TVH: Pain Management

Now I know we talk about pain management a lot.

I must have a low pain tolerance or something because last year I had a liver biopsy. (One of the many tests because we weren't sure what was wrong.) They gave me demoral before the procedure. They said that it wouldn't be that bad. Afterward they had to give me 3 more shots of demoral IV before I stopped being in pain.

I know this is major surgery and it will probably be much more pain then a liver biopsy.

I am guessing I should mention that to my doctor. Of course I don't know how my body will handle surgery. Although I was doing pretty good after my tubal in 1997. (I also had an epidural for that though.) Don't remember much pain anyways.

I never thought I would write so much on the boards once I got my date!

inspiringmind
This would be a good thing to mention to your Doc. That way, he/she knows to be prepared and make the right orders for your post op.
They may decide to give an epidural as well for the surgery to help with the pain management.
Good Luck!
Hugs,
Suzanne

Make sure you tell the "right" people when you are in the hospital about if your pain is being managed properly. The nurses will just smile and nod and not help any more than what you are already getting. Make sure you tell one of the doctors that come around if what you are getting isn't doing the trick. There was one I finally told (while in tears because the nurse wouldn't believe me that the pain medication wasn't helping) He got really mad and ordered me more pain meds on the spot because he said to be in pain in the hospital was unexceptable. BTW, it was one of the residents and not the "main" dr who quickly does his rounds in the morning. That may have helped too. Just some info to stick in your pocket in case you need it!

I agree, I plan on having conversations with both my surgeons especially now that I need to have the rectocele repair, possible bladder repair, and the abdominal hyst. I am very concerned about the pain control and I want to know upfront what the deal is! I have been to this hospital before, and the nurse's were brutal as far as not giving me enough pain meds. I think they assume since I'm only 4'11" that I only need a drop and should be fine. Unfortunately I can tolerate much more than my 6'1" 200+lb DH. My doctor told me it's about how your body metabolizes medication and everyone is different regardless of size. I refuse to be sitting around crying in pain again like after my c-section. That is probably the one thing that makes me the most anxious at this point is worrying about being left in pain. I love it when the nurse says be right back and 8 hours later another shift is in and they know nothing.........OMG....it was a nightmare, and I am so afraid it will happen again! I am going to make sure I talk to the doctor's and make it perfectly clear that I don't want that to happen again.
Best Wishes (pain free)
alicia

i worry about this some too as i have a low tolerance for pain as well.. however i also do not wake up very well to being put to sleep..

i know i keep thinking oh its just vaginal.. it wont be anything.. but then again i know that its major surgery

Gray27,
I think regardless if it's vaginal it's still major surgery and don't feel like you don't need as much pain medication as anyone else would, and don't be a hero trying to tough it out. It's so much better to keep the pain under control than start square one once it's all worn off.
Hopefully we will be pain free. Or at least comfortable enough to rest
Alicia

Yes, talk to your surgeon about this prior to surgery. Ask what his pain managment plan is.

My days in the hospital after my TAH, I was given the morphin pump which I controlled. I was also told to tell the nurse when the pump wasn't enough and they gave me added pain meds. I felt that they all took pain very seriously. I also asked for Xanax at night to help me sleep. The nurse had to call the resident on call to order it, but no one denied or question my need for it.

I think everyone worries about pain control. I've had very good results from polite, persistent requests and asking to know what I'm being given and WHEN. I even wrote it down, so I could keep on top of the pain when switched to pills & planning for discharge (plus I wanted to remember to take stool softeners with each narcotic pill). I hear more about the horror stories than happy endings, I guess those of us with good experiences don't have much to say.

Ask WHICH doctor is in charge of your pain medication orders- sometimes the anesthesiologist is responsible for writing the order, sometimes the doctor is using a standard pre-printed sheet, sometimes they write it from scratch and forget to include something. Then you can ask your nurse to call the correct doctor to get something added or changed- nurses can only give what is ordered and I've seen nurses call the wrong doctor, that delays getting you medicine. Anesthesiologists commonly write "standard orders" for the recovery room that may not work once you're 12 or 24 hrs post-op. Maybe your needs aren't standard! The miscommunication usually happens when you're being transferred from recovery to your room, this is when I try to get my husband to check on details for me. If one kind of medicine doesn't work, there are usually alternatives or anti-nausea meds to make it better. I also had good pain relief from things like a heating pad (hospitals usually have water filled ones) and raised toilet seat (to take the strain off my abdominal incision).

I flirted with my anesthesiologist before being put under & he took awesome care of me. He made sure my pain was OK post-op & checked on me in my room even after he was done since I had difficult to control pain (and even tougher veins- he replaced my IV for the nurse which made her life much easier). Also he made notes in my chart to alert the docs who took over my care & those notes should help me for my upcoming surgery. It IS possible to have a minimally painful recovery!

Hi, Please talk to your doctor at your pre-op appointment about pain management. Ask what drugs you will be given and how often. After I told my doctor my concerns (horrible pain with my c-section) she decided to give me morphine shots every 6 hours. She gave me my prescripition for codine to fill for use at home. I kept a small notebook with me in the hospital so I could keep track of all the medication they gave me. When it was almost time for my next dose, I would buzz the nurse and ask for my shot.

I had great nursing care- i think pain management has gotten much better than it use to be!