mtsaz100,
Thanks so much for your reply and support. I sure hope they put me on some very strong pain meds post-op, as pre-op I have been on MS Contin 30mg twice a day and 2-5mg oxy IR every 4-6 hrs. for bt and it's barely tolerable also. I've been taking the MS Contin for almost 4 years now and I believe I need an increase or something, especially at post-op.
I've never had dilaudid or methadone but I know they are really strong drugs. Hopefully, they'll just increase the MS Contin and the oxycodone mg's and I hope they add valium for muscle relaxation. The combo does work well for me with very little side effects, just not enough at the current dose I've gown tolerable to.
I do have a well known neurosurgeon from a teaching hospital performing the surgery so I believe he'll do a good job. I only got to see him for 5 minutes at my appt. and that kinda freaked me out, like he didn't have time to address my concerns or fear. Still, I'm putting my life and health into a strangers hands and hoping for the best possible outcome.
I will keep you posted at post-op. Thanks again! :-)
Thanks so much for your reply and support. I sure hope they put me on some very strong pain meds post-op, as pre-op I have been on MS Contin 30mg twice a day and 2-5mg oxy IR every 4-6 hrs. for bt and it's barely tolerable also. I've been taking the MS Contin for almost 4 years now and I believe I need an increase or something, especially at post-op.
I've never had dilaudid or methadone but I know they are really strong drugs. Hopefully, they'll just increase the MS Contin and the oxycodone mg's and I hope they add valium for muscle relaxation. The combo does work well for me with very little side effects, just not enough at the current dose I've gown tolerable to.
I do have a well known neurosurgeon from a teaching hospital performing the surgery so I believe he'll do a good job. I only got to see him for 5 minutes at my appt. and that kinda freaked me out, like he didn't have time to address my concerns or fear. Still, I'm putting my life and health into a strangers hands and hoping for the best possible outcome.
I will keep you posted at post-op. Thanks again! :-)
ok this is a must. YOU MUST HAVE A PAIN CONSULT PRE OP. The reason is because you've been on pain meds for a long time and you are tolerant to more than 1-2 percocet which is what they will give you post op. YOU MUST BE ASSERTIVE. TELL THEM YOU ARE TOLERANT AND YOU NEED A PAIN CONSULT. DO NOT TAKE NO FOR AN ANSWER. DO NOTLET THEM SAY "WE WILL MANAGE IT". TELL THEM YOU MUST HAVE THE CONSULT.
Demand that you get a consult with the acute pain service, or something similiarly named. Its for people like you who are tolerant to high doses of opiates. The anesthesiologist will need to know, and also the post op pain providers (dr/nurses) will need to know that 2 percocet or 5mg of morphine every 4 hours isn't going to cut it for you. YOU MUST DEMAND THIS. IF THEY SAY "OH IT WILL BE OK", you will be the one who is screwed. Now if the dr says "you will be in the hospital 1-2 days and I think I can manage your pain. If its not being managed then we will get the consult done. Thats fair. That means the dr knows he/she has to kick it into high gear and deal with it. They may or may not say that, they just might get you the pain consult. Where are you having it done may I ask?
Hi mtsaz100 and guest,
I'm having it done at UPMC Presbyterian hospital in Pittsburgh. When I had the initial pre-op visit with the neuro as I said, he was like a puff of smoke and I was able to talk a little while to a resident neuro that came in the room first. Then they sent in the neuro's nurse's assistant who showed me the model of the spine and how the procedure would be done and etc., at that point is when I started asking ALOT of questions to her about my meds and my fear and concerns. She assured me that they have a team of post-op pain med specialists and anesthesiologists who I would be able to address the pain med issue to AFTER I awake in the recovery room in regard to what meds they would send me home with because I explained to her that I can't take vicodin, percocet, darvocet, or anything that contains acetominophen, aspirin or ibuprofen in it because I have severe GERD's and my stomach can't tolerate those. She said that they would take care of all of it for me when I explain it to the post-op med specialists before they discharge me. I didn't get to mention my already existing tolerance to the narcotics I already take though. She just said, the neurosurgeon, anesthesiologist and nurses would all be aware of what I take based on the intake form they had me complete for that visit that lists all of the meds that I'm currently on.
