360 procedure/spinal fusion L4-L5/L5-S1

[danswife]

I'm having this procedure done on Wednesday morning and I was wondering what kind of pain management I can expect afterwards.  I am having both disks replaced with "PEET" material and having my spine fused in that same spot.  I am currently on Morphine Sulphate 30mg as needed for pain, Phenergan 25mg as needed (both are pretty much 1-2x daily), Soma 350mg 1 every 8 hours and Lyrica 100mg every 8 hours (as well as topamax 100mg 2x daily for migraines, nadalol 40mg 1x daily, trazodone 50mg 1x daily, and lovaza 4g 1x daily.)  Since I already have a tolerance to opoids, I'm scared that afterwards I will not have enough pain medicine and I will be in terrible pain.  I'm basically freaking out about the surgery and that I'm going to be in more pain afterwards than I am in now, and I don't know how that can be possible.  I'm really just looking for some advice.  Thank you.

[sandee1818]

Also as toomanyadvil has pointed out, never assume that your Dr's know everything. Better to be safe and be your own advocate or have someone you trust do that for you.
Mistakes are often made because one assumes their Dr knows whats going on.

[sandee1818]

You really need to discuss your concerns with your Dr. In my experience the medications they give you right after surgery are quite potent and I am sure your Dr knows about the tolerance issue and is taking it into account. The best thing you can do is be your own advocate and discuss all of your fears and worries with your Dr so he can address them and ease your fears, that is what they are there for. Dr's do realise that patients get scared and worried before surgery and they want to ease your mind and answer your questions so your more comfortable with the surgery.

Good luck

[danswife]

Yes it did, thank you.

[Toomanyadvil]

Try not to worry too much about what will happen afterwards. At least for a bit the mixture of the anestisia and IV pain meds should knock you out. So when you take your first few oral doses you should be okay and sleep alot for the first 24 to 48 hours depending on how the anestesia effects your body. If  the pain is intolerable you can always call your DR or go to the ER.
They dont want you to be in intolerable pain and will make sure to take care of you with the dose thats most effective at the safest level.
Tell them before you go home what your pain level feels like.
Usually for post surgical pain a short acting drug like percocet or lortab is used. Your morphine is stronger than either of those. (I'm assuming it is the immediate release morphine because your able to take it as needed).

I have one thing to add, but I will message you personally.
Hope this helped a bit


  

[danswife]

thank you... I am bringing a list of all my meds. I'm just very hesitant about the pain mgmt afterwards (about not having enough) and I'm not afraid of the actual surgery- I'm afraid of the pain afterwards.  I'm also afraid that when I go home the pain will increase tenfold just because I'm not going to be on the IV anymore and pills tend not to work at all compared to the IV.  I'm just scared, and this is happening all tomorrow morning.  I just don't want to go in and be in more pain afterwards for months than I was beforehand.  It seems to defeat the purpose of the surgery, kwim?  I know I'm freaking out about the whole thing, but I can't help it.

[Toomanyadvil]

Just reread and want to make sure I was clear when I said to let the prescribing DR know..I'm refering to the DR who prescribes your normal day to day medications. They may want you to take cartain medications or not wnat you to.
Sorry, my advise didnt seem clear on that part to me

:)

[Toomanyadvil]

Reading your post, it seems you are on alot of medication. Beacuse you have a tolerance the medication amounts will be different and you'll want to make sure you are very clear with the anestesiologist as to how much of what and how often you take something. Some medication tolerance can effect the anestitia dosage and the dosage of the "happy drug" they give you before you go in to be put under(Trust me , you'll want to make sure you get the best working dosage of the happy medication as possible. It is a life saver for surgery). I'm suprised your DR's havent adivsed you to cut back on the as needed medications as much as possible.

Your pain management afterwards(I assume you mean in the actual recovery room post procedure) will also be different as your body is accustum to recieving CNS drugs. The medication they give you in recovery will be IV and will be stronger than any oral meds you have been taking.  But still your tolerance will play a role in how well they effect your pain.

My advice is to make sure you let everyone who is involved with your surgery know about all the medications you take.  There going to ask you anyway but it's important for you still to let your anestisiologist and DR(who i assume knows?) so that they can take care of you and your pain properly.

If you are getting take home medications from the surgery you'll want to ask your presrcibing DR what they prefer you do before you even go in for surgery...whether to take the meds from the surgery or go back to your normal medication regimine. And what meds you can take with the others. When your on PM what to do afterward can be a pain so it's better to make sure you know exactly what your DR's want you to do with pain medication.

Hope this helped and good luck.  Just bring a list of the meds, how much and how often and you'll do fine. They are used tio adjusting dosages for us chronic pain patients.

:)