Got my surgery dates.

[dalmatica]

To get the details on how I ended up where I am going, check out my "Appt. with Dr. Boachie" thread. That said, my dates are April 14th for anterior and April 18th (if I'm up to it which I highly doubt) or 21st for posterior. I am feeling both scared shitless of the pain and yet looking forward to hopefully being as straight as I was last year at this time before everything went south.

I have a question that I hope someone out there can answer: I have been on Oxycodone for a year now (from a pain doc, not my back doc). My orthopod usually uses Dilaudid after surgery for 48 hours with the self-administered pump. Will this put me in withdrawal or since it's a narcotic, will it not cause that? This is my biggest fear of the whole surgery. thanks, Krysi

[Koelrich]

I take those too, as long as you have the other meds you should be fine. You will want to take them when you get back home though because the pain will be way to much to deal with. I'll bet they will also give you something else to go with the oxycodone to help with the pain control.

-- Kevin Oelrich

[dalmatica]

Thank you Kevin. Seriously, this is what I worry about. What if I go into withdrawal right after surgery or if I'm still on a vent and can't tell them. I know I am obsessing right now because of the stress but what you said has made me feel better. Again, thank you, Krysi

[Susie*Bee]

Krysi--so glad to hear you've got your dates set. That's such a big step. Be sure to put them on the calendar when you get a chance! About the meds--my two cents' worth-- just make sure too that all the doctors realize what you've been taking in plenty of time ahead of the surgeries in case they want to change things. Has your surgeon been notified of all your meds you're currently taking? Take care! Susie

[dalmatica]

I was checking out the April calender and I can't figure out how to get my dates on there. Computer whiz I'm not. Can someone please help? thanks!

[Susie*Bee]

Im no whiz, but...

This should get you there...
1.pull up the calendar page
2.at the bottom is a box that says "calendar jump"--click on the choice tab and highlight "surgery and bracing dates"--this will get you to the right calendar.
3.at the bottom is a box that says "add new event"--click on it and you'll see what to do...
4.put in your date (you'll need to do the whole thing more than once, since you're having multiple surgeries), title (Dalmatica's surgery #1, tentative surgery #2, or whatever), then the event info (like: anterior and whatever other info, hospital, surgeon, time, etc.--just whatever you want.

That should do 'er. I think! Good luck. And if that doesn't work, let me know.

[Karen Ocker]

pain management

Dalmatica:
Use a pain management doc. He/she has a lot of experience with this. That's what I did and it was a great help. We were in touch by e-mail between visits.
Where do you live?

[txmarinemom]

I have a question that I hope someone out there can answer: I have been on Oxycodone for a year now (from a pain doc, not my back doc). My orthopod usually uses Dilaudid after surgery for 48 hours with the self-administered pump. Will this put me in withdrawal or since it's a narcotic, will it not cause that? This is my biggest fear of the whole surgery. thanks, Krysi

Heya, Krysi ...

I tried pain mgmt for 4 years. We tried all the drugs ... everything from the Hydrocodones (Vicoprofen, Vidodin, Norco) to the Oxycodones (Oxycontin, Percocet, Percodan) to Duragesic patches to Methadone. We tried FJ injections, rhizotomies, Botox (10 shots into nickel sized knots - with no noticeable effect), etc., etc. Unfortunately, nothing we tried gave me any relief.

The downside to all that is I now have an incredibly high tolerance to pain meds, and my biggest fear a few weeks ago before surgery was how - or IF - they'd be able to manage my pain. I met with Anesthesiology pre-op to devise a fairly aggressive mgmt plan. You might consider this option to put your mind at ease.

You *can* actually withdrawal from one narcotic while on another - especially when the drugs are of different families. That said, just be upfront with Anesthesiology and they won't let that happen. A common pain mgmt approach after surgery is Dilaudid via PCA (self-admin pump), backed up by Percodan or Percocet (depending on your susceptibility), and perhaps Vicodin or Norco for breakthrough pain. The goal is normally to get you off the PCA by day 2 or 3.

Truly, the most prudent thing is to make sure your possible dependence on oxycodone - and fear of potential withdrawal - is noted so it doesn't become an issue after surgery. Try not to worry, hon ... this should be one of the easier things to address.

Regards,
Pam

[Koelrich]

Heya, Krysi ...

I tried pain mgmt for 4 years. We tried all the drugs ... everything from the Hydrocodones (Vicoprofen, Vidodin, Norco) to the Oxycodones (Oxycontin, Percocet, Percodan) to Duragesic patches to Methadone. We tried FJ injections, rhizotomies, Botox (10 shots into nickel sized knots - with no noticeable effect), etc., etc. Unfortunately, nothing we tried gave me any relief.

The downside to all that is I now have an incredibly high tolerance to pain meds, and my biggest fear a few weeks ago before surgery was how - or IF - they'd be able to manage my pain. I met with Anesthesiology pre-op to devise a fairly aggressive mgmt plan. You might consider this option to put your mind at ease.

You *can* actually withdrawal from one narcotic while on another - especially when the drugs are of different families. That said, just be upfront with Anesthesiology and they won't let that happen. A common pain mgmt approach after surgery is Dilaudid via PCA (self-admin pump), backed up by Percodan or Percocet (depending on your susceptibility), and perhaps Vicodin or Norco for breakthrough pain. The goal is normally to get you off the PCA by day 2 or 3.

Truly, the most prudent thing is to make sure your possible dependence on oxycodone - and fear of potential withdrawal - is noted so it doesn't become an issue after surgery. Try not to worry, hon ... this should be one of the easier things to address.

Regards,
Pam

txmarinemom
can I ask why when I was asking about pain meds you did not share your information about the meds? that’s all I was wondering about peoples problems, results etc, when it came to these powerful pain meds.
Today at the Pain clinic they kept me with the Oxycodone, and Methadone… Then
I got prescribed Clonazepam, has anyone had any results with this medication?
off note:: they also put me on Benazepril, Metoprolol. for my heart. my top reading ranged from 146 to 176 today in clinic. Has anyone else started having problems with their heart related to their Scoliosis.
Otherwise I would just like to know what do you all think about what meds are the best. I asked about the fentanyl patches, he said that as soon as you remove them you will go through withdraws, so a oral medication last longer in the blood stream.

Thanks,
Kevin O

[txmarinemom]

txmarinemom
can I ask why when I was asking about pain meds you did not share your information about the meds? that’s all I was wondering about peoples problems, results etc, when it came to these powerful pain meds.
Today at the Pain clinic they kept me with the Oxycodone, and Methadone… Then
I got prescribed Clonazepam, has anyone had any results with this medication?
....
Otherwise I would just like to know what do you all think about what meds are the best. I asked about the fentanyl patches, he said that as soon as you remove them you will go through withdraws, so a oral medication last longer in the blood stream.

Thanks,
Kevin O

Kevin, quite frankly, you didn't ask about pain meds until *after* you'd crawled up one side of my ass and down the other. That generally doesn't encourage a desire to go out of my way (it's an option, not an obligation). I will answer your query because you addressed me directly. However, if the tone even remotely turns back to that of a few days ago, I will not subject anyone to an encore. I'd like to think we can hold an adult discussion - on both sides - and I am perfectly willing to do so.

Moving on now ...

I do, unfortunately, have experience (however ineffective they were for me) with the stronger pain meds. Your questions about which ones are best for scoli isn't an easy answer across the board for everyone. What works great for one person may do nothing for another. Some people attain great results with Oxycontin and some swear by Duragesic patches; neither do a thing for me. You continue to be ask what pain meds are "best", and unfortunately, there's not one generic answer for everyone. I wish it were that easy.

Clonazepam (Klonopin) is a benzodiazepine (and CNS - central nervous system depressant - similar to Alprazalom/Xanax, Diazepam/Valium, etc.). Because its half life is longer than Valium or Xanax, it's usually rx'd (not exclusively) for seizures vs. panic disorder/anxiety (Xanax) or muscle relaxant effects (Valium). BTW, there really are no true "muscle relaxers" ... while not benzos, Soma, Robaxin, Skelaxin, Flexeril, etc. are all CNS depressants.

I personally have never heard of Clonazepam/Klonopin as an addition to pain meds, and won't even venture a guess why it was added. You'd need to ask your doctor.

Fentanyl Duragesics are designed to stay on 72 hours at a time. This was an issue for me playing softball (I had to tape them on with bio-occlusive tape - and even then they were NASTY by the time I changed them out). You aren't supposed to soak in hot water, sweat, or generally do anything that raises your core temperature as the med can release too quickly. As far as immediate withdrawal, there IS ~some~ cummulative effect (you have to wear them a while to build up any sort of level in your bloodstream) and I'd say "immediate withdrawal" is a bit over-exaggerated by your physician. If anything, I've read about LESS dependence developing on the patches vs. oral meds. Then again, I'm not a doctor. All I know is after 4 aggravating months of trying to keep the damn things on, one day I just didn't "patch up". I'm sure that's not the recommended way to stop wearing them, but they were a MAJOR pain in the ass - and I had no issues with withdrawal.