Here's an issue though, the form they sent me home with states that BEFORE surgery, if I'm currently taking any medications like, morphine, oxycontin, demerol, fentenyl or dilaudid, prior arrangements for those meds should be made with the original physician with whom I currently receive them from, which is my PCP and she said she will still continue to prescribe me the meds even after the surgery. Then the form says, AFTER surgery, if these strong narcotic pain meds are required or in high doses that the staff will make arrangements for a consultation with a pain management physician to help meet my pain medication needs. It also says that narcotic pain medication will be provided for up to 6-8 weeks after surgery. Now, the way I'm interpreting (narcotic pain meds) is that they are planning on giving me vicodin or percocet like you guys said right? And we all know that's not gonna do nothing for me.
The arrangement that they say they will make with a pain management physician for me, is done AFTER surgery and I do need to address this BEFORE surgery like you said. So, do I demand to speak with that physician during my pre-op while they're getting me ready to go in? I've been concerned about this issue ever since that initial visit, that I wouldn't be given the right amount of pain meds in recovery or when sent home. I definitely DON'T want to be screwed and left in major pain or have them blow me off and tell me, "It'll be o.k." All my neuro said that day was, "don't worry, I'll take care of you and you'll feel 100% better than you do know", and that I'd only be in the op-room for about an hour and that I will only be kept overnight and discharged the next day at the same time I was admitted unless any problems arised to keep me longer.
My surgery is this Friday and the hospital is calling me Thursday to go over all of the meds I take and all the instructions I'm to do. Should I mention it then that I demand to see the pain specialist doc or wait until the pre-op when they're getting me ready? If I do demand to see that pain specialist, will they try to delay my surgery or postpone it? They've had all of the info about my meds and my medical condition since Sept. 28th and you'd think that if they reviewed my paperwork, they'd know that I require extra attention to manage my pain with this surgery. I know I'm NOT signing any consent forms until I know that I'm going to get the pain relief that I deserve and need badly! I'm already freaked out enough over this!!
With all this said, can you give me more advice as to what I should do and when? The clock's ticking and I'm running out of time! Thank you so much for your help!
I'm having it done at UPMC Presbyterian hospital in Pittsburgh. When I had the initial pre-op visit with the neuro as I said, he was like a puff of smoke and I was able to talk a little while to a resident neuro that came in the room first. Then they sent in the neuro's nurse's assistant who showed me the model of the spine and how the procedure would be done and etc., at that point is when I started asking ALOT of questions to her about my meds and my fear and concerns. She assured me that they have a team of post-op pain med specialists and anesthesiologists who I would be able to address the pain med issue to AFTER I awake in the recovery room in regard to what meds they would send me home with because I explained to her that I can't take vicodin, percocet, darvocet, or anything that contains acetominophen, aspirin or ibuprofen in it because I have severe GERD's and my stomach can't tolerate those. She said that they would take care of all of it for me when I explain it to the post-op med specialists before they discharge me. I didn't get to mention my already existing tolerance to the narcotics I already take though. She just said, the neurosurgeon, anesthesiologist and nurses would all be aware of what I take based on the intake form they had me complete for that visit that lists all of the meds that I'm currently on.
Here's an issue though, the form they sent me home with states that BEFORE surgery, if I'm currently taking any medications like, morphine, oxycontin, demerol, fentenyl or dilaudid, prior arrangements for those meds should be made with the original physician with whom I currently receive them from, which is my PCP and she said she will still continue to prescribe me the meds even after the surgery. Then the form says, AFTER surgery, if these strong narcotic pain meds are required or in high doses that the staff will make arrangements for a consultation with a pain management physician to help meet my pain medication needs. It also says that narcotic pain medication will be provided for up to 6-8 weeks after surgery. Now, the way I'm interpreting (narcotic pain meds) is that they are planning on giving me vicodin or percocet like you guys said right? And we all know that's not gonna do nothing for me.
The arrangement that they say they will make with a pain management physician for me, is done AFTER surgery and I do need to address this BEFORE surgery like you said. So, do I demand to speak with that physician during my pre-op while they're getting me ready to go in? I've been concerned about this issue ever since that initial visit, that I wouldn't be given the right amount of pain meds in recovery or when sent home. I definitely DON'T want to be screwed and left in major pain or have them blow me off and tell me, "It'll be o.k." All my neuro said that day was, "don't worry, I'll take care of you and you'll feel 100% better than you do know", and that I'd only be in the op-room for about an hour and that I will only be kept overnight and discharged the next day at the same time I was admitted unless any problems arised to keep me longer.
My surgery is this Friday and the hospital is calling me Thursday to go over all of the meds I take and all the instructions I'm to do. Should I mention it then that I demand to see the pain specialist doc or wait until the pre-op when they're getting me ready? If I do demand to see that pain specialist, will they try to delay my surgery or postpone it? They've had all of the info about my meds and my medical condition since Sept. 28th and you'd think that if they reviewed my paperwork, they'd know that I require extra attention to manage my pain with this surgery. I know I'm NOT signing any consent forms until I know that I'm going to get the pain relief that I deserve and need badly! I'm already freaked out enough over this!!
