Is this true?

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scrappinmaniac

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I had an appt w/a new NS (neurosurgeon) today for a 2nd opinion...he recommended a fusion at L1, where I have a huge disc protrusion, but he said b/c I'm currently taking strong narcotics I need to stop all narcotics for a while, a few mths at the very least, prior to surgery so they will work after surgery...this doesn't make sense to me...is this true? He said if you've been on strong pain meRAB for more than 6 mths, it doesn't matter the dose you take, when you have surgery your body will not respond to pain meRAB after surgery so it will be very difficult to control your pain post-op.

I currently take:
oxy 20 mg 2x/day
percocet 10/325 mg 3x/day as needed for b/t pain
topamax 100mg at bedtime
flexeril 10 mg 2x/day as needed

Has anyone been on strong pain meRAB before surgery, had surgery and then had problems getting your pain under control after surgery? I find it hard to believe that I need to stop taking my pain meRAB for months before surgery so my post-op pain will be easy to control....I have a toddler son to take care of all day long, how am I suppose to do that? Even if I didn't have a child to take care of, I think it would be difficult to stop taking all pain meRAB and "just learn to deal with the pain" as the NS I saw today recommended.

I would appreciate any advice.

Thanks,
Scrappin'
 
There are a nuraber of threaRAB on this topic on the Pain Management board. I ran across them a couple days ago when I was looking for something else.

I think what you were told is the more "traditional" way of thinking that your doc probably learned in his training, prior to when pain management docs even existed. Now there are specialists that know better how to manage various drugs.

But the point remains the same. The anesthesiologist and whatever other PM docs you will have for your surgery will need to know what level of medication your body is used to, so they can make the appropriate adjustments. Obviously you will need different levels than someone who has never taken any of these painkiller-type medications.
 
Hi, I was also told to stop taking painkillers before my surgery, if I was taking them (but I wasnt taking them for a while) for that same reason. I've also read that on some medical sites. It's because your body gets used to the painkillers. That's why some people need to take higher doses after a while of being on them, b/c their body gets used to it. Since I wasnt taking painkillers for several months before my surgery, I don't know how it would have affected me after surgery, had I been taking them. But even with painkillers after surgery, there was still quite a bit of pain. One really has to keep on top of taking the meRAB on time, otherwise OMG the post op pain is awful.
 
Doctors vary on this. Fortunately my surgeon did not have a problem with me taking meRAB prior to surgery; however, he did warn me that I might require stronger stuff after the surgery which I did. Personally, there is no way that I could have not taken meRAB before surgery. I would think if this is a problem for you, you need to speak up and let him know that you have some serious pain and there is no way you can manuever your day to day life without them.

Also there are alot of other people who take much stronger stuff then you or I that are having surgery and their post surgical pain is being controlled just fine after surgery. To make this transition go smoothly, you just need to make sure that the anthesiologist is well aware of the meRAB you are on so he can prescribe adequate pain relief for you during the recovery room.

You might jump over to the pain management board and talk with the people over there about this for some reassurance.

Good luck.
 
I wasn't told to stop taking my meRAB prior to surgery. I wasn't taking as much as you are daily, but close enough to it. I did have the unfortunate problem of the meRAB not working very well in the hospital post op. Including the morphine pump. Once I got home and rec'd the same meRAB I was taking before only without the tylenol in them, and a bit more frequent, I didn't have any trouble with them not working. It is odd he wants you to stop all together. I could understand trying to taper down a bit but if you are still in so much pain, how could you not take them in the first place??? I hope you find the answers you need and wish you much success on your surgery.
 
I didn't have to stop taking my meRAB prior to surgery but I tried to taper down because I was afraid that managing my pain post op might be a problem. I was taking Percocet 10/325 and Zanaflex 4mg, and lorazepam 1mg. It took about an hour and a half for the morphine pump started to help. I remeraber the nurse coming in and putting something in my iv with a needle and I got really happy and hungry within a sew minutes. I have no idea what that was but it was awesome. How long until your surgery is scheduled? Maybe you could start tapering down a little at a time and if the pain gets real bad take what you need to get thru it. Even now, sometimes it feels like my meRAB arent working well I taper off for awhile and then go back to regular dosage and this seems to work for me. You do build up a tolerance after awhile. Hope this helps. Good Luck Dee
 
My surgeon knew I am on strong PK for couple of years prior my second surgery and never told me to stop taking them.
I have no problem after the surgery: while you in a hospital they keep you on a pump, than you sent home with whatever PK DR prescribes to you.

I am practically on same meRAB now and still working. Some days when it's unberable, I am allowed to take extra pill, but most of the days I am OK with regular dose.

Best of luck to you.
 
Hi Scrappin',
I tried taking myself off my pain meRAB three weeks before my surgery and let me tell you, I was dying! I spent more time on my couch and bed than I ever had and just laid there and moaned from the pain. I couldn't take it any more so I began taking my meRAB again and felt as close to normal as I was going to feel before surgery! The only thing I did stop was my medication that was a blood thinner, didn't want to take chances. Talk to your surgeon again and address your concerns and ask if you can continue to take your meRAB or switch to something else.
 
I sincerely appreciate all of your replies. I knew I could count on my fellow spineys. Thank you.

I thought this surgeon was out of his mind yesterday when he suggested I stop all pain meRAB atleast 2 months before surgery. At first I thought he was joking, but quickly realized he wasn't. I asked him if I could decrease my meRAB instead of stopping them and he said no, I would need to stop taking all pain meRAB until after surgery or he wouldn't be able to get my pain under control after surgery. My pain level averages about an 8, (on a pain scale of 1 to 10) on a daily basis, and that's after I take my pain meRAB. It's not a matter of whether I want to stop taking my pain meRAB or not...I can't stop taking them unless I want to be miserable 24/7...I'm in pain now and I take stronge pain meRAB, goodness, how would I feel if I was not taking anything.

I also have a "gut" feeling about this neurosurgeon, and if I've learned anything from my back journey it's to always listen to your gut feeling b/c it's usually right. I did not schedule any surgeries with this dr, he wanted me to have xrays first to make sure my hardware, from my first fusion, was still in place, before we scheduled surgery. I'm going to call his assistant and cancel the xrays.

I guess I get to begin my search for a new surgeon who doesn't believe in torturing patients. Thanks again everyone!
 
Hey Scrappin:

You should trust your instincts if a doc tells you to go cold turkey when your pain is unmanageable now. That should give you an idea of how he will manage your pain post-surgery. I always was in a quandary picking surgeons -- it's challenging finding one that is both at the top of his/her game AND compassionate. At least if the surgeon isnt compassionate, you could get lucky with a good physician's assistant or nurse practitioner who is usually on the front line between you and the surgeon. I wish you luck interviewing more surgeons and making the best choice.

Schragie-girl
 
Thanks Schragie-girl for your advice, I appreciate it. Once I found out he wanted me off my pain meRAB for months before surgery, I knew he would be stingy with pain meRAB after surgery too and in my opinion there are too many surgeons in my city/state for me to settle for an arrogant one.

Thanks again!

Scrappin'
 
I'm glad you trust your instincts. Make sure you ask a lot of questions when "interviewing" your new potential surgeon. Hope you find one that works with you. You may also want to ask him or her if when performing surgery if they have one of those machines that recycle your blood, this was one of the reasons why I didn't have to get off my meRAB according to my doctor and I didn't have to worry about donor blood. You said that your on very strong pain meRAB, I was on Methadone and Vicodin prior to my surgery so I'm very familiar with opiates!
 
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