Help with Surgery pain without additional pain meds

[ItsNotReallyMe]

Hi all. I am worried and I need help and suggestions. I am in pain management since 2000 (before they started calling it that lol) I have chronic pain and because of previous cancer, I have very little small intestine and my stomach is actually just the bottom of my esophagus fashioned into a small pouch. Very similar to what people consider gastric bypass, but much more extreme. Because of that I have been taking liquid oxycodone and am up to 30mg every 4 hours plus a 25 fentanyl patch. I always take as prescribed, but for some reason with the liquid and the stopper I lose about 1/2 to 1 dose per bottle and I use 9 bottles a month. I just found out I am having surgery 2 days before it is refill time. I called my Dr to let him know and also try to get additional meds because of the outpatient surgery that is going to cause more pain for about a week. He is out of town! He left instructions for his partner to write me my regular refills so she will, but she will NOT write for any more or any sooner. I contacted the surgeon and he will ONLY write for 15 Vicodin 10mg and I am leary to do even that with all the regulations of other Doctors when I have signed a contract not to take meds from any other Dr. That dose would do nothing. I am already in more and more pain, because I have to wean off my gabapentin to be off for the surgery, so my nerve pain is coming back with a vengence. I am a 41 yo widow and I do not smoke, drink or do any other drugs, I am completely boring and do NOT use my meds illegally, however, I NEED to do something to help me make it through this painful surgery with not only no additional meds, but the possibility of having a day with nothing. I have taken a saw before and opened up the bottle to get the bits at the end, so I may need to do that, but I am hoping someone has an idea that might help me make my pain meds work better for a week until my Dr gets back into town 6 days after my surgery. I KNOW he will write for more and even some sort of "pop" since we discussed the surgery last month, we just though it was going to be next month. I am REALLY scared. I do not do pain well at all anymore so if anyone could give me some suggestions I would appreciate it. I am going to be completely alone after the surgery, so I am terrified of being in horrid pain and no where to get out of it.

 

[cduggles]

I know you're worried, and I understand completely. I'm sure you'll get some great advice here and I will take a pass at it first.

Use the Vicodin. Those pain management contracts are to make sure you don't sell your meds. Additionally they were prescribed to you for surgery. Any doctor who doesn't understand that needs a call from your usual pain doctor.

You have a few options:
1. Talk to the doctor covering for your pain doctor again and ask her to contact your regular physician because this is an emergency and you discussed it with him previously.

(The words "urgent" and "emergency" should be used with everyone you speak to, particularly staff who are there to prevent you from talking to a doctor.)

2. Talk to a doctor who is familiar with your medical history to get an Rx (doctors who treat cancer aren't as limited in prescribing power). Also see #3.

3. When you call physicians who have previously treated you (with your medical history you know many), if they won't prescribe something, ask them to call the doctor covering for your pain doctor to advise her of your condition. A few of those calls and she'll break. Just keep them coming.

Before you call them, call the covering doctor and tell her to expect a number of calls from other physicians who have treated you to explain your medical history. If she refuses to prescribe at that point, call every doctor who has treated you either in the last five years or treated you for cancer or performed your surgery. First ask if they can help you and then explain there's a doctor covering for your usual doctor and you are going to have surgery and need additional medication for pain.

4. Get meds from an alternative source.

5. If all else fails, talk to everyone you meet on staff before and after surgery about your lack of post-op medication and your "deep concerns" and "fears of being alone in agony". Sometimes it takes a nurse or other doctor (like an anesthesiologist) to hear you and relay your concerns or do something themselves to make sure you are taken care of post-op.

6. If all else fails, ask to be transferred post-op straight to the ER for follow-up pain management unless they have a pain management doctor available that day before you are discharged. Basically don't leave until you get appropriate meds for your medical history and pain.

Good luck, CD

 

[gmlifer]

Reschedule your surgery or find a different surgeon.

 

[keeping]

my uncle was only given 14 30/500 co-codamols for his takehome pain after a hip operation and he seemed okay