With all this said, can you give me more advice as to what I should do and when? The clock's ticking and I'm running out of time! Thank you so much for your help!
I think that it's a good idea to talk to them about your concerns about getting proper pain management. You seem to have drawn a few conclusions about what they're going to be doing without really checking to see what they're going to actually do, and that seems to worry you! I think that would be the best course of action. Are you in the hospital now?
No I'm out, but trust me, when you are on as little as a vicodin daily or 2 for pain, for any length of time, and then you have surgery and they give you vicodin, well, it doesn't help much because you are tolerant to it. When you are on oxycontin, mscontin, etc, thats a whole other game. When they give you the normal (no pain meds dose) of post op injection, which is equal to what you take each dose orally in your mscontin/oxycontin/methadone or whatever, it does nothing and you are (choose a word). If you have a pain consult and explain this to the palliative care person who does pain management in the hospital, they know to give you twice as much or three times as much and it wont kill you. Trust me, I've been down this road and unless you take care of it when you talk to the dr (BEFORE ADMIT) so he/she can order it when you are admitted, things get too busy and you get lost in the shuffle. No one cares about it as much as you, so you really need to be assertive and not take NO for an answer.
healthfitnessguy,
Thanks for your reply and advice.
No, I'm not in the hospital. I go in for my multiple ACDF tomorrow at 7am. I don't feel that I have drawn any unnecessary conclusions, I'm only going by what the paperwork says about their protocol, my surgery and about the pain management before and after. As I stated in my last reply.
I received my confirmation call today and I am correct about what I have concluded. I don't get the option of consulting with the hospital pain specialist until after the surgery, but was told that I can try to address my concerns as to what they intend to do about managing my pain during my pre-op when the surgeon and anethesiologists come to speak with me before I go in the OR. I completely intend on getting the answers I need before I go in. I'm not gonna slight myself, that's for sure!
I'm only freaked because I've done the research on the statistics of this procedure (which aren't very favorable), talked to my husband and stepfather who've had it done, read the horrible outcomes and results that others have endured and the continued problems at post-op.
The only facts I have are the one's they presented me with and at best, the only thing I will gain is the return of the neurological deficits in my left arm that this herniation and it's components have robbed me of. I'm facing permanent nerve damage that will only continue to get worse in the future as will the DDD, osteoarthritis, osteophyte bone spurs and the adjacent level syndrome occuring.
I'm just trying to focus on the positive and pray that I get the proper pain treatment at the hospital.
Thanks for your reply and advice.
No, I'm not in the hospital. I go in for my multiple ACDF tomorrow at 7am. I don't feel that I have drawn any unnecessary conclusions, I'm only going by what the paperwork says about their protocol, my surgery and about the pain management before and after. As I stated in my last reply.
I received my confirmation call today and I am correct about what I have concluded. I don't get the option of consulting with the hospital pain specialist until after the surgery, but was told that I can try to address my concerns as to what they intend to do about managing my pain during my pre-op when the surgeon and anethesiologists come to speak with me before I go in the OR. I completely intend on getting the answers I need before I go in. I'm not gonna slight myself, that's for sure!
I'm only freaked because I've done the research on the statistics of this procedure (which aren't very favorable), talked to my husband and stepfather who've had it done, read the horrible outcomes and results that others have endured and the continued problems at post-op.
The only facts I have are the one's they presented me with and at best, the only thing I will gain is the return of the neurological deficits in my left arm that this herniation and it's components have robbed me of. I'm facing permanent nerve damage that will only continue to get worse in the future as will the DDD, osteoarthritis, osteophyte bone spurs and the adjacent level syndrome occuring.
I'm just trying to focus on the positive and pray that I get the proper pain treatment at the hospital.
Hey mtsaz100,
I agree with you 100%!! When a person goes in for this type of surgery and hasn't been on a constant narcotic med much less an opiate med, they only treat you with the lowest grade pain med believing it will be enough for the average person. It is, if you're not tolerant to these meds as you and I are.
I appreciate your advice since you have already gone through this, twice. I'm making sure I get what I need in pre-op as you said. I want specifics too, like what they're giving me, how much, and how often and what I'm being discharged with.
Thanks again, you've helped me alot!