Regards,
Pam

[Susie*Bee]

In the news recently was an article about fentenyl patches being recalled... and I noticed ChrisWBS had attached an article about it to a post in the "Pain Patch?" thread. You can read that if you like. I don't know if this will take you there or not, but at least I'm trying... it's on page 2 of this thread:

http://www.scoliosis.org/forum/showt...ght=pain+patch

Otherwise, I know hardly anything about meds... Sorry!

[txmarinemom]

Susie*Bee ...

If I recall, the recall was issued because some doofus tried *chewing* the patch.

Sorry, but these people are the reason my hair dryer tag warns me not to use while sleeping or bathing - and my coffee cup advises me the contents are hot ...

While all drugs aren't for everyone, I don't think I've ever seen issues with the patches when used as prescribed (and, yeah ... they have quite a few rules).

Regards,
Pam

[Susie*Bee]

Pam--the article I read and the one Chris posted (that I referred to above) didn't talk about that. There is a defect/tear in some that could allow too much opioid into a patient's system. Yep, some people are pretty dumb though. Chewing the patch??? I agree with you about a lot of those warnings! But with this latest fentanyl recall, anyway, I don't think that's the case.

[Koelrich]

I personally have never heard of Clonazepam/Klonopin as an addition to pain meds, and won't even venture a guess why it was added. You'd need to ask your doctor.
lRegards,
Pam

Yeah MY POINT!!! I don't know why he tried the stupid Diazapam???? I took the Clonazepam last night and it took about 25 minutes and I started to feel "something" beginning but... It is nothing like the oxycodone or the other pain meds that I am taking. One thing I can't figure out is, why if I am one of the worst cases he has seen (he reminds me every time he usually has me take my shirt off to show the other residents my back each time he comes in (usually 3 or 4 tails follow him in.) I told him my feelings about my end of rope. I told him that I want to go out of state, he said he would send a referral to the Saint Louis doc like I asked. BUT THIS STUPID CRAP that he keeps adding to the methadone and oxycodone treatment is pissing me off. Yes I slept pretty well actually. BUT I told him I was not looking for something to knock me out. He claimed "ohh NO" this is not like the diazepam, it wont do that. But the Pharmacist said now... this is going to make you drowsy it’s a muscle relaxed drug. SO I am going to keep taking this 2 times a day and see if (with an Open Mind) see if it will do what my doctor says it will do.

While writing this I just got a call back already (10:47am), (I sent a letter to the Saint Louis Doc last night ahead of my doctors referral, I couldn‘t wait for them to get someone around to do the letter writing)
The nurse asked about what kind of Insurance I had. She said they can’t accept my Iowa Title 19 insurance. BUT, they are very, very nice in Saint Louis because she (I don’t even know who she is) (all she knows about me is a small review and a picture that I sent along with the email.) She is willing to take the time to look into Chicago or Madison WI for a good enough surgeon that may be able to do something about my problem. (banking on if THEY accept Iowa Title 19 INS. She was surprised that I had already been a patient Dr. Weinstein though.

Thanks for the Saint Louis route, even though it fell through . THEY are helping me find somewhere I may be able to go. They surly haven’t even received the referral from my Pain Clinic doc yet, since it was just yesterday when I was in clinic.
I really hope either I get the meds to help me or a DOCTOR, But yes Pam you are seemingly right, I am NOT going to find what I need in Iowa City.
OH yeah, one of his Very smart "tails" asked if my doc thought if the "TENS" unit would work. So I have an apt on the 24th at PT to get it for a trial period to see if that does anything for me. I see that some people have had results with it but what about everyone else, what is your opinions on this "shocking" device?.
Thanks,
Kevin Oelrich

[txmarinemom]

Pam--the article I read and the one Chris posted (that I referred to above) didn't talk about that. There is a defect/tear in some that could allow too much opioid into a patient's system. Yep, some people are pretty dumb though. Chewing the patch??? I agree with you about a lot of those warnings! But with this latest fentanyl recall, anyway, I don't think that's the case.

Yep, I realized that when I went back and looked, and even typed a "oops, my bad" post ... but apparently didn't hit "submit" after I previewed.

(I hate it when I do that - especially on looooooooooooong posts - LOL!)