Surgery with a high morphine tolerance?

[Venusia]

SWIM is having a large tumor removed from the inside of her femur on Friday, and she's worried about pain control post-op. SWIM has a fairly high tolerance to opioid meds (currently on 180 mgs of morphine a day and was on 120 mgs of oxycodone a day recently, before the switch to morphine). SWIM is worried about what they might send her home with and if it will be enough to control the very painful surgical recovery. What might they give SWIM for such a painful procedure? It will be an inpatient procedure, so they'll monitor SWIM, but the hospital is over an hour's drive away and getting a better CII script could take days to arrive in the mail if they can't get it right before SWIM leaves. SWIM doesn't want to ask for a specific drug and look like she's fishing for the "good stuff" but doesn't want to be in horrid pain either. Any ideas as to what might be given and what to do if it isn't enough? SWIM's pain doc has said he cannot do anything in regards to that pain, just SWIM's low back pain and radiculopathy. Any advice/speculations/past experiences might help a lot. Thanks in advance!

[538wireman]

Swim thinks that Swiy's best bet is to be upfront and honest with Swiy's surgeon about the meds Swiy currently takes.

Swiy's surgeon should be able to make the proper dosage adjustments from there.

[Venusia]

Originally Posted by 538wireman

Swim thinks that Swiy's best bet is to be upfront and honest with Swiy's surgeon about the meds Swiy currently takes.

Swiy's surgeon should be able to make the proper dosage adjustments from there.

SWIM has been up front and honest about the dosages of all her meds, which includes the 180 of morphine (obtained legally and through her pain clinic), but SWIM just worries that the doc might underestimate her low threshold for pain and high tolerance. Surgery is scary enough, but the idea of being in lots of pain from bone surgery after taking a maximal dose of her scripted post op pills scares her a lot too. SWIM is eskeered of the whole lot, but this is a point of major stress when SWIM thinks about it.

[538wireman]

First of all, RELAX.

With that being said, Swiy needs to go into the surgery with the attitude that EVERYTHING is gonna be allrite. Swiy does NOT need to be getting all wound up over the "what if's".

Swim has had a few surgeries (some were good, some were not so good).
All of the times that Swim's pain med's were not doing the job, all he had to do was let the nurse or Doc know and the med's were changed/upped to accomodate what pain Swim was in.

The one thing Swiy has to remember is that Swiy is the "customer", If Swiy is not happy with the attention Swiy is getting as far as pain managment, remember that even the Doc's have "bosses".

[Venusia]

You're right. I do need to relax. Having positive thoughts will help. I have never had a major surgery or an intubated general anaesthesia, so I am a bit freaked. Thank you for reminding me to relax and be positive about it.

Some Klonopin for SWIM might help too.

[538wireman]

Originally Posted by venusia

Thank you for reminding me to relax and be positive about it.

Swiy is welcome.

[ex-junkie]

^all that really needs to be said, is that youre very scared that the medication wont be effective as a result of tolerance. this is quite a normal concern to have for anybody going into surgery. from there you can ask what your options for medication will be, and they should give you a run down of what will be available to you, and hopefully find the medication appropriate to your situation.

goodluck.

[Spucky]

180mg. Morphine is not so much that other Pain-Killers do not work anymore!
Swimhobbydoctor think maybe swiny will get some short-acting Fentanyl
in the situation where Pain becomes miserable!
If they make trouble, because of sheduled Drug,
ask the Man behind your Mask for Ketamin,
Ketamin is a brilliant Painkiller and helps much better than Opioids!

And Remember rule Nr.1: "Don`t Panic"!

[Venusia]

Well, back home from surgery. SWIM got a dilaudid Patient Contol Analgesic pump (SWIM was in space and could have been attacked by fire ants and she'd still be happy and sleeping) for the first 24 hrs, and then morphine and dilaudid tabs for the next 24 hours and was sent home with a bottle of #90 5/325 percs and a lecture on how SWIM should try to get off the pain meds from the Pain Managment Team. *rolls eyes* SWIM was well taken care of though. Had and to fight a bit to get the order to go from shots of morphine and and tabs of Lortab to tabs of dilaudid and the PCA. However, all in all, it went well. The doctors still have no clue what the tumor is. It's outta SWIM's leg though.

Thanks for the support and answers. SWIM is very thankful.

[ex-junkie]

good to hear things went well.

getting off the pain management will be in your best interests though.

[Venusia]

Originally Posted by ex-junkie

good to hear things went well.

getting off the pain management will be in your best interests though.

Thanks! I am up and around, even without the crutches for tiny bits at a time. I am feeling tons better than yesterday, and the day before.

And I know that it will be superhumanly difficult to wean off the meds, but my pain doc is awesome and I have no doubt that he'll wean me down properly come the right time. I just didn't like that the pain team at the hospital had to give me a lecture while I was in horrid pain from surgery when they know I have a doctor that specializes in pain mgmt and will (via procedures and very minor surgeries) do what it takes to get me as close to pain-free without meds in the long run. Oh well, just a minor annoyance, and I get that they only want to see someone my age well and not reliant on meds.

[ex-junkie]

ah having an opiate addiction/pain management doc is the win tbh. aint nobody understands it better than they do. you should be in good hands.

good to hear youre up and and about, but take it easy still.

[538wireman]

Swim is glad everything went well and Swiy was well taken care of.

[Venusia]

Thanks guys! SWIYs' kind words mean a lot.