I agree with you 100%!! When a person goes in for this type of surgery and hasn't been on a constant narcotic med much less an opiate med, they only treat you with the lowest grade pain med believing it will be enough for the average person. It is, if you're not tolerant to these meds as you and I are.
I appreciate your advice since you have already gone through this, twice. I'm making sure I get what I need in pre-op as you said. I want specifics too, like what they're giving me, how much, and how often and what I'm being discharged with.
Thanks again, you've helped me alot!
The university of utah (you can do a search and find it) did a study about this. They then developed software that they used to calculate the dose a person needs when tolerant to opiates. It works by them slowly giving you I think fentanyl and the software measures a few vital signs very subtly, one being breathing. The point being, they were surprised at how much some people needed. Far more than they ever thought possible or would have ever dared to give someone. I wish they would provide that software to every hospital in the country, but even if they did, many wouldn't use it. I need to have knee replacement. In fact, I was going to have it when this myelopathy cropped up and so my neck became the priority. I called all the hospitals and in a city the size I live in (top 5 in the us) only 2-3 have an acute pain service. Amazing.
Demand a consult. Dont let them talk you out of it.
Demand a consult. Dont let them talk you out of it.
If you only have the one level, you are a prime candidate for an artificial disk replacement. One that will allow for you to still have range of motion. And yes, symptoms will only worsen if you have tried all this other stuff without sucess, surgery is the next step.
EXACTLY Cheryl. I wish so much that I didn' t have to have my surgery in 1992, then I could have artificial discs put in. They will do it with 2 levels if you go to a center doing an FDA study. Only one level of one brand of disc is FDA approved, but studies are underway for 2 levels. There was a dr who undid a fusion and put artificial disc in, and he also put 2 in above and below a 2level fusion. I contacted him==he did this while the professor of neurosurgery in at a university in Australia. Now he is in Reno NV and he is now sort of tied up by regulations of the FDA from doing what he knows works. I wish oh do I wish that I was younger. I think the people who are 20-30 and having these surgeries (fusions) are in for wonderful things in the next few years. Like artificial discs put in to undo the fusion. I'm 50 so I will probably never see the day when I could get one now that I have 3 levels done. If I was going in for a single level I would NEVER accept a fusion unless the DR had a VERY good reason for doing it vs an artificial disc. The beauty of the artificial disc is that it preserves movement. You don't lose hardly any range of motion with one or two levels fused. You wont even notice. What you do have happen is adjacent segment disease rears its ugly head at some time in the future, above/below take all the movement that the fused segments did and they wear out prematurely. That is why I had to have my 3rd fusion. It did take 17 yrs and I feel SO much better, but I did need to have it done.
Dont fuse if you dont have to. Get an artificial disc if you can. Just my .02 worth.
Dont fuse if you dont have to. Get an artificial disc if you can. Just my .02 worth.
I'm not understanding this.
I had an artificial disc and was fused. Are you saying most people do not have to be fused with an artificial disc?
Also I have limitations with movement in my neck since this surgery in 2005.
Just want to make sure I understand what you are trying to say. Thanks.
I had an artificial disc and was fused. Are you saying most people do not have to be fused with an artificial disc?
Also I have limitations with movement in my neck since this surgery in 2005.
Just want to make sure I understand what you are trying to say. Thanks.
I'm glad to hear this. My brother just got an artificial disc put in and I was really concerned about him but it looks like he's going to be okay. I didn't think it was going to be that great for him but your post really confirmed it for me. Do you know how much flexibility you lose with a fusion beyond two levels?
Was your brother fused along with his artificial disc replacement?
I understand that most people are and that's why I find this topic so amazing. I'd like more info on how they undo a fusion...because the one I had (C5-C6), 4 yrs ago, has left me miserable.
Any further info would be great.
I understand that most people are and that's why I find this topic so amazing. I'd like more info on how they undo a fusion...because the one I had (C5-C6), 4 yrs ago, has left me miserable.
Any further info would be great.
Hello I had C5-C6 fusion done last nov 17/08 I was scared to death about this surgury but I was tired of droping things and not being able to do things. one year later i am now have the same problems on my rite side so time to got back to the surgen and get a ct scan. You will not be the same after your sugury!! but it is best to have it done before perment damage is done. I have also had L5S1 fusion as well. All of my injures are work related. If your dotor say's you will be pain free after the sugury he is lying I was told that this sugury was done to stop the numbnes in my hand and arm NOT for the pain. I wish you the best in the future and hope you get the surgury. Tip after your recovery I needed to get my drivers licence renewed and i mentioned that i had a neck fusion and they pulled my drivers becouse I could not shoulder check properly so keep that in mind.