscle spasms.  They told me anti inflammatories could stop bone from healing and bonding so they did not give me any. For me the first two weeks were horrible. Afterwards it gradually got better. Be careful in Phys therapy if it feels like it is making it worse like it did for me, i cancelled my remaining appointments and did the excersises at home at a slower pace felt much better. Hope it helps
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1459695_tn?1285969193
i should elaborate a lil more,when i went to fill the prescription for the percocet 10,my pharmacist didnt want to fill it,he said they were giving me too much tylenol.they had been giving me 80 percocet 5 a week for a month before surgery.he told me they made oxycodone's,which he said was the percocet w/o the tylenol.i called today to talk to the doc bout my concern taking all the tylenol,and got his assistant who was very rude to me.since i filled the percocet 10,i have been keeping a journel,putting in what time and how many pills and what kind of pain im in each time i take them.i am getting very lil to no sleep,i dont know why i am in more pain than before the surgery,but it is making me insane,lol,not that its funny,but i have to laugh or i will cry at this point.i feel like the doctors just think im drug seeking or something,which makes me very upset cuz i am the furthest thing from a drug addict.i just dont want to take pills that are not helping and i want to ask to have them let me try the oxycodone's w/o the tylenol,im just scared that they will again think im drug seeking.i am just so frustrated and dont know what to do anymore?i had been living with the neck pain for over 4 yrs til i finally got an ER doctor to do an MRI and find out that i did indeed have something wrong and wasnt faking and looking for drugs!i begged my PCP for 3 months to send me for an MRI cuz i knew something must be wrong cuz of the numbness in my arms/hands,and he flat out told me he didnt prescribe pain pills and i was fine!now i just want to heal properly and not be in pain anymore,they are fitting me for a cervical stimulator on monday which i am hoping will help.and i hope that it is just going to take a lil while longer for the pain to stop in the back of my neck.i also think i have extensive nerve damage in the tops of my shoulders,i can barely feel hot or cold on them and very strong men can rub them as hard as they can and i can barely feel it.i know i sound like a hypocondriac,but im not exaggerating in any way.this is the problem i think when i talk to the doctors,it just all seems to unbelievable,especially the fact that i have waited so long in pain to do anything about it.any feedback is welcome,i also think i have a problem getting the doctors to understand me,i get very tongue tied and nervous when i talk to them and i always feel like they dont believe me,it dosnt help that so many people do fake injuries and exaggerate pain just to get meds to get high or sell them,I AM NOT THAT PERSON,i just want to live a "normal" life,or as close to it as possible,im so sorry to babble,i just needed to get it out and have someone who understands liisten and not judge,thank you all and GOD BLESS U ALL
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Avatar_f_tn
But that's not the only concern.  They are also concerned that you might take more than you are prescribed, which you have already done- unfortunately although that is a sign of uncontrolled pain, it's also a sign of narcotic addiction, and doctors tend to see the latter instead of the former.  They spend a lot of time in school training to see narcotic dependence, and a lot of time in their offices seeing narcotic addicts trying to fool their way into a bottle of pills- that's their first assumption.

Is it fair to the rest of us?  Heck no.  But it's our reality, it's what we have to work with.

But your PCP should be referring you to pain management and a regular neurosurgeon so you can figure out why you are hurting so badly.  I don't think the emergency surgeon is going to want to keep giving you meds indefinitely- he's going to want to pass you off to someone else.  So best get on finding someone, otherwise you'll be without pain meds at all :(
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1459695_tn?1285969193
i am trying to get into the pain clinic now,im just waiting for an appt. i have no problem taking them as prescribed i just need to be on the right dose and something for the spasms also.i am completely honest with them and tell them how many i take and how often and they keep giving me the scripts for the way i take them,my biggest concern is all the tylenol they are letting me take.instead of taking 2 percocet 10 i could be taking 1 oxycodone 30 and it would probably last alot longer without the unnecessary tylenol,,i have no problem being monitored and taking drug tests and pill counts,its just getting into the clinic,there are so many people in my state that are in it for all the wrong reasons,it dosnt leave room for ppl that really need the help.i dont want to take pills indefinitely,thats why i want a specialist who can asess the situation and help deal with it without medication,and hopefully all went well with the surgery,thats another of my concerns,i was very scared to wake up in the OR in such pain,i thought it wasnt usual not to wake up in recovery
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Avatar_f_tn
I'm sorry you are having all of this pain after having surgery.  My Pain Management doctor used to assist surgeries and was the first one to tell me that a cervical fusion would help my shoulder and arm pain and tingles, but not do much for my neck and base of skull pain.  I am so glad he knew and told me because I would have had it done and expected a lot less pain.
It's so good that you are honest with the doctor about how much you are taking. It really does help us in the long run to be honest because we build trust with the doctor and they can see if something is working or not.  One thing about the oxycodone to keep in mind is that it can make it hard for you to sleep.  When I first started taking it, I had to take lortab at night or I would not be able to sleep.  Also, I would caution you about taking any strong meds right now if you haven't been on meds before the surgery.  I know it's so difficult with the pain and you need to be comfortable to help the healing process, but I wish I had progressed with my meds slower in the beginning because now I'm on a high dose and they only work like percoset used to.  Barely.  I also take oxycodone 30mg and I can tell you it does not last any longer than percoset.  It is only stronger.  I still take tylenol with it at nearly every dose.  As long as you aren't taking more than 4000 mg a day of tylenol, you should be okay, although your doctor will obviously know better than me how much is safe for you to take.  
Be careful about relying too much on the soft collar.  My husband has had multiple surgeries done by some of the best surgeons in Atlanta and they did not give him a brace or collar because it's important to use the muscles after surgery.  One of the only benefits about a collar is that it does keep you from moving your neck too far to one side or the other and overstretching it.  Some surgeons do have their patients wear collars, but if your surgeon did not, I would try not to use it all the time.
Nearly every single one of us here in this forum are also legitimate people with chronic pain and we understand where you're coming from in not wanting to be viewed as a drug seeker.  There is a terrible stigma attatched to people who take pain meds and it's not fair.  The best thing you can do is take your meds as prescribed and tell the doctor honestly how they are working.  Most Pain Management doctors do understand that we have real pain and they are usually good about prescribing the right meds and explaining about them.  I hope the PM you're going to is a good one and will help you so you can continue to heal from the surgery.  
I'm surprised they're doing the spinal cord stimulator so soon after the fusion, but hopefully it will help you a lot.  Please keep us updated on how you are doing and how things go for you.  Also, reading the other posts here is a great way to see that we're not alone in having disabling pain and having to deal with the stigma of taking pain meds.  I hope the swelling and everything starts to go down soon for you and that you get some relief from the pain!
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Avatar_f_tn
I don't have any personal experience with cervical pain but a lot with surgery and post-op pain.  It definitely sounds like at 2 weeks out your pain is way out of proportion.  I think at 2 weeks out you would still be experiencing some post-op pain but it should be more easily controlled.

I've had 9 surgeries on my hand, including a fusion of one of the joints in March.  With my first surgery (an implant) initially I had a normal post-op course.  Bad pain immediately after the surgery but it was well controlled with medication.  But since the implant failed, I had to have the subsequent surgeries.  At times, I expect too much too soon.

After my surgery in March, they gave me high doses of Dilaudid for the post-op pain.  It did nothing.  It wasn't even as helpful as Advil.

I also think that your surgeon wouldn't be considering pain management for a patient automatically or even at a few weeks out.  The optimal hope is that the surgery fixes you problem.  Usually people have surgery, do some physical therapy and are okay.  Getting to a zero pain level after any surgery can take time, though.

But your pain sounds extreme and your surgeon should be looking at why that is.  If you aren't getting any cooperation from him, maybe you need to get a second opinion.  (My former brother-in-law had a hip replacement.  Should have been fairly simple.  He had terrible, uncontrollable pain after the surgery.  Because he had addiction issues, he wasn't really taken seriously.  Eventually his wife convinced him to get a second opinion.  Turns out the orthopedic surgeon had somehow put the replacement in the wrong way.  He had to have another surgery and now is totally recovered, though sadly is still an addict.)

I'm sure the reason you're taking more medication than prescribed is due to the fact that you are possibly under-medicated due to your extreme pain.  But taking more than prescribed is never a good idea.  It will cause your doctor to lose trust in you.  You need to be honest with him that the pain control he is prescribing is not adequate.  And, again, if he can't or won't deal with this, you need to look for a second opinion.  In the meantime, if your pain is that out of control and your surgeon refuses to do anything about it, you could go to the ER.  They can probably give you something to help the pain immediately and likely will give you a small prescription to carry you over until you can see another doctor or someone at the pain clinic.

Best of luck with everything.  I hope your pain gets under better control shortly.
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1459695_tn?1285969193
well,i wish i could say today went great,but,sadly it did not.i called when the office opened to talk to my doc's asst. to see if he could remove the steri strips today when i went to get my cervical stimulator since it is hard for me to get rides and i had the appt for tomorrow,well,this morning anyway and to tell her i needed a refill on my meds.she called me back and said he was in surgery all day,so he could not take them off today,i obviously understood,and then she told me that he said friday that i couldn't have anymore pain meds that i should be in the pain clinic by now!i explained to her that their office still hadnt sent my records and referrel to the clinic,therefore i was still waiting to here from them,she told me she didn't know what to tell me,that's what he said and i could talk to him tomorrow at my appt.i asked her what i was suppose to do for pain in the meantime since i had taken my last 2 earlier in the morning,she said he was at the hospital that i go to and i could go to the ER and see what happend,if they would contact him in between surgeries to see me.so i went and ended up seeing the first doctor who actually listend to me and had the MRI done that showed the 3 completely blown out disks in my neck,proving that i wasnt just crazy and complaining for no reason of extreme pain and numbness,anyway,he was apalled at how my doctor had been treating me since post surgery,he got me in to see the head doctor of the ER dept. who talked with me and listened to my symptoms and how bad the pain was.he then called for my surgeon to come and see me,my surgeon,in front of everyone,docs,nurses,etc...told me he did his part,actually said and i quote"i did u a favor by doing this surgery,i don't even take your insurance"and then proceeded to tell me that there was no reason i should be in pain 2 weeks after having a fusion done!!that i should be almost ready to return to work and to suck it up and deal with it!!!i swear that is what the man said to me!then told me he would give me 40 percocet 5 mg and they better last me 2 weeks!i just started crying,and i never cry,i just couldnt believe he was saying these things to me,then he told me that he was going to tell the hospital not to do anything for me if i came back in there,i just looked at him,mouth open and tears streaming down my face.i couldn't even speak,he walked away and the head of the ER docs came over,apologized to me for my doc's behavior,and told me if he was one of his doctors he would be doing something about it,but,he just does surgeries there,he told me not to worry,he wasn't going to let me leave without making sure i was taken care of until i could get into a pain clinic and a PCP,and he stayed true to his word,he got me an appt. for fri morning with a new PCP,im waiting for the pain clinic to call me with an appt. and he gave me a prescription for 2 weeks of oxycodone 30mg,and told me if i still wasn't in the pain clinic when they ran out he would give me another script til i got into the clinic.all of the doctors and nurses that heard what my surgeon said to me apologized and couldn't believe he talked to me like that.basically cuz i have state insurance and he dosnt take it,he figures he did his part by doing the surgery and the aftercare is not his prob,maybe im wrong,but,i dont think thats right.if he agreed to do the surgery,he should also agree to take care of me until im recovered,am i wrong for thinking this?be honest,cuz i am really confused about this,i just don't understand?i especially dont understand how he thinks i should be almost recovered?am i missing something or did i have another surgery that i don't know about?cuz i have yet to talk to anyone who has had this surgery and felt great a couple weeks later.so now i have to go to my surgeon in the morning and have my steri strips taken off,and i know he is going to be rude to me cuz im sure he knows that the other doctor helped me and made sure i was taken care of before i left,instead of shoving me out the door like he wanted him to.i really don't understand why he thinks it's ok to treat me this way?just cuz i have state insurance now?UGH!!!!!im so frustrated,please,any and all feedback is much appreciated,honesty is a must,i really want to know if im wrong for thinking he is way out of hand for acting this way
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Avatar_f_tn
I'm sorry you're having to deal with all of that because of the insurance.  I have state insurance at the moment as well and there is such a stigma associated with it.  It's really stupid given the state of the economy these days.  
I really don't know what a surgeon is supposed to do as far as after care so I can't help there.  I do know most of the Neurosurgeons I've ever met are arrogant jerks.  A lot of of them think that because they literally hold your life in their hands they can treat people however they want.
It's really great that the ER doc helped you.  They don't usually do so much for people.  I hope the meds help you to be comfortable to you can heal up.  
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1459695_tn?1285969193
well,so far the oxycodone 30mg are helping very much,this morning i had to take one and then another one almost an hour later to b able to move about,but after that 1 every 5 hours is doing the trick and keeping the pain at a bareable level,FINALLY,yeah!!now my only prob is finding a doctor willing to prescribe them until i can get into the pain clinic,not such an easy task.im hoping if i call the doctor from the ER tomorrow and tell him they are working well and just see if all else fails if he will prescribe them until i get into the clinic,it dosnt hurt to ask and he knows the whole situation,like i said before,i have no prob going for drug tests or pill counts whenever asked,the worse he can do is say no,right?well,lil sister slept over tonight,she is 17,and just got her to bed,so that's where im off too,goodnight all